두개강내·외로 다발성 전이를 일으킨 악성 뇌수막종 : 분할 정위적 방사선치료 및 통상적 방사선치료의 유용성 -1례보고 -

정한섭,이명기,박정호,강정수,김혜숙,김대조,Jeong, Han Seob,Lee, Myung Ki,Park, Jeong Ho,Kang, Jeong Su,Kim, Hye Sook,Kim, Dae Jo 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.10

We report a case of 54 years old male with malignant meningioma originating in the posterior fossa with multiple recurrences, intracranial and extracranial metastases. In spite of gross total removal of tumor and conventional external radiation therapy(CERT), 2 more recurrences, 5 more intracranial metastases and 1 extracranial metastasis to the rib were developed. We tried fractionated stereotactic radiation therapy(FSRT) and CERT to the intracranial metastasis with satisfactory result. Extracranial metastasis to the rib was resected and histological finding was similar to that of original tumor.

RMA2모형의 매개변수 검정 관한 실험적 연구

조홍제(Cho Hong Je),강상규(Kang Sang Gyoo),김대조(Kim Dae Jo) 대한토목학회 2003 대한토목학회 학술대회 Vol.2003 No.10

실험적 뇌수종시 뇌실확장에 대한 국소뇌혈류 및 생체역학적 인자에 미치는 영향

김대조,백민우,정철구,조병일,김영,조경석,성기원,박영섭,박춘근,김문찬,김달수,강준기,최창락 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.2

To evaluate the biomechanical changes and cerebral blood flow in hydrocephalic brain, this study was designed to determine the regional cerebral blood flow(rCBF ; frontal cortex and periventricular area), the pressure volume index(PVI) and the resistance to the absorption of cerebrospinal fluid(Ro) in different stages of the kaolin-induced hydrocephalus. Fifty five 8 week-old cats, weighing 900g to l,300g were used in this experiment. The experimental animals were divided into 2 groups ; a normal control(5 cats), and kaolin-induced hydrocephalic groups(50 cats). The kaolin-induced 1,2,4,6 and 8 weeks hydrocephalic groups after intracisternal injection of the kaolin. The rCBF was measured by hydrogen clearance technique and the PVI and Ro were determined by the technique of bolus manipulation of CSF. A significant elevation of the intracranial pressure(ICP) was observed in 2 weeks after kaolin injection and peak value(ICP= 10.2±0.9 ㎜Hg) was obtained in 4 weeks after kaolin injection. The significant decreases in rCBF were revealed in both frontal cortex and periventricular area of kaolin-induced hydrocephalic cats. The PVI was significantly increased from the normal value 0.77± 0.02 ㎖ to 1.60±0.16 ㎖ at 4 weeks after kaolin injection and increased to 2.12±0.34 ㎖ at 6 weeks after kaolin injection. Ro was significantly decreased from the normal value 90.6±1.3 ㎜Hg/㎖/min to 36.8±4.3 ㎜Hg/㎖/min at 4 weeks after kaolin injection and further decreased to 62±1.9 ㎜Hg/㎖/min at 8 weeks after kaolin injection. In hydrocephalic cats, the size of the ventricle(septum pellucidum-caudate nucleus distance) continued to increase in size up to 9.40±0.7 ㎜ at the 4th weeks. However, there was no further increase in ventricular size after the 4th weeks. This study indicated that kaolin-induced hydrocephalic cats led to dramatic changes in volume-buffering capacity expressed as PVI, coupled a reduction in the Ro. The absorptive defect and loss of volume-buffering capacity are not sufficient to cause progressive ventricular enlargement. It is assuming that some microcirculatory impairment in the brain parenchyma is playing an important role which facilitates ventricular expansion with changes of biomechanical property of the brain.

초등학교 학생들의 고쳐쓰기 능력 증진을 위한 전체적 접근 전략 지도의 효과

김대조 한국초등국어교육학회 2006 한국초등국어교육 Vol.30 No.-

본 연구는 초등학생들의 고쳐쓰기 능력을 증진시키는 한 방법으로 전체적 접근의 전략지도를 통해 고쳐쓰기 능력 증진의 효과를 알아보는 데에 목적이 있다. 대체로 초등학생들은 글의 부분적인 교정에 치우쳐 글의 의미와 구조에 대해서는 자세히 살피지 못하고 어휘나 맞춤법 정도에서 고쳐쓰기를 한다. 고쳐쓰기는 단지 어휘나 맞춤법을 정정하는 것이 아니라 글의 의미를 정교화하고 필자의 사고를 점검해보는 방향으로 이루어져야 한다. 따라서 본 연구에서는 학생들이 글의 전체적인 의미를 중심으로 고쳐쓰기를 할 수 있도록 전체적 접근, 즉 의미 중심의 고쳐쓰기 지도 전략을 구안·적용한 후, 그 효과를 검증해보고자 한다. 초등학생의 고쳐쓰기에 나타난 문제점은 크게 고쳐쓰기의 수준과 지식의 문제이다. 수준이란 많은 학생들이 고쳐쓰기를 할 때에 글 수준이나 문단 수준의 상위 단계로 나아가지 못하고, 낱말과 문장을 고치는 부분적인 고쳐쓰기에 치중하고 있다는 것이다. 또한 고쳐쓰기의 지식이란 학생들이 고쳐쓰기에 필요한 전략이나 방법에 대한 지식이 매우 부족함을 말한다. 이러한 문제점들을 해결하기 위해 필자는 전체적 접근의 고쳐쓰기 지도 전략 프로그램을 구안하여 보았다, 그리고 학생들에게 전략을 적용한 후 그 결과를 몇 가지 관점에 따라 분석해 보았다. 분석 결과, 전체적 접근의 고쳐쓰기 전략 지도는 부분적 접근의 고쳐쓰기 지도에 비해 초등학생의 고쳐쓰기 능력 향상에 긍정적인 효과가 있었다. 또한 상위 집단의 학생들이 하위 집단의 학생들에 비해 전체적 접근의 고쳐쓰기 전략 지도의 효과가 더욱 크게 나타났다. This study investigates the effect of meaning centered strategies to increase rewriting ability in the elementary school. Elementary school students are not doing properly rewriting. The rewriting of elementary school students has a partiality to the part. So, students can not look into overall meaning of the text in rewriting. Generally elementary school students rewrite in about vocabulary or orthography. The writer has to be able to make the meaning of the text elaborate and check own thought through the rewriting process. Therefore, in this study, I'd like to verify the effects of meaning centered strategies to increase rewriting ability in the elementary school. The problem to appear of the elementary school student is about the level and knowledge problem of rewriting. What the problem about the level is, when students rewrite the text, they are laying the stress at the rewriting to be the partial like a word and sentence. And what the problem about the knowledge is, when students rewrite the text, they lacked the knowledge about the strategy or method which needs rewriting. I looked into the strategy of the rewriting to solve the problem. I created a teaching strategy of rewriting so that the rewriting of a meaning center was achieved. I divided the stage of the meaning centered rewriting strategy into a ‘search’, ‘reconsideration’, ‘rewriting’ and looked into specific strategies to do in an each step. Findings of this study were follows: first, meaning centered strategy had a significant effect on improvement of rewriting ability. Second, A meaning centered strategy's effectiveness is high, rather a lower rank group than an upper group.

흉추강내 동정맥기형을 동반한 마미의 거대한 상의세포종 1례 보고

김동희,이신하,박권희,김정철,김대조 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.3

Spinal ependymomas originate in the ependymal lining and grow rather slowly which allows them to reach considerable size and length. The great majority of primary tumors of the cauda equina are ependymomas and show a rather marked predilection for the male. Histologically ependymomas are benign but metastasis and anaplasia have been reported. The basic architectural structures of the ependymoma are the ependymal rosettes and pseudo-rosettes. Intradural spinal arteriovenous malformations are relatively rare lesions and found only at autopsy or incidentally during surgical operations before the advent of investigative procedure. Development of myelography and spinal angiography have shown that vascular malformations of the spinal cord are not rare. Male is more predominant than female. The etiology and pathophysiological mechanisms are uncertain but many authors have believed that congenital, trauma, inflammations, tumoral processes, vasculitis and abnormal posture are influenced on A-V malformations of the spinal cord. No reports have been noticed about giant ependymomas of the cauda equina combined with spinal A-V malformations. We have experienced a case of giant ependymomas of the cauda equina associated with thoracic intradural spinal A-V malformations in forty-two year-old male and reviewed the literatures.

읽기 영역 수행평가 목표의 위계화 방안

김대조 한국초등국어교육학회 2004 한국초등국어교육 Vol.26 No.-

수행평가는 학생의 실제적인 사고과정을 지속적으로 평가하여 학생에 대한 올바른 이해와 개별적 발달을 돕는 데에 목적이 있다. 그러나 학교에서 이루어지는 수행 평가의 모습은 그 본연의 취지를 살리지 못하는 경우가 많다. 그렇게 된 원인은 여러 가지가 있겠지만, 본고에서는 수행평가 문항 제작을 위한 평가 목표의 부재를 그 원인으로 생각해 보았다. 따라서 읽기 수행평가 목표를 위계적으로 분류해 봄으로써 수행평가 문항 제작의 기준을 제시해 보았다. 본고에서는 읽기 수행평가 목표의 위계화 방향을 두 가지 축으로 제시하였다. 하나는 읽기 수행평가 목표 요소의 내용적 측면에서 본 위계화이고, 다른 하나는 읽기 수행평가 수행 수준의 위계화이다. 내용적 측면의 위계화는 B. S. Bloom의 교육목표 분류학을 바탕으로 하였고, 수행 수준의 위계화는 M. D. Merrill의 내용요소표시이론을 근거로 위계화의 방향을 설정하였다. 목표 요소의 위계화는 읽기 수행평가 목표 요소를 각각 지식력, 이해력, 적용력, 분석력, 종합력, 평가력의 영역으로 나누어 분류하였다. 그리고 수행 수준의 위계화는 각 읽기 목표 요소에 기억, 활용, 발견의 3단계 수준을 두어 위계화 하였다. 이는 고차적인 사고능력 평가를 위한 기초 작업으로써 목표의 위계화를 통해 수행평가문항 제작의 기준을 마련하기 위함이다. 이렇게 만들어진 2차원적 위계화를 통해 읽기 수행평가 시에 각 목표 요소의 수행 수준을 높인다면, 학생들의 창의적인 국어사용 능력 신장에 도움을 줄 수 있으리라 기대된다. The performance assessment evaluates actually thinking course of the students to the continuance. And there is the purpose in helping straight understanding and individual development about the students. The performance assessment is many case not to rescue the purpose in these days. The reason to become so various will be. But the one of the fact is an performance assessment objectives for an evaluation items manufacture do not exist is the most big problem. So I tried to present the criteria of a performance assessment evaluation items manufacture by try to classify a performance assessment objectives in reading. I presented a hierarchy method of a performance assessment objective in this paper to two kind side. One is a content hierarchy of a performance assessment objective element. And another is the grade of rank of a processing levels. The hierarchy of performance assessment objective classified each as the area of a knowledge, comprehension, application, analysis, synthesis and evaluation. And hierarchy of processing level is classified each as the area of a remember, use and find. Such objective hierarchy will become the criteria at a performance assessment evaluation items manufacture.

원발성 척추 경막상 Ewing's Sarcoma : 1례 보고 Report of 1 Case

김한호,강창구,김동희,김대조 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.10

Ewing's sarcoma, origination primarily in the spinal epidural space is exceptionally rare. There are only 6 case reports in English literature until 1986. We experienced a case of epidural Ewing's sarcoma originated in thouacic spinal canal at T6~T7 level with myelopathy. Initial neural decompression was very effective and complete recovery was achieved. But local recurrence occured in relatively short follow up period(8months). Subsequent radiotherapy showed us dramatic tumor regression and improvement of neurologic deficit. The problems that concerned in this tumor are its accurate diagnosis and appropriate therapeutic modality. We reviewed the literatures that deal with exceptional locations of Ewing's sarcoma and current therapeutic approaches with their outcomes.

척추경나사못을 이용한 요추부의 수술적 치험

김한호,강창구,김동희,김대조 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9

Transpedicular screw fixation of the lumbar spine has evolved rapidly and become one of the reliable methods to application. We treated 42 cases of lumbar spine disease using above method from October, 1987, to Feburary, 1993. The disease entities were spondylolisthesis 24cases(58%), spondylolysis 14 cases(33%), fracture and dislocation 3 cases(7%), postsurgical instability 1 case(2%). The most frequent clinical symptom and sigh was low back pain with radiating pain accompanying limitation of straight leg raising, which clinical outcome was excellent with wide laminctomy. The transpedicular screw fixation allow adequate neural decompression. short segment fixation and prevention of motion limitation of lumbar spine. But one of the important complication driven with this method was root injury which must be prevented by surgen's throught knowledge to pedicular anatomy and meticulous operative technique. The instrument failure is also the troublesome problem. The appropriate bone fusion will be the acceptable strategy to overcome the eventual possibility of instument failure.

뇌간 신경교종 1예

김형동,이정길,김대조,옥영철,이규웅 대한신경외과학회 1975 Journal of Korean neurosurgical society Vol.4 No.1

Intracranial gliomas were found more commonly in childhood(70 to 80%) than in adulthood (40 to 45%). The common infratentorial tumors in children were cerebellar astrocytoima(26.9%), medullo-blastoma(18.5%) and brain stem glioma(10.5%). Brain stem gliomas were infiltrating type of tumor and frequently involved the pons and medulla. An almost pathognomic syndrome of the brain stem gliomas consists in the presences of multiple bilateral cranial nerve abnormalities in combination with involving signs of pyramidal tract and cerebro-dentato-rubro-thalamic tract in the absence signs of increased ICP, especially in the early stage. These tumors take grave course because of clinical malignancy and lack of definite therapy. Once diagnosed, radiation therapy was at best palliative treatment. Sometimes surgical therapy could be attempted to find out currable cysts. We have been experienced in a case of brain stem glioma recently that was confirmed with an autopsy; astrocytoma grade Ⅱ to Ⅲ, microscopically.

소뇌출혈에서 앙와위 후두하 측면 접근법을 통한 뇌정위적 배액술

김준오,이명기,박일한,김중석,김대조 The Korean Neurosurgical Society 2004 Journal of Korean neurosurgical society Vol.35 No.2