Distinct Specialized Center of Excellence, the Story of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital

( Shin Jung ),( In-young Kim ),( Kyung-sub Moon ),( Tae-young Jung ),( Woo-youl Jang ),( Yeong Jin Kim ),( Tae-kyu Lee ),( Sue Jee Park ),( Sa-hoe Lim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2023 Brain Tumor Research and Treatment Vol.11 No.2

The paper provides a comprehensive overview of the growth and development of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital over the past 18 years. As the first brain tumor center in Korea when it was established in April 2004, Hwasun Neurosurgery has since become one of the leading institutions in brain tumor education and research in the country. Its impressive clinical and basic research capabilities, dedication to professional education, and numerous academic achievements have all contributed to its reputation as a top-tier institution. We hope this will become a useful guide for other brain tumor centers or educational institutions by sharing the story of Hwasun Neurosurgery.

신경외과 수술 환자의 수술 관련 욕창 발생 위험요인

김상옥l최선미l이승아l강재연 병원간호사회 2022 임상간호연구 Vol.28 No.1

Purpose: The purpose of this study was to evaluate risk factors of pressure injuries in patients after neurosurgery. Methods: A retrospective case-control study was conducted using 273 patients undergoing neurosurgery admitted to a general hospital from 2015 to 2021. Data were collected from September 1 to 30, 2021. The data were analyzed using the SPSS/WIN 26.0 program. Results: Risk factors significantly influencing the occurrence of pressure injuries in the patients undergoing neurosurgery were hypertension (OR=3.12, p=.024), postoperative hypoalbuminemia (OR=0.30, p=.028), and prolonged operative duration (OR=1.00, p=.001). The regression model explained 86.0% of the variance of the outcome variable. Conclusion: In order to prevent surgery-related pressure injuries in patients undergoing neurosurgery, thorough blood pressure management, avoidance of hypoalbuminemia, and preventive nursing intervention considering operative duration are required.

Analysis of Dermatologic Diseases in Neurosurgical In-Patients: A Retrospective Study of 463 Cases

( Kyung Min Kim ),( Hei Sung Kim ),( Jeesuk Yu ),( Jong Tae Kim ),( Sang Hyun Cho ) 대한피부과학회 2016 Annals of Dermatology Vol.28 No.3

Background: Both the skin and the neurologic system are derived from the ectoderm during embryogenesis, and thus patients with neurologic disorders may have accompanying dermatologic diseases. For example, seborrheic dermatitis is more frequently observed in patients with Parkinsonism and other neurologic disorders. To date, however, there has been limited review on dermatologic diseases in neurosurgical in-patients. Objective: The purpose of this study was to characterize dermatological problems encountered in a neurosurgery unit and to compare these data to previous reports of in-patient dermatologic consultations. Methods: A retrospective review was conducted over all in-patient dermatology consultations from the neurosurgery unit during a 3-year period. Results: Of 2,770 dermatology consultations, 463 (16.7%) came from the department of neurosurgery. The most frequent age group was the 6th decade of life, and the ratio of men to women was 1.07. Consults were most frequently placed from patients with intracranial hemorrhage (23.8%). Eczema/dermatitis (36.5%; n=204) and cutaneous infections (27.0%; n=151) accounted for more than half of all dermatological consultations, followed by cutaneous adverse drug reactions (11.8%; n=66). Additionally, seborrheic dermatitis was significantly more frequent (p=0.048, odds ratio=1.96) in patients with intracranial hemorrhage. Conclusion: This study characterizes the distribution of skin disorders in patients admitted to the neurosurgery service based on the consultations that have been made for dermatologic evaluation. Collaboration between the neurosurgeons and dermatologists may improve the quality of patient care and help to better predict the occurrence of these conditions. (Ann Dermatol 28(3) 314∼320, 2016)

신경외과 영역에서 전문간호사제도의 역할 및 효율성

조경기 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7

The purpose of this article is to identify and explain the role and effectiveness of nurse practitioners(NPs) in the field of neurosurgery. The role of nurse practitioner has expanded over the past 15 years in the areas of administration clinical activities, counseling, and surgical assistance. One primary activity of the NPs in our department is the frequent periodic neurological examination and rapid detection of deteriorating critical patients. They also improve the rapport between the patients and neurosurgery service and cover severe manpower shortage of resident staffs. The department of neurosurgery in the hospital can maintain adequate coverage for the neurosurgical patients without increasing the number of residents. The author believes that NPs can improve the quality of care and outcome in a cost-effective manner. Concerns with acceptance and the role of neurosurgical NPs are clearly no longer on issue.

뇌혈관질환에 대한 오령산(五苓散) 치료의 일본 유용성 - 2011년 제20회 일본뇌신경외과한방의학회 학술대회 발표논문을 중심으로-

장인수,권승원,김경욱,Jang, In-soo,Kwon, Seung-won,Kim, Kying-wook 대한중풍순환신경학회 2011 대한중풍.순환신경학회지 Vol.12 No.1

Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.

Predictive Performance of Serum Procalcitonin for the Diagnosis of Bacterial Meningitis after Neurosurgery

최성호,최상호 대한감염학회 2013 Infection and Chemotherapy Vol.45 No.3

Background: Postoperative bacterial meningitis (PBM) is a serious potential complication after neurosurgery. Early diagnosis and introduction of antimicrobial therapy are necessary to reduce the rate of fatal outcomes from PBM. However, PBM is not easily differentiated from postoperative aseptic meningitis (PAM), which usually has favorable clinical outcomes. Serum procalcitonin (S-PCT)has been found to be a useful marker for distinguishing community-acquired bacterial from viral meningitis. We investigated the predictive performance of S-PCT for PBM in patients who underwent neurosurgery. Materials and Methods: Between September 2009 and August 2010, we prospectively collected data from patients who underwent neurosurgery and had cerebrospinal fluid (CSF) pleocytosis within 14 days of surgery. Based on the CSF culture results, patients were categorized as either PBM or PAM cases. We compared the laboratory test results including S-PCT levels between PBM and PAM cases, and investigated the predictive performance of S-PCT for PBM. Results: During the study period, PBM and PAM occurred in 14 and 64 patients, respectively. There was no significant difference in CSF profiles between PBM and PAM cases. S-PCT level ≥ 0.15 ng/mL (50.0% vs. 20.0%, P = 0.07) and C-reactive protein (CRP)level ≥ 2.5 mg/dL (75.0% vs. 46.5%, P = 0.16) tended to be more frequent in PBM than in PAM cases. A blood white blood cell (BWBC)count ≥ 9,500/mm3 was more frequently found in PBM cases (85.7% vs. 50.8%, P = 0.02) than in PAM cases. For the diagnosis of PBM, an S-PCT level ≥ 0.15 ng/mL had a specificity of 80.0%. The combined criteria of a CRP level ≥ 2.5 mg/dL, B-WBC count ≥ 9,500/mm3, and an S-PCT level ≥ 0.15 ng/mL had the highest specificity (92.6%) of all the criteria. An S-PCT level ≥0.15ng/mL had low sensitivity (50.0%), and the combined criteria of CRP level ≥ 2.5 mg/dL, B-WBC count ≥ 9,500/mm3, and S-PCT level ≥ 0.15 ng/mL had an improved sensitivity of 85.7%. However, the sensitivity did not significantly differ from that of a B-WBC count ≥ 9,500/mm3 (85.7%). Conclusions: S-PCT showed limited performance for the diagnosis of postoperative meningitis. However, it could be a useful adjunct for the improvement of diagnostic sensitivity when used in combination with other inflammatory markers.

Fluid management in patients undergoing neurosurgery

류태하 대한마취통증의학회 2021 Anesthesia and pain medicine Vol.16 No.3

Fluid management is an important component of perioperative care for patients undergoing neurosurgery. The primary goal of fluid management in neurosurgery is the maintenance of normovolemia and prevention of serum osmolarity reduction. To maintain normovolemia, it is important to administer fluids in appropriate amounts following appropriate methods, and to prevent a decrease in serum osmolarity, the choice of fluid is essential. There is considerable debate about the choice and optimal amounts of fluids administered in the perioperative period. However, there is little high-quality clinical research on fluid therapy for patients undergoing neurosurgery. This review will discuss the choice and optimal amounts of fluids in neurosurgical patients based on the literature, recent issues, and perioperative fluid management practices.

Image-guided Stereotactic Neurosurgery: Practices and Pitfalls

Jung, Na Young,Kim, Minsoo,Kim, Young Goo,Jung, Hyun Ho,Chang, Jin Woo,Park, Yong Gou,Chang, Won Seok International Society for Simulation Surgery 2015 Journal of International Society for Simulation Su Vol.2 No.2

Image-guided neurosurgery (IGN) is a technique for localizing objects of surgical interest within the brain. In the past, its main use was placement of electrodes; however, the advent of computed tomography has led to a rebirth of IGN. Advances in computing techniques and neuroimaging tools allow improved surgical planning and intraoperative information. IGN influences many neurosurgical fields including neuro-oncology, functional disease, and radiosurgery. As development continues, several problems remain to be solved. This article provides a general overview of IGN with a brief discussion of future directions.

신경외과 영역에서의 내시경

고용 한양대학교 의과대학 2000 한양의대 학술지 Vol.20 No.1

Endoscopy is used as one of treatment tools in neurosurgery. It was introduced to minimize surgical complications by traction of brain and making the way to lesions. Endoscopic brain surgery is frequently used in hydrocephalus, intraventricular or pituitary lesions, and used as an assited surgery for microscope in aneurysm, cisternal or skull base lesions. Endoscopic spinal surgery is mostly applied for herniated intervertebral disc and additionally used for tumor or traumatic lesions. A Rigid or flexible endoscope with several types of lens(0, 30, 70 degree), one blade bipolar or laser, lens cleansing system are needed. Stereotactic system or ultrasound is also useful for making a precise target. The advantages of endoscopic surgery are less bleeding, less operating time, less hospitalization, low cost, less or no incision to the brain or face. However, well trained neurosurgeon and good equipments are optional.

Telemedicine in Neurosurgery: Standardizing the Spinal Physical Examination Using A Modified Delphi Method

Alexander F. Haddad,John F. Burke,Praveen V. Mummaneni,Andrew K. Chan,Michael M. Safaee,John J. Knightly,Rory R. Mayer,Brenton H. Pennicooke,Anthony M. Digiorgio,Philip R. Weinstein,Aaron J. Clark,Dea 대한척추신경외과학회 2021 Neurospine Vol.18 No.2

Objective: The use of telemedicine has dramatically increased due to the coronavirus disease 2019 pandemic. Many neurosurgeons are now using telemedicine technologies for preoperative evaluations and routine outpatient visits. Our goal was to standardize the telemedicine motor neurologic examination, summarize the evidence surrounding clinical use of telehealth technologies, and discuss financial and legal considerations. Methods: We identified a 12-member panel composed of spine surgeons, fellows, and senior residents at a single institution. We created an initial telehealth strength examination protocol based on published data and developed 10 agree/disagree statements summarizing the protocol. A blinded Delphi method was utilized to build consensus for each statement, defined as >80% agreement and no significant disagreement using a 2-way binomial test (significance threshold of p<0.05). Any statement that did not meet consensus was edited and iteratively resubmitted to the panel until consensus was achieved. In the final round, the panel was unblinded and the protocol was finalized. Results: After the first round, 4/10 statements failed to meet consensus (<80% agreement, and p=0.031, p=0.031, p=0.003, and p=0.031 statistical disagreement, respectively). The disagreement pertained to grading of strength of the upper (3/10 statements) and lower extremities (1/10 statement). The amended statements clarified strength grading, achieved consensus (>80% agreement, p>0.05 disagreement), and were used to create the final telehealth strength examination protocol. Conclusion: The resulting protocol was used in our clinic to standardize the telehealth strength examination. This protocol, as well as our summary of telehealth clinical practice, should aid neurosurgical clinics in integrating telemedicine modalities into their practice.