순천향대학교 부천병원 원격조회 시스템 개발과 이를 이용한 뇌졸중 환자의 신경외과 치료결정

김범태 ( Bum Tae Kim ),황선철 ( Sun Chul Hwang ),임수빈 ( Su Bin Im ),신원한 ( Won Han Shin ),안재억 ( Jae Ouk Ahn ) 한국보건정보통계학회 (구 한국보건통계학회) 2005 보건정보통계학회지 Vol.30 No.2

뇌간과 소뇌의 발생

김범태 ( Bum Tae Kim ),임수빈 ( Soo Bin Im ),황선철 ( Sun Chul Hwang ),신원한 ( Won Han Shin ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.1

Brain stem in is the most important portion in the development of central nervous system. Cerebellum is divided from the part of brain stem. The development of brain stem has three steps of neurulation, diverticulation and mantle formation. On the anatomical and functional consideration, brain stem and cerebellum have major roles on the whole neuronal axis. The malformations in these development produce congenital anomalies.

중대뇌동맥의 수술해부학

김범태 ( Bum Tae Kim ) 대한뇌종양학회 2004 대한뇌종양학회지 Vol.3 No.1

Middle cerebral artery(MCA) originated at the division of the internal carotid artery just level of the olfactory trigone. MCA(M1) courses forward and laterally to enter the insular region. The main division may not appear until the artery is within the insular region. The striate arteries arise from the infero-medial aspect of the M1, along either its proximal or dis-tal segments or along the MCA trunks distal to the bifurcation. M2 can have a defined bifurcation or trifurcation or variation in between. The main division and cortical branches of the MCA course over the surface of the insular. A fter passing and then loop over the frontal, parietal and temporal operculum(M3), the MCA extend into the sulci of the surface pf yje brain, laterally. Because of the variety of the cortical branches(M4), precise nomenclature of the distal vessel is problematical.

숨뇌의 신경해부학

김범태 ( Bum Tae Kim ),황선철 ( Sun Chul Hwang ),임수빈 ( Soo Bin Im ),신원한 ( Won Han Shin ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.2

The medulla oblongata is the most caudal part of the brain stem. It is continuous with the spinal cord at the foramen magnum and extends rostrally for 2.5cm to the caudal border of pons. The central canal of the spinal cord is continuous through the medulla, at the point called obex. The rostral part of the medulla occupies the floor of the fourth ventricle. The roof of the ventricle is formed by tela choroidea, choroid plexus and cerebellum. The pyramidal decussation and the inferior olivary complex are the characteristic anatomical features of the medulla. The medulla contains the cranial nerve nuclei of hypoglossal nerve, accessory nerve, vagus nerve, and glossopharyngeal nerve. They are concerned with neurophysiology, regulation of heart rate and respiration. The medulla also serves as a conduits for the passage of ascending and descending tracts connecting the spinal cord to the higher centers of the nervous system.

공직선거법 제93조 제1항, 한정위헌결정의 의의와 개선방안

김범태 ( Bum Tae Kim ) 조선대학교 사회과학연구원 2013 서석사회과학논총 Vol.6 No.1

인터넷은 전자민주주의 시대에 다른 어떤 수단보다 적은 비용으로 다양한 국민들이 자신의 정치적 의사를 손쉽게 표현할 수 있는 공간이다. 인터넷 선거운동은 사실상 기존의 선거운동 양상을 뛰어넘어 선거의 패러다임을 근본적으로 변화시켰다. 그럼에도 불구하고 중앙선거관리위원회가 인터넷 선거운동의 부작용만을 의식한 나머지 규제 일변도의 법적용을 강제하려는 것은 문제가 많다. 이는 정치 불신과 정치무관심 그리고 유권자의 정치참여 포기로 이어져 당선자의 대표권을 심각하게 훼손하고 있다. 선거는 민주정치의 핵심이라고 할 수 있는 국민의 정치적 의사를 형성하는데 가장 중요한 수단으로서 국민의 자유로운 의사를 공정하게 반영할 수 있을 때 그 의미를 가진다. 이러한 선거가 불합리한 공직선거법 때문에 국민의 자유로운 의사를 형성하고 표현하는데 걸림돌이 된다면 이는 마땅히 개정되어야 한다. 이와 관련 헌법재판소는 2011년 11월 29일 공직선거법 제93조 제1항에 대하여 한정위헌결정을 하였다. 그리하여 법 개정을 통하여 지난 4·11총선 때부터 전향적으로 SNS 등에 의한 선거운동의 규제를 완화했으나 근본적인 선거운동의 자유가 확대되었다고 보기는 어렵다. 공직선거법은 중앙선거관리위원회의 규제수단이 아닌 국민이 자유로운 의사를 표현하여 알권리를 충족시켜주는 수단이 되어야 한다. 따라서 선거운동의 자유성과 공정성을 담보할 수 있도록 정치 무관심과 투표율 저조를 막기 위한 법적· 제도적 장치를 마련해야 한다. 즉, 국민들의 정치참여를 견인하고, 표현의 자유와 명확성의 원칙 그리고 과잉금지의 원칙에 대한 침해논란을 없애고, 민주정치에서 국민의 기본권의 핵심인 표현의 자유를 보장하기 위하여 제93조 제1항에 대하여 폐지 또는 개정을 해야 할 것이다. The Internet is a space that people can easily express their political decision at a lower cost than any other means in the era of e-democracy. Internet campaign of the election fundamentally transformed paradigm of election beyond traditional campaign. Nevertheless, there are many problems that the Central Election Management Committee want to force the regulation of legal and they are only aware of the side effects of Internet campaign. This lead to political distrust, political apathy and abandonment of voter, the elect representation has been seriously undermined. Election is the most important means to form political decision of people called the core of democratic politics, there is a meaning when reflect people`s free intention. If the election has become a stumbling block to express and form for people`s free intention due to irrational Public Offices Election Law, it ought to be revised. In this regard, the Constitutional Court ruled decision on limited unconstitutionality regarding Public Official Election Law Article 93,paragraph 1, November 29, 2011. Thus, through law amendments, we decided to ease restrictions for election campaign by SNS from April 11, but it is difficult to see that fundamental campaigning is expand. Public Official Election Law is not just methods of third party prefer of the Central Election Commission, it should be means of expression and satisfy to rights to know for peoples`s free intention. Therefore, to ensure the freedom and fairness of the election campaign, there`s an urgent need for a legal and institutional framework to improve political apathy and a low turnout. Namely, to inspire to people for participation in politics, to eliminate infringement controversy for the freedom of expression, principle of clarity and principle of the proportion, in order to guarantee the rights of freedom of expression for people as the core of basic rights in democratic politics, Article 93, paragraph 1 will be revised or repealed.

자서전 쓰기 집단상담 프로그램이 자기수용, 긍정정서, 자기성찰, 삶의 기대에 미치는 효과

김범태(Bum Tae Kim),정성진(Sung-Jin Chung) 삼육대학교 미래사회와기독교연구소 2023 융합학문과 기독교 Vol.4 No.1

본 연구는 자서전 쓰기 집단상담 프로그램이 자기수용, 긍정정서, 자기성찰, 삶의 기대에 미치는 영향을 분석하기 위해 실시했다. 연구참여자는 대학교 재학 중이거나 졸업한 20대 남녀를 대상으로 모집했다. 실험군에는 연구의 목적을 이해하고 참여하기로 동의한 13명을 선발하여 배정하고, 자서전 쓰기 집단상담 프로그램을 시행하였다. 통제군에는 온라인 홍보를 통하여 자발적으로 참여를 희망한 동년배 12명을 배정하였다. 자서전 쓰기 집단상담 프로그램은 기존의 글쓰기치료 기법과 연구자가 개발한 ‘자서전 안내질문’ 및 활동을 결합하여 8회기 프로그램으로 구성했다. 실험군과 통제군의 변화를 측정하기 위해서 사용한 도구는 무조건적 자기수용 척도, 한국판 정적 정서 및 부적정서 척도, 자기성찰 척도, 삶의 기대 척도였다. 연구 결과, 자서전 쓰기 집단상담 프로그램을 시행한 실험군은 자기수용, 긍정정서, 자기성찰, 삶의 기대 등 연구 변인의 점수에서 모두 유의한 변화를 보인 반면. 통제군은 자기수용을 제외한 다른 모든 변인에서 사전검사와 사후검사 간 유의한 차이가 없었다. 참여자들은 자서전을 쓰고 싶지만 방법을 잘 모르는 사람들을 위한 글쓰기 모듈인 ‘자서전 안내질문’에 대해서도 도움이 되었다며 효용성을 인정했다. 그동안 자서전 쓰기가 주로 쓰기 지도방안이나 교수학습과정 연구 등에 활용되는 데 그치거나 노인의 정서 안정을 위해서만 활용되었지만, 자서전 쓰기 집단상담 프로그램이 20대 성인에게도 긍정적인 변화를 일으킬 수 있음을 입증하였다는 것에 본 연구의 의의가 있다. 마지막으로 본 연구의 제한점을 논의하고, 이를 바탕으로 후속 연구를 위한 제언을 담았다. This study was conducted to analyze how the autobiographical writing group counseling program affects selfacceptance, affirmation, self-reflection, and life expectancy. Participants were recruited among male and female in their 20s who are currently attending or graduating from universities. In the experimental group, 13 participants who understood the purpose of the study and agreed to participate were selected and assigned, and an autobiographical writing group counseling program was implemented. In the control group, 12 participants who wished to participate voluntarily through online promotion were assigned, and no treatment was given. The autobiography writing group counseling program was composed of 8 sessions by combining existing writing therapy techniques and ‘the autobiography writing guide’ and activities which made by the researcher. The measurement tools used to measure changes of the experimental and control groups were the Unconditional Self-Acceptance Scale, the Korean Version of Positive and Negative Emotions Scales, the Self-Reflection Scale, and the Life Expectancy Scale. As a result of the study, a significant change was found in the self-acceptance, positive emotions, self-reflection, and life expectancy scores of the experimental group that implemented the autobiographical writing group counseling program. In the control group, there was no significant difference between pre-test and post-test in all other variables except self-acceptance. Participants acknowledged usefulness of ‘the autobiography writing guide’ which is a writing module for those who want to write an autobiography, but don't know how to write it. In the past, autobiography writing was mainly used for research on writing instructional methods or teaching-learning process or was used only for stabilizing emotions of the elderly. The significance of this study was that it proved that the autobiographical writing group counseling program can also cause positive changes in adults in their 20s. Finally, the limitations of this study and suggestions for the future study were discussed.

뇌동맥류 파열에 의한 뇌지주막하 출혈후 혈관 조영상 혈관연축과 임상적 혈관연축의 상관관계

서동상,김범태,임수빈,조성진,신원한,최순관,변박장,Suh, Dong-Sang,Kim, Bum-Tae,Im, Soo-Bin,Cho, Sung-Jin,Shin, Won-Han,Choi, Soon-Kwan,Byun, Bark-Jang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Objective : Delayed ischemic neurologic deficit(DIND) is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However, the correlation between angiographic vasospasm(AV) and DIND after SAH is not precisely known. The authors investigated the timing, incidence, characteristics of DIND, and analyzed correlation between AV and DIND. Patients and Methods : A series of 126 patients with SAH and performed cerebral angiography which, confirmed anterior circulation aneurysm, admitted to between January 1996 to December 1998, were studied retrospectively. A comparative analysis between group 1(G1) in which AV patients presented with DIND, and group 2(G2) patients did not DIND, were done. AV was graded according to location, distribution and degree. Location of vasospasm was classified as basal type(BT), distal type(DT). BT was involved horizontally and include the bilateral carotid systems, proximal middle cerebral artery(MCA) and proximal anterior cerebral artery(ACA). DT was involved vertically and include the MCA branches as they become vertically or posteriorly oriented and the ACA distal to the anterior communicating artery. BT and DT all defined ether as localized type(LT) or combined type(CT). Distribution of vasospasm was classified as type I, type II and type III. Type I represents the involvement of bilateral carotid systems and bilateral anterior cerebral artery, type II was designed as one carotid system without involving anterior cerebral artery, and type III when only some portions of the anterior cerebral artery were involved, bilaterally. Degree of vasospasm was classified as mild(less than 25%), moderate(between 25-50%), severe(greater than 50%), and those were determined by comparing the caliber of the artery in vasospasm to that of the nearest area of apparently normal vessel. Results : The incidence of AV & DIND was 57/126(45.2%), 29/126(23.0%), and timing of DIND was 9 days(${\pm}4.1$) after initial hemorrhage. As for the location, BT was seen in 12 cases(40.0%), DT 11 cases(36.7%) and CT 7 cases (23.3%), respectively. Where as G1, BT was seen 5 cases(18.5%), DT 5 cases(18.5%) and CT 17 cases(63.0%), respectively in G2. CT AV was more correlated with DIND than LT AV(p<0.05). For distribution, type I was seen in 16 cases(59.2%), type II 4 cases(14.8%), type III 7 cases(25.9%) in G1 where as type I was seen in 7 cases(23.3%), type II 10 cases(33.3%), type III 13(43.3%) in G2. Type I AV was well correlated with DIND unlike to type II or type III(p<0.05). As for the degree, mild was seen in 4 cases(14.8%), moderate 14 cases(51.9%), severe 9 cases (33.3%) in G1, and mild 16 cases(18.5%), moderate 11 cases(36.7%) and severe 3 cases(10.0%) in G2. Moderate to severe type AV was well correlated with DIND(p<0.05). Conclusion : These results indicate that it may be possible to predict DIND according to careful analysis of location, distribution, degree of AV in patients with aneurysmal SAH.

헌혈 세트를 이용한 두피하 혈종의 치료 - 치료 수기 -

서동상,김범태,조성진,신원한,최순관,변박장,Suh, Dong-Sang,Kim, Bum-Tae,Cho, Sung-Jin,Shin, Won-Han,Choi, Soon-Kwan,Byun, Bark-Jang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Sugaleal hematoma usually develop one to eight days after minor head trauma or clotting disorders in children. The galeal aponeurosa in children is loosely attatched to the pericranium, allowing the collection of large quantity of blood. Most cases of subgaleal hematomas resolve spontaneously, however some cases require surgical intervention, aspiration of subgaleal hematoma often alleviate symptoms briefly and but do not shorten the time to resolution. Reaccumulation, infection following aspiration also had been reported. Here, we report the efficacy of using the blood donating set for the treatment of subgaleal hematoma in our series.

단락술후 발생한 긴장성 기뇌증 - 증 례 보 고 -

이재학,김범태,조성진,신원한,최순관,변박장,Lee, Jae-Hack,Kim, Bum-Tae,Cho, Sung-Jin,Shin, Won-Han,Choi, Soon-Kwan,Byun, Bark-Jang 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Pneumocephalus is exceedingly rare in the absence of trauma or recent surgery. It is most commonly seen after severe head injury, with disruption of the dura and subsequent cerebrospinal fluid leakage. Intracranial air has also been reported as a complication of shunting. This may be secondary to intermittent shunt failure or a persistent communication between the extracranial and intracranial space that permits the entrance of air. In the present case, air appeared to enter the ventricular system through the fistula that connected the frontal sinus. This air replaced the CSF being drained into the peritoneal cavity by the shunt. The decrease of intracranial pressure after a shunt might play a role in causing pneumocephalus. We report a case of tension pneumocephalus after shunting for hydrocephalus as a life-threatning complication.

후방 경유법에 의한 경추부 수막종 제거후 발생한 전방 경막외 혈종 - 증례보고 -

서동상,김범태,조성진,장재칠,신원한,최순관,변박장,Suh, Dong-Sang,Kim, Bum-Tae,Cho, Sung-Jin,Chang, Jae-Chil,Shin, Won-Han,Choi, Soon-Kwan,Byun, Bark-Jang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

We report a case of anterior spinal epidural hematoma, after removal of cervical meningioma by posterior approach, which occurred in a 61-year-old man who presented with left hemiparesis and hypalgesia. A cervical mass surgically confirmed as meningioma was removed by posterior approach. 3 hours after operation, the patient revealed quadriparesis with respiratory difficulty. We herewith report a rare case of anterior spinal epidural hematoma which caused a catastrophic aggrevation of postoperative course.