일측성 광대뼈골절 환자에서 수평계와 자를 이용한 변위 교정의 간단한 파악법

이형석,이경석,김준식,김남균,Yi, Hyung-Suk,Lee, Kyung-Suk,Kim, Jun-Sik,Kim, Nam-Gyun 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.2

Purpose: The zygoma is a key element which composes the facial contour. Zygomatic fracture induces facial asymmetry. We use radiologic evaluation or inspections mainly for identification of symmetry after reduction depressed zygomatic fracture. But the disadvantages of such methods are time-consuming and complicated process. So we tried to develop a new testing method with a ruler and a level. Methods: In unilateral depressed zygomatic fracture patient, parallel to the patient's head to make sure lay horizontaly. Put the leg of a ruler on the malar eminence so that it is at the same distance from the facial midline. Then take the level of malar eminence as put the level above the ruler. This process was performed before and after the reduction. Results: We were able to fix with plate and screw after checking the results of reduction fast and easily. Good results were obtained at post-operative radiologic evaluation. Conclusion: We can easily get the ruler and level around life. This method is not only simple but also shorttime process compared with other method-radiologic evaluation or inspection. And the operator can explain the results to the patients easily and objectively. Authors obtained the good results with this new method, and would introduce it for another method of identifying the result of reduction in depressed zygomatic fractures.

귀밑샘에 생긴 다형선종의 수술적 치료로써의 제한적 국소절제술

이형석,김준식,김남균,이경석,이윤정,Yi, Hyung-Suk,Kim, Jun-Sik,Kim, Nam-Gyun,Lee, Kyung-Suk,Lee, Yoon-Jung 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.4

Purpose: Pleomorphic adenoma is the most common benign neoplasm in parotid gland. Superficial parotidectomy was usually used to remove the pleomorphic adenoma. But, this method has to remove tumor with normal parotid tissue. Authors did lumpectomy to remove pleomorphic adenoma in parotid gland, because pleomorphic adenoma is wrapped in a capsule as it grows. The purpose of this study is to evaluate the efficacy of lumpectomy as a treatment of pleomorphic adenoma in parotid gland. Method: From 2002 to 2008, 8 patients underwent the lumpectomy of the pleomorphic adenoma in parotid gland. Occurrence of the complications and recurrance were evaluated. Result: Patients were followed-up for a mean 45 months. There were no recurrance or no complication after lumpectomy. Conclusion: Authors suggest that the lumpectomy lead to decrese complications, recurrane and can be used as a procedure for the resection of pleomorphic adenoma in parotid gland.

임상 술기 교육을 위한 동료 지원 학습 및 비디오 평가를 사용한 완전학습 모형 개발과 적용

이형석(Hyung Suk Yi),김민정(Min Jeong Kim) 학습자중심교과교육학회 2022 학습자중심교과교육연구 Vol.22 No.1

목적 환자 안전에 대한 인식이 강화되면서 의과대학 졸업생들에게 숙련되고 정확하게 임상 수기를 수행하는 것이 요구되고 있다. 학생들이 안전하고 숙련된 술기 수행 목표에 도달하기 위해서는 반복적인 술기 학습과 피드백이 필요하다. 그러나 여전히 의과대학 교육에서 임상 수기 교육을 위한 시간, 장소와 인적 자원의 제약으로 인해, 학생들이 완전한 수행 역량을 갖출 수 있도록 교육과정을 운영하는 것이 어려운 것이 현실이다. 이 연구는 임상수기 교육과정에서 동료지원학습과 동영상 평가를 활용함으로써 학생들이 완전한 술기 수행 역량을 성취할 수 있는지 확인하고, 대안적 교수-학습 방법으로써의 적용가능성을 살펴보고자 하였다. 방법 일개 의과대학에서 처음으로 임상수기교육을 시작하는 의학과 1학년 임상수기입문교육과정에 Benjamin Bloom의 완전학습모형을 적용하여 학습 목표설정, 성취 수준 설정, 학습 활동, 형성평가, 반복 교육과 심화학습단계로 수업을 설계하고 적용하였다. 반복학습 단계에서는 동료지원학습을 활용하였으며, 모든 평가와 피드백은 학생들이 개인별로 술기 수행을 촬영하여 제출한 동영상으로 하였다. 수업이 종료된 후 학생들의 성취 정도와 과정에 대한 학생과 교수의 인식을 조사하였다. 결과 반복 학습 횟수의 차이는 있었으나 모든 학생이 의도한 성과에 도달하였다. 학생들은 동료들과의 직간접적인 학습 경험이 술기 수행에 도움이 됨을 보고하였으며 동영상을 통한 평가와 피드백도 대부분의 학생이 만족함을 알 수 있었다. 결론 제한적인 교육 환경 아래서 동료지원학습과 동영상을 활용한 평가와 피드백은 임상수기 완전학습을 구현할 수 있는 학습 방법으로 활용 가능하며, 향후 지속적으로 학습 효과를 유지하기 위한 학습전략을 탐색하고 그것을 반영한 완전학습 프로그램을 개발이 필요할 것이다. Objectives With the growing awareness of patient safety, medical school graduates are required to perform skillfully and accurately clinical skills. Repeated skill learning and feedback are necessary for students to reach their goals for safe and skilled skill performance. However, the reality is that it is difficult to operate the curriculum so that students can have full performance competency due to the constraints of time, place and human resources for clinical skill education in medical school education. The purpose of this study is to confirm whether students can achieve complete skill performance competency by using peer-assisted learning and video evaluation in the clinical skill curriculum, and to examine their applicability as an alternative teaching and learning method. Methods In the clinical skill introductory curriculum, the class was designed and applied in the steps of learning goal setting, achievement level setting, learning activity, formative evaluation, repeated education, and in-depth learning, by applying Benjamin Bloom s mastery learning model. In the repetitive learning stage, peer-assisted learning was used, and all evaluations were made with videos submitted by students filming individual skill performances. After the class was over, the students achievement level and the students and professors perceptions of the process were investigated. Results All students achieved the intended performance although there was a difference in the number of repetitions. Students reported that direct and indirect learning experiences with peers were helpful in skill performance, and it was found that most students were satisfied with the evaluation and feedback through videos. Conclusions Under a limited educational environment, peer-assisted learning and evaluation and feedback using videos can be used as a learning method to implement complete clinical skill learning. It will be necessary to explore a learning strategy to maintain the learning effect continuously and develop a mastery learning that reflects it.

리스프랑 관절 골절 및 탈구의 수상 기전과 치료 방법에 따른 임상적 결과와 예후 분석

박현우,이형석,Park, Hyun-Woo,Yi, Hyung Suk 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.3

Purpose: The purpose of this study was to assess the treatment outcomes and prognosis of Lisfranc joint fracture and dislocation according to the mechanism of injury and treatment method. Materials and Methods: Twenty six patients with Lisfranc fracture-dislocation who had been treated surgically were included in this retrospective study. The patients were divided into two groups according to mechanism of injury: direct crushing injury (16 patients) and indirect rotational or compressive injury (10 patients). The patients were also divided into three groups according to the surgical methods. The parameters used were radiographic evaluation, patients' subjective satisfaction levels, length of hospital stay, and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score. Statistical analysis was performed. Results: The mean postoperative AOFAS midfoot score was 78.7. The mean length of stay was 39.6 days. Statistically significant differences in subjective satisfaction, AOFAS midfoot score, and length of hospital stay were observed between the two groups (p<0.05). However, no significance differences were observed between the three groups who were divided according to the different surgical methods (p>0.05). Conclusion: Mechanism of trauma and the severity of soft-tissue injury were significant prognostic factors affecting the surgical outcomes of Lisfranc joint fracture and dislocation.

Zafirlukast 복용 후 발병한 Churg - Strauss syndrome 1 례

조이대(Yi Dae Cho),김남진(Nam Jin Kim),정재원(Jae Won Jeong),김우경(Woo Kyung Kim),오장원(Jang Weon Oh),이형석(Hyung Suk Lee),이규철(Kyu Cheol Lee),남승연(Sung Yeon Nam),김한성(Han Sung Kim) 대한천식알레르기학회 2002 천식 및 알레르기 Vol.22 No.2

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베트남의 도로개발 현황과 한국기업의 진출전략

이상근(Sang-Keun Yi),이형석(Hyung-Suk Lee),권봉경(Bong-Kyung Kwon) 대한토목학회 2008 대한토목학회지 Vol.56 No.9

중증 외상 환자에서 초기 진단에 실패한 골절

박희곤 ( Hee Gon Park ),유재성 ( Jae Sung Yoo ),이형석 ( Hyung Suk Yi ) 대한골절학회 2014 대한골절학회지 Vol.27 No.2

목적: 중증 외상 환자에서 지연 진단된 골절의 종류와 원인, 진단방법 및 처치에 대해 알아보고자 한다.대상 및 방법: 2001년 1월부터 2012년 5월까지 단국대학교병원 응급실에 내원한 20세 이상의 성인에서 Injury Severity Score 16 이상의 중증 외상 환자 4,643명 중 골절의 초기 진단에 실패하였던 58명, 62예의 골절을 대상으로 하였다. 동반 손상의 종류, 골절의 위치, 진단방법, 초기 진단에 실패하였던 이유에 대해 조사하였다.결과: 총 62예의 초기 진단에 실패한 진단 중 척추 골절 8예, 견관절 주위 골절 10예, 상지 골절 8예, 골반 및 비구 골절 10예, 하지 골절 26예였다. 동반 손상은 두부 손상이 23예로 가장 많았으며, 지연 진단 방법으로는 방사선의학 전문의의 판독에 의한 경우가 가장 많았고, 초기 진단에 실패한 원인을 살펴보면 방사선 검사가 적절하지 않거나 골절을 발견하지 못한 경우가 가장 많았다.결론: 중증 외상 환자에서 골절의 초기 진단 실패를 방지하기 위해서는 면밀한 이학적 검사를 통해 골절을 의심하는 것이 우선시되어야 할 것이며, 적절한 영상 평가를 위해서는 정확한 영상을 얻는 것이 중요할 것이다. 특히 골절이 발견된 경우 동측 상지 또는 하지의 다른 골절의 평가에 더욱 주의를 기울여야 할 것이다. Purpose: The purpose of this study is to analyze anatomic distributions, diagnostic methods, and prognosis of missed fractures in patients with severe injury.Materials and Methods: A review of single-institutional medical records between January 2001 and May 2012 identified 58 patients with 62 delayed diagnoses of fractures among 4,643 severely injured patients older than 20 years with Injury Severity Scores higher than 16. We evaluated combined injuries, location of fractures, diagnostic methods, and reasons for missed diagnosis at initial exam.Results: Among 62 missed fractures, there were eight cases of spine fracture, 10 cases of peri-shoulder joint fracture, eight cases of upper extremity fracture, 10 cases of pelvis of acetabulum fracture, and 26 cases of lower extremity fracture. Head injury was the most common concomitant injury (23 cases). Initially missed fractures were most commonly discovered by official reading by radiologists. The most common reasons for misdiagnosis were the use of improper radiologic study and missed-reading of proper radiologic studies.Conclusion: In order to prevent misdiagnosis of fractures in patients with severe injury, meticulous physical examination with suspicion of fractures should come first. In addition, obtaining proper radiologic study and thorough evaluation of radio-logic images are important to decreasing the rates of missed fracture diagnoses. In addition, thorough surveillance for ipsi-lateral fractures is important in extremities with identified fractures.

PDP 검사기술의 개발동향

이상윤(Sang-Yoon Lee),김기홍(Gee Hong Kim),최이배(Yi Bae Choi),이형석(Hyung Suk Lee),임쌍근(Sang Gun Lim) Korean Society for Precision Engineering 2001 한국정밀공학회지 Vol.18 No.11

경추부에 발생한 골막성 연골종의 증례 보고 : Case Report

이형중,김영수,이형석,이승로,함창곡,고용,오성훈,오석전,김남규,김광명 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.5

The authors experienced a case of cervical periosteal chondroma presenting with symptom of spinal cord compression in 26-year-old woman. The diagnosis was based on the characteristic features of computed tomographic scan and magnetic resonance imaging scan. Total surgical removal in two-staged operation was followed by full neurological recovery. column was observed and rarely reported in this literature.