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당뇨가 있는 고혈압 환자에서 목표 혈압을 얼마까지 할 것인가?
진동규,이승진 대한고혈압학회 2011 Clinical Hypertension Vol.17 No.1
Hypertension is an independent risk factor of atherosclerotic cardiovascular disease. Diabetes multiplies the risk when combined. Therefore, it is crucial for the doctors to control the blood pressure (BP) properly in hypertensive patients with diabetes. And then, how much do we lower the BP? Several guidelines recommend target BP levels to minimize the risk under the basis of so many experimental and observational studies. But, we must consider several factors to properly apply the guidelines in the clinical fields. First, diabetes is not a uniform but a diverse disease. From asymptomatic microvascular disease to macrovascular cardiovascular disease, diabetic clinical findings are so different. So we must define where the patients stand in long diabetic road, and what the patients want to us. Second, because more people are becoming health-conscious, more people take the aspirin, lipid-lowering agents and other medications. It’s means that interpretation of the results of recent studies is more difficult than previous, old studies. Third, measuring the BP in the hospital is really reflect the ambulatory BP? Now, it’s too early to conclude that the one is more better than the other. From the next study, we can consider the use of ambulatory, home BP monitoring combined with hospital BP measuring. Finally, although BP lowering-effects are similar, all anti-hypertensives do not have same effect in diabetic patients. For example, angiotensin converting enzyme-inhibitor is more superior than calcium channel blocker in patients with heart failure. So, we must consider what type of drug used in the study.
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진동규,최중언,정상섭,이규창 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12
Twenty patients with cerebellar astrocytoma were treated at department of neurosurgery. Yonsei University College of Medicine between 1980 and 1990. Thirteen underwent total tumor resection and seven subtotal resection. Among them eight patients received postoperative radiation therapy. All twenty patients showed clinical signs of increased ICP. mainly headache and vomiting. Among whom eighteen revealed consistant findings of hydrocephalus in brain CT scan. We classified brain CT findings into 4 type : cyst with mural node, cyst with ring enhancement, solid form and mixed type of cystic and solid form. Total resection showed good result, which was choice of treatment. Radiation therapy did not changed outcome, even in subtotal resection cases. Instead, radiation therapy was reserved for recurrent case. We tried to avoid precraniotomy ventriculoperitoneal shunt, which reduced shunting rate. All 20 patients ran through benign clinical course with long term survival.
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외상이 경추 후종인대 골화증 환자의 수술결과에 미치는 영향
진동규,진병호,조용은,윤도흠,김영수,Chin, Dong-Kyu,Jin, Byung-Ho,Cho, Yong-Eun,Yoon, Do-Heum,Kim, Young-Soo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.7
Objectives : Most cases of cervical ossification of the posterior longitudinal ligament(OPLL) present with myelopathy or myeloradiculopathy, which sometimes is further complicated by minor trauma to the spinal cord. The main purpose of surgery in these patients is the alleviation symptoms but also as protection against further deterioration. The purpose of this study is to analyze the influence of trauma on the surgical outcome in patients with cervical OPLL. Methods : Over the past 13 years, we have operated on 123 patients with myelopathy associated with cevical OPLL. Among these, thirty patients had cervical cord injury associated with major or minor trauma and their clinical and radiographic data were reviewed retrosepctively. Results : As to cause of trauma, seventeen were related with traffic accident and 13 were related with minor slipping injury. The pre- and post-operative motor power were significantly weaker in the patients with trauma, but the degree of motor improvement was significantly higher(trauma group : $0.90{\pm}1.49$, non-trauma group : $0.41{\pm}0.80$). Conclusion : These results indicate that even indirect minor trauma to the cervical spine can cause irreversible changes to the spinal cord if this is associated with underlying cervical stenosis with OPLL. Although less favorable results may be anticipated in patients with trauma, operative decompression could improve motor power and protect further deterioration.
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진동규,윤수한,최중언,이혜연,정인혁 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.6
One hundred human cerebral hemispheres from 50 cadevers were dissected for evaluation on the variation of the tentorial sinus. Tentorial sinuses were found in 43 hemispheres which revealed a total of 63 branches. Tentorial sinuses were observed bilaterally in 14 cadevers and unilaterally in 15, but were absent in 21 cadevers. We divided the draining site of the tentorial sinuses at the straingt sinus into 3 zones ; Zone 1, anterior one third of the straight sinus, into which 15 out of 63 tentorial sinuses were found to be drained, zone 2 which is the most prevalent site, middle one third of the straight sinus draining 27 out of 63 tentorial sinuses and zone 3, posterior one third of the straight sinus draining 21 out of 63 tentonal sinuses.
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위시상 정맥동 혈전증 : 증례보고 Case Report
진동규,최중언 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11
Superior sagittal sinus thrombosis(SSST) is not uncommon and is frequently an underdiagnosed clinical condition with high mortality if the diagnosis is delayed or prompt appropriate treatment is not given. Currently, with the introduction of CT and MRI in the radiographic imaging technique, the diagnosis, which was solely depended on cerebral angiography, has become easier task. Authors experienced two cases of SSST with multiple intracerebral hemorrhage and we describe the clinical course and the radiologic findings of SSST.
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