1.Traumatic Disc Injuries and the Iatrogenic Spinal Disability.
Kyeong Seok LEE ; Jae Won DOH ; Seok Mann YOON ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Neurosurgical Society 2000;29(7):935-939
No abstract available.
3.Morphometric Study of the Lumbar Posterior Longitudinal Ligament
Sang Beom LEE ; Jae Chil CHANG ; Gwang Soo LEE ; Jae Chan HWANG ; Hack Gun BAE ; Jae Won DOH
Journal of Korean Neurosurgical Society 2018;61(1):89-96
OBJECTIVE: Morphometric data for the lumbar posterior longitudinal ligament (PLL) was investigated to identify whether there is a difference in the morphometry of the PLL of the lumbar spine at each level with respect to the pattern of intervertebral disc displacement.METHODS: In 14 formalin-fixed adult cadavers (12 males and 2 females), from L1 to L5, the authors measured the width and height of the PLL and compared them with other landmarks such as the disc and the pedicle.RESULTS: Horizontally, at the upper margin of the disc, the central portion of the superficial PLL covered 17.8–36.9% of the disc width and the fan-like portion of the PLL covered 63.9–76.7% of the disc width. At the level of the median portion of the disc, the PLL covered 69.1–74.5% of the disc width. Vertically, at the level of the medial margin of the pedicle, the fan-like portion of the PLL covered 23.5–29.9% of the disc height. In general, a significant difference in length was not found in the right-left and male-female comparisons.CONCLUSION: This study presents the morphometric data on the pattern of intervertebral disc displacement and helps to improve the knowledge of the surgical anatomy of the lumbar PLL.
Adult
;
Cadaver
;
Humans
;
Intervertebral Disc Displacement
;
Longitudinal Ligaments
;
Lumbar Vertebrae
;
Male
;
Spine
4.Clinical Analysis of Stereotactic Aspiration and Conservative Management in Spontaneous Thalamic Hematoma.
Cheon Hyun NAM ; Jae Kyu KANG ; Jong Oung DOH ; Chun Dae LEE
Journal of Korean Neurosurgical Society 2001;30(2):156-162
OBJECTIVES: The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. METHODS: The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows: age and sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. RESULTS: The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows: good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age and sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. CONCLUSION: Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
Craniotomy
;
Hematoma*
;
Hemorrhage
;
Humans
;
Internal Capsule
5.Surgical Experience of Cervical Spine Injury.
Kyeong Seok LEE ; Jae Won DOH ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Neurosurgical Society 1995;24(12):1520-1529
Development of new surgical devices and approaches for management of injuries to the cervical spine has offered various methods of treatment available. Making it is not easy in choosing the most suitable method of treatment. We present our experience and results of 90 operations performed during the past eight-year-period(1986-1993) including 10 halo-vest applications. The timing of operation was within 7 days posttrauma in 34.2%, 8-14 days in 27.4%, 15-28 days in 1.0%, and over 28 days in 27.4%. In 18 cases of upper(C1-3) cervical spine injuries, 23 operations were performed, all approached from the posterior. In 5 cases of lower(C4-7) cervical spine injuries, 67 operations were performed, the anterior approach used in 33 patients and the posterior approach in 18 patients. Halo-vest was applied in 6 patients with upper cervical spine injuries and in 4 patients with lower cervical spine injuries. The halo-vest was inadequate in maintaining the stability of the injured spine in 5 out of 0 cases. The complication rate was 23.3% in postrior approaches and 32.4% in anterior approaches. Overall, 27 complications(0%) occurred in 90 operations, and the reoperation rate was 16.4%(85 operations for 73 patients, except for the halo-vest applications). Internal fixation with a variety of devices has become a popular procedure for ervical spine injuries. Despite the popular and wide usage of such devices, the occurrence of complications and the need to reoperate has rendered the procedure to be applied with much caution regarding its technical aspects and possible problems it may pose. In our study, the rate of reoperation and complications following such procedures were quite high. We conclude that in choosing the most proper surgical approach for ervical spine injuries with minimal occurrence of any complications, a stringent criteria should be adhered to rather then easily select the more fashionable, new of fancy devices over the traditional techniques.
Humans
;
Reoperation
;
Spine*
6.Primary Infections Disorders of the Spine:Report of 40 Cases.
Kyeong Seok LEE ; Jae Won DOH ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Neurosurgical Society 1996;25(8):1655-1660
Although the prevalence of infectious disorders has been decreased, tuberculous infections are still common in this country. Therefore epidemiological data for the correct diagnosis of some spinal infections and proper selection of susceptible antibiotics are necessary. We presented a series of 40 patients with primary spinal infection dated from January 1990 to December 1994. Tuberculosis was the most common infection constituting 85% of this series, while pyogenic infection constituted only 10%, and primary discitis shared 5%. In a half of the tuberculous spondylitis, there were histories of previous tuberculosis except the vertebrae. We could identify the pathogenic organisms in only 47.5% o the cases(in 4 of 6 pyogenic infection and 15 of 34 tuberculous infection). Since it is difficult to differentiate the pyogenic and tuberculous infections by clinical or radiological features alone, some pyogenic infections might have been regarded as tuberculous, although the pyogenic spinal infections are rare. Nevertheless the tuberculous spinal infection outnumbered pyogenic ones in this country, which is similar to the patterns of other third-world countries. Therefore, correct identification of the microbial agent is important not only for the proper treatment but also to evaluate the patients of primary spinal infections in this country.
Anti-Bacterial Agents
;
Developing Countries
;
Diagnosis
;
Discitis
;
Epidemiology
;
Humans
;
Prevalence
;
Spine
;
Spondylitis
;
Tuberculosis
7.A Giant Aneurysmal Cerebral Arteriovenous Malformation in Childhood: Case Report.
Jong Oung DOH ; Yoon Sun HAHN ; Young Soo KIM ; Han Jae LEE
Journal of Korean Neurosurgical Society 1977;6(1):79-86
A giant aneurysmal cerebral arteriovenous malformation in the left parieto-occipital region is described in a 4 year old child, including resolution of the alternating hemiparesis and left ventricular hypertrophy of the heart following successful removal of the malformation by microsurgical technique. This arteriovenous malformation has a large aneurysmal sac, 6x5x4cm, in size with several feeders from branches of the left middle and posterior cerebral arteries and drains directly into the straight sinus. So we have proposed to call it "a giant aneurysmal cerebral arteriovenous malformation".
Aneurysm*
;
Arteriovenous Malformations
;
Child
;
Child, Preschool
;
Heart
;
Humans
;
Hypertrophy, Left Ventricular
;
Intracranial Arteriovenous Malformations*
;
Paresis
;
Posterior Cerebral Artery
8.A study of serum and urine protein eleptrophoresis in patients with idiopathic nephorotic syndrome.
Jae Seok KIM ; Ju Il LEE ; Hyun Kuk DOH ; Seong Eun KIM ; Ki Hyun KIM ; Jong Seong KIM
Korean Journal of Medicine 1993;45(5):622-630
No abstract available.
Humans
9.Clinical Features and Outcome of Low Back Pain in Out-Patient Department.
Kyeong Seok LEE ; Jae Won DOH ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Neurosurgical Society 1996;25(6):1209-1216
The following is our report a series of 220 patients who visited the neurosurgical out-patient department from January 1994 to June 1994 complaining of low back pain. We investigated how they were treated and what was the outcome on December 1995. Three certified neurosurgeons had managed these patients. Although the patients were not significantly different in terms of age, sex, and the duration of pain, the diagnostic methods(p<0.005), impression(p<0.01), and the methods of treatment(p<0.01) differred from doctor to doctor. The rates of admission and operation were 11.8% and 7.3%, respectively, and found to be consistent among doctors. We conducted telephonic interviews of 123 patients during December 1995 with the following outcome : improved in 69.1%, unchanged in 22.0%, and aggravated in 4.1%, together with six(4.9%) deaths. The cause of death was cancer in four cases, respiratory failure in one, and unknown in one. Sixteen patients underwent surgery in this hospital, while the other 12 patients were operated on in other hospitals. The outcome was favorable when 1) the patients were female, 2) the age was 21-40 years old, 3) presence of sciatica, 4) the duration was 1 week to 3 months, 5) the diagnostic impression was herniated lumbar disc, 6) drugs were not prescribed, and finally 7) managed by senior doctor. However, these differences were statistically not significant(p>0.1). Although low back pain is a very common complaint, there was enormous ambiguity with respect to its diagnosis and management. Neverthless, the outcomes were not significantly different. Despite the above, we still feel that low back pains should be more systematically classified and precisely dignosed. Also the therapeutic efficacies of different modalities of treatment should be critically reviewed.
Cause of Death
;
Diagnosis
;
Female
;
Humans
;
Low Back Pain*
;
Outpatients*
;
Respiratory Insufficiency
;
Sciatica
10.Self-reported Pain Intensity and Disability Related to Sleep Disturbance and Fatigue in Patients with Low-Back Pain.
Kyeong Seok LEE ; Jae Won DOH ; Hack Gun BAE ; Il Gyu YUN
Journal of Korean Neurosurgical Society 1999;28(4):470-474
Low back pain is one of the most common symptoms in medical practice. Differential diagnosis of back pain is complicated, however. Self-reported pain intensity and disability may affect on the decision for diagnosis or therapy. Exaggerated symptoms may cause unnecessary investigations or even surgical interventions. Self-reported pain intensity and disability are not in proportion to the objective physical findings. We investigated the relationship between self-reported pain intensity or disability and sleep disturbance or fatigue. The study was conducted as a survey using a questionnaire from November 1997 to March 1998. The survey included consecutive 368 patients who visited the neurosurgical out-patient department complaining of low back pain. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. By multiple regression analysis, self-reported pain intensity corresponded best with the sleep disturbance. Age and fatigue were also related to the pain intensity. There was no good agreement between pain intensity and region or duration of the pain, appetite or indigestion. Disability corresponded best with the sleep disturbance. Fatigue, appetite, and indigestion were also related to the disability. There was no good relationship between disability and region or duration of the pain, or age. Self-reported pain intensity and disability are related to the psychological distress represented as sleep disturbance, fatigue, poor appetite or indigestion. Inquiring about sleep or fatigue is important to understand the underlying psychological condition, which may exaggerate pain intensity and disability.
Appetite
;
Back Pain
;
Diagnosis
;
Diagnosis, Differential
;
Dyspepsia
;
Fatigue*
;
Humans
;
Low Back Pain
;
Outpatients
;
Surveys and Questionnaires
;
Spine
;
Visual Analog Scale