유발전위 반응검사의 의의

김국기 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.2

요통의 감별진단

김국기 한국만성질환관리협회 1996 월간성인병 Vol.188 No.-

동맥류 및 뇌 동정맥 기형에 있어서의 유발 전위 반응

김국기 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.2

Somatosensory evoked responses (SSERs) and auditory evoked responses (AERs) were studied in 33 patients with cerebral aneurysms and arteriovenous malformations (AVMs) to see if these tests were useful indicators of cerebral vasospasm. 7/21 had abnormal SSER and 5/28 an abnormal AER. The SSER was abnormal in 4/7 patients with severe vasospasm but in only 1/13 without spasm or with mild or moderate spasm Abnormal SSERs in patients Kith severe vasospasm indicated a poor prognosis. Abnormalities on the SSER and AER correlated best with the degree of clinical deficit. These tests seemed insufficiently sensitive to reliably detect impending ischemia.

완전 뇌하수체 적출이 성선에 미치는 영향에 관한 실험적인 연구

김국기 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.1

It is well known that in studying the effects of hypophysectomy, removal of the pituitary must be essentially complete without injury of the neighboring region of the brain. We devised a new method of total hypophysectomy using microsurgical instruments, and observed the effects on the gonad in the dog. 1. Operative method. The animals were anesthetized with pentobarbital sodium 30㎎/㎏ body weight and then a wcoden bar, about 5 cm in diameter, was inserted in the mouth to displace the mandibular angle anterodownwardly. After aseptic draping at operative field vertical incision from the midline of the vertex to just behind the mandibular angle was made on the right side of frontotemporal region. Temporal muscles were also incised vertically and retractor was applied to expose the frontotemporal bone. Following wide craniectomy down to the base of middle cranial fossa and careful opening of the dura mater, temporal lobe was retracted upward and medially at the tip of the middle cranial fossa with narrow brain retractor. As the 3rd cranial nerve and internal carotid artery were exposed, arachnoid membrane was torn with microforceps and microscissors, and aspirated the cerebrospinal fluid slowly to obtain wider exposure, then elevated posterior communicating artery to expose the pituitary body and stalk. The stalk was clipped or crushed with microforceps and then sectioned with microscissors, then Pituitary body was isolated with microelevator and removed in a piece with microforceps or sucked out with suction. The wound was closed in layers. 2. Postoperative management and the results. Among these experimental animals, 6 dogs were observed for the period of 43∼77 days, and in 6 dogs dexamethasone was given intrarmus-cularly for one or two weeks following hypophysectomy, the rest were used as normal control. Following clinical observation, these animals were sacrificed with intracarotid arterial infusion of 10% neutral formalin solution and removed the brain and the gonads, and fixed in 10% neutral formalin solution. The removed brain was examined and pituitary fossa was a1so scrutinized. The genads were stained with hematoxylin-eosin, periodic acid Schiff (PAS) and toluidine blue staining methods. The observed results were as follows: 1) Average diameter of testicular seminiferous tubules was 0.17 ㎜ in normal control group, but became markedly reduced to 0.10 ㎜ following hypophysectomy. With administration of dexamethasone for 1 and 2 weeks, diameter ranged 0.09 ㎜ and 0.13 ㎜, respectively. 2) Testicular lesions in hypophysectomy group were characterized by marked reduction of spermatogenic activity, representing stage of germ cell aplasia with loss of spermatogonia, spermatocytes and spermatids. But in cases with dexamethasone administration, the pattern resembled various stages of germ cell arrest as with increased mitotic activities of spermatogenia and spermatocytes. 3) Those numerical alternations of spermatogenic cells accompanied secondary histological manifestations which included relative increase of Sertoli cell, mild thickening of basement membrane and Leydig cell hyperplasia. The findings following administration of dexamethasone became modified to reveal less prominent Sertcli cells and rather distinct Leydig cell clustering. Basement membrane thickening remained unchanged. 4) Ovarian changes in hypophysectomized dogs on the other hand. disclosed reduction of overall size accompanying decrease in number and size of Graafian follicles, atrcphy of follicular and cortical stremal cells, degeneration of ova and absence of corpus lutea. Follicular and stromal cells appeared responded to administration of dexamethasone relatively in considerable degree. 5) Mast cells normally distributed mainly in the tunica albuginea of both testis and ovary, increased following hypophysectomy to extend along fibrotic interstitial tissue of testis, but became reduced to the level of normal control group following administration of dexamethasone.

뇌경막하 혈종의 CT 소견 : Analysis of 5 Cases

김국기,김예철,강영철,문석배,이봉암,이영근 대한신경외과학회 1978 Journal of Korean neurosurgical society Vol.7 No.1

Computed tomography (CT) is a new and innovative radiologic technique, the diagnostic value of which has been well established by many reports. On account of its rapidity and non-invasiveness, CT has become the diagnostic procedure of choice for the initial evaluation of head trauma patients. The authors have performed CT scan Eusing EMI-5005 on 5 cases of subdural hematoma during the period of 8 months from October 1977 to May 1978 at the Department of Neurosurgery, Kyung Hee University Hospital. Various attenuation coefficients of hematoma such as hyperdense, hypodense, isodense and of mixed density were observed by the CT images. One case of isodensity hematoma were clearly identifiable by delayed enhancement technique, which had been confused by ordinary, noninfused method.

요추추간핵 마미강내 탈출 1예 : case report

김국기,고학종,조병규,채진,최길수,심보성 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.1

Rupture of the lumbar intervertebral disc into the dural sac is very rare. Total of 11 cases have been reported in the literatures. In Korea, one case of the intradural herniated disc of L_(4,5) interspace was reported at Seoul National University Hospital in 1972. Patients of the intradural herniated disc have usually a long history of recurrent low back pain and sudden exacerbation of symptoms with radiating pain on both lower extremities precipitated by minor trauma. A 47 years old female was admitted to Seoul National University Hospital complaining of severe low back pain and radiating gluteal pain on both sides. She had intermittent lumbago of 25 years' duration. Eight months prior to admission, radiating gluteal pain on both sides developed in addition to the aggravation of the lumbago due to minor back trauma. Physical and neurological examination showed local protrusion and the tenderness of the L3, L4 spinous process area, the hyperalgesia on the right L3, L4, and L5 dermatomes, no saddle anesthesia, normal dorsiflexion of both ankles and great toes, slight decrease of the right knee jerk and bilateral absence of the ankle jerk, and no sphincter dysfunction. Myelogram showed complete block at the L3-4 interspace level. Total laminectomy of the L3 and L4 was done. When the dura was opened, a solid round mass of a thumb-tip size was seen occupying the whole dural sac, compressing the nerve roots. The mass was a herniated disc from L3-4 interspace that had ruptured through central part of the posterior longitudinal ligament and ventral dural wall. Protruded intradural mass was removed en masse after incision of the overlying arachnoid membrane and the remaining L3-4 interspace disc material was removed in pieces extradurally. The mass was revealed as a degenerated nucleus pulposus on microscopic examination. The patient had an uneventful recovery with improvement of the neurological deficits.

우리나라 신체장해 평가법(의협개정안)과 외국법과의 비교 연구

김국기 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.3

In 1992 the Korean Medical Association intended to make revised evaluation and rate of physical impairment based upon rate and evaluation of physical impairment according to National Compensation Law which was composed of 14 subdivisions with various rates of physical impairment Committee of Evaluation of Physical Impairment in Korean Neurosurgical Society provided revised evaluation of nervous or mental impairment, peripheral newe impairment and spinal column impairment Because McBride Disability Evaluation and Guide to the Evaluation of Permanent Impairment by American Medical Association have been used widely in this field the author describe evaluation and rate of physical impairment in each method briefly and compare to revised evaluation by Korean Medical Association in subject of neurologic and spinal impairment.

흉추 척수내 낭미충증 1예

김남인,임영진,김태성,김국기,이봉암,임언 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.9

Cerebral cysticercosis is relatively common disease in Korea. But spinal intramedullary cysticercosis is very rare. We have recently experienced a case of thoracic intramedullary cysticercosis which was misdiagnosed as intramedullary tumor. We performed CT myelography and MRI, and they showed a cystic mass, suggesting intramedullary tumor. Laminectomy was performed and cystic mass was removed. Pathological diagnosis of specimen was cysticercosis.

신경외과 영역에서 수술중 초음파 이용에 관한 연구

김남인,임영진,김태성,김국기,이봉암,임언 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.1-3

Recent technological advances in ultrasound instrumentation have resulted in equipment that will image in "real-time" slices of the human brain similar in quality to computerized tomography(CT). Multiple authors have attested to its usefulness in location, characterizing, and facilitating in the biopsy or removal, or both, of intracerebral masses. In this study, the author has examined the efficacy of intraoperative neurosurgical ultrasound in 18 patients who were admitted to the Department of Neurosurgery. Kyung Hee University Hospital. The results were as follows, 1) It can provide critical assistance in precise localization of subcortical masses, since in many instances the overlying surface of brain provides no clue for localization 2) This technique is very useful for the identificantion of deep lesions, providing information about their solid and cystic components and about the shortest route of access to tumor. 3) It provides precise information to help guide biopsy needles into deep lesions, and to confirm their presence within the lesion itself. 4) The system is highly accurate in visualizing ventricular catheters during and after their placement. 5) The system is inherently safe for the patient and the operating room personnel since there is no radiation exposure.

생활도로에서의 교통사고 특성 및 교통안전 대책에 관한 연구 : 서울시 서초구를 중심으로 case study of Seochogu, Seoul

김홍상,김국기 明知大學校 産業技術硏究所 1998 産業技術硏究所論文集 Vol.17 No.-

The nation must make the comfortable life space where, by development of traffic circumstance, people can live healthily and pleasantly. But the facts are that most of residential streets are decreasing and vehicles are filling there. The streets which must be able to reach easily and to use delightfully have been perceiving detour of saturated streets, and traffic accidents which occured from these streets are the cause and the result of many problems. So the purpose of this paper is analyzing times and kinds of accidents, making answers, preventing accidents from outbreaking on residential streets.