뇌정위적 정신수술의 장기 추적 결과

손병철,김문찬,이철,강준기,Son, Byung-Chul,Kim, Moon-Chan,Lee, Chul,Kang, Joon-Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.4

Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

소뇌 교각부 종양의 임상적 분석

손병철,조경근,박춘근,지철,이길송,이상원,강준기,최창락 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.11

Although the cerbellopontine area is a relatively small portion in the intracranial cavity, various kinds of tumors could be found in this area due to it's anatomical characteristics. There are several cranial nerves, brain stem, aquaduct of Sylvius, cerebellum and important vascultures in this area, so various neurological symptoms and signs could be occured when the tumor developed in this region. A clinical analysis of 49 patients with cerebellopontine angle tumors during the last 5 years at the department of neurosurgery of C.U.M.C was done retrospectively. There were 19 men and 30 women with mean age of 43.8 years. The most frequent tumor was acoustic neuroma-37 of these patients(75.8%) and followed by meniningioma and ependymoma in frequency. The most frequent clinical symptom were headache and hearing disturbance. On the radiological evaluation, simple plain X-ray film showed normal in 43.3% and CT scan of the brain showed hydrocephalus and asymmetric cistern in 28% and in 25% of patients respectively. Surgery was done by total extirpation in 19 cases and partial removal in 23 cases and the result were excellent or good in 29 cases.

국내자판기산업의 현황 및 문제점

손병철,Son, Byeong-Cheol 한국전자정보통신산업진흥회 1997 電子振興 Vol.17 No.9

후두와로 확장된 거대 경추 경막하 지방종

손병철,이일우,강준기,최창락 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

Intraspinal lipomas are rare, benign neoplasms, comprising less than 1% of all intradural spinal tumors. Such tumors occur in the thoracic and cervical region, however, extension into the posterior fossa is most unusual. A case of large cervical intradural spinal liplma with extension into the posterior fossa in adult female is presented. Clinical feature was slowly progressing quadriparesis. Brain and cervical spine computed tomography confirmed the diagnosis and Magnetic resonnance imaging was very useful for delineation of the anatomy of the lipoma as an aid in planning th operation. Operative therapy consisted of combined suboccipital craniectomy, spinal laminotomy and laminoplasty, subtotal tumor decompression.

고양이 소뇌 치상핵파괴시 전기생리학적 변화

손병철,김문찬,강준기,최창락 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.9

Spasticity is a wide variety of motor problems to connote difficulty with coordinated movements, involuntary spasms, rigidity. abnormal primitive reflexes and hyperactive reflexes. Electrophysiologically, spasticity is represented as the involuntary firing of motor units on a reflex basis at a polysynaptic spinal cord level. associated with interruption of descending cortical pathways. Although many procedures have been tried over the years to combat this spasticity, and the multitude of procedures indicates that none are entirely satisfactory, the reduction in spasticity produced by dentatotomy has been confirmed in many neurological centers. The F-wave is a late response recorded in the electromyography of a muscle following stimulation of its nerve supply. There is evidence that the size of the F-wave is dependent on motor neuron excitability. If such a relationship exists, procedures which are carried out to relieve motor neuron excitability might be expected to change F-wave size and it might therefore be possible to use the F-wave as an objective monitor during stereotactic dentatotomy. We have investigated this possiblity in 10 cats, weighing 2.8 to 3.7kg each. The size of F-wave Amplitude in experimental animals were devided into 2 groups, normal control group values(10 cats, before dentatotomy) and the dentatotomy group values (10 cats after dentatotomy). The F-wave size and F/M ratio were recorded from right tibialis anterior muscle after application of supramaximal stimulation (250 V. 100 mA. 2Hz. 10 times) on the right peroneal nerve. The results were as follows : 1) The size of M-wave amplitude did not change significantly in experimental models (before dentatotomy, 2805.5±1012.3 ㎶ ; dentatotomy group, 2555.5±725.9 ㎶, P>0.05). 2) The individual size of F-wave showed a wide variability from each stimulus, which emphasises the importance of using 10 stimulating responses. The mean value of F-wave amplitude before dentatotomy was 4365±113.2 ㎶. 3) The size of F-wave amplitude was significantly reduced after duntatotomy (before dentatotomy, 436.5±113.2㎶ ; after dantatotomy : 212.5±49.3 ㎶, P<0.05). The size of F-wave amplitude decreased about 48.6% after dentatotomy. 4) The F/M ratio also significantly reduced after dentatotomy(before dentatotomy, 17.1±6.6% ; after dentatotomy, 8.5±1.2%, P<0.05) and mean reduction was 49.7%. The results demonstrated that the dentatotomy markedly decreased the size of F-wave amplitude in experimental cats and indicated that the monitoring of F-wave amplitude during dentatotomy might be useful as an objective monitor for the relief of spasticity.

작은 피질하 병변에 대한 정위적 개두술 및 경-구 접근법

손병철,김문찬,이관성,박춘근,홍용길,강준기 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.12

뇌실로 파열되어 있는 뇌농양에 대한 뇌정위적 내시경하 제거술 - 증례보고 -

손병철,김문찬,강준기,Son, Byung-Chul,Kim, Moon-Chan,Kang, Joon-Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.6

The major indication of endoscope in neurosurgical field is intraventricular procedures. Recently, it can be used selectively in the intraaxial mass lesion associated cavity. For example, cystic mass, with liquefied necrosis, and blood clot can be approached with this technique. The authors present its usage in brain abscess ruptured into lateral ventricle. The neuroendoscope was introduced into abscess cavity through stereotactic guidance, the pus was then removed through continuous irrigation and suction under direct video visualization. The intraventricular pus was also cleaned through gentle, direct endoscopic irrigation and suction. The postoperative clinical course was uneventful. Brief overview is given for this intraaxial neuroendoscopic procedure.

후두신경통의 진단과 치료: 큰뒤통수신경 포착증후군을 중심으로

손병철 대한의사협회 2023 대한의사협회지 Vol.66 No.1

Background: Occipital neuralgia is defined as paroxysmal shooting, or stabbing pain in the posterior part of the scalp, in the distribution of the greater and lesser occipital nerves. Occipital neuralgia may present only as an intermittent stabbing pain, but different opinions exist on its cause and diagnostic criteria. Current Concepts: According to the latest version of headache classification, only paroxysmal stabbing pain is included in the diagnostic criteria, and persistent aching pain is excluded. Pain intensity was also limited to severe cases. It has therefore become difficult to classify existing occipital neuralgia, whose main symptom is persistent pain rather than paroxysmal stabbing pain. Occipital neuralgia is classified as either idiopathic or secondary. Secondary occipital neuralgia is caused by structural lesions innervating the trigeminocervical complex (TCC) in the upper spinal cord, the dorsal root of second cervical cord, and the greater occipital nerve (GON). Discussion and Conclusion: Although idiopathic occipital neuralgia has no cause, the entrapment of the GON in the tendinous aponeurotic attachment of the trapezius muscle at the superior nuchal line has recently been proposed as an etiology. Chronic, irritating afferent input of occipital neuralgia caused by entrapment of the GON seems to be associated with sensitization and hypersensitivity of the second-order neurons in the TCC receiving convergent input from trigeminal and occipital structures. TCC sensitization induces referred pain in the facial trigeminal area.

대구 협성학교의 설립과 운영에 관한 고찰

손병철 재단법인 대구경북연구원 2021 대구경북연구 Vol.20 No.1

1906년 대구경북지역 유림들이 지방 영학(營學)인 낙육재에서 시작한 대구 협성학교는 1907년 경상감영 내로 이전하면서 설립 취지를 밝혔다. 충군사상을 기반으로 한 신학문 수용이라는 대구 협성학교 설립 취지는 구국을 위해 설립된 사립학교였음을 보여준다. 대구경북지역 전통 유림들이 대구광문사를 중심으로 대구 협성학교를 설립하였지만 일본 세력 확대에 따라 친일관찰사 박중양과 개화지식인 중심인 대한협회대구지부가 운영의 주체로 되었다. 1907년 한일신협약 체결 이후 한층 강화된 일본의 침략정책에 맞서 운동회, 토론회 등의 국권회복 교육활동을 전개하였고 교원강습소, 교사연수 등 교사교육에도 참여하였다. 본 연구에서 대구경북지역 유림들이 중심이 되어 자주적으로 설립한 대구 협성학교는 대구경북지역 근대교육에 큰 공헌을 하였음을 밝혔지만 대구 협성학교 시작인 경상감영 내 낙육재의 변화가 명확하지 않아 앞으로 해결해야 할 과제이다. Daegu Hyeopseong School was established in 1906 by local Confucian scholars with the name of ‘Nakyukjae’, a local government school. The purpose of the establishment of Daegu Hyupseong School was to accept of modern academics based on the patriotism, which shows that local private schools were established for saving country and enlightenment. Daegu Hyupseong School promoted the establishment of a school by local Confucian scholars in Daegu, based on Gwangmunsa, but with the expansion of Japanese power, pro-Japanese provincial governors and the Daegu branch of the Daehan Association, centered on enlightened scholars became the main body of its administration. Despite the change in the governing body of the school, Daegu Hyupseong School conducted educational activities to cultivate students' skills such as athletic meeting and discussion activities, and participated in teacher education such as teacher training centers and teacher training. This study makes attempt to show that the Daegu Hyupseong School, which was independently established by the Daegu-Gyeongbuk Confucian scholars, has made a great contribution to modern education in the Daegu-Gyeongbuk area. The location of Nakyukjae, which seemed to be the start of Daegu Hyupseong School, and how the school changed is not clear, which still remains to be investigated.

좌전하행동맥 만성 완전폐쇄병변의 치료 후 호전된 폐고혈압 1예

손병철 대한내과학회 2018 대한내과학회 추계학술대회 Vol.2018 No.1