절단된 안면신경의 일차문합술

강진성,한기환,송중원,오재훈 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.4

Because the facial nerve innervates the muscles of facial expression, injury to this nerve may cause social, psychological, and functional disability. For this reason, a transected facial nerve must be restored appropriately by any one of a variety of approaches. The choice of anastomosis should be based upon the cause, location of transection and the length of time since paralysis was first noted. Although there are numerous methods of anastomosis, none will result in complete recovery. And thus, the method must be carefully selected and tailored to suit each patient. During the 20 months between July 1988 and February 1990. We have been operated (immediate end to were epineurial repair) in 20 patients. 15 of 20 aged 23 to 60. There were 13 males and 2 females. The nerve injury was unilateral in all cases. One of 15 received a nerve graft harvested from the greater auricular nerve. 12 of 15 Stensen's duct injuries were associated with served zygomatic branch and/or buccal branch. So an end to end anastomosis of the duct was performed simultaneously with anastomosis of the nerve. Failure to repair the duct resulted in a salivary fistula in two cases. To show the success of the procedure, EMG(electromyogram) and NCV(nerve conduction velocity) were done at least 6 months following surgery. The findings have been considered good to excellent and the reinnervated muscles have showed symmetric movements in all cases.

초등학교 과학 수업에서 개념도 활용의 효과

강석진,이유영,고한중,전경문,노태희 한국초등과학교육학회 2004 초등과학교육 Vol.23 No.1

In this study, we investigated the effects of using concept mapping as an instructional tool on 4th graders' achievement, science learning motivation, and attitude toward science classes. T재 classes (38 students) from an elementary school were respectively assigned to a control group and a treatment group. Students were taught about "expansion of matter by heat" and "heat transfer". These topics were chosen because they require students to understand more concepts as well as relationships among them. A science learning motivation test and an attitude toward science classes test were administered as pretests. A researcher-made achievement test, the science learning motivation test, and the attitude toward science classes test were administered as posttests. The results indicated that using concept mapping in 4th-grade science classes was not significantly effective in improving students' achievement though a statistically significant positive effect was found in the subcategory of knowledge. No statistically significant effect of using concept mapping was found in the scores of the science learning motivation test and the attitude toward science classes test. Educational implications are discussed.

삭골(Bone shaving)한 골의 재생에 골막이 미치는 영향

강진성,권건영,송중원,오석희,한기환 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.5

Many orientals have a more prominent malar eminence and mandibular angle than westerners so their faces often look rough and unattracive. In recent years more people want to have a more attractive and beautiful face due to economic prosperity and westernization. Therefore people receiving bone shavings or osteotomies for cosmetic purposes are increasing. The effects of the periosteum on lay bone grafts were investigated but the effect of the periosteum after bone shaving or osteotomy is little known. The authors investigated the effect of the periosteum on the regeneration of bone in membranous and endochondral bone of rabbits. Bony defects each measuring about 5.0×5.0×1.5mm were made on the left and right sides of the parietal bones of 15 rabbits and femurs of 15 other rabbits respectively. The periosteum was preserved on the left and removed on the right. The following results were obtained: 1) The average thickness of the regenerated bones in groups 2 δ4 were thinner than those in groups 1 δ 3 at 4, 8 and 12 weeks postoperatively but the differences of thickness were statistically significant at onl 4weeks postoperatively(P<0.05). 2) The histological findings in groups 2 δ 4 showed lesser regeneration of the shaved bone than those in groups 1 δ 3 at 4, 8 and 12weeks postoperatively. 3) There was no significant increase in the thickness of the regenerated bone after 8 weeks postoperatively in all groups. 4) At 12 weeks postoperatively, the thickness of the regenerated bone in all groups was over 70% of the thickness of the resected bone. In summary, the authors found that it is important to perform overcorrection and resect the periosteum simultaneously in bone shaving to prevent the unwanted regeneration.

성인의 급성 심장사에서 정상 심장례의 분석

강신몽,이원태,이한영,서중석,최영식,권일훈,정낙은 大韓法醫學會 2000 대한법의학회지 Vol.24 No.2

The authors analysed 53 cases of sudden cardiac death(SCD) without prominent structural abnormalies of heart out of witnessed 300 cases. Thirty four cases were associated with sleep and 19 with activity or rest. Twenty one cases were classified as having normal hearts, and the rest as structurally mild abnormal ones. Male was predominant, and almost of the victims were suffered in their twenties or thirties. All cases collapsed instantaneously or in very short time with various and not specific terminal symptoms. Inducing or trigger factors are not clarified in almost of the cases. Mechanisms or causes of death could not be defined clearly. We concluded that careful heart examination with detailed clinical history under the appropriate postmortem investigation system is only effective approach for the true mechanism and cause of death.

각종 치과레이저의 Streptococcus mutans에 대한 증식 기능억제 효과

한강석,국중기,유소영,김화숙,박종휘,박현동,이상훈 大韓小兒齒科學會 2003 大韓小兒齒科學會誌 Vol.30 No.3

레이저의 구강내 산 생성 세균인 S. mutans에 대한 증식 및 기능 억제효과를 평가하기 위하여 S. mutans KCTC 3065가 포함된 세균 pellet에 Er:YAG 레이저와 Nd:YAG 레이저를 비접촉식 방법으로, 조사세기 50mJ, 조사시간 5초, 그리고 pulse repetition rate를 각각 10Hz와 30Hz로 하여 조사하고 세균 군락수, 산 생성능, 불용성 세포외다당류의 합성량을 측정하여 다음과 같은 결과를 얻었다. 1. Chinese ink로 photosensitization을 시행한 후 Nd:YAG 레이저를 조사한 경우가 S. mutans의 증식을 가장 많이 억제하였으며 Er:YAG 레이저 조사도 증식을 억제하였다. Chinese ink를 사용하지 않고 ND:YAG 레이저를 단독으로 조사한 경우는 S. mutans의 증식을 억제하지 못하였다. 2. Chinese ink로 photosensitization을 시행한 후 Nd:YAG 레이저를 조사한 경우가 일정기간 동안 S. mutans의 산생성능을 가장 많이 억제하였으며 Er:YAG 레이저 조사도 산 생성능을 억제하였다. Chinese ink를 사용하지 않고 Nd:YAG 레이저를 단독으로 조사한 경우는 S. mutans의 산 생성능을 억제하지 못하였다. Er:YAG 레이저와 Chinese ink로 photosensitization을 시행한 후 Nd:YAG 레이저를 조사한 경우는 pulse repetition rate가 클수록 전반적으로 세균의 산생성능을 더 많이 억제하였다. 3. 레이저 조사는 S. mutans의 불용성 세포외다당류의 합성에 영향을 미치지 못하였다. 이상의 결과로 보아 Er:YAG 레이저와 Chinese ink로 photosensitization을 시행한 후의 Nd:YAG 레이저 조사는 일정시간 동안 S. mutans의 증식과 산 생성능을 억제시키므로써 치아우식증 예방효과를 얻을 수 있다고 사료되나 억제효과가 오래가지 않아 임상적으로 효과를 얻기 위해서는 자주 조사를 해주어야 한다는 문제점을 안고 있어 임상적으로 치아우식증 예방이란 단독 목적으로 사용하기에는 실용성이 크지 않다고 사료된다. This was performed to evaluate the inhibitory effect of laser on the growth of S. mutans. The bacterial pallets containing S. mutans KCTC 3065 were irradiated with Er:YAG laser and Nd:YAG laser by non-contact method at an intensity of 50mJ for 5 sec with the pulse repetition rates of 10Hz and 30Hz, respectively. The following results were obtained on colony count, acid producing ability, and the amount of insoluble extracellular polysaccharide synthesis. 1. The irradiation of Nd:YAG laser after photosensitization with Chinese ink inhibited the proliferation of S. mutans the most, and the irradiation of Er:YAG also inhibited the proliferation. However, the irradiation of Nd:YAG laser alone could not inhibited the proliferation of S. mutans. The pulse repetition rate did not affect significantly on the proliferation of bacteria in overall. 2. The irradiation of Nd:YAG laser after the photosensitization with Chinese ink inhibited the acid production of S. mutans the most for a certain period of time. Er:YAG laser also inhibited acid production. When Nd:YAG laser was used alone, the acid production of S. mutans was not been inhibited. The irradiation of Nd:YAG laser after photosensitization with Chinese ink inhibited the acid production ability of bacteria the most as the pulse repetition rate increased. 3. Laser irradiation did not inhibited the synthesis of insoluble extracellular polysaccharide of S. mutans. From these results, we conclude that the irradiatioin of Er:YAG laser and Nd:YAG laser after photosensitization with Chinese ink would inhibit the proliferation and acid production by S. mutans, which may prenent dental caries. However, this effect does not last long time so that the laser irradiation should be repeated frequently in order to obtain clinical effect; thus, this laser irradiation would not have a clinical usefulness in preventing dental caries when used solely.

경골 골수강내 금속정 삽입술시 적절한 도입부에 대한 해부학적 분석

강수용,이은우,강기서,이한준,정호중,정평호 대한골절학회 2004 대한골절학회지 Vol.17 No.2

다발성 외상 후 횡문근융해증 환자에서의 손상초기 급성신부전의 예측인자

문중범,이강현,황성오,이진웅,한병근,최승옥,강성준 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3

Background: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma. Methods: This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creating phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF. Results: Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin. Conclusion: We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.

X-관련성 만성육아종성질환의 진단을 위한 PMA-activated NBT 검사

김중곤,조한익,오흥범,김의종,최강원 대한감염학회 1996 감염 Vol.28 No.1

목적 : Activated NBT 검사는 만성육아종성질환을 선별하는 검사이다. 활성제로 PMA를 사용하면 X-linked CGD의 경우 보인자를 감별할 수 있다. 방법 : CGD의 가족력을 부인하는 정상인 30명을 대상으로 PMA activated NBT 슬라이드 검사를 실시하여, 정상대조에서의 formazan 형성율을 보았으며, 동일 검사를 CGD가 강력히 의심되는 환자와 그 가족에 대하여 실시하였다. 결과 : 정상대조 30명 전원에서 98% 이상의 formazan 형성세포가 관찰되었다. 환자에게 실시한 결과 세환자 모두에서 0%의 결과를 보였다. 환자의 어머니에서는 각각 57, 70, 67%의 결과를 보였다. 결론 : 본 연구를 통하여 세 환자는 X-관련성 만성육아종성질환이라는 진단을 내릴 수 있었다. PMA activated NBT 슬라이드 검사는 시행하기가 쉽고 재현성이 좋으므로, 어러 검사실에서 소아기 면역결핍증을 선별하는 검사의 하나로 시행되는게 바람직하다고 사료된다. Background : Chronic granulomatous disease(CGD) is uncommon inherited disorder in which phagocytic cells fail to produce antimicrobial superoxide(O₂) due to NADPH oxidase deficiency. This disease can be easily screened by activated nitroblue tetrazolium(NBT) test. In case of X-linked CGD, carriers also can be detected. Methods : PMA(phorbol myristate acetate) activated NBT test was performed as previously described. Test performance was evaluated in 30 normal persons who denied family history mimicking CGD. Test was also applied to the three strongly suspected cases of CGD. Two of the cases were 12 year old boy and 7 year old boy, who suffered from many infectious diseases since 6 month old and 4 month old, respectively. The other remaining case was 22 year old man who suffered from many infectious diseases since 6 year old, but now relatively in health compared to the other two cases. Results : More than 98% formazan formation was observed in all normal controls. No formazan positive cell was shown in all of the three patients. However, applied to the mothers, the test revealed 57%, 70%, 67% positive cells, respectively. Conclusion:X-linked transmission of CGD could be determined with the results of PMA activated NBT slide test. This test can be easily performed. It would be better to do this test routinely as one of the tests for the screening of the immmunodeficiency syndrome in childhood.

전두사골 수막뇌류 및 Saethre-Chotzen증후군에 의한 안와격리증의 치험

송중원,한기환,박성근,강진성 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2

본 교실에서는 전두사골 수막뇌류에 의한 안와격리증 2례는 두개내 접근으로 수막뇌류 절제술을 실시함과 동시에 두 개외 접근으로 안와내벽 및 외벽 절골술로써 교정하였으며 Saethre-Chotzen 후군에 의한 1례는 두개골 성형술과 U형 절골술로 교정하여 비교적 만족할 만한 결과를 얻을 수 있었기에 보고하는 바이다. The authors experienced two cases of mild hypertelorism with frontoethmoidal meningoencephalocele and one with Saethre-Chotzen syndrome. The first and second cases, which had nasofrontal and nasoethmoidal meningoencephalocele respectively, were corrected by resection of the meningoencephalocele, repair of the dura, and calvarial bone graft intracranially, and combined medial and lateral orbital wall osteotomy with augmentation rhinoplasty with calvarial bone grafts extracranially. To stabilize the orbital contents medially, a split osteotomy of the lateral orbital wall and interpositional bone graft were done in order to avoid step deformity of the lateral orbital rim. The third case, Saethre-Chotzen syndrome characterized brachycephaly, hypertelorism, ptosis of the eye lid, maxillary hypoplasia, lower set frontral hair line, and partial cutaneous syndactyly was corrected by a Modified Marchac technique for remodelling the forehead and a subcranial U-osteotomy for mild hypertelorism. Maxillary hypoplasia was corrected effectively by advancement on the medial portion of the U-shaped bony segment. Augmentaton rhinoplasty with calvarial bone graft and chip bone grafts on the anterior nasal spine was done simultaneously. A large amount of nasal bone grafts in two cases were absorbed, and then augmentation rhinoplasty using silicone implant was performed after 6 months, 12 months respectively. In mild hypertelorism with associated deformity, a extranial osteotomy with augmentation rhinoplasty and correction of associated deformities can offer good aesthetic results.

백서의 원위부 피편에 동맥유입의 중요성에 관한 실험적 연구

최규남,최희윤,강희문,김한중 大韓成形外科學會 1983 Archives of Plastic Surgery Vol.10 No.2

Microsurgery and myocutaneous flap have been developed recently for wide employment in plastic and reconstructive surgery. Therefore, the delay procedure has been declined in its use recently, because it has many difficult problems. If the flap is longer and larger, it should be delayed for complete survival, but delay requires considerable time. Therefore, as a substitute for delay, vascular anastomosis in the distal part of a flap will theoretically give the same effect. In this study, we investigated the importance of arterial inflow in the distal side of a flap in rats. The experiment was done in 3 different groups according to the design of flaps and in each group 3 subgroups were made. In A flap, the superficial epigastric artery was preserved or anastomosis. In V flap. the superficial epigastric vein was preserved or anastomosis. In C flap, as a control flap, both artery and vein were severed. In result, A flaps in all 3 groups were completely survived. Both V and C flaps in all 3 groups were showed distal necrosis. But C flaps were showed more necrosis than V flaps. In conclusion, we suggest the possibility that a large flap may be transposed in one stage with vascular anastomosis in the distal part-preferably artery and vein, or artery only.