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.

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.

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.

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

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

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.

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.

<說文解字> 小篆體 重複字 硏究

孫叡徹 한국중국어문학회 2001 中國文學 Vol.35 No.-

情憤在<淡文解字>墨, 收柔7揷准字律小築九千三百五十三수字, 和所街的昇緯字卽重文一千一百六十三수字, 急共一万零五百十六수字. 本液文, 要探消<淡文解字>中的重'31題. 因蛇, 先摘出了字形相同約字, 恩共有三十수字. 原宋把速些重出字可分衆三大美, 一淪小篆之綱的重出字, 一論小篆和重文之同的重出字, 異一流重文之的重出字. 但是重文之同的重出字只有一수字而已,因而把達一今字合井於小篆和重文之同的重出字. 然後, 又把小篆和重文之同的重出字分努字災同 美者和字災相昇者二美. 逑洋分了 以後, 探<免文解字>申重出字的賠果, 略述如下. 1. 小篆之同的重出字有十수字, 즈中'湲'로丙수字不是探펴凉象, 園冷츠丙수字只是大徐本有帶渼而重臺收柔的, 因而小篆之同的重出字脊字. 小篆和重文之同的重出字申, 字보同業者有킨수字, 而其中龍括重文之同的重出字一우; 字災相昇香有十三부字. 2. 速些所街的重出字쏠中, 凉要刪掉的街九수小篆和)二수重文. 由沈算來, 在끌嵬文解字<中所牧柔>的字散, 是九千三百四十四수小篆和一千一百五十一수重文, 蔥合万零四百九十五字. 3. 小篆之的重出字, 由于探求其各各字的本災, 可斷定座凉刪掉娜一字. 速辯做的端果, 除了把後面的'藍'字要改亐'蘿'之外, 其徐수字鄧飾上所述, 催擺其本災, 都要刪掉丙톨中一수字. 4. 小篆和重文之的重出字之中, 其字보同美者쏠中, 要刪掉小篆的是'和'旱'丙字, 要把重文的字形改亐的是'雇'和'喜'諦字, 而且重文之同的重出宇골中, 也要把'亥'字的重文改亐, 除了速五부字之訃, 都要測掉努重文. 5. 小篆和重文之同的重出字之中, 其字次相류촐올中, 要把重文的字形改琴的, 是'然' · '泥' -'怒'和'暠'等四우字, 其値九수字鄧要測掉其重支. 除了上面所逑之外, 運潗驛決的同題, 等待出後的斷究.

一段階 耳介成形術을 利用한 小耳病 再建例

한예식,이정윤 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.1

Total ear reconstrucion has been one of the most difficult problem in plastic surgeon. It required multiple procedures, prolonged hospitalization, high cost, and the final appearance of the reconstructed ear was still far from normal. In 1983, Song and co-workers studying the blood supply to the skin of the auricular area, presented another method of single stage total ear reconstruction. We operated 3 anotic patients with Song`s one stage total ear reconstruction procedure and agreed that this procedure solved some problems, especially shortening of multiple procedures, in classic Tanzer`s procedure. But, another problems were noted in Song`s procedure. 1. One stage technique will require minor secondary procedures for good final results. 2. Post auricular skin grafted area was larger than Tanzer`s procedure. 3. Definition of the cartilage framework was obtuse in early postoperative period, because the contraction of the skin graft and fixation of the skin flap were simultaneously occured. 4. This procedure may have high complication rate.

한국문화에서의 가족치료의 개발

엄예선 서울여자대학교 여성연구소 1992 여성연구논총 Vol.6 No.-