잠수병의 방사선학적 소견 및 치료에 대한 연구

허재택 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : The aim of this study are to detect the radiological findings of decompression sickness that could elucidate the pathogenesis of decompression sickness and to evaluate the results of management of decompression sickness with hyperbaric oxygen therapy. Methods : Forty nine patients(42 men and 7 women; 23-51, mean 32 years) were referred to the Hyperbaric Oxygen Therapy Center of Dong-A University Hospital for diving related injuries. All patients were studied neurologically and radiologically. Forty patients(81.6%) were type 1 decompression sickness who complained pains in various sites. Eight patients(16.3%) were type 2 decompression sickness with spinal cord involvement and underwent MR examination of the spinal cord. One patient(2.0%) was type 2 decompression sickness with chest involvement. Two patients(4.1%) among nine patients of type 2 decompression sickness were combined with type 3 decompression sickness who was suspected of cerebral embolization. All patients of type 1 were treated with therapeutic hyperbaric recompressions of US Navy treatment table 5 and auxiliary therapy. Six patients of type 2 were treated with US Navy treatment table 6 and two patients of type 3 were treated with US Navy treatment table 6A. Results : Magnetic Resonance Image(MRI) demonstrated patchy areas of increased signal intensity in the spinal cord on both T2-weighted and fast SE T2-weighted images in five patients with symptoms of spinal cord injury, corresponding to an area of the cord believed to be clinically involved. Chest X-ray and spiral computed tomogrphy(CT)scan demonstrated patchy area in right middle lobe of lung in type 2 decopmression sickness of chest involvement and disappeared two weeks later with hyperbaric oxygen therapy. All patients of type Ⅰ decompression sickness were improved with hyperbaric oxygen therapy and auxiliary therapy. Motor weakness of extrimities were improved immediately during hyperbaric therapy within hyperbaric chamber in six patients among eight patients of type 2 decompression sickness with spinal cord involvementbut. Two patients who were not improved during first time of hyperbaric oxygen therapy were remained neurological deficit 6 months later. One patient of type 2 decompression sickness with chest involvement were also improved with hyperbaric oxygen therapy and auxiliary therapy. Two patients of type 3 decompression sickness combined with hype 2 were also improved neurologically after hyperbaric oxygen therapy with auxiliary therapy. Conclusion : MRI has proved to be reliable in the detection of spinal cord involvement due to decompression sickness that were previously undetectable by other neuroradiological investigations(such as myelography, CT, angiography, isotopic tests) and its pathologic findings might be corresponded to ischemic injury of spinal cord. Patch area which was demonstrated by chest spiral CT and chest P-A of type 2 decompression sickness might be related to hemorrhage of lung parenchyme due to alveolar rupture which was resolved two weeks later. Therapeutic hyperbaric recompression is very effective in the management of decompresion sickness.

고양이에서 척수 외상으로 인한 심부정맥에 관한 연구

허재택,이영우 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.2

This study was undertaken to determine the cardiovascular response to the spinal cord trauma in cats and to determine the autonomic mechanisms involved. The electrocardiogram and arterial blood pressure were recorded in anesthetized cats after the spinal cord trauma of 500 gm-㎝ at T4-T6 levels. 1. Acute spinal cord trauma caused a wide variety of severe cardiac arrhythmias and acute hypertension. 2. The increase of blood pressure could be prevented by intravenous phenoxybenzamine, an alpha adrenergic blocking agent. The pressor response was mediated by the alpha adrenergic receptor sites of the peripheral nervous system. 3. Tachycardia was occurred by the administration of atropine and bilateral vagotomy before trauma without affecting pressor response. 4. The arrhythmias could be eliminated by the combined administration of propranolol and atropine, but not prevented by the administration of either propranolol or atropine without affecting pressor response. These results suggest that the arrhythmias might be a response of hyperactivity of both sympathetic and parasympathetic divisions of the autonomic nervous system.

가토 대뇌피질 Synaptosome에서 Na^(+)-dependent ^(14)C-GABA이동에 미치는 Lidocaine의 영향

허재택 부산의대 1988 부산의대잡지 - 부산대학교 의과대학 Vol.28 No.2

흉강내 수막류 1 예

허재택,이영우 대한신경외과학회 1982 Journal of Korean neurosurgical society Vol.11 No.4

흉강내 수막류는 매우 희귀한 질병이며 이제까지 보고도 적다. 본 교실에서 46세의 여자환자에서 가슴과 상배부에 다발성 지방종을 동반한 흉강내 수막류 1예를 경험하였기에 문헌고찰과 함께 보고한다. An intrathoracic meningocele is a saccular protrusion of the meninges through a normal or enlarged intervertebral foramen or bony defect of the thoracic vertebrae. It extends aneteriorly between the ribs and into the thoracic cavity, displacing the pleura and lung and lying in the paravertebral gutter if of sufficient size. Meningocele, single or multiple, are prone to occur in cases of von Reckling-hausen's neurofibromatosis, often in association with kyphoscoliosis. In this case, we found a case of intrathoracic meningocele associated with multiple lipoma of variable sizes in the back and hyperpigmentation in the anterior chest and upper back region but no evidence of neurofibromatosis. Because of rarity of this disease entity, we report a case of intrathoracic meningocele with a review of literature.

만성 척수손상 환자에 대한 대망전위수술 : 예비보고 Preliminary Report

허재택,김형동,최휴진,김기욱 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.7

The omentum has been used over the years for a variety of clinical problems. Recently it has shown that placing the omemtum on the brain and spinal cord can lead to an extensive development of vascular connections at the omental/CNS interface. Success with omental transposition to the human brain has led to increasing intreast in placing the omentum onto the human spinal cord. One paraplegic patient was chosen to enter into a feasibility study to see if omental transposition to their spinal cord might result in clinical benefit. The length of time from injury was about 21 months respectively. This patient had little, if any, motor and sensory function below umbilicus level. The operation required surgical lengthening of the pedicled omentum followed by its placement into a subcutaneous tunnel created backward along the lateral chest wall up to T-10, 11 level. An extensive thoracic laminectomy was then performed followed by a wide opening of the dura. In our case the cord showed segmental shrinkage of the spinal cord consistent with previous trauma. The omentum was laid directly onto the underlying spinal cord. Our observation for five months has shown that placement of the omentum onto the chronically injured spinal cord allowed for subsequent improvement in neuroelectrical activity, as manifested by reproducible somatosensory evoked potentials, and, more importantly, in moter function. It is considered that placing the omentum directly upon the brain or spinal cord may have the effect of either improving local vascular perfusion or, possibly, exerting some biochemicals(neurotransmitter), or as yet unknown, influence. But further observation is warranted to determine whether this improvement will be continued and will be observed in another cases.

인체에서 체위변화와 말초맥파도달시간의 관계

허재택,허기영,정동근 대한의용생체공학회 2001 의공학회지 Vol.22 No.2

동맥계에서 맥파의 전달속도는 혈관의 긴장도에 따라 결정된다. 동맥혈관의 긴장도는 혈압에 의존적이며 순간적인 혈압의 증가에 따른 혈관긴장도의 변화는 순환기계의 질병을 야기할 수 있다. 본 연구에서는 말초맥파를 이용한 동맥 긴장도 평가 방법의 유용성을 밝히기 위하여 말초맥파 도달시간을 체위에 따라 측정하고, 체위 변화에 따른 정수압 변화와 말초맥파도달시간의 관계를 관찰하였다. 말초맥파도달시간의 측정은 심전도의 QRS파 피크로부터 말초에서 나타나는 광전용적맥파의 최대기울기점까지 시간을 측정하였다. 생체 신호를 아날로그-디지털 변환하여 PC에서 매번 심장주기마다 맥파도달시간을 분석하였으며 결과는 스플라인 보간법을 사용하여 그래프로 결과를 제시하였다. 소프트웨어는 C++을 사용하여 windows 환경에서 운용하였다. 앙아위에서 말초맥파도달시간은 233.38$\pm$1.84 ms이었으며 서있는 자세에서는 226.77$\pm$2.16 ms로 유의하게 감소하였다. 앙아위의 자세에서 손을 수직으로 들어올림에 따라 말초맥파도달시간은 각도에 비례하여 증가하는 특성을 보였다. 이러한 실험결과는 말초맥파도달시간이 동맥계의 일시적인 압력 변화에 매우 민감하게 반응하는 것을 제시하였으며, 고혈압 및 동맥경화가 있는 환자에서 예후를 판단하는 방법으로 유용하게 사용될 것이라 사료된다.

저체온 및 순환정지를 이용하여 모야모야 병이 동반된 뇌기저 동맥 첨부의 복합성 뇌동맥류 수술

조철민,허재택,하상수,우종수,이수일 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.5

Giant and complex aneurysm of the posterior circulation can pose several technical challenges with high operative morbidity. Recent advances in cardiac surgery have raised interest in the technique of deep hypothermic circulatory arrest for the management of giant and complex intracranial aneurysms of posterior circulation. The criteria for selecting patients for this procedure can be based on a preoperative analysis of available studies that suggests high risk with standard intervention. Using the technique of deep hypothermic circulatory arrest, we have successfully operated on a case of complex basilar tip aneurysm with MoyaMoya disease resulting in no significant neurological complications. We therefore suggest that patients with giant and complex intracranial aneurysms of posterior circulation might benefit from the use of deep hypothermic circulatory arrest technique.

자발성 뇌지주막하 출혈후 임상적 뇌혈관 연축에 관련된 요인들ㄹ에 대한 연구

김규홍,허재택 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.11

Authors analysed a series of 175 pastients with aneurysmal subarachnoid hemorrhage(SAH) who have undergone the treatment for subarachnoid hemorrhage from July, 1990 to May, 1994 to assess the clinical factors related to clinical vasospasm. This investigation revealed following conclusions. 1) The severity of subarachnoid hemorrhage as seen on computed tomography seemed to be correlated with the appearance of clinical vasospasm. Patients with severe SAH on initial CT scan were at higher risk of clinical vasospasm. 2) Patients with history of hypertension had more significant clinical vasospasm than did normotensive patients after aneurysmal SAH. 3) Aneurysms of the anterior communicating artery were showen to have the highest incidence of clinical vasospasm. 4) Patients with moderate to severe diffuse vasospasm on cerebral angiography had more significant clinical vasospasm than patients with no or local vasospasm. These conclusions suggest that clinical vasospasm after aneurysmal SAH are related to the following predictable factors ; amount of blood on the initial CT scan ; angiographic vasospasm ; history of hypertension and location of aneurysm. Proper management of these factors may diminish the incidence and severity of clinical vasospasm and reduce the morbidity and mortality rate.

유아의 결합조직형성 대뇌 성상세포종

김경범,허재택,송영진,허해경,나서희,정진숙,최순섭 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.12

Ruptured Mycotic Aneurysm of the Distal Middle Cerebral Artery Manifesting as Subacute Subdural Hematoma

이상민,허재택,최재형,박현석 대한뇌혈관외과학회 2013 Journal of Cerebrovascular and Endovascular Neuros Vol.15 No.3

Mycotic aneurysms are rare inflammatory neurovascular lesions. Ruptured mycotic aneurysm manifesting as subdural hematoma is extremely rare. A 72-year-old male patient was admitted to our hospital with headache and drowsiness. Computer tomography (CT) of brain and CT angiography revealed subdural hematoma and an aneurysm located at the M4 segment of the left middle cerebral artery (MCA). Cerebral angiogram revealed 2 aneurysms; one located at the left distal MCA and the other at the bifurcation of left MCA. Laboratory studies showed leukocytosis and elevated inflammatory factors. The patent was treated with antibiotic therapy for 4 weeks. The follow-up CT and cerebral angiography showed that the mycotic aneurysm was completely resolved, and the patient was nearly free of symptoms.