• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.151-154
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• 2012

We report here two cases of primary intraosseous meningioma with aggressive behavior. A 68-year-old man presented with a one year history of a soft, enlarging mass in the right parietal region. Magnetic resonance image (MRI) revealed a 6 cm sized, heterogeneously-enhancing, bony expansi1e mass in the right parietal bone, and computed tomograph (CT) showed a bony, destructive lesion. The tumor, including the surrounding normal bone, was totally resected. Dural invasion was not apparent Diagnosis was atypical meningioma, which extensively metastasized within the skull one year later. A 74-year-old woman presented with a 5-month history of a soft mass on the left frontal area. MRI revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the left frontal bone, and CT showed a destructive lesion. The mass was adhered tightly to the scalp and dura mater. The lesion was totally removed. Biopsy showed a papillary meningioma. The patient refused adjuvant radiation therapy and later underwent two reoperations for recurred lesions, at 19 and at 45 months postoperative. The patient experienced back pain 5 years later, and MRI showed an osteolytic lesion on the 11th thoracic vertebra. After her operation, a metastatic papillary meningioma was diagnosed. These osteolytic intraosseous meningiomas had atypical/malignant pathologies, which metastasized to whole skull and the spine.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.195-201
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• 2019

Purpose: This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch^®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch^® during decompressive craniectomy in traumatic brain injury patients. Methods: We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch^® or not (Neuro-Patch^® group, n=71; control group, n=55). Patients' baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma. Results: No significant difference was found between the two groups regarding patients' baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch^® group than in the control group. Conclusions: The use of Neuro-Patch^® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch^®.

• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.243-246
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• 2010

Purpose : Eosinophilic granuloma is a rare benign tumor that is characterized histologically by the presence of destructive granulomas containing numerous Langerhans, cells. The most common presentation of eosinophilic granuloma is a painful, immobile scalp mass in the frontal and parietal bones occurring predominantly in children and adolescents or young adults. We report a representative case of eosinophilic granuloma. Methods : A 16-year-old woman complained of an enlarging fixed scalp mass without pain and tenderness which measured $3{\times}4.5cm$ at the frontal area, which had been found incidentally 2 months before. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion. The tumor and surrounding bony edges were completely removed via a bicoronal approach. The bony defect was reconstructed with bone cement. Results : The tumor was involved frontal bone and dura mater. We confirmed the tumor by the documentation of Birbeck's granules by electron microscopy. There is no evidence of local recurrence during postoperative 1.5 years. Conclusion : The present case shows the characteristic feature of frontal bone involvment of the eosinophilic granuloma. The prognosis of eosinophilic granuloma depend on age at diagnosis and number of bones involved. We consider that best choice of treatment for eosinophilic granuloma is surgical excision.

• Journal of Sericultural and Entomological Science
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• v.51 no.2
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• pp.197-200
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• 2013

Silk fibroin is a natural biomaterial that has the biocompatibility and other many advantages. But as a silk fibroin membrane thickness increases, the transparency becomes more opaque. Because the transparency of membranes tissue such as the cornea and dura mater are necessary, transparent membrane is required to replace these transparent membranes. In this study, we fabricated blending silk fibroin membranes that made by mixing the various inorganic salts or polymer in an aqueous solution of silk fibroin. The transparency of the membranes were analyzed. the transparency of these membranes is very different, depending on the mixed materials. Inorganic salts mixed silk membrane was more transparent than the polymer mixed one. Especially, the silk fibroin membrane with calcium chloride was very transparent. We showed the possibility of blending silk fibroin membrane, which can be used in perfect transparent membrane such as the cornea. In the future, we expect that the transparent blending silk fibroin membrane can be used in various medical applications.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.392-395
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• 2011

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.105-111
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• 2005

Objective: Tremor, either essential tremor or Parkinsonian tremor, has been effectively and safely treated by lesioning the ventral intermediate(Vim) nucleus of the thalamus with or without mircroelectrode recording. The authors evaluate the treatment outcome of sixteen tremor patients who had been treated with thalamotomy without microelectrode. Methods: Between September, 2001, and December, 2003, sixteen tremor patients were treated with thalamotomy without microelectrode recording. Twelve patients suffered from Parkinsonian tremor and four patients were essential tremor patients. The male to female ratio was 1.6 to 1 with median age of 59.6 years (range; 39-74 years). Under local anesthesia, a 3mm hole was made using a hand-held twist drill, and the dura mater was penetrated with a 1.2mm sharp drill beat. Radiofrequency(RF) electrode was placed in the Vim nucleus of thalamus. With intraoperative macrostimulation, RF lesion was made. Postoperative CT scan and/or MR imaging was performed to confirm the localization of the target lesioned. Preoperative and postoperative tremor was evaluated with simple tremor severity scale and the development of complications related with the procedure was closely reviewed at the immediate postoperative period and the last follow-up. Results: It produces immediate relief in up to 98.4% of the patients. There were no development of complications related with procedure, all patients discharged one or two days after surgery. Conclusion: Vim thalamotomy without microelectrode recording is a safe and effective procedure to control the tremor with minimal morbidity. Intraoperative macroelectrode stimulation safely localizes the Vim nucleus target of the thalamus for the treatment of patients with tremor.

• Journal of Pharmacopuncture
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• v.17 no.1
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• pp.70-73
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• 2014

Objectives: Yamen is the fifteenth acupoint of the Governor Vessel Meridian (GV15). It is anatomically close to the medulla oblongata, so finding the safety depth of the acupoint is very important. However, few studies on the safety depth of GV15 have been done. Methods: This study tried to measure the safety depth of GV15 by using magnetic resonance imaging (MRI) scans and to analyze the factors affecting the safety depth through multiple regression analyses. This study was carried out for patients who had a brain MRI scan while visiting Jeonju Wonkwang Hospital, Korea. The shortest distance between the glabella and the occipital protuberance (DGO), the horizontal distance between the glabella and the back of the head (DGB) and the dangerous depth (DD) were measured from the sagittal views of the MRI images. The DD is the horizontal distance from the skin's surface at GV15 to the spinal dura mater. Results: The model suggested that the safety depth (SD) was significantly associated with gender (${\beta}$ = 0.474, P < 0.0001), DGO (${\beta}$ = 0.272, P = 0.027), and BMI (${\beta}$ = 0.249, P = 0.005) and the combination of three variables can explain the SD, with $R^2$ = 0.571 (Table 3). A longer SD was associated with males and with greater BMI and DGO. Conclusion: This study suggests that gender, BMI and DGO may be important factors when the SD of GV15 is considered clinically through a multiple regression analysis of GV15.

• Physical Therapy Korea
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• v.27 no.1
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• pp.70-77
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• 2020

Background: Neck pain can be caused by any structure in the neck, such as intervertebral discs, ligaments, muscles, facet joints, dura mater, and nerve roots. The hyoid bone is a structure that is also related to head and neck posture, neck movement and pain, but there are no studies on hyoid deviation, neck pain, and range of motion (ROM). Objects: The purpose of this study was to investigate the effect of fascia relaxation and mobilization of the hyoid bone on the ROM, pain, and lateral deviation of the hyoid bone. Methods: Twenty-five patients with neck pain identified by the lateral motion test (10 males [35.13 ± 7.67 years, 172.69 ± 3.90 cm, 78.77 ± 6.96 kg] and 15 females [35.13 ± 10.05 years, 161.11 ± 4.09 cm, 52.59 ± 2.98 kg]) was chosen randomly. Baseline values for pain, neck ROM, and lateral deviation in the hyoid bone were recorded using a visual analogue scale (VAS), goniometer, and tape measure. Then, each patient was treated with hyoid fascia relaxation and mobilization, and all results were recorded after intervention. Comparison of the results before and after intervention was analyzed using paird t-test (p < 0.05). Results: Right rotation, extension, VAS, and rotational asymmetry statistically significant differences (p < 0.05). Right rotation and extension increased ROM, rotational asymmetry ratio and VAS decreased. However, there was no significant difference in flexion, left rotation, center point (p > 0.05). Conclusion: Fascia relaxation and hyoid mobilization could improve the ROM of cervical extension, asymmetry of the cervical rotation and neck pain.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.435-440
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• 2023

Few studies have examined the basilar venous plexus (BVP) and to our knowledge, no previous study has described its histology. The present anatomical study was performed to better elucidate these structures. In ten cadavers, the BVP was dissected. The anatomical and histological evaluation of the intraluminal trabeculae within this sinus were evaluated. Once all gross measurements were made, the clivus and overlying BVP were harvested and submitted for histological analysis. A BVP was identified in all specimens and in each of these, intraluminal trabeculae were identified. The mean number of trabeculae per plexus was five. These were most concentrated in the upper half of the clivus and were more often centrally located. These septations traveled in a posterior to anterior direction and usually, from inferiorly to superiorly however some were noted to travel horizontally. In a few specimens the trabeculae had wider bases, especially on the posterior attachment to the meningeal layer of dura mater. More commonly, the trabeculae ended in a denticulate form at their two terminal ends. The trabeculae were on average were 0.85 mm in length. The mean width of the trabeculae was 0.35 mm. These septations were consistent with the cords of Willis as are found in the lumen of some of the other intradural venous sinuses. An understanding of the internal anatomy of the BVP can aid in our understanding of venous pathology. Furthermore, this knowledge will benefit patients undergoing interventional treatments that involve the BVP.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.719-723
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• 2022

Rosai-Dorfman Disease (RDD) is a rare lymphoproliferative disease, and the occurrence of isolated intracranial RDD is extremely rare. Most cases of intracranial RDDs present as dural masses showing homogenous enhancement on MRI, which makes it difficult to differentiate these masses from meningiomas before surgery unless massive cervical lymphadenopathy is observed. We herein report a rare case of isolated intracranial RDD in a 65-year-old male. Brain MRI revealed a well-defined enhancing mass-like lesion involving the right frontal convexity and subtle diffusion restriction. However, only a subtle blush was observed on the preoperative cerebral angiogram. Although instances of isolated intracranial RDD are rare, it should be considered as a potential differential diagnosis when a dural mass with hypovascularity is visualized on the cerebral angiogram.