외상후 발작의 위험인자에 대한 조사

이재학,배학근,윤석만,도재원,이경석,윤일규,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Risk Factors for Posttraumatic Seizure The authors evaluate the risk factors for posttraumatic seizures. this prospective study was performed in a series of 470 head injured patient from January 1996 to Decomber 1998. The patients who were dead within 1 week of injury or children from 3 years old and under were excluded. There were 358 male and 112 female with a mean age of 35.2±22.8 years (range, 4-88 years). The results were as follows : 1). Of the 470 patients, pasttraumatic seizure occurred in 48 patients(10.2%): early seizure in 28(6%) and late seizure in 20 patients(4.2%). 2). The clinical risk factors for posttraumatic seizure were poor consciousness at admission, presence of brainstem herniation signs, poor GCS score, and posttraumatic amnesia more than 24 hours after trauma(p<0.001). 3). The radiological risk factors for posttraumatic seizure were subdural hematoma(p<0.001), intracerebral hematoma (p<0.02), mutiple intracranial CT lesions(p<0.001), or delayed lesions on follow-up CT scans(p<0.001). the incidence of seizure increased according to the severity of diffuse brain lesion(p<0.001), and the seizure rate in mass lesion was higher than that in diffuse lesion(p<0.001). 5). Hypoxia and coagulopathy had a statistically significant influence on posttraumatic seizure(p<0.05). Hypoxia had a infuence on occurrence of late seizure(p<0.05). 6). The incidence of posttraumatic seizure signiticantly increased in surgical group compared with coservative group(p<0.001) and significantly increased in patient who underwent decompressive craniectomy compared with those who underwent craniotomy(p<0.001) 7). Preventive administration of antiepileptic drugs decreased the incidence of early seizure, but did not affect on the reduction of late seizure. 8). Multivariate logistic regression analysis showed the subdural hematoma, GCS score, delayed lesion, and intracerebral hematoma in order of importance for seizure risk. in conclusion, the risk factors affecting on the occurrence of seizure were clinical status at admission, CT lesions, and severity of diffuse brain inJury. Considering that hypoxia affected on the late seizure, it is necessary to detect and treat it immediately after trauma. In addition, the patients who underwent decompressive craniectomy should be carefully followed to evaluate the risk of late seizure. Even though preventive administration of antiepileptic drugs had a tendency to decrease the incidence of early seizure, it is unclear whether administration of antiepileptic drugs can reduce the incidence of posttraumatic seizures. Prospective study will be needed in the selected patients.

60세 이상 환자의 척추수술

윤석만,이경석,도재원,배학근,윤일규 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Objective: Advances in surgical technique, anesthesia and perioperative patient management, coupled with the rapid increase in the population of patients reaching their 60s or older, have led to a signiticant rise in spinal precedures. The objective of this study was to evaluate frequency of the disease, surgical results and postoperative complications of the aged patients who underwent spinal surgeries. Methods : We reviewed all spinal procedures for spinal lesions including degenerative diseases, trauma, tumor and others in patients aged 60 years or older between January 1 1994 and October 1 1998(56 men and 26 women), retrospectively. Final outcome was assessed by telephone interview with the patient or the family in 67.1%(55/82). Results : There were 56 male patients and 26 female patients. There were 57 cases of degenerative diseases, 14 cases of trauma, 5 cases of metastaisis, 4 cases of infection and 2 cases of others. According to the level of surgical procedures, there were 20 cases fo cervical spine, 8 cases of thoracic spine, 54 cases of lumbar spine. Postoperaive complications included the following(17/82): 7 dural tears, 2 sepsis, 2 nerve root injury and 6 others. There were no operation-related deaths. During follow up period, ten patients(12.2%) had died, 45 patients(54.9%) were contacted and 27 patients(32.9%) could not be located. Mean follow up period for the 45 patients contacted was 26.1±15.7 months. Of the 45 persons contacted, 34(75.6%) reported improvement, 6(13.3%) no change and 5(11.1%) aggravation of their preoperative symptoms. Conclusion: Spine surgery in patients aged 60 years or older has higher complication rate compare to the younger but it is reasonable to consider the surgical procedures even in the elderly if it is needed. We should give attention not to tear the dura during the surgical procedures, especially in the elderly.

자발성 뇌지주막하 출혈 환자에서 최초 뇌실 크기의 임상적 의의

신일영,윤일규,윤석만,도재원,이경석,배학근,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

The purpose of this study is to invesetigate the clinical significance of initial enlargement of ventricle in the patients who had aneurysmal SAH. Of the total 821 patients with aneursmal SAH who were registerd in SAH data bank system between 1989-1999, 307 patients who had been already measured in the size of ventricle at the time of admission, were studied retrospectively. The size of ventricle was calculated by bifrontal index. Normal size of ventricle was defined as 30% or less, mild enlargement was defined as 31 to 39%, and moderate enlargement of vertricle was defined as more than 39% in bifrontal index. The sizes of ventricle using bifrontal index were analysed according to the age, sex, blood pressure, consciousness at admission, medical history of hypertension, location of ruptured aneurysm, Fisher's grade on CT(computerized tomography) scan at the time of admission, cerebral vasospasm, intraventricular hemorrhage (IVH), performance of external ventricular drainage (EVD), and prognosis at discherge. Chi-square test and ANONA were used in the statistical evaluation. The results were as follows : 1) Of the 307 patients, 235(76.5%) had a mild to moderate enlargement of ventricle at the time of admission (more than 30% in bifrontal index). 2) The size of ventricle was enlarged according to the increase of age (p<0.05). 3) In the patients who had ruptured aneurysm on anterior cerebral artery, the size of ventricle significantly increased and showed a higher incidence in mild enlargement compared with moderate enlargement of ventricle (p<0.05). 4) The size of ventricle increased in th patients who had IVH and the EVD was more frequently performed in th patients who had the enlarged ventricle associated with IVH (p<0.05). 5) In the patients who had high Fisher's grade, the size of ventricle had a tendency to increase, but there was no statistical significance. 6) In the patients who had poor prognosis, the size of ventricle had a tendency to increase, but there was no statistical significance. Conclusively, the initial size of ventricle was enlarged in th aged patients, ruptured aneurysm on anterior communicating artery, high FIsher's grade, patients associated with IVH. Considering those factors, prediction for the enlargement of ventricle size may help to treat the patients suffering aneurysmal SAH.

NEAR-INFRARED PHOTOMETRY OF THE STAR CLUSTERS IN THE DWARF IRREGULAR GALAXY IC 5152

Kyeong, Jae-Mann,Sung, Eon-Chang,Kim, Sang-Chul,Sohn, Sang-Mo Tony,Sung, Hyun-Il The Korean Astronomical Society 2006 Journal of The Korean Astronomical Society Vol.39 No.4

We present JHK-band near-infrared photometry of the star clusters in the dwarf irregular galaxy IC 5152. After excluding possible foreground stars, a number of candidate star clusters are identified in the near-infrared images of IC 5152, which include young populations. Especially, five young star clusters are identified in the(J-H, H-K) two color diagram and the total extinction values toward these clusters are estimated to be $A_v=2-6$ from the comparison with the theoretical values given by the Leitherer et al.(1999)'s theoretical star cluster model.

PHOTOMETRIC PROPERTIES OF THE OPEN CLUSTER NGC 2194

Kyeong, Jae-Mann,Byun, Yong-Ik,Sung, Eon-Chang The Korean Astronomical Society 2005 Journal of The Korean Astronomical Society Vol.38 No.4

UBVIJHK photometry of the open cluster NGC 2194 are presented. Color-Magnitude diagrams of this cluster show well-defined main sequence and red giant clump. The main sequence also contains clear evidence of binary populations. Based on color-color diagrams, absolute magnitude of red giant clump, ZAMS fitting, and comparisons of observed color-magnitude diagrams with theoretical models, we derive following parameters for the cluster; reddening $E(B-V)=0.44{\pm}0.04$, age of log $t{\sim}8.8$, and finally distance of $(m-M)_0=12.20{\pm}0.18$.

JK PHOTOMETRY OF BRIGHT GIANTS IN NGC6712

KYEONG JAE-MANN,BYUN YONG-IK The Korean Astronomical Society 1998 Journal of The Korean Astronomical Society Vol.31 No.2

With a large format near-infrared camera at the 2.2-m telescope on Mauna Kea Observatory, we performed J K near-infrared observations for the metal rich globular cluster NGC6712. This cluster lies near the galactic plane and therefore suffers heavy reddening. We present the near-infrared color-magnitude diagram and also derive the metallicity ([Fe/H] ${\~}-0.96{\pm}0.27$) as well as its distance modulus ((m - M) ${\~}13.42{\pm}0.12$).

NEAR-INFRARED PHOTOMETRY OF METAL RICH GLOBULAR CLUSTER M71

Jae-Mann Kyeong,Yong-Ik Byun,Mun-Suk Chun 한국우주과학회 1997 Journal of Astronomy and Space Sciences Vol.14 No.2

UBV I CCD PHOTOMETRY OF THE OLD OPEN CLUSTER NGC 1193

Kyeong, Jae-Mann,Kim, Sang-Chul,Hiriart, David,Sung, Eon-Chang The Korean Astronomical Society 2008 Journal of The Korean Astronomical Society Vol.41 No.6

We present UBV I photometry of the old open cluster NGC 1193. Color-magnitude diagrams (CMDs) of this cluster show a well defined main sequence and a sparse red giant branch. For the inner region of r < 50", three blue straggler candidates are newly found in addition to the objects Kaluzny (1988) already found. The color-color diagrams show that the reddening value toward NGC 1193 is E(B - V ) = $0.19{\pm}0.04$. From the ultraviolet excess measurement, we derived the metallicity to be [Fe/H]= $-0.45{\pm}0.12$. A distance modulus of ${(m\;-\;M)}_0$ = $13.3{\pm}0.15$ is obtained from zero age main sequence fitting with the empirically calibrated Hyades isochrone of Pinsonneault et al. (2004). CMD comparison with the Padova isochrones by Bertelli et al. (1994) gives an age of log t = $9.7{\pm}0.1$.

PHOTOMETRIC STUDY OF THE OLD OPEN CLUSTER TOMBAUGH 2

KYEONG JAE-MANN,BYUN YONG-IK The Korean Astronomical Society 2000 Journal of The Korean Astronomical Society Vol.33 No.3

We present the results of near-IR band (JHK) photometric study for the old open cluster To 2. Combined with existing optical data, our IR photometry is used to derive the reddening E(B- V)=0.24$\pm$0.12 and the distance (m-M)o=14.6$\pm$0.42. Comparison with theoretical isochrones suggests the age and metallicity of To 2 are log t$\~$9.3 and [Fe/H]$\~$-0.3, respectively.

UBVI CCD PHOTOMETRY OF OPEN CLUSTER NGC 2324

KYEONG JAE-MANN,BYUN YONG-IK,SUNG EON-CHANG The Korean Astronomical Society 2001 Journal of The Korean Astronomical Society Vol.34 No.3

UBVI CCD photometry of open cluster NGC 2324 is presented. C-M diagrams of this cluster show well-defined main sequence with a red giant clump centered at B - V =1.05, V =13.45. We derived the major cluster characteristics; E(B - V)=0.17$\pm$0.12 from color-color diagram and mean color of red giant clump stars, (m - M)o=13.1$\pm$0.1 from zero age main sequence fitting, and [Fe/H]$\~$-0.32 from comparison the theoretical model developed by Bertelli et al. (1994) to the observed C-M diagrams. We estimate the age of NGC 2324 to be log t$\~$8.8 by applying isochrone fitting and morphological age index method.