특발성 안면신경마비 환자의 안면 기공요법 경험과 안면 기공요법의 효과적인 교육 방안 : 질적 연구

윤강현,이승민,임지석,조예은,이화진,김지혜,강중원,이상훈 대한침구의학회 2015 대한침구의학회지 Vol.32 No.1

Objectives : This study is designed to explore the experience of patients who received facial Qigong exercise education, to identify whether facial Qigong exercise is effective for Bell’s Palsy patients and to aid in developing a more efficient exercise program. Methods : Eight patients who visited the Facial Palsy Center in Kyung Hee University Korean Medicine Hospital between September 2014 and December 2014 for treatment of Bell’s palsy were interviewed. All patients received facial Qigong exercise education at least two times. The interview was conducted for 20 to 30 minutes and included discussion related to the experience of facial palsy, facial Qigong exercise and suggestions for a more efficient facial Qigong program. Results : The patients replied that they experienced emotions such as anxiety, depression and confusion when they discovered the symptoms of facial palsy. They also suggested that they had regained mental stability and physically recovered through facial Qigong exercise and also suggested possible improvements for the system of facial Qigong exercise in terms of time/place/educator. Conclusions : The results from the interviews suggest that facial Qigong exercise might be an effective treatment for Bell’s Palsy patients from a psychological and physical perspective. A more patient-centered environment should be established to ensure efficient treatment.

역방향 전박골 유리 피판을 이용한 쇄골 부위의 재건 1례

윤강모,이삼용,김대영,조백현 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.5

The ideal modalities of reconstruction for head and neck should pursue excellent function and should be immediate, reliable and vesatile, not resulting deformities in appearance. Microvascular free tissue transfers have facilitated immediate reconstruction of various complex defects after radical ablation of head and neck cancer. Since first described by Yang et all.(1981) in the chinese literature, the redial forearm or chinese flap based on the radial and ulnar arteries has undergone a great deal of modification. The flap is widely used in microsurgical reconstruction with antegrade venous anastomosis or retrograde because of its ease in harvesting and versatility in covering complex defect, especially those requiring soft tissue and bone. We here introduce a new modified technique, i.e. "the counterwise", compared antegrade and retrograde method, the proximal artery was anastomosed in an antegrade direction but the distal vein was anastomosed in a retrograde direction. After the radical ablation of the squamous cell carcinoma and the mid portion of clavicle, the reconstruction with the radial forearm osteocutaneous free flap was done. The proximal radial artery of the flap was anastomosed to lateral thoracic artery. And the distal vena comitante of the radial artery was anastomosed to external jugular vein by end-to-side instead of left subclavian vein which was resected with tumor ablation. At postoperative 2 days, the flap developed mild venous congestion but it was resolved and the flap survived well. This case demonstrates that the counterwise radial forearm Osteocutaneous free flap is considered as a valuable technique for reconstruction of defects.

개방창 감염에 대한 Flomoxef의 임상 효과

윤강모,안호범,김대영,이삼용,조백현,이민철 최신의학사 1995 最新醫學 Vol.38 No.5

공영장례 조례 분석 및 향후 과제 고찰

윤강인(Yun, Kang In),김종일(Kim, Jong Il),황예음(Hwang, Ye Eum),임시현(Lim Si Hyun) 한국지역사회학회 2021 지역사회연구 Vol.29 No.4

본 연구는 장례지원의 직접적인 의무를 갖고 장례과정을 지원 또는 위임의 권한을 가진 지방자치단체의 공영장례 조례를 분석대상으로 특징과 한계점을 분석하고자 하였다. 총 48건의 조례를 대상으로 사회복지조례 분석틀을 이용하여 공영장례의 개념 및 권리성, 대상자의 범위, 급여의 종류 및 수준, 전달체계를 분석하였다. 분석결과를 요약하면 다음과 같다. 공영장례 조례는 무연고 사망자와 연고자의 능력부족으로 장례를 치를 수 없는 사망자에 대한 장례지원이 주된 과업이며, 고인의 존엄성 유지 및 사회적 책무이행, 공동체 의식실현에 그 목적을 두고 있다. 그러나 무연고 사망자 외에 공영장례지원 대상 선정 문제는 저소득이나 기초생활수급자 등 전제조건을 내세우는 경우를 제외하면 지방자치단체의 임의적 판단에 의존하는 경향이 있다. 그리고 급여의 전달체계를 살펴보면 비혈연 관계인도 급여신청이나 급여를 수령하여 장례를 치를 수 있는 변화의 움직임이 보이고 있으나 급여수준이 평균 장례비용보다 현저히 낮고 장례 문제에 있어 혈연관계를 우선시하는 제도적 현실로 미루었을 때, 상당한 개선이 필요할 것으로 예상된다. 이러한 분석내용을 바탕으로 향후 제·개정될 공영장례 조례의 발전방향을 제시하는 한편, 그 토대를 마련하기 위한 중앙정부의 책무에 대해서도 논의하였다. This research aims to analyze the characteristics and limitations of ordinances specifically enacted by local governments which bear the responsibility and possess the authority to delegate or support the funeral process under the Ordinance on the Support of Public Funerals. Utilizing the analytical standard of ordinance on social welfare, a total of 48 ordinances have been analyzed. The summary of the analyzed result is as follows. The major task of the Ordinance on the Support of Public Funerals is to provide assistance to the deceased with no social ties and also to those who lack the ability to carry out the funeral process, and its purpose is to maintain dignity and carry out the social responsibility of the deceased, and to fulfill the communal spirit. However, the selection of subjects depends entirely on the arbitrary judgment of the local government, with the exception of subjects without social ties or special cases with prerequisite conditions such as subjects with low income or recipients of livelihood benefits. Furthermore, there is room for significant improvement in the delivery of funds, considering the fact that the payout and the institutions in charge display a tendency to only recognize recipients with blood ties, despite the ongoing discussions on granting the right to receive payment to persons without any blood relations. Based on these issues, this research provides the desirable direction on the enactment and amendment of the Ordinance on the Support of Public Funerals and discusses the burdens of the central government in laying the foundation for the upcoming developments.

후종인대 골화증으로 유발된 경추 척수병증 1례에 대한 증례보고: 온침요법을 중심으로

이승민,윤강현,임지석,조예은,박지민,남동우,최도영 대한침구의학회 2014 대한침구의학회지 Vol.31 No.3

Objectives : The purpose of this study t is to investigate the effects of warm needling therapy in a patient with cervical myelopathy caused by ossification of posterior longitudinal ligament. Methods : A 53-year-old Korean male patient diagnosed with cervical myelopathy due to ossification of posterior longitudinal ligamenwas treated with warm needling therapy on posterior neck aside from the routine inpatient treatment from June 26th to July 16th. Clinical improvement was evaluated with visual analogue scale(VAS), Japanese orthopedic score(JOA), grip and release test, finger escape sign and patient satisfaction was measured using a five-point Likert scale. Results : After 21 days of treatment, the patient showed improvement in VAS, JOA, grip and release test and finger escape sign. The patient also expressed satisfaction with the treatment. Conclusions : The results suggest that warm needling therapy may be an effective additional treatment for cervical myelopathy and other symptoms related to ossification of posterior longitudinal ligament(OPLL). Further studies should be carried out regarding possible long-lasting effects.

경추 전만 정도 및 연령에 따른 경추 추간판 탈출 양상 분석 연구

임지석,윤강현,이승민,조예은,박지민,이상훈,김용석 대한침구의학회 2015 대한침구의학회지 Vol.32 No.3

Objectives : The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age. Methods : 67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb’s method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed. Results : Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis. Conclusions : Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.

융기성 피부섬유육종의 치험2례

이삼용,안호범,조백현,윤강모 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.3

Dermatofibrosarcoma protuberans is an uncommon soft tissue neoplasm that usually presents as a painless, often long standing mass arising in the dermis of the skin. In most patients, the nodule enlarges slowly and painlessly for a period of 3 months to 2 years as it infiltrates the adjacent tissue and becomes multinodular. At the later stage, however, its growth rate accelerates, and it can ulcerate, bleed, or become painful. Histologically, on light microscopy, this tumor shows the characteristic cartwheel patterns, with the fibroblasts arranged radially about a small central hub of fibrous tissue, and on electron microscopy, fairly monotonous population of spindle-shaped cells with a few stellate cells. Many of the spindle cells contained intracytoplasmic aggregates of microfilaments with dense bodies and were partially surrounded by basal lamina, interpreted as being typical of myofibroblasts. Other cells showed typical features of fibroblasts Dermatofibrosarcoma protuberans typically arises on the trunk and proximal extremities. head and neck and scalp lesions have also been described. It is more frequent in men with a peak incidence during the third decade of life. We have encountered 2 cases, develpoed on the both ear lobules of a 25-year-old woman and the right lower of a 7-year-old child ; but there were no evidence of metastasis. A scapular fasciocutaneous free flap and a skin graft covered large defects resulting from wide tumor excision. Follow-up at 1 year showed the patient doing well with no evidence of local or regioal recurrence.

복어독의 주성분인 Tetrodotoxin의 항암 기전, 효과에 대한 문헌 고찰

조예은,이승민,윤강현,임지석,이승훈,최도영,이재동 대한침구의학회 2015 대한침구의학회지 Vol.32 No.1

Objectives : The purpose of this study is to explore the antitumor mechanism and effects of tetrodotoxin through a literature review of experimental and clinical studies. Methods : Medical databases, including The Cochrane Library, Pubmed, NDSL, RISS4u and National Assembly Library, were searched for relevant articles published from January 1, 2000 to October 31, 2014 using the keywords ‘tetrodotoxin’, ‘cancer’ and ‘tumor'. The results were classified into experimental studies(in vitro and in vivo) and clinical studies. Analysis of the results was conducted on several research areas including the mechanism, antitumor effect and adverse effects of tetrodotoxin(TTX). Results : A total of 34 experimental studies(32 in vitro and 2 in vivo) and 3 clinical studies were found in the search. Most of the experimental studies suggested blocking of voltage-gated sodium channels in metastasis of tumor cells as the main antitumor mechanism of TTX. The most common type of cancers mentioned in the experimental studies were prostate and breast cancer. All of the clinical studies were on the application of TTX on moderate to severe cancer-related pain. No adverse effects of TTX were reported in in vivo studies but mild to moderate adverse events were reported in clinical studies. Conclusions : The results show that tetrodotoxin, which is the main component of Tetraodontidae(commonly known as pufferfish) poison, could be clinically used for antitumor therapy. However, further studies should be conducted on its safety.

대상포진에 대한 한양방 병행치료 치험 1례

조예은,이승민,윤강현,임지석,김지혜,최도영,이재동 대한침구의학회 2014 대한침구의학회지 Vol.31 No.1

Objectives : The aim of this study is to report a case of a 51-year-old patient with Herpes zoster, whose symptoms were relieved within five weeks after the East-west medical combined treatment. Methods : A Herpes zoster patient with extreme pain around the right lower ribs and lower back was admitted into the Korean medicine hospital. Bee venom acupuncture was applied directly onto the site of pain and electroacupuncture was applied on GV6-BL20, inferior site of spinous process of the 12th thoracic vertebra-BL21, GV5-BL22, GV4-BL23 six times a week. Moxibustion was applied on BL49, BL50, BL51, BL52, GB25, LR13 six times a week, and the patient took daily doses of herbal medicine and western medicines such as anticonvulsants, analgesics, antiepileptics. The patient's symptoms were evaluated with numeric rating scale(NRS) and neuropathic pain scale(NPS). Results : The results were as follows:1. After the East-west medical combined treatment, the NRS grade decreased from 8 to 1. 2. On the neuropathic pain scale, the patient's symptoms changed from deep sharp pain and burning sensation to superficial dull pain and coldness. Sensitivity to touch, discomfort, and itchiness also decreased. Sudden attacks of pain appeared 14 to 21 days after onset, but disappeared after final treatment. Conclusions : The results of the above patient suggests that the East-west medical combined treatment may be effective for total remission of herpes zoster. Further research is needed to confirm such effects.

대둔근피판술의 임상적 이용

최광림,김광석,윤강모,이장혁,이삼용,조백현 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.1

Ulcer in buttock is mainly a pressure sore, which is frequently occurred at the sacral region in Korea and its surgical treatment is chiefly the operation using gluteus maximus myocutaneous flaps. For the treatment of ulcerated lesion in gluteal area, various methods using gluteus maximus muscle have been developed. We reviewed and analyzed the 100 cases using gluteus maximus myocutaneous flaps in our department since 1980. The results were summarized as follows.; 1)The ratio between male and female was 3:1. 2)The prevalent age groups were between third and fifth decades. 3)The main cause was the trauma. 4)The wound culture showed the pattern of mixed infections in most cases, consisting of Staphylociccus, Pseudomonas, Enterococcus, Streptococcus, and others. 5)The postoperative complications were noted in about thirty percent of the cases. The complications were flap tip necrosis, wound infection, wound disruption, and others. 6)For thetreatment of small ulcers, a pure skin flap or myoplasty may be used, but for the treatment of large one, a kind of myocutaneous flap should be selected. 7)Gluteus maximus myocutaneous flaps can be used as variable methods, but of which the island flap is ideal in deep and large ulcerated lesion.