주관 증후군의 수술적 치료: 척골 신경의 전방 근하 전위술과 전방 근막하 전위술의 비교

강수환,송석환,박일중,이상욱,이승구,박승범,Kang, Soo-Hwan,Song, Seok-Whan,Park, Il-Jung,Lee, Sang-Uk,Rhee, Seung-Koo,Park, Seung-Bum 대한미세수술학회 2008 Archives of reconstructive microsurgery Vol.17 No.1

Surgical treatment of compressive ulnar neuropathy at the elbow has been performed with a wide variety of techniques. Among these techniques, anterior submuscular transposition of the ulnar nerve has been regarded as the method of choice by many authors. It has many advantages including a low recurrence rate, scar-free vascular bed, and protection from repeated trauma to the nerve. However, anterior submuscular transposition is technically demanding and requires more extensive soft tissue dissection. On the other hand, anterior subfascial transposition is less invasive, requires a relatively shorter operation time than the submuscular technique, and also can be done safely even in patiensts with elbow arthritis. We evaluated the clinical results of anterior submuscular transposition compared with anterior subfascial transposition. Fifteen patients underwent anterior submuscular transposition and ten patients underwent anterior subfascial transposition of the ulnar nerve. The mean follow-up time was 15 months (range 10 to 38 months) in the anterior submuscular transposition group and 7 months (range 6 to 15 months) in the anterior subfascial transposition group. According to the outcome status determination algorithm devised by Mowlavi, 3 patients (20%) showed total relief, 10 patiensts (66.7%) improvement and 2 patients (13.3%) no changes in the anterior submuscular transposition group. In the anterior subfascial transposition group, 2 patients (20%) showed total relief, 7 patients (70%) improvement and 1 patient (10%) displayed no changes. Statistically there was no significant difference of the clinical results between the two surgical techniques. Therefore we would suggest anterior subfascial transposition of the ulnar nerve as a preferred method for treatment of cubital tunnel syndrome.

초음파상 고에코 소견을 보인 손목에 발생한 결절종

강수환,기세린,최남용,송현목,송현석,Kang, Soo Hwan,Kee, Serine,Choi, Nam Yong,Song, Hyun Mok,Song, Hyun Seok 대한정형외과초음파학회 2014 대한정형외과 초음파학회지 Vol.7 No.1

결절종은 수부나 손목 관절의 관절막 혹은 건초에서 흔히 발생하는 연부 조직 양성 종양으로 초음파상 경계가 명확한 저 에코성의 낭성 종괴로 보여 비교적 정확하게 진단할 수 있다. 저자들은 손목 관절의 수장부 요측에서 촉지되는 종괴에 대하여, 술전에 시행한 초음파 검사 상 고 에코성 소견을 보여서 고형성 종괴로 추정하였으나, 수술 소견 및 조직학적 검사에서 결절종으로 진단되었던 예를 경험하였기에 고 에코를 보이는 결절종에 대한 문헌 고찰과 함께 보고하고자 한다. Ganglionic cyst is the most common benign tumor in the wrist and hand, and easily diagnosed with ultrasonography. Ganglionic cyst in sonography usually appears as hypoechoic or anechoic with well-demarcated cystic mass. We report a case of the hyperechoic mass at the volar aspect of the wrist, which confirmed as ganglionic cyst by operative and histological findings.

손목에서 발생한 요골 동맥의 외막 낭포 - 1예 보고 -

강수환,박일중,김동엽,김광섭,Kang, Soo Hwan,Park, Il-Jung,Kim, Dong Yeob,Kim, Kwang Sub 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.2

Simple ganglions are most common benign tumor of the hand and wrist. However, cystic adventitial disease is an uncommon vascular anomaly first described in 1947 in the external iliac artery. It usually involves the popliteal artery, although other arteries and veins may also be involved. Radial artery adventitial cysts are found directly within the adventitia, whereas the more common wrist ganglions may extrinsically compress or adhere to the artery walls. The diagnosis is rarely made before surgery because of their similar appearance and location. The authors report a rare case of a 46-year old woman with mucoid adventitial cyst of the radial artery in the wrist.

Lichtman 제 III기 Kienbock 병에서 시행한 제 4+5 신전구획동맥 유경 생골 이식술

강수환,김철진,정양국,류지현,Kang, Soo-Hwan,Kim, Chol-Jin,Chung, Yang-Guk,Ryu, Ji-Hyun 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.1

Purpose: The purpose of this study was to evaluate the clinical results of the 4+5th extensor compartmental artery pedicled vascularized bone graft in advanced Lichtman stage III Kienbock's disease. Materials and Methods: Eight patients with advanced Lichtman stage III Kienbock's disease who underwent the 4+5th extensor compartmental artery pedicled vascularized bone graft and followed up more than 1 year were analyzed retrospectively. There were 3 men and 5 women. The mean age was 43.6 years old. Two patients were Lichtman stage IIIA and six patients were IIIB. The clinical outcomes were evaluated with radiocarpal joint pain, range of motion, grip strength, carpal-height ratio, radioscaphoid angle, return to daily living activity and/or work. The mean follow up period was 38.5 months (range from 12 to 86 months). Results: On last follow up, the pain was disappeared in 6 patients, and mild occasional pain was remained in 2 patients. Mean radiocarpal joint flexion and extension were 55 degrees and 60 degrees, 87% and 88% of the normal side, respectively. The carpal-height ratio was maintained or improved in 6 patients and slightly decreased in 2 patients. Radioscaphoid angle were improved or maintained in 7 patients. Mean grip strength was 67 lb, 93% of the normal side. All 8 patients returned to daily living activities and/or their previous works. Conclusion: The 4+5th extensor compartmental artery pedicled vascularized bone graft prevented the progression of disease and provided clinical improvement even in advanced Lichtman stage III Kienbock's disease.

제 4 신전구획동맥 혈관부착 골 이식술을 이용한 키엔벡 질환의 치료: 예비 결과

강수환,김형민,정창훈,이상욱,이강욱,박일중,Kang, Soo-Hwan,Kim, Hyoung-Min,Jeong, Chang-Hoon,Lee, Sang-Uk,Lee, Kang-Wook,Park, Il-Jung 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.1

Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbo${\ddot{o}}$ck disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbo${\ddot{o}}$ck disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbo${\ddot{o}}$ck disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbo${\ddot{o}}$ck's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.

에스트로겐 수용체 ${\beta}$ 발현과 유방암 재발과의 관련성

강수환,최정은,이수정,Kang, Su-Hwan,Choi, Jung-Eun,Lee, Soo-Jung 영남의대학술지편집위원회 2011 Yeungnam University Journal of Medicine Vol.28 No.2

Background: It has been reported that estrogen receptor beta ($ER{\beta}$) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha ($ER{\alpha}$) expression in breast cancer. The association of $ER{\beta}$ mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of $ER{\alpha}$ and $ER{\beta}$ via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between $ER{\beta}$ expression and recurrence in the hormonal therapy group, and between $ER{\beta}$ expression and known prognostic factors. Methods: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at $-70^{\circ}C$ until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. Results: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of $ER{\alpha}+/ER{\beta}+$, $ER{\alpha}+/ER{\beta}-$, $ER{\alpha}-/ER{\beta}+$, and $ER{\alpha}-/ER{\beta}$ group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. $ER{\beta}$ was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the $ER{\beta}$ expression tended to recur, but there was no clinical significance (p=0.084). Conclusion: The $ER{\beta}$ expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

방정환의 동화와 소년소설에서의 성장과 근대성의 문제

강수환(Kang, Soohwan) 한국아동청소년문학학회 2021 아동청소년문학연구 Vol.- No.28

본 논문은 방정환의 동화와 소년소설을 분석 텍스트 삼아 방정환의 동화와 소년소설에서 발견되는 성장과 근대성의 의미를 분석한다. 비교문학적 분석을 위해 본 논문은 프랑코 모레티(Franco Moretti)의 교양소설 연구와 크리스토퍼 파크스(Christopher Parkes)의 영국 아동문학 연구를 참조했다. 방정환에게 ‘어린이’와 ‘소년’은 근대의 기획이라는 동일한 목표를 공유하며 창발한 존재였다. 그러나 방정환에게 어린이는 ‘반근대의 충동’(낭만)처럼 재현되는 데에 반해 소년은 ‘근대의 표상’(현실)으로 다루어졌다. 본 논문은 이러한 두 존재 사이의 간극을 이해하는 데에 착목함으로써 이들을 둘러싼 성장과 근대성의 의미에 접근하고자 한다. 외관상 어린이와 소년은 상반된 존재처럼 보이지만, 이러한 경향은 아동을 주인공으로 삼는 영국 낭만주의 문학에서도 비슷하게 나타났다. 파크스는 당시의 어린이 인물을 “살아있는 자본주의 정신의 구현”으로 독해했는데, 본 논문은 이를 ‘살아있는 근대주의 정신의 구현’으로 변용하여 적용했다. 방정환의 어린이와 소년은 동전의 양면처럼 이어진 존재다. 그의 동화 속 어린이의 형상은 근대주의와는 거리가 멀어 보이지만, 어린이와 근대주의 사이의 거리는 둘의 관계가 반대적임을 시사하지 않는다. 그들 사이의 거리는 잠정적이기 때문이다. 어린이는 ‘근대의 표상’에 더욱 부합하는 인물로 성장하기 위해 현실로 직행하기에 앞서 잠정적으로 분리된다. 텍스트를 분석한 결과 방정환의 동화 속 어린이의 유희는 모더니티의 감각을 체화하는 한에서 발생하는 것이었다. 그러므로 이때의 어린이는 ‘반근대의 충동’보다는, 근대주의적 정신의 이면이자 일종의 예비단계에 해당한다고 볼 수 있다. 근대성을 내면화한 어린이는, 소년으로 성장하여 본격적으로 근대적 기획의 과업을 짊어지고 현실 속으로 개입해야 한다. 하지만 식민지라는 현실조건은 어린이에서 소년으로 성장한 이들에게 동일한 내러티브를 쥐여주지 않았다. 그 결과 방정환의 소년소설에서 소년은 일련의 과정을 거쳐 성숙에 이른다기보다는 이미 성숙한 존재로 나타난다. 그의 소년소설은 이미 성숙한 소년의 본질이 주변 어른 인물 인물에 의해 발견․공인되는 형식의 서사를 반복한다. 이는 ‘내면의 법’(자아)과 ‘외부의 법’(사회화) 간의 조화를 도모했던 서구의 교양소설 모델과 상응하지 않는 것이었다. 본 논문은 이를 식민지라는 현실조건의 차이에서 기인하는 것으로 보고, 당대의 현실과 방정환의 소년소설에서 드러난 특징 사이의 관계를 분석한다. This paper analyzes the meaning of growth and modernity in Bang Jeonghwan’s fairy tales and juvenile novels. For comparative literary analysis, this paper referred to Franco Moretti’s study of Bildungsroman and Christopher Parkes’ study of British children’s literature. For Bang Jeonghwan, “children” and “juvenile” were emergent beings sharing the same goal: The modern project. However, to Bang Jeonghwan, children were treated as “anti-modern impulses” (romance), whereas juveniles were treated as “modern representations”(reality). The two seem to be the opposite. This paper attempts to approach the meaning of growth and modernity by understanding the gap between Bang Jeonghwan’s ‘children’ and ‘juvenile.’ In appearance, ‘children’ and ‘juvenile’ seem to be contradictory. This was similarly found in British romantic literature, with children as the protagonists. Parkes read the character of children at the time as “the living embodiment of the spirit of capitalism.” This paper transforms and applies it as ‘the living embodiment of the spirit of modernism.’ Bang Jeonghwan’s ‘children’ and ‘juvenile’ are connected like both sides of a coin. The figures of children in his fairy tales seem far from modernism, but the distance between children and modernism does not suggest that their relationship is the opposite. Because the distance between them is temporary. Children are temporarily separated from reality in order to grow into beings more consistent with the “modern representation.” As a result of analyzing the text, the children’s enjoyment in Bang Jeonghwan’s fairy tales occurred as long as they have embodied the sense of modernity. Therefore, children here can be considered the backside of ‘the spirit of modernism’ and kind of preliminary stage rather than ‘anti-modern impulses.’ Children who have internalized modernity must grow into juveniles and take on the task of the modern project in earnest and intervene in reality. However, due to the colonial condition, those who grew up from children to juveniles could not get the same narrative. As a result, in Bang Jeonghwan’s juvenile novel, the juvenile appears as an already mature being, rather than reaching maturity through a series of processes. His juvenile novels repeat the narrative in which the already mature juvenile"s nature is discovered and recognized by the adult character around him. It did not correspond to the model of Western Bildungsroman, which promoted harmony between the “inner law”(self) and the “external law”(socialization). This paper regards it as a result of the difference in the conditions of the colonization and analyzes the relationship between the reality of the time and the characteristics revealed in Bang Jeonghwan’s juvenile novels.

동종 탈회 골 기질의 골 재생 촉진 효과

강수환 ( Soo Hwan Kang ),정양국 ( Yang Guk Chung ),이윤경 ( Yun Gyoung Lee ),김양수 ( Yang Soo Kim ),김용식 ( Yong Sik Kim ),김정만 ( Jung Man Kim ),박세욱 ( Se Wook Park ) 한국조직공학과 재생의학회 2010 조직공학과 재생의학 Vol.7 No.4

The purpose of this study is to investigate the efficacy of bone regeneration of combined demineralized bone matrix (DBM) and osteoconductive allogeneic cancellous bone granule implantation in critical size bone defect, rabbit radius model. We grafted the mixture of DBM and allogeneic cancellous bone granules in the experimental group, and the mixture of autoclaved DBM and allogeneic cancellous bone granules in the control group in 30 New Zealand White rabbits. At the 3, 6, 9, and 12 weeks post-implantation, radiographic and bone mineral density BMD evaluation were performed, and micro-CT and histologic assessments were performed with 6 and 12 week specimens. In comparison of the results of radiographic, BMD, and micro-CT evaluations, the experimental group showed much more and earlier bone formation than the control group, which indicated the enhanced bone regeneration by the effect of DBM on allogeneic cancellous bone granule scaffolds. Histologic evaluation also revealed rapid bone resorption, new bone formation, and maturation in experimental groups. There was no inflammatory or foreign body giant cell infiltration suggesting biologic incompatibility. Combined DBM and allogeneic cancellous bone granule composite grafts will be useful alternatives to autogenous bone grafts in various clinical conditions which require bone regeneration.

초기유방암에서 피하유방 전절제술과 즉시유방재건술

강수환(Su Hwan Kang),이수정(Soo Jung Lee),우상현(Sang Hyun Woo),정재호(Jae Ho Jeong),설정현(Jung Hyun Seul) 대한외과학회 1999 Annals of Surgical Treatment and Research(ASRT) Vol.57 No.4

세 외국인 여행자의 `눈`과 보편에의 탐색 잭 런던, 조르주 뒤크로, 이사벨라 버드 비숍의 방문기를 중심으로

강수환 ( Kang Soohwan ) 국제비교한국학회 2016 비교한국학 Comparative Korean Studies Vol.24 No.2

본고는 근대 초기 조선을 방문한 서구 방문자들의 여행기에 나타난 그들의 시선과 태도를 분석한다. 여기서 다룰 세 명의 서구 방문자는 잭 런던, 조르주 뒤크로, 이 사벨라 버드 비숍이다. 각각은 1904년(잭 런던), 1901년(조르주 뒤크로), 그리고 1894년과 1897년(이사벨라 버드 비숍)에 조선을 방문한다. 세 방문자 각각은 청일전쟁(1894~5)부터 러일전쟁(1904~5)이 발발한 시기에 조선을 찾는다. 해당 시기는 조선, 더 나아가 동아시아 질서에 커다란 재편이 발생한 구간이라는 점에서 그 중요성이 남다르다. 근대 초기 한반도를 찾은 여행자 중에서도, 위 시기의 작가와 저작을 선택한 건 그 이유에서다. 제목에서도 알 수 있듯, 본고는 당대 외국인의 눈에 비친 조선보다는 `외국인의 눈` 그 자체에 주목한다. 즉, 스스로 보편의 질서에 위치해있다고 믿었던 서구 방문자들의 시선에서 조선-타자는 어떻게 포착되었는지, 한편 그 타자를 보편 속으로 어떻게 관계시키고자 했는지를 살피려는 것이다. 이를 통해 `오리엔탈리즘`과 `유럽중심주의`를 넘어서는 인식과 표상을 구상해보려는 것이 본고의 목적이다. 잭 런던의 민족주의로 가장한 인종주의와, 조르주 뒤크로의 (문화)상대주의로 가장한 타자화는 오늘날 `유럽중심주의`의 어떤 원형적 모델을 제공한다. 사미르 아민의 정식에 따르자면, 전자는 유럽이 이미 보편주의를 발견했다는 주장이며, 후자는 보편주의의 필요성을 아예 간과하는 주장이다. 하지만 이사벨라 버드 비숍은 앞선두 인물과는 다른 태도를 견지한다. 그 역시 최초에는 조선을 결핍과 미달의 공간으로 파악한다. 하지만 후반부에서 그의 태도는 전환되어, 조선이 보편에 가닿을 수 있는 가능성을 발견하기에 이른다. 그와 같은 변화는 비숍이 `기질`이라는 서사의 허구성을 파악하고, 조선의 체제·구조적 문제를 통찰한 데서 기인한다. 그리고 이는 소수자로서 보편으로의 안착을 모색했던 비숍 자신의 위치가 만들어낸 효과로 추정된다. 종종 “문명의 충돌”로 요약되는 오늘날의 현실에서 새로운 보편에의 요구는 시급한 과제이다. 보편성의 출현이 `좌절된 특수성`이나 또는 그것의 자리에서만 대자적으로 출현한다고 한다면, 전체-보편으로부터 배제된 자리 위에서 조선이 도야해야 할 보편에의 가능성을 살폈던 비숍의 관점을 참조하는 것은 오늘날 유의미한 작업일 것이다. This paper tries to analyze three foreign travelers` viewpoint and attitude who visited in early modern Korea. It deals with Jack London, Georges Ducrocq and Isabella Bird Bishop`s essay. Each of them, came into Korea at 1904(London), 1901(Ducrocq) and 1894 & 1897(Bishop). As title of this paper, I focus on `eyes of foreigners` rather than on the images of Korea which is represented by foreign traveler. Hereby, the purpose of this paper is con-ceiving the new perception and representation beyond `Orientalism` and `Eurocentrism`. London`s racism that disguised as nationalism and Ducrocq`s `othernization` that dis-guised (cultural)relativism are provide a archetypal model of nowaday`s Eurocentrism. According to Samir Amin, the former is kind of an argument that Europe discovered universalism already and the latter is an argument that ignoring the necessity of universalism. But Isabella Bird Bishop shows different viewpoint and attitude. At first, she understood Korea as lacking, nonstandard space as just as Jack London did. But later, especially when she wit-nessed the success of Siberian settler from Korea, her perception about Korea was converted. Maybe the change of her viewpoint is comes from her witness and insight. She observed `dis-position` as a fictional narrative and gained a insight into Korea`s systematic problem. And this result is assumed to an effect which made from Bishop`s status that seek for the safe arriv-al into universality as a minority. According to Slavoj Zizek, "a universality arises “for itself” only through or at the site of a thwarted particularity." Bishop tried to find possibility of universality on Korea which the place is excluded from conventional totality-universality that constructed by Europe. This is why we have to refer to the Bishop`s perspective today.