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- 저자 : 鄭福洙 (검색결과 6 건)
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鄭福秀,田成穗,金昞駿 中央醫學社 1972 中央醫學 Vol.22 No.2
Acute Subdural Hematoma is the one which neurosurgeons encounter commonly in severe head injuries and needs emergency surgery. But the fact that the mortality of it is still very high (60-90%), inspite of the recent improvement of the technique of anesthesia, transfusion, and the use of drug which could reduce the intracranial pressure such as mannitol and steroids, is disheartening to all neurosurgeons. In my country, the acute subdural hematoma has been recognized and treated since the 1950th, by neurosurgeons and sporadic reports for the subdural hematomas which included acute, subacute and chronic forms has appeared. Nevertheless, the report of the collected acute subdurall hematomas is rarely seen. The reason is felt that the illness is quite common around us but the mortality is so high to make the report be delayed. The authors have treated 40 cases of surgically confirmed acute subdural hematomas during 18 months from April 1969 to Sept. 1970 and as observed clinically. Followings are the results. 1) The sex incidence showed Male, 3 to Female 1, and age incidence ranged 5 years of age to 70 years. But it was most common in 3rd decade to 5th decade. 2) Most common mode of injury was traffic accident(27 cases) and there were 8 cases of falling accident and 5 cases of direct batting over the head by blunt materials. 3) There were no lucid intervals in 3/4 of the cases but in 11 cases, the lucid interval could he seen. Most common pupillary change was ipsilateral mydriasis(28 cases). Bilateral mydriasis were in 2 cases and others showed miotic or normal pupils. Bilateral positive Babinski's signs were noted in 22 cases and there were 3 cases of positive unilateral Babinski's sign. 4) Site of the hematoma: Most common site of the hernatoma was temporo-parietal region. but there were 2 cases of confined frontal pole lesions and 2 cases of posterior fossa lesion. In 34 cases of 40, the site of hematoma was confirmed by carotid angiography and on the rest, direct surgery was performed without carotid angiography. There were 2 cases of bilateral: acute subdural hematomas. 5) Mortality 20 cases of 40, have survived. The age, level of consciousness, bilateral positive Babinski's sign, and intracranial and/or extracranial associated injuries were felt to be the influencing factor to the mortality. In 5 cases of 20 which expired, have died one month after surgery and the cause of death were intractable diabetes insipidurs, septicemia, pneumonia, acute renal failure and intractable convulsive seizure. In survivors, hemiplegia, hydrocephalus, aphasia and mental deteriorations were observed which improved gradually except the 5 cases and 15 cases of 20 which have survived could remain to return to his usual daily activity.
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頭蓋骨에 發生한 原發性 Ewing’s Sarcoma : 症例報告 Report of A Case
鄭福秀,田成穗,金昞駿 中央醫學社 1972 中央醫學 Vol.22 No.2
Ewing's sarcoma is a malignant tumor of the bone which is common in the long bone and pelvic bone but is very rare in the skull. The authors have had a primary Ewing's sarcoma of the skull on a 7 years old girl. 7 years old girl happened to notice the small elastic hard mass on the right parietal region since about 3 months prior to admission which grew gradually without any pain or other symptoms. On admission, physical examination revealed T:37.5'C, P:94/min and B.P: 100/80mmHg, and there was small egg sized mass on the right parietal region. Except it, there was no abnormal neurological and physical findings. The laboratory data revealed WBC:8, 800(Neurto.; 68%, Lympho.; 27% and Eosino.; 5%), hemoglobin: 9. 0Gm% blood Alkaline Phosphatase: 9. 0 Bodansky Units, and urinalysis and stool examinations were within normal limits. X-ray findings: All long bone and pelvic bone check revealed no abnormalities. Skull showed soft tissue swelling on the right parietal region and sun-burst appearance of the skull at the area. Operation: The patient underwent second stage surgery on the tumor(First time biopsy and second time total excision). Tissue pathology revealed decalcified osteoid bone which shows osteolytic changes, which has evidence of infiltration of indistinct nucleoli and cytoplasmic border of anaplastic cells having with round and oval shaped of cell all throughout at around blood vessels. Also tumor mass contains abundant vascularity and associated with fibrous septal formation. The patient was discharged from hospital 10 days after second surgery but did not receive radiation therapy and was reported she succumbed 3 months after the second surgery.
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內頸動脈 閉鎖에 關聯된 腦底部 異常 血管網(2例의 症例報告)
趙鍾孝,鄭福秀,金昞駿 中央醫學社 1970 中央醫學 Vol.19 No.5
In these years, Japanese neurosurgeons have reported number of disorders related to the occlusion of the internal carotid arteries in Japanese race. The typical angiographic picture is the occlusion or narrowing of the internal carotid arteries with the angiomatous abnormal vascular network at the base of brain. Those were called with many synonyms such as the occlusion of the circle of Willis, telangiectasis, vascular malformation or cerebral retemirabile. Since the authors nave observed such two patients in Korean women recently, the clinical findings and the carotid angiographic features of the cases were presented. One case was 27 year-old female and the other was 62-year-old female. Both of the cases had the primary subarachnoid hemorrhage and there was no other neurological deficits than menJngeal irritation signs. They were recovered with the conservative treatment. The angiographic pictures of case one revealed the bilateral occlusion of the carotid arteries at end of the siphon with the presence of abnormal vascular network in the brain bases bilaterally and the other case showed the bilateral occlusion of the carotid arteries at the end of the siphon but abnormal vascular network was seen only in the left side. In addition to the report of the cases, references for the kind of those disorders, essentially for the discussion of their etiology and their nature, were reviewed.
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田成穗,朱寅秀,鄭福秀,金淳都 中央醫學社 1970 中央醫學 Vol.19 No.5
5 cases of Diabetes Insipidus following head injuries were reported. he conclusions are as follow: 1) 2 patients of the 5 cases sustained basal skull fracture. Others, I subdural hematoma, 1 subdural hygroma and another was cerebral laceration. Diabetes insipidus was recovered in 2 basal skull fracture spontaneously and others all expired with gradual deterioration. 2) Appearance of the diabetes insipidus was 10 days to 6 weeks following the head, injuries. 3) Spontaneous recovery could be expected in less severely traumatized occasions and the diabetes insipidus would be permanent in cases of severe head injuries. 4) Antidiuretic hormone was the only effective medicine for the post-traumatic diabetes insipidus.
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