좌골부 및 전자부 욕창의 재건을 위한 후대퇴근막 피판술

문구현,방사익 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

연구목적: 욕창은 장기적으로 반복되는 압박으로 인해 피부 및 연부조직에 생긴 괴사를 말하며 이는 주로 골 돌출부 주위에 잘 발생한다. 이러한 욕창은 교통사고 및 산업재해의 증가로 척추손상 및 지체마비 환자가 늘어나고 집중 치료를 요하는 의식불명, 만성병증의 환자수가 증가하면서 그 발생 빈도도 증가 하고 있다. 그리고 욕창은 천골부, 대전자부 및 좌골부 등에서 호발한다. 추후에 보행이 가능한 환자의 경우 근피판보다는 근육을 보존할 수 있는 근막피판을 사용하는 것이 수술 후 보행에 더 도움을 줄 수가 있다. 그러므로 기존에 수술적 치료를 시행한 환자의 경우나, 욕창의 크기가 큰 경우, 추후에 보행이 가능한 환자에게 있어서 사용할 수 있는 술식의 유용성을 확인하고자 했다. 대상 및 방법 : 1999년 9월부터 2000년 8월까지 본원에 입원 중이던 6 례의 전자부 욕창과 5례의 좌골부 욕창을 가진 남자환자 7명, 여자환자 4명을 대상으로 하였으며, 원인별로 볼 때는 하반신 마비가 가장 많았다. 하둔부동맥 및 대퇴 심동맥의 제 1, 2 심부관통동맥으로부터 혈액공급을 받는 후대퇴근막피판을 작성한 후 피판을 전위하는 방법을 사용하였다. 결과: 피부 괴사등의 합병증 없이 모른 예에서 결손 부위을 막을 수가 있었으며 적당한 연부조직을 함께 전위 시켜줌으로 해서 추적관찰 기간 동안 욕창의 재발을 방지 할 수 있었으며 보행이 가능한 환자에 있어서도 보행에 문제가 없었다. 결론: 하둔부동맥 및 대퇴 심동맥의 제 1, 2 심부관통동맥으로부터 혈액 공급을 받는 후대퇴근막피판술은 수술이 쉽고, 출혈이 비교적 적으며 수술시간이 짧고, 피판 공여부의 봉합이 쉬우며, 보행 가능한 환자에서는 하지 근육의 기능을 보존할 수 있고, 만약 욕창이 재발 시 피판을 재거상 하여 전진시킴으로서 치료가 가능하며, 근육의 손상을 주지 않으므로 재발시 다른 수술 적 방법을 고려할 수 있는 여러가지 장점이 있는 술식이라 판단된다. Purpose : Pressure sore is an area of ischemic tissue loss resulting from prolonged or often repeated pressure, usually over a bony prominence of body. There has been recent reports describing superior durability of fasciocutaneous flap in sore reconstruction over musculocutaneous flap. Contrary to common musculocutaneous flap using gluteus & harmstring muscle, posterior fasciocutaneous flap does not incorporate any muscle, making it useful especially in ambulatory patients. Material and Methods : From September 1999 to October 2000 we have used posterior thigh fasciocutaneous flap for coverage of six trochanteric sores and five ischial sores. Posterior thigh fasciocutaneous flap is perfused by first & second profunda femoris perforating arteries. Results: All the patients recovered without any serious complications. Three cases developed minimal hematoma but it was corrected by simple evacuation. During the follow up period none of the patients were recurred and for those patients who were able to walk, there was no problem in walking. Conclusion : Posterior thigh fasciocutaneous flap has several advantages. It is easier to elevate, less operation time, less hematoma formation, good donor site morbidity and making possible to preserve the muscle component.

내시경을 이용한 전두부 지방종 제거술

문구현 충북대학교 의학연구소 2000 忠北醫大學術誌 Vol.10 No.2

연구목적: 지방종은 성형외과 영역에서 가장 흔히 접하게되는 연부조직 양성 종양이다. 작은 표재성 지방종은 증상이 없으나 안면부에 발생시에는 눈에 쉽게 띄기에 수술적 치료를 요하게 된다. 전통적인 안면부 지방종의 치료법은 피부절개를 통한 제거술이나 이는 술후 해당부위에 반흔이 필연적으로 남게된다. 최근 성형수술 분야에서 내시경의 이용이 점차 늘고 있어 최소한의 절개만으로 원하는 결과를 얻는 수술법들이 속속 소개되고 있으나 아직 안변부 지방종에 내시경을 이용한 보고가 없어 저자는 내시경을 이용한 지방종 적출술을 시도하여 이의 유용성을 확인하고자 하였다. 대상 및 방법: 최근 18개월간 전두부에 발생한 지방종 환자 4례에서 내시경을 이용한 적출 술을 시도하였다 종괴의 크기는 직경 2.0 -2.7cm 이었고 2개가 떨어져 동시에 발생했던 1례를 제외하고는 모두 단일 병변을 지니고 있었다. 직경 4mm의 내시경을 이용하여 전부두 골막하 박리와 종괴 적출을 시행하였다. 결과: 눈에 띄는 부위에 반흔을 남기지 않고 모든 례에서 성공적으로 종양을 제거할수 있었고 혈종, 감염, 신경손상과 같은 합병증은 발생하지 않았다. 조직학적 검사상 보두 지방종으로 확인되었고 모든 환자들은 미용적으로 매우 만족해 하였다. 추적 관찰에서도 지방종의 재발이나 전두부 윤곽 변형등의 이차적인 합병증은 발생하지 않았다. 결론: 본 수술법은 원위부 절개를 통해 보이는 곳에 반흔을 남기지 않으면서도 전부두에 발생한 지방종 제거에 효과적인 방법이라고 사료되며 안면 다른 부위에서도 선택적으로 이용할 수 있으리라 판단된다. Purpose : Lipomas are probably the most common benign soft tissue tumor presenting to the cutaneous surgeon. Small superficial lipomas are symptom free but facial location rendered patients to receive surgery because of cosmetic concerns. Traditional treatment of facial lipoma has been direct excision with incision placed over the tumor which resulted in linear scar on corresponding location. In recent plastic surgery fields, endoscopy-assisted procedures are widely applied for minimal Incision technique so the author tried endoscopic extirpation of facial lipomas to evaluate it's efficacy. Materials and Methods: Four patients having forehead lipomas are included in this study. Diameter of the lesions were ranged from 2.0 to 2.7 centimeter and all had single mass except one case with double lesions. 4mm diameter endoscpoe was used for subperiosteal dissection and lipoma removal. Results: All tumors are successfully removed without noticeable scars on forehead and other morbidity like hematoma, infection and nerve problem. Histologic confirmation of lipoma was done. Cosmetically patients were very satisfied with the results and during follow -up, late comlications like recurrence and contour irregularity didn't occurred. Conclusion : The author concluded this endoscopy assisted extirpation with remote incision results in cosmetically excellent results and should be primary option in facial lipoma treatment.

회수수 안정화제를 사용한 콘크리트의 공학적 특성에 관한 연구

김기정,金光華,이문환,이세현,한천구 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2

In this study is investigated the engineering properties of concrete using stabilizing agent of recycling water in order to suggest a practical use of recycling water. According to the results. as stabilizing agent is added. fluidity and air content varies slightly with W/C, but does not make a big difference. Bleeding is reduced by adding stabilizing agent, and so it decreases by about 40% at the adding ratio of 0.15%. When stabilizing agent is not added, compressive strength decreases in comparison with plain concrete, but increases by adding stabilizing agent, so it is largest at adding ratio of 0.30%(W/C 30%) and 0.15%(W/C 40, 50%). Length change by drying shrinkage is larger than plain concrete in the case of no adding of stabilizing agent, but decreases by the use of stabilizing agent. Therefore, it is thought that when stabilizing agent is added to recycling water, quality deterioration of concrete is prevented, moreover, quality of concrete can be improved.

안정화제를 사용한 회수수의 고형분량 및 방치시간에 따른 시멘트 모르터의 특성

金光華,김기정,이문환,이세현,한천구 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

This study is intended to investigate the fundamental properties of cement mortar with solid content and leaving time of recycled water that stabilizing agent is added. According to the results, fluidity and air content does not make a big difference with variation of solid content. As the leaving time of recycled water is long, fluidity and air content increases. Setting time is shortened due to fine particle with an increase of solid content and leaving time. Compressive strength and flexural strength increase with an increase of solid content, and they increase at the leaving time of 1 day, but decrease after 2days. Length change by drying shrinkage is smaller than that of plain concrete, and is almost same with variation of solid content. And it is reduced at the leaving time of 1 day, but increases after that. Therefore, it analyzed that the effect of stabilizing agent is best under condition of adding ratio of 0.15%, solid content of 3% and leaving time of 1day, and it also works upto solid content of 5% and leaving time of 2days.

Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps For Upper Body Defects

Mun, Goo-Hyun Korean Society of Plastic and Reconstructive Surge 2013 Archives of Plastic Surgery Vol.40 No.1

The Continuing Battles against Seroma in Latissimus Dorsi Flap Donor Sites

Goo-Hyun Mun 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.5

How to deal with revisions?

Goo-Hyun Mun 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.2

How to deal with revisions?

Mun, Goo-Hyun Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.2

Revising manuscripts is often challenging and may be a task that authors do not want to face, but it is a crucial step for significantly improving authors' work before the final publication. Understanding these general rules and the several tips discussed above may be helpful for authors in dealing with comments from editors and reviewers.

The Continuing Battles against Seroma in Latissimus Dorsi Flap Donor Sites

Mun, Goo-Hyun Korean Society of Plastic and Reconstructive Surge 2012 Archives of Plastic Surgery Vol.39 No.5

Spray Characteristics of Y-jet Nozzle in Oil Burner Development

( Mun Hee Lee ),( Wook Hwan Yeo ),( Dong Hyun Nam ),( Jung Goo Hong ) 한국액체미립화학회 2017 한국액체미립화학회 학술강연회 논문집 Vol.2017 No.-

Environmental and energy-efficient factors are most important issues for combustor used throughout the industry. The oil burner is a combustion device for power generation boiler. The combustion performance in the furnace greatly depends on the spray characteristics of the fuel injector. The liquid fuel of the power generation boiler mainly uses heavy fuel oil, residual oil and crude oil. Therefore, it is necessary to develop a combustion device capable of satisfying the regulation of combustion emissions (NO_x, CO, etc.) required by a power generation company and minimizing the consumption of steam used as a spraying medium, thereby preventing a decrease in boiler efficiency. In this study, we investigated the spray characteristics of internal, intermixed(Y-jet type) atomizers using steam and air as spraying media. In experiment, single hole nozzle was designed and lab-scale nozzle which is simulating actual size nozzle was used. Five internal, intermixed type nozzles were designed. First, three internal, intermixed type nozzles were designed, and feedback was performed through the first spray test. The second experiment was conducted by designing two additional nozzles considering the resultant variables. Therefore, it was measured that the spray characteristics, spray angle, SMD and injection velocity. The spray image and spray pattern were determined by the design layout-out of the nozzle hole. The spray characteristics were found by the changes of the liquid injection pressure and the air flow rate. The characteristics of the internal and intermixed nozzles were determined by the total cross-sectional area of the nozzle exit regardless of the nozzle type. In addition, the change of the spray angle has little effect with liquid and air injection pressure, and the spray angle is influenced by designing the nozzle exit orifice. Finally, representative nozzles were selected to measure the injection velocity.