미세혈관의 결찰방법에 따른 혈관의 조직학적 연구

김현수,김정태,김석권 동아대학교의과대학 1997 동아의대학술지 Vol.9 No.2

결핵균 α-항원의 정제와 면역화학적 분석에 관한 연구

김석권,백태현,김화중,박정규,최대경 충남대학교부설 생명공학연구소 1992 생물공학연구지 Vol.2 No.-

α-antigen from the culture filtrate of Mycobacterium tuberculosis H37Rv was purified by improved purification procedures and immunoaffinity chromatography using rabbit anti-α serum. Improved purification procedures were involved 50% ammonium sulfate precipitation, hydroxylapatite chromatography, Sephadex G-75 chromatography and preparative natural polyacrylamide gel electrophoresis(PAGE). We also produced seven monoclonal antibodies against α-antigen by hybridoma technique and analyzed immunochemical characterization of α-antigen by SDS-PAGE, ELISA and Western bolt using monoclonal antibodies. The results were summarized as follows; 1. The purification of α-antigen from the unheated culture filtrate by 50% ammonium sulfate precipitation, hydroxylapatite chromatography and Sephadex G-75 chromatography resulted in recovery of 16% of α-antigen and 28.5-fold purification. α-antigen purified further by preparative natural-PAGE showed a single distinctive band of 30 KDa molecule on SDS-PAGE. 2. The molecular weight of α-antigen was 30,000 as determined by SDS-PAGE and Sephadex G-75 chromatography. 3. α-antigen was purified by immunoaffinity chromatography as single step. The affinity purified α-antigen showed a band of 30 KDa molecule and showed another contaminated band of 32 KDa molecule on SDS-PAGE. 4. By Western blot analysis, seven monoclonal antibodies against α-antigen showed a distinct band of 30 KDa molecule and multiple different bands between 25 KDa and 65 KDa molecules. 5. All monoclonal antibodies produced were revealed strong cross reactivities with the sonicate antigens of slow growing and rapid growing mycobacteria by ELISA. These results suggest that α-antigen, 30 KDa of molecular weight, could be purified well by the im-proved above purification procedures and contains many cross-reactive antigenic determinants on the molecule.

가토의 대퇴정맥결손부에 이식된 PTFE도관의 조직학적 변화

김현수,김석권,양순재 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.1

In this study, 42 Polytetrafluoroethylene prostheses (Gore Tex: internal diameter 1.5 mm, length 8 mm, fibrilar length 30μm, wall thickness 0.2 mm) were used to reconstruct the vascular gap of rabbit femoral vein. To enhance the patency rate and promote the healing process, the prostheses were connected to rabbit femoral vein by means of stair-like sleeve anastomosis. The specimens were obtained in 12 hours (n=4), 1 day (n=4), 3 days(n=4), 1 week (n=10), 2 weeks (n=10), 3 weeks(n=10). After determination of patency, the specimens were prepared with H&E stains and investigated under microscope. After 1 week, endothelial-like cells were observed around anastomotic area from the adjacent vein. After 3 weeks, all microvenous grafts were completely covered by endothelial lining. The anastomotic area was more prominent in the endothelial lining than in the central area. There was some evidence of migrating cells from adjacent soft tissue through micropores of PTFE prostheses. Overall patency rate of PTFE prostheses connected by stair-like sleeve anastomosis was 85.7%. We concluded stair-like sleeve anastomsis of PTFE prostheses in the rabbit femoral vein result in better overall patency rate than end-to-end anastomosis.

개인의의 개방병원 참여에 대한 의견

김석범,권굉보,강복수,김기홍 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.1

A mailed survey with structured questionnaire was conducted to study the demand of private physicians who were operating their own clinics in the community to be a attending physician at the general hospital. The responding proportion was 21.6 percent of the 960 private physicians. A total of 207 responders : 65.2 percent wanted to be a attending physician. In particular, the physicians who were male, young, surgeon and teaching hospital careered after specialist were more highly motivated. The major activities what they wanted as a attending physician were medical care for the admission patients. They responded that the hospital charges for the medical services and the responsibility of malpractice issues should be fairly shared by attending physician and hospital according to their contributions. There is growing consensus that the need of attending physician at the general hospital will become wide spread, but little organizational preparation to assure the quality of medical care of attending physicians including training of resident physicians and students. In addition, the effective reimbursement system should be develop to compensate appropriately according to the medical achievement of the attending physicians.

Estrogen이 가토의 이개변형에 미치는 영향

오경,김정희,김정태,김석권 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.1

Congenital auricular deformities such as lop ear, cup ear, prominent ear, and Stahl's ear can be corrected nonsurgically in the early neonatal period(first week after birth) obtaining satisfactory results. Auricular cartilage consists of chondrocytes and intercellular materials that are mainly assembled from collagen, elastin, and a proteoglycan aggergate. Cartilageelasticity is dependent upon the concentration of the proteoglycan aggregate. Hyaluronic acid, which is a constituent of proteoglycan aggregate and is increased by estrogens, has an important play on disconnecting the proteoglycan aggregate. So the increased estrogen results in the lack of elasticity. The circulating levels of free estradiol are higher during the first 72 hours after birth and decreases thereafter, so the ear is soft and easily malleable in this early neonatal period. In this study, we have applied aluminium splint(90 degree-angulated, 180 degree-angulated, and rolled) on rabbit ear. All of the rabbit was divided into 3 groups containing 3 types of deformities. In group 1, estrogen was applied to the deformed ear with regional injection to the perichondrium of auricular cartilage. In group 2. estrogen was applied topically with ointment. In group 3, as control group, saline was injected to the perichondrium. Four weeks later, in group 2, the shape of the deformed rabbit ear was maintained, and did not return to its original shape even after splint removal. From these results, we concluded that estrogen ointment could be tried as adjunctive therapeutic modalities to the nonsurgical treatment of the congenital auricular deformities.

지방이식의 다양한 임상적 이용

이근철,정영하,김정태,김석권 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1

Generally alloplastic matrials such as collagen compound and liquid silicone injection. or autologous fat injection have been used for correction of surface irregularity. But, except for autologous fat injection, the other methods have been proved to be not effective or even dangerous. Then with the explosion in the popularity of liposuction, the autologous fat injection has been applied to variable clinical uses for contouring of the soft tissue irregularities. The author performed main operations with fat injection as ancillary procedure in 16 patients from 1993 to 1996, and long term follow-ups were reported. The lesions treated most frequently were cheeks, and others were thighs, legs, nasolabial folds and upper eyelids in order of frequency. The donor sites were lower abdomen, thigh, buttock and cheek. Our method of fat injection was used as an ancillary procedure for improving post-operative results in variable cases (craniofacial microsomia, fibrous dysplasia, asymmetry of leg, etc). And the important technical points in our method for reducing the absorption of fat after injection were atraumatic liposuction, multilayered dispersed injection, and 20% overcorrection. We obtained satisfactory aethetic results without major complications.

조직 확장기를 이용한 안면부 재건

오 경,정영하,김정태,김석권 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1

In the past years skin grafts, local flaps and free flaps have been used in reconstructing skin or sift tissue defects and deformities of the face where primary closure is not feasible. A number of local flaps have been used for reconstruction of facial defects and deformities, but the size of a defect that could be treated in such a way was restricted and the donor site deformity was another problem of local flaps. Introduction of the tissue expansion technique has made it possible to cover even wider defects with neighboring skin and advantageous in facial reconstruction in that such defects can be resurfaced with skin of similar color, texture and thickness, a match superior to that of skin obtained elsewhere. We used tissue expanders in reconstructing defects and deformities of the face(post-burn scar ; 17cases, post-traumatic scar ; 7cases, congenital nevus ; 3cases, total 27cases) from Mar. 1990 to Sep. 1996. We used or croissant type tissue expander for the reconstruction of small-sized scar on medial cheek and to use rectangular type expander for large-sized scar on lateral cheek. Ports are placed under the scar or scalp. Expansion period ranged from 28days to 97days (mean 7weeks) and overinflation (mean 170%) was done. And Various methods are used for prevention of complication. We have made anchoring sutures of the remained capsule to the underlying periosteum for prevention of ectropion. We have got satisfactory results from that aesthetically and functionally, so report the results with a review of the current literature.

수평절골술에 의한 턱 성형술

정영하,최기영,김석권 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

Many methods are used for genioplasty, such as alloplastic implants, horizontal osteotomy, bone or cartilarge graft and so on. Among these methods, alloplastic implants and horizontal osteotomy are most frequently used. Augmentation of chin with a silastic rubber implant is the procedure of choice for mild form of microgenia. But this technique has disadvantages of possible malposition or bone erosion and is contraindicated in the patients with a moderate to severe degree of microgenia, which are apparent in both sagittal(anteroposterior) and horizontal dimensions. The preferred technique is the horizontal osteotomy, which yields excellent results, even in the difficult cases such as implant failure, asymmetry, or vertical mandibular disproportion. It is a safe, reliable, and simple procedure that is relatively free of either significant side effects or complications. We performed 6 cases of horizontal osteotomy and concluded as follows., 1. The procedure is relatively simple 2. This method is widely applicable to various conditions of chin deformity, and especially more natural degree of microgenia. 3. It effectively influences soft tissue in submental region as well as bone contour with a more natural aesthetic results. 4. The osteotomy line should be placed at least 2mm inferiorly to mental formen. 5. It is safe and relatively free of complications with maximal aesthetic results.

협부 화상반흔의 교정에 있어서 Cervicofacial Flap의 이용

유성종,이학수,김석권,김성수 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.4

The face and its features have been the subject of poet and artistic endeavors throughout the ages. Because a person's face is hghly visible and difficult to camouflage, large burn scar on sheek is obvious to others and may be distressing to the affected individual. Particular skill is required of the surgeon reconstructing large burn scar on cheek, because the cosmetic result will have physical and psychological implocations for patient. Cervicofacial flap has much advantages for reconstruction of large burn scar on cheek as followings; 1. Satisfactory color and controur match. 2. Excellent result in function and appearance. 3. One stage reconstruction as simple procedure. 4. Inset scar lies along nasolabial fold and RSTL. 5. No requirement of delay procedure. 6. Good viability.

한국의 발톱진균증 환자의 삶의 질에 관한 연구

조백기,박종갑,김형옥,김성욱,백승철,김진우,김시용,안규중,전재복,오지원,김낙인,이규석,오칠환,김수남,김상태,손숙자,신용우,김동석,이원우,권경술,서대헌,황규왕,이종석,고재경,강원형,정기양,최응호,김기홍,박석돈,강승주,함정희,명기범,김방순,구상완,김병수,원영호,김한욱,송은섭,정병수,노병인,홍창권,박장규,한지윤,김광중,구대원,김종민,김재홍,유희준,양경미 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

Background: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that is a refractory disease which may cause a deleterious effect on patiets quality of life (QOL). Objective: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the chandes of QOL after treatment. Methods: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after sytemic antifungal treatment. Responses to the questionnaire were scored by 5-point scale (1∼4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptorn and functional impact, patients views concerning treatment, and relationship with doctor. Results: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS : from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients view concerning treatment (AS: from 1.34 to 1.02). 4. The drgree of patients satisfaction at the therapeutic effect was very high- 62.4% (immediately after treatment) and 65.8% (9 months affer initiation of treatment) of patients answered excellent or good. Conclusion: This study confirms that toenail onychomycosis has significant impact on the overall QOL of patients. Also the effect of antifungal therapy on patients QOL were watisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis. [Kor J Med Mycol 3(1): 115∼124]