Ⅵ. 泌尿器系統에 있어서의 Sulfa劑의 應用

文九鉉 中央醫學社 1961 中央醫學 Vol.1 No.6

Crouzon씨병 교정치료를 위한 개선된 Frontofacial monobloc advancement와 Cranial vault remodeling 병행수술 방법

문구현,이윤호 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Crouzon's disease characterized by exorbitism, retromaxillism, inframaxillism, and paradoxic retrogenia, was first described by Crouzon in 1912. Premature fusion of cranial sutures results in a variety of calvarial deformities, but oxycephaly and brachycephaly are most often observed.¹ According to the severity of deformity and patient's age, the method of surgical correction should be selected. In adults, for reasons of safety, staged operation, first, limited frontocranial remodeling if necessary and facial advancement later, is generally favored. Combined orbitofacial monobloc advancement and frontal repositioning was popularized by Oritz-Monasterio(1978) but this technique has been reserved only for child. Persistent intracranial dead space, increased risk of ascending infection via nasofrontal communication, possibility of frontal bone flap resorption, and some technical difficulties rendered monobloc advancement to be not indicated in adults. We thought that modification and improvement of original monobloc procedure combined with cranial vault remodeling could overcome above mentioned disadvantages. Authors' combined procedure can correct deformities of midface, forehead and cranial vault simultaneously in one stage. We performed our combined surgical procedures of modified frontofacial monobloc advancement and cranial vault remodeling in 22 year-old female patient and obtained successful without complication. Through our limited experience, this new methods probably can be safely applied to the adult patients of Crouzon's disease with calvarial deformities and correct not only front-orbito-facial region but also whole cranial vault deformity in one stage.

倫落女性에 對한 現況 및 性病에 關한 硏究

文九鉉 慶北大學校 1964 論文集 Vol.8 No.-

Five hundred and ten prostitutes living in Taegu, Kyung Joo, and Pou Hang areas were investigated for their present conditions and morbidities of the venereal diseases. Bacteriological studies of 28 strains of gonococci, 33 of coagulase positive and 75 of coagulase negative staphylococci isolated from the cervix were also made, and the following results were obtained. Ⅰ. Present conditions of prostitutes. 1. Ages of 66.6% of prostitutes were from 21 to 25 years. 2. Ages of menarche ranged from 16 to 19 years in most cases (80%). 3. First sexual intercourse was made under the ages of 20 years in 77.0%. 4. 89.0 per cent of prostitutes had not received an education higher than the level of primary school. 5. In 62.4% of prostitutes, it was found that they had no jobs in the past. 6. Important motives of the first sexual intercourse were love affaris (48.0%) and prostitution (22.0%). First intercourse of most of prostitutes (82.0%) was extra-marital. 7. Causes of fall into the misery were the difficulty in economic condition (57.1%0, seduction (27.6%) and abandonment (15.3%). 8. Prostitutes from urban areas showed a little higher percentage than those from rural areas. Ⅱ. Venereal diseases. 1. Lesions and/or pus discharges in the cervix were found in 51% of prostitutes and cervical erosions in 33.2%. 2. Gram negative diplococci in discharges were observed intracellularly or extracellualry in 31% of persons examined, and a high incidence of Gram negatice diplococci was noted among prostitutes for Koreans than in those for U.N. Forces. The appearance of leucocytes and Gram positive diplococci in discharges were almost the same in the both groups of prostitutes. 3. Thirtytwo strains of gonococci were isolated from specimens showing Gram negative diplococci upon staining, and three strains from those showing no Gram negative diplococci. 4. Thirtyfive strains out of 95 Gram negative diplococci showing positive oxidase reaction were identified as gonococci and the remaining as N. catarrhalis, N. sicca, N. flava or mimea group. 5. Gonococci were sensitive to penicillin, less sensitive to terramycin and erythromycin, moderately resistant to chloramphenicol, kanamycin and albamycin, and highly resistant to streptomycin and sulfadimethoxine. 6. One hundred and sixtytwo strains of staphylococci were/isolated from cervical discharges, and 33 strains of them were coagulase positive. 7. Among 33 strains of coagulase positive strains, 20 strains were identifed belonging to phage groupⅠ, one mixed group and 12 non-typable. Strains belonging to groupⅠ were identified as phage type 29 and one belonging mixed group as 29/6. 8. The sensitivity of staphylococci to various antibiotics showed no marked difference between coagulase positive and negative ones. Most of the strains were sensitive to antibiotics, and very few of them were resistant. 9. Serological test for syphilis was positive by VDRL test in 10.5% of prostitutes, while Syphilis recenta was not found. The incidence of positive VDRL test was higher among prostitutes in areas of poor sanitation and higher among those for Koreans. 10. Chancroid was found in 11 cases (1.9%) but Lymphogranuloma venereum and Granuloma inguinale were nor found.

역행성 동맥 혈류를 이용한 원위 유리피판술의 실험적 연구

문구현,민경원,이민구 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.3

Microsurgical free-tissue transfer has allowed surgeons to salvage injured limbs but choosing appropriate healthy recipient vessels has proved to be a difficult problem. Retrograde flow flaps are established in island flaps. Retrograde flow anastomosis could prevent the possible kinking and twisting of the arterial anastomosis. By not interrupting the proximal blood flow to the fracture or soft tissue defect site, the compromise of fracture or wound healing might be prevented. We wished to establish an animal model in rat for a retrograde arterial flow based free flap. Nembutal-anesthetized male rats, weighing 250 to 300 gm, were used. The femoral artery and common carotid artery exposed and divided. The systemic and retrograde arterial pressure were quantified by utilizing a paralle tubing system connected with peripheral arterial line. In this study, the retrograde flow was not pulsatile and the retrograde arterial pressure was 64-65 mmHg, with a mean arterial pressure of 106-109 mmHg. An epigastric skin flap, measuring 3x3 cm, was raised with its vascular pedicle. The epigastric free flap was transferred in the same rat from femoral vessels to carotid vessels in end to end fashion. We anastomosed the donor ateries to the distal parts of the divided recipient arteries and the donor veins to the proximal parts of the recipient veins. Twelve experiments were performed and the transplantations succeeded in 75 percent of them. In the remaining 25 percent, the experiments failed due to thrombosis at the site of anastomosis, or other causes. This animal model represents an excellent example of retrograde arterial flow free flap transfer that is reliable.

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.

Nd:YAG 레이저를 이용한 피부혈관종의 치료

현원석,문구현,방사익,오갑성 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.6

Although Nd:YAG laser(1064nm) showed good reduction effects on treatment of cutaneous hemangioma, its use was limited because of non-selective laser absorption and complications such as scar formation. So, we applied different modalities of Nd:YAG laser for more effective and safe treatment.We applied Nd:YAG laser to 9 patients with hemangioma on upper eyelid, cheek, back, arm, and parotid area from February, 1999 to February, 2002. The age at treatment ranged from 4 months to 4 years. Nd:YAG laser was irradiated both inside of the hemangioma by using a bare fiber through a 16G Tefflon cannula and outside of it by cooling the skin with a ice-cube. Nd:YAG laser was irradiated directly into the lesion through the bare fiber and safely to the skin through the ice cube.The mean number of treatment was 1.8, and the time interval between the next treatment was 4.5 months. The mean follow-up period was 13.5 months. Six patients showed almost full regression. Two patients had surgical excision after laser treatment, and one showed slow regression to be in the clinical observation.

Management of Malignant Melanoma

문구현 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.5

慢性前立腺炎 療法의 實際

文九鉉 中央醫學社 1962 中央醫學 Vol.3 No.1

淋疾의 治療

文九鉉 대한의학협회 1965 대한의학협회지 Vol.8 No.5

정제된 우형 해면골을 이용한 비익 기저부의 증강

문구현,김진환 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.1

It is generally accepted that autografts of bone are superior to any other types of bone graft. But this technique may be hampered by the size of the bone defect and requires additional surgical procedure, therefore results in increased risk of infection and morbidity. Recently, there is increasing interest in autogenous bone substitute and biomaterials which being extensively investigated: coral, ceramic implants and xenograft can be used as bone substitutes. Some authors have reported successful results using bovine cancellous bone graft in experimental and clinical studies. Authors experienced 15 cases augmentation of cleft lip nose deformity of hypoplastic pyriform rim and maxillary alveolus by using Lubboc(R) (purified bovine cancellous bone matrix) including 3 failure cases of autogenous bone graft. The patient's followup period ranged from 4 months to 30 months. In our series, we found no adverse immune reaction and experienced favorable aesthetic results in augmentaion of alar base with maintenance of considerable volume and stability. Through long term follow-up, this new purified bovine cancellous bone can be a reliable bone substitute in the treatment of minor bone defect.