• The Korean Journal of Pain
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• 제5권2호
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• pp.258-262
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• 1992

1991년 3월 부터 1992년 2월까지 부산대학교병원 통증치료실에 내원한 27명의 대상포진후 신경통 환자를 대상으로 하여 저출력 레이저의 치료효과를 관찰한 바를 아래와 같이 요약한다. 1) 주된 병소부위는 흉추신경분포부위이었다. 2) 70세 미만의 환자에서는 VAS의 개선율이 57%로 효과가 있었으나, 70세 이상의 환자에서는 VAS 개선율이 27%로 현저히 감소하였다. 3) 발병후 치료시간 까지의 기간이 1개월 이내인 환자는 저출력 레이저에 의한 치료효과가 좋았으나, 12개월이상 경과한 환자는 치료효과가 좋지 않았다. 4) 발병후 1개월이내에 치료를 실시한 환자의 VAS개선율이 50%가 되기까지의 평균 조사횟수는 5.7회이었다.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.118-125
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• 2000

Objective : Trigeminal neurinomas are rare tumors that may locate in the middle fossa or posterior fossa and straddled both the middle and posterior fossa, according to their origin in the nerve complex. The aim of this study was to analyze the clinical presentation, operative approaches employed and outcome in 15 patients who were treated surgically, with special emphasis on surgical approach. Method : Between 1994 and 1998, a total of fifteen patients were histopathologically identified as neurinomas originating from the trigeminal nerve complex at the tumor clinic in the neuroscience center of the our university. Results : The surgical approach to these tumors depends on their anatomical location and tumor size. Six patients had tumors confined to the middle fossa, five patients had tumors limited to the posterior fossa, and four patients both in middle and posterior fossa components of their tumors. Nine neurinomas were removed via the conventional approach(pterional, subtemporal, suboccipital) and six were excised using skull base approach(transzygomatic subtemporal, orbitozygomatic, transpetrosal). Total resection of the tumor was possible in 10 cases. Total resection of tumor was accomplished in 83% of patients following skull base approach compared with 56% of patients following conventional approach. The surgical outcome was excellent or good in 13 cases, fair in one and, poor in one. There was no operative death. In the immediate postoperative period, aggravation of preoperative facial hypesthesia and 6th cranial nerve palsy were common. Although, these deficits were generally transient, eight patients remained with some degree of trigeminal hypesthesia, two had facial weakness, one neurotrophic keratitis, one diplopia, and one mastication difficulty. Conclusion : Surgical approach to the trigeminal neurinoma depends on the tumor location and tumor size. Skull base approach provides more complete tumor excision without increased morbidity compared to conventional approach. Surgeons have to be meticulous in order to reduce postoperative complication.

• 한국임상수의학회지
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• 제32권5호
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• pp.464-468
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• 2015

6살의 중성화한 수컷 말티즈는 운동실조로 인하여 내원하였다. 본 증례는 일반방사선 촬영, 컴퓨터단층촬영, 자기공명영상을 실시하여 낭종의 위치, 크기, 척수와의 관련성 및 동반된 질환을 알 수 있었다. 자기공명영상 결과 T1W과 FLAIR 영상에서는 hypointense한 영역, T2W 영상에서는 hyperintense한 영역이 L1~2 척수의 등쪽으로 나타났다. 이는 CSF와 동일한 신호로 나타났으며, 등쪽에서 척수를 압박하여 배쪽으로 이동시켰다. 낭종의 길이는 25 mm, 두께는 4 mm로 나타났다. 무증상일 경우는 치료가 필요 없으나, 본 증례는 신경학적 이상이 나타나 수술적 치료를 실시하였다.

• Journal of Genetic Medicine
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• 제14권2호
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• pp.56-61
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• 2017

Purpose: Neurofibromatosis type 2 (NF2) is characterized by multiple tumors, including vestibular schwannoma (VS) and others affecting cranial and peripheral nerves. NF2 is caused by mutation of the NF2 gene. The mutation spectrum of NF2 has not been characterized in Korean patients. In the current study, the clinical and genetic characteristics of Korean NF2 patients were analyzed. Materials and Methods: Twenty-five unrelated Korean families were enrolled according to the Manchester criteria. Genetic analysis was performed by direct sequencing and multiplex ligation-dependent probe amplification methods using genomic DNA from peripheral lymphocytes or tumor tissues. Results: All patients had bilateral/unilateral VS and/or other cranial and peripheral nerve tumors. Two patients were familial cases and the other 24 patients were sporadic. Germline NF2 mutations were detected in peripheral lymphocytes from both familial cases, but only in 26.1% of the 23 sporadic families. Somatic mutations were also found in tumor tissues from two of the sporadic families. These somatic mutations were not found in peripheral lymphocytes. A total of 10 different mutations including 2 novel mutations were found in 40.0% of studied families. Five mutations (50.0%) were located in exon 6 of NF2, the FERM domain coding region. Conclusion: Family history was an important factor in identifying germline NF2 mutations. Further study is required to investigate whether exon 6 is a mutation hotspot in Korean NF2 patients and its correlation to phenotypic severity.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.30-36
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• 2001

1) 소뇌교각부 수막종의 빈도는 1.6%, 소뇌교각부 종양의 16%를 차지했고, 14례(82%)가 여성 이었다. 2) 증상은 청신경 장애(12례), 두통(10례), 소뇌장애(9례) 순이었다. 3) 종양은 주로 천막으로 확장 되었고(11례), 병리소견은 16례(94%)에서 양성 이었다. 4) 11례에서 내이도의 후방에, 3례에서 전방에 종양이 위치했고 3례에서는 en-plaque형 수막종 이었다. 5) 수술은 모두 S상 정맥동 후방접근법을 시행하여 14례에서 전적출을 시행하였다. 이중 1례에서 방사선 치료를 시행하였으며, 아전적출을 시행한 3례중 2례에서 방사선 치료를 시행하였다. 6) 제 7 및 8 뇌신경 복합체는 9례에서 종양의 전방에, 4례에서 종양의 후방에 위치했다. 7) 수술후 장기 추적관찰 결과는 16례에서 양호하였으며, 1례에서 사망하였다. 추적검사상 1례에서 재발하였다.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.336-341
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• 2006

Objective : The authors conducted a retrospective study to evaluate the preservation rates of serviceable hearing and to determine its prognostic factors after gamma knife stereotactic radiosurgery[GK SRS] in the patient with vestibular schwannomas. Methods : Between December 1997 and March 2005, 54 patients with a sporadic vestibular schwannoma and serviceable hearing [Gardner Robertson grade I-II] were enrolled in this study. Electronic database of medical records and radiological examinations before and after GK SRS were investigated to the last follow up. The mean marginal dose was $12.3{\pm}0.7Gy$. The mean maximum dose delivered to the tumor center was 24.7Gy [$22{\sim}30Gy$]. The median tumor volume was 2cc [$0.1{\sim}9.1cc$]. The median follow-up period of magnetic resonance[MR] imaging was 31 months [$6{\sim}99\;months$], and the mean follow-up period of audiometry was 24 months [$4{\sim}70\;months$]. Results : The tumor control rate was 100% in the patients with the follow up period more than 2 years. The trigeminal and facial nerve preservation rates were 98% and 100%, respectively. Twenty-eight [52%] of the 54 patients preserved serviceable hearing and 16 [30%] patients retained their pre-GK G-R grade level after GK SRS. In the univariate and multivariate analysis, there was no significant prognostic factor in preservation of the serviceable hearing. Conclusion : The hearing preservation rate is still unsatisfactory compared with the results of other cranial nerve preservation and tumor control in the treatment of vestibular schwannoma by GK SRS. More sophisticated strategy during and after GK SRS is necessary to improve long-term hearing preservation.

• 한국임상수의학회지
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• 제40권5호
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• pp.336-340
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• 2023

A dog (2-year old, female, Shih-Tzu) presented with hyperthermia and right-sided facial paralysis characterized by the inability to close the right eye and drooling from the right side of the mouth after H3N2 influenza vaccination [A/Canine/Korea/01/07(H3N2) strain; Caniflu-Max, Bionote, Hwaseong, Gyeonggi-do, ROK]. To determine the cause of the fever and neurological symptoms, physical examination, ophthalmic examination, thoracic and abdominal radiography, abdominal ultrasonography, complete blood counts, serum chemistry values, and electrolyte levels were determined. In addition, Cerebrospinal fluid analysis, antinuclear antibody test, fever of unknown origin polymerase chain reaction (PCR) panel, tick-borne pathogen PCR panel were performed. As a result, hyperthermia, leukocytosis, and elevated C-reactive protein were confirmed. In addition, neurological examination revealed decreased right eyelid reflexes, corneal reflexes, threat response, and facial sensation, it was possible to suspect problems with the trigeminal and facial nerves of the cranial nerve. Magnetic resonance imaging revealed a lesion suggestive of myositis in the right muscular lesion at atlanto-occipital junction level on site of vaccine injection. Therefore, right-sided facial paralysis was tentatively determined to be a secondary cause of nerve damage caused by myositis. The patient was treated with immunosuppressants such as prednisolone and mycophenolate mofetil. After 3 months of immunosuppressant therapy, the patient's symptoms improved.

• 대한한의학회지
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• 제35권3호
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• pp.103-115
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• 2014

Objectives: The purpose of this survey was to investigate the need for new medical devices based on opinions of members of the Korean medical society. Methods: We distributed two independent questionnaires sequentially over two-week intervals to 16,510 doctors via the Korean Medical Society, and received replies from 888 and 928 doctors, respectively. The survey was carried out through a web-based questionnaire system. The first questionnaire focused on demand for new diagnostic and therapeutic medical devices that are specific for Korean medicine (KM). In contrast, the second questionnaire focused on demand for new hybrid medical devices which are useful both in Western medicine (WM) and KM. Results: In purchase intention of Korean medical devices (KMDs), demand for diagnostic devices was greater than for therapeutic ones. Among diagnostic devices, the purchase intention of 'imaging devices' ranked the highest and was followed by 'musculoskeletal diagnostic devices'. Among therapeutic KMDs, the purchase intention of 'musculoskeletal treatment devices' ranked the highest, followed by 'cranial nerve rehabilitation devices'. In the purchase intention of hybrid medical devices that can be used both in WM and KM, 'ultrasonic-based medical device' ranked the highest, followed by 'MRI-based medical device'. Conclusions: There is increasing demand for clinically useful medical devices among Korean medical doctors. Within demand for new devices, hybrid devices that can be used in both WM and KM were most strongly desired. This survey will be useful in establishing strategic plans for the development of medical devices in KM. Keywords: Korean medicine, medical device, demand survey, questionnaire.

• 간호행정학회지
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• 제20권1호
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• pp.117-127
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• 2014

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

• 대한한방내과학회지
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• 제32권4호
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• pp.530-541
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• 2011

Objectives : Categorized as 'cheongyeol' herbs, Herba Prunellae, Flos Lonicerae and Radix Scutellaria have been proven to have effect on degenerative brain disease, cerebrovascular disease and brain tumor because of their anti inflammation, antioxidant, or anticancer effects. In this study, we studied activity against reactive oxygen species and anti inflammation effect of these three 'Cheongyeol' herbs. Methods : We measured each herb's yield of ethanol extracts, phenolic contents and activities against DPPH, hydroxyl radical and superoxide anion. Also through 6-hydroxydopamine (6-OHDA) induced oxidative damage in SH-SY5Y human neuroblastoma cell line, we measured antioxidant effect and NO activity of the three herbs. From the three herbs, we chose Prunella Herba, which showed the highest antioxidant effect, and studied its cell survival rate and anti inflammation effect through COX-2 and iNOS. Results : All three herbs showed significant results, and especially Prunella Herba showed significant effect on phenol contents, antioxidant effect on various active oxygen and antioxidant, and anti inflammation effect through cell line. Conclusions : Further study of the origin concept of 'cheongyeol' and research into specific mechanisms and role in treatment of cranial nerve disease, seems warranted.