• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1332-1335
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• 2001

Acase of malignant schwannoma in the cervico-thoracic region with lung metastasis is presented. The patient was 55-year-old man presented with right arm weakness. Magnetic resonance image demonstrated lobulated enhancing soft tissue masses in spinal canal, neural foramen and right paraspinal space at C7-T1 level compressing the dural sac and spinal cord. Subtotal removal was performed and histological diagnosis of malignant schwannoma was made. Reoperation due to recurrence was done but subsequent metastasis to lung was observed.

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.129-136
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• 2016

Objective : The purpose of this study was to figure out the radiologic findings and risk factors related to adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF) using 3-year follow-up radiography, computed tomography (CT), and magnetic resonance image (MRI). Methods : A retrospective matched comparative study was performed for 64 patients who underwent single-level ACDF with a cage and plate. Radiologic parameters, including upper segment range of motion (USROM), lower segment range of motion (LSROM), upper segment disc height (UDH), and lower segment disc height (LDH), clinical outcomes assessed with neck and arm visual analogue scale (VAS), and risk factors were analyzed. Results : Patients were categorized into the ASD (32 patients) and non-ASD (32 patients) group. The decrease of UDH was significantly greater in the ASD group at each follow-up visit. At 36 months postoperatively, the difference for USROM value from the preoperative one significantly increased in the ASD group than non-ASD group. Preoperative other segment degeneration was significantly associated with the increased incidence of ASD at 36 months. However, pain intensity for the neck and arm was not significantly different between groups at any post-operative follow-up visit. Conclusion : The main factor affecting ASD is preoperative other segment degeneration out of the adjacent segment. In addition, patients over the age of 50 are at higher risk of developing ASD. Although there was definite radiologic degeneration in the ASD group, no significant difference was observed between the ASD and non-ASD groups in terms of the incidence of symptomatic disease.

• 한국컴퓨터정보학회:학술대회논문집
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• 한국컴퓨터정보학회 2016년도 제54차 하계학술대회논문집 24권2호
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• pp.295-296
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• 2016

본 연구에서는 LED 광 자극이 뇌의 어느 영역을 자극하여 신경신호를 전달하는지에 관해서 관찰하고자 연구를 진행하였다. 광 자극에 의한 뇌 영역의 활성변화를 관찰하기 위하여 실험용 소동물과 영상장비인 9.4T MRI를 이용하여 연구를 수행 하였다. 실험용 소동물은 Balb/c 마우스를 이용하였으며 기능적 자기공명영상 획득 방법 중 하나인 에코평면영상 기법을 이용하여 뇌 영상을 획득 하였다. 획득한 영상을 바탕으로 뇌 영역의 자극 정도를 확인해보기 위해 영상처리기법인 재편성(realignment), 일치(co-registration), 표준화(normalization), 평활화(smoothing) 방법으로 영상을 전처리 하고, statistical parametric map (SPM12)을 사용하여 분석하였다. 본 연구에서는 광자극이 소동물 뇌 영역 중 하나인 상구(Superior colliculus)영역과 대뇌의 시각피질 (visual cortex, V1) 영역에서 자극을 일으키는 것을 확인할 수 있었다.

• Imaging Science in Dentistry
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• 제33권4호
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• pp.239-244
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• 2003

Malignant fibrous histiocytoma (MFH) is a pleomorphic soft tissue sarcoma. Three cases of MFH were reported in our study. The first case involved in the right infratemporal fossa of a 32-year-old female was presented. MR imaging revealed a 5.0 × 3.3 cm soft tissue mass of inhomogeneous high signal intensity. The second case was found in the right hard palate of a 66-year-old male. CT demonstrated bone destruction and MR imaging showed a 4 × 4 cm sized soft tissue mass of heterogeneous high signal intensity. The final case was found in the left masticator space of a 37-year-old male. The CT image showed a large mass with massive bone destruction of the left mandibular ramus, while the MRI displayed a soft tissue mass, 8 cm diameter. Our cases exhibited the general features of MFH. MRI is essential in the imaging of MFH, namely to depict tumor borders and demonstrate relationships with adjacent structures.

• Advances in pediatric surgery
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• 제15권2호
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• pp.113-120
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• 2009

Pediatric lymphangioma can occur at any site. However the neck is the most common site. There are two treatment modalities (surgical excision and intralesional injection) for lymphangiomas. But, the treatment guide line for lymphangioma has not been established, yet. The aim of this study is to establish the treatment guide line based on our experience with lymphangiomas. Medical records of 82 cases of lymphangioma were reviewed retrospectively. On MRI (magnetic resonance image) findings, lymphangiomas were divided into 4 groups by the proportion of the cyst bigger than 2 cm in diameter of the tumor; group A-proportion of cyst occupies more than 75%, group B-proportion of the cyst 50~75%, group C-25~50%, and D in less than 25%. All patients were treated with OK-432 intralesional injection as the initial treatment. The effective response rates of OK-432 in group A & B were 88.2% and 88.8%, respectively. Group C response was 38.0% and D only 20.0%. Twenty-three patients received surgical excision. The result of surgical excision was generally satisfactory. Surgical site infection occurred in 1 case and postoperative bleeding in 1 case. Theses results indicate that intralesional injection of OK-432 could be the first line therapy in group A & B. In group C, OK-432 would be better as the first line therapy than surgery. For the group D, surgical excision should be the first line of treatment.

• 동의생리병리학회지
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• 제27권5호
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• pp.672-676
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• 2013

The purpose of this study is to report that a patient suffered from Common Peroneal Neuropathy (CPN) caused by ankle sprain was improved by acupuncture plus electro-acupuncture. In this study, the patient was diagnosed with magnetic resonance image(MRI) and electomyography(EMG). We treated at acupoints ST36, ST41, SP9, GB34, GB39 and LR3 by acupuncture plus electro-acupuncture twice a day for 16 days; a total of 30 times. We used evaluation scale including muscle manual testing(MMT) and visual analogue scale (VAS). MMT changed from Grade 0 to Grade 5 and VAS changed from 10 to 2 after treatment for 16days with hospitalization. Though it is a case report, these results suggest that acupuncture and electrical acupuncture might have valid effect on CPN in controlled environment.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.139-144
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• 2010

Objective : We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department. Methods : We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients. Results : Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues : by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures. Conclusion : The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.

• 보건의료산업학회지
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• 제4권1호
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• pp.145-156
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• 2010

The purpose of this study is one of high price medical equipment wished to grasp propriety factor about the MRI introduction, analyzing payability through cost accounting into compensation. It was investigated from January 1 to December 31, 2007 about the MRI of a General Hospital. Expectation availability was 23.2 cases, but actual availability did achievement more than 196.1% with 45.5 items. It is estimated that there are a lot of occurrence cases because great reasons that actual availability increases more than expectation availability is excellent resolving power than a CT, and is device that prefer to reason back that radiation damage is less in person body. The followings show the main results of this study. 1. The MRI was construed in order of cost accounting, wave and personnel expenses 45.4%, administrative expenses 53.0%, and material costs 1.6%. 2. According to CVP (Cost-volume-profit) analysis, BEP (Break Even Point) profit is 173,931,428 won for 11 months, and break even usage number of items are 37.5 cases, and separation usage number of items were confirmed by 1.4 cases. Therefore, was construed that can achieve BEP within 11 months though usage number of items keeps 1.4 items day to create the MRI's hospital operation profit. 3. Estimated limit profitability appears high by 96.7%, exceed fixed charges even if when is non-benefit and when it is benefit consider variable, is judged that the MRI's addition induction helps in hospital management enhancing earning rates.

• Journal of Korean Neurosurgical Society
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• 제38권5호
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• pp.359-365
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• 2005

Objective : The study investigates the extent of brain shift and its effect on the accuracy of the stereotaxic procedure. Methods : Thirty-five patients underwent 40stereotactic procedures between June 2002 and March 2004. There were 26 males, mean age 59years old. There were 34procedures for Parkinson's disease, 2 for essential tremor, 3 for cerebral palsy, 1 for dystonia. Patients were divided in four groups based on postoperative pneumocephalus : under 5cc [9 procedures], between $5{\sim}10cc$ [13procedures], between $10{\sim}15cc$ [11 procedures] and more than 15cc [7procedures]. The coordinates of the anterior commissure[AC], posterior commissure[PC], and target were defined in pre-and intraoperative magnetic resonance image scans and the amount of air volume was measured with @Target (BrainLab, Heimstetten, Germany]. Results : The mean AC-PC was 26.5mm for patients with less than 5cc, 26.9mm for $5{\sim}10cc$, 25.8mm for $10{\sim}15cc$ and 26.2mm for more than 15cc. The length of AC-PC line and coordinates of AC, PC was also not statistically different, Euclidean distance as well as ${\Delta}x$, ${\Delta}y$, ${\Delta}z$ of AC, PC, and target were also not statistically different among the groups [p>,1]. There was a variance in target of $0.7{\sim}7.6mm$, Euclidean distance of 2.5mm, related to electrophysiology but not to brain-shift. Conclusion : The amount of air accumulated in the intracranial space and compressing the cortical surface has no effect on the localization of subcortical stereotactic target and landmarks.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1019-1023
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• 2000

Objective : Endoscopic third ventriculostomy is gaining popularity as a minimally invasive surgical option for certain types of hydrocephalus as an alternative to shunting. The authors have tried to fenestrate down to the subdural space passing through the prepontine cistern to lessen or avoid the chance of redoing due to healing. Materials and Method : A 48-year-old male patient with several years of intractable headache was presented. Magnetic Resonance Image(MRI) of the brain revealed marked ventricular dilatation with stenotic cerebral aqueduct. A 2.3mm flexible steerable endoscope($Neuroview^{(R)}$) was introduced via precoronal route and accessed to the third ventricular floor. Using 3-French Fogarty balloon catheter, thin third ventricular floor and the arachnoid membrane of the prepontine cistern were fenestrated, so called "double fenestration". To confirm the fenestration, subdural compa-rtment of the left abducens nerve was identified during the procedure. Forceful pulsating flow through the orifice convinced the patency of the opening. Results : The patient was discharged on the third postoperative day without any postoperative complications. The postoperative follow-up MRI of the brain, at second and sixth months, clearly demonstrated the flow void through the third ventricular floor. Conclusions : Endoscopic third ventriculostomy was successfully performed on an adult hydrocephalus patient with aqueduct stenosis. The third ventricular floor and arachnoid membrane of the prepontine cistern were fenestrated to achieve double fenestration to minimize the chance for failure. The details of this procedure and results are described.