비골골절 정복술 후 복합 환기실리콘부목과 바세린 거즈를 이용한 비강충전

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: The majority of nasal bone fractures have been managed by closed reduction and intranasal packing. Various packing methods have been used for maintaining stability of nasal bone and reducing patient's discomfort. In this study we compare previous procedure with only vaseline gauze and nasal packing with airway silicone splint and vaseline gauze after closed reduction of nasal bone fracture. Methods: We performed a prospective study with 60 patient treated nasal bone fracture from Dec. 2009 to Oct. 2010. Sixty patients were divided into vaseline gauze packing group and airway silicone splint and vaseline gauze packing group. Airway silicone splint (Doley Combo Splint®) consists of silicone sheet, hemicircular airway tube and Rhinocell®. We evaluated the patients' discomfort such as nasal obstruction through questioning survey and recorded packing periods and accidental packing material removal. Results: Nasal obstruction, dry mouth, swallowing difficulty and headache associated with intranasal packing were significantly improved among the patients who underwent packing with airway silicone splint and vaseline gauze. And packing period of airway silicone splint packing group was longer than other group Conclusion: Intranasal packing with airway silicone splint and vaseline gauze can be a useful method for reducing patients' discomfort associated with nasal obstruction. And this method can be used in the others surgery such as septoplasty and corrective rhinoplasty

액취증에서 투메슨트와 최소절개를 통한 피하조직 절제술의 치료 효과

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Purpose: Axillary osmidrosis is a condition of abnormal unpleasant body odor caused mostly by apocrine gland secretion. Surgical excision of the subcutaneous tissue has been the treatment of choice for several decade. However, there are risks for complications including wound necrosis, hematoma, seroma, obvious scars following surgical treatment. We report our method of treatment of subdermal excision with small skin incision under local anesthesia with tumescent infiltration. Methods: From December 2008 to August 2010, 33 consecutive patients underwent subdermal excision with small transverse incision under tumescent anesthesia for axillary osmidrosis. The average age of the patients was 22 years (range, 13 to 62 years) and the average follow-up period was 7.6 months (range, 3 to 22 months). Result: Through a questionnaire that was answered by 33 patients, 97% reported satisfactory reduction of malodor. Complication included small hematoma (1.5%) and superficial epidermal necrosis (1.5%) which healed spontaneously. According to the postoperative histologic examination, only a few remnant of apocrine and eccrine glands were found. Conclusion: The subdermal excision with small incision using tumescent anesthesia for axillary osmidrosis decreases the bleeding during procedure and enables removal of sweat glands easily under direct vision. Therefore this operation has the advantages such as a high success rate, rapid recovery and a low complication and recurrence rate.

朝鮮時代 地方都市의 空間構造에 關한 硏究 : 尙州, 慶州, 大邱를 中心으로

예명해,足立裕司,신상화 대구대학교 과학기술연구소 1998 科學技術硏究 Vol.5 No.3

The objective of this research is to clarify the regional structure of the cities of the Chosun Dynasty and the principles of their formation. A comparative study of three cities, namely Sangju. Kyoungju and Taegu has been carried out. The results of the investigation are as follows. 1) Although the formation of the cities of Sangju, Kyoungju and Taegu took place before the occurance of Feng-shui, it is clear that the adoption of Feng-shui and techniques complimentary to the natural topography were highly regarded in the Chosun Dynasty. 2) The political ideas at the time, based on the strict principles and ranking-order of Confucianism also influenced the process of formation; seen particularly well in the structure of the GAMYOUNG. In addition, sacrificial facilities, being an expression of confucianism, were newly established outside these castle cities.

두피에 발생한 혈관 육종 증례 보고 2례

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: Angiosarcoma of the scalp is rare vascular tumor originating from endothelial cell. The prognosis is very poor with high propensity of local recurrence and distant metastasis. The author reports experiences with the latissimus dorsi free flap in the reconstruction of soft tissue defect of scalp caused by excision of angiosarcoma. Methods: Two patients visited the hospital with 9x10cm, 8x11cm sized lesion on scalp. Distinguishing features were frequent occurrence of a peripheral erythematous ring, satellite nodules, intratumoral hemorrhage, and the tendency to bleed spontaneously. Both lesions in each patient had developed and increased in size for 5 months and for 3 months, respectively. Results: Two patients were diagnosed as an angiosarcoma. Prior to the operations, the patients had evaluations preoperatively including brain CT, brain MRI and whole-body PET-CT. There were no evidence of metastasis. We performed wide excision and reconstruction by latissimus dorsi musculocutaneous free flap with split thickness skin graft on both cases. In case 2, radiation therapy was done within 1 month of tumor excision. Multiple distant metastasis occurred in case 1. Conclusion: Angiosarcoma is a highly malignant tumor with poor prognosis. Treatment and reconstruction method was not yet established. Reconstruction methods include free flap, split thickness skin graft, local flap. We performed latissimus dorsi musculocutaneous free flap as reconstruction method. This method has advantages that have sufficient blood supply and bulk that offer durability to radiation therapy. However, it has a disadvantage in detection of local recurrences. And it has high potency than other reconstruction method for distant metastasis due to sufficient blood supply. Further discussion between doctor and patient is needed for the best possible selection of treatment.

위볼기 동맥 천공지 프로팰러 피판을 이용한 천골부 욕창의 재건

한예식 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Purpose : Superior gluteal artery perforator(SGAP) flaps are surgical options in pressure sore reconstruction. There are several advantages in reliability, preservation of muscle, versatility in flap design, and low donor site morbidity. An anatomical study was carried out to improve the flap's effective value. SGAP propeller flap can be successfully used in sacral pressure sore reconstruction. so we report this clinical experiences with review of the literatures Methods : 5 cadaver were dissected to investigate localization, distribution of the perforators and to measure thickness of subcutaneous tissue on gluteal region. and SGAP propeller flaps were performed in 3 patients with sacral pressure sore. The fasciocutaneous flap based on the SGAP was designed in elliptical shaped pattern from sacral region toward the inferolateral aspect of buttock and was elevated from adjacent tissue. The flaps rotated 120~180 degree to cover sacral defect. Donor defect was repaired primarily. Results : Several perforators were found under the SGAP propeller flap area. Its mean number was 3. The thickness of elevated flap were 2.02cm in medial side and 4.49cm in lateral side. The patients' mean age was 52.3 and the average follow up period was 9 months. No serious complications such as flap necrosis or infection occurred except 1 hematoma in postoperative day 3. No functional disturbances in walking were observed. The long term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusion : The anatomical study suggests that the SGAP flap as propeller type is possible in its enough volume and perforators' location. The SGAP propeller flap may be a reliable method in sacral sore reconstruction especially in patients who expected ability in walking after rehabilitation

一段階 耳介成形術을 利用한 小耳病 再建例

한예식,이정윤 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.1

Total ear reconstrucion has been one of the most difficult problem in plastic surgeon. It required multiple procedures, prolonged hospitalization, high cost, and the final appearance of the reconstructed ear was still far from normal. In 1983, Song and co-workers studying the blood supply to the skin of the auricular area, presented another method of single stage total ear reconstruction. We operated 3 anotic patients with Song`s one stage total ear reconstruction procedure and agreed that this procedure solved some problems, especially shortening of multiple procedures, in classic Tanzer`s procedure. But, another problems were noted in Song`s procedure. 1. One stage technique will require minor secondary procedures for good final results. 2. Post auricular skin grafted area was larger than Tanzer`s procedure. 3. Definition of the cartilage framework was obtuse in early postoperative period, because the contraction of the skin graft and fixation of the skin flap were simultaneously occured. 4. This procedure may have high complication rate.

채종박에 대한 extrusion처리 및 formaldehyde처리가 젖소의 반추위내 in situ 분해율에 미치는 영향

문여황 진주산업대학교 농업기술연구소 1998 農業技術硏究所報 Vol.11 No.-

채종박에 대한 extrusion처리의 적정온도를 규명하기 위하여 반추위 누관이 장착된 Holstein젖소 4두를 이용하여 in situ시험을 수행하였다. 시험구는 무처리, 110, 135 및 150℃ extrusioncc처리구, 그리고 0.3% formaldehyde처리구로서 총 5처리를 두어 반추위내에서 0, 3, 6, 9, 12 및 24시간동안 발효시켰다. 공시동물은 NRC(1988)요구량의 110%수준에서 농후사료와 조사료를 각가 50%씩 급여하였고, 물과 린칼블록은 자유섭취토록하였다. 시험사료 중 조단백질의 반추위내 분해특성에 대한 비선형회귀방정식과 유효분해도(ED)의 결과는 다음과 같이 유도되었다. 무처리구 : P = 61.63 + 34.01(1-e^-0.075) ED(k=0.05) = 82.04% 110℃ extrusion : P = 34.56 + 54.81(1-e^-0.049t) ; ED(k=0.05) = 61.69% 135℃ extrusion : P = 35.23 + 41.19(1-e^-0.076t) ; ED(k=0.05) = 60.07% 150℃ extrusion : P = 29.53 + 60.67(1-e^-0.034t) ; ED(k=0.05) = 54.09% 0.3% HCHO : P = 15.17 + 67.27(1-e^0.046t) : ED(k=0.05) = 52.94% 단, P = 반추위내 발효시간(t)동안 소실율, k = 사료의 통과속도(%/시간/100). 건물, 조단백질, 유기물 및 에너지의 반추위내 분해율은 처리에 의해 유의적으로 감소되었으며, formaldehyde처리구에서 가장 낮았고, extrusion 처리온도에 따라서는 온도가 증가함에 따라 각 영양소의 분해율은 감소되었다. 조단백질의 경우, 150℃에서 extrusion처리시 반추위내 분해율과 서서히 분해되는 부분(b)이 formaldehyde처리구와 비슷한 수준이었으며, 시간당 분해상수(c)는 처리구중 가장 낮았다. Four ruminally cannulated Holstein cows were employed to verify the effect of temperature in extrusion processing on ruminal degradation characteristics of rapeseed meal. Treatments were composed of rapeseed meals untreated(Control), extruded at 110, 135 and 150℃, and treated with 0.3% formaldehyde(HCHO). In situ trials were scheduled to 0, 3, 6, 9, 12 and 24 hours of suspension time in the rumen. Animals fed the diet of 50 : 50 in concentrated and roughage(orchard grass hay) at 110% of NRC(1988) requirement, and were ad libitum access to water and mineral block. Non-linear regression equations for degradation characteristics and effective degradability(ED) of crude protein in the rumen were obtained as follows. Control P = 61.63+34.01(1-e^-0.075t) ; ED(k=0.05) = 82.04% 110℃ extrusion P = 34.56 + 54.81(1-e^-0.049t) ; ED(k=0.05) = 61.69% 135℃ extrusion P = 35.23 + 41.19(1-e^-0.076t) ; ED(k=0.05) = 60.07% 150℃ extrusion P = 29.53 + 60.67(1-e^-0.034t) ; ED(k=0.05) = 54.09% 0.3% HCHO P = 15.17 + 67.27(1-e^0.046t) : ED(k=0.05) = 52.94% where, P = Degradability during the time(t) suspended in the rumen, k = Passage rate(%/hr/100). Ruminal degradabilities of dry matter, crude protein, organic matter and energy significantly decreased by extrusion or HCHO treatments, and were lowest for the HCHO treatment. Increasing the temperature of extrusion processing resulted a decrease in the ruminal degradabilities of nutrients. The rapeseed meal extruded at 135℃ was similar to the 0.3% HCHO treatment in degradation characteristic of crude protein, and was slowest in degradation rate per hour of nutrient in the rumen.

물상보증인과 후순위저당권자와의 관계

김여회 대구효성카돌릭대학교사회과학연구소 1999 사회과학논총 Vol.1 No.-

We have two threory on the extend of application of the article 368 of the ciyil law by a standard of the object of the aggregate mortgage. One is a broad theory which is set on the several objects, the same or different kinds, the other is a narrow theory which is set on the same kind object. The essential element in the aggregate mortgage is the right of a mortgage, it is the same in the broad aggregate mortgage in the narrow. This article should be applicated, as a nextmortgage on the object can be set anytime and the broad aggrgate mortgagee is nessary balance of the next each mortgagee because of doing the right of choice of a mortgagee. There are two threory on the extend of application of the article 368 of the civil law by a standard a possessor of the object is same, a debtor or a guarantor of a secured mortgage. The other is a theory which should be applicated in such case the possessor of the object is each other the same or different. A aggregate mortgage come into being in such case the possessor of the object is each other the same or different. As this article is the only one in our civil law, it should be a standard which we can be solve the problem come from doing the right of a aggregate mortgage as possible as widly. We prescribe article 368 that say it is setting up mortgage on the several real estate, if we are due to this article, We have no any prescribe for the same of the possessor, consequently, this article should be applicated without exception. The subrogation of the next mortgagee in the article 368, clause 2 of the civil law is that of the law of reality to arbitrate between aggegate mortgagee and next mortgagee. The subrogation in the article 481·482 of the civil law is of the law of obligations to arbitrate interests among a creditor, a debtor, a subrogator. Consequently, as the right in the law of reality has preference to the right in the law of obligation. The preference theory of the next mortgagee is right.

지나이다 기피우수의 페테르부르그 일기에서 본 작가의 형상

한예경 대구대학교 인문과학 예술문화연구소 2000 人文科學硏究 Vol.21 No.-

Петербургские Дневники-это в лервуЮ очередь документ эпохи, соде ржаЮщий собЫтийно-Фактический материал. Анализ дневникого текста Зинаиды「иппиус услоЖнеется недосткоам контеста. Далеко не всё, создан ное поэттессов издано в России. Отсутствует собраниие соуиниениий з. Г., не собраны вместе многоуислнные отзывы о ней её современников. Так Же односторонне оценивались и идеологические взгляды поэтессы, ук ладываюшиеся в простую Формулу, звучащую прблизительно так: "Мадонна серебряного века" очернила Россию и русскую кул4ьтуру." Её образ пред ствлялся двойственным: с одной строны, "изысканная эстетка", с друго й-" злобная пасквилянтка." Нтак, даЖе беглый экскурс в область худо Жественного творчества 「иппиус позволяет внести определённые коррек тивы в слоЖившийся в сознании читателя чсойчивнй образ. Обращение кЖанру дневника не было случайиым в творчестве 「иппиус. На протяЖении своего долгого творчекого лути поэтесса неоднократно обращалась кмемуарным Жанрам. То Же чувство ответственности перед потомками, стр емление довести до них правду в"страшные годы России"(А. Блок) и по будило З. 「. запечтлеть "эти годы" в форме литературного дневника. Следуег заметить, что в характернстнке Петербургских дневников. В записах большое место занимает фиксация общественно-политических со бытий. В Петербургских дневниках представлены записи, которые вела З. 「. в период с 1914 по 1919 годы. Петербргские дневники предста вят собой ценный исторко-литературиый документ эпохи. Характерной че ртой образа автора в дневниках является стремление к обьективности изложения. Одной из оснобеных личностных характеристнк З. 「. считал ась субективность. Однако , несмотря на повышенную эмоциональнось ха рактера, З. 「. постоянно стремится сдерживать себя, пытаясь обуздать свой субьективизм. В то же время именно интеллектуальность З 「.яв ляется тем сдерживающим фактором, который вводит в рамки корректности её сильные эмоции. З. 「. сознвала уникальнть историческго момен та и хотела докумнтально сохранить кусок уходящей россии. ЧУВСТВУеТ СВОЮ ответственностЬ художника перед эпохой. Образ автора в Петербур гских дневниках далёк от образа "декадентской мадонны." Перед читаел ям предстает совсем другое лицо - лицо умного, и серЬёзного мыслител я, сильной личности, нашедщей в себе мужество статъ летописецем траг ической зпохи и честно рассказать в времени и о себе. И З. Г. всегда была верна зтому завету. Она могла упрекнуть себя во многом, но в од ном никогда! Она всегда оставалась честной перед собой и своим врем енем. Зто совсем немало для летописеца, роль которого взяла на себя " декадентская мадонна."

흙의 指數的 特性에 관한 硏究

姜乂默,趙成燮,金成完 충남대학교 농업과학연구소 1977 農業技術硏究報告 Vol.4 No.2

These experiments were carried out to analyse the correlation among various soil parameters which characterize the mechanical properties of the disturbed and undisturbed soil, and to analyse Atterberg Limits for the basin of downstream of Hanriver Keum river, Nakdong river, and Asan bay. 1. Wet density of soil was the lowest in the basin of Nakdong river which contains the highest amount of clay minerals among the soil samples, and was increased in the order of Han river, Keum river and Asan bay. It was appeared that the unit weight of natural soil was changed in accordance with the clay mineral content which determines the moisture content. 2. Curved relationship was recognized, showing that dry density of soil was decreased with increasing the moisture content. Soils from the basin of Asan bay were appeared to have the highest dry density and the next was those of Keum river, the second lowest Han river, and the lowest Nakdong river. 3. When the liquid limit of soils was over 40 percent, their plastic index was above the A-line plastic chart. 4. Between dry density and void ratio of soils, a curved relationship was found, in which dry density was decreased as void ratio increased, and the differences between them became greater in soils containing higher amount of coarse grained soil. Decreasing tendency of dry density in accordance with increase of void ratio was the most significant at Asan bay which contained the lowest clay content, and other decreasing order of dry density was Keum river, Han river, and Nakdong river.