초음파(A-scan)에 의한 두개강내 질환의 진단에 관한 연구

조성옥,심보성 최신의학사 1971 最新醫學 Vol.14 No.4

The use of ultrasound in medical diagnosis goes back to the brothers Dussik, who attempted to outline the cerebral structures with aid of the ultrasonic transmission technique as early as 1942. Unfortunately this method, called "hyperphonographv", did not lead to the hoped-for success. In 1950 French, et al. reported that they were able to diagnose the brain tumor by using ultrasound reflection method on the exposed brain. On the next year they used direct cortical application of this method for localization of brain tumors during operation. Leksell in 1955 introduced the echo pulse method on the intact skull for the detection of space-occupying intracranial lesions. Echoencephalography is the term coined by Leksell for a new technique by which the position of the midline structures of the brain can be determined by passing a beam of pulsed ultrasound into the head and recording the returning echoes. This technique, used increasingly in Europe and Japan since 1956 and a little later in United States, has been little used in Korea. The purpose of this report is to present our experiences with A-scan echoencephalography in 80 normal persons and 395 patients with intracranial lesions in the last 26 months. An Aloka SSD-9B ultrasonic analyzer (A-scope) was used. The machine is basically an ultrasound generator and receiver, displaying the echoes on an oscilloscope with camera attachment for permanent recording. The 1 and 2.25 Mc. /sec. crystals are made of barium titanate, whereas the 5 and 10 Mc. /sec. crystals are made of piezoelectric quartz. For investigations through the intact skull usually used 2. 25 Mc. /sec. transducer, but 1 Mc. /sec. transdurcer was used when the skull is thick or when the passage of sound in otherwise attenuated. The 5 and 10 Mc. /sec. transducers were used for dural or cortical echoencephalgraphy. 1. All normal persons showed normal pulsating midline echo, however mild shift (2-3 mm.) of midline etho was observed in about 10 per cent of theni 2. In 231 acute craniocerebral injuries, midline echo shift (2 mm.) was found in 19 of 141 cerebral contusion cases, 23 of 26 unilateral epidural hematomas, 40 of 54 unilateral subdural hematomas, 1 of 5 bilateral subdural hematomas and in all of 2 unilateral epi- and subdural hematomas and 3 traumatic intra?cerebral hematomas. 3. In 62 acute cerebrovascular disease cases, midline echo shift (>2 mm.) was found in 3 of 28 cerebral infarction cases, 9 of 12 intracerebral hematoma cases and 4 of 22 spontaneous subarachnoid hemorrhage cases. In 10 of 12 intracerebral hematoma cases, however, evident hematoma echoes were observed. 4. In surgically verified 42 intracranial tumors, midline echo shift was found in only 17 cases (52 per cent) and in 15 suspected intracranial tumors only 6 cases (40 per cent). However in 17 cases of cerebral hemispheric tumors, midline echo shift was found in 14 cases (82 per cent). In 5 cases of craniopharyngioma all showed cystic tumor echoes and corresponding midline echo shift in 3 cases, in 3 cases of pineal tumor also showed tumor echoes in all cases with midline echo shift in 2 cases, and all cases of 2 thalamic tumors and 1 cerebral paragonimiasis showed midline echo shift. So the diagnostic value of A-scan in intracranial tumors was 90 per cent when excluded posterior fossa tumors and pituitary adenomas. 5. Midline echo shift was observed in 4 of 32 epilepsy cases, 5 of 7 infantile cerebral atrophy cases and all of 3 brain abscesses. In three of typical hydrocephalic patients no midline echo shift was found but double midline echoes were observed. In conclusion it can be stated that the A-scan echoencephalography is a relibale, harmless and rapid method for the exclusion or confirmation of various space-occupying intracranial lesions and hydrocephalus, when the extent of midline echo shift, special reflexions from hematoma, tumor and ventricles, etc. and variation in sound attenuation are taken into consideration.

두부손상에 있어서 임상증후와 방사선학적 소견의 관계에 대한 연구

조성옥 충남대학교 의과대학 지역사회의학연구소 1979 충남의대잡지 Vol.6 No.2

A study was done on the correlation between clinical and radiological aspect of 402 head injury patients which were admitted into emergency room from 1975 to 1979. Following results were obtained. 52% of cases showed positive finding interpreted as skull fracture on plain X-rays. Of these 84% were linear fracture while communited were 14% and the depressed 2%. 65% of fracture was found on temporoparietal bone and rests were 14% on frontal, 12% on base and 9% on occipital bone. The incidence of skull fracture was higher as the level of consciousness was worse. However there were considerable exceptions in this rule and there were 72 cases of fracture in alert and cooperative 166 patients. The temporoparietal fracture line was observed in majority of extradural hemorrhage. The discrepancy between radiological fracture site and various intracranial hemorrhagic lesions were found in 18.6% The carotid angiography was done on 83 cases. This angiographic study offer valuable information on hematoma sites or in planning surgical approach. The incidence of neurogical sequales were 5-8 times higher in fractured cases.

뇌부종에 대한 임상적 연구

조성옥 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.2

The study of cerebral swelling has occupied investigators since the dawn of the neurosurgical science. Nearly all form of insults to the brain can upset cerebral water balance and lead to edema. The progressive brain swelling ultimately causes a rise in intracranial pressure and present neurosurgeons grave challenge in clincal practice. In this study, a clinical analysis on 209 cases of cerebral. edema which were admitted into department of neurosurgery, Chungnam National Univerity Hospital from Jan. 1978 to Oct. 1980 were done and following results were obtained. 1. The commonest causes of cerebral edema was trauma (59.8%) and the others were cerebrovascular accident(21.5%) and brain tumror(15.8%) in that order. 2. Various degree of consciousness disturbance was observed in 65.1% of patients while oculomoter nerve palsy in 36.8% and decerebrated rigidity in 15.3% of patient. 3. 83.7% of cases showed localized edema around the pathological lesion or confined to one cerebral hemishere making shift of midline. However 16.3% of patients showed no midline shift while there was definite clinical sign of increased intracranial and diffuse rarefaction of density on C-T scan. C-T scan has proved great value assesing status of cerebral edema. 4. 44% of patient were underwent surgical removal of space occupying lesion with or without decompressive surgery. Tracheostomy also was performed in 42% of patients with great benifit. Hypertonic solution and corticosteroid also proved value for the control of brain edema.

두개강내로 침범한 녹색종 : A Case Report

조성옥 충남대학교 의과대학 지역사회의학연구소 1976 충남의대잡지 Vol.3 No.2

Chloroma is an unusual presenting feature of acute leukemia in childhood. These are found in relation to the periosteum of the skull, paranasal sinuses, orbits, vertebrae or ribs. Chloromas may occasionally central of peripheral neurologic disturbance, as this patient demonstrated. 9 year old girl entered this hospital with complaints of protrusion of left eye, headache and vomiting. A month prior to admission the parent noted slight protrusion of left eye which had progressed rapidly with development of another small masses in the scalp. On admission, the patient showed rather anemic somewhat dull mentality and moderate papilledema on right. Blood picture and biopsy of scalp mass revealed hematologic and cytologic features of acute leukemia. The girl has deteriorated rapidly and died on the 28th hospital day. Autopsy showed multiple chloromas in relation to the periosteum of orbital fossa, ribs, pelvis, and skill. There were four masses as large as one to two cm in diameter at the inner aspect of dura mata which were compressing the brain. It is rare in this country that the infiltration of chloroma on the dura mata was proved in autopsy.

학습방법이 피로도에 미치는 영향에 관한 연구

조성옥 이화여자대학교 체육대학 1968 梨花體育學會誌 Vol.- No.2

腰椎間板脫出症 五十例의 手術 結果에 對하여

趙誠玉,張秉烈,高又鏈 국군의무사령부 1964 대한군진의학학술지 Vol.3 No.1

두부외상에 의한 뇌신경손상에 대한 임상적 고찰

조성옥 충남대학교 의과대학 지역사회의학연구소 1977 충남의대잡지 Vol.4 No.1

A clinical analysis was carried out on 76 cases of cranial nerve injury out of 285 cases of head injury observed at Chungnam University Hospital in two and half years:1973, Jul. and 1976, Jan. The most frequently affected nerves were occulomotor (48 case), acoustic(10 case), facial(9 case), and abduscence nerve(5 case)in order. Intracranial bleeding was provided by surgery in about half of patients which showed unilateral pupillary dilatation. The outcome of facial palsy was worse in the group of immediate palsy than delayed one. Conductive hearing difficulty was more frequent and showed better prognosis than receptive one.

충남지방에 있어서 요통환자의 임상적 고찰

조성옥,윤승호,박준식 충남대학교 의과대학 지역사회의학연구소 1975 충남의대잡지 Vol.2 No.1

The purpose of this study was to investigate the clinical status of low back pain patients in Chungnam province where the farmers are the predominant population. From Jan, 1974 to Feb, 1975, 414 patients with low back pain had visited this hospital or our survey team. All the patients were taken x-ray and careful clinical evaluation were performed. The results were as follows. 1. 67.3% of patient were age proup of 20∼49 years. The mean age was 35.9 years. Male was slighlty outnumbared than female. 2. Sciatica occured in 48.3% of the patients. This figure seems rather high percentage. 3. 33.1% of patients believed that the first symptoms were the result of accidents or heavy ligting while the 66.9% of patients were unable to show the causes. 4. Prior to first hospital vist, 24.2% of patients were treated with herb medicine, 18.4% with alcapuncture and 29.0% with steroid derivertives at drug stores. considerable mumber of piatents had been treated with herb medicine as long as 6 months. 75% of patients who were treated with steroids at drug stores developed signs of side effect. 5. The most common neurological signs were motion disturebance of spine (36.4%), straight leg raising straining (40.0%) sensory disturbance (16.7%) , diminution or loss of deep tendon reflex(15.5%-25.5%) 6. X-ray showed marginal sclerosis and osteophyte of body (57.4%) abnormality (13.5%) Myelography was done on 36 patients and 29 patients showed positive finding of herniated intervertebral disc.

뇌경막외출혈의 임상적 고찰

조성옥 충남대학교 의과대학 지역사회의학연구소 1978 충남의대잡지 Vol.5 No.2

43 cases of extradural hematoma were admitted and underwent surgery in Chungnam University hospital in 4 years since 1974 to 1978. A clinical observation was made and following results were obtained. 1. The lucid interval was noted in 19 cases and the mortality of this group was 0. 5%. 2. 30 cases showed pupillary abnormality, contralateral dilatation in 3 cases, ipsilateral dilatation in 21 cases and bilateral fixed dilatation in 5 cases. The dilated fixed pupil resulted in death except one case. 3. Motor signs had more lateralizing value than pupillary abnormality. 25 cases showed contralateral weakness while only one case in the ipsilateral side. 4. Mortality rate was 28%. It seems that there was no direct relation with size of he-matorna but rather depend on the severity of associated cerebral contusion. 5. The mechanism of extradural hematoma formation was discussed.

후두와내에 발생한 지주막낭종 : 증예보고

조성옥 충남대학교 의과대학 지역사회의학연구소 1974 충남의대잡지 Vol.1 No.1

Idiopathic benign arachnoid cyst occur less commonly within the posterior fossa. It seems probable that such cyst in the posterior fossa may also be developmental in origin. In this paper, we present a case of arachnoid cyst in the posterior fossa. An 8 month old female baby was admitted to neurosurgical unit complaining of large head, vomiting, mental retardation and occasional fever. Examination showed Parinaud's syndrome and tense fantanell. Positive ventricurography revealed obstruction of aqueduct with dilatation of ventricles. Posterior fossa exploration showed a cyst of about 4cm in diameter. Partial removal of the cyst wall and the Tolkildsen's procedure was performed. Tissue examination identified the fibrous cyst wall with glial and ependymal tissue. Postoperative course was uneventful and the pressure has relieved.