신경성 척수종양(신경초종)에 대한 임상적 분석

염진영 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

The author analyzed 23 cases of spinal schwannomas who had been operated at the our hospital from Mar. 1992 to Feb. 1998. The result were summerized as followings: 1) The spinal schwannomas were most common in the 6th and 7th decade of age (11 cases, 48%) and the ratio of male to female was 1.3 : 1. 2) The tumors were ocupied in intradural-extramedullary area(11 cases, 48%), dumbbell shaped intra-and extradural area(9 cases, 39%), extradural area(3 cases, 13%) in order frequency. 3) 83% of the IDEM tumors were located in the thoracolumbar area and 86% of the IDED tumors in the cervical area. All IDEM tumors(11 cases) were located in posterior or posterolateral space of the cord. 4) The size of extradural mass was larger than intradural mass in the IDED tumors(7 of 9 cases, 78%) 5) The symptome duration was average 14.5 months. Neurologic symptoms were root radiculopathic pain(18 cases, 78%), dermatomic patterned sensory deficit(12 cases, 52%),motor deficit(10 cases, 43%), sphincter weakness(2 cases, 9%) in order frequency. 6) The rate of abnormality of the plain radiologic study was 43% and the most common positive finding was the widening of the intervertebral foramen(8 cases, 35%). MRI revealed low or iso signal intensity in T1WI(19 cases, 83%), high signal intensity in T2WI(20 cases, 87%), relative homogenous well enhancement(16 cases, 70%), and peripheral rim enhancement in 5 casese of 11 IDEM tumors 7) The total removal was possible in 20 cases(87%). The ratio of postoperative improvement was 91%(21 cases).

뇌 미만성 축삭손상 환자의 임상적 고찰

염진영 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.2

The distribution and extent of the traumatic lesions were evaluated with MRI in 20 patients with diffuse axonal injury (DAI). Author also analyzed patients with diffuse axonal injury clinically. Lower initial Glasgow coma scale (GCS), prolonged duration of coma, associated with brain stem lesion were proved to be poor prognostic factors of DAI. Diffuse axonal injury is most commonly involved in the white matter of the frontal and temporal lobes, and the splenium of the corpus callosum. In this study, the sensitivies of the imaging techniques for DAI were 63.0% in T1WI and 100% in T2WI of the MRI respectively. More accurate detection and delineation of the traumatic lesions with MRI should permit more accurate prediction of neurologic and cognitive recovery and assist in optimizing form of the treatment.

뇌실내 출혈을 동반한 뇌동맥류 환자의 임상적 고찰

염진영 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2

Intraventricular hemorrhage(IVH) from aneurysm is generally considered to be of grave prognostic significance. Twenty-one cases have been studied retrospectively. The overall incidence of the intraventricular hemorrhage from aneurysm was 17.6%. The outcome in the patients with IVH from ruptured aneurysm have been estimated the variables of amount of IVH, ventricular dilatation with Graeb's grading system, vetricular size index(VSI). The higher Graeb's grading score and VSI, to be poorer prognosis. Early extraventricular drainage in IVH from ruptured aneurysm can reduced mortality.

Orion Plate를 이용한 경추 전방 경유 융합술의 임상적 고찰 : 외상성 경추 손상 환자에서

염진영 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

The anterior interbody fusion for cervical spine injury may not provide adequate immediate stabilization, but anterior cervical plating has overcome this main disadvantage. But bicortical screw and unlocking plating system has the potential fisk for injury to the spinal cord or soft tissue. The new angled locking screw(Orion plate system) was designed to avoid such surgical complication. Between Jan. 1995 and Dec. 1996, 20 patients with cervical spinal injuries were operated by anterior cervical fusion with the Orion plate system. 10 patients(half cases) were operated in one level fusion, 10 cases were fused in two level though cervical body corpectomy. All patients were showed good cervical arrangement with neurological improvement at discharge except 2 patients with Frankel grade A. All patients has good bony fusion through followed-up 18 months. The author conclude that the Orion plate system in anterior cervical fusion may be safe and good in immediate postoperative stability.

두개강내 종양에 대한 임상적 고찰

염진영,김윤 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.1

A analysis was performed with 93 intracranial tumor patients, who were admitted and managed at the Department of Neurosurgery of chungam National University . Hospital from Jul. 1983 to Jul. 1986. Among the 93 intracranial tumors, 61 cases were confirmed by operation. The author classified the intracranial tumors according to Russell and Rubinstein's classification. Clinical manifetations. radiological findings and incidence of the various tumors with regards to their location, were analyzed. The results were as follows; 1. Intracranial tumors were found most frequently in 4th decade(24. 7%), and the ratio of male to female was 1.21 : 1. 2. Among the intracranial tumors, gliomas were found most frequently(32.8%), and followed by meningiomas(19.7%), pituitary adenomas(13. 1%), acoustic neuroma(11. 5%). Meningioma occupied the highest incidence as a single disease entity. 3. Intracranial tumors occured more frequently in the frontal and parietal area of the supratentorial region. 4. The predominating neurological manifestations were headache, vomiting and papilledma in the order. Convlsions occured in 25 cases(26.9%) of the total 93 cases, and focal motor seizure occured in 14 cases(56%) of the 25 convulsion cases. 5. Duration of neurological symptoms noted most frequently from 8 weeks to 6 months in 23 cases of the total 93 cases, all patients of glioblastoma multiforme showed the shortest symptom duration less than 6 months. 6. Cerebral angiographic findings revealed tumor staining in the meningioma(58.3%) and glioma (30%). The preenhanced CT scans in the astrocytoma(85.7%) showed hypodense, and the peritumoral low density occured more predominantly in the glioblastoma multiforme. 10 cases(83. 3%) out of total 12 meningiomas were enhanced moderate to marked degree after injection of the contrast dye.

경추부에 발생한 지주막 낭종 1예 : Case Report

염진영 최신의학사 1993 最新醫學 Vol.36 No.10

경추간판탈출증 환자에서 추체간 Plate-cage 사용에 대한 평가

염진영 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Objectives of the this study is to detail the operative and technical aspects of the new anterior cervical instrumentation and to identify its suitability for an extensive clinical study. The controversy over the need for fusion in the surgery of cervical disc disease is in part fueled by the absence of an ideal technique. However, the design of the integrated anterior cervical plate and cage device(PCB) appears to provide immediate stability and to restore disc height and cervical lordosis in addition to reducing graft recipient and donor site-related complications. After a standard anterior cervical discectomy and preparation of the disc space, the correct size of the cage with integrated plate is inserted. Self-taping screws are inserted. Lubboc bone was used in our series. The technique was used in 19 patients that were followed from 2 to 12 months(median 22 weeks). The technique was easy to learn and implement. After surgery no screw backout or device failure was identified. All patients improved clinically. The author conclude that the cervical plate-cage(PCB) system in anterior cervical fusion may be safe and good in immediate postoperative stability.

경막상 신경초종을 동반한 흉추부 해면상 혈관종 : 증례 보고 Case Report

염진영 최신의학사 1993 最新醫學 Vol.36 No.10

요추부 후방 골유합술시 제4요추 분절동맥의 손상에 의해 발생된 후복막하 혈종의 코일 색전술 치험 1례

이방훈,염진영,최승원,김선환,고현송 대한척추신경외과학회 2004 Neurospine Vol.1 No.1

In spine sugery, iatrogenic vascular injury is unusual, and most common vascular injury is said to be a tear of the left common iliac artery. We report a case of retroperitoneal hematoma from lumbar segmental artery injury after posterior lumbar fusion and pedicle screw fixation. This 60-year-old woman presented with 6 months history of low back pain and radiating pain to the left lower leg. She complained of claudication after 10 meters walking due to spondylolisthesis and spinal stenosis at L2-L5 level. She underwent multiple total laminectomy, posterior lumbar inter-body fusion, and transpedicular screw at L2-L5. During operation there was not evidence of complications such as bleeding. She complained of abdominal pain on post-operation I day and showed tenderness on left upper quadrant. Hemoglobin was 8.4 g/dL on postoperative laboratory examination. Abdominal CT scan revealed retroperitoneal hematoma. We performed angiography for evaluation of hematoma and found extravasation of dye at segmental artery of L4 level. We embolized the bleeding artery with coil successfully. Her postoperative abdominal pain and tenderness were relieved after then and discharged without pain or neurological deficit.

두부 외상에 의한 뇌경막하 수종에 관한 임상적 고찰

김관태,염진영 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

A series of 36 patients with subdural hygroma, admitted to the Department of Neurosurgery of Chungnam National University Hospital from Feb. 1982 to Jun. 1985 is presented. The following results were obtained. 1. Males were more frequently involved than females. Peak age incidence was the 1st and above 7th decade(47%). 2. The duration from trauma to initial discovery of subdural hygroma on brain CT scan was within 4 weeks in 28 cases(82%). 3. Findings on brain CT scans of subdural hygromas revealed bilateral cases(53%), only frontal area(58%), and including cases in frontal area(94%) in respect of location. 4. The outcome in cases of subdural hygroma seems to relate with the severity of the associated brain injuries and level of consciousness on admission.