두부 손상과 외상후성 전간에 관한 임상적 연구

유영락 中央醫學社 1977 中央醫學 Vol.33 No.1

The relationship between head injury and epilepsy has long been debated and studied. In the, clinical and basic investigations of this problem, however, one aspect has often been discussed but scientifically neglected; little has been reported concerning the evaluation of pharmacologic prophylaxis in this disorder. Head injury is now one of the commonest causes of fits which may develop soon after. the injury or month later. The risk of epilepsy are related to. whether the dura is penetrated or not. Early epilepsy is the term used for convulsion at the time of injury or when the patient is still suffering from the direct effects of trauma. In practice, the majority of early epilepsy occurs within the first week following trauma. Late epilepsy is used to describe convulsive seizures attributed to the late. effects of injury after the acute symptoms and signs have disappeared. In a series of 381 cases of emergency craniotomy for head injury, 19 per cent developed epilepsy, the incidence of early seizures being 8 per cent and of late: seizures, 11 per cent. In the study of 226 cases of EEG following craniocerebral injury reviewed, 29 per cent showed abnormalities features, the relatively high incidence of a normal record in unselected head injury. Convincing statistical evidence concerning the effect of the prophylactic administration of drugs has not been discovered but many investigators have. often been mentioned that there are possibility of preventing posttraumatic epilepsy in the early study of pharmacologic prophylaxis of posttraumatic epilepsy. Judging from experience with epilepsy after head injury, it seems wise to persist With prophylactic anti convulsants for, at least 6 months to two or three years. The traumatic epilepsy would appear unwise to look to the EEG for guidance about the epilepsy developing or the wisdom of stopping treatment common sense and clinical judgment are more reliable.

성인의 소뇌 낭상 성상세포종

유영락,정환영 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.1

A 48-year-old male patient is presented in whom huge cystic cerebellar astrocytoma simulated cerebellopentine angle tumor. Surprisingly enough, the symptoms started only 20 days prior to admission and expired before opening the dura. The neurological manifestations were of throbbing suboccipital headache, right hemiparesis, slurred speech and ataxia associated with acute increased intracranial pressure. The vertebral angiogram revealed downwardly displaced inferior posterior cerebellar artery without tumor blush. There was no evidence of increased uptake of radioactive isotope in brain scan. Suboccipital craniectomy and total laminectomy of the first and second cervical spine was performed but intradural manipulation was postponed because of tensely bulged dura. excessive bleeding and unstable vital signs to tolerate general anesthesia. The patient died of respiratory arrest 5 hours after the operation. The huge size of cystic astrocytoma on the right cerebellar hemisphere and tremendous cerebellomedullary herniation were found at the time of postmortem examination. Various pathophysiologica1 mechanism which caused this unusual regrettable clinical outcome are briefly considered.

후두하부 경유법에 의한 삼차신경지 절제술 경험 2례

유영락,김풍식,정환영 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.2

Until the latest date, in many operative procedures for the trigeminal neuralgia, the partial trigeminal rhizotomy using suboccipital approach was considered hazard, great risk, high mortality, clinical results- also seen net so satisfactory and more difficult technically than the temporal sensory root section. Nowaday, the suboccipital approach tried again by many other neurosurgeons and began comparison of the subtemporal and suboccipital rhizotomy. The suboccipital rhizotomy became recognized ease, safety of the method, excellent chance of lasting relief and least impairment. We got excellent clinical result and reported 2 cases of trigeminal neuralgia using Exum Walker and Kempe's method.

Methyl-methacrylate로 보강한 수액 비루의 외과적 치료

유영락 中央醫學社 1978 中央醫學 Vol.35 No.5

두부 손상과 외상후성 전간에 관한 임상적 연구

유영락 漢陽大學校 1979 論文集 Vol.13 No.-

The relationship between head injury and epilepsy has long been debated and studied. In the clinical and basic investigations of this problem, however, one aspect has often been discussed but scientifically neglected; little has been reported concerning the evaluation of phrophylaxis in this disorder. Head injury is now one of the commonest causes of fits which may develop soon after the injury or month later. The risk of epilepsy are related to whether the dura is penetrated or not. Early epilepsy is the term used for convulsion at the time of injury or when the patient is still suffering from the direct effects of trauma. In practice, the majority of early epilepsy occures withn the first week following trauma. Late epilepsy is used to describe convulsive seizures attributed to the late effects of injury sfter the acute symptoms and signs have disappeared. In a series of 381 cases of emergency craniotomy for head injury, 19 per cent developed epilepsy, the incidence of early seizures being 8 per cent and of late seizures, 11 per cent. In the study of 226 cases of EEG following craniocerebral injury reviewed, 29 per cent showed abnormalities features, the relatively high incidence of abnormal record in unselected head injury. Convincing statistical evidence concerning the effect of the prophylactic adminstration of drugs has not been discovered but many investigators have often been mentioned that there are possibility of preventing post-traumatic epilepsy in the early study of pharmacologic prophylaxis of postt-raumatic epilepsy. Judging from experience with epilepsy after head injury, it seems wise to persist with prophylactic anticonvulsants for at least 6 months to two or three years. The traumatic epilepsy would appear unwise to look to the EEG for guidance about the epilepsy developing or the wisdom of stopping treatment-common sense and clinical judgement are more reliable.

경추 추간판 탈출증 측방 도달 수술법 개선에 대한 임상적 연구

유영락,정환영,위영섭 한양대학교 의과대학 1985 한양의대 학술지 Vol.5 No.1

In conventional cervical spondylotic osteophytectomy, annulus fibrosus is removed for good surgical vista. Preservation of anterior annulus fibrosus, however, is important to prevent forward angulation of the cervical spine because it is weight-bearing strong fibrous band having 6 to 7mm in thickness. Transforaminal osteophytectomy and discectomy preserving anterior annulus fibrosus were performed in 108 patients. The surgery necessitated section of the posterior half of longus colli muscle under the surgical microscope via anterolateral transverse exposure. Using various currette, unilateral foraminal and posterior spurs were removed as well as Luschka's connection. For the contralateral osteophytes, bilateral exposures were convenient. Surprisingly, most of herniated posterolateral discs were "roof disc" at the intervertebral foramen. Different from Verbiest's or Pasztor's approach for vertebral artery insufficiency, tranverse process remained intact. Postoperative X-rays demonstrated complete removal of osteophytes clearly. Surgical results were exellent in 75%, go d in 14.8%, fair in 6.5% and poor in 3.7%. One patient developed persistant postoperative CSF leakage for 8 weeks.

坐骨神經痛의 病態와 藥物療法

劉永樂 藥業新聞社 1981 (月刊) 醫藥情報 Vol.1981 No.9

경추 추간판 탈출증에 대한 효소 카이모파페인에 관한 임상적 연구

유영락,김남규,오석전,이언,정환영 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.1

The intradiscal injection of chymopapain has been performed for the treatment of cervical disc herniation in 86 patients since 1984. C1 C2 puncture myelography and CT myelography were prefered for the adjuncts. A discography preceded enzyme injection to observe whereabouts of intradically injected substances. Technique: The 21-gauge spinal puncture needle is introduced anterolaterally into the disc space with the aid of the fluoroscopic image intensifier. Care should be taken not to injure the vertebral endplate. Urografin-60 is injected in the amount of less than 0.5ml. although some leak of the dye is found at the anterior and posterior parts of the annulus, one ml (2.5 nKat) of chymopapain injection can be carried out. Following results were obtained. 1) Follow-up of 86 cases showed excellent in 36 cases (41.9%), good in 38 cases (44.2%), fair in 8 cases (9.3%), unchanged in three cases (3.5%), and worse in one case (1.2%), respectively. 2) There are good results in chemonucleolysis on three interspaces as well as one or two interspaces. 3) The cervical CT myelography is preferable to other diagnostic studies for evaluation of herniated cdervical disc. 4) The postinjection-spinal-instability developed in 69 (80.2%) of the 86 cases for there to four days but it disappeared within a week. 5) In discograpgy, there were contrast medium leakage to epidural, anterior and posterior interspaces in 25 cases (29.1%) of patients but were not related with the outcome of the chemonucleolysis. 6) 79 cases (91.9%) showed the narrowing of the intervertebral disc space within three months after chemonucleolysis. 7) No serious complication such as anaphylaxis or immediate profound hypotension was observed. In conclusion, cervical chemonucleolysis with chymopapain is demonstrated to be an effective treatment of cervical disc herniation.

소프트웨어 난독화를 통한 안티 템퍼링 연구 동향

유영락(Youngrak Ryu),조호묵(Homook Cho) 한국정보과학회 2023 한국정보과학회 학술발표논문집 Vol.2023 No.6

요추추간판 조영상의 재평가 : 요수 조영상 및 요추전산화 단층촬영과의 비교연구

오석전,유영락,김남규,김덕용,정환영 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.1

Since 1984, lateral lumbar discography has been performed in 1100 cases which were preliminarily evaluated by myelography, CT scan, CT myelography etc. The discorgraphic findings were compared with those of the above-described various adjuncts. Technique: The patient is positioned right up on the radioluscent filming table under the aid of the fluoroscopic image intensifier. The 4-inch, 18-guage spinal puncture meedle and 6-inch, 22-guage spinal needles are directed with a two-needle method from a point 8-12 cm lateral to the spinous process of the disc to be injected, with the needle maintained at an angle of 60 degree toward the disc. Injection of the L5-S1 disc requires a 30 degree caudal angulation. If the tip of the needle is located middle 1/3 of the dics both anteriorly and laterally, 2 ml of the Urografin-60 is injected. Myelographic indentation and bulging patterns of the CT and CT myelography were closely related with discographic findings. But these findings were not uniquely linked to each other. As a primary diagnostic procedure, the discography has definite limitation and disadvantages. But unique advantage of the discography was found from these experiences. Discography offered definite information on 1) Ready communication between the disc space and the systemic venous system 2) Ruptured or extruded disc 3) Direction of extradural leakage 4) Remaining amount of intradiscally injected substance