• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.301-303
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• 2015

We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.215-218
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• 2015

Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

• Journal of Korean Neurosurgical Society
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• 제50권5호
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• pp.468-471
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• 2011

Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Spinal mesenchymal chondrosarcomas are even rarer and, to the best of our knowledge those that are concomitantly located in the intradural and extradural regions, have never been reported. We report a case of a 25-year-old man with back pain and bilateral progressive weakness of the lower extremities. Magnetic resonance imaging revealed a markedly enhanced dumbbell-shaped mass at the T7 level. The lesion was intradurally located at the left side of the spinal cord, and extended extradurally to the extraforminal space through the T7-8 intervertebral foramen. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed mesenchymal chondrosarcoma. Postoperative radiation therapy and chemotherapy were also performed to prevent local recurrence and metastasis. The patient has been symptom-free for two years after surgery. Herein, we reviewed and discussed the clinical characteristics, treatments, and outcomes of primary intraspinal mesenchymal chondrosarcomas in the literature.

• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.88-92
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• 2009

Purpose: The purpose of this study was to evaluate the effects of exercise on functional status in stroke patients. The understanding of the course of recovery after stroke and factors affecting outcomes are important in planning and evaluation of stroke rehabilitation. Methods: To predict the outcom of stroke patient, we measured in the beginnig of rehabilitation, on 36 patients. The variables were gender, age, duration of rehabilitation treatment, motor assessment scale(MAS). Results: The patient age in 50-59 years was 41.7%. The stroke left side motor weakness were found 55.6%. The duration of rehabilitation treatment in 2-3 months was 50.0%. In the difference 24.63 for motor assessment scale after a rehabilitation treatment had significantly higher than 10.86 for motor assessment scale at initial. Gender by motor assessment scale after a rehabilitation treatment was 25.7 in male and 23.2 in female(P<0.05). Past history by motor assessment scale after a rehabilitation treatment was 26.7 in hypertension, 24.6 in cardiac disorder and 21.8 in diabetes mellitus(P<0.05). Conclusion: The subjective symptoms of motor assessment scale after a rehabilitation treatment was significantly associated with gender.

• 지구물리
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• 제6권3호
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• pp.165-177
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• 2003

필댐의 안정성 해석에 있어서 누수와 내부침식은 매우 중요한 평가의 한 부분이다 연구대상 지역의 필댐은 내부침식으로 추정되는 댐 상부의 공동발생 및 과대 누수량으로 문제가 발생하여, CGS(compaction grouting system)으로 보강공사를 수행하였으며, 본 보강방법은 주입재료 및 주입압력이 중요한 변수로 작용을 한다. 본 연구에서는 CGS 보강이 필댐의 안정성에 미치는 영향을 CGS보강 전후에 지구물리탐사를 수행하여 해석하였다. 본 조사에 적용된 방법에는 전기비저항탐사, 탄성파 굴절법탐사, GPR탐사, HFMT탐사 등이 적용되었다. 조사결과 CGS 보강으로 댐의 전제척인 거동에 많은 영향을 준 것으로 나타났으며, 주입압력이 과대하여 댐 중심코아에 많은 변위가 발생된 것을 확인할 수 있었다.

• Investigative Magnetic Resonance Imaging
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• 제15권2호
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• pp.165-169
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• 2011

심장점액종은 심장의 가장 흔한 양성 종양이다. 하지만 국소전이와 원격전이의 증례들이 낮은 빈도로 보고되어 있다. 뇌경색을 주소로 내원한 49세 여자 환자의 심장초음파에서 심장 점액종이 발견되었으며 수술로 절제 1년 후에 구음장애가 발생하여 촬영한 자기공명영상에서 여러개의 조영증강이 되는 출혈성뇌전이 병변들이 관찰되었다. 방사선치료 후 추적 자기공명영상에서 병변의 크기들이 작아지는 것을 확인할 수 있었다. 양성 종양이지만 심장 점액종은 드물게 지연되어 전이를 보일 수 있다. 저자들은 심장 점액종을 수술로 완전히 절제 후 지연되어 나타난 뇌전이를 경험하여 증례 및 문헌고찰을 하는 바이다.

• Journal of Chest Surgery
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• 제30권6호
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• pp.625-630
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• 1997

56세 남자 환자가 신경과에 내원하였는데, 그는 최근에 심해지는 우측 세번째에서 다섯번째 수지의 반복 적인 저린 통증과 파악력의 약화를 주소로 하였다. 이와 함께 보행시 하지 동통을 호소하였다. 경동맥 조영술상 우내경동맥이 완전히 막혀 있었고 좌우총경동맥과 외경동맥, 좌내 경동맥은 심각한 협착이 있었다. 함께 시행한 대동맥 조영술상 신동맥이하는 완전한 폐색을 보였고 양측 대퇴 동맥은 지연 조영 을 보였다. 두개의 동맥 병변에 대해 단계별로 수술 계획을 세웠다. 양측 경동맥 병변은 경동맥 내막절제술을 시행 하였다. 이 때 좌측은·경동맥 션트를 사용하였다. 복부대동맥 병변은 2주후에 시행되었으며 복강동맥하방의 대동맥을 결찰하고 허혈시 신장을 보존하기위 해 신보존액을 주입하였다. 역 Y 회로 이식술과 신보존을 시행하여 린분간의 허혈동안에도 성공적으로 시술되었으며 별다른 문제없이 술 후 보름만에 퇴원하였다.

• 대한임상검사과학회지
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• 제49권3호
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• pp.316-321
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• 2017

빗장밑혈류빼앗김증후군은 좌측 몸쪽부분 빗장밑동맥 혹은 팔머리동맥에 심한 혈관 협착이나 폐색이 원인이 되어 발생한다. 병변이 있는 부위에서는 제한적이며, 불충분한 혈류가 발생하여 반대쪽으로부터 연결혈관을 통해 일부 혈액이 유입될 수 있다. 이러한 현상을 빗장밑혈류빼앗김현상이라고 한다. 이중초음파검사는 빗장밑혈류빼앗김현상을 측정하는데 유용한다. 빗장밑혈류빼앗김현상을 보이는 일부 환자에서는 척추뇌바닥혈류부전 혹은 허혈성 말초동맥질환 증상을 호소한다. 빗장밑혈류빼앗김증후군은 빗장밑혈류빼앗김현상과 더불어 신경학적 증상이 반드시 동반될 경우로 정의할 수 있다. 저자는 팔머리동맥의 심한 협착을 보이는 환자에서 척추동맥과 더불어 바깥목동맥과 전방순환계를 담당하는 온목동맥 및 속목동맥에서 이중초음파검사를 이용한 혈류빼앗김현상이 관찰된 증례를 보고하고자 한다.

• Advances in pediatric surgery
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• 제16권2호
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• pp.101-107
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• 2010

Herniorrhaphy of Indirect inguinal hernia (IIH) is one of the most frequently performed surgical procedures in children. The overall incidence of inguinal hernias in childhood ranges from 0.8 to 4.4 %. The incidence is up to 10 times higher in boys than girls, especially much higher in premature infants. IIHs in children are basically an arrest of embryologic development rather than an acquired weakness, which explains the increased incidence in premature infants. In normal development, the processus vaginalis closes, obliterating the peritoneal opening of the internal ring between 36th and 40th week of gestation. This process is often incomplete, leaving a small patent processus in many newborns. However, closure continues postnatally, and the rate of patency is inversely proportional to age of the child. The presence of a patent processus vaginalis is a necessary but not sufficient variable in developing a congenital IIH. In other words, all congenital IIHs are preceded by a patent processus vaginalis, but not all patent processus vaginalis go on to become IIHs. The overall incidence of IIH in population is approximately 1 to 2 % and the incidence of a processus vaginalis is approximately 12 to 14%, clinically appreciable IIH should develop in approximately 8 to 12 % of patients with a patent processus vaginalis. Although the classic open inguinal hernia repair remains the gold standard for most pediatric surgeons, laparoscopic repair is being performed in many centers. Like open technique, laparoscopic technique is fundamentally a high ligation of the indirect hernia sac with or without internal ring ligation. The advantages of laparoscopic approach include the ease of examining the contralateral internal ring, the avoidance of access damage to vas and vessels during mobilization of cord, decreased operative time, and an ability to identify unsuspected direct or femoral hernias. Almost all groin hernias in children are IIHs and occur as a result of incomplete closure of processus vaginalis. The treatment is repair by high ligation of hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone, open exploration is no longer indicated due to potential risk of infertility.