月經痛의 臨床的 硏究

金恩基(Kim Eun-Ki),梁秀烈(Yang Su-Yeel),李京燮(Lee Kyung-Sub),宋炳基(Song Byoung-Key) 대한한의학회 1992 대한한의학회지 Vol.13 No.1

전방 외측 대퇴 유리 피판을 접어서 시행한 혀 재건의 증례 보고

이형철,김은기,Lee, Hyung-Chul,Kim, Eun-Key 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.1

Tongue reconstruction after oncologic resection with free flap is important to conserve function and shape. Vertical rectus myocutaneous free flap is usually used for total tongue reconstruction, but our patient was thin and primary closure after flap elevation seemed hard. So we used anterolateral thigh free flap to reduce donor site morbidity and to maintain bulk of the tongue as much as possible. Deepithelization of both middle side of flap and folding was done to mimic normal tongue base's shape and volume. Flap survived without complication and patient underwent concurrent chemoradiation therapy three weeks after surgery. Anterolateral thigh free flap can be good candidate for total tongue reconstruction especially in thin patient.

유리비골피부피판을 이용한 두경부 재건 시 CT Angiography를 통한 천공지의 확인

장택진,김은기,최종우,Chang, Tack-Jin,Kim, Eun Key,Choi, Jong Woo 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.1

Purpose: Fibular osteocutaneous free flap is the procedure of choice for mandibular reconstruction. However, the anatomic consistency and the reliability of the skin paddle have been considered to be questionable and the utilization of the fibular osteocutaneous free flap can be challenging for the inexperienced surgeon. Preoperative computed tomography (CT) angiography can support revolutionary help with the operator design of the fibular osteocutaneous flap. The purpose of this article is to share the valuable experience of support with preoperative CT angiography. Methods: Three consecutive patients, who needed mandibular reconstruction, were treated with fibular osteocutaneous free flap. Each of the patients had undergone lower extremity CT angiography before the surgery. The CT angiographies were scrupulously investigated to calculate the locations and the tracts of the peroneal artery perforators. We compared the findings of the CT angiography with those of the real operation. Results: The information about the perforators was sufficiently matched with the findings of the operation. With the use of preoperative CT angiography, we were able to achieve confident performance during operation, shortening of operation time, and fine outcomes with a no flap failure. Conclusion: The CT angiography of lower extremity can provide reliable information of the perforators of the fibular osteocutaneous free flap.

하인두 재건을 위한 전외측 대퇴부 유리 피판의 변형된 도안

김성찬,김은기,Kim, Sung-Chan,Kim, Eun-Key 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.1

Purpose: Defect after ablation of hypopharyngeal cancer often requires reconstruction by free tissue transfer. Since neo-hypopharynx is totally buried, various methods have been suggested for monitoring. We propose a modified design of anterolateral thigh (ALT) free flap for reconstruction of pharyngolaryngectomy defect, which has an exteriorized part for clinical monitoring and allows for primary closure. Materials and Methods: Three consecutive patients with hypopharyngeal cancer were reconstructed with ALT flap with modified design: 1) distal part of flap was elongated into fusiform shape and used as exteriorized monitoring segment with a deepithelized bridge and 2) proximal part was designed as curve so the maximum width of the flap was reduced to less than 10 cm. Results: Patient 1, 2 had uneventful postoperative course with healthy skin color and fresh pin prick bleeding. In patient 3, defect after cancer ablation was shorter than usual and deepithelized bridge was longer. When the general hemodynamic status of the patient was aggravated in postoperative course, the color of monitoring skin was changed. Viability of the whole flap was confirmed by endoscopy. However, leakage developed after 3 weeks and repair was necessary. In all patients the donor sites were closed primarily. Conclusion: By the modified design of ALT flap, clinical monitoring can be possible by examining exteriorized monitoring flap and also donor site can be closed primarily. However possibility of false positive exists and technical caution and patient selection is needed because of danger of leakage.

두피에 생긴 광범위한 편평세포암의 수술적 치료로써 유리피판술의 증례

윤지영(Jiyoung Yun),김은기(Eun Key Kim) 대한두개저학회 2013 대한두개저학회지 Vol.8 No.1

Wide excision of extensive sq cc in scalp often requires free flap for adequate coverage. Various flaps can be considered depending on the size of the defect, donor site morbidity, or surgeon preferences etc. Here we report a case of extensive squamous cell carcinoma in scalp initially covered with free LD flap, which eventually required a free VRAM flap with wide skin paddle after severe atrophy of muscle portion probably due to adjuvant radiation. 51 year-old female was diagnosed SCC on three fourths of scalp. After wide excision, LD free flap was performed to cover the defect. After three months later, SCC was reccured on the skull, so artificial bone graft was performed with partial elevation of the previous LD flap. The patient underwent adjuvant radiation and developed a few events of infection afterwards. Infection finally subsided but artificial bone was exposed at thinned LD muscle portion. Finally a free VRAM flap covered the defect. There was no significant complication such as flap necrosis or fat necrosis. The VRAM flap was well maintained throughout the follow-up period. Postoperative radiotherapy could cause severe atrophy of a muscle flap and a thin muscle flap like LD might even develop full thickness defect. In such situation a MC flap with larger skin peddle and small muscle flap such as TRAM or VRAM would be a better option than a MC flap with small skin paddle and thin wide muscle such as LD.

비전형적인 심하복벽동맥의 주행을 파악하기 위한 수술 전 CT Angiography의 유용성

이택종,김성찬,엄진섭,김은기,Lee, Taek-Jong,Kim, Sung-Chan,Eom, Jin-Sup,Kim, Eun-Key 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.1

Purpose: Purpose: The free deep inferior epigastric artery perforator (DIEP) flap is a popular option for autologous breast reconstruction. However, the anatomy of the deep inferior epigastric artery(DIEA) may vary from one individual to another. Unexpected vascular anomaly can confuse the surgeon and affects on the safety of the free DIEP flap. Materials and Methods: Thirty five consecutive patients who underwent free DIEP/TRAM flap for immediate breast reconstruction between Mar. 2010 and Oct. 2010 were enrolled in this study. Computed tomography angiography (CT angiography) of abdomen was evaluated part of our standard preoperative assessment: atypical patterns of DIEA/DIEP were evaluated by preoperative CT angiography and compared with intraoperative finding. Results: Atypical patterns of DIEA/DIEP which may affect preoperative planning were noted as the following: Circummusclar/subfascial DIEA (n=1), DIEA running underneath rectus muscle (n=8), septocutaneous perforator (n=3), peritoneo-cutaneous perforator (n=1), a large branch going into peritoneum (n=1), and very early division and muscle penetration of DIEA (n=1). Conclusion: Atypical DIEA/DIEP that might change the operation plan is not rare, so the individualized planning based on the preoperative CT angiography is recommended. Preoperative CT angiography could help to select reliable and easy-to-dissect perforator in free DIEP/TRAM breast reconstruction.

少腹逐瘀湯의 效能에 關한 實驗的 硏究

金恩基,張峻福,李京燮,宋炳基 慶熙大學校 1995 論文集 Vol.24 No.-

This experiment was performed on analgesic, anti-pyretic, sedative, anti-swelling, anti-thrombotic, anti-tumor effect and response of isolated uterus by administrating high and low concentration of Sopokchukeotang's hot-water-extract to experimental animals. This administration purpose to investigate the efficacy of the Sopokchukeotang which is known as having effects on treating female genital diseases on basis of oriental medicine literature and its clinical use. The results obtained were as follows: 1. The writhing syndrome induced by acetic acid was decreased by administration of the Sopokchukeotang's hot-water-extract. However, there was no statistical significance between sample and control group. 2. The administration of the Sopokchukeotang's hot-water-extract elevated the pain threshold significantly by on hindpaw edema induced by 1% carrageenin in rat. 3. Abnormally elevated body temperature induced by thyphoid vaccine was decreased by the administration of the Sopokchukeotang's hot-water-extract. But, there was no statistical significance. 4. Sleeping time induced by Pentobarbital-sodium was prolonged by the administration of the Sopokchukeotang's hot-water-extract. However significant effect was recognized only in the treated by low concentration group(p<0.05). 5. The significant decrease of swelling induced by carrageenin was noted in the group treated by high concentration(p<0.05, p<0.01). 6. The group treated by low concentration showed significant anti-swelling effect on the swellings induced by yeast, but not in the group treated by high concentration didn't show it(p<0.05). 7. The serum FDP was decreased significantly by administrating the Sopokchukeotang's hot-water-extract to the experimental thrombosis(p<0.05, p<0.01). 8. The serum fibrinogen was increased significant by the administration of the Sopokchukeotang's hot-water-extract on the experimental thrombosis(p<0.01, p<0.001). 9. The prothrombin time was not influenced by the adminstration of the Sopokchukeotang's hot-water-extract on the experimental thrombosis. 10. The administration of the Sopokchukeotang's hot-water-extract did riot make a prolongation the survival in Saroma 180 ascitic tumor implanted Rats. 11. The administration of the Sopokchukeotang's hot-water-extract had no effect on the normal movement of the isolated uterus. However, it showed the relaxation effect on the oxytocin induced muscle contraction of the isolated uterus. According to the above results, it might be recognized that the Sopokchukeotang's hot-water-extract has the effect of analgesia, anti-pyrexia, sedation, anti-swelling, anti-thrombosis and relaxation effect on the oxytocin induced contraction of uterus muscle. However, anti-tumor effect of Sopokchukeotang's hot-water-extract was not appeared in the experiments. According to the above results. Sopokchukeotang's not-water-extract can be applied on the various inflammatory diseases in female genital organs.

水蛭, 맹충, 斑猫가 姙娠에 미치는 影響

宋炳基,李京燮,金恩基 慶熙大學校韓醫科大學韓醫學硏究所 1996 慶熙韓醫大論文集 Vol.19 No.2

It is acknowledge that Hirudo, Tabanus and Mylabris are contraindicated drugs of pregnancy. The present work was done to investigate the influences of Hirudo, Tabanus, Mylabris on pregnancy. The extracted and condensed liquid of Hirudo, Tabanus and Mylabris were administered to experimental animals and the influences were evaluated on pregnant maintenance, corpus lutein functions and toxic action of kidney and liver during pregnancy. The result of this wors were summerized as follows: 1. The extracted and condensed liquid of Hirudo, Tabanus, and Mylabris was revealed action on the remarkable decrease of fertilized eggs, implantation in number. 2. When Hirudo, Tabanus, and Mylabris were administered the false-pregnant rabbit the decease of HCG was revealed. 3. The increase of GOT, GPT, BUN, ALP, creatinine, uric acid, urine protein was revealed, after Hirudo, Tabanus, Mylabris were administered to the false pregnant rabbit. According to the above results, it may be recognized that Hirudo, Tabanus, Mylabris obstruct pregnant maintenance and the functions of corpus lutein and give damage to kidney and liver during pregnancy.