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

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.

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

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.

Cheek Flap을 이용한 안면부 재건

한예식,홍인식,이정윤,안희창 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.4

There are several technique for facial reconstruction using local, regional and distant flaps. Most of these techniques require multiple stages, leave poor color match, and create serious complications at donor site. Since 1959, a wide variety of defects in the eyelid and cheek have been reconstructed with Mustarde's cheek flap. This can mobilize a large area to be rotated into the defect, and effectively cover a relatively large defect with minimal distortion and with good color match. Advantage of the cheek flap include easy accessibility and operative technique. In the old age group that present most commonly with eyelid malignancies, there is sufficient laxity of the skin, and therefore, abundant tissue is available to reconstruct the lower lid. Problems which can develop with this flap include hematoma, infection, or flap necrosis early in the postoperative course. Late complications include problems resulting mainly from skin tension and gravity, causing ectropion or lateral canthal distortion. The author experienced excellent functional and esthetic result form 15 cases of facial reconstruction with Mustsarde's cheek flap. We reviewed history and surgical techniques of this flap referring the literature.

대두박에 대한 extrusion처리 및 formaldehyde처리가 젖소의 반추위내 in situ분해율에 미치는 영향

문여황,김기원,문점동,조광일,김병기,이성실,이상철 진주산업대학교 농업기술연구소 2001 農業技術硏究所報 Vol.14 No.-

This experiment was conducted to investigate the effect of temperature of extrusion processing on ruminal degradation characteristics of soybean meal. Four ruminally cannulated Holstein cows were employed to in situ trial and treatments were composed of soybean meals untreated(Control), extruded at 115, 130 and 155℃, and treated with 0.3% formaldehyde(HCHO). The nylon bags were suspended for 0, 3, 6, 9, 12 and 24 hours in the rumen, respectively. Animals fed the diet of 50 : 50 in concentrate and orchard grass hay at 110% of NRC(1988) requirements, and were freely access to water and mineral block. The regression equations for degradation characteristics and effective degradability(ED) of crude protein of soybean meals in the rumen were obtained as follows. Control P = 26.41 + 69.86(1-e^-0.041t) ; ED(k=0.05) = 57.89% 115℃ extrusion P = 3.39 + 44.76(1-e^-0.013t) ; ED(k=0.05) = 12.63% 130℃ extrusion P = 2.79 + 56.60(1-e^-0.015t) ; ED(k=0.05) = 15.85% 155℃ extrusion P = 1.71 + 31.48(1-e^-0.018t) ; ED(k=0.05) = 0.04% 0.3% HCHO P = 7.23 + 35.14(1-e^-0.015t) ; ED(k=0.05) = 15.34% where, P = Degradability during the time(t) suspended in the rumen, k = Passage rate at the rumen(%/hr/100). Ruminal degradabilities of dry matter, crude protein, organic matter and energy significantly (P<.01) decreased by extrusion or HCHO treatments, but did not affected by the temperature of extrusion processing. The ruminal degradation of soybean meals treated extrusion and formaldehyde, paticularly crude protein, was low beyond expectation.

Wonderful Night, Merry Christmas! : 사적 카메라 그리고 침묵의 미학

김예경 고려대학교 응용문화연구소 2010 에피스테메 Vol.- No.4

This article concerns about the short film <Wonderful Nigh, Merry Christams !> (2004, 16'47) realized by Ieggi. It studies the later in relation with the underground film which comes into the world in earnest in sixty, or the personal films produced in America. The term ‘personal film' is used in two sens in its context: same as underground, film which tells personal life. This later in sixty took as base of its mind the early avant-garde movement. As anti-culture or counter-culture these avant-garde and underground movement raze in profound relation with the modernism. How the problem of the subject or individual in modernism has something with these new movements of art? Suzan Sontag says, in every time, it has to newly create the aim of spirituality suited for the time. In modernism, the desire of ‘new man' produced in cultural movement the desire of ‘new art'. What this later advocate against the established culture is ‘aesthetic of silence'. This study, as its first step, is given to the problem of subject and silence implicated in the underground film and finally in <Wonderful Night, Merry Christmas!>. 본 논문은 단편 영화 <Wonderful Nigh, Merry Christams!> (예기, 2004, 16'47)에 관한 것이며, 그것을 60년대에 본격적으로 탄생한 언더그라운드영화, 또는 미국을 중심으로 제작된 사적영화 personal film와의 관계 속에서 탐구하고자 한다. 본 논문에서 사적영화란 용어는 문맥에 따라 언더그라운드와 개인적 소사를 담은 영화라는 두 가지 의미로 쓰였다. 60년대의 사적 영화는 언더그라운드영화로서 앞선 전위예술운동을 정신적 기반으로 삼았다. 반문화 또는 저항문화로써의 이들 전후 전위예술운동, 언더그라운드는 모더니즘과 깊은 관계하여 일어난다. 모더니즘이 갖는 주체 또는 개체 indiviual문제는 이 새롭게 등장한 예술운동과 어떠한 관계를 맺는가? 수잔 손탁은 “어느 시대를 막론하고 그 시대에 적합한 ‘정신성'의 목표를 새롭게 재창조해야 한다”고 말한다. 모더니즘 안에서의 ‘새로운 인간'에 관한 욕구는 문화운동에서의 ‘새로운 예술'에의 욕구 또한 낳았다. 이 새로운 예술이 제창하는 것은 기존의 예술에 관한 ‘침묵의 미학'이다. 본 논문은 언더그라운드를 통해, 그리고 궁극적으로는 <Wonderful Night…>을 통해 드러나는 주체와 침묵의 문제를 탐구고자 한다.

製造物 責任 訴訟과 立證責任

金麗會 대구효성가톨릭대학교 1997 연구논문집 Vol.54 No.1

In recent years, as the production, sale and consumption of the goods becomes large quantity, the products liability come to serious day by day. The products liability pay for damage that some goods with a defect come to a consumer or a third in a production and flowing. A principle of law on the products liability come into being in the Anglo-American law, is discussed actively in Germany, Japan and France, tend to legislation in these days. If we compose legaly the liability of the producers who produce goods with a defect, we clear up that is the contact liability or that is the tort liability? We have difficult as interpretation of the contemporary civi law, i-e, the contact liability and the tort one. It is reality that we are returned to products liability as a amendment of the proof law. It is right that we will make a peculiar law to solve difficult of a principle of law on the products liability.

지방자치단체 공무원 교육훈련 전이에 영향을 미치는 요인에 관한 실증적 조사

강여진,최호진 서울대학교 행정대학원 2003 行政論叢 Vol.41 No.2

본 연구에서는 교육훈련 전이에 영향을 미치는 제 요인들을 국내·외 선행연구의 문헌검토를 통해 도출하여 지방자치단체의 공무원들을 대상으로 실증적으로 규명하였다. 선행연구 검토 결과 본 연구에서는 교육훈련 전이에 영향을 미치는 제 요인들로 크게 두 가지 요인, 즉 교육훈련 프로그램의 설계요인으로서 강사의 자질, 교육내용, 피훈련자의 개인적 특성(학습동기, 성취욕구, 자기유능감)과 조직적 환경요인으로 상사 및 동료의 지원, 지속적 학습문화로 설정한 뒤, 설문조사를 실시하였고 조사결과를 요인분석과 회귀분석을 통해 분석하였다. 분석결과, 교육훈련 프로그램의 설계요인과 조직적 환경요인이 공무원 교육훈련 전이에 대해 통계적으로 유의미한 긍정적인 영향을 미친다는 결론을 얻었다. The purpose of this study were to find the relationship between training components and training transfer, and to analyze the effects of the training program components and the organizational support on the training transfer. First, training program components made trainer’s teaching ability, training contents, and trainee’s personal characteristics(motivation to learn, need for achievement, and self-efficacy) that were supposed to affect the training transfer were chosen by the literature review. Second, organizational support made superior’s support, peer’s support, and continuous learning culture. Also, this study examines the four hypotheses based on the literature reviews by way of conducting questionnaire surveys to the sample of about 702 local government’s civil servants. The result from empirical tests showed that training components were correlated to the training transfer positively. Specially, the higher superior’s support, peer’s support, training contents, trainee’s motivation to learn, and continuous learning culture were related. Trainer’s teaching ability, trainee’s self-efficacy, and trainee’s need for achievement were accepted partially.