외상성 뇌경막하 활액낭종의 임상적 고찰

박정율,서중근,이훈갑,이기찬,주정화 대한신경외과학회 1987 Journal of Korean neurosurgical society Vol.16 No.4

The authors a series of 40 cases of traumatic subdural hygroma and discuss the clinical and radiological features, management, surgical results, and pathogenesis. The "simple hygroma" accounted for majority of cases(78%) and among "complex hygroma" cases, subdural hematoma was most often accompanied. Skull fractures was found in 33% of cases. Bilateral subdural hygroma were seen in 67% and delayed onset were noted in 10 cases(25%). Changes in mental status without focal signs of neurologic deficit was noted in over 50% of cases. Although 75% of cases showed full recovery, clinical course marked by persistence of neurologic dificit was noted in 12.5% of cases. Operation was underwent in 72% and simple burr hole drainage was done in most of cases. Reaccumulation rate was relatively high(27.5%) after initial operation. The mortality rate was 12.5%.

흥분성 신경전달물질의 Cortical Spreading Depression 유발에 대한 실험적 연구 : 대뇌피질 국소 도포를 위한 새 실험 모형 new topical application model

박정율,이기찬,이훈갑 고려대학교 의과대학 1995 고려대 의대 잡지 Vol.32 No.2

The purpose of this study was to devise a new model for topical application of chemical substances to rat cerebral cortex that successfully and repeatedly initiated the CSD in conjunction with responses from various excitatory amino acids(EAAs). Various EAA agents, including glutamate itself, that act on single or multiple subtypes of EAA receptor were examined; kainate, aspartate, N-methyl-D-aspartate (NMDA), quisqualate, and alpha-amino-3 -hydroxy- 5-methyl-4-isoxazole-propriate (AMPA). Through the model with a specially designed well buried in 1.5 mm depth of the cerebral cortex, these chemical agents were topically applied to the cortical gray matter. Dose of EAA between 10^(-7) and 10^(-4) M concentration were escalated for triggering the CSD and its rate of consistency in triggering was also evaluated. Total of 50 Sprague-Dawley rats were used and divided into seven groups including the sham group. The results are as follows: 1. CSDs were repeatedly initiated in all experimental groups with relatively consistent rates. Duration of CSDs were 1 - 4 minutes(mean 2.2±1.4) and amplitudes were 20 - 40 mV. 2. Effective dose_(50)(ED_(50)), that trigger over 50% of CSD, was 10^(-5) M(n=8) for glutamate, 10^(??) M(n=8) for aspartate, 10^(-5) M(n=7) for quisqualate, and 10^(??) M(n=7) for NMDA and kainate group. 3. Among those acting on the single receptor. AMPA was shown to be the most effective in triggering CSD, and NMDA, and kainate were in descending orders. Aspartate, that was known to act on multiple EAA receptors, showed highest rate of triggering CSD among all groups, but glutamate, known to act on all receptors of its subtypes, showed most consistent rate of triggering CSD at dose escalation study. Some of possible factors that might be involved in these results would be the difference in number of receptors presented in various regions of cerebral cortex, receptor-specificity of various EAAs, and the mode of triggering of CSD, etc.. Results from present study showed that it was possible, by using newly devised in vivo rat model for topical application of chemical agents to the cerebral cortex, not only to initiate but also repeatedly produce CSDs without additional injuries to the cortex.

동적, 실시간 체열촬영술

박정율 대한체열학회 2003 대한체열진단학회지 Vol.3 No.1

만성 불응성 통증에 대한 고주파 치료

박정율,박동혁 대한노인병학회 2001 대한노인병학회지 Vol.5 No.4

2세 이하 소아에서의 두부외상

박정율,이자규,박윤관,정홍섭,이기찬,이훈갑 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2

The most common cause of head injury in the first two years of life is a fall. This is usually from a low height, frequently onto a soft surface, and is rarely associated with neurological disturbance or intracranial damage. The brain and intracranial compartment undergo a multiplicity of physiologic and anatomical changes which influence the type of head injury and response to such injury, especially for those in first two years of age. Purpose of this study is to retrospectively analyze the clinical result of 68 cases of such age group admitted to our department due to head injuries and to evaluate the various clinical parameters influencing the outcome. The mean duration of admission period was 15 days and mean duration of follow-up period 29.4 months. Most common mode of injury was from stairway injury(32.3%), followed by in-car accident (19.1%). with suspected child abuse being only 2.9%. Cerebral contusion was the most frequent diagnosis being 43 cases(63.2%), followed by skull fracture in 31 (45.6%). For the outcome related to various categories, 5 cases of death were due to diffuse axonal injury or intracranial hemorrhage, but most simple linear fractures were not associated with underlying brain injury. Among those required the operation (18 cases), subdural and/or epidural hematoma were the most common pathology (50%), followed by subdural hygroma and depressed skull fracture. The outcome, however, was not related to type of pathology. Instead, it was rather closely related to the initial PGCS. The PGCS at admission was found out to be the major predicting factor to outcome. In overall, 34/36(94.4%) cases with normal PGCS in these age groups showed good recovery with deaths being 5/7(71.4%) cases of PGCS≤5 at admission. The good recovery in these age groups regardless of causes was 73.5% but the mortality rate was 10.3%. The specific clinical parameters related to bad outcome were hypoxia, shock, anisocoria, and bilateral abnormal light reflex. Parameters such as anemia, hypo- or hyperthermia, hypotension, seizure did not directly influence the outcome.

근적외선을 이용한 두개강내 혈종의 진단

박정율,홍기선,김상대,김세훈,임동준,조태형 대한체열학회 2003 대한체열진단학회지 Vol.3 No.1

만성 요통의 진단과 치료

박정율 대한가정의학회 2001 Korean Journal of Family Medicine Vol.22 No.9

의학교육에 있어서의 Tutorial System : 학내 도입을 위한 제의 Proposal for Introduction to Current Curriculum

박정율,이기찬,이훈갑,채병국,유세화,최종상,조재홍 고려대학교 의과대학 1997 고려대 의대 잡지 Vol.34 No.2

Tutorial system in medical education in general is a system which deals with problem-oriented, self-directed, and small group learning to encourage students to assume responsibility for their own learnings and to provide capabilities to cope with the environment where greater expansion of medical knowledge is being piling up. But it is not just another system to tried out in short time. Rather it requires a new curriculum with many different types of resources and requires certain period of time to evaluate the effects and drawbacks. Each medical school should customize upon its basic status of current system when in attempt to adapt this system. The purpose of this study was first to review the basic concept of this system and prerequisites for the introduction of an ideal and practical model for our institution. Basic resources in medical school and medical center were reviewed and evaluated. Then, short- and long-term ideal plan for future curriculum based on present status is proposed. Although situation in our medical school is in the stage of advancement both academically and structurally, authors believe that our school should adapt this system in a customized fashion for the time being and improve upon the method of applying as it fits in place of new curriculum in future. Finally, authors wish to stress that this system should not be considered as just another a new curriculum nor it can be accomplished in short time with few trained teachers. Rather, every staff member of school should have an enduring mind to make this system work to provide a better learning environment for our medical students.

경추의 생체역학

박정율,서중근 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6

A through understanding of the biomechanics of the cervical spine is necessary to apply its knowledge to management of cervical disorders intelligently. In this article authors tried to fully review the biomechanics of cervical spine by, first, going over the basic anatomical and physiological characteristics of the cervical spine. Then, with these in mind, related kinematics are reviewed with discussion of some of important clinical applications related to these facts. Finally, diagnostic points of cervical instability are stressed which can be used as some of the guidelines in management of such patients in actual clinical situations.

노인 연령층에서의 만성 요통의 진단과 치료

박정율 대한노인병학회 2001 대한노인병학회지 Vol.5 No.2