• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1461-1468
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• 2000

Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.236-241
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• 2015

Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.436-440
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• 2007

Objective : Spinal cord hemangioblastoma is an uncommon vascular neoplasm with a benign nature and is associated with von Hippel-Lindau (VHL) disease in 20-30% of patients. Total removal of these tumors without significant neurological deficit remains a great challenge. The purpose of this study was to investigate the efficacy of VHL mutation analysis and to evaluate surgical outcome of patients with spinal cord hemangioblastomas. Methods : This study included nine patients treated for spinal cord hemangioblastomas at our institute between December 1994 and March 2006. There were four male and five female patients. Mean age was 37.8 years. The mean follow-up period was 22.4 months. Magnetic resonance imaging (MRI) of the complete neuraxis was done in all cases and VHL mutation analysis was performed in three cases for a definite diagnosis. Results : Six patients had intramedullary tumor, and the remaining patients had intradural extramedullary lesions. Five patients were associated with VHL disease. The von Hippel-Lindau mutation analysis was done in three patients and two of them showed VHL gene abnormality. Tumors were located in the cervical cord in five cases and in the thoracic cord in four cases. All patients underwent surgical intervention, and total removal was achieved in six cases. All patients showed improvement or, at least, clinically stationary state. Surgical complications did not develop in any cases. Conclusion : Spinal hemangioblastoma in this series has been safely and effectively removed via a posterior approach. Postoperatively, clinical outcome was excellent in the majority of cases. The VHL mutation analysis was useful in patients with family history and in those with multiple hemangioblastomas.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.164-168
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• 2009

Objective : Bilateral C1-2 transarticular screw fixation (TAF) with interspinous wiring has been the best treatment for atlantoaxial instability (AAI). However, several factors may disturb satisfactory placement of bilateral screws. This study evaluates the usefulness of unilateral TAF when bilateral TAF is not available. Methods : Between January 2003 and December 2007, TAF was performed in 54 patients with AAI. Preoperative studies including cervical x-ray, three dimensional computed tomogram, CT angiogram, and magnetic resonance image were checked. The atlanto-dental interval (ADI) was measured in preoperative period, immediate postoperatively, and postoperative 1, 3 and 6 months. Results : Unilateral TAF was performed in 27 patients (50%). The causes of unilateral TAF were anomalous course of vertebral artery in 20 patients (74%), severe degenerative arthritis in 3 (11%), fracture of C1 in 2, hemangioblastoma in one, and screw malposition in one. The mean ADI in unilateral group was measured as 2.63 mm in immediate postoperatively, 2.61 mm in 1 month, 2.64 mm in 3 months and 2.61 mm in 6 months postoperatively. The mean ADI of bilateral group was also measured as following; 2.76 mm in immediate postoperative, 2.71 mm in 1 month, 2.73 mm in 3 months, 2.73 mm in 6 months postoperatively. Comparison of ADI measurement showed no significant difference in both groups, and moreover fusion rate was 100% in bilateral and 96.3% in unilateral group (p=0.317). Conclusion : Even though bilateral TAF is best option for AAI in biomechanical perspectives, unilateral screw fixation also can be a useful alternative in otherwise dangerous or infeasible cases through bilateral screw placement.

• Journal of Chest Surgery
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• 제28권6호
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• pp.533-541
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• 1995

We recently developed a new model of moving actuator type totally implantable artificial heart[TIAH , based on the reverse position of the aortic and pulmonary conduits. This concept was proposed by one of surgeons in our team[Joon-Ryang Rho, M.D. to facilitate anatomical fitting of TIAHs. The moving actuator type electromechanical TIAH consisted of the left and right blood sacs, and the moving actuator including a motor. The inverted umbrella type polyurethane valves were used in the blood pumps. The aortic conduit was positioned anterior to the pulmonary conduit, which was the opposite relation to the conventional configuration of other total artificial hearts. We also adapted slip-in connectors for the aortic and pulmonary conduits. Two sheep , weighing 60-69 kg, were used for implantation. After small cervical incision and trans-sternal bilateral thoracotomy, cardiopulmonary bypass [CPB was administered using an American Optical 5-head pump and a membrane oxygenator[Univox-IC, Bentley . The anterior and posterior vena cavae were drained separately for venous return. An arterial return cannula was inserted into the right common carotid artery. During CPB, almost all of the ventricular myocardium was excised down to the atrioventricular groove and the artificial heart was implanted. We achieved 3-day survival in the first sheep and 2-day survival in the second. The day after operation the first sheep was successfully extubated and the second sheep was weaned from a respirator with good condition. After extubation, the first sheep walked around in the cage and fed herself. Serial laboratory and hemodynamic examinations were done during the experiments. In both sheep, pulmonary dysfunction was gradually developed, which was accompanied by acute renal failure. The animals were sacrificed and autopsy was done. Unexpected pregnnacy was incidentally found in both sheep. To our knowledge this is the first report of significant survival cases in the orthotopic implantation of electric TIAH using sheep.

• Parasites, Hosts and Diseases
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• 제45권3호
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• pp.191-198
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• 2007

A total of 205 larval gnathostomes were collected from 18 (22.5%) of 80 red banded odd-tooth snakes, Dinodon rufozonatum rufozonatum, which had been smuggled from China and confiscated at Customs in Susan, Republic of Korea. In order to identify the species, some of the larvae were observed by a light microscope and a scanning electron microscope (SEM). The larvae were $2.18{\times}0.29mm$ in average size, and had a pair of lips at the anterior end, a muscular esophagus, 2 pairs of cervical sacs, and brownish intestines. The head bulb was characteristically equipped with 4 rows of hooklets; the average number of hooklets in each respective row was 38.6, 40.5, 41.5, and 43.7. In SEM views, the mouth evidenced a pair of lateral lips of equal size in a half-moon shape. Each lip featured a couple of labial papillae and a small amphid located between the 2 papillae. The hooklets on the head bulb had single-pointed, posteriorly-curved tips. The cuticular spines were larger and more densely distributed on the anterior part of the body, and decreased gradually in size and number toward the posterior body. On the basis of these morphological characteristics, the larvae were identified as the third stage larvae of Gnathostoma hispidum.

• 대한두경부종양학회지
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• 제12권2호
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• pp.161-168
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• 1996

The neuorogenic tumor is known to be originated from neural crest, and the involved cells are Schwann cell, ganglion cell, and paraganglion cell. The Schwannoma, neurofibroma, and malignant schwannoma arise from the schwann cell, ganglioneuroma is from ganglion cell, and carotid body tumor and glomus tumor are originated from paraganglion cell. Authors reviewed thirty-eight patients of the neurogenic tumors in the head and neck, excluding intracranial tumor and Von-Recklinghausen disease, surgically treated at the Department of Surgery, Pusan Paik Hospital from January 1981 to May 1996. Of the 38 cases, 28 cases were schwannoma, 6 cases neurofibroma, 2 cases malignant schwannoma, and 2 cases paraganglioma. These tumors occurred at any age, but the majority of patients occurred in the fourth decade of life. There was female preponderance (M : F=1 : 1. 53) in sex ratio. The lateral cervical region was the most common distribution. 12 cases arose from the anterior triangle of neck, and 12 cases from the posterior triangle of neck. The major nerve origin of tumor could be identified in 30 cases (80%). 11 cases were treated by simple excision, and partial excision was 3 cases. Excision with parotidectomy 1 case, enucleation 11 cases, enucleation with parotidectomy 7 cases, radical neck dissection 1 cases, upper neck dissection 2 cases, suprahyoid dissection 1 case, Caldwell­Luc operation 1 case. The postoperative complications were hoarseness (2 cases), facial palsy (1 case), Homer syndrome (1 case), and hypoesthesia of tongue (1 case).

• 구강회복응용과학지
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• 제24권3호
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• pp.253-267
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• 2008

이 연구의 목적은 임플란트 고정체와 지대주간의 직경 차이가 임플란트 지지조직에 발생하는 응력에 미치는 영향을 평가 하는 것이다. 본 연구에는 세 가지 직경(4.0, 5.0, 6.0㎜)의 3i 임플란트 고정체에 지대주의 직경을 달리하여 수복하고, 하중 조건(15, 30 lb)에 따라 임플란트 지지조직에 발생한 응력의 정도와 분포를 광탄성 응력 분석법을 이용하여 비교, 분석하였다. 연구결과 고정체의 직경이 증가할수록, 상부 보철물에 가해지는 하중에 대하여 고정체 변연부의 응력집중이 높게 나타났으며, 상부 보철물의 근원심 폭경을 증가시키는 것이나, 임플란트 고정체의 직경에 비해 작은 지대주를 사용하는 것은 고정체 주위의 응력양상에 영향을 주지 않았다.

• 척추신경추나의학회지
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• 제10권1호
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• pp.47-61
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• 2015

Objectives : The purpose of this study is body parameters characteristics through posture analysis system of musculoskeletal problem patient Methods : Posture analysis system were performed for 164 patients to measure body parameters such as Q-angle, body inclination, neck inclination, PCMT(posterior cervical muscle tension), Knee flexion and posture balance. Statistical analysis using statistical analysis techniques and Pearson correlation coefficients was performed to assess the body parameters obtained by posture analysis system. Results : More than half of people out of 164 reported low back pain, 34.8% of the total was found to have neck pain. There was not a significant difference between genders from the characteristics of gender based body parameters expect for the statistical difference in Q angle, PCMT. There was a significant correlation between low back pain and multiple response status. There was a significant correlations between knee pain and Q angle. Also There was a significant correlations between pelvic pain and posture balance of ankle. Conclusions : Posture analysis system can be used to perform the analysis in place of X-ray measuring body posture and clinical parameters. The results of this study are expected to be the basis for further research on the clinical application of posture analysis system.

• The Korean Journal of Pain
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• 제19권2호
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• pp.146-151
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• 2006

Background: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. Methods: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. Results: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2⁣-C4 levels. At the upper extremities, paresthesia was evoked in 86⁣-93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7-⁣T12, T10⁣-L1 and T11-⁣L1 vertebral segments, respectively. Conclusions: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.