시각증상을 동반한 전교통동맥 동맥류 2례

손병철,이상원,강준기,최창락 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

Interference with visual pathways is usually not caused by intracranial aneurysms. Aneurysms of the anterior communication artery rarely produce visual symptoms and signs in spite of their proximity to the visual pathways. The reason may be that these aneurysms rupture and present with subarachnoid hemorrhage before becoming large enough to exert significant pressure on the chiasm of optic nerves. The visual symptoms would be presented as visual field defect or impaired vision. These can be explained as the result of direct compression of the optic pathways, ischemic changes in the visual pathways caused by severe vasospasm after subarachnoid hemorrhage, or intraocular pathology such as retinal hemorrhage. 2 cases of anterior communication artery aneurysms associated with visual symptoms are presented with a brief review of literatures.

소뇌 교각부 종양의 임상적 분석

손병철,조경근,박춘근,지철,이길송,이상원,강준기,최창락 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.11

Although the cerbellopontine area is a relatively small portion in the intracranial cavity, various kinds of tumors could be found in this area due to it's anatomical characteristics. There are several cranial nerves, brain stem, aquaduct of Sylvius, cerebellum and important vascultures in this area, so various neurological symptoms and signs could be occured when the tumor developed in this region. A clinical analysis of 49 patients with cerebellopontine angle tumors during the last 5 years at the department of neurosurgery of C.U.M.C was done retrospectively. There were 19 men and 30 women with mean age of 43.8 years. The most frequent tumor was acoustic neuroma-37 of these patients(75.8%) and followed by meniningioma and ependymoma in frequency. The most frequent clinical symptom were headache and hearing disturbance. On the radiological evaluation, simple plain X-ray film showed normal in 43.3% and CT scan of the brain showed hydrocephalus and asymmetric cistern in 28% and in 25% of patients respectively. Surgery was done by total extirpation in 19 cases and partial removal in 23 cases and the result were excellent or good in 29 cases.

후두와로 확장된 거대 경추 경막하 지방종

손병철,이일우,강준기,최창락 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

Intraspinal lipomas are rare, benign neoplasms, comprising less than 1% of all intradural spinal tumors. Such tumors occur in the thoracic and cervical region, however, extension into the posterior fossa is most unusual. A case of large cervical intradural spinal liplma with extension into the posterior fossa in adult female is presented. Clinical feature was slowly progressing quadriparesis. Brain and cervical spine computed tomography confirmed the diagnosis and Magnetic resonnance imaging was very useful for delineation of the anatomy of the lipoma as an aid in planning th operation. Operative therapy consisted of combined suboccipital craniectomy, spinal laminotomy and laminoplasty, subtotal tumor decompression.

고양이 소뇌 치상핵파괴시 전기생리학적 변화

손병철,김문찬,강준기,최창락 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9

Spasticity is a wide variety of motor problems to connote difficulty with coordinated movements, involuntary spasms, rigidity. abnormal primitive reflexes and hyperactive reflexes. Electrophysiologically, spasticity is represented as the involuntary firing of motor units on a reflex basis at a polysynaptic spinal cord level. associated with interruption of descending cortical pathways. Although many procedures have been tried over the years to combat this spasticity, and the multitude of procedures indicates that none are entirely satisfactory, the reduction in spasticity produced by dentatotomy has been confirmed in many neurological centers. The F-wave is a late response recorded in the electromyography of a muscle following stimulation of its nerve supply. There is evidence that the size of the F-wave is dependent on motor neuron excitability. If such a relationship exists, procedures which are carried out to relieve motor neuron excitability might be expected to change F-wave size and it might therefore be possible to use the F-wave as an objective monitor during stereotactic dentatotomy. We have investigated this possiblity in 10 cats, weighing 2.8 to 3.7kg each. The size of F-wave Amplitude in experimental animals were devided into 2 groups, normal control group values(10 cats, before dentatotomy) and the dentatotomy group values (10 cats after dentatotomy). The F-wave size and F/M ratio were recorded from right tibialis anterior muscle after application of supramaximal stimulation (250 V. 100 mA. 2Hz. 10 times) on the right peroneal nerve. The results were as follows : 1) The size of M-wave amplitude did not change significantly in experimental models (before dentatotomy, 2805.5±1012.3 ㎶ ; dentatotomy group, 2555.5±725.9 ㎶, P>0.05). 2) The individual size of F-wave showed a wide variability from each stimulus, which emphasises the importance of using 10 stimulating responses. The mean value of F-wave amplitude before dentatotomy was 4365±113.2 ㎶. 3) The size of F-wave amplitude was significantly reduced after duntatotomy (before dentatotomy, 436.5±113.2㎶ ; after dantatotomy : 212.5±49.3 ㎶, P<0.05). The size of F-wave amplitude decreased about 48.6% after dentatotomy. 4) The F/M ratio also significantly reduced after dentatotomy(before dentatotomy, 17.1±6.6% ; after dentatotomy, 8.5±1.2%, P<0.05) and mean reduction was 49.7%. The results demonstrated that the dentatotomy markedly decreased the size of F-wave amplitude in experimental cats and indicated that the monitoring of F-wave amplitude during dentatotomy might be useful as an objective monitor for the relief of spasticity.

초등학교 조직의 현상학적 체험 연구

손병철 한국교육행정학회 2009 한국교육행정학회 학술연구발표회논문집 Vol.2009 No.8

경상북도관찰부공립소학교의 설립과 운영

손병철 고려대학교세종캠퍼스 한국학연구소 2019 한국학연구 Vol.69 No.-

Gyeongsangbuk-do Province Public Basic School was the first school in Daegu, which was established in 1896 as the result of Gap-o Reform at the end of the Joseon Dynasty. About the location of the basic school, the first record was in the Gyeongsang Gamyoung Gonghaedo, which specified the location of the school as the right side of Sunhwa-dang. Teachers of Gyeongsangbuk-do Province Public Basic School were 2 kinds. Some were appointed from Hansung Teachers School graduates, and others were teacher-assistants who were recommended from local scholars and approved from Hakbu. Finance of the school was supported 360 won annually from Basic School subsidiary regulation. There were not many students. There were students who were above 15 years, unlike today, and some students were already married. Before the basic school changed into primary school, the existence of Gyeongsangbuk-do Province Public Basic School for 10 years, was the result of the effort of our people, who were trying to make the legitimate and institutional foundation of contemporary education. 경상북도관찰부공립소학교는 구한말 갑오개혁의 일환으로 1896년 대구에 세워진 최초의 근대학교였다. 일제강점기를 거치면서 경상북도관찰부공립소학교의 존재는 부정되었지만 경상감영 관아 공해도의 선화당 우측 편 전 장관청 자리에 공립소학교가 나와 있다. 경상북도관찰부공립소학교의 교원은 한성사범학교 졸업생 중 학부에서 발령을 받은 교원과 지방 유림의 천거로 학부가 인정한 부교원 제도가 있었다. 재정은 소학교보조규칙에 의해 연간 360원의 지원금액이 확정되었지만 당시 외획이라는 세금조달방식으로 인해 지방에서 확보하는데 어려움이 있었다. 학생들은 오륜의 유교적인 내용과 개명진보를 위한 내용을 배웠고 15세 이상의 학생들은 자율적인 개진협회 활동도 하였다. 경상북도관찰부공립소학교는 1906년 학부령 제27호에 의해 보통학교로 개편되기까지 설립 이후 10년 동안 부족한 여건에서 제도적, 법적으로 체계를 마련해가는 과정이었다. 경상북도관찰부공립소학교의 설립과 운영에 대한 연구가 대구 근대교육의 재검토로 이어져 대구근대교육의 시작이 일본에 의한 것이 아니라 우리 스스로 노력이었음을 밝혀야 할 것이다.

좌전하행동맥 만성 완전폐쇄병변의 치료 후 호전된 폐고혈압 1예

손병철 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1

사회심리적 건강측정도구를 이용한 동일 직장 내 생산직과 사무직 근로자의 스트레스 수준 평가

손병철,전진호,이찬희,김대환,이창희,박수경 인제대학교 1999 仁濟醫學 Vol.20 No.1

목적: 정신적 건강은 근로자의 건강관리에서 신체적 건강 못지 않게 중요한 부분이다. 본 연구의 목적은 직무 관련 특성에 따른 스트레스의 수준을 평가함으로씨 근로자의 정신건강 관리에 일조하고자 하는 것이다. 방법 및 재료: 개인보다는 집단적 분석에 용이하고, 신뢰도와 타당도가 높은 것으로 알려진 사회심리적 건강측정도구(Psychosocial well-being index, PWI)를 이용하여 1998년 8월부터 11월까지 근무환경이 비교적 좋은 부산시내 1개 제조업 근로자 186명(사무직 91명, 생산직 95명)을 대상으로 스트레스 수준을 평가하였다. 결과: 전체적인 PWI 수준은 37.3±14.9로 낮은 편이었으며 특성별로는 규칙적인 운동을 하는 경우 낮았지만(p<0.05), 사무직과 생산직 근로자 간의 전체 PWI 수준은 차이가 없었다. 생산직 근로자에서는 젊은 연령층, 미혼, 근무경력이 짧은 군에서, 사무직 근로자에서는 규칙적인 운동을 하지 않는 경우에서 각각 PWI 수준이 높아(p<0.05) 스트레스에 영향을 미치는 특성에 차이를 보였다. PWI의 구성요인별 스트레스 수준은 작업교대를 하는 경우 사회적 역할수행 및 자기신뢰도 요인이, 젊은 연령층에서 우울증 요인이, 규칙적인 운동을 하지 않는 경우에서 수면장애 및 불안 요인이, 결혼하지 않은 경우 일반건강 및 생명력 요인이 각각 높아(p<0.05) 영향을 받는 요인에서 차이를 보였다. 다변량 분석 결과 설명력은 작았지만 전체적으로는 젊은 연령층, 규칙적인 운동을 않는 경우, 작업교대를 하는 경우(R2=0.068), 사무직 근로자에서는 규칙적인 운동을 않는 경우(R2=0.076), 생산직 근로자에서는 근무경력이 짧은 경우가(R2=0.128) 각각 스트레스 증가에 영향을 미치는 요인으로 관찰되었다(p<0.05). 결론: 본 연구의 결과는 타연구에 비하여 스트레스의 전반적인 수준이 낮고 일반적으로 생산직이 사무직 보다 스트레스 수준이 높다는 견해와 차이를 보여 스트레스의 수준은 생산직, 사무직 그 자체 보다는 작업환경, 근무여건 등에 더 많이 영향을 받는 것으로 평가된다. 그러나 스트레스에 영향을 미치는 특성이 양 군에서와 PWI의 구성요인 별로 차이를 보이므로 대상자의 특성을 고려한 스트레스 관리 프로그램 개발이 중요할 것으로 생각된다. 사내의 규칙적인 운동 프로그램, 효율적이며 평등한 작업교대 등은 근로자의 전반적인 스트레스 개선에 긍정적인 효과를 지닐 수 있다. Objective : Stress is a major factor influencing worker's health. This study was performed to evaluate stress level in blue and white collar workers and to propose the helpful advice fit for the worker's situation. Methods and Materials : From August to November 1998, stress level was measured on 91 white collar workers and 95 blue collar workers in a company through Psychosocial Well-being Index(PWI). Results: PWI score in total was relatively lower as 37.3±14.9, and it had no difference between blue and white collar workers, except lower in regular exorcise group(p<0.05). In blue collar workers, it was higher in younger age, unmarried, short tenure group (p<0.05). In white collar workers, it was lower in regular exercise group (p<0.05). In multiple regression analysis, the factors that increasing stress level weve younger age, no regular exercise, job shift in total workers(R2=0.068), shorter tenure in blue collar workers(R2=0.128) (p<0.05), and no regular exercise in white collar workers(R2=0.076). Conclusion : It considered that the stress level maybe mainly depend on work environment and situation rather than blue and white collar, itself. Therefore, the control program should be prepared based on the worker' s situation. Regular exercise and balanced job shift is recommened to improve well-being of workers.

중뇌종양에 의한 적핵진전에 대한 Vim 시상핵절제술 - 증례보고 -

손병철,김문찬,류경식,강준기,Son, Byung-Chul,Kim, Moon-Chan,Ryu, Kyung-Sik,Kang, Joon-Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.10

This 26-year-old man gradually developed a disabling midbrain tremor involving both distal and proximal part of left upper arm. On neurologic examination, oculomotor palsy, and ataxia of the left arm were noted. Radiologic examination revealed a mass lesion on midbrain tegmentum. He was tentatively diagnosed as brain tumor (presumably germinoma) without stereotactic biopsy. Conventional radiation therapy was given for this lesion. Although there was improvement in the radiologic imaging, his midbrain tremor worsened and became untolerable. The authors performed MR-guided stereotactic Vim-thalamotomy. With macroelectrode stimulation and radiofequency lesioning, his resting, postural and action tremors were almost completely abolished in both distal and proximal part of left upper extremity. Authors consider that Vim thalamotomy is still an effective means of controlling midbrain tremor involving proximal upper limb.

후두신경통의 진단과 치료: 큰뒤통수신경 포착증후군을 중심으로

손병철 대한의사협회 2023 대한의사협회지 Vol.66 No.1

Background: Occipital neuralgia is defined as paroxysmal shooting, or stabbing pain in the posterior part of the scalp, in the distribution of the greater and lesser occipital nerves. Occipital neuralgia may present only as an intermittent stabbing pain, but different opinions exist on its cause and diagnostic criteria. Current Concepts: According to the latest version of headache classification, only paroxysmal stabbing pain is included in the diagnostic criteria, and persistent aching pain is excluded. Pain intensity was also limited to severe cases. It has therefore become difficult to classify existing occipital neuralgia, whose main symptom is persistent pain rather than paroxysmal stabbing pain. Occipital neuralgia is classified as either idiopathic or secondary. Secondary occipital neuralgia is caused by structural lesions innervating the trigeminocervical complex (TCC) in the upper spinal cord, the dorsal root of second cervical cord, and the greater occipital nerve (GON). Discussion and Conclusion: Although idiopathic occipital neuralgia has no cause, the entrapment of the GON in the tendinous aponeurotic attachment of the trapezius muscle at the superior nuchal line has recently been proposed as an etiology. Chronic, irritating afferent input of occipital neuralgia caused by entrapment of the GON seems to be associated with sensitization and hypersensitivity of the second-order neurons in the TCC receiving convergent input from trigeminal and occipital structures. TCC sensitization induces referred pain in the facial trigeminal area.