Divided Nevus의 治驗例

김훈남,최성천 최신의학사 1977 最新醫學 Vol.20 No.10

The term divided nevus was proposed in 1919 by A. Fucks to designate the simultaneous occurance of nevi on opposing parts of the upper and lower lids. The two nevi form a unite when the lids are closed and are divided when the eye is opened. A total of 35 cases bas been described till 1969. In the Korea, we reported one case of this divided nevus and an examination unveiled 10X17 mrn-10X15 mm large slightly elevated nevi on the both eye lids. The nevi were excised and the defects were covered with adjacent flaps. Biopsy taken from the nevi showed compound nevus.

出血性 Shock에서 Steroid가 胸管淋巴의 流出量, Acid Phosphatase 및 蛋白量과 그 分劃像에 미치는 影響에 關하여

金勳男,洪善熹 慶北大學校 醫科大學 1974 慶北醫大誌 Vol.15 No.1

脾摘出術을 施行한 雜種成犬 11마리를 steroid 投與群(7마리)과 非投與群(4마리)으로 나누어 血壓 40 mmHg 內外의 出血性 shock을 惹起시킨 다음 每時間마다 4時間에 걸쳐 4回, 胸管淋巴의 流出量, acid phosphatase 活性度, 蛋白量 및 그 分劃像을 測定한 結果는 다음과 같다. 1. 胸管淋巴量은 steroid 非投與群에서는 時間의 經過와 더불어 減少하였는데 比해서 steroid 投與群에서는 거의 減少하지 않았고 오히려 增加하는 傾向을 보였다. 2. 胸管淋巴의 acid phosphatase 活性度는 兩群에서 다같이 顯著하게 增加하였으나 steroid 投與群의 增加가 輕微하였다. 3. 胸管淋巴의 蛋白量 및 그 分劃像은 兩群間에 差異를 볼 수 없었다. 4. 出血性 shock에서 steroid 投與가 胸管淋巴量을 增加시키고 acid phosphatase 活性度를 抑制한다고 볼 수 있으며 이런 點에서 出血性 shock의 治療에 도움이 된다고 생각된다. In hemorrhage, the return of lymph to general circulation through the thoracic duct has been shown to be an important step in blood volume restoration and cardiovascular compensation and proteolytic enzymes released from lysosomes during shock has been known to be deleterious to tissues and cells. Ideally, a substance which increases thoracic duct lymph flow without increased lysosomal enzyme content should have a therapeutic merit in the treatment of shock. With use of glucocorticoids, an increased lymph flow might be expected, because glucocorticoids have a certain hemodynamic mechanism. At the same time, since steroids stabilize lysosoma membrane, an increased release of lysosomal enzyme might be avoided with their use. However, the effect of steroids on thoracic duct lymph flow and lysosomal enzyme content hasl not been extensively investigated. The author studied the effect of steroid on flow, protein content and acid phosphatase activities of thoracic duct lymph in canine hemorrhagic shock of 40mmHg blood pressure and the follwing results were obtained. The administration of dexamethasone 30 minutes after onset of shock slightly increased the flow of thoracic lymph, whereas a marked decrease of lymph flow was observed in the non-treated dog. In concentration of protein and its fraction of serum and lymph, no difference between steroid treated and non-treated dogs was noted. The accumulation of serum acid phosphatase in steroid administered dog was considerably lower than that of non-treated one. Lymphatic acid phosphatase content was similarly affected. As a result, it was postulated that the administration of glucocorticoid might be effective in the treatment of hemorrhagic shock.

出血性 Shock에서 Steroid가 胸管淋巴의 流出量, Acid Phosphatase 및 蛋白量과 그 分劃像에 미치는 影響에 關하여

金勳男,洪善憙 慶北大學校 醫科大學 1974 慶北醫大雜誌 Vol.15 No.1

양측 고관절 전치환술에서 동시수술과 분리수술의 조기 임상 결과 비교

김훈,신종환,남우동,안기찬,서승석,김영창,최장석,이영구 인제대학교 1998 仁濟醫學 Vol.19 No.1

대퇴골두 무혈성 괴사증은 비교적 흔한 고관절의 병변으로서 반수 이상에서 양측성으로 발생하며 대개 질병이 진행된 상태에서 병원을 찾아오므로 양측에 대하여 고관절 전치환술을 요하는 경우가 많다. 고관절 전치환술의 수술방법이나 재료에 대하여는 많은 연구가 있어왔으나 양측성 고관절 전치환술에 있어 한번의 마취하에 양측 모두 수술하는 경우와 두 번으로 나누어 수술하는 경우에 대한 연구는 많지않다. 이에 저자들은 양측성 고관절 전치환술을 요하는 환자들을 대상으로 동시에 수술한 경우와 분리하여 수술한 경우를 비교 분석하였다. 수술중후의 실혈량과 술후 합병증은 유의한 차이가 없었으나, 동시 수술한 경우 총수술시간과 재원기간이 짧았으며 또한 병원비 역시 적게 소요되는 것으로 나타났다. 이상의 결과들을 바탕으로 양측 고관절에 대하여 고관절 전치환술을 요하는 경우 한번의 마취하에 양측 고관절 전치환술을 시행하는 것이 환자의 경제적인 측면에서 더 유리할 것으로 사료되었다. In this retrospective study, we compared 13 patients who had one stage THRA with 12 patients who had similar bilateral THRA in two stages. Thus we achieved following results. 1.No significant differences in estimated intraoperative blood loss, postoperative hemovac drainage, postoperative complications in the two groups. 2.The one stage bilateral procedure offered advantages over two stage bilateral procedures, including shorter length of hospital stay, shorter operation time and reduced economic costs. In conclusion, these results suggest that one stage procedure might be useful method in total hip replacement arthroplasty.

正常韓國人과 膽囊炎患者의 膽囊 및 總輸膽管膽汁의 膽汁酸濃度에 關하여

金勳男(Hoon Nam Kim) 대한외과학회 1972 Annals of Surgical Treatment and Research Vol.14 No.3

구슬봉합법을 이용한 이중검 성형술의 다양한 임상적 적용

김훈남,김준형,한기환,손대구,정영진 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

안면부에 시행한 자가지방 이식술에 대한 임상적 고찰

김훈남 대한미용성형외과학회 1995 Archives of Aesthetic Plastic Surgery Vol.1 No.1

四肢의 Scar Revision에 있어 Modified Millard's Trick의 利用

金勳男,崔性玔,李斗炯,李圭源,皇甫宗演 大韓成形外科學會 1976 Archives of Plastic Surgery Vol.3 No.1

No matter how various methods may be tried, for scar repair of extremities, the results were not so acceptable unfortunately. Of these procedures, Millard's trick (The Double-Breasted Vest Principle) is the one of most popular methods and which has been loved by many surgeons, esp, plastic surgeons, up to date. However, even this method couldn't satisfied us, because of undesirable disadvantages, and our new repair method, entitle "Modified Millard's Trick Method" was designed with supplement of disadvantages of Millard's Tric in mind and has been used in attempt to prevent recurrence of the usual spread. This approach is advocated for scars in area where stretch-ing is usual or where a careful regular repair has failed to prevent it. If there is any depression associated with the scar, this is corrected simultaneously by advancing both skin flaps in opposite direction. We have tired this new method for 1- cases of patients, esp. for relatively wide linear scar (over 5cm) on extremities.

Tongue Flap을 利用한 廣範圍한 赤唇部 缺損의 修復

金勳男,林慶全,李圭源,皇甫宗演,李斗炯 大韓成形外科學會 1975 Archives of Plastic Surgery Vol.2 No.1

Many different techniques of cheiloplasty have been proposed and developed to reconstruct a vermilion defect for many years. The purpose of this paper is to propose another donor site, tongue, which is available for lining a new lip. A 37 year-old male patient was admitted to our department by the extensive defect of the lower lip vermilion due to human bite. We have used musculo-mucosal flap from the tip of the tongue in the reconstruction of the lower lip vermilion. Here, the result was satisfactory, and patient was discharged with nearly normal state to aesthetic and functional fidelity.

건선환자에서 Adalimumab 과 Cyclosporine 사용 후 발생한 Follicular Lymphoma

배경남,하대룡,손진화,이정수,신기혁,김훈수,고현창,김문범,김병수 대한건선학회 2020 대한건선학회지 Vol.17 No.1

Biologics and conventional immunosuppressants are widely used for psoriasis. Among them, tumor necrosis factor-α inhibitors and cyclosporine are frequently implicated for moderate to severe plaque psoriasis. However, because of their immunoregulatory effect, both have been suspected to increase the risk of lymphomas, although each drug’s individual effect has never been definitively proven. Of course, little is known about the potential synergistic effect of them on the development of lymphoma. A 47-year old man, previously diagnosed with psoriasis, was treated with adalimumab for 9 months and received cyclosporine for 6 months thereafter. Three months later, he developed dyspnea and weight loss. Laboratory exam showed markedly elevated white blood cells and multifocal lymphadenopathy and pleural effusion were revealed by imaging studies. Bone marrow and lymph node biopsy confirmed the diagnosis of follicular lymphoma. Here, we report a case of follicular lymphoma in a patient with psoriasis treated with adalimumab followed by cyclosporine.