派越戰傷者의 神經外科的 考察

朴東春,朴昌秀,全炳權,崔一龍 中央醫學社 1971 中央醫學 Vol.21 No.4

The authors have analyzed 781 cases of Korean wounded veterans who were evacuated from Vietnam Warfield, chiefly on view of neurosurgical aspect, collected for last 4 years and 10 months. The results of the observation are summarized as followings; 1. There divided into 275 cases of head injuries, 268 cases of peripheral nerve injuries, 128 cases of vertebral and spinal cord injuries and 110 cases of H.N.P. and others in the total 781 cases of the injured veterans. 2. In 275 cases of head injuries, 149 patients or 54.2% were injured from fragment of shell, explosives, grenade and booby trap, which were over to the ratio of the reports of `Neurological surgery of trauma in Korean war’ published by office of surgeon general department of the army, Washington and automobile-accident and bullet injury in that order. 3. On the site of head injury, the frontal injury was most frequent in rate of 40.4% and next temporal and parietal in that order. Craniectomy was carried out on 164 cases (60%) of head injuries and cranioplasty on 147 cases. 4. 48.7% of total head injuries were resulted into sequelae such as hemiplegia (13.8%), cranial nerve palsy, speech disturbance and epilepsy in that order. 5. In. the larger proportions of the causes of the peripheral nerve injuries, fragment injury occupied 66.4% and bullet 27% and total cases divided into 9% brachial injury, 20% ulnar injury, 15% median, 18% radial, 18% sciatic, 9.7% personnel, 7.5% tibial nerve injury. 6. On the other hand, 45. 3% of lumbar and 44. 7% of thoracic injury 17, ere demonstrated and paraplegia in 25% of cord injury. 7. In 128 cases of vertebral and spinal cord injury, 47.4% of cases were resulted from fragment injury, which was similar to the cases of the bullet injury in rate of 46% in Korean conflict.

전통차 코너 - 대흥사의 다풍

박동춘,Park, Dong-Chun 한국화재보험협회 1998 防災와 保險 Vol.76 No.-

하부뇨관배석술

朴東春 한국의학사 1984 診斷과治療 Vol.4 No.6

비위축성 신절석술 55례

김태진,박동춘 영남대학교 의과대학 1992 Yeungnam University Journal of Medicine Vol.9 No.1

1983년 7월부터 1990년 6월까지 만 7년동안 비위축성 신절석술을 시행하였던 53명의 환자를 대상으로 수술후 합병증과 잔석의 빈도 등을 중심으로 임상적 관찰한 결과를 요약하면 다음과 같다. 가장 흔한 주소는 측복통으로 40례(72.7%)에서 나타났고, 다음은 혈뇨로 16례(29.1%)였고 증상 없이 우연히 발견된 경우는 4례(7.3%)였다. 동반질환은 타요로계 결석질환이 16례(29.1%)로 가장 많았으며, 그외에 고혈압 11례(20.0%), 위궤양 7례(12.7%), 신낭종 5례(9.1%)등이었다. 수술전 요배양검사에서는 양성이었던 경우가 19례(34.5%)로 나타났으며, 그중 포도상구균이 5례로 가장 많았고, 그외에 대장균 3례, 녹농균 3례, Proteus 및 Acinebacter가 각각 2례 등이었다. 신결석의 형태에 따른 분포는 다발성결석이 20례, 완전녹각석이 13례, 부분녹각석(분지결석)이 10례, 신배결석이 9례, 신우결석이 3례이었다. 신결석의 성분분포는 수산칼슘과 인산칼슘의 혼합결석이 22례(40.0%)로 가장 많았고 다음은 수산칼슘석이 17례(30.1%), 인산마그네슘암모늄석이 8례(14.5%), 뇨산석이 3례(5.5%) 등이 순이었다. 평균수술 시간은 219.8분이었고 신혈관 차단시간은 평균 43.5분이었으며, 수술중 수혈은 22례(40.0%)였으며 수술당 평균수혈양은 2.36 pints이었다. 수술후 합병증은 지속적 요로감염 5례(9.1%), 무기폐 4례(7.3%), 일시적 뇨누출 2례(3.6%), 지연출혈 2례(3.6%) 및 요저류 2례(3.6%) 등이었고, 술후 3㎜이상의 잔류결석은 15례(27.3%)였으나, 추적관찰중 례(53.3%)에서 자연배출 되었고 결석의 재발은 2례(3.6%)에서 관찰되었다. 이상의 결과로 비위축성 신절석술은 결석조각을 모두 제거하고 누두성형을 시행하여 뇨정체를 없애줌으로써 결석재발의 빈도를 감소시키는데 좋은 방법이라고 사료된다. 55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients(36 male and 19 female) ranged in age from 3 to 72years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 2O and 90 minutes, rvith a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases(9.4%), atelectasis in 4(7.5%), transient urine leak in 2(3.8%), delayed bleeding in 2(3.8%) and urinary retention in 2(3.8%). Postoperative residual stones were identified in 15(27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases(87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short followup period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.

인쇄체 영문의 구문론적 인식 ( Comparison with Two Gradient Methods Through the Application to the Vector Linear Predictor )

박동춘,박성한 대한전자공학회 1987 대한전자공학회 학술대회 Vol.1987 No.7

구례 지역과 화엄사의 차 문화에 관한 문헌 고찰

박동춘,이창숙 한국정토학회 2020 정토학연구 Vol.34 No.-

본 논문은 문헌 연구로 구례 지역과 화엄사의 차 문화에 대해 세 가지 측면에서 고찰하였다. 첫째, 차 문화는 선종 유입과 도당구법승, 왕의 친소 관계 등과 관련되어있다. 따라서 신라에 차를 들여온 계층은 도당구법승으로 선종의 수행법에 관심을 갖고 있던 승려들이 당에서 익힌 좌선법과 함께 차를 들여온 경향이 크다. 하지만 9세기에 이르러서야 왕실 귀족과 승려들 사이에 차가 확산 되었다. 흥덕왕(828)이 지리산에 차 씨를 심게 했다는 기록은 지리산을 차 시배지로 볼 수 있는 자료이다. 둘째, 구례는 차 생산지로서 조선 전기까지는 차를 토공했던 기록이 있으나 16세기 이후에는 주요 생산지역에서 빠져 있다. 셋째, 화엄사 장죽전을 차 시배지와 관련하여 검토할 수 있는 문헌은 연기조사가 화엄사를 세운 최초의 사찰이라는 점이다. 연기조사는 범승으로 법흥왕(544) 때에 화엄사를 창건했다. 이 당시 수행 중에 차를 마시는 것은 중국화 된 불교, 즉 남선종의 수행체계에서 형성된 풍토였다. 신라에 차 문화를 소개한 승려들은 남선종에 관심을 가졌던 도당구법승이다. 차와 수행이 융합된 시기는 혜능선사(638~713)가 소주를 중심으로 설법을 폈던 시기이다. 더구나 북방 사찰에서 수행 중 차를 마시는 것이 허락된 것은 8세기 무렵이다. 법흥왕때 연기조사가 화엄사를 창건하고 동시에 화엄사 부근에 차 씨를 심었다는 점은 이 당시 신라에 차가 소개되지 않았을 가능성이 크다. 따라서 화엄사 장죽전을 차나무 시배지로 상정하기란 선종의 유입 시기와 문헌 사료를 고찰해 볼 때 수긍하기 어렵다. 신라에 차를 소개한 계층이 선종의 수행법에 관심을 가졌던 도당구법승이었다는 점에서 볼 때 차나무 시배지로 보기에는 미흡하다. 하지만 구례 지역과 화엄사가 차 문화에 미친 영향은 크며 고려와 조선 전기까지도 그 위상은 공고하다. 화엄사 주변에 산재한 차나무가 어느 시기에 파종되어 군락을 이루고 있는지, 차 문화 발전을 위해 다양한 측면에서 연구될 필요성이 있다. This thesis is a literature study that examines the tea culture of Gurye(求禮) area and Hwaeomsa(華嚴寺) from three aspects. First, the tea culture is related to the influx of the Zen Buddhism(禪宗), a monk who studied abroad in the Tang Dynasty(唐), and the royal relationship of the king. Therefore, the class that brought tea to Silla was monks who studied abroad in the Tang Dynasty, and monks who were interested in the practice of the Zen buddhism tended to bring the zen method, a ascetic practices method learned in the Tang Dynasty. However, it was not until the 9th century that tea spread to royal nobles and monks. The record that King Heungdeok(828, 興德王) had tea seeds planted on Mt. Jirisan supports the view of Mt. Jiri as a tea Sibaeji(始培地). Second, Gurye is a tea production area, and there is a record of making tea until the early Joseon Dynasty(朝鮮), but after the 16th century, it has been omitted from major production areas. Third, the literature that sees Jangjukjeon(長竹田) at Hwaeomsa as a tea Sibaeji is that it was the first temple that built Hwaeomsa. Hwaeomsa was founded in the time of King Beopheung(544, 法興王) as Yeongi Josa(緣起 祖師) is Beomseung(梵僧). Drinking tea at the time was a ascetic practice culture formed in the Buddhist system of Chineseization, that is, the Namseonjong(南禪宗). The monks who introduced tea culture to Silla were Dodang-gu Beopseung(渡唐求法僧), who had an interest in Namseonjong. The time when tea and a ascetic practices were fused was the time when Huineng Seonsa(638~713, 慧能 禪師) preached a sermon centering on Soju. Moreover, it was around the 8th century that drinking tea during a ascetic practice was allowed in northern temples. It is very likely that no tea was introduced to Silla at that time, as the fact that during the reign of King Beopheung, Yeongi Josa founded Hwaeomsa and planted tea seeds near Hwaeomsa. It is difficult to convince when considering the time of the influx of the Zen Buddhism and the literature and history to assume Jangjukjeon of Hwaeomsa as a tea tree plantation. Considering that the class who introduced tea to Silla was the Dodang-gu beopsang who was interested in the practice of the Zen Buddhism, Hwaeomsa is not enough to be viewed as a tea tree plantation site in that it is a Gyohak(敎學) temple that values Hwaeom(華嚴). However, the influence of the Gurye region and Hwaeomsa on tea culture was significant, and its status was solid even in Goryeo and the early Josenon Dynasty. It is necessary to investigate at what time the tea trees scattered around Hwaeomsa were planted and formed a community, and to develop tea culture from various aspects.

陰囊水腫 診斷에 있어서의 水腫造影術의 利用

朴東春 慶北大學校 醫科大學 1979 慶北醫大誌 Vol.20 No.2

一側性 陰襄水腫 患者 42例를 對象으로 選定하여 그들의 水腫을 直接 經皮 穿剌한 다음 造影劑를 注入하여 撮影한 X-線所見 ?? 水腫造影像과 手術所見을 比較 觀察하였다. 水腫造影上 造影劑가 腹腔內로 流入됨을 볼 수 있는 境遇를 交通性 水腫, 볼 수 없는 境遇를 非交通性 水腫으로 判讀하였던 바 交通性과 非交通性 水腫과의 鑑別診斷率은 95%였다. 陰襄水腫 42例 中 交通性 水腫이 34例로 非交通性 水腫보다 4倍 程度 많았다. 靑年期의 水腫은 大部分이 交通性 精系水腫이었고, 激烈한 運動으로 因한 腹壓 抗進에 依해 느슨하게 閉??되어 있던 초상돌기가 再開放되어 發生하는 것으로 생각된다. 水腫造影術은 交通性 水腫과 非交通性 水腫과의 鑑別診斷에 利用할 수 있는 簡單하고 安全한 方法이며, 이로써 陰襄水腫 患者의 術前 術式 決定에 도움을 얻을 수 있다고 思料된다. Hydrocelography, an X-ray examination following the percutaneous injection of contrast medium into the hydrocele cavity. was carried out on 42 partients with unilateral hydrocele, and comparative results between the hydrocelographic findings and operative findings were evaluated. In reading the hydrocelograms, the hydroceles were classified as communicating when the contrast medium enters into the peritoneal cavity, and as noncommunicating when it does not. The accuracy of hydrocelography in the differential diagnosis of communicating from noncommunicating hydroceles in young adults were communicating cord tyes which might be caused by recanalization of the loosely obliterated funicular process due to the increased intraabdominal pressure from strenuous physical activity. Hydrocelography was considered to be safe and easy to perform, and useful in determining preoperative surgical approaches.

하부 요관결석환자에서 Dormia Stone Dislodger를 이용한 경뇨도적 요관배석술의 의의

김은길,서준규,김영수,박동춘 영남대학교 의과대학 1985 Yeungnam University Journal of Medicine Vol.2 No.1

저자들은 하부 요관결석에서 경뇨도적배석술의 유용성을 알아보고자1983년 9월부터 1985년 8월까지 만 2년동안 영남대학병원 비뇨기과에 입원한 하부 요관결속 환자중 결석의 크기가 1.0㎝ 이하이며 방광경 조작의 적응이 되는 37명에서 Dormia stone dislodger를 이용한 경뇨도적 배석술을 시행하여 다음과 같은 결과를 얻었다. 1.37명의 환자중 16명에서 결석이 조작 즉시 배출되었고, 5명에서는 유치한 catheter 제거시 동시에 배출되었으며, 4명에서는 조작후 1주이내에 자연배출되어 68%의 성공률를 얻었다. 2.결석의 크기에 따른 성공률은 결석의 장경이 0.4㎝ 이하인 경우 77%, 0.4∼0.6㎝인 경우 58%, 0.6㎝ 이상에서 33%로서 결석의 크기가 작을수록 성공률이 높았다. 3.합병증으로는 배석기의 파손으로 요관 절석술을 시행한 1례, 요관협착으로 중등도의 수신증이 병발한 1례, 지속적인 혈뇨가 생긴 1례로서 8.1%의 합병증률을 보였다. 이상의 결과로 1.0㎝ 이하의 하부 요관결석에서 경뇨도적 요관배석술을 시행하여 비교적 높은 성공률과 낮은 합병증률을 보였다. 이에 저자들은 하부 요관결석 환자에서, 특히 결석의 크기가 작고 반복적인 동통이 동반된 경우에는 일차적으로 경뇨도적 요관배석술을 시행해 보는 것이 바람직하다 하겠다. Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethal stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10㎜ in greatest diameter. The result are summarized as follows. 1.The overall success rate was 68%(25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2.Higher success rate was observed in smaller stone;79% in less than 4mm,58% in 4-6mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3.The morbidity rate was 8.1%(3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy.In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethal manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

重複尿管의 外科的 處置

朴東春 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.2

最近 3年間 慶北醫大 泌尿器科學敎室에서 治驗한 重複尿管患者 8例中 5例에서 上極腎半切除術, 尿管腎盂吻合術, 同側尿管尿管吻合術, 尿管 tapering 後 再移植術, 一次縫合術 等의 各種 術式을 施行하여 좋은 結果를 얻었기에 報告하고 이들 術式의 適應症에 대해 簡略히 考察하였다. Personal experience with various surgical procedures, such as heminephroureterectomy, urete-ropyelostomy, ipsilateral uretero-ureterostomy, ureteral reimplantation with ureteral tapering, and primary repair of the separated segments, in ureteral duplication in 5 patients during the last 3 years is reported. All patients have done well clinically and radiologically. The operative techniques employed in each patient are briefly discussed.

경요도전립선전기기화술이 초기 임상경험 : 경요도전립선절제술 및 레이저 전립선절제술과의 비교

김정현,문기학,정희창,박동춘 영남대학교의과대학 1998 Yeungnam University Journal of Medicine Vol.15 No.2

최근에 Roller loop electrode를 이용한 경요도전립선전기기화술에 관심이 집중되고 있다. 저자들은 전립선비대중에서 전립선전기기화술의 가치를 알아보기 위해 Roller loop electrode를 이용한 전립선전기기화술(TEVP, 17례)을 레이저전립선절제술(VLAP, 39례)과 전통적 경요도전립선절제술(TURP, 59례)과 비교 분석해 보았다. TEVP는 효과 면에서는 전통적인 경요도전립선절제술에는 미치진 못하지만 VLAP과는 유사한 효과를 보였으며 안전성면과 경제적인 면에서는 VLAP을 능가하는 치료법으로 사료된다. 본 연구가 적은 환자를 대상으로 10개월까지 관찰한 결과이고 경요도전립선전기기화술의 초기 경험이라 명확한 결론을 내리기에는 다소 성급한 면이 있으나 전통적인 전립선절제술에 비해 짧은 입원기간, 짧은 요도관유치기간 및 적은 출혈 등을 보여주며 레이저 시술의 단점인 고가장비가 필요 없다는 점에서는 전통적 전립선절제술의 대체 술기로 높이 평가되어진다. Recently, several alternatives have been attempted in the management of benign prostatic hyperplasia (BPH) to reduce morbidity of traditional transurethral resection of the prostate (TURP). Among new modalities, transurethral electrovaporization (TEVP) is considered as a promising altermative. To evaluate the safety and initial efficacy of TEVP using the roller loop electrode (ProSurg Inc. USA) on BPH patients, we compared the results of TEVP with those of TURP and visual laser ablation of the prostate (VLAP). In this study, a total of 115 patients with symptomatic BPH were underwent TEVP (n=17), TURP (n=59) or VLAP (n=39) since 1995. Before treatment, patients were evaluated with an International Prostate Symptom Score (IPSS) and the measurement of maximal uroflow rate (MFR) and postvoid residual urine (PVR). After treatment, the operative and hospital records were reviewed. The uroflowmetry and IPSS were re-evaluated 3-10 months after treatment. In clinical outcome of re-evaluation compared to the preoperative parameters, there was a clinically significant improvement in three procedures. TEVP resulted in 62% reduction in IPSS (TURP, 73% : VLAP, 69%), 84% improvement in MFR (TURP, 113% : VLAP, 91%), and 74% reduction in PVR (TURP, 88% : VLAP, 78%). TEVP had shorter duration of hospitalization and catheterization than the others. TEVP was associated with lower rates of treatment-related complication than TURP. In conclusions, TEVP is considered as a useful procedure to treat symptomatic BPH. And, the advantages of TEVP over TURP include excellent intraoperative hemostasis, lower morbidity, shorter hospital stay and simple technique. In addition the advantages over VLAP include lower cost, shorter duration of catheterization and early symptom improvement.