세균성 중추신경계 감염증의 최신지견

권병덕 한림대학교의료원 1984 人間科學 Vol.8 No.6

Doppler Ultrasound를 이용한 뇌기적 동맥의 혈류속도 측정 : Examination Technique and Normal Values in Korean

권병덕,권양,임승철,황충진 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.3

We present the examination technique and normal values of flow velocity from intracranial basal cerebral arteries for a recently developed pulsed Doppler system operating at 2 MHz emitting frequency. Peak systolic, peak diastolic, and mean flow velocity values are analyzed from fast-Fourier transformed(FFT) Doppler spectra at selected depths for 50 presumed normal subjects ranging in age from 18 to 73 years. Interindividual variation is high for peak flow but moderate for mean flow velocity values, which hence are more likely to discriminate normal from abnormal. Flow velocity values within the posterior cerebral attery(PCA) and the basilar artery(BA) are significantly lower than in the anterior cerebral artery(ACA) and the middle cerebral artery(MCA), which is also unique in the showing significantly decreasing values with increasing age. Calculated mean flow velocities are 61±14㎝/s in the middle artery(MCA) and 51±14㎝/s in the anterior cerebral artery(ACA), and 45±11㎝/s in the posterior artery(PCA) through the temporal window and 43±14㎝/s in the basilar artery through the subocciptal window and 15±5㎝/s in the opthalmic artery and 47±13㎝/s in the internal carotid artery(ICA) through the transorbital window. A new scanning system is introduced, which we suggest will reduce interindividual variations and improve the accurate separation of nearby vessels, which are major causes of the comparatively large standard deviations at present.

뇌폐흡충증으로 진단된 뇌농양 1례 보고

권병덕,황성남,최길수,지제근 대한신경외과학회 1979 Journal of Korean neurosurgical society Vol.8 No.2

Cerebral paragonimiasis, occurring as an extrapulmonary infestation, is one of the important intracranial lesions in Korea. In this paper we report a case of cerebral paragonimiasis which showed very similar C-T findings to pyogenic brain absence and was verified by pathologic research. Though we don't have much experiences in the diagnosis of the cereal paragonimiasis with C-T Scan, we found out some differences between pyogenic abscess and that due to cerebral paragonimiasis in several aspects.

C-T상 뇌종양과 혼동하기 쉬운 병소

권병덕,고영초,이현구,최길수 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.1

As more experience with computed tomography(C.T) is acquired, it is becoming apparent that differential diagnosis based on C.T appearances can be difficult. Many different pathologic processes can have similar enhancement patterns. We present 10 patients who underwent operation under the impression of brain tumor by C.T and angiogram but proved to have non-neoplastic lesions. The importance of careful evaluation of the history before offering a final opinion based on the C.T findings cannot be overemphasized. The clinician must be aware of the limitations and pitfalls associated with the computed tomography.

Dandy-Walker Cyst 2례 보고

권병덕,고영초,조병규,최길수 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.1

Dandy-Walker cyst is a rare disease causing hydrocephalus as a result of congenital outlet obstruction of the fourth ventricle. The clinical and C-T findings in two cases of the Dandy-Walker cyst which were confirmed through posterior fossa exploration are described. The patients were an infant and a girl aged 8 months and 16 months, who had presented signs of increased intracranial pressure for relatively short periods before admission. Brain C-T scan showed a generalized hydrocephalus with a large CSF-filled cystic space in the posterior fossa, indicating a defect of cerebellar vermis. Arachnoid cyst, megacisterna magna, ependymal cyst, and porencephalic cyst should be included in differential diagnosis and brain C-T scan alone is not sufficient in pathologic differentiation Posterior fossa exploration and cystic membrane excision were done in both cases with simultaneous ventriculo-peritoneal shunt in the latter case.

미세혈관감압술을 통한 반측성 안면경련증과 삼차신경통의 치료결과에 대한 고찰

권병덕,최길수 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.1

Recently the cause of hemifacial spasm and trigeminel neuralgia is known to be vascular compression-distortion in the root exit and entry zone of each nerve. The microvascular decompression of the 5th and 7th cranial nerves is a method of refined and non-traumatic surgical treatment of these disabling diseases. 33 patients with intractable hemifacial spasm and 7 patients with trigeminal neuralgia were treated by microvascular decompression and the follow-up results were evaluated. The surgical results in 33 cases of hemifacial spasm were as follow: Excellent-18, Good-7, Fair-6, Poor-2. Disturbance of hearing as a complication appeared in 6 cases, but improved gradually except one case. The surgical finding and results in 7 cases of trigeminal neuralgia were as follow: In 6 cases the causative vessel was SCA and in one case SCV indented the nerve root. All 7 patients with trigeminal neuralgia were relieved from facial pain after surgey.

Time-Course and Severity of Cerebral Vasospasm in the "Double-SAH" Canine Model

Kwun, Byung Duk,Peterson, John W.,Zervas, Nicholas T. 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.9

지주막하 출혈 후 발생하는 중요한 합병증인 뇌혈관 연축의 발생기전을 연구하기 위하여 개발된 개에서 "Two-hemorrhage" 모델의 뇌혈관조영상의 시간경과에 따른 변화를 분석하였다. 전신마취와 정상적인 탄산가스 분압상태에서 개의 기저부에 제1차 출혈(급성기 모델)과 제2차 출혈(만성기 모델)을 시행한 후 72시간 후에 뇌혈관 촬영을 하여 출혈전 상태와 비교하여 뇌혈관 연축의 정도를 통계처리하였다. 급성기 모델에서는 경도(10% 미만)의 혈관 수축이 발현되나 제2차 출혈로 만든 만성기 모델에서는 대부분의 동물에서 중등도(35%) 이상의 혈관 여축이 나타났다. 혈관 연축의 정도에 따른 통계학적 분포 분석에 의하면 아마도 혈관연축의 병리란 기전은 여러 요소가 복합적인 기전에 의하여 발생할 것이라는 것을 시사해주며 이러한 Two-hemorrhage 모델은 치료약재를 시험하거나 병태생리를 연구하는 데 기초 자료가 된다.

Surgical Result for Ruptured Anterior Circulation Aneurysms in Elderly Patients

Kwun, Byung Duk,Kim, Jung Hoon,Whang, C. Jin 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.5

많은 저자들은 노령환자들에서 뇌동맥류 수술후 결과가 불량하다고 보고한 반면, 또 다른 저자들은 이들 노령환자들에서도 수술 후 좋은 결과를 얻었다고 보고하였다. 이에 저자들은 조령환자들에서 파열된 전방순환동맥류의 수술결과를 확인하기 위하여 1989년 6월부터 1994년 5월까지 파열된 전방순환동맥류로 본원 신경외과에 입원하여 수술적 치료를 받았던 66세 이상의 환자들을 대상으로 수술결과에 영향을 미칠 수 있는 여러 요인들을 분석하여(the clinical grading, the location of aneurysms, the multiplicity, the presence of the angiographic vsospasm, the development of the symptomatic vsospasm, the presence of the hypertension, Fisher's grade Ⅳ, and the timing of surgery), 그 결과를 65세 이하의 환자들과 비교하였다. 두군간의 전반적인 수술결과는 의미있는 차이를 보이지 않았으며, location 와의 다른 요인들은 수술결과에 영향을 미치지 않았다. 경증 지주막하출혈 환자(Hunt and Hess Grade Ⅰ,Ⅱ)들의 경우 연령 및 수술시기와 관계없이 수술결과는 상당히 양호하였으며, 따라서 노령이라하더라도 경증 지주막하출혈 환자들의 경우 조기수술의 가능하였고 그 성적이 좋았다. 저자들은 단지 노령이라는 이유만으로 수술적응증에서 제외되는 것은 부적당하다고 생각되며, 수술결과에 가장 영향을 미칠 수 있는 요인은 연령이 아니라 수술전 환자상태라고 생각한다. In order to define the surgical result for ruptured anterior circulation aneurysms in the elderly. 59patients(from June 1989 to May 1994)whose age was 66years of age or older were analyzed. The factors which might influence the outcome were statistically compared between those aged 66 years or older (elderly patients group : 413 patients : 87.5% ); the clinical grading, the location of aneurysms, the multiplicity the presence of the angiographic vasospasm. the presence of the hypertension. Fisher's grade Ⅳ (intracerebral hemorrhage or intraventricular hemorrhage). and the timing of surgery. Overall outcome between two groups was not different singificantly. and many factors did not affect the outcome except the location Surgical outcome in good grade patients(Hunt and Hess Grade Ⅰ,Ⅱ) was excellent regardless of age and timing of surgery. "Early surgery in the elderly?" The answer was Yes especially in good grade patients. We conclude that surgical outcome for ruptured anterior ciculation aneruysms in the elderly does not seem to be directly affected by age. so elderly patients need not therefore be excluded from the benefits of surgery just because of their chronolgical age. It is principally the patient's condition during the acute stage that determine the surgical outcome.

제4뇌실 낭미충증

박용기,권병덕,최선길,강성구 한림대학교의료원 1983 人間科學 Vol.7 No.10

2차 전지의 방전에 의한 수소-공기 혼합가스의 점화에 관한 연구

이춘하,권병덕,오종용 한국안전학회 2004 한국안전학회지 Vol.19 No.3

This papers describes on the experimental consideration for the intrinsically-safe explosion-proof capability of rechargeable battery's body about main item, rechargeable battery and cellular phone battery which is selling in domestic that IEC(Intemational Electrotechnical Commission) recommend the measurement of ignition limit by short circuit of rechargeable battery and temperature increase test to use a explosion grade Group ΠC type of explosion-proof type apparatus test an object of hydrogen gas. Because of that, there are many different results for existence or nonexistence for ignition by different company and different types. It is concluded that the maximum of self temperature increasing by spark circuit of rechargeable battery is 180℃ in case of Nickel-Hydrogen, and 110C in case of Nickel-Cadmium. The reaction of cellular battery for external temperature have following processes. It is confirmed that the temperature of reaction is rise slantly as the ambient temperature rising, then exterior shape of one is swell up and change when the temperature of ambient reach to about 130~140℃, and when reach to about 160℃ the battery is blown up. Therefore, it is considered that have to be in considering selection of rechargeable battery using in itself due to different ignition limits of various rechargeable battery when the portable electric containing rechargeable battery are designed, produced and used, the characteristics and the proper safety factors of devices.