1.A clinical study of core decompression for osteonecrosis of the femoral head.
Suk Hyun LEE ; Won Yong SHON ; Jae Suk CHANG ; Wuk Song CHANG ; Kyung Wuk RHA
The Journal of the Korean Orthopaedic Association 1993;28(1):62-69
No abstract available.
Decompression*
;
Head*
;
Osteonecrosis*
2.The Fate of Untreated ACL Insufficient Knee Joint
Hong Chul LIM ; Won Yong SHON ; Wuk Song CHANG ; Eung Joo LEE
The Journal of the Korean Orthopaedic Association 1994;29(1):348-354
The purpose of this study is to access and describe the status of patients with untreated anterior cruciate ligament ruptures to determine if prediction of functional deterioration in these knees were inevitable. 29 patients with rupture of the anterior cruciate ligament verified arthroscopically were evaluated at an average of 3 years and 8 month after injury. This group of patients was selected by the retrospective review in patients who were treated with traumatic ligament injury of the knee joint. The average age at the injury time was 25.9 years ranged from 16 to 44 years and most of injuries occured during sports activities including 12 cases (4196) occured while the patients were playing football. Meniscal lesions were found in 21 cases(72.4%) of all 29 cases of which were 15 cases in the medial, 4 in the lateral and 2 in both side. Follow up functional average score using the Hospital for Special Surgery Knee was 35.8 which would be fall in the Fair range defined as moderate functional disability and depending on the condition of thigh muscle, the functional score was 38.3 in case of less than 2cm atropy of the thigh on the involved side and 32.6 in case of more than 2cm atrophy. There was statistically significant difference (p < 0.05) of the functional score. Reinjuries of the same knee joint were experienced in 22 cases (76%). Rehabilitation of thigh muscles would play an important part in recovery from the injuries.
Anterior Cruciate Ligament
;
Atrophy
;
Follow-Up Studies
;
Football
;
Humans
;
Knee Joint
;
Knee
;
Ligaments
;
Muscles
;
Rehabilitation
;
Retrospective Studies
;
Rupture
;
Sports
;
Thigh
3.A Case of Intrahepatic Cholangiocarcinoma in Polycystic Liver Disease.
Jin Hee SON ; So Young KWON ; Song Wuk SONG ; Ju Hyup YUM ; Jae Min KO ; Myung Soo AHN ; Kyung Woo CHOI ; Hee Jin CHANG
The Korean Journal of Hepatology 1999;5(2):156-161
Cholangiocarcinoma has been associated with various fibrocystic diseases of liver and biliary tract, but cholangiocarcinoma in polycystic liver disease (PLD) was extremely rare. It was reported that the prognosis of cholangiocarcinoma associated PLD was very poor and distant metastases were common. We report a rare case of intrahepatic cholangiocarcinoma associated with PLD in 58- year- old female who presented vague abdominal pain. She had also polycystic kidneys with normal renal function. MRI showed well demonstrated tumor with central scar and a adjacent large cyst in the left lobe of the liver. She underwent extended left lobectomy. On microscopic examination, the tumor was moderately differentiated cholangiocarcinoma having abundant fibrous stroma and necrosis and the adjacent cyst showed focal in situ carcinomatous changes in the lining epithelium.
Abdominal Pain
;
Biliary Tract
;
Cholangiocarcinoma*
;
Cicatrix
;
Epithelium
;
Female
;
Humans
;
Liver Diseases*
;
Liver*
;
Magnetic Resonance Imaging
;
Necrosis
;
Neoplasm Metastasis
;
Polycystic Kidney Diseases
;
Prognosis
;
Cholangiocarcinoma
4.Neurologic Complication Following Spinal Epidural Anesthesia in a Patient with Spinal Intradural Extramedullary Tumor.
Sung Hoon KIM ; Geun Sung SONG ; Dong Wuk SON ; Sang Won LEE
Journal of Korean Neurosurgical Society 2010;48(6):544-546
Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.
Aged
;
Anesthesia, Epidural
;
Female
;
Humans
;
Hypesthesia
;
Knee
;
Magnetic Resonance Spectroscopy
;
Neurologic Manifestations
;
Osteoarthritis
;
Paraplegia
;
Recovery Room
;
Spine
5.Localization of motor speech area by functional MRI during word generation.
Sang Wuk JEONG ; In Chan SONG ; Kyung Min LEE ; Sang Kun LEE ; Kee Hyun CHANG
Journal of the Korean Neurological Association 1998;16(5):654-659
BACKGROUND: Until recently lateralization or localization of language area was possible only by electrical stimulation or Wada test. We describe here a convenient and noninvasive method of language localization with functional magnetic resonance image (MRI). METHOD: Twelve healthy right-handed Korean young volunteers (M:F=9:3, mean age: 24 years) were recruited for this study. We collected brain activation image of 6 slice using gradient echo EPI (Echo-planar imaging) during 8 sets of resting and activation periods. During resting periods, each of 10 Korean nouns composed of two to four syllables was shown continuously every 3 seconds and the subjects were required to simply read the words. The activation task was to generate words as many as possible beginning with the same initial syllable seen on screen without any movement. The data were analyzed using SPM (statistical parametric mapping) and the activated signals were overlayed on a T1-weighed image. RESULT: The activated areas were observed in the perisylvian areas including inferior frontal gyrus and middle superior temporal gyri in 9 subjects. (left in 7, right in 2) Another one subject showed nonsignificant activation in left pre-& postcentral gyrus. The remaining two subjects showed only motion artifacts. Therefore, except motion artifact we localized motor speech areas in 9 of 10 subjects. CONCLUSION: Activation of motor speech area is observed by functional MRI using EPI technique efficiently, quickly and noninvasively. Such functional mapping may have value for the neurosurgical planning.
Artifacts
;
Brain
;
Electric Stimulation
;
Magnetic Resonance Imaging*
;
Volunteers
6.Guillain-Barre Syndrome Following Spinal Fusion for Thoracic Vertebral Fracture.
Dong Wuk SON ; Geun Sung SONG ; Sun Ki SUNG ; Sung Hoon KIM
Journal of Korean Neurosurgical Society 2011;50(5):464-467
There have been very few reports in the literature of Guillain-Barre syndrome (GBS) after spinal surgery. We present a unique case of GBS following spinal fusion for thoracic vertebral fracture. The aim of this report is to illustrate the importance of early neurological assessment and determining the exact cause of a new neurological deficit that occurs after an operation.
Guillain-Barre Syndrome
;
Spinal Fusion
7.An Unusual Case of Post-Operative Spondylitis Caused by Mycobacterium Intracellulare in an Immunosuppressed Patient.
Sung Hoon KIM ; Dong Wuk SON ; Sang Weon LEE ; Geun Sung SONG
Journal of Korean Neurosurgical Society 2011;50(5):460-463
There are few reported cases of post-operative spondylitis caused by Mycobacterium intracellulare. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, Mycobacterium intracellulare was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.
Aged
;
Biopsy
;
Blood Sedimentation
;
C-Reactive Protein
;
Epidural Abscess
;
Female
;
Fever
;
Fractures, Compression
;
Hematoma
;
Humans
;
Low Back Pain
;
Magnetic Resonance Spectroscopy
;
Multiple Organ Failure
;
Mycobacterium
;
Mycobacterium avium Complex
;
Neurologic Manifestations
;
Osteomyelitis
;
Paraparesis
;
Polymerase Chain Reaction
;
Spinal Cord
;
Spondylitis
8.Surgical Management of Syringomyelia Associated with Spinal Adhesive Arachnoiditis, a Late Complication of Tuberculous Meningitis: A Case Report.
Jun Seok LEE ; Geun Sung SONG ; Dong Wuk SON
Korean Journal of Neurotrauma 2017;13(1):34-38
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3. We performed laminectomy from C7 to T1, dissected the arachnoid adhesion and placed a syringo-pleural shunt via keyhole myelotomy. One year after the operation, his neurological condition improved. The postoperative control magnetic resonance imaging revealed the correctly located shunt and significantly diminished syringomyelia cavities. We aim to discuss the mechanism of syrinx formation following tuberculous meningitis and to share our surgical therapeutic experience with this rare disease entity.
Adhesives*
;
Adult
;
Arachnoid*
;
Arachnoiditis*
;
Atrophy
;
Cerebrospinal Fluid Shunts
;
Humans
;
Laminectomy
;
Lower Extremity
;
Magnetic Resonance Imaging
;
Muscle Spasticity
;
Paresis
;
Rare Diseases
;
Spinal Cord
;
Syringomyelia*
;
Tuberculosis, Meningeal*
9.Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature.
Dong Wuk SON ; Geun Sung SONG ; In Ho HAN ; Byung Kwan CHOI
Journal of Korean Neurosurgical Society 2011;50(1):57-59
Intradural extramedullary (IDEM) ependymomas occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 57-year-old woman with an IDEM ependymoma. She was referred for the evaluation of a 4-month history of increasing neck pain and muscular weakness of the left extremities. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an IDEM tumor with spinal cord compression. At the time of surgery, an encapsulated IDEM tumor without a dural attachment or medullary infiltration was noted, but the tumor capsule adherent to the spinal cord and root was left in place to minimize the risk of neurological sequelae. Histologic examination revealed a benign classic ependymoma. The post-operative course was uneventful and radiotherapy was performed. The patient showed an excellent clinical recovery, with no recurrence after 5 years of follow-up.
Ependymoma
;
Extremities
;
Female
;
Follow-Up Studies
;
Humans
;
Hypogonadism
;
Magnetic Resonance Imaging
;
Middle Aged
;
Mitochondrial Diseases
;
Muscle Weakness
;
Neck Pain
;
Ophthalmoplegia
;
Recurrence
;
Spinal Cord
;
Spinal Cord Compression
;
Spine
10.Effectiveness of the Laminoplasty in the Elderly Patients with Cervical Spondylotic Myelopathy.
Doo Kyung SON ; Dong Wuk SON ; Geun Sung SONG ; Sang Weon LEE
Korean Journal of Spine 2014;11(2):39-44
OBJECTIVE: The purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients. METHODS: A retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation. RESULTS: Mean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same. CONCLUSION: We conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group.
Aged*
;
Asian Continental Ancestry Group
;
Hospitalization
;
Humans
;
Orthopedics
;
Retrospective Studies
;
Spinal Cord Diseases*