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강제구,Kang, Jae Goo 대한후두음성언어의학회 2012 대한후두음성언어의학회지 Vol.23 No.2
Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.
강제구,류재영,문준환,이등호,최호영,전성환 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.5
Background and Objectives:Caudal septal deformities are surgically challenging disorders. A number of corrective programs have been described with variable success. Causes of frequent failure in correction of the caudal deformities have been conservatism and unrealistic dependence on incisional method such as cross hatching, and limited comprehension of the extrinsic and intrinsic forces causing caudal deformities. We reviewed and evaluated the surgical techniques for correction of the caudal septal deformities performed at our institution. Subjects and Method:A retrospective study was performed on 24 patients who underwent septal surgeries for severe caudal septal deformities between Feb 2001 to May 2004. With open approach, all deforming forces around the caudal septum were released and definite intraoperative correction was possible. Results:All 24 patients showed definite improvement in terms of functional and anesthetic outcomes. Potential complications related with structural instability as well as other inherent complications of nasal surgery have not been encountered. Conclusion:For successful correction of the caudal septal deformities, completed exposure and releasing all the extrinsic forces around the caudal deformities via open rhinoplasty approach is desirable to avoid frequent recurrences.
국선표,강제구,이광수,Kook, Sun-Pyo,Kang, Jegu,Lee, Kwang-Soo 한국병원경영학회 2022 병원경영학회지 Vol.27 No.3
Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.
송주헌,김호찬,강제구,노동환 대한이비인후과학회 부산,울산,경남 지부회 2015 임상이비인후과 Vol.26 No.2
Middle East Respiratory Syndrome (MERS) caused by a single-stranded, positive-sense RNA beta-coronavirus (MERS-CoV) was first isolated in Jeddah, Saudi Arabia. Approximately 180 cases of MERS have occurred in a recent Korean outbreak. Clinical features vary from asymptomatic infection to severe pneumonia with acute respiratory distress syndrome and/or multiorgan failure. To control acute respiratory failure, endotracheal intubation is frequently required; in most patients with prolonged endotracheal intubation, tracheotomy is mandatory to appropriately control the airways and to avoid serious complications of extended intubation. Tracheotomy can be a high-risk procedure because it generates profuse droplets and aerosols, which in turn promote interpersonal dissemination of the virus. Herein, we report the first tracheotomy case in a Korean MERS patient to describe appropriate airway management and protection of medical staff.
코성형술에 사용된 고어텍스의 안정성에 관한 다기관 평가
진홍률,이주연,강제구,김경수,김영기,김춘동,노환중,동헌종,문형진,박동준,박효진,윤영석,윤자복,윤주헌,이상학,이재서,연제엽 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.12
Background and Objectives: Materials and Method:A retrospective multicenter study was caried out on 15 surgeons from 1 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. Results:The overall complication rate asociated with Gore-Tex was 2.5% (21 cases). Infection was the most com-mon complication (18 cases;2.1%) folowed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher asociation rate between in-fection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. Conclusion:The infection rate of Gore-Tex used in rhinoplasty was efore, we suggest judicious use of Gore-Tex in rhinoplasty.