朝鮮近代文藝

金東仁 朝鮮及滿洲社 1932 朝鮮及滿洲 Vol.- No.293

頭腦外傷에 對한 臨床的 考察

琴東仁 충남대학교 의과대학 지역사회의학연구소 1977 충남의대잡지 Vol.4 No.2

In modern society, characterized by variability of daily life, complicated industrial structure and suprizingly increased traffics, the danger of unexpected accident is always threatening the people. About two thirds of traffic accident patient have head injury of various forms. A clinical analysis was carried out with 550 cases of craniocerebral injuries observed at the department of neurosurgery, Chungnam National University Hospital in 4 years between Jun, 1973 and Jul, 1976. The results were as follows: 1. There were 418 men 132 wonmen:male female ratio was 3 : 1. 2. The commonest cause of head injury was traffic accident (53.5% of total patient) and the next was "falls"(22.3%). 3. In sku11 fractures, vault fractures were 85.8%, basal skull fracdures 14.2%. The incidence of simple fractures was higher that of compound fractures, the ratio being 9.4. Most of liner fratures were simple fractures. 4. Among the intracranial hemorrhagic lesions, subdural hematoma occupied about half of the total cases, most of them were acute cases. The epidural heinatoma, the predilection site was temporal area, occupied about 26.7% of total intracranial hemorrhagic lesions. The intracerebral hematoma occurred predominantly in temporal lobe. 5. About 56.9% of the patients with intracranial hemorrhagic lesions were accompanied by skull fracture while 30.2% of the patient having skull fracture presented intracranial hemorrhagic lesions. 6. The level of consciouseness on admission was altered in about 80% of the total patients vomiting occured in 22.2% of total patients and early convulsive attacks were notice in 5.1%. 7. Overall mortality rate of all the head injurry patient was 10.4% and their operative rate was 30.3%. The mortality rate in severe cerebral contusion was 41.9%. 8. Sequalae were noticed in about 38.5% of the total patients. The most frequent one was postconcussional syndrome the incidence being 29% of the total patients. 9. Associated injuries were found in about 11.3% of the total patients. The frequent one were mandible and/or teeth, femur and rib in order.

일산화탄소가 태아혈액의 산소평형 곡선에 미치는 영향에 관한 연구

금동인,김윤,박해근 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.1

Oxygen equilibrium curve of fetal blood is a major determinant of tissue oxygen tension and thus of oxygen supply to fetal tissue. Despite the great clinical importance of this area, oxygen binding properties of fetal blood currently are known only at one point on the curve, i. e. the affinity at half saturation, P_50 and also direct measurement of carbon monoxide's effect on oxygen binding are not known for fetal blood. The goal of this study was to synthesize the results of these measurements into clinically useful practical equations describing oxygen transport in the presence and absence of carbon monoxide in normal fetal blood. Oxygen equilibrium curves of fetal blood samples were measured by means of thin blood film dual wave length spectrophotometry and electrode oximetry using soret wave lengths of 430-453 ㎚ under standard condition. All measurements was made on blood whose isohemoglobin profile has been established by isoelectric focussing. Obtained results are summarized as follows. 1. Hb_F content of cord blood was 66.2±1.35% of total Hb. 2. The oxygen equilibrium curves of fetal blood were shifted to the left with increasing CO saturation of Hb. P_50 of normal fetal blood and of blood saturated by 11.7, 19.0, 31.8, and 45.7% carbon monoxide were 23.83±0.47, 20.16±0.28, 19.34±0.63, 15.88±0.73, and 12.11±0.28㎜Hg, respectively. 3. The relationship between log P_50 and〔COHb, %〕of the fetal blood was log P_50=1.382-0.006〔COHb, %〕. The correlation coefficient(r=-0.95) was statistically significant. The P_50 of fetal blood in the presence or absence of carbon monoxide can be obtained by the following equation. P_50(㎜Hg)=antilog〔1.382-0.006〔COHb, %〕〕 4. Hill's constant(n) and K values of normal fetal blood were 2.55 and 3.2×10 exp (-4). An increase in the K values and a decrease in the Hill's constant (n) were associated with the increased saturation of carbon monoxide in the fetal blood. Hill's relationship (log (S/1-S) vs. log Po_2) in the presence〔COHb, %〕and absence of carbon monoxide exhibited linear and correlation coefficient (r>0.99). were statistically significant 5. The relationships between Hill's constant (n) or log K and log〔COHb, %〕can be expressed as following equation. n=2.693-0.65 log〔COHb, %〕 log K=1.48 log〔COHb, %〕-1.48 Both of correlation coefficient, -0.99 and 0.99, were statistically significant. 6. Oxygen equilibrium curve of fetal blood saturated partially with carbon monoxide can be obtained from the following formulas. PO_2=〔SO_2/K (1-SO_2)〕^1/n n=2.693-0.65 log〔COHb, %〕 K=antilog〔1.48 log〔COHb, %〕-4.18〕

頭腦外傷에 對한 臨床的 考察

琴東仁 충남대학교 대학원 1977 論文集 Vol.8 No.-

In modern society, characterized by variability of daily life, complicated industrial structure and suprizingly increased traffics, the danger of unexpected accident is always threatening the people. About two thirds of traffic accident patient have head injury of various forms. A c1inca1 analysis was carried out with 550 cases of craniocererebral injuries observed at the Department of Neurosurgery, Chungnam National University Hospital in 4 years between Jun; 1973 and Jul., 1976. The results were as follows : 1) There were 418 men 132 women; male female ratio was 3:1 2) The commonest cause of head injury was traffic accident(53.5% of total patient). and the next was "falls"(22.3%). 3) In skull fractures, vault fractures were 85.8%, basal skull fractures 14.2%. The incidence of simple fractures was higher that of compound fractures, the ratio-being 9;4 Most of linear fratures were simple fractures. 4) Among the intracranial hemorrhagic lesions, subdural hematoma occupied about half of the total cases, most of them were acute cases. The epidural hematoma, the predilection site was temporal area, occupied about 26.7% of total intracranial hemorrhagic lesions. The intracerebral hematoma occurred predominantly in temporal lobe. 5) About 56.9% of the patients with intracranial hemorrhagic lesions were accompanied by skull fracture while 30.2% of the patient having skull fracture presented intracranial hemorrhagic lesions. 6) The level of consciousness on admission was altered in about 80% of the total patients vomiting occured in 22.2% of the total patients and early convulsive attacks were noticed in 5.1%. 7) Overall mortality rate of all the head injury patient was 10.4% and their operative rate was 30.3%. The mortality rate in severe cerebral contusion was 41.9% 8) Sequalae were noticed in about 38.5% of the total patients. The most frequent one was postconcussional syndrome the incidence being 29% of the total patients. 9) Associated injuries were found in about 11.3% of the total patients. The frequent one were mandible and/or teeth, femur and rib in order

제4뇌실 뇌낭충증

금동인,조성옥 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.1

Cerebral cysticercosis is, unfortunately, a frequent disease in Korea. Cysts in the ventricular system are rarest form. They are most frequently observed in the fourth ventricle, more rarely in the lateral and third ventricles. The clinical picture of ventricular cysticercosis is that of increased intracranial pressure with hydrocephalus. Of the surgical interventions of cerebral cysticercosis most favorable result can be expected in this variety. Two cases of cysticercosis in the fourth ventricle were reported. Neither case had the hx. of T. Solium infestation nor typical blood and C.S.F. picture. The clinical picture was that of increased intracranial pressure with occasinal sudden hydrocephalic attack which usually lasted 24 hrs. The first case died abruptly because of sudden respiratory arrest.

측뇌실로 파열된 중대뇌동맥 진균성 동맥류 1예

금동인,백지현,조성옥 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.2

Approximately 4% of cerebral aneurysms are of mycotic origin. The desination of "mycotic" for arterial lesions of infectious origin was provided by Osier in 1885, and. The relationship of mycotic aneurysms in any location to bacterial endocarditis was made clear by the review of Stengel and Wolferth in 1923. Mycotic aneurysms are abnormalities of the vessel wall resulting from infacted emboli, most commonly arising from the heart as a part of the spectrum of bacterial endocarditis. The middle cerebral artery is most commonly involved, including its proximal division which is a common site for congenital aneurysms also. Recently we experienced a case of middle cerebral mycotic anenrysm ruptured into the lateral ventricle and sucessful removal of the hematoma after clipping of the aneurysm. The patient was discharged uneventhly in mild left hemiplegias we discussed with a brief review of the literature.

두개강내로 침범한 녹색종의 1예 : A Case Report

금동인,조성옥 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.2

Chloroma is an unusnal 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 produce central or 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 mass 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 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 skull. 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.

뇌질환에 대한 방사성 동위원소 촬영의 진단적 의의

금동인,김성호,구환희 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Brain scan using radioactive Technetium 99m-pertechnetate were done on the 60 suspicious cerebral lesion patients, who were diagnosed and treated at the Department of Neurosurgery, CNU, Hospital since Jun, 1982 to `Jun. 1984. The results were analysed in the aspect of diagnostic significance as follows. 1. The brain scan were positive in 50% of the suspicious brain lesion and there was significant difference between the number of hot area and the positive rate of brain computerized tomography. 2. The brain scan were positive in 46% of the head trauma and are more positive in subdural hematoma than in other injury. 3. The brain scan were positive in 67% of the brain tumor and variable abnormal brain scan pattern were noted. 4. The brain scan were positive in 66% of the brain vascular lesions and aneurysm are not usually visualized by scanning unless they are very large.

외상성 중대뇌동맥 폐색증의 2예

금동인,김관태,김윤 대한신경외과학회 1977 Journal of Korean neurosurgical society Vol.6 No.2

Traumatic middle cerebral artery occlusion has rarely been discussed in the neurosurgical literature. Since Deveer and Browder reported the first case in 1942, only 24 cases of posttraumatic middle cerebral artery occlusion has been reported until now. We experienced 2 cases of posttraumatic middle cerebral artery occlusion recently. One patient was 39 years old male who developed right hemiplegia, aphasia, and mental confusion after blent head injury. Left carotid angiography was done and it revealed complete obstruction of the middle cerebral artery in its initial portion. The other patient transfered to our Emergency Room under the semicomatous stale with multiple facial laceration wounds. Simple skull X-ray revealed multiple linear skull fractures on the left frontal region. Left carotid angiogram showed complete obstruction of left middle cerebral artery in its proximal portion like as former case. During hospitalijation, marked improvement was showed in both cases under the conservative treatment with steroid and low molecular weight dextran.

뇌질환에 대한 CT 소견의 임상적 고찰

금동인 충남대학교 의과대학 지역사회의학연구소 1983 충남의대잡지 Vol.10 No.2

The computed tomographic scan has revolutionized the management of intracranial lesion and has been established as an accurate diagnostic modality. The computed tomography was perorformed in 226 intracranial lesions and those findings were retrospectivery analyzed. The results were summerized as tollows: Age incidence was prevalaent in older than 40 year old in brain neoplasm, and 50 year old in cerebrovascular accident, and 20-30 year old in cerebrocranial trauma. The ratio of male and female was 2 : 1 in intracranial hematoma and craniocerebral trauma. 190 abnormal CT findings were subdivided into brain neoplasm 46, orbital tumor 3, intracerebral hematoma 28, aneurysm 4, AVM 4, craniocerebral trauma 113, brain abscess 2, hydrocephalus 3, cerebral atrophy 2, parasites 2. Durationbetween morbid onset and CT scannigs were 0-12 hours : 102(45.1%) 12-24 hours : 17(3.5%) 24-36 hours : 13(5.7%) 36-48 hours : 10(4.4%) 48- : 84(37.2%) Neurological findings were cheaked into mental state, pupil reflex and motor respond. Brainneoplasm and craniocerbral trauma were subdivided into spesfic diseases.