척수신경 결찰 만성통증모델 및 후신경근 절단 백서의 척수에서 Neuronal Nitric Oxide Synthase(nNOS) 발현에 관한 연구

염진영,김윤,Youm, Jin Young,Kim, Youn 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.7

Objective : The NOS inhibitors exhibit antinociceptive activity in rat model of neuropathic pain. NOS activity increases in the dorsal root ganglia(DRG) in neurop-athic pain. However, NOS activity decreases in the dorsal horn of spinal cord in the nerve injury models of neuropathic pain. To investigate whether the mechanism of decrease of NOS expression in the dorsal horn is related to a secondary effect resulting from increased NO production and likewise in the spinal DRG in the spinal nerve ligation model of neuropathic pain. Methods : We conducted behavioral tests for neuropathic pain, and nNOS immunohistochemistry and NADPH-diaphorase histochemistry after tight ligation of the 5th lumbar(L5) and 6th lumbar(L6) spinal nerves and L5 dorsal rhizotomy. Results : Typical neuropathic pain behaviors occurred 7 days after post-ligation in the neuropathic surgery group, but neuropathic pain behaviors in the dorsal rhizotomy group were absent or weak 7 days after post-operation. There was a decrease in the number of nNOS immunoreactive dorsal horn neurons on the both side(especially ipsilateral side) 7 days after post-ligation. The number of nNOS immunoreactive neurons in both side of the dorsal horn was not decreased 7 days after L5 dorsal rhizotomy. Conclusion : These data indicate that the changes in the injured DRG is essential for development and maintenance of neuropathic pain, and mechanism of decrease of nNOS expression in the dorsal horn is a secondary effect against the changes in the DRG including increased NO production in the spinal nerve ligation model of neuropathic pain.

UAE로 취업한 한인 의료직 종사자의 임상 경험

염진영(Youm Jin-Young),김정수(Kim Jung-Soo) 대한방사선과학회(구 대한방사선기술학회) 2018 방사선기술과학 Vol.41 No.4

This study was intented as an investigation of the meaning of clinical experience for gapproach was used to investigate clinical experience for Korean health professionals, A total of 10 health professional immigrants working in UAE hospitals were selected who has experience in Korea over 2 years and UAE for 1 year. Data were collected through in-depth interviews, participant observation and questionnaire. The findings were created with four essential themes; struggling to adapt at workplace at the beginning, feeling frustrated to communicate with different languages, professional reputations as a specialist, a variety of opportunities for self-development supported from hospitals and caring system of staff’s health. The results indicate that the Korean health professionals were able to develop capabilities and competency with clinical experience in UAE hospitals. The results of this study suggest that lived experimental evidence for Korean migrants of health professionals. A further direction of this study, will be expected to provide more experimental in-formation for health professional immigrants to middle east.

신경초종과 유사한 아령형 형태의 상부경추 골외 척추척삭종 1례 - 증례보고 -

백원철,염진영,김선환,고현송,송시헌,김윤,Baek, Won-Cheol,Youm, Jin-Young,Kim, Seon-Hwan,Koh, Hyeon-Song,Song, Shi-Hun,Kim, Youn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

The authors report a case of an extremely rare extraosseous chordoma in the upper cervical spine of a 70-year-old woman, which occupied the intradural and extradural portions, simultaneously. She underwent the operation with C2,3 total laminectomy and grossly total removal and postoperative radiation therapy. Extraosseous chordoma was very rare in the literatures. In addition, it was the first reported case of the extraosseous chordoma occupeid the intradural and extradural portions, simultaneously. And extraosseous chordoma must be distinguished from ecchordosis physaliphora, which is benign nature, usually asymptomatic.

자발성 뇌실질내 출혈 환자에서 혈종 증가의 위험 인자에 대한 분석

이용묵,고현송,염진영,김성호,송시헌,김윤,Lee, Yong-Mook,Koh, Hyeon-Song,Youm, Jin-Young,Kim, Seong-Ho,Song, Shi-Hun,Kim, Youn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

반복적인 소뇌 출혈로 발현한 후두와 모세혈관 확장증 - 증례보고 -

이용묵,고현송,조준희,염진영,송시헌,김윤,Lee, Yong-Mook,Koh, Hyeon-Song,Cho, Jun-Hee,Youm, Jin-Young,Song, Shi-Hun,Kim, Youn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Hemorrhage due to capillary telangiectasia is rare. We report a case of capillary telangiectasia presenting with repeated cerebellar hemorrhage in a 38-year-old male. To our knowledge this is the first case of repeated cerebellar hemorrhage from the capillary telangiectasia. At the first operation, we removed hematoma only, but rebleeding occurred repeatedly in the same area. Finally, we evacuated the recurrent hematoma and vascular mass of capillary telangiectasia at the second operation under surgical microscope. Based on the findings of this case and a review of the literature, we conclude that capillary telangiectasia can be the cause of the massive repeated hemorrhage.

뇌동맥류 파열에 의한 지주막하 출혈 후 수두증 발생의 위험 인자에 대한 임상 연구

최정재,고현송,조준희,김선환,염진영,송시헌,김윤,Choi, Jeong-Jae,Koh, Hyeon-Song,Cho, Jun-Hee,Kim, Seon-Hwan,Youm, Jin-Young,Song, Shi-Hun,Kim, Youn 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.12

Objective : The authors analyzed the incidence, the cause and the prognosis of hydrocephalus following aneurysmal subarachnoid hemorrhage to evaluate the risk factors of hydrocephalus and to provide the proper treatment method for hydrocephalus following aneurysmal subarachnoid hemorrhage. Methods : The 505 cases of subarachnoid hemorrhage followed by aneurysmal surgery from January 1990 to May 1999, were divided into shunt group and shunt-free group and we were reviewed for the clinical status, Fisher's grade, brain CT findings and prognosis. Results : The incidence of acute hydrocephalus was 37.2% of patients and 18.9% to developed chronic hydrocephalus. Shunt surgery due to chronic hydrocephalus was required in 6.5% of patients. We found following variables were significantly related to shunt-dependent hydrocephalus : high Hunt-Hess and Fisher grade, initial CT findings of intraventricular hemorrahge, posterior circulation aneurysm, preoperative rebleeding, delayed ischemic deficits, and initial high ventricular size index. There were no statistically significant relationships between shunt-dependent hydrocephalus and patient age or sex, timing of operation. The previous hypertension was not related to shunt dependent hydrocephalus. Prognosis in shunt group showed poor result. Conclusion : The risk factors of hydrocephalus following aneurysmal subarachnoid hemorrhage are high Hunt-Hess grade, high Fisher's grade, aneurysms of posterior circulations, preoperative aneurysmal rebleeding, delayed ischemic deficits, initial CT findings of intraventricular hemorrahge and initially increased ventricular size. The patients with these factors should the carefully observed and managed accordingly due to poor prognosis related to hydrocephalus requiring shunt operation.

연수의 낭종성 혈관아세포종 1예 -증례보고-

김선환 ( Seon Hwan Kim ),송시헌 ( Shi Hun Song ),고현송 ( Hyeon Song Koh ),염진영 ( Jin Young Youm ),김윤 ( Youn Kim ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.1

Hemangioblastomas of the medulla oblongata are benign vascular neoplasms that malignantly locate. Most of tumors are solid and cystic natures are extremely rare in medulla oblongata. We experienced a cystic hemangioblastoma located in medulla oblongata and successful treated by surgical excision. A 47-year-old man with a 3-months history of paresthesia on left upper extremity and trunk. MRI revealed a cystic mass with enhancing small nodule on dorsal portion of medulla oblongata. Using a suboccipital craniectomy the tumor was totally removed. The authors report a rare case of cystic hemangioblastoma in medulla oblongata and review the literatures.

임상 : 천막상부 수술 후 발생한 소뇌출혈에 대한 임상 분석

전기현 ( Ki Hyun Jeon ),김선환 ( Seon Hwan Kim ),고현송 ( Hyun Song Koh ),염진영 ( Jin Young Youm ),송시헌 ( Shi Hun Song ),김윤 ( Youn Kim ) 대한뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.1

Objective￡ºCerebellar hemorrhage after supratentorial surgery is a very seldom but serious complication. The purpose this study is to analyze the available clinical data on cerebellar hemorrhage after supratentorial surgery and apply them treatment for the better prognosis. Methods￡ºBetween 1995 and 2004, we experienced 5 cases of cerebellar hemorrhage after supratentorial surgery. analyzed the data of 71 cases of cerebellar hemorrhage after supratentorial surgery about demographics, radiologic findings, risk factors, treatments and prognosis via retrospective study(5 from our records and 66 from the literature). Results￡ºThe incidence of cerebellar hemorrhage after supratentorial surgery is 0.2% in the literature and 0.17% in hospital. Twenty two patients(30.9%) were operated on for aneurysms, and 21 patients(29.5%) were operated on tumors. Sixty cases were positioned supine with head rotation and 58 cases underwent cerebrospinal fluid drainage during surgery. Cerebellar hemorrhage after supratentorial surgery carries a mortality of about 22%. Conclusion￡ºRemote cerebellar hemorrhage most commonly follows supratentorial surgery, performed with the patient in the supine position with head rotation, that involve opening of cerebrospinal fluid cisterns or the ventricular system. The most important keys to minimize this hazardous sequela are to be aware of this potential complication, diagnose early and treat it promptly.

후두개와 수술 후 경막 하 콜라겐 매트릭스 이식술의 뇌척수액 유출 방지에 대한 효용성

정은오(Eun-Oh Jeong),김선환(Seon-Hwan Kim),임정욱(Jeong-Wook Lim) 권현조(Hyon-Jo Kwon),최승원(Seung-Won Choi),고현송(Hyeon-Song Koh),염진영(Jin-Young Youm),송시헌(Shi-Hun Song) 대한두개저학회 2016 대한두개저학회지 Vol.11 No.2

Objective : Complete protection from CSF(cerebrospinal fluid) leakage after posterior fossa surgerywas difficult, although many variable methods has been performed. Collagen matrix is product toprotect dura defect and prevent CSF leakage. The authors performed collagen matrix underlay graftand identified effectiveness of this technique for CSF sealing.Methods : The authors evaluated 92 posterior fossa surgery used fibrin glue, polyethylene glycol(PEG) sealant, fibrinogen based collagen fleece, collagen matrix between January 2006 andDecember 2015. CSF leakage incidence according to use of variable dura sealing materials wasassessed.Results : CSF leakage occurred 8 cases(8.7%) in 92 posterior fossa surgery. CSF leakage didn’toccur in 42 cases underwent collagen matrix underlay graft. Cases of fibrin glue, polyethyleneglycol(PEG) sealant, fibrinogen based collagen fleece had effect of CSF leakage block, howeverdidn’t have significant difference according to use of this materials.Conclusion : Collagen matrix underlay graft after posterior fossa surgery didn’t have complicationsuch as chemical injury and infection and had effect of CSF sealing.

뇌실질내 기생한 Sparganum증 1예

염진영,김태동,송시헌,김관태,김윤 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.3

A patient is reported with sparganosis of the intracerebral region involving sparganum mansoni. This 40-year-old man had complained of focal motor seizure in right exitremities during the 18 months before operation. Brain CT scan revealed worm-like linear enhancement in left frontoparietal area. Left frontoparietal osteoplastic craniotomy was performed and a live sparganum mansoni was successfully removed from intracerebral region. This is very rare case in which a live sparganum mansoni was removed from the intracerebral region.