터널 갱구부 저토피 및 관통부 변경에 따른 안정성 검토 사례 연구

이사익(Saik Lee),최영철(Youngchul Choi),정우용(Wooyong Jung),김국한(Kookhan Kim),김동인(Dongin Kim) 한국암반공학회 2013 터널과지하공간 Vol.23 No.2

국토의 70%가 산지인 우리나라는 도로건설 등에 필요한 토지가 매우 부족할 뿐만 아니라 환경에 대한 국민들의 관심이 고조되어 터널 시공이 증가하는 추세이다. 남해고속도로 냉정~부산간 확장공사 대동1터널 시공 시 계곡부 위치 및 갱문 이격으로 저토피가 발생하였고, 민원 등으로 착공이 지연되어 관통부 변경이 불가피하였다. 이에 다중TSP를 적용하여 관통부 위치를 변경하였고 안정해석을 실시하였다. 해석결과 터널의 안정성 에 문제가 없는 것으로 나타났으며, 시공 중 추가적인 안정성을 확보하고자 계측기 설치 및 기계굴착, 저토피구간 추가 보강, 반단면 굴착을 실시하였다. Around 70% of Korea is mountainous, an increase in tunnel construction. It’s due to the growing interest of the public for the environment and land required for the road construction is very scarce. During construction of ‘Daedong 1 tunnel’ in the expressway expansion project between Naengjeong and Busan, there are shallow shaft due to this tunnel located in the valley and the shafts are separated, and penetrating location change was inevitable for construction was delayed because of complaint. So, we change the position of the penetrating by applying multi-channel TSP, and conducted a stability analysis. The analysis results showed that there is no problem on the stability of the tunnel. To secure the construction of additional stability, We installed instrument, performed mechanical excavation, added reinforcement at shallow shaft and conducted bench cut.

부견갑부 유리 피판을 이용한 소아의 손, 발등 재건

김석한,현원석,이지혁,문구현,방사익,오갑성,Kim, Sukhan,Hyon, Wonsok,Lee, Jihyuck,Mun, Goohyun,Bang, Saik,Oh, Kapsung 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1

Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).

뇌의 인지 처리속도에 따른 사람의 의사결정모델과 주의력의 관계

송민석(Minseok Song),이효주(Hyoju Lee),홍사익(Saik Hong),안민규(Minkyu Ahn) 한국정보과학회 2022 한국정보과학회 학술발표논문집 Vol.2022 No.06

국소마취에 의한 성형외과 수술에서 보조적으로 사용된 정맥 마취의 효과

이태섭,방사익,강훈 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1

When operations in the field of plastic surgery are performed under local anesthesia, the degree of pain suffering the patients becomes different depending on the kind, dosage effective duration of anesthetic agent and the technique of the operator. Patients suffer from pain physically and psychologically when skin infiltration is carried out. Recently, out-patient surgery has increased in number, so the necessity of more complete analgesia for the patient undergoing surgery is required. Patients were operated under the local infiltrative anesthesia, and the supplemental intravenous anesthesia to kill pain. Patients were randomly divided into four groups differing in combinations of intravenous anesthetic agents, such as ketamine, midazolam, fentanyl that have potent analgesic sedative and amnesic effects. By random allocation patients received ketamine and midazolam(Group Ⅰ), ketamine and fentanyl(Group Ⅱ), midazolam and fentanyl(Group Ⅲ), ketamine, fentanyl arts midazolam(Group Ⅳ). The purpose of this study is to focus on the results obtained in four groups for finding out a more safe and less complicated combination of intravenous anesthetic agents and for standardization of dosage. In conclusion the group I (ketamine and midazolam) showed better results than other groups for the following reasons; no significant change in vital signs, no hypoxia no complication such as nausea, headache unpleasant dream, and hallucination, potent analgesia effects, amnesia. We have found this combination to be a highly satisfactory anesthesia and analgesia technique for outpatient plastic surgery from the standpoints of the surgeon and the patient.

제 1형 콜라겐 판이 전층피부결손의 창상치유에 미치는 영항

이의태,한상벽,박경찬,방사익,김석화,서활,박흥식,현원석,오태석 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Wound healing is a natural process proceeded by connective tissue deposition, epithelialization, and wound contraction. Excessive wound contraction causes postoperative scar contractures. Although full thickness skin grafts are known to inhibit wound contraction. the precise mechanism has not been determined. Up to now, dermis is thought to be the essential component of inhibition of contraction. To assess the effect of type Ⅰcollagen-the major component of dermis-upon wound contraction, we compared the wound healing of open wound with that of collagen sheet applied wound. Two full thickness skin defects were created on the back of adult male Sprague-Dawley rats. After the application of a thin sheet of type Ⅰ collagen upon one defect in each rat, the area of both wounds in relation to original wound area(day 0) was serially measured at 2, 4, 6.10, and 21 days postoperatively. The difference in the mean area ratios between two groups was then compared using Wilcoxon rank sums test. In addition, we performed histological examination of serial punch biopsies taken at 2,4,6,10, and 21 days postoperatively. During the 3 weeks period, the decrease in the area of collagen sheet applied wound was greater than that of open wounds. For the first 10 days, there was a significant difference (p<0.053 or less) in the mean wound areas between the two groups and histological examination revealed the presence of continuous epithelialization between the collagen sheet and wound bed at the wound margin. By the end of three weeks, no significant difference could be found(p=0.1842)in mean wound area ratios. Thus, the application of thin type Ⅰ collagen sheet upon full thickness skin defects in rats does not inhibit wound contraction, but it promotes both wound contraction and epithelialization and results in rapid wound healing.

어린이에게 완전 절단된 음경의 미세 수술학적 재접합 : A CASE REPORT

김광명,백재승,김석화,최황,이종국,방사익 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.2

Amputation of the penis is rare. It may occur by self-mutilation in psychotics, iatrogenically at the time of surgery, or as the result of industrial accidents or criminal acts. Aside from its sexual aspect the loss of the phallus incurs a definite handicap in body image and voiding. Before the era of microvascular surgery, the replantation of the amputated penis was done without vascular repair. The fact that the penile replantation is possible without the microvascular repair is a testament to the unique anatomy of the penile vasculature. But the most common complications after replantation without vessel repair were distal skin necrosis, fistula formation, and stricture of urethra. Among these complications, skin necrosis was most common, Microvascular repair avoids extensive skin necrosis because it establishes immediately subcutaneous circulation rather than relying on blood flow across corpora cavernosa and subcutaneous tissue, as occurs when no attempt at vascular anastomosis is made. Cohen(1977)and Tamai(1977)were the first to achieve successful replantation of the penis using microsurgical techniques. Their works were followed by many further cases of microsurgically treated patients, but they were almost all in adults and amputations at the middle of penile shaft. We report a successful microsurgical repair following iatrogenic amputation at the subcoronal area of the penis in a boy who is 11 years old.