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전외측대퇴유리피판 (Anterolateral Thigh Free Flap)을 이용한 구강안면부 결손의 재건
김철환,방대연,황승연,Kim, Chul-Hwan,Bhang, Dae-Yeon,Hwang, Seung-Yeon 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.6
Recently, the anterolateral thigh(ALT) flap, based on the septocutaneous vessels or musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery has gained popularity in head and neck soft-tissue reconstruction. It has some advantages in free-flap surgery with respect to the radial forearm free flap, such as low donor site morbidity, availability of different tissues with large amounts of skin, adaptability as a sensate or flow-through flap (with the possibility of harvesting a long pedicle with a suitable vessel diameter). Moreover, the thickness of the flap is adjustable until the subdermal fat level, allowing it to be used as a thin or ultrathin flap. This clinical cases are ALT free flap reconstructions without functional impairment of the donor limbs (transitory and permanent) based on anastomosis with superficial temporal arteries and veins in patient of huge resection defect on face, lip and tongue.
구강암 수술 및 재건 환자에서의 C-Reactive Protein 수치의 변화
김철환,황승연,Kim, Chul-Hwan,Hwang, Seung-Yeon 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.5
Purpose: The aim of this study is that we evaluate the change of the White Blood Cell(WBC) count, Absolute Neutrophil Count (ANC), Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) values, and try to make standardization for postoperative sequels before and after the oral cancer resection and reconstructive surgery. Materials and Methods: The study was comprised of 34 patients (male 15, female 19) who were diagnosed as an oral cancer and had performed ablation and reconstructive surgery at Dankook university dental hos-pital. Each blood specimen was collected from patients and estimated WBC count, Neutrophil count, ESR, CRP on first, third, fifth, seventh day efore and after surgery and analyzing inter relationship between each value. Classifying Group I (resection with reconstructive surgery patients) and Group II (resection without reconstructive surgery patients). Also classifying group A (below 4 hours of operation time), Group B (4 to 8 hours of operation time), Group C (above 8 hours of operation time), each group was analyzed and compared. The Following results were induced. Results: (1) In coefficient of correlation, the CRP and WBC has highest value except WBC count and Neutrophil count. (2) There was no significant difference any lapse in the progress between Group I and II of WBC count, Neutrophil count, but the CRP shows statistically higher level in group I than group II at immediate postoperative day, and 1 to 5 days after surgery. (3) There is no significant difference any lapse in the progress between Group A, B, C of WBC count, Neutrophil count, but CRP shows statistically significant difference in 1 day, 3 days after surgery Conclusion: It should be suggested that, determination of CRP is most valuable parameter for postopera-tive management and determination of postoperative clinical changes than other parameter such as WBC count, neutrophil count, and ESR values in oral cancer patient after resection and reconstructive surgery, based on the results of this study.
김철환,이경호 ( Chul Hwan Kim,Kyung Ho Lee ) 한국경제학회 1997 經濟學硏究 Vol.45 No.3
1970-1995년 사이의 연간 자료를 사용하여 한국의 재정적자와 대미달러 환율 사이의 관계를 실증적으로 분석한 결과 두 변수 사이에 공적분관계가 존재하는 것으로 나타났다. 오차수정모형을 사용하여 두 변수 사이의 인과관계를 추정한 결과 재정적자가 환율에 영향을 미치는 것이 아니라, 환율변동이 재정적자에 영향을 미치는 일방적인 인과방향이 장기적으로 존재하는 것으로 나타났다. 이제까지 우리 나라의 이자율과 환율이 각각 자본시장과 외환시장에서 결정되지 못하고, 정책적으로 결정되어 왔던 점을 감안하면 재정적자가 이자율을 변화시켜 환율에 영향을 주는 것은 기대하기 어렵다. 재정적자가 환율에 영향을 미치지 못하는 것으로 나타난 우리의 추정결과는 이러한 현실을 비교적 잘 반영하고 있다. 환율로부터 재정적자로의 장기적인 인과관계의 존재에 대해서는 명확한 설명이 쉽지 않다. 이러한 관계에 대한 하나의 가능한 설명은 두 변수가 수출, 소득 등의 다른 변수를 매개로 하여 장기적으로 함께 움직이는 경향이 존재 할 수 있다는 점이다.
김철환,김미숙,Kim, Chul-Hwan,Kim, Mi-Suk 대한구강악안면외과학회 1999 대한구강악안면외과학회지 Vol.25 No.4
Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.
미스 반 데어 로에의 IIT 캠퍼스의 구성과 공간적 특성에 관한 연구
김철환(Kim, Chul-Hwan) 한국산학기술학회 2014 한국산학기술학회논문지 Vol.15 No.11
본 연구는 미스 반 데어 로에의 일리노이 공과대학 캠퍼스(1339-1359)의 구성과 공간적 특성을 분석하는 것을 주제로 한다. 미스의 건축에 대한 연구가 “보편적 공간”이나 구조적 합리성 등 단일 건축물에 치중되어 왔다면 IIT 캠퍼스는 여러 동의 건물로 공공 공간을 구성한 단지계획이라는 점이 연구의 동기라고 할 수 있다. 본 연구에서는 미스의 기존 작품들과의 연관성을 도출하고 IIT 캠퍼스의 계획의도를 분석하기 위해 미스가 그린 스케치, 배치도, 투시도 등을 분석하였다. 그리하여 도출한 결론은, 첫째 미스는 단순한 형태의 선형건물을 공공 공간을 규정하는 벽처럼 사용하여 “흐르는 공간”을 캠퍼스 전반 에 구현하였다. 둘째, IIT 캠퍼스는 그 자체로 도시 공간의 한 일부분으로서 통합되는 “중립적 프레임”이 되었다. 셋째, 캠퍼 스의 내부에는 학생들을 위해 외부의 혼잡함으로부터 보호받으며 조용한 안정감을 주는 동시에 주변 공간과 연속되고 개방 된 공공 공간을 만들었다. This study examined the composition and spatial characteristics of the Illinois Institute of Technology (1939-1959) campus by Mies van der Rohe. Studies of the Mies’ architecture has been focused mostly on “universal space”, structural rationality for a single building. Therefore, it is interesting to study an IIT campus through which Mies composed public space dealing with several buildings together. To determine the relationships with his previous works and the design intentions for IIT campus, this paper studied his preliminary sketches, perspective drawings etc.. By doing so, the paper presents the following conclusions. First, Mies composed the IIT campus with simple linear buildings as walls to create the “flowing space” through the campus. Secondly, the IIT campus could become the “neutral frame” integrating the campus with urban space. Third, Mies also created an open, continuous public space in the center of the campus that allows protective, quiet seclusion for the students.