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위성인터넷통신을 이용한 Web 기반 원격의료시스템 개발
황선철 ( Seon Cheol Hwang ) 한국인터넷정보학회 2000 인터넷정보학회논문지 Vol.1 No.1
일반적으로 유선망을 통한 인터넷 접속은 의료영상과 같이 대용량의 데이터를 전송하기에는 전송속도가 매우 낮다. 인터넷의 이러한 문제를 해결하기 위해 본 연구에서는 고속의 위성 인터넷 통신을 위한 비대칭 위성 데이터 통신 시스템을 개발하였다. 비대칭 위성 데이터 통신은 데이터 경로가 비대칭인 것으로 데이터의 요청은 유선망을 통하고 대용량 데이터의 수신은 위성을 통하는 방식이다. 본 비대칭 위성 데이터 통신 시스템은 기존의 유선망에 비해 약 10-30배의 전송속도 향상의 결과를 얻을 수 있었다. 또한 인터넷을 통해 인증된 모든 병원으로부터 원격 의료를 수행할 수 있는 웹 기반의 원격의료시스템을 개발하였다. 이 시스템은 Java를 이용하여 개발하였으며 별도의 도구를 구입하지 않더라도 넷스케이프와 같은 웹 브라우저를 통해 세계 어디에서나 의료 영상과 정보를 접속하고 검색할 수 있는 기능을 가지고 있다. 원격의료시스템의 전송 속도를 향상시키기 위해 JPEG을 통해 영상을 압축하였다. 결론적으로 우리는 제안한 비대칭 위성기술과 웹 기술을 이용하여 고속의 범용 원격의료시스템을 개발할 수 있었으며 이를 이용하여 의료영상시스템을 병원내부용도에서 범용의 원격의료시스템으로 그 범위를 확장시킬 수 있었다. In general cases, the conventional Internet connected to a terrestrial network is too slow to transmit large medical images. To overcome this low speed problem of the Internet, we have developed asymmetric satellite data communication system (ASDCS) as a fast satellite Internet communication method. The ASDCS uses a receive-only satellite link for data delivery and a terrestrial network for control communication. The satellite communication link we implemented showed the very high-speed performance compared to the terrestrial link. Using ASDCS, the satellite Internet communication was 10-30 times faster than the conventional terrestrial Internet link. Also we have developed a Web-based Telemedicine system that can access every permitted server of hospital via the Internet. Java programming techniques were used to make our system and it can access and retrieve medical information and images through only public web browser such as Netscape TM without additional specific tools. To increase the transmitting speed of our Telemedicine system, JPEG method was used. In conclusion, we were able to develop a fast and public Telemedicine system using the proposed ASDCS and Web technology. ASDCS technology increased the speed of the conventional Internet and Web technology extended the scope of use for Telemedicine system from intrahospital to public use.
안와를 포함한 관자놀이 두개골절개술에서 두 개의 골편을 이용한 수술기법 : 미용적 측면의 개선방법
황선철(Sun-Chul Hwang),김범태(Bum-Tae Kim),임수빈(Soo-Bin Im),신원한(Won-Han Shin) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.1
Cosmetic problems after the orbitopterional craniotomy are big concerns caused by the injury to the temporalis muscle and more destructive resection of the orbit. This report describes the techniques to dissect the physiologic plane of the temporalis muscle and fascia and to preserve the contour of orbit. Subfascial dissection of the temporalis muscle for the scalp reflection was applied to preserve the frontal branch of the facial nerve. The temporalis muscle was detached from the temporal fossa with anterior to posterior and proximal to distal manner. The muscle was not incised vertically or cauterized. A usual pterional craniotomy was performed and then an orbital craniotomy was followed. The passing drill (#8TA11, Midas Rex) was used to cut the orbital rim. The first cut was made on the lateral to the supraorbital notch. The second cut was proximal to the frontozygomatic suture. Following, the orbital roof was thinned to 3 to 4 cm posteriorly with cutting drills. The drilling was connected to the cutting edges of the orbital rim and the superior orbital fissure. After dural closure, the bone flaps were fixed with a Neuroclip??. This technique has been used for the 21 adult patients (11 male and 10 female patients) to clip anterior communicating artery aneurysms. The thickness of the temporalis muscle was measured at 3 points before surgery and in 3 months after surgery. As a result, it provided a wide basal exposure for clipping aneurysms. There were no injuries to the frontal branch of facial nerve. The most vulnerable area of periorbital injuries was just distal to frontozygomatic suture. All the patients suffered from the periorbital swelling after operation, which was subsided around 5 days. The bulk of the temporalis muscle was not significantly reduced and the reduction of the muscle thickness was less than 10%. The rigid fixation of the orbital and pterional bone flaps could be achieved. Although orbitopterional craniotomy requires extensive works, cosmetic results may be optimal if the physiologic dissection of the temporalis muscle and fascia and appropriate resection and fixation of orbital roof were performed.
황선철 ( Sun Chul Hwang ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.1
Pencils are common instruments for children to use and play with. This report describes an unusual penetrating orbitocranial injury in a 5-year-old girl who was struck in her facewith a pencil. She was holding it at a desk, and her friend pushed her back. The pencil penetrated the left lower eyelid and went deep into the right frontal lobe through the base of the skull. It was removed at the emergency room, after which brain CT was performed to detect the development of an intracranial hematoma. No complications occurred after conservative management with antibiotics and an antiepileptic drug. Pencils can be hazardous to children, and a penetrating head injury with a pencil may be managed without cranial surgery. (J Korean Soc Traumatol 2012;25:28-31)
황선철 ( Sun Chul Hwang ),김범태 ( Bum Tae Kim ),임수빈 ( Soo Bin Im ),신원한 ( Won Han Shin ),고은석 ( Eun Seok Koh ) 대한뇌종양학회 2004 대한뇌종양학회지 Vol.3 No.2
The exact preoperative diagnosis in the cerebellar midline tumor is crucial to design the operative plan such as the extent of tumor resection, preservation of critical structures, and need to be shunt. We experienced 2 cases, which were suspected as usual radiologic diagnoses but were revealed as rare entities in the pathology. A 15-year-old child presented with sudden headache while he was studying. The features of radiologic images suggested the hematoma caused by the underlying lesion. Medulloblastoma, cavernous hemangioma, and ependymoma were suspected. After operation, pathology revealed it to be hemorrhagic pilocytic astrocytoma. A 40-year-old woman suffered from lasting headache and ataxia. In the radiologic finding, it was a huge cystic mass with a mural nodule. We took into consideration cerebellar tumor such as dermoid cyst, hemangioblatoma, or cystic astrocytoma. The pathologic diagnosis was the mature teratoma. These rare entities of pathology occurred in the cerebellar midline region should be considered in the progress of diagnosis and we will review it with pertinent literatures.
경막하 지방종으로 오인될 수 있는 외상성 요천추부 아급성 경막하 출혈
황선철(Sun-Chul Hwang),김형간(Hyung-Kan Kim),조성희(Seong-Hee Cho),남대철(Dae-Chul Nam),이헌근(Heon-Keun Lee),박경언(Kyeong-Eon Park),나재범(Jae-Boem Na),김동희(Dong-Hee Kim) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.5
외상성 요천추부 경막하 혈종은 해부학 및 병리학적인 원인으로 인하여 경막외 혈종에 비해 빈도가 극히 드문 것으로 알려져 있다. 외상의 시기가 불분명한 경우 시간 경과에 따른 혈종의 신호 강도가 두개강내 혈종과 척추강 내 혈종에서 일치하지 않는 경우가 많기 때문에 감별진단에 있어서 많은 혼돈을 주게 된다. 이에 지방억제 자기공명영상 및 컴퓨터단층촬영 등의 시도들이 행해지고 있다. 외상 시기를 정확히 알 수 없는 경막하 혈종을 자기공명영상과 컴퓨터단층촬영을 이용하여 경막하 지방종과 감별진단하여 조기에 수술적 감압술 시행 후, 좋은 예후를 보인 증례를 문헌 고찰과 함께 보고하고자 한다. Traumatic lumbosacral spinal subdural hematoma due to anatomical and pathological causes is rare, compared to epidural hematoma. If the time of trauma cannot be determined, intracranial and intraspinal signal intensity according to lapse of time are not coincident, resulting in confusion in terms of differentiation. Fat suppression magnetic resonance image (MRI) and computed tomography (CT) are utilized for differentiation. The intention of this study is to report on a case where spinal subdural hematoma of unknown time of occurrence is differentiated from subdural lipoma by taking advantage of fat suppression MRI and CT in order to perform an early surgical decompression with auxiliary review of literature demonstrating good prognosis of the procedure.