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두경부 악성 종양 절제술후 요골 전완 유리피판을 이용한 재건술의 평가
김현직(Hyun Jik Kim),임영창(Young Chang Lim),송미현(Mee Hyun Song),이원재(Won Jae Lee),최은창(Eun Chang Choi) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2
Background and Objectives: The reconstruction is very important in Head and neck cancer surgery to repair the defect created by resection of tumors, to enable successful wound healing, to restore function and to provide acceptable cosmesis. The radial forearm free flap has been the most useful reconstructive flap because it provides a moderate amount of thin, pliable, relatively hairless skin and comparatively simple to do with minimal morbidity. The aims of this study is to estimate the outcome of the reconstruction with radial forearm free flap with the several factors in 140 head and neck cancer cases in our hospital for last 10 years. Materials and Methods: Retrospective review of the records of 140 patients underwent resection of the head and neck tumors and reconstruction with a radial forearm free flap from 1993 to 2003. The age, sex of the patients, Primary site, the complication of donor and recipient site, flap survival rate, median time to start diet, patient subjective symtoms about swallowing and articulating and the fact of revision reconstructive surgery were analyzed. Results: In primary pathologic site, 56 cases were oral cavity cancers, 44 cases, oropharyngeal cancers and 22 cases, hypopharyngeal cancers. Flap survival rate was 93.6% (13 leases). On donor site, wound dehiscence, hematoma, sensory change and infection were noted and on recipient site, most common complication were fistula and wound dehiscence. The complication rate of recipient's site was 19.1 % and donor site, 3.5%. In 118 cases (84.3%), the patients could take all kinds of food. Swallowing difficulty were noted in 22 cases 05.7%). In 5 cases, there was articulation difficulty but most of patients except patients having total laryngectomy (18 cases) couldn't have any difficulty in articulation and speaking. Conclusion: We conclude that the radial forearm free flap is the most appropriate reconstructive material for treating the defect in head and neck reconstruction.
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김은영(Kim Eun Young),송미현(Song Mee Hyun) 한국창의력교육학회 2012 창의력교육연구 Vol.12 No.2
본 연구의 목적은 SNS를 활용한 대학의 비교과 프로그램 '창의성 동아리'를 통해 대학 내 창의성 프로그램의 확대와 SNS의 적용가능성을 검토해 보는 것이다. 연구대상은 S여대 창의성 동아리로 5개 팀 22명의 학생이 5개월간 활동하였다. S여대 창의성 동아리 활동은 페이스북으로 진행되었고, Treffinger, Isaken, Dorval(2000)이 개발한 창의적 문제해결 모형 중 과정요소를 활용하여 창의적 문제해결반응, SNS반응, 동아리반응, 관리자반응 등으로 동아리 활동을 분석하였다. 연구결과, SNS를 활용한 창의성 동아리 활동은 창의적 문제해결 과정요소 중 '문제(도전)의 이해' 중 '자료탐색', '행동(실천)을 위한 준비' 중 '수용적 토대 구축'이 가장 높게 나타났다. 창의적 사고 중에서는 발산적 사고가 수렴적 사고보다 높게 나타났다. 전체 동아리 활동 중에서는 'SNS 반응'과 '동아리반응'이 높게 나타났다. 그리고 학생들이 지각한 창의성 동아리의 성과로는 의사소통능력 및 협업능력 향상, 자신감 고취, 삶의 태도 변화가 나타났으며, SNS 활용성으로는 즉각적인 의사소통과 자료공유, 홍보 등이 나타났다. 본 연구는 대학의 비교과 영역에서 창의성 프로그램의 적용과 SNS를 활용한 창의성 프로그램에 대한 시사점을 제공하였다. The purpose of this study is to examine practicable application and expansion of SNS (Social Networking Service) for creative program through non-curriculum in University. In this study, 22 students in 5 Creativity communitys of S University participate for 5 months. Activities in Creativity communitys were worked with SNS(face-book) and analyzed SNS response, community response, supervisor response, Creative Problem Solving(CPS) response through CPS processes of Treffinger, Isaksen, Dorval(2000). The results of CPS processes in this study were the highest 'exploring data' in stage 'understanding the challenge' and 'building acceptance' in stage 'preparing for action'. SNS response and community response were higher than all activity in 5 communitys. Also perceived performances of Creativity community were improvement of communication, cooperation, self-confidence, and change of attitude toward life. Practicable applications of SNS in Creativity communitys represented instant communication, data sharing, public relations(PR) etc. This study provided implications about using SNS in CPS processes, applying to creative program through non-curriculum in University.
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전정신경초종환자에서 내이도내 신경의 국소해부학적 지식을 근거로 한 기능 보존 술식의 치료결과 분석
이욱진(Wook Jin Lee),이종대(Jong Dae Lee),김성헌(Sung Huhn Kim),송미현(Mee Hyun Song),이호기(Ho-Ki Lee),이원상(Won-Sang Lee) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.2
Objectives : In this study, we classified the anatomical correlation of the facial nerve, vestibular nerve, and cochlear nerve along different locations of the internal auditory canal and analyzed the clinical outcome of hearing preservation surgery of vestibular schwannoma through the middle cranial fossa approach performed based on the anatomical study results. Methods : Cadaveric temporal bone dissection of 58 Koreans was performed and each nerve distribution pattern along the segment from the brainstem to the base of internal auditory canal was classified and schematized. Clinical application results were obtained from medical records of 14 patients who were diagnosed of tumor originating from the internal auditory canal and received mass excision via extended middle cranial fossa approach. Results : The cochlear nerve and vestibular nerve could be separated at porus of the internal auditory canal in only about 6% of our materials, but we could identify the facial nerve, vestibular nerve complex and cochlear nerve individually at the midportion in about 88%. Hearing preservation, which was achieved in 10 of 14 patients was more feasible when the tumor was of superior vestibular nerve origin with medial location in the internal auditory canal and when the patient had better preoperative hearing. Conclusion : Applying the above mentioned topographic anatomical information to the extended midcranial fossa approach, the vestibular nerve and the cochlear nerve could be separated by initiating the dissection at the mid-portion after exposing the internal auditory canal and consequently achieve favorable results of functional preservation including hearing.
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임영창(Young Chang Lim),임정택(Jeong Taek Lim),강주완(Joo Wan Kang),최현승(Hyun Seung Choi),송미현(Mee Hyun Song),김민범(Min Byum Kim),최은창(Eun Chang Choi) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.1
Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002. Results: Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy. Conclusion: A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.
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