前頭蓋窩에 局限된 腦硬膜外血腫의 經驗

崔德永,朴孝一,蔡進,沈輔星 최신의학사 1968 最新醫學 Vol.11 No.12

Epidural Hematoma Confined To The Anterior l; ossa. Duck Tung Choi, M.D., Hyo B Park, M.D., Jin Chae, M.D., and Bo Sung Sim, M.D. Department. of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea. Epidural hematomas confined to the anterior cranial fossa are rare lesions. There are only 24 reported -cases in the Iiterature. A. 47-year-old male patient was admitted to the Seoul National University Hospital on August 1, 1967. He suffered a blow on his head and lost his consciousness for about 10 minutes and about 4 hours later became lethalgic and confused. The left pupil became dilated and fixed, the deep tendon reflexes of both sides were increased and bilateral ankle clones and Babinskis sign were positive. The plain skull x-ray revealed linear fracture in the left frontal region. The left carotid angiogram showed posteriar shift of the left anterior carebral artery. Following removal of the huge epidural hematoma confined to the left anterior -cranial fossa, the patient was discharged on the 60 th postoperative day in excellent condition.

일측성 후방접근법을 이요한 흉요추부 골절의 전후방 동시 척추고정술

최덕영,김영백,여상준,박승원,황성남 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.4

Objective : The purpose of this study is to report the technical feasibility and the result of one stage operation for the bursting fracture of the thoracolumbar spine by posterior approach. Methods : Seven patients underwent corpectomy and replaced the space with titanium mesh cage filled up with autologous bone pieces through unilateral posterior route after removal of the facet joint and the pedicle followed by pedicle screw fixation at the same surgical field. Results : All patients tolerated the procedures well except one patient complicated with air embolism. Postoperative radiographs showed effective decompression and well placed instruments. Preoperative neurological deficits disappeared completely in two patients but some deficits persisted in the remainders. In two patients, epidural venous bleeding was troublesome and he needed transfusion of 5 pints of packed red blood cell. And another patient complicated with air embolism during operation was recovered with impunity after operation. To insert the mesh cage through the narrow corridor posterolaterally, it was unavoidable to sacrifice one spinal root. Conclusion : In spite of technical difficulty, one stage spondylodesis for the bursting thoracolumbar spine though unilateral posterior approach seem to be an effective operative procedure.

家兎組織의 Adenosine Diphosphate Ribose Pyrophosphohydrolase의 性狀

崔德瀯 全南大醫大 1970 전남의대학술지 Vol.7 No.4

뇌졸중의 외과적 치료

최덕영 중앙대부설한국의과학연구소 1988 한국의과학 Vol.20 No.2

실험적 뇌내혈종에서의 뇌부종에 대한 연구

최덕영,김영백,황성남 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.3

An experiment was designed to investigate the brain edema with temporary microballoon to simulate intracerebral hemorrhage. A temporary mass lesion was made on the region of right basal ganglia(0.4㎖) with inflatable microballoon. After a 5 hours inflation state, the balloon was deflated and then we measured water content of the brain by vacuum freeze drying method at regular interval according to the groups. And we compared it with sham-treated group(balloon insertion without inflation) and permanent group(balloon inflation without deflation) respectively. There was no significant difference in water content between both hemispheres of all groups. In temporary group, the water contents of both hemisphere were higher than control group for initial 7 days, but became normalized in 4 weeks. The water content of cortex was higher than that of white matter for initial 7 days but reversed in 4 weeks comparatively in temporary group.

Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정

최덕영,장진하,정희정,Choi, Deok Young,Chang, Jin Ha,Chung, Hee Jung 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.10

목 적 : Rett 증후군 환자에서는 일반인에서 보다 돌연사의 확률이 높은 것으로 알려져 있으며, 그 원인으로 자율신경계 기능 부전에 의한 치명적인 부정맥 같은 심장의 전기 생리적 불안정성이 가장 의심되고 있다. 본 연구는 Rett 증후군 환자에서 심박수 변이도와 교정 QT 간격을 측정하여 실제로 자율신경 활성도에 문제가 있는지의 여부를 확인하기 위하여 실시하였다. 방 법 : 분자유전학적 염색체검사나 임상적 진단기준에 의하여 진단된 Rett 증후군 환자 12례를 대상군으로, 나이가 비슷한 정상아 30례를 대조군으로 하여 이들에서의 자율신경 활성도인 심박수 변이도와 교정 QT 간격을 측정하여 비교하였다. 심박수 변이도는 24시간 보행 심전도를 기록한 후 디지털화 된 심전도를 자동적으로 분석하여 power spectrum을 만들고 그 중 주파수영역(고주파 성분, 저주파 성분, 극소저주파 성분, LF/HF 비율)과 시간 영역(평균 RR 간격, SDNN, rMSSD, pNN50), 교정 QT 간격을 측정하여 비교하였다. 비교는 세 그룹으로 나누어서 전체 Rett 증후군과 정상 대조군 사이, 전형적인 Rett 증후군과 정상 대조군 사이, 비전형적 Rett 증후군과 정상 대조군 사이에서 실시하였다. 결 과 : 1) Rett 증후군 환자에서는 대조군에서 보다 시간영역의 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율이 의미있게 높았으며(P<0.005), 교정 QT 간격도 의미있게 연장되어(P<0.005) 있었다. 2) 전형적인 Rett 증후군 환자에서도 대조군에서 보다 rMSSD이 통계적으로 의미있게 낮았고(P<0.005), LF/HF 비율도 의미있게 높았으며(P<0.05), 교정 QT 간격도 의미있게 연장되어 있었다(P<0.001). 3) 비전형적 Rett 증후군에서도 마찬가지로 rMSSD이 통계적으로 의미있게 낮았고(P<0.05), LF/HF 비율도 의미있게 높았으며(P<0.001), 교정 QT간격도 의미있게 연장되어 있었다(P<0.05). 4) 이상의 결과에서 Rett 증후군에서는 전형적인 환자나 비전형적인 환자 모두 미주신경긴장의 변화와 호흡에 의해 민감한 영향을 받는 rMSSD의 저하가 있었고, 교감-부교감신경 균형성을 나타내는 LF/HF 비율의 증가가 있었으며, 자율신경계에 영향을 받는 교정 QT 간격이 연장되었던 것으로 보아, 교감-부교감신경의 균형성에 이상이 있는 것으로 사료된다. 결 론 : Rett 증후군 환자에서 자율신경 활성도의 지표인 심박수 변이도의 의미있는 저하와 교정 QT 간격의 의미있는 연장이 나타나는 것으로 미루어 보아, 이 질환에서 자주 동반되는 돌연사가 일어나는 원인 중의 하나로 이러한 교감-부교감신경의 불균형을 의심할 수 있겠다. Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

심낭삼출 환자의 임상적 고찰

최덕영 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.5

We have experienced the 37 patients of pericardial effusion during last 8 years[1986-1993 . They were 17 male and 20 female patients, and their age range was 6months to 80 years.The causes of this pericardial effusion were 10 cases of tuberculosis, 7 cases of malignancy, 2 cases of acute pyogenic infection, 2 cases of postpericardiotomy pericardial effusion, 2 cases of trauma, 1 case of congenital heart disease, 1 case of SLE, and other 12 cases of unknown origin. All patients, except one, were managed by pericardiotomy with subxiphoid tube drainage. One case was managed by pericardiectomy. After operation, their symptoms and sign were dramaticaly improved. However, 3 patients were died postoperatively. Two of them were died of respiratory failure. One of them was died 28 months later with unrelated cause. They have already far advanced lung cancer. We conclude that the pericardiotomy with subxiphoid tube drainage was effective treatment in the patients with pericardial effusion.

Seed-layer 공정을 이용한 Ba_0.66Sr_0.34TiO₃박막의 제조 및 전기적 특성 연구

최덕영,박철호,손영국 한국세라믹학회 2003 한국세라믹학회지 Vol.40 No.2

R.F. Magnetron Sputtering법을 이용하여 Pt/Ti/ $SiO_2$/Si기판 위에 seed-layers와 $Ba_{0.66}$S $r_{0.34}$Ti $O_3$박막을 제조하였다. 다양한 기판온도에 따른 BST 박막의 전기적인 특성(정전용량과 누설전류)과 seed-layer층이 BST 박막에 미치는 영향을 조사하였다. BST 박막은 seed-layer층을 삽입함으로써 박막의 결정성이 향상되었고, 박막의 기판온도(결정화온도)도 상당히 낮출 수 있었다. 순수한 BST에 비하여 seed-layer를 삽입한 BST는 높은 유전상수와 낮은 유전손실 및 낮은 누설전류를 가지는 우수한 전기적 특성을 나타내었다. BST 박막의 전기적 특성은 기판온도에 따라 영향을 받고, seed-layer에 의해 향상됨을 알 수 있었다. $Ba_{0.66}Sr_{0.34}TiO_3$ thin films and seed-layers were deposited on $Pt/Ti/SiO_2/Si$substrate by R.F. magnetron sputtering method. Effects of various substrate temperature conditions on electrical properties (such as capacitance and leakage current) of BST thin films were studied. The effect of seed-layer was also studied. When seed-layer was inserted between BST and Pt, the crystallization of the BST thin films was considerably improved and the processing temperature was lowered. Compared to the pure BST thin films, dielectric constant, dielectric loss, and leakage current of BST thin films deposited on the seed-layer were considerably improved. It could be revealed that electrical properties are influenced by the substrate temperatures of BST thin films and are enhanced by the seed-layer.

조직편을 이용한 기관지흉막루의 수술적 치료 -4례 보고-

최덕영,손동섭,조대윤,양기민,Choe, Deok-Yeong,Son, Dong-Seop,Jo, Dae-Yun,Yang, Gi-Min 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.7

Empyema with bronchopleural fistula is a serious complication after resectional surgery of the lung. Several methods in treating empyema with bronchopleural fistula have been developed, but the results were not always satisfactory. Recently, successful results have been reported with the surgical treatments using tissue flap (the omentum and f or the chest wall muscles) to close the bronchopleural fistula in patients with thoracic empyema. We have performed surgical procedures to treat bronchopleural fistula using omentum in 1 patient an chest wall muscles in 3 patients. Their postoperative courses were uneventful. 기관지흥막루를 동반한 농흥은 폐 수술이후 나타날 수 있는 심각한 합병증중의 하나이다. 이같은 기관지 흥막루를 동반한 농흥의 수술을 치료하는 몇가지 방법들이 있으나 그 결과는 언제나 만족스러운 것은 아니다. 최근 조직편 (대망, 흉벽근)을 이용하여 농흥환자에서 기관지흥막루를 막아 좋은 결과를 얻은 보고들이 나오고 있다. 우리는 1명의 환자에서 대망을, 3명의 환자에서 흉벽근을 이용하여 기관지흥막루를 막아주었다. 수술후 환자들은 특별한 문제없이 퇴원하였다.

악성림프종과 병발한 폐의 편평세포암종 -1례보고-

최덕영,손동섭,조대윤,Choe, Deok-Yeong,Son, Dong-Seop,Jo, Dae-Yun 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.1

악성림프종과 병발한 폐의 편평세포암종을 1례 치험하였다. 환자는 19세 남자로 비 흡연자였다. 수술은 우 전폐절제술을 시행하였고 조직소견상 전이의 증거는 없었다. 조직의 확진은 면역조직화자염색을 통해 이루어졌다. 환자는 술후 3개월째 흉벽으로 림프종의 재발이 있었으며 술후 5개월째 호흡부전으로 사망하였다. We have experienced a case of squamous cell carcinoma of lung mixed with malignant Iymphoma. The patient was a 19-years-old male. He was a non-smoker. Right pneumonectomy was done. We could not find any evidences of metastasis. The postoperative course was uneventful The tissue diagnosis was confirmed by immunohistochemical method. The Iymphoma recurred at 3 months after operation and the patient was dead at 5 months After operation because of respiratory failure.