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Experimental Trial for the Prevention of Adhesion with Dural Substitutes in Craniectomy State.

Young Jo CHA ; Si Hun SONG ; Seong Ho KIM ; Kwan Tae KIM ; Youn KIM

Journal of Korean Neurosurgical Society.1993;22(11):1167-1174.

In a series of rabbits, two craniectomies were made in both side of the parietal hone. Each lesion was filled with gelfoam, lyocura, fat and dural film. Five rabbits were left empty as a control group. The animals were killed in one month after the operation. The degree of adhesion between the soft tissue of the scalp and various dural substitute was evaluated at the time of operative dissection and studied histopathologically. The results were as follows. 1) The insertion of dural substituted substances can prevent the adhesion between the scalp and dura mater. 2) The dural film was most effective in prevention of adhesion. 3) The dural film inserted group exhibited inflammatory reaction. 4) The gelfoam, lyodura and fat inserted groups were though to have had a moderate prevention effect of adhesion. With these results, we could conclude that the insertion of material between the dura and scalp can prevent adhesion. However the ideal inserted material which can pevent inflammatory reaction and adhesion has not been determined. At this point we have not found and ideal substitute. To get an ideal material for prevention of adhesion, further intensive study is required.
Animals ; Dura Mater ; Gelatin Sponge, Absorbable ; Rabbits ; Rabeprazole ; Scalp

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A Stereotactic Device for Gamma Knife Irradiation to Cell Lines.

Hyun Tai CHUNG ; Jeong Eun KIM ; Dong Gyu KIM ; Hee Won JUNG

Journal of Korean Neurosurgical Society.2004;35(6):639-642.

OBJECTIVE: The purpose of this work is to build a well-plate holder for in vitro gamma knife irradiation to cell lines and to verify its validity. METHODS: A well-plate holder for gamma ray irradiation to cell lines using gamma knife was made of acrylonitrile. Inside the holder, a hexahedral space was excavated to hold well plates. The actual radiation dose to cell lines was obtained by comparing the relative dose of the holder with the gamma knife quality assurance standard phantom. All parameters necessary for cell line irradiation were calculated using the commercial software, Leksell Gamma Plan(R) v5.32. Dose distribution was drawn to six and ninety-six wells to search for optimal parameters for cell line irradiation. RESULTS: The dose rate at the center of the well-plate holder was 94+/-4% of the standard phantom and resulting absolute dose at the central area was 2.1+/-0.1Gy/min. The dose distributions of our phantom was the same as that of the standard phantom in qualitative comparison using an image analyzing software. Appropriate isodose lines which fit with the practical situation were obtained with the 18mm collimator of the Gamma knife. CONCLUSION: Our results show that a well-plate holder for gamma knife irradiation is confident and accurate. It can be used for the study of in vitro cellular effects by gamma knife irradiation in the future.
Acrylonitrile ; Cell Line* ; Gamma Rays

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Persistent Autonomic Hyperfunction Following Hypertensive Intracerebral Hemorrhage.

Seung Joon LEE ; Chun Kee CHUNG

Journal of Korean Neurosurgical Society.2004;35(6):636-638.

Persistent autonomic hyperfunction is not well-recognized disease entity. Recently the authors experienced one case following hypertensive intracerebral hemorrhage in the basal ganglia. It was manifested as storms of hypertension, tachycardia, hyperthermia, severe diaphoresis, hyperventilation and decerebrate posture. Extensive investigations on infection, pheochromocytoma or status epilepticus revealed no abnormalities. Medications including antibiotics, antipyretics and antiepileptic agents were administered, but in vain. However, intravenous morphine infusion managed to stabilize his conditions. To our knowledge, the present case is the first one to be thermographed, and is the second case next to Rossitch's report of autonomic dysfunction following intracerebral hemorrhage.
Anti-Bacterial Agents ; Anticonvulsants ; Antipyretics ; Basal Ganglia ; Cerebral Hemorrhage ; Fever ; Hypertension ; Hyperventilation ; Intracranial Hemorrhage, Hypertensive* ; Morphine ; Pheochromocytoma ; Posture ; Status Epilepticus ; Tachycardia

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Hemorrhagic Cerebral Metastases from Hepatocellular Carcinoma: Presumptive Role of Minor Head Trauma.

Sung Bum KIM ; Hyeong Joong YI ; Yong KO ; Suck Jun OH

Journal of Korean Neurosurgical Society.2004;35(6):631-635.

We report two cases of cranial metastasis hepatocellular carcinomas in young adults of their early 30s, with intracerebral hemorrhage. Both patients experienced minor head trauma several days before the onset of neurological deterioration. Detailed description of cases and review of the relevant literatures are presented with emphasis on the presumptive role of minor head trauma and pertinent magnetic resonance features.
Carcinoma, Hepatocellular* ; Cerebral Hemorrhage ; Craniocerebral Trauma* ; Head* ; Humans ; Neoplasm Metastasis* ; Young Adult

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Respiratory Arrest due to Tension Pneumoperitoneum and Pneumomediastinum without Pneumothorax: Complication of the Lumbar Spinal Surgery.

Seung Ho LIM ; Jae Kyu KANG ; Jong Woong DOH

Journal of Korean Neurosurgical Society.2004;35(6):628-630.

The authors present a case of respiration arrest after posterior lumbar interbody fusion. This rare complication occurred because of the tension pneumoperitoneum and pneumomediastinum. We report the pathophysiology and treatments.
Mediastinal Emphysema* ; Pneumoperitoneum* ; Pneumothorax* ; Respiration

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Vertebral Artery Injury Following Blunt Trauma to the Cervical Spine Case Report and Literature Review.

Choong Hyo KIM ; Keun Tae CHO ; Chun Kee CHUNG

Journal of Korean Neurosurgical Society.2004;35(6):625-627.

Vertebral artery injury may occur following blunt trauma to the cervical spine and can produce severe neurological deficit. We report upon two patients having vertebral artery injury following blunt trauma to the cervical spine. The first one developed a cerebellar infarct and the second cervical cord ischemia. The possibility of vertebral artery injury should be considered in patients with cervical spine injury, especially in those having a subluxation or fracture of the facet joint. Early signs of vertebral artery injury may be silent. Non-invasive techniques, such as magnetic resonance angiography should be utilized in such cases.
Humans ; Ischemia ; Magnetic Resonance Angiography ; Spine* ; Vascular System Injuries ; Vertebral Artery* ; Wounds, Nonpenetrating ; Zygapophyseal Joint

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Traumatic Thoracic Spondyloptosis: A Case Report.

Chul Woo LEE ; Sun Chul HWANG ; Soo Bin IM ; Bun Tae KIM ; Won Han SHIN

Journal of Korean Neurosurgical Society.2004;35(6):622-624.

The thoracic spine is rigidly stabilized by the ribs, anterior and posterior longitudinal ligaments, and a sagittal orientation of the facet joints that resists axial rotation and horizontal translation. Thus, a significant force is required to cause a fracture and dislocation in the thoracic spine. A 32-year-old man was involved in a motor-vehicle accident and presented with complete paraplegia and spondyloptosis on the 8th thoracic vertebral segment. He also suffered with hypoxia and hypovolemic shock. Posterior reduction and fixation with pedicle screw was achieved with the anatomic alignment and rigid stability. This posterior technique for thoracic spondyloptosis is believed to be sufficient to make good alignment and solid fixation.
Adult ; Anoxia ; Dislocations ; Humans ; Longitudinal Ligaments ; Paraplegia ; Ribs ; Shock ; Spine ; Zygapophyseal Joint

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Posterior Short Segment Fixation and Fusion in a Displaced Hangman's Fracture.

Jae Taek HONG ; Sang Won LEE ; Byung Chul SON ; Moon Chan KIM

Journal of Korean Neurosurgical Society.2004;35(6):618-621.

Although most cases of C2 traumatic spondylolisthesis, a so called Hangman's fracture, can be managed by a closed reduction and immobilization, surgery should be considered in the cases of non-reducible fractures or a recurrent subluxation. This report details our recent experience with the surgical treatment of a Type II Hangman's fracture after an unsuccessful closed reduction. Advantage and the technique of the posterior short segment fixation are discussed.
Immobilization ; Spondylolisthesis

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Endoscopic Multiple Wide Fenestrations of Intraventricular Arachnoid Cyst Arising in Lateral Ventricle.

Seung Jin CHOI ; Cheol JI ; Jae Geun AHN ; Moon Chan KIM

Journal of Korean Neurosurgical Society.2004;35(6):614-617.

Intraventricular arachnoid cyst is an uncommon disease and a few surgical experiences have been reported. The authors present an experience of neuroendoscopic surgery in a 4-year-old-male patient with a large arachnoid cyst arising from the right lateral ventricle, who had suffered from generalized tonic clonic seizure. On operation, various portions of the cyst could be easily approached without unwanted parenchymal injury because most of the cystic membrane was movable and not adherent to the ventricular wall except choroid plexus area, which could be considered as origin site of the cyst. Marked shrinkages by electrocoagulation and multiple wide fenestrations of the cyst were obtained through the endoscopic working channel without difficulty. Postoperative brain computed tomography demonstrated decreasing ventricular size with no evidence of cystic recurrence. The postoperative course was uneventful for eight months follow-up period. We suggest that endoscopic procedure has definite advantages as the surgical method of choice for the treatment of intraventricular arachnoid cysts.
Arachnoid Cysts ; Arachnoid* ; Brain ; Choroid Plexus ; Electrocoagulation ; Follow-Up Studies ; Humans ; Lateral Ventricles* ; Membranes ; Recurrence ; Seizures

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Alterations of Spontaneous Behaviors and the Neuronal Activities of the Deep Cerebral Nuclei by Subthalamic Lesion with Kainic Acid in Rat Parkinsonian Models with 6-hydroxydopamine.

Jong Hee CHANG ; Yong Sook PARK ; Mi Fa JEON ; Jin Woo CHANG ; Yong Gou PARK ; Sang Sup CHUNG

Journal of Korean Neurosurgical Society.2004;35(6):605-613.

OBJECTIVE: The purpose of this study is to investigate the effect of ipsilateral subthalamic nucleus(STN) lesioning on the spontaneous behavioral changes and the alteration of neuronal activities of deep cerebral nuclei in the rat parkinsonian model with 6-hydroxydopamine(6-OHDA). METHODS: To identify the spontaneous behavioral changes, apomorphine-induced rotational test and forepaw adjusting step were performed. We subsequently investigated the alteration of neuronal activities in the substantia nigra pars reticulata(SNpr) and globus pallidus(GP), in order to compare them with the behavioral changes in rat parkinsonian models. RESULTS: The STN lesioning in the rat parkinsonian model clearly improved behavioral changes. Compared to the normal control rats, rat PD models exhibited a significant increase in mean firing rates and the percentage of bursting neurons in the STN and SNpr. In the STN-lesioned rat PD models, mean firing rates and the percentage of bursting neurons in the SNpr were reduced and those in the GP increased. CONCLUSION: STN lesioning induced behavior improvement in rat parkinsonian models seems to be consistent with the surgical outcomes of the STN stimulation therapy in advanced Parkinsonn's disease(PD). The alteration of the neuronal activities in the SNpr and GP suggests that these sites are responsible for the improvement of parkinsonian motor symptoms observed following STN lesioning in rat parkinsonian models. The significance of bursting activity in the SNpr and GP remains obscure. Further study is necessary to elucidate the pathophysiological mechanism of PD.
Animals ; Fires ; Globus Pallidus ; Kainic Acid* ; Neurons* ; Oxidopamine* ; Parkinson Disease ; Rats* ; Substantia Nigra ; Subthalamic Nucleus

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