유전성 구상적혈구증의 임상적 고찰

송홍석(Hong Suck Song),조진환(Jin Whan Cho),곽동협(Dong Hyeop Kwak),강영우(Young Woo Kang) 대한내과학회 1987 대한내과학회지 Vol.32 No.4

N/A The authors reviewed the Kortean Literature extensively in search of hereditary spherocytosis, and find 46 patients and 22 analyzable family members. Then, a clinical study was carried out retrospectively on 73 patients with hereditary spherocytosis including 5 patients from the Dongsan hospital, Keimyung University, The result of the this study were as follows: Male to female ratio was 1:1.2 with slight female predominance and the age distribution was between 3 month and 53 years with mean age of 16.9 years. Family history was present in 54.3%. The age of onset in 53 symptomatic patients was below 1 year in 12 cases, 1-10 years in 29 cases, over 10 years in 12 cases, and the duration of symptams were below l year in 13 cases, 1-10 years in 25 cases and over 10 years in 15 cases. Pallor and jaundice were the most frequent complaint (29 cases: 41.4%). Abdominal mass was observed in 13 cases (18.6%), general weakness in 12 cases (17.1%), dizziness in 11 cases (15.7%), abdominal pain in 8 cases (11.4%), anorexia in 4 cases (5.7%) in order of frequency, and the subjective symptom was absent in 14 cases (20%). Physical findings revealed pallor in 78.5%, jaundice in 73.4%, splenomegaly in 89.4%, hepatomegaly in 68.9%, cardiac murmur in 50%, growth retardation in 11.5%, and the spleen was enlarged below the left costal margin with mean size of 6.2±4.1 cm and the liver was enlarged below the right costal margin with mean size of 3.5±1.9 cm, Laboratory findings revealed anemin (Hb<12 gm/dl) in 91,8% with mean of 8.4±2.5 (range: 3.9±14.5) gm/dl, reticulocytosis in 93,3% with mean of 9,6+11.9 (range: 0. 1 76.0)%, and hyperbilirubinemia in 93 with mean of 4.0±3.9 (range: 0.6-27.4) mg/dl. Mean corpuscular volume was increased in 20%, normal in 70%, and decreased in 14% with mean of 92.7±13.8 (range: 68-144) fl, and mean corpuscular hemoglobin concentration was in- creased in 16%, normal in 58%, and decreased in 26% with mean of 32.8±2.9 (range: 25.7-40.0) pg. In osmotic fragility test, initial concentration of hemolysis above 0.51% was 54 cases (94.7%) with mean of 0.66±0.11 (range: 0.38-0.90)%. Splenectomy was performed in 38 cases and the aver- age weight of the spleen was 633±389 (range: 150-1.500) gm, and the accessory spleen was found in 10 cases (26.3%). There was no significant difference between male and female, and also present and absent family history groups, but statistically significant correlation was found between spleen size and hemoglobin, spleen size and MCV, liver size and MCV, negatively, and MCHC and initial concentration of osmotic fragility test positively (p<0.01).

Characteristics of Writing in Parkinson’s Disease: Focused on Pen Pressure, Letter Size, and Writing Speed

이한솔(Han Sol Lee),윤진영(Jinyoung Youn),조진환(Jin Whan Cho),안종현(Jong Hyeon Ahn),윤지혜(Ji Hye Yoon),나덕렬(Duk L. Na) 한국언어청각임상학회 2020 Communication Sciences and Disorders Vol.25 No.1

배경 및 목적: 파킨슨병(PD)의 운동 장애는 쓰기 수행에서 글자 크기뿐만 아니라 필압과 속도 측면에도 영향을 미칠 수 있다. 본 연구의 목적은 PD의 쓰기 특성을 필압, 크기, 속도를 중심으로 살펴보고자 하였다. 방법: PD 38명과 정상 성인(NA) 25명, 총 63명을 대상으로, 태블릿 PC와 디지털펜을 가지고 필압, 획의 길이, 쓰기 시간을 측정할 수 있는 소프트웨어를 사용하여 점선 따라 그리기와 문장 쓰기 과제를 실시하고, 필압, 글자 크기, 쓰기 속도를 분석하였다. 결과: 점선 따라 그리기 과제에서 필압은 두 집단 간 차이가 없었고, 쓰기 속도는 PD 집단이 NA 집단 보다 느렸다. 문장 쓰기 과제에서 PD 집단이 NA 집단 보다 필압이 저하되고, 글자 크기가 작으며, 쓰기 속도가 느렸다. 두 집단은 공통적으로 글자 크기와 쓰기 속도 간의 정적 상관이 나타났으며, PD 집단은 필압과 쓰기 속도 간의 정적 상관도 나타났다. 논의 및 결론: 본 연구 결과는 PD로 인하여 강도, 크기, 속도 등의 운동 능력을 조절하는 것의 어려움이 쓰기 수행 시 필압, 글자 크기, 쓰기 속도로 반영될 수 있음을 보여준다. 본 연구는 그간 글자 크기에만 초점이 맞추어졌던 PD의 쓰기 특성에서 필압이나 쓰기 속도와 같이 다양한 요소를 측정하는 것이 중요함을 확인하였다는 점에서 의의가 있다. Objectives: Movement disorders in Parkinson’s disease (PD) can affect not only letter size but also pen pressure and writing speed. The purpose of this study was to investigate the characteristics of writing with focus on pressure, size, and speed in PD. Methods: Sixty-three subjects (38 in a PD group and 25 in a normal adult [NA] group) performed tasks involving drawing along dotted lines and sentence writing using a tablet PC, digital pen, and software that could measure pen pressure, stroke length, and duration. Results: In the task involving drawing along a dotted line, the PD group showed significantly slower writing speed compared with the findings in the NA group. Additionally, in the task involving sentence writing, the PD group showed significantly weaker pen pressure, smaller letter size, and slower writing speed compared with the NA group. Moreover, both groups showed a positive correlation between letter size and writing speed, but only the PD group showed a positive correlation between pen pressure and writing speed. Conclusion: Difficulty in motor control of strength, size, speed, etc. owing to PD is reflected in pen pressure, letter size, and writing speed when performing a writing task. Our results show an importance in measuring multiple factors such as pen pressure and writing speed in the characteristics of writing in PD, which has until now, has been focused only on letter size.

파킨슨병 환자에서 시각적 단서에 따른 쓰기 수행력과 인지, 우울, 운동능력 간의 상관관계

이한솔(Han Sol Lee),윤진영(Jinyoung Youn),안종현(Jong Hyeon Ahn),조진환(Jin Whan Cho),나덕렬(Duk L. Na),윤지혜(Ji Hye Yoon) 한국언어치료학회 2021 한국언어치료학회 학술발표대회 논문집 Vol.2021 No.11

Idea Innovotion 대둔근 도상피판과 쌈지봉합을 이용한 천골부 욕창치료

조진환 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.6

Gluteus maximus myocutaneous island flap has several distinct advantage for the treatment of the sacral sore. It has wider rotational arc than the turn-over or rotation flap and can avoid suture line on the mid-line and save muscle function. And the round block purse string suture may reduce the defect size. Then we have been combined the two procedures for treatment of the sacral sore. This method permit a primary donor site closure and stable flap coverage without specific complication in the case of relatively large sized sacral sore.

광배근 및 전거근 이중피판을 이용한 상,하지의 재건

조진환,서영태,방유현 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.5

The dual muscle flap(Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients(3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.

수지부역혈행성 피판술에 관한 연구

조진환,방유현 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1

Fingertip injuries represent the most common type of injuries were seen in the upper extrimity. Reconstruction of a injured digit needs good aesthetic result as well as functional recovery. From August 1994 to August 1996, sixty two digits in the fifty four patients were treated by using the reverse digital island flaps. The age of the patients ranged from 13 to 64 years. We reviewed the medical records of our cases and analyzed them in several aspects. Majority of the cases(79%) were covered primarily. Neurorrhaphy was performed in 26 digits(42%). The survival of these flaps was successful in all cases except one case. The mean values of the static two point discrimination in sensate and nonsensate flaps were 6.5 mm and 10.3 mm retrospectively. In this study, venous congestion was the most common early complication(9.6%). Arterial insufficiency and flap loss(6.4%) were the troublesome early complications. Bulky mushroom shaped flap(24.6%), scar contracture(6.4%), paronychia(8.2%), cold intolerance(9.6%), hyperesthesia(3.2%) and flap atrophy(4.8%) were the late complications. In conclusion, despites of its complications, reverse digital island flap provide durable skin cover, superior aesthetic result and excellent sensory restoration.

두개 안면수술에 이용된 관상절개술후의 합병증에 대한 경헙 및 고찰

조진환,안덕선 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.5

For exposure of the craniofacial skeleton above the Le Fort Ⅰ level, the most frequently used approach is the coronal incision. A retrospective clinical study on the use of this approach in the treatment of cranio-maxillo-facial surgery in 34 patients over the past 2 years was done. We are discussing the surgical indications, techniques, and complications of the coronal approach. In our series of 34 patients, 6 patients(18%) had hematoma, 5 patients(15%) transient frontal nerve palsy and 11(32%) patients had sensory deficit. This technique provides optimum exposure of the facial skeleton including zygomatic arch allowing for accurate anatomic reduction and fixation of the bony segments and good cosmetic result in the incision sites. And, this also provides an opportunity to harvest cranial bone through the same incision when immediate bone graft is indicated. With an adequate knowledge of surgical anatomy and careful dissection, a coronal approach will provide an excellent outcome with minimal or no complications.

Solitary neurofibroma

조진환,안덕선 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.6

Neurofibromas are uncommon tumors which originated from cells of the sheath of schwann, fibroblast and perineurium. Malignant transformation of solitary neurofibroma are extremely rare, especially in younger age. Recently we had 5months old patient who presented with solitary neurofibroma with malignant potenitial on occiput. The patient was 5months old female, who had mass on occiput. The mass and overlying skin were completely excised, but recurred in three months, and showed a neurofibroma with malignant potential by the histopathologic findings.

제1족지 수질부 유리피판을 이용한 수지재건

조진환,방유현 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15㎜ (mean S2-PD value; 7.2㎜). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.

내시경 탐사를 이용한 굴근건 봉합술

김종서,조진환,손병규 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.1

Repair of injured tendon especially is still a difficult problem in hand surgery. The challenge is to restore the gliding mechanism of the tendon. Despite increasing knowledge of tendon healing and subsequently better postoperative result, the problem formation of adhesion between the tendon and its direct surroundings remains. It is now agreed that primary repair of both flexor tendon is the treatment of choice with preservation and resto-ration of the tendon sheath. The flexor tendon sheath plays an important role in flexor nutrition, especially for the volar part of the tendon, by secreting the synovial fluid. Although data to data are indications that it will lead to fewer adhesions. Tendon sheath are sometimes restored by autologous graft. It is excellent management that the tendon sheath and pulley system are restored during tendon repair. The method of minimal injury to tendon sheath and pulley is better than restoration of that. The exploration of divided tendon through wound margin with endoscope minimizes sheath and pulley injuries. The blunt extraction of divided tendon from invisible wound site is a risky method for exploration of tendon. This endoscopic method is less traumatic, causes less pain, and requires a minimal incision. And the patient with endoscopic tenorrhaphy can exercise immediately because less operation site discomport and can be discharged early. The new tenorrhaphy technique using endoscope is expected to give better result than conventional method.