자발성 두개강내압 저하증

공두식,김종수,박관,남도현,어환,홍승철,신형진,김종현,Kong, Doo Sik,Kim, Jong Soo,Park, Kwan,Nam, Do Hyun,Eoh, Whan,Shin, Hyung-Jin,Hong, Seung-Chyul,Kim, Jong Hyun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

Prognosis of Non-Small Cell Lung Cancer with Synchronous Brain Metastases Treated with Gamma Knife Radiosurgery

공두식,이정일,남도현,박관,김종현,김진국,박준오,박근칠 대한의학회 2006 Journal of Korean medical science Vol.21 No.3

반측성 안면 경련증에 대한 미세 혈관 감압술 후 발생한 지연성 안면 신경 마비의 임상적 특징

공두식(Doo-Sik Kong),이덕주(Deok-Joo Lee),박재성(Jae-Sung Park),이정아(Jeong-A Lee),박관(Kwan Park) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.2

Background : Microvascular decompression for hemifacial spasm provides a long- term cure rate. Delayed facial palsy has only been sporadically described in the literature. The purpose of this report is to evaluate the incidence of delayed facial palsy after MVD and its clinical course. Methods : From January, 1998 to April, 2005, 500 consecutive patients underwent microvascular decompression for hemifacial spasm in our institute. The male: female ratio was about 1:3 (131:369) and their mean age was 44.7 years (range: 19-75 years). We investigated the following clinical characteristics for all the patients: age, gender, side of spasm, the offending structures (the compressing vessels), and infection with herpes simplex virus. Their medical recording and radiological data were reviewed. Results : During this period, 49 patients (9.8%) developed delayed facial palsy after microvascular decompression. There were 38 women and 11 men in this study. The onset of palsy occurred between postoperative day 7 and 23 (average: 12.5 days). The palsy was at least Grade II or worse on the House-Brackmann scale. The mean time to recovery was 5.2 weeks (range: 25 days-17 weeks); delayed facial palsy in 48 patients were improved to the complete recovery, but only one patient had remained weakness at the follow-up examination. Conclusion : The incidence of delayed facial palsy (9.8%) was not so low as has been reported the literatures. Although the degree of facial palsy was variable, almost all patients exhibited a complete recovery without any further special treatment.

비파열 흔적자궁 임신 1례

공두식 ( Du Sik Kong ),이재오 ( Jae Oh Lee ),박윤정 ( Yun Jung Park ),서영욱 ( Young Wook Soh ) 대한주산의학회 2001 Perinatology Vol.12 No.1

Clinical and Radiological Characteristics of Angiomatous Meningiomas

황주영,공두식,설호준,남도현,이정일,최정원 대한뇌종양학회 2016 Brain Tumor Research and Treatment Vol. No.

Background Angiomatous meningioma is a rare histological subtype of meningioma. Therefore, this specific medical condition is rarely reviewed in the literature. In the present work, we report the clinical and radiological features with postoperative outcomes of angiomatous meningioma. Methods This retrospective study included the patients who were pathologically diagnosed with angiomatous meningioma after surgical resection between February 2010 and September 2015 in our institute. We analyzed the clinical data, radiological manifestation, treatment and prognosis of all patients. Results The 15 patients (5 males and 10 females) were diagnosed with angiomatous meningioma during the study period. The median age of patients at the time of surgery was 63 years (range: 40 to 80 years). According to Simpson classification, 7, 5, and 3 patients achieved Simpson grade I, II, and IV resection, respectively. In the follow-up period, recurrence was noted in one patient. Ten out of the 15 patients showed homogeneous enhancement. Two patients demonstrated cystic changes. There was no occurrence of calcification or hemorrhage in our patients. Characteristically, 14 out of 15 patients showed signal voids of vessels. Significant peritumoral edema was observed in the majority of tumors (67%). Conclusion Angiomatous meningiomas are rare benign meningioma. Brain images of angiomatous meningioma usually demonstrate signal void signs and peritumoral edema. In the present study, angiomatous meningiomas showed good prognosis after surgical resection.

아데노이드 절제술 후 발생한 뇌척수액 누출: 추체 첨부 수막류 1례

김병길,허유진,공두식,홍상덕 대한비과학회 2020 Journal of rhinology Vol.27 No.2

Cerebrospinal fluid (CSF) leak is possible and can be a cause of recurrent bacterial meningitis. Petrous apex meningocele (PAM) is mostly asymptomatic and is often found during incidental imaging tests. We experienced a case of CSF rhinorrhea with recurrent meningitis in bilateral PAM after adenoidectomy. This report highlights the diagnostic process of CSF leak, identification of leakage site, and surgical approach to petrous apex lesions.

라스케씨 열낭종에 대한 비중격 피판을 이용한 내시경적 조대술 이후 발생한 두개내 출혈 1예

황규현,이은규,공두식,홍상덕 대한두개저학회 2024 대한두개저학회지 Vol.19 No.1

Rathke’s cleft cyst (RCC) is a benign tumor that occurs in the pituitary or suprasellar region. Recently, marsupialization of RCC with nasoseptal flap is used to prevent stricture and recurrence after marsupialization. A 26-year-old female with recurrent RCC treated with marsupialization using nasoseptal flap, had intracranial hemorrhage after the surgery. Bleeding from the flap margin is considered to be the cause of the intracranial hemorrhage. Surgeons should be aware of the potential for this type of delayed hemorrhage when utilizing a nasoseptal flap in skull base surgery.

증강현실 기반 수술 항법 연구

장태수(taesoojang),공두식(Doo-Sik Kong),우운택(Woontack Woo) 한국HCI학회 2020 한국HCI학회 학술대회 Vol.2020 No.2

본 연구는 증강현실 기술을 활용하여 뇌수술의 한 종류인 비공을 통한 비강내 경접형동접근법을 이용한 뇌하수체 종양 수술(TSA: Endonasal Transsphenodinal Approach through Nostril)의 수술 조건에서 각각 분리된 내시경 화면에 기존 분리되어 있던 의료정보 화면을 내시경 비디오에 증강하여 제공하는 방법에 대한 연구이다. 내시경 접근법 수술은 기존의 다른 수술과 달리 외비에 절개를 할 필요가 없는 비침습 수술이다. 기존의 수술 환경에서 집도를 진행하는 의사의 시야가 환자, 내시경 영상화면, 의료정보 영상화면, 뇌수술 내비게이션 화면으로 분리되어 직관적이지 않은 문제점이 있다. 본 연구에서는 이렇게 직관적으로 통합되지 않은 수술 정보들을 증강현실 기술을 사용하여 직관적으로 사용자인 외과의사에 제공하기 위한 연구를 진행하였다. 이를 위하여 컴퓨터 비젼 기술을 활용하여 내시경 화면에 증강현실 데이터를 출력하기 위한 시스템의 설계 및 구현을 제안하고 논의한다. 이를 통하여 경접형동접근법을 이용한 뇌하수체 종양 수술에서 의료 증강현실 환경을 제공할 것으로 기대된다.

뇌하수체줄기에서 발생한 뇌하수체선종

이정훈 ( Jeong Hoon Lee ),공두식 ( Doo Sik Kong ),박관 ( Kwan Park ),김종현 ( Jong Hyun Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2

We report two rare cases of pituitary adenomas arising from the pituitary stalk. The major complaints of both patients were headaches and visual disturbances. On magnetic resonance imaging, both tumors were suprasellar in location. Gross tumor excision was performed via the pterional approach. The pathologic diagnoses were pituitary adenomas in both patients. The tumors were shown to be non-functioning by immunochemistry analyses. No remnant tumors existed postoperatively on follow-up magnetic resonance imaging. The pituitary stalk was preserved in both cases and pituitary hormonal activity remained intact postoperatively. One patient had normal visual function pre- and post-operatively;the other patient had improvement in the visual field defect and temporal hemianopsia involving the left eye. While there are many case reports involving ectopic pituitary adenomas, pituitary adenomas originating from the pituitary stalk are extremely rare.

가상 환자를 사용한 증강현실 수술 항법 연구

장태수(Tae-Soo Jang),공두식(Doo-Sik Kong),우운택(Woontack Woo) 대한전자공학회 2020 대한전자공학회 학술대회 Vol.2020 No.8

TSA (Endonasal Trans-sphenoidal Approach through Nostril) can be used to remove a pituitary tumor without an incision in the face using an endoscope. Currently performing TSA pituitary tumor surgery is surgery using endoscopic video. In the surgical environment, a zone-type video monitor is using. The video monitor and the monitor of the patient"s medical information navigation system are separated, and thus, there is inconvenient user experience checking different monitors during surgery. This study focuses on improving the discomfort of the user experience by augmented information of the navigation system on the existing endoscopic video. We propose an augmented reality information system using virtual surgical images based on virtual patients using a phantom. Through this, the possibility of navigation technology using augmented medical reality in TSA surgery was confirmed.