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.

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.

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.

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.

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.

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.

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.

한강권역 국가지하수관측망의 관측자료 분석

강수환(Soo-Hwan Kang),백건하(Keon-Ha Baek),배종섬(Jong-Soem Bae),신경희(Kyung-Hee Shin) 대한지질학회 2017 대한지질학회 학술대회 Vol.2017 No.10

‘인간’, 부조리와 ‘괴물’의 출현 장소-봉준호의 <살인의 추억>을 중심으로-

강수환 ( Kang Soo-hwan ) 인하대학교 한국학연구소 2015 한국학연구 Vol.0 No.39

봉준호 감독의 <살인의 추억>은 10여년이 지난 오늘날에도 지속적으로 언급되고 있다. 그것은 영화가 오늘날의 현실을 관통하는 점이 있기 때문이다. 봉준호의 영화는 특히 인간과 사회 간의 관계 속에서 표출되는 불가해한 지점들을 끊임없이 포착해왔다. 그들은 마치 ‘괴물’처럼 종종 비합리적이고 폭력적이며 과잉이다. <살인의 추억>도 마찬가지이다. 영화는 ‘평범한’ 인물들로부터 드러나는 괴물적 속성을 잘 담아낸다. 본고는 등장인물 사이에서 어떤 방식으로 ‘괴물’의 속성이 출현하는가를 살피고자 했다. 서사 속에서의 ‘괴물’들은 어떤 ‘합리’의 과정에서 출현하기보다는 그 반대에 가깝다. 실제로 ‘부조리’란 괴물의 뚜렷한 속성이다. ‘괴물’은 정해진 규칙을 파기함으로써 발생한다. 인간은 늘 ‘합리성’을 열망하지만 자연의 ‘비합리성’ 앞에서 실족한다. 그 점에서 카뮈는 부조리를 ‘인간의 조건’ 그 자체로 이해한다. 마찬가지로 영화 속 ‘괴물’ 또한 그들은 외부적 조건이 아닌 외밀한 속성으로부터 출현하는 양상을 띤다. 영화는 한 인물 속에 인간과 ‘괴물’의 양상이 혼재할 수 있다는 사실을 보여준다. ‘허구’와 ‘현실’도, ‘부조리’와 ‘합리’도, ‘괴물’과 ‘인간’도 모두 별개의 영역이 아니다. 각 영역은 모두 각자의 대립항이자 동시에 상호관계하는 동전의 양면이다. 이 지점에서 본고는 일견 ‘괴물’스러워 보이는 인간의 ‘부조리함’이야 말로 그를 소위 ‘합리적 인간’일 수 있도록 보증하는 하나의 조건이 아닌가 하는 질문을 던지고자 한다. 한편 이 속성은 법의 ‘예외상태’와도 유관해 보인다. 법률은 그 자체로 내속적인 한계-결여를 지닌다. 그 내속적 한계로 인해 법은 자기 유지를 위해 주권자의 예외상태 선포를 통해 법 스스로를 정지시키기도 한다. 마찬가지로 부조리를 내속적 특징으로 지닌 ‘(사회적 동물로서의)인간’ 또한 자기 유지를 위하여 주체에 의해 예외상태가 선포될 때, ‘괴물’의 출현이 이루어지며, 이는 ‘법률’과 ‘인간’이 동어반복적 ‘의무’에 종속될 때 나타난다. Memories of Murder that was directed by Bong Jun-Ho has been referred until now even it was released 12 years ago. It is probably because his movie still has an insight on today’s reality. His movies tried to capture the point of incomprehensibility between Human-being and Society. They are often irrational, violent and excessive. Such as Monster. Memories of Murder is to same as well. It shows clearly the feature of monster which comes from ordinary people. So that this study tried to examines how the monster characters appeared in this film. Monsters did not appear from rationality but rather than from opposite thing. Indeed, absurdity is a distinct attribute of monster. They usually break the rules in their own society. A human-being always desires the rationality but they always failed by irrationality of nature. That’s why A. Camus insists the absurdity as attribute of human-being itself. Likewise, monsters arise out of their own ‘extimate’ condition, not out of external factors in this film. Memories of Murder let us know that a person can keep aspects of human and monster as his own attribute at the same time. There is no individual thing between Fiction and Real, Absurdity and Rationality, and Monster and Human. Every each thing is opposite clause of another, and at the same time, interrelated with another as two side of the same coin. Then, what if the absurdity which it looks like attribute of monster is just a condition that is able to approve himself a rational human? Meanwhile it is considered concerning with State of Exception. The laws can be stopped by a sovereign’s declaration of state of exception, human(as social-animal) also could stop his own humanity through declaring the state of exception by his subject to maintain himself. Monsters arise this process. And it usually occurs when Law and human are subordinated to tautological duty.

유동하는 사이버 공간과 현대인들의 일상성

강수환(Kang Soo-Hwan) 인문콘텐츠학회 2013 인문콘텐츠 Vol.0 No.30

유동하는 근대에서는 모든 ‘견고한 것’들이 액화되어 그 연결고리가 해체되고 세속화되며, 유동성이 권력으로서 대두되는데 이는 ‘사이버 공간’의 특징과 유사성을 지닌다. 본 연구는 현대인들의 트위터 이용양상을 통해 유동하는 사이버 공간속에서 어떤 방식으로 그들이 나름의 ‘일상성’을 소비하는가를 밝히는 것을 목적으로 한다. 트위터는 현대인들이 가장 즐겨 사용하는 SNS 중 하나다. 트위터는 리좀의 원리와 유사한 매체 특성을 통해 확산성과 다양성을 생산하기도 한다. 이는 웹 3.0 시대로 접어들며 현대인들의 일상에 보다 밀착되는 추세다. 이러한 개인들이 트위터에 참여하는 데에는 ‘유명인’이 되고 싶어 하는 논리가 작용하는데, 그것은 상품의 ‘교환가치’로서 책정된다. 트위터 속 개인은 ‘시선’을 매개로 상품으로서 소비하고, 소비되며 보다 ‘일상성’에 천착하게 된다. 한편 이러한 사이버 공간에는 정작 ‘세계’가 없어 보이나, 사이버 공간 특유의 ‘보편 형식’이 각각의 이용자들을 “세계 전체”로 직접 연결시키고 있음을 볼 수 있다. 이를 가능케 하는 바탕에는 카니발주의가 있다. 일상성이 뒤집어지고 구성원 모두가 평등하게 즐기는 무대란 카니발의 속성이자 사이버 공간의 특징이다. 카니발은 일상에서 발생하는 불안을 해소하기 위한 축제며, 이는 일상으로의 회귀를 위해서이다. 스마트폰 속으로 이식된 트위터를 통해 카니발은 일상 어디서든 가능하다. 이처럼 트위터의 기본 서사란 일상성의 전복이 아닌 ‘일상성으로의 회귀’에 있는 셈이다. In liquid modern, every solid is melted so that disintegrated its connecting-links and be secularized. And liquidity is on the rise as power. It has similarity with feature of cyberspace. This study tries to explore how contemporary men consume their ‘quotidiennete’ in liquid cyberspace by observing their way of using the Twitter. Twitter is most popular SNS in the world. Twitter can be the media that produces diffusivity and diversity through the similarity with Rhizome system. It is going to be closer to comtemporary men’s routine since advent of web3.0. This individual’s reason of participating in Twitter is base on the logic of hoping to get more fame. And fame is priced the value which is correspond to an ‘exchange-value’ of the merchandise. In Twitter, people are consuming and consumed through ‘other’s gaze’, and immerse into ‘quotidiennete’. On the other hand, this cyberspace seems like ‘worldless’ but we can see all of the user connected to “whole-world” directly by a ‘formal universal’ which is a feature of cyberspace. It’s affected from ‘Carnivalism’. The stage which turns over the routine and makes everyone share enjoyment is one of the intrinsic attribute of carnival and cyberspace. Carnival is kind of festival to get rid of anxiety from daily routine and it has purpose to return to daily life. Through the Twitter which implanted to smart-phone, carnival is always possible to happen at everywhere. Like this, the basic narrative of Twitter is not ‘overturing the routine’, but ‘returning to quotidiennete’.