• 제목/요약/키워드: Korean Flap

검색결과 2,504건 처리시간 0.027초

경부청소술을 시행한 환자를 대상으로 한 경부청소술 후 장애지수에 대한 한글화 버전 표준화 (Validation of the Korean Version of the Neck Dissection Impairment Index in Patients Who Underwent Neck Dissection)

  • 임원섭;이창욱;이윤세;조민우;정영호;최승호;김상윤;남순열
    • 대한두경부종양학회지
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    • 제37권2호
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    • pp.43-50
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    • 2021
  • Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

터널구간 운행시 KTX HVAC-여압장치 작동에 따른 $CO_2$와 PM10 변화연구 (A Study on $CO_2$ and PM10 Changes by Operation of KTX HVAC-Pressurization Equipment in Tunnel Sections)

  • 소진섭;유성연
    • 한국철도학회논문집
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    • 제10권6호
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    • pp.723-729
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    • 2007
  • 환경부는 2006년 12월에 ${\ulcorner}$대중교통수단 실내공기질 관리 가이드라인${\lrcorner}$을 마련하였다. 관리항목으로 이산화탄소$(CO_2)$와 미세먼지(PM10)에 대해 각각 Level 1(평상시)과 Level 2(혼잡시)고 가이드라인을 제시하였다. 이에 따라 현재는 법적 기준이 아니지만, 열차와 전동차에 대해 실내공기질 관리가 필요하게 되었다. KTX는 터널 진입시 발생하는 고압의 압력파로 인한 이명현상을 방지하기 위해 여압장치가 설치되어 있다. 외부 신선공기는 플랩의 작동에 의해 공기 순환이 이루어진다. 본 연구는 2008년까지 진행되고 있는 코레일 기본연구과제로, 2006년 7월에 KTX가 운행하는 경부선(서울-부산)과 호남선(용산-목포)을 대상으로 실내공기청정도를 측정하였다. 터널구간에서 KTX 여압장치 작동에 따른 실내공기질 변화를 측정하고, KTX ATESS 레코더 기록파일과 비교 분석하였다. 측정결과 미세먼지 농도는 환경부 가이드라인에 매우 양호하였고, 이산화탄소 농도는 터널 일부구간으로 옥산-오탄, 고등-휴대, 개착-일직 터널에서 변화가 있지만, KTX 객실 공기청정도는 환경부에서 제시하고 있는 가이드라인에 만족한 수준으로 나타났다.

20, 30대 한국 남성의 전두부 모발선의 모양과 위치 (The Shape and the Location of Forehead Hairline of Korean Males in Their 20s & 30s)

  • 윤성원;김정헌
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.295-299
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    • 2011
  • Purpose: It is generally believed that alopecia is caused by various factors such as scars, stress, genetical factors, androgens, etc. Androgenic alopecia is one of the most common cause of alopecia and found mainly in males. Propecia (Merck & Co., USA) and Minoxidil (McNEIL-PPC, Inc, USA) were the drugs approved from FDA for treatment of androgenic alopecia. Surgical treatments such as flap, tissue expansion, scalp reduction and hair transplantation can be considered if necessary. Hair micrograft techniques were developed for natural hair shapes and minimal adverse effect. There were attempts to measure the length of the forehead of the Korean young adults. However attempts to classify the shape and location of forehead hairline were rare. This study attempted to find out standard hairlines of young adults in their 20s & 30s and the result would be the guideline of the hairline in hair replacement surgery of male patients in their 40s & 50s. Methods: 200 male adults in 20s and 30s were photographed and measured the length of 11 vertical index lines to determine hairline. The indexes are the distances from hairline to intercanthal midpoint (A), to medial canthus (B), to upper eyelid fissure (C), to lower eyelid fissure (D), to lateral canthus (E) and distance from lateral highest point to medial lowest point, if the hairline is M-shape (F). Additionally, we classified the hairlines into 4 groups, M, horizontal, inverted U and irregular shapes. Results: The most common hairline of male adults in their 20s is inverted U-shape (53.3%), followed by horizontal-shape, M-shape, irregular-shape. In their 30s, inverted U-shape (59%) is followed by irregular-shape, M-shape, horizontal-shape. The M-shape is more frequently found in males in 30s than those in 20s. The mean values of the indexes in their 20s are as follows: A (76.14 mm), B (Rt: 75.78 mm, Lt:76.41 mm), C (Rt: 69.43 mm, Lt: 69.92 mm), D (Rt: 76.92 mm, Lt:77.46 mm), E (Rt: 64.16 mm, Lt: 64.73 mm), F (4.09 mm). Those in their 30s are as follows: A (76.13 mm), B (Rt: 76.114 mm, Lt: 76.02 mm), C (Rt: 69.87 mm, Lt: 70.37 mm), D (Rt: 77.37 mm, Lt: 77.58 mm), E (Rt: 69.63 mm, Lt: 69.85 mm), F (6.14 mm). Conclusion: The knowledge about human body measurement is indispensable to plastic surgeons. In this study, inverted U shape is the most common type of hairline in 30s, and similar distribution is found in 20s. The percentage of M shape in their 30s is elevated more than 10% compared to that in their 20s. The study of hairline shapes and 11 indexes of hairlines can be useful for planning of the hair transplantation and postoperative evaluation. This study being based on photogrammetry, there may be differences between actual distance of curved face and projected distance on flat photographs.

한국고유종 각시붕어 Rhodeus uyekii 후각기관의 형태 및 조직, 세포화학적 특성 연구 (Morphology, Histology, and Histochemistry of the Olfactory Organ in Korean Endemic Fish, Rhodeus uyekii (Pices, Cyprinidae))

  • 김현태;윤승운;이용주;박종영
    • 한국어류학회지
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    • 제31권3호
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    • pp.123-130
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    • 2019
  • 한국 고유종 각시붕어 Rhodeus uyekii의 후각기관과 서식처의 물리 및 화학적 특성 그리고 생태적 습성과의 연관성을 알아보기 위해 실체현미경, 광학현미경, 주사전자현미경을 이용하여 해부 및 조직, 세포화학적 특성을 조사하였다. 후각기관의 외부형태는 반원의 전비공과 후비공, 비경계판으로 구성되는데, 특히 전비공의 앞쪽에는 아치형의 조직이 돌출되어 있다. 비강 내에는 14~15개의 후판으로 구성되는 로제트 구조를 보유하며 후판은 감각상피와 비감각상피로 구분된다. 감각상피는 후감각뉴런, 지지세포, 기저세포, 림프구, 형질세포로 구성되는 반면에 비감각세포는 층상상피세포, 점액세포, 비감각섬모세포, 미확인세포가 1종류 확인된다. 점액세포의 세포화학적 특성은 산성 및 중성의 황점액소(sulfomucine)로 나타났다.

편측성 완전 구순구개열 환자의 포괄적 치료 (COMPREHENSIVE TREATMENT OF UNILATERAL COMPLETE CLEFT LIP AND PALATE)

  • 이정근;황병남;최은주;김용빈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권4호
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    • pp.430-435
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    • 2000
  • Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

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족관절 인공관절 치환술: 반 구속형과 자유형 치환물의 단기 추시 결과 비교 (Total Ankle Arthroplasty : Short Term follow up Results of Semiconstrained Type and Unconstrained Type)

  • 강규복;최재혁;김택선;김학준;권제호
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.177-181
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    • 2007
  • Purpose: The purpose of this study is to compare the two prosthesis that used for total ankle arthroplasty. Materials and Methods: From Sept. 2003 to Jun 2006, 13 patients and 14 ankles that could be follow up more than 1 months. Semiconstrained type (Group I, 7 cases) and Unconstrained type (Group II, 7 cases) were used for total ankle arthroplasty. Mean age was 63.2 year-old, 12 ankles are men and 2 ankles were women. Mean follow up periods were 29 months. The criteria to compare the clinical result were postoperative range of motion, AOFAS score and residual bone stock of medial malleolus. Results: Postoperative range of motion of group I was $43.6{\pm}9.4$ degrees and of group II was $50.7{\pm}7.3$ degrees (p=0.115). Postoperative AOFAS score of group I was $77.1{\pm}13.0$ points and of group II was $86.0{\pm}5.7$ points (p=0.094). Resected bone stock in medial malleolus of group I was $10.7{\pm}2.5\;mm$ and of group II was $5.1{\pm}1.2\;mm$ (p=0.003). Total number of complication in our study was 9 cases. 3 cases were a malleolar fracture, two occurred at intra-operation, the other at follow-up period. Re-operation was done in 6 cases, 3 cases were calcaneal corrective osteotomy, 2 cases were resection of a heterotopic bone and one case was pedicular flap operation for skin problem. Conclusion: In our hospital, mobile bearing type prosthesis shows good result than a semiconstrained type in respect of residual bone stock in medial malleolus. Postoperative range of motion and AOFAS score between two groups shows no significant difference. But small number of patients and short term follow up period is a defect in our study, afterward more population and long term follow up period are needed.

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함기화된 상악 구치부에서 변형 측방 접근법을 이용한 상악동 거상술과 임플란트 동시식립에 대한 증례보고 (Simultaneous implant placement with sinus augmentation using a modified lateral approach in the pneumatized posterior maxilla: A Case Report)

  • 선유경;차재국;이중석;정의원
    • 대한치과의사협회지
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    • 제56권3호
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    • pp.142-150
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    • 2018
  • In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

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최소침습 갑상선 수술법 :전통적 갑상선 수술법의 변형술식 (Minimally Invasive Technique for Thyroidectomy ; A Modification of the Conventional Thyoidectomy Technique)

  • 박정수;정웅윤;장항석
    • 대한두경부종양학회지
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    • 제16권2호
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    • pp.177-181
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    • 2000
  • 배경 및 목적: Theodor Kocker에 의해 일반화된 전통적인 갑상선 수술방법은 갑상선 질환의 종류 및 정도, 수술범위와 상관없이 광범위한 수술범위로 인한 조직 손상으로 인해 수술후 환자들의 여러가지 불편감은 물론 경부의 넓은 부위의 통증과 경부 피부부종, 장액종, 혈종 등과 같은 후유증을 동반할 수 있다. 최근 본 저자들은 이같은 전통적 갑상선 수술의 부작용을 최소화하기 위해 작은 피부절개($3{\sim}4.5cm$) 후 피하 피판(subplatysmal skin flap) 없이 직접 갑상선으로 접근하는 새로운 수술기법으로서 최소침습 갑상선 수술기법을 개발하였기에 그 술식을 소개하고 전통적인 갑상선 절제술에 대한 우월성을 확인하고자 본 연구를 시행하였다. 대상 및 방법: 1999년 1월 15일 부터 2000년 1월 14일까지 573예의 갑상선 수술 예 중 최소침습 갑상선절제술이 시행되었던 466예와 1998년 1월 15일부터 1999년 1월 14일까지 전통적 갑상선 수술을 시행한 549예 중 거대 종양(양성>6cm, 악성>5cm), 흉골하 선종, 국소진행암, 재발암, 측경부의 다발성 림프절 전이가 있었던 112예를 제외한 437예의 임상병리적 특성과 피부절개 길이, 수술 시간, 수술중 출혈양, 수술후 진통제 요구빈도 및 재윈기간, 수술 후 합병증 발생빈도를 비교 분석하였다. 결 과: 두 군간의 임상병리적 특성상의 유의한 차이는 없었다. 피부절개 길이($3.7{\pm}0.7cm,\;vs\;9.6{\pm}3.3cm$), 수술 시간($57.6{\pm}11.7$분 vs $85.2{\pm}32.3$분) 수술 중 출혈양($18.4{\pm}15.3ml\;vs\;43.1{\pm}21.8ml$), 수술후 재원기간($1.6{\pm}0.5$일 vs $4.3{\pm}1.6$일), 및 수술후 진통제 요구빈도가 전통적 수술군에 비해 최소침습 수술군에서 통계적으로 유의하게 감소되었으나(p<0.05), 수술후 장액종 및 혈종 형성, 일시적인 음색변화, 일시적인 저칼슘혈증과 같은 합병증의 발생빈도는 각각 4.3%(n=20)와 4.8%(n=21)로 두 군간에 유의한 차이가 없었다. 결 론: 최소침습 갑상선 수술법은 새로운 수술기구의 도입 없이도 갑상선 수술의 충분한 시야를 확보할 수 있고 안전하고 간단하게 시행할 수 있으며, 기존 수술법으로 인한 부작용을 최소화할 수 있어 전통적 인 수술법을 대치할 수 있는 새로운 방법으로 사료된다.

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방사선조사 및 고압산소요법이 미세혈관 문합술에 미치는 영향 (THE EFFECTS OF IRRADIATION AND HYPERBARIC OXYGEN THERAPY ON MICROVASCULAR ANASTOMOSIS)

  • 최성원;김병용;박정현;윤정훈;육종인;유재하;이의웅;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권5호
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    • pp.455-461
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    • 2000
  • Malignant tumors of the head and neck frequently require treatment with both radiotherapy and surgery. Reconstruction of the defect in previously irradiated field is a challenge to surgeon, who must produce both a functional and an esthetic result. Hyperbaric oxygen therapy(HBO) has been used in an attempt to reduce the deleterious effects of radiation. But the issue of whether prior irradiation and HBO of the recipient site of a free flap affects the result of reconstruction continues to generate controversy. So, the effects of irradiation and hypergbaric oxygen therapy on microvascular anastomosis was evaluated in an experimental study in femoral vessels of rats. The experimental groups were divided into 3 groups, contorol group, irradiation group, and irradiation and HBO group. Preoperative irradiation was delivered in the left groin field with single dose corresponding 2,000cGy and total 48 hours of HBO was given 100% oxygen at 2.4 atmosphere for 4 weeks. The femoral vessels of 60 rats were anastomosed after irradiation and HBO treatment. Three days, 1 week, 2 weeks and 4 weeks after surgery, the femoral vessels were evaluated for patency and histopathologic changes. There was no notable effect of irradiation on patency of femoral vessels in rats and the radiation effects were obvious on histological examination which showed the sloughing of the endothelial cells, subintimal hyperplasia and fibrosis on the media and adventitia of femoral arteries. The histologic changes of the femoral veins were mild and not typical. But the effects of hyperbaric oxygen therapy after irradiation was seen not marked difference in irradiation group.

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구순열 이차비기형의 교정; 아동과 성인에서의 이차 비성형술 (Correction of Secondary cleft lip-nasal deformity; secondary rhinoplasty in children and adults)

  • 송진아;명훈;황순정;서병무;이종호;정필호;김명진;최진영
    • 대한구순구개열학회지
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    • 제6권1호
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    • pp.17-25
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    • 2003
  • 본 교실에서 최근 4년 동안 행해진 수술의 경향을 분석한 결과를 정리해 보면 이차 비기형의 교정은 양측성의 경우 비교적 이른 시기인 4-5세에 시행되었고 편측성의 경우에는 치조성형술(alveoloplasty)의 시행을 먼저 고려한 후 10세에서 13세 경에 시행된 것을 알 수 있었다. 교정부위는 편측성의 경우 비대칭을 교정하는 수술이 중점적으로, 양측성의 경우 비주 연장술이 중점적으로 행해졌는데 아동과 성인에서 모두 비주와 비첨 수술이 거의 90%정도를 차지하였다. 그 외에 비중격 성형술, 비공 성형술 등이 10% 내외로 시행되었다. 비첨 성형술은 양측성 구순열의 경우 모두Millard's forked flap으로 시행되었고 편측성의 경우 간단하게 연골을 박리하고 Tajima suture를 시행한 경우가 아동에서 77%, 성인에서 30% 였다. 개방형 비성형술을 시행한 경우는 아동에서 40%, 성인에서 71%를 보였다. 자가 연골이식을 시행한 경우는 아동에서 23%, 성인에서 70%를 보였다. 비중격의 편향을 보이는 편측성 구순열 환자 모두에서 비중격 수술이 시행된 것은 아니었는데, 비익의 비대칭에는 적극적인 치료가 이루어진 반면 비중격의 비대칭에는 그렇지 못한 것을 알 수 있었다. 대부분의 수술이 심미적인 부분에 초점을 맞추고 있었으며 비중격 성형술의 시행에 있어 비강폐쇄의 객관적 평가가 이루어지지 않은 것이 개선해야 할 부분으로 사료되었다.

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