Aspiration Pneumonia caused by Povidone-iodine (Betadine) in Cleft Palate Patient

김석화,석효현,정의철,박지웅,최태현,Kim, Sukwha,Seok, Hyo Hyun,Jeong, Eui Cheol,Park, Ji Ung,Choi, Tae Hyun Korean Cleft Palate-Craniofacial Association 2013 Archives of Craniofacial Surgery Vol.14 No.1

Povidone-iodine (PVP-I, Betadine) has many advantages as a disinfectant solution for preoperative preparations, especially for oral surgery. It is widely used because of its low toxicity and excellent bactericidal effect. The authors report a case of pneumonia secondary due to the aspiration of PVP-I, which was used as an oral disinfectant. We present a case of aspiration pneumonia that resulted from the careless use of PVP-I during preoperative preparation. The patient was a 10-month-old female scheduled for elective surgery to correct a complete cleft of secondary palate. During the preparation of the oral cavity for that cleft palate patient, PVP-I was incidentally aspirated to the airway. The lung resistance was noted with positive pressure and pneumonic infiltration on chest radiograph was seen. The operation was postponed and the patient underwent respiratory care. Three months later, elective palatoplasty under general anesthesia was performed without complication. Based on the experiences of this case, the authors advise that throat-packing should be placed before oral preparation to prevent serious pulmonary complications.

환자안전 : 새로운 의료표준

김석화,Kim, Seok-Hwa 대한병원협회 2006 대한병원협회지 Vol.35 No.5

환자안전: 유비쿼터스 병원

김석화,Kim, Seok-Hwa 대한병원협회 2007 대한병원협회지 Vol.36 No.5

구순열 수술 후 인중의 변형과 구륜근 결손

김석화,정연우,천정은,박찬영,오명준,김정홍,최태현,Kim, Suk-Wha,Jeong, Yeon-Woo,Cheon, Jung-Eun,Park, Chan-Young,Oh, Myung-June,Kim, Jung-Hong,Choi, Tae-Hyun 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.4

Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.

사물인터넷 디바이스 서비스 탐색 및 원격제어

김석화(SeokHwa Kim),정재훈(Jaehoon (Paul) Jeong) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.6

클라우드 기반의 사물인터넷 기기를 위한 DNS Naming Service

김석화(SeokHwa Kim),정재훈(Jaehoon (Paul) Jeong) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.11

네트워크 주소 변환 시스템 기반의 DNS 네이밍 기법

김석화(Seokhwa Kim),정재훈(Jaehoon (Paul) Jeong) 한국통신학회 2018 한국통신학회 학술대회논문집 Vol.2018 No.6

해외건설프로젝트 '11년 수주실적 및 '12년 수주전망 분석

김석화(Suk Hwa Kim) 한국강구조학회 2012 韓國鋼構造學會誌 Vol.24 No.1

Abdominal closure with different oblique planes in island TRAM flaps: a method for achieving a better scar and contour of the donor site

Tae Hyun Kim,김덕열,Chung Hun Kim,김석화,안희창 대한미용성형외과학회 2024 Archives of Aesthetic Plastic Surgery Vol.30 No.2

Background An autologous abdominal flap can provide an aesthetically pleasing breast with a natural feel. However, contracted scars and hourglass contour deformities at the abdominal donor site can sometimes occur. These complications can reduce pa tient satisfaction and quality of life. Therefore, we performed different oblique plane closure of the abdominal donor site and evaluated the aesthetic scores in comparison with the conventional vertical single plane closure. Methods The procedures begin with a beveled incision down to the fascia level during transverse rectus abdominis muscle flap elevation. At the time of donor site closure, Scarpa’s fascia and the subcutaneous layers are sutured while being pulled downward. Sixty patients were divided into two groups: group A (single vertical plane closure) and group B (different oblique plane closure). Abdominal scars were scored by five review ers using the scar scale. Results There were no significant differences in scores for vascularization, dog-ear presence, and umbilical shape of the scar between the two groups. However, group B showed marked improvements in flatness, contracture, and thickness of the scar sur face. Notably, the different oblique plane closure in group B achieved much higher scores for the abdominal contour than group A. Conclusions The vertical single plane suture of the abdominal donor site may result in depressive contracture with poor cosmetic outcomes. The different oblique plane clo sure technique markedly improved the appearance of scars on the abdomen. This technique is likely to enhance patient satisfaction with both the breast and abdominal outcomes of breast reconstruction using an abdominal flap.

인터넷 건강정보가 의사-환자 관계에 미치는 영향에 대한 의사들의 인지도 조사

김정은(Jeong-Eun Kim),김석화(Suk-Wha Kim),신윤주(Yoon-Ju Shin) 사이버커뮤니케이션학회 2007 사이버 커뮤니케이션 학보 Vol.21 No.1

의사와 환자의 의사소통은 의사-환자 관계에 중대한 영향을 미친다. 인터넷 건강정보는 진료현장에서 의사소통 패러다임의 변화를 일으키고 있어 인터넷 건강정보에 관한 의사들의 인지도를 분석해 볼 필요가 있다. 본 연구는 인터넷 건강정보의 영향에 대한 의사들의 인지도를 조사하기 위하여 전국의 의과 대학 교수와 개원의를 대상으로 온라인 설문조사를 실시하였다. 설문지는 소비자대상 약품광고에 대한 의사들의 인식 조사에 사용된 설문지의 문항을 수정 보완한 25문항을 사용하였고, 조사기간은 2007년 1월 21일부터 24일까지 4일 동안이었다. 발송 대상 3,100건 중 회신 349건으로 응답률 11. 26%였다. 연구결과 의사들은 인터넷 건강정보의 정확성이나 적절성에 대해서는 부정적인 생각을 하고 있었다. 또한 인터넷 건강정보는 의료비 지출을 증가시키고, 불필요한 병원 방문을 유도하기도 하며, 진료시간을 길게 만든다고 생각하고 있었다. 의사-환자 관계에 대해서는 전반적으로 볼 때 부정적인 영향을 미친다고 생각하는 경향이 조금 더 많이 나타났다. 그러나 환자의 입장에서 볼 때는 인터넷 건강정보가 질병에 대한 이해도를 높여주고, 진료의 질 향상과 치료결괴에 대해서 어느 정도 긍정적인 영향을 미친다고 평가를 하고 있었다. 즉 인터넷 건강정보는 긍정적인 측면을 가지고 있으나, 주변의 여건상 부정적인 영향을 미칠 기능성도 잠재하고 있다고 인지하고 있는 것으로 나타났다. 따라서 현재의 의료 환경에서 의사들이 환자를 위하여 충분한 시간을 할애함으로써 인터넷 건강정보의 긍정적인 측면을 적극적으로 활용할 수 있고, 의사-환자 관계에 대하여 긍정적인 결과를 가져올 수 있도록 하는 방안의 모색이 필요하다. Background: The objective of the study was to determine physician's views of the effects of internet health information on the doctor-patient relationship. Methods: Cross-sectional online survey of Korean physicians to determine their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. Questionnaire with 25 items were sent to the physicians' e-mail, and 349 physicians replied. Results: Most of the Korean physicians(89.1 %) reported that they had experiences of patients asking or requesting about internet health information. They perceived that internet health information may enhance the patients' knowledge about their health. However, they perceived that internet health information may have variety of negative effects such as; heightening the cost of health care by adopting the inappropriate health service utilization(53.3%); making the patients over-concerned about their health(60.5%); damaging the time efficiency of the visit(54.7%). The physicians deemed those information were not relevant to the patients' health condition(71.3%), and even were not correct(37.3%). They perceived the effects of internet health information on the doctor-patient relationship could be negative(22.3%), neutral(45.0%), and positive(16.3%). Conclusions: Internet health information can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information; enhancing physicians' communication and education skills; and reimbursing the physicians' time & efforts for the adoption of internet information and technology.