유리피판을 이용한 두경부재건술에 관한 임상적 고찰

윤근철 충남대학교 의과대학 지역사회의학연구소 1988 충남의대잡지 Vol.15 No.2

The method of reconstruction has been known to take large part in the quality of treatment of head and neck malignancies. Every effort has been made by many reconstructive surgeons to improve postoperative life quality of the patients. Among them, free flap by microvascular transfer techniqueare relatively new but much contributory method. We have experienced 8 free flap cases for reconstruction of head and neck cancer patient since 1987. They are 5 cases of forearm free flaps for cervical pharyngoesophagus reconstruction and 3 cases of scapular steocutaneous free flaps for lower jaw reconstruction. Although the quantity of our experience is not large, we discuss its advantages, disadvantages for further refinement.

유리전박피판술의 응용과 유리전박이중피판술의 고안

윤근철 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.2

Since the opening era of reconstructive microsugery, many free flap donor sites have been investigated and used clinically. Up to date over-sixty free flaps have been registered in our surgical memorandum. Among them several free flaps deserve to be admired for their superior clinical adoptability to the other free flaps. The forearm free flap, which is also called "Chinese free flap" because it was introduced to us by Chinese plastic surgeons, is used and admired world-widely recently for it's convenience of performance and acceptable clinical results. Author performed the forearm free flap in reconstructing one case of compound facial defect and three cases of pharyngoesophagus ablation. Notably the auther duplicated the flap for inner lining of nose and release of stenotic permenant tracheal opening. Four cases of forearm free flap and method of duplicating flap are reviewed and discussed with literatures.

두경부 유리피판 26례 분석

정복성,윤근철,심경보,고경석,한상훈 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.3

Twenty four patients(21 males and 3 females) aged 14 to 70 years underwent 26 microvascular free tissue transfers in head and neck reconstructions from April 1990 to July 1992 (27 months) . Nineteen cases were tumors in head and neck area, and four were acquired deformities such as burn alopecia, burn scar contracture of the neck, Romberg disease and frontal sinus infection, and one was hemifaclal microsomia. The free flaps were executed successfully in 15 upper aerodigestive tracts, in 2 scalps and 3 skull bases and in contouring and resurfacing six facial and cervical lesions. The selection of donor site was bases upon the location of defect and the volume of tissue required : the forearm free flap was used in 11 cases, the rectus abdominis in 5, the groin in 2, the jejunum in 2, the occipital scalp in one, the first toe web space in one, the latissimus dorsi in one, the serratus anterior in one, the parietotemporalis fascia in one and the omentum in one. The free tissue transfers were primarily indicated in all patients in our series and there was no flap failure. The complications were minimal and the morbidities low. A free flap in the head and neck area is not only the most expedient method of reconstruction but also either the most reliable or the only available one in some clinical situations.

"후천성안면열-Noma 후유증"의 치험례

신영진,윤근철 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.5

The authors experienced reconstruction of a complex adult facial deformity extending from right side of nose to right anterior part of the maxilla owing to tissue necrosis from small pox complication in a neonate. Because the event ocurred in the very early period of life, the secondary deviation of the facial structures through growth was an additional problem besides simple tissue defects. As it seemed that was vary like the features of congenital facial cleft due to the error in viviparity, we dared to name deformity acquired facial cleft. Etiologically the deformity can be classified as a sequale of noma which defines a mixed aggressive infection of the facial tissue in chronically mal nourished children during or soon after an acute debilitation illness. Because the socioeconomic condition of our country has improved so much, active noma cases are rare nowadays. So we are presenting a case of acquired facial cleft due to noma sequale for following reasons in summary. 1. Noma survivor is quite rare nowadays and there is rare clinical report of reconstructing that deformity in this country. 2. Because the deformity or defects of this case involves multiple facial units, we consider the experience of reconstructing this case is invaluable.

韓國人의 食事嗜好에 關한 硏究 : (Ⅰ.基本味의 變化)

남궁석,장건형,양철영,윤은숙 서울保健大學 1985 論文集 Vol.5 No.1

한국인의 식사가호의 변화를 조사하기 위해 4원미의 측정, 맛의 기호성조사, 미맹검사를 위한 실험을 실시한 결과, 다음과 같은 결론을 얻었다. 1. 기본미의 최소감각농도는 짠맛이 0.008-0.015%, 단맛이 0.244-0.246%, 신맛 0.004-0.006%, 쓴맛 0.008-0.012%였다. 2. 기본미의 최소감미농도는 짠맛 0.013-0.015%, 단맛 0.247-0.250%, 신맛 0.007-0.010%, 쓴맛 0.011-0.015%였다. 3. 4원미의 최소감각농도의 평균농도는 짠맛이 0.021%. 단맛 0.2446%, 신맛 0.0050%, 쓴맛 0.0104% 이었고, 최소감미농도의 펑균농도는 짠맛이 0.0137%. 단맛 0.2480%, 신맛 0.0089%, 쓴맛 0.0133%으로 나타났다. 4. 음식맛에 대한 기호도는 단맛 12-14%로, 외국사람들이 나타낸 10-12%에 비하여 단맛을 좋아하는 경향을 보이며, 신맛인 orange juice 0.85%. 미역초우침 0.5356%이고, 짠맛은 콩나물국0.3446-0.6892%, 두부찌게 0.9189%로서, 종래의 국의 염분농도인 1.040-1.900%보다 낮은 염분농도를 좋아하는 경향을 나타냈으며, 쓴맛은 0.0565-0.075%였다. 5. 식품의 기호맛중 단맛과 신맛은 농촌거주인이 높은 농도를 좋아하는 경향이고 쓴맛은 도시거주인들이 농촌거주인보다도 높은 농도를 좋아하였다. 6. PTC(0.03% Phenylthio Carbamide) 물질에 의한 미맹검사 결과는 7.10%가 미행으로 나타났으며, 표현된 맛으로는 단맛(1.0%), 신맛(0.8%), 짠맛(0.8%), 기타의 맛(1.6%), 맛이 없다(2.9%) 로 나타냈다. Four primary taste, dietary preference and taste blind testing were investigated to provide data applicable to food industry and to improve Korean dietary life. The results were summarized as follows.. 1. The detection threshold concentration of four primary taste by panel members, was 0.008-0.015% of salt, 0.244-0.246% of sweet, 0.004-0.006% of sour and 0.008-0.012% of bitter, respectively. 2. T he recognition threshold concentration of salt, sweet, sour and bitter was 0.013-0.015%, 0.247-0:250%, 0.007-0.010% and 0.011-0.015%, respectively. 3. The average detection threshold of salt, sweet, sour and bitter was 0.012, 0.244, 0.005 and 0.010%, The average recognition threshold was 0.013, 0.248, 0.008 and 0.013%, respectively. 4. The most dietary preference were 12-14% of with sugar content, 0.85% of orange juice, 0.488%of seaweed seasoning with acetic acid,0.344-0.689% of soybeen sprout soup, 0.918% of poststew with bean curd with ~odium chloride, 0.056-0.075% of bitter with caffein, respectively. 5. Farm village panel members liked higher concentration of sweet sour and than others member, college student and business men liked higher. concentration of bitter than farm village members. 6. The result of taste blind testing by four groups, showed that blind numers were 7.10%, taste was sweet (1.0%), sour (0.8%), salt (0.8%), other taste (1.6%) and no taste (2.9%), respectively.

자기공명 분석법을 이용한 백서 피판의 대사에 대한 연구

이윤,이대근,임태환,윤근철,고경석,이춘신,정복성 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

Innumerable techniques have been used to measure, index, or predict the viability of skin flaps after elevation. However, these are largely indirect and don't accurately reflect the events that occur at kthe cellular level. A method was sought that gives direct, reproducible, and accurate data about physiological and biochemical changes that occur during flap elevation. Because of its ability to monitor changes in the levels of high energy phosphorus metabolites(ATP, or adenosine triphosphate, PC or phosphocreatine, Pi or inorganic phosphate), 31-P magnetic resonance spectroscopy (MRS) holds promise of providing direct assessment of the metabolic status and biochemical changes that occur during skin flap elevation. MRS monitoring was performed on three portions of raised random pattern skin flaps of 5 rats. The spectrometer used for 31-P nuclear magnetic resonance analysis was a Bruker Biospec(4.7 Tesla) system, and a modified surface coil constructed of two layers of copper coil was used. The results have validated the ability of 31-P MRS to : 1. define the regional flxes in the levels of ATP, PCr, and Pi in skin flaps. 2. demonstrate that, of these, PCr levels represent the most sensitive indicator of flap well being. 3. measure intracellular pH through the chemical shift of the Pi resonance. 4. establish predictive correlations between profile of normal, compromised, and failing skin flaps and have thus prepared the way for noninvasive in vivo topical magnetic resonance investigations of flaps.

백내장수술시 점안마취와 구후마취의 통증에 관한 연구

윤경철(Kyung Chul Yoon),조철웅(Chul Wong Cho),서만성(Man Seong Seo),양건진(Kun Jin Yang) 대한안과학회 1996 대한안과학회지 Vol.37 No.12

두안부 경로를 통한 두개내 골종의 치료 例 1例

윤근철,김석화,민경원,김진환,김현집 大韓成形外科學會 1981 Archives of Plastic Surgery Vol.8 No.2

Fronto-ethmoidal osteoma is relatively rare neoplasm in the of head and neck surgery. Because of it's vincinity to brain and eyes. it can evoke difficult problems especially when is very large. There were a few cases of clinical reports about fronto-ethmoidal osteoma which was removed by external approach without difficulty. We experienced vered large fronto-ethmoidal osteoma extending anterior cranial fossa, orbit and nasal cavity. Operation was done by craniofacial approach and we report it wih reviews of frontoethmoidal osteoma.

Scapular Osteocutaneous Free Flap 을 이용한 하악재건 3 예

윤근철,이택종,유장열,이향주 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.3

Although there are many methods and donor sites in the mandibular reconstruction by microvascular tissue transfer, the iliac bone with deep circumflex iliac artery has been used most commonly. Meanwhile, Acland introduced scapular osteocutaneou free flap using the periosteal branch of circumflex scapular artery in 1985. In reconstructing 3 cases of mandibular composite defects, we adopted the scapular osteocutaneous free flap to avoid the handicaps of iliac bone free flap i.e bulkness, difficulties in mucosa-bone dissociated reconstruction etc.. After resonable period of follow-up, we reviewed the cases and methods of reconstruction and concluded that the scapular osteocutaneouos free flap hs following merits. 1. Technically easy especially in the large mucosal defect and in case the mucosal detet is not near to the bone defect. 2. Aesthetically good. 3. Structural stability is tolerable inspite of scapular bone osteotomies. And in one case we modified the procedure by elevating the bone with attached Teres major muscle belly to meet the need of soft tissue defect resulting from neck dissection.

전박유리피판의 다양한 임상 이용례

윤근철,이택종 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.3

There are so many free flaps in our surgical memorandum that on one dare say which flap in the best. But most plastic surgeon use some free flaps more frequently doing certain free flaps rarely. So it can be concluded that free flap with many advantages and few disadvantage wins the love and favorites of plastic surgeon. As the forearm free flap meets these requirements, it has become one of the most commonly used free flap recently. Doing clinical application of forearm free flap, we found it can be modified diversely owing to it's anatomical characteristics. 4 methods of modification will be presented with 5 cases; 1. Tubing....case 1. and case 2.,(case 3.) 2. Double flap.....case 3.,(case 4.) 3. Reproductive flap.....case 4. 4. As a conduit to the other free flap.....case 5.