• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.389-391
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• 2010

Hypereosinophilic syndrome is a rare hematologic disorder with sustained eosinophilia. Peripheral blood eosinophilia without an underlying etiology and with organs dysfunction has been designated hypereosinophilic syndrome. We report a rare case of symptomatic spinal infiltration of eosinophils at osteolytic T5 in patient with idiopathic hypereosinophilic syndrome.

• 한방재활의학과학회지
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• 제21권3호
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• pp.1-11
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• 2011

Objectives : This study was performed to evaluate the effects of root of Scutellariae Radix(SR) water extract against inflammatory response in the spinal cord injury(SCI). Methods : SCI was induced by mechanical contusion following laminectomy of 10th thoracic vertebra in Sprague-Dawley rat. SR was orally given once a day for 7days after SCI. Myeloperoxidase(MPO) positive neutrophils infiltration was examined. Inducible nitric oxide synthase(iNOS) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) expressions were observed with immunohistochemistry. Glial fibrillary acidic protein(GFAP) positive astrocytes were examined using immuno-fluorescence. Results : 1. SR reduced MPO-positive neutrophils infiltration in peri-damage regions of the contusive SCI-induced rats. 2. SR reduced iNOS positive cells in the white matter of the contusive SCI-induced rats. 3. SR reduced TNF-${\alpha}$ positive cells in the gray and white matter of the contusive SCI-induced rats. 4. SR reduced cell number and size of astrocytes in peri-damage regions of the contusive SCI-induced rats. Conclusions : These results suggest that SR plays an inhibitory role against inflammatory response in the SCI.

• Journal of Korean Neurosurgical Society
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• 제37권3호
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• pp.187-192
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• 2005

Objective: Spinal myeloma has been treated with radiation therapy and chemotherapy. However, the role of surgery was not fully evaluated. This study is performed to evaluate the efficacy of surgery in the treatment of spinal myeloma. Methods: 22 patients who were treated with surgery for spinal myeloma from August 1999 to April 2003 were analyzed. Radiological finding, surgical methods and result were reviewed in retrospective study. For compression fracture due to myeloma infiltration, percutaneous vertebroplasy(PVP) was done. Decompression surgery with or without fixation was performed for patients with neurologic deficit. The modalities of surgery consist of PVP (14 cases), corpectomy and fixation (7 cases), and laminectomy and epidural mass removal (3 cases). To evaluate clinical outcome, visual analogue pain score and Frankel neurological scale were used. Results: In 14 cases of PVP, total 57 vertebral segments were treated including 21 thoracic vertebral bodies and 36 lumbar vertebral bodies. Pain relief was achieved in all cases. The pain score changed from 7.7 (preoperatively) to 2.5 (postoperatively). And pain relief effect was maintained over than one year. Frankel grade improved in decompression cases. Conclusion: Surgical treatment can alleviate pain and improve neurologic deficit immediately in spinal myeloma patients.

• Journal of Korean Neurosurgical Society
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• 제50권1호
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• pp.57-59
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• 2011

Intradural extramedullary (IDEM) ependymomas occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 57-year-old woman with an IDEM ependymoma. She was referred for the evaluation of a 4-month history of increasing neck pain and muscular weakness of the left extremities. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an IDEM tumor with spinal cord compression. At the time of surgery, an encapsulated IDEM tumor without a dural attachment or medullary infiltration was noted, but the tumor capsule adherent to the spinal cord and root was left in place to minimize the risk of neurological sequelae. Histologic examination revealed a benign classic ependymoma. The post-operative course was uneventful and radiotherapy was performed. The patient showed an excellent clinical recovery, with no recurrence after 5 years of follow-up.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.296-299
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• 2006

A 35-year-old woman, previously treated for systemic metastases from retroperitoneal yolk sac tumor, presented with progressive painful paraparesis. Preoperative images showed severe cord compression by the metastatic infiltration of the lumbar vertebrae and epidural mass as well as a huge retroperitoneal mass. While performing unremarkable surgery in prone position, the patient abruptly fell into hypoxic insults and circulatory arrest. Intraoperative pulmonary tumor embolism was deemed a cause of death. When planning operative procedure for this dangerous malignancy, scrupulous manipulation is mandated and the possibility of fatal pulmonary tumor embolism should also be addressed and fully discussed preoperatively.

• The Korean Journal of Pain
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• 제34권2호
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• pp.193-200
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• 2021

Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

• Journal of Korean Neurosurgical Society
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• 제57권6호
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• pp.445-454
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• 2015

Objective : In the present study we analyzed neuroprotective and antiapoptotic effect of the difumarate salt S-15176, as an anti-ischemic, an antioxidant and a stabilizer of mitochondrial membrane in secondary damage following spinal cord injury (SCI) in a rat model. Methods : Three groups were performed with 30 Wistar rats; control (1), trauma (2), and a trauma+S-15176 (10 mg/kg i.p., dimethyl sulfoxide) treatment (3). SCI was performed at the thoracic level using the weight-drop technique. Spinal cord tissues were collected following intracardiac perfusion in 3rd and 7th days of posttrauma. Hematoxylin and eosin staining for histopatology, terminal deoxynucleotidyl transferase dUTP nick end labeling assay for apoptotic cells and immunohistochemistry for proapoptotic cytochrome-c, Bax and caspase 9 were performed to all groups. Functional recovery test were applied to each group in 3rd and 7th days following SCI. Results : In trauma group, edematous regions, diffuse hemorrhage, necrosis, leukocyte infiltration and severe degeneration in motor neurons were observed prominently in gray matter. The number of apoptotic cells was significantly higher (p<0.05) than control group. In the S-15176-treated groups, apoptotic cell number in 3rd and 7th days (p<0.001), also cytochrome-c (p<0.001), Bax (p<0.001) and caspase 9 immunoreactive cells (p<0.001) were significantly decreased in number compared to trauma groups. Hemorrhage and edema in the focal areas were also noticed in gray matter of treatment groups. Results of the locomotor test were significantly increased in treatment group (p<0.05) when compared to trauma groups. Conclusion : We suggest that difumarate salt S-15176 prevents mitochondrial pathways of apoptosis and protects spinal cord from secondary injury and helps to preserve motor function following SCI in rats.

• Anatomy and Cell Biology
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• 제50권3호
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• pp.207-213
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• 2017

Glycogen synthase kinase $(GSK)-3{\beta}$ and related enzymes are associated with various forms of neuroinflammation, including spinal cord injury (SCI). Our aim was to evaluate whether lithium, a non-selective inhibitor of $GSK-3{\beta}$, ameliorated SCI progression, and also to analyze whether lithium affected the expression levels of two representative $GSK-3{\beta}$-associated molecules, nuclear factor erythroid 2-related factor-2 (Nrf-2) and heme oxygenase-1 (HO-1) (a target gene of Nrf-2). Intraperitoneal lithium chloride (80 mg/kg/day for 3 days) significantly improved locomotor function at 8 days post-injury (DPI); this was maintained until 14 DPI (P<0.05). Western blotting showed significantly increased phosphorylation of $GSK-3{\beta}$ (Ser9), Nrf-2, and the Nrf-2 target HO-1 in the spinal cords of lithium-treated animals. Fewer neuropathological changes (e.g., hemorrhage, inflammatory cell infiltration, and tissue loss) were observed in the spinal cords of the lithium-treated group compared with the vehicle-treated group. Microglial activation (evaluated by measuring the immunoreactivity of ionized calcium-binding protein-1) was also significantly reduced in the lithium-treated group. These findings suggest that $GSK-3{\beta}$ becomes activated after SCI, and that a non-specific enzyme inhibitor, lithium, ameliorates rat SCI by increasing phosphorylation of $GSK-3{\beta}$ and the associated molecules Nrf-2 and HO-1.

• Journal of Korean Neurosurgical Society
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• 제37권1호
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• pp.70-72
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• 2005

Primary spinal cord lymphomas are rare, and are either extra-/intradural masses with leptomeningeal infiltration or intramedullary in nature. The authors present a patient with a diffuse large B-cell lymphoma involving the sacral nerve root, extension to extradural space, and the cranial nerve.

• 한방재활의학과학회지
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• 제32권1호
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• pp.51-62
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• 2022

Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.