유리 측대퇴 피판을 이용한 압궤수부손상 재건술

김수신,백세민,김동일 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.1

Utilizing the lateral thigh flap as originally described by Se-Min Baek. in 1983, we have treated seven cases of reconstruction involving crushing injuries of the hand. This flap is derived from the third perforator of the deep femoral artery and accompanying wein as per Baek`s method. When a large skin flap was needed such as the case of crushing hand injuries, a lateral thigh flap was more useful than any other flap. From our experiences for reconstruction of crushing hand injuries, the following advantages of this flap are noted: 1. It is possible to obtain a large size of all skin flap. 2. It is relatively thin with a small amount of the subcutaneous fat. 3. The vascular pedicle is long (10㎝ or more), facilitating microvascular anastomosis. 4. The lateral thigh flap can be a sensory flap. 5. It can be accommodated easily to any operating position.

알코올이 Dynamic Posturography에 미치는 영향

이진춘,고의경,장민호,이병주,백무진,노환중,왕수건,전경명 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.2

원인 불명의 실신 환자의 진단에 있어서 Head - up tilt Test 의 유용성과 혈관미주신경성 실신 환자의 임상적 특징

윤호중(Ho Joong Youn),정욱성(Wook Sung Chung),백상홍(Sang Hong Baek),김철민(Chul Min Kim),박인수(In Soo Park),김재형(Jae Hyung Kim),최규보(Kyu Bo Choi),홍순조(Soon Jo Hong) 대한내과학회 1994 대한내과학회지 Vol.47 No.2

N/A Background: Syncope, defined as a transient loss of consciousness, is a frequently encountered symptom, but despite thorough clinical and invasive diagnostic investigation, the cause of syncope remains unexplained. In recent years, head-up tilt test has been of increasing interest as a diagnostic aids in patients with unexplained syncope. We studied to define the usefulness of various diagnostic test in the evaluation of patients with recurrent syncope, to assess the usefulness of head-up tilt test in the working of syncope of unknown origin and to evaluate the clinical characteristics of subgroups of patients with syncope induced by head-up tilt test. Methods: Between June, 1991 and November, 1992 at St. Mary`s hospital, 21 patients with history of syncope and 24 control subjects without history of syncope underwent 60° head-up tild test for 60 min. Results: 1) The definite cause for recurrent syncope were diagnosed in 10 of patients (47,6%) after clinical and invasive tests. 2) During head-up tilt test, vasovagal responses were provoked in 5 of 21 patients (23.8%) with recurrent syncope and 1 of 24 patients (4.2%) without syncope (p<0,05). 3) The head-up tilt test induced symptomatic bradycardia or hypotension in 3 of 10 patients (30%.) with negative electrophysiologic results. 4) During tilt induced vasovagal response, a) mean heart rate decreased to 42±24 beat/min from supine control of 70±12 beat/min (p<0. 05), b) mean systolic blood pressure decreased to 95±12 mmHg from supine control of 120±S mmHg (p<0,05), c) mean diastolic blood pressure decreased to 60±21mmHg from supine control of 72±13 mmHg (p<0.05), d) the time interval to onset of vasovagal response was 22±12 min. Conclusions: 1) In a large proportion of patients with recurrent syncope, the diagnosis remains unexplained despite a neurologic and cardiologic investigation including an electrophysiologic study. 2) Vasovagal responses are frequent cause in patients with recurrent unexplained syncope. 3) The head-up tilt test may be a simple, safe and highly yielding provocative test in the investigation of syncope of unknown origin.

僧帽筋皮辯(TRAPEZIUS MYCOUTANEOUS FLAP)의 임상적 응용

백세민,김수신 大韓成形外科學會 1986 Archives of Plastic Surgery Vol.13 No.1

The concept of the myocutaneous flap has established various anatomic territories from which flaps may be elevated for reconstruction of defects in the area of head and neck. The trapezius muscle is a flat, triangular muscle, covering the back of the neck and shoulder. It arises from the medial one-third of the superior nuchal line of the occipital bone, the external occipital protuberance, the ligamentum nuchae, the spine of the seventh cervical and the spines of all the thracic vertebrae and the corresponding portion of the supraspinous ligament. The upper part of the muscle inserts to the lateral third of the clavicle; the middle part into the medial edge of the acromion and the upper border of the spine of the scapular; the lower part to terminate in a tubercle at the medial end of the spine of the scapular. The trapezius is supplied by the accessory nerve and also by branches from the third and fourth cervical nerves, which are probably sensory. The vascular supply comes from the transverse cercical artery and the occipital artery primarily. In an effort to define clinical usefulness of the trapezius myocutaneous flaps, this paper describes various myocutaneous flaps, incorporating various portions of the muscle and bone, and reports the clinical applications.

사북-고한지역이 탄광폐석에 대한 암석학적 특성 연구

백환조,임길재,서백수,민경원,정연태 강원대학교 석재복합신소재제품연구센터 1996 석재연 논문집 Vol.1 No.-

사북 및 고한 지역에 분포하는 동원탄좌와 삼척탄좌에 적치되어 있는 석탄폐석은 대부분 사암과 흑색 셰일로서, 사북광업소의 경우 약 730만 m³, 정암광업소에는 약 830만 m³의 폐석이 적치되어 있다. 동원탄좌 사북광업소의 석탄폐석중 사암은 대부분 평균 입자의 크기가 0.15∼0.9㎜에 해당하는 등립질 조직을 보이는 이질석영사암으로서, 입자의 모양과 원마도에 따른 분류로는 low sphericity의 subrounded grain에 해당된다. 또한 흑색 셰일은 평균 광물 입자의 크기가 0.05㎜ 이하이고 비교적 물결 모양의 충리를 나타내고 있다. 삼척탄좌 정암광업소의 사암은 대부분 평균 입자의 크기가 0.15∼0.3mm의 범위에 해당하는 등립질의 이질석영사암으로서 대체로 low sphericity의 subrounded grain에 해당되며, 흑색 셰일은 평균 장경이 약 0.03∼0.06㎜에 달하고, 충리가 비교적 잘 발달되어 있다. 주성분 원소들의 화학분석 결과에 따르면 동원탄좌 사북광업소의 사암은 삼척탄좌 정암광업소의 사암에 비해 상대적으로 SiO₂의 평균함량이 약간 더 높은 값을 보이고 있는데, 특히 동원탄좌 사북광업소의 일부 사암(D-4 및 D-5)은 치밀한 조직의 석영으로 구성되어 있고, 소량의 점토광물만이 기질을 이루고 있어 건설재료로서 그 활용가치가 높다고 판단된다. 또한 삼척탄좌의 사암(S-3 및 S-4)은 동원탄좌의 사암보다 상대적으로 낮은 SiO₂ 함량과 높은 Al₂O₃, Fe₂O₃*, K₂O 및 L.O.I. 함량을 보이는데, 이는 기질을 이루는 점토광물의 양이 상대적으로 많음을 반영한다. 삼척탄전의 석탄폐석에 대한 암석학적 및 지구화학적인 특징에 의하면 사암의 경우는 대체로 건설재료로서 활용이 가능하나, 흑색 셰일의 경우는 비교적 탄질물이 많이 함유되어 있어 직접적인 건설재료로의 이용은 비효율적일 것으로 생각된다. The coal mine waste rocks piled in he Sabuk and Gohan district consist mainly of sandstones and black shales, and the estimated volumes of the waste rocks are about 7,300,000m³ and about 8,300,000m³ at the Sabuk mine, Dongwon Coal Co. and the Jeongam mine, Samchok Coal Co., respectively. Sandstones in the waste pile yard of the Sabuk mine are mainly equigranular argillaceous arenites composed of low spherical and subrounded grains of 0.15∼0.9㎜ in size. Black shales show generally wavy lamination and their average grain sizes are less than 0.05㎜. Sandstones in the waste pile yard of the Jeongam mine are also mainly equigranular argillaceous arenite of low spherical, subrounded and 0.15∼0.3㎜ sized grains, and black shales exhibit well developed laminar structure with grains of 0.03∼0.06㎜ in size. Sandstones at the Sabuk mine have higher SiO₂ contents than those at the Jeongam mine, and especially some sandstones (D-4 and D-5) have extremely high SiO₂ contents, reflecting their compact textured quartz grains with small amounts of argillaceous matrix. Compared with those at the Sabuk mine, Sandstones at the Jeongam mine display lower SiO₂ contents but higher abundances of Al₂O₃, Fe₂O₃, K₂O, and L.O.I., reflecting relatively lower amounts of clay minerals. According to their petrological and geochemical properties, sandstones rather than black shales in the Sabuk and Gohan district could be potentially utilized as raw materials for construction and especially for polymer-concrete, which is now under design for mass production in this area.

포스포닐화된 어택틱 폴리프로필레수지에 의한 금속이온의 흡착에 관한 연구

백승화,이수민,오인교 圓光大學校 1981 論文集 Vol.15 No.1

The adsorption of metal ions by chelating agent-loaded resins was studied in aqueous media. The resins were prepared by loading the conventional cation exchange resin, coated glass powder by pohsphonyl atactic polypropylene resin(200 to 250 mesh) with chelating agents containing hydroxyl groups. The composition of synthetic resins was analyzed by infrared absorption spectroscopy and also discussed. The optimum conditions for the adsorption of metal ions were determined with respect to the shaking time, the effect of cation concentration and the effect of adsorption of capacities on the industrial waste water in the medium.

안지오텐신 변환효소 억제제와 안지오텐신 II 수용체 차단제 투여 후 발생한 급성 신부전과 폐부종으로 전원된 선천성 단일신 환자의 치료 1예

백두현,김경진,홍성철,강석형,송하응,김혜인,김수현,오현정,강혜원,김서우,유민아,류동열,최규복,강덕희 이화여자대학교 의과대학 2010 EMJ (Ewha medical journal) Vol.33 No.1

Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function. We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output. Conclusion:This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

석·골재용 암석의 풍화에 따른 특성 변화

민경원,서백수,진호일,임길재 강원대학교 부설 석재복합신소재 제품연구센터 2000 석재연 논문집 Vol.5 No.-

화강암의 조직을 고려하여 4개지역에서 6개 석ㆍ골재 석산을 대상으로 신선한 화강암과 풍화된 화강암을 Ⅰ ~ Ⅵ단계까지 체계적으로 채취된 화강암을 대상으로 풍화에 따른 화강암의 물리적ㆍ화학적 특성 변화에 대한 고찰(민경원 등, 1998)에 추가하여, 풍화에 의한 slake 내구성과 색도의 변화를 측정하고 토의하였다. slake 내구성 시험에서는 일반적으로 Ⅰ~Ⅲ 단계의 화강암이 시험 주기가 증가할수록 선형적이 질량감소를 보이고 Ⅳ~Ⅵ 단계에서는 곡선 모양의 감소 경향을 보여주면 세립질의 화강암이 상대적으로 높은 내구성을 가진다. 풍화에 따라 암석의 백색도는 감소하고 황색도는 증가하며, 표준화된 백색도-황생도 지수는 풍화단게를 지시해 줄 수 있는 유용한 지시자로 제안되었다. Fresh and weathered granitic rocks of grades Ⅰ to Ⅵ were sampled systematically from six stone and aggregate quarries in four chosen areas in consideration of their textures. In addition to the observed variations. of physical and chemical properties of granitic rocks in terms of weathering grades(Min et al., 1998), slake durability and color index variations were measured and discussed in this article. In the slake durability test, generally with increasing test cycles the granitic rocks of grades Ⅰ to Ⅲ show linear losses of weight but those of Grades Ⅳ to Ⅴ show curvilinear trends, and the fine-grained weathered granitic rocks have comparatively higher durability. As weathering proceeds, whiteness of rocks decreases and yellowness increases. A normalized whiteness-yellowness index is suggested as a weathering index to be one of useful indicators of weathering grades.

Post-cleft Defofmity의 치험례

백세민,김수신,김동일,김우경,차진한 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.4

There is increasing demand by cleft patients for improvement in their esthetic appearance and occlusion. Cleft lip and palate deformoty is a multifaceted problem. It is important to consider the underlying skeleton of the face as well as the covering soft tissue. With proper presurgical planing such as photographic, cephalmetric and dental cast analysis, the two jaw osteotomy and other procedures were performed simultaneously in 6 post-cleft deformity cases. We improved their facial appearance and occlusion. Their acceptance and satisfaction are exceptionally high.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.