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        역행성 동맥 혈류를 이용한 원위 유리피판술의 실험적 연구

        문구,민경원,이민구 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.3

        Microsurgical free-tissue transfer has allowed surgeons to salvage injured limbs but choosing appropriate healthy recipient vessels has proved to be a difficult problem. Retrograde flow flaps are established in island flaps. Retrograde flow anastomosis could prevent the possible kinking and twisting of the arterial anastomosis. By not interrupting the proximal blood flow to the fracture or soft tissue defect site, the compromise of fracture or wound healing might be prevented. We wished to establish an animal model in rat for a retrograde arterial flow based free flap. Nembutal-anesthetized male rats, weighing 250 to 300 gm, were used. The femoral artery and common carotid artery exposed and divided. The systemic and retrograde arterial pressure were quantified by utilizing a paralle tubing system connected with peripheral arterial line. In this study, the retrograde flow was not pulsatile and the retrograde arterial pressure was 64-65 mmHg, with a mean arterial pressure of 106-109 mmHg. An epigastric skin flap, measuring 3x3 cm, was raised with its vascular pedicle. The epigastric free flap was transferred in the same rat from femoral vessels to carotid vessels in end to end fashion. We anastomosed the donor ateries to the distal parts of the divided recipient arteries and the donor veins to the proximal parts of the recipient veins. Twelve experiments were performed and the transplantations succeeded in 75 percent of them. In the remaining 25 percent, the experiments failed due to thrombosis at the site of anastomosis, or other causes. This animal model represents an excellent example of retrograde arterial flow free flap transfer that is reliable.

      • KCI등재
      • 柴胡疏肝散이 胃腸管運動과 Stress에 미치는 影響

        韓宗鉉,文錫哉,文九 圓光大學校大學院 1989 論文集 Vol.3 No.-

        Effects of Shihosogansan extract on the gastrointestinal tract were studied in isolated organ segments in vitro. Treatment of Shihosogansan extract caused an increase of the contractile response of the isolated rat stomach, ileum, and duodenum. Higher response was observed in stomach and ileum segments than in duodenum. Generally the magnitude of increase was related to the dose of Shihosogansan extract. The contractile response of isolated rat ileum induced by Shihosogansan extract was inhibited if atropine was pretreated to the ileum segment. Meanwhile, pretreatment of pheniramine maleate of cyproheptadine did not altered the effects of Shihosogansan extract. The contractile response induced by Shihosogansan extract was appeared to be closely related to the concentration of calcium since the response was decreased significantly if the concentration of calcium in the medium was reduced or verapamil, an inhibitor of Ca (???)ion, was pretreated. Effects of Shihosogansan extract on the stress induced by various stimuli were also investigated in rat and mouse in vivo. Administration of Shihosogansan extract (10 and 100 mg/kg,po) to rat and mouse caused an increase of the total waiting time as measured by the automatic reflex conditioner. Shihosogansan extract treated group also showed a significant lower level of plasma cortisol compare to the controls after the swimming stress at 4℃ and the electrical stress. No significant difference was observed in plasma cortisol concentration, however in the swimming stress at 20℃ and the mix stress (sound, electric and light) experiments. The results presented in this study suggests that the therapeutic effects of Shihosogansan on the gastrointestinal tract function might due to its action on the parasympathetic nerve system of the gastrointestinal tract. Shihosogansan also appeared to have strong antistress effects especially to the powerful stress such as swimming stress at 4℃ and electrical stress.

      • KCI등재후보
      • 좌골부 및 전자부 욕창의 재건을 위한 후대퇴근막 피판술

        문구,방사익 충북대학교 의학연구소 2001 忠北醫大學術誌 Vol.11 No.2

        연구목적: 욕창은 장기적으로 반복되는 압박으로 인해 피부 및 연부조직에 생긴 괴사를 말하며 이는 주로 골 돌출부 주위에 잘 발생한다. 이러한 욕창은 교통사고 및 산업재해의 증가로 척추손상 및 지체마비 환자가 늘어나고 집중 치료를 요하는 의식불명, 만성병증의 환자수가 증가하면서 그 발생 빈도도 증가 하고 있다. 그리고 욕창은 천골부, 대전자부 및 좌골부 등에서 호발한다. 추후에 보행이 가능한 환자의 경우 근피판보다는 근육을 보존할 수 있는 근막피판을 사용하는 것이 수술 후 보행에 더 도움을 줄 수가 있다. 그러므로 기존에 수술적 치료를 시행한 환자의 경우나, 욕창의 크기가 큰 경우, 추후에 보행이 가능한 환자에게 있어서 사용할 수 있는 술식의 유용성을 확인하고자 했다. 대상 및 방법 : 1999년 9월부터 2000년 8월까지 본원에 입원 중이던 6 례의 전자부 욕창과 5례의 좌골부 욕창을 가진 남자환자 7명, 여자환자 4명을 대상으로 하였으며, 원인별로 볼 때는 하반신 마비가 가장 많았다. 하둔부동맥 및 대퇴 심동맥의 제 1, 2 심부관통동맥으로부터 혈액공급을 받는 후대퇴근막피판을 작성한 후 피판을 전위하는 방법을 사용하였다. 결과: 피부 괴사등의 합병증 없이 모른 예에서 결손 부위을 막을 수가 있었으며 적당한 연부조직을 함께 전위 시켜줌으로 해서 추적관찰 기간 동안 욕창의 재발을 방지 할 수 있었으며 보행이 가능한 환자에 있어서도 보행에 문제가 없었다. 결론: 하둔부동맥 및 대퇴 심동맥의 제 1, 2 심부관통동맥으로부터 혈액 공급을 받는 후대퇴근막피판술은 수술이 쉽고, 출혈이 비교적 적으며 수술시간이 짧고, 피판 공여부의 봉합이 쉬우며, 보행 가능한 환자에서는 하지 근육의 기능을 보존할 수 있고, 만약 욕창이 재발 시 피판을 재거상 하여 전진시킴으로서 치료가 가능하며, 근육의 손상을 주지 않으므로 재발시 다른 수술 적 방법을 고려할 수 있는 여러가지 장점이 있는 술식이라 판단된다. Purpose : Pressure sore is an area of ischemic tissue loss resulting from prolonged or often repeated pressure, usually over a bony prominence of body. There has been recent reports describing superior durability of fasciocutaneous flap in sore reconstruction over musculocutaneous flap. Contrary to common musculocutaneous flap using gluteus & harmstring muscle, posterior fasciocutaneous flap does not incorporate any muscle, making it useful especially in ambulatory patients. Material and Methods : From September 1999 to October 2000 we have used posterior thigh fasciocutaneous flap for coverage of six trochanteric sores and five ischial sores. Posterior thigh fasciocutaneous flap is perfused by first & second profunda femoris perforating arteries. Results: All the patients recovered without any serious complications. Three cases developed minimal hematoma but it was corrected by simple evacuation. During the follow up period none of the patients were recurred and for those patients who were able to walk, there was no problem in walking. Conclusion : Posterior thigh fasciocutaneous flap has several advantages. It is easier to elevate, less operation time, less hematoma formation, good donor site morbidity and making possible to preserve the muscle component.

      • SCOPUSKCI등재

        Crouzon씨병 교정치료를 위한 개선된 Frontofacial monobloc advancement와 Cranial vault remodeling 병행수술 방법

        문구,이윤호 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

        Crouzon's disease characterized by exorbitism, retromaxillism, inframaxillism, and paradoxic retrogenia, was first described by Crouzon in 1912. Premature fusion of cranial sutures results in a variety of calvarial deformities, but oxycephaly and brachycephaly are most often observed.¹ According to the severity of deformity and patient's age, the method of surgical correction should be selected. In adults, for reasons of safety, staged operation, first, limited frontocranial remodeling if necessary and facial advancement later, is generally favored. Combined orbitofacial monobloc advancement and frontal repositioning was popularized by Oritz-Monasterio(1978) but this technique has been reserved only for child. Persistent intracranial dead space, increased risk of ascending infection via nasofrontal communication, possibility of frontal bone flap resorption, and some technical difficulties rendered monobloc advancement to be not indicated in adults. We thought that modification and improvement of original monobloc procedure combined with cranial vault remodeling could overcome above mentioned disadvantages. Authors' combined procedure can correct deformities of midface, forehead and cranial vault simultaneously in one stage. We performed our combined surgical procedures of modified frontofacial monobloc advancement and cranial vault remodeling in 22 year-old female patient and obtained successful without complication. Through our limited experience, this new methods probably can be safely applied to the adult patients of Crouzon's disease with calvarial deformities and correct not only front-orbito-facial region but also whole cranial vault deformity in one stage.

      • 倫落女性에 對한 現況 및 性病에 關한 硏究

        文九 慶北大學校 1964 論文集 Vol.8 No.-

        Five hundred and ten prostitutes living in Taegu, Kyung Joo, and Pou Hang areas were investigated for their present conditions and morbidities of the venereal diseases. Bacteriological studies of 28 strains of gonococci, 33 of coagulase positive and 75 of coagulase negative staphylococci isolated from the cervix were also made, and the following results were obtained. Ⅰ. Present conditions of prostitutes. 1. Ages of 66.6% of prostitutes were from 21 to 25 years. 2. Ages of menarche ranged from 16 to 19 years in most cases (80%). 3. First sexual intercourse was made under the ages of 20 years in 77.0%. 4. 89.0 per cent of prostitutes had not received an education higher than the level of primary school. 5. In 62.4% of prostitutes, it was found that they had no jobs in the past. 6. Important motives of the first sexual intercourse were love affaris (48.0%) and prostitution (22.0%). First intercourse of most of prostitutes (82.0%) was extra-marital. 7. Causes of fall into the misery were the difficulty in economic condition (57.1%0, seduction (27.6%) and abandonment (15.3%). 8. Prostitutes from urban areas showed a little higher percentage than those from rural areas. Ⅱ. Venereal diseases. 1. Lesions and/or pus discharges in the cervix were found in 51% of prostitutes and cervical erosions in 33.2%. 2. Gram negative diplococci in discharges were observed intracellularly or extracellualry in 31% of persons examined, and a high incidence of Gram negatice diplococci was noted among prostitutes for Koreans than in those for U.N. Forces. The appearance of leucocytes and Gram positive diplococci in discharges were almost the same in the both groups of prostitutes. 3. Thirtytwo strains of gonococci were isolated from specimens showing Gram negative diplococci upon staining, and three strains from those showing no Gram negative diplococci. 4. Thirtyfive strains out of 95 Gram negative diplococci showing positive oxidase reaction were identified as gonococci and the remaining as N. catarrhalis, N. sicca, N. flava or mimea group. 5. Gonococci were sensitive to penicillin, less sensitive to terramycin and erythromycin, moderately resistant to chloramphenicol, kanamycin and albamycin, and highly resistant to streptomycin and sulfadimethoxine. 6. One hundred and sixtytwo strains of staphylococci were/isolated from cervical discharges, and 33 strains of them were coagulase positive. 7. Among 33 strains of coagulase positive strains, 20 strains were identifed belonging to phage groupⅠ, one mixed group and 12 non-typable. Strains belonging to groupⅠ were identified as phage type 29 and one belonging mixed group as 29/6. 8. The sensitivity of staphylococci to various antibiotics showed no marked difference between coagulase positive and negative ones. Most of the strains were sensitive to antibiotics, and very few of them were resistant. 9. Serological test for syphilis was positive by VDRL test in 10.5% of prostitutes, while Syphilis recenta was not found. The incidence of positive VDRL test was higher among prostitutes in areas of poor sanitation and higher among those for Koreans. 10. Chancroid was found in 11 cases (1.9%) but Lymphogranuloma venereum and Granuloma inguinale were nor found.

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