• 제목/요약/키워드: Skin defects

검색결과 382건 처리시간 0.029초

Ehlers-Danlos syndrome 환아의 맹출장애 : 증례보고 (DENTAL MANAGEMENT ASSOCIATED WITH ERUPTION DISORDERS IN A PATIENT WITH EHLERS-DANLOS SYNDROME : A CASE REPORT)

  • 진달래;김종철;이상훈;김정욱;김영재;현홍근;신터전;장기택
    • 대한장애인치과학회지
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    • 제8권2호
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    • pp.127-133
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    • 2012
  • EDS는 관절의 과운동성, 피부의 과신장, 조직 약화 등을 임상적 특징으로 하는 유전 질환이다. 피부, 골격, 근육, 인대, 점막, 혈관 등을 구성하는 교원질의 합성 과정과 관련된 유전자의 결함으로 결합조직이 비정상적으로 변하므로 신체 전반에 걸쳐 그 증상이 나타난다. 구강 영역에서도 교원 질과 관련된 조직에 영향을 받게 된다. 구강 점막, 치주 조직, 측두하악관절 및 치아 경조직에 문제가 발생할 수 있으므로, 총체적이고 정기적인 구강관리가 이루어져야 한다. 이번 증례와 같이 EDS에 의해 치아의 맹출 장애가 발생하고, 치은비대, 유착, 매복, 선천적 결손치, 부정교합 등이 관찰되는 경우에도 구강 위생 관리와 함께 장기적인 계획 하에 맹출 관리 및 치료가 요구된다. EDS 환아의 치과 치료시에는 질환의 원인과 전신적 특징에 대한 이해를 바탕으로, 비정상적 교원질 대사에 의해 약화된 점막과 치주조직, 지혈 관리, 반흔 형성 및 측두하악관절에 대한 종합적인 고려와 지속적인 관리가 필요하다.

복합재 격자 구조 비파괴평가를 위한 초음파전파 영상화 시스템 활용 연구 (Study on Application of Ultrasonic Propagation Imager for Non-destructive Evaluation of Composite Lattice Structure)

  • 박재윤;신혜진;이정률
    • Composites Research
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    • 제30권6호
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    • pp.356-364
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    • 2017
  • 복합재 격자 구조는 동일한 무게를 갖는 다른 구조에 비해 더 큰 하중을 견딜 수 있다는 장점으로 인해 다양한 분야에 적용이 시도되고 있다. 최근, 국내에서도 복합재 격자 구조 제작을 위한 기술 개발이 이루어지고 있으며 이에 복합재 격자 구조를 빠르고 정밀하게 검사할 수 있는 비파괴검사 기술의 개발 역시 필요하게 되었다. 본 논문에서는 초음파전파 영상화 시스템들을 활용하여 복합재 격자 구조에 빠르고 정밀한 비파괴검사를 하기 위한 연구를 수행하였다. 레이저 펄스에코 초음파전파 영상화 시스템을 통해 스킨에 쌓여 있는 복합재 격자 구조의 내부 리브 구조를 관찰할 수 있었고 접착분리를 검출할 수 있는 가능성을 확인하였다. 또한 검사시간을 줄이기 위해 주파수 영역을 최적화 하기 위한 밴드 디바이더를 개발 적용하였으며, 검사 결과의 질을 향상시키기 위해 곡률 보상 알고리즘을 개발하였다. 유도파 초음파전파 영상화 시스템으로는 리브 구조에 있는 층간분리 결함을 확인할 수 있었으며, 다중 소스 초음파전파영상을 통해 검사 영역을 확대시켰고 가변시간창 진폭 이미지 알고리즘을 통해 결함을 강조시킬 수 있도록 했다. 이와 같은 결과들을 통해 격자구조에 최적화 된 초음파전파 영상화 시스템의 지속적인 개발이 이뤄지면 복합재 격자 구조의 대량생산에 이은 고속 정밀 비파괴검사가 이뤄질 수 있을 것으로 판단된다.

미세수술을 이용한 하지 재건술 (Reconstruction of the Lower Extremity with the Microsurgical Technique)

  • 한수봉;전창훈
    • Archives of Reconstructive Microsurgery
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    • 제3권1호
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    • pp.32-39
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    • 1994
  • 본 연세대학교 의과대학 정형외과학교실에서는 1982년에서 1989년 사이에 모두 160건의 미세수술기법을 이용한 하지 재건술을 시행하였다. 이들중 남자가 96건, 여자가 64건이었으며 이들의 평균연령은 23.8세이고, 약 21.4개월의 치유 관찰기간을 두었다. 원인으로는 교통사고가 118건, 종양이 18건, 작업장손상이 12건, 화상 5건, 폭발사고가 2건이며 기타 9건이었다. 이중 견갑피판이식이 55건, 서혜부피판이식이 35건, 유리 혈관부착 골피판이식이 23건, 견갑피판이식이 18건, 견갑부 및 광배근 복합피판이 9건, 분절절제술 및 회전재접합술이 8건이었다. 모두 134건에서 성공적인 치유를 경험하였으며, 기능 및 외관에서 모두 좋은 성적을 거두었다. 유리 혈관부착 골피판을 이용한 미세수술적 하지재건술을 광범위한 골결손과 손상 신경재건 및 여러차례의 재건술이 필요한 경우에 좋은 적응증이 되며 이러한 미세수술적 하지재건술은 광범위한 골결손과 손상신경재건 및 여러차례의 재건술이 필요한 경우에 좋은 적응증이 되며 이러한 점에서 상기기법으로 한번의 재건술이라는 장점을 지닌다.

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상피세포 피복 인공기관의 개발 (Artificial Trachea Covered by Ipithelium)

  • 김광택;이윤신
    • Journal of Chest Surgery
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    • 제30권8호
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    • pp.739-746
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    • 1997
  • 기관결손을 대체할 이장적인 보철물을 개발하려는 다양한 실험연구가 있었다. 인공기관보철물의 조건으로 는 공기에 비투과성, 적이지 않는 형태의 안전성, 생체내에서 섬 유아세포의 증식과 상피세포 재생에 필요한 생체적합성이 요구된다. 생체적합성이 우수한 포리우레탄 소재의 다공성포리우레탄 튜브에 gelatin으로 도포하고 isoplastic고리를 보강하여 외경 20 m길이 30 m의 인공기관보철물을 제작하였다. 인공기관의 생체적합성과 상피세포재생을 촉진하기위해 콜라겐 물질인 gelatin을 감마선으로 고정하여 도포하였다. 인공기관보철물을 잡종성견 10마리를 대상으로 경흉부기관에 이식하였다. 실험군에서는 다공성 폴리머에 gelatin으로 피복한 인공기관을 이식하였고 대조군에서는 gelatin으로 피복하지않은 인공기관과 ,다공성 폴리머에 gelatin을 피복한 기관에 자가심장 편을 접합시킨 것을 이식하여 실험하였다. 다공성 폴리머에 gelatin피복한 기관과 자가심낭편을 접합한 기관 을 이식한 후 6주째에 인공기관 내면에 상피화가 관찰되었다. gelatin 피복한 기관을 대상으로 외번문합과 내 문합을 비교한 결과 외번문합에서 문합부의 육아종 협착이 더 심하게 생겼다. 심낭편을 접착한 기관에서는 문합부와 접착부에 감염과 염증이 있었다. 본 실험결과 다공성포리우레탄 튜브에 gelatin을 도포한 인공기관 보철물은 상피재생과 생체적합성이 우수하며 재질개선과 문합부의 협착을 막는 연구보완이 되면 임상적용 을 기대 할수 있다.

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소아기에 발현한 C형 Niemann Pick 병 1례 (A Case of Childhood-Onset Niemann Pick Type C Disease)

  • 정지원;서고훈;오아름;진희경;배재성;김구환;유한욱;이범희
    • 대한유전성대사질환학회지
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    • 제18권1호
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    • pp.30-34
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    • 2018
  • C형 Niemann-Pick 병은 NPC1 및 NPC2 유전자의 돌연변이로 인해 발생하며 상염색체 열성으로 유전된다. 신생아 간염 및 간비비대로 발현하며 안구의 수직운동 마비, 조화운동불능, 근육긴장이상, 경련 등의 신경학적 증상이 서서히 발현 하는 것을 특징으로 한다. 저자들은 복부 팽만 및 심한 비장비대로 입원한 3세 남아에서 간 조직 검사 및 유전자 검사, 섬유모세포의 Filipin 염색으로 확진 된 C형 Niemann-Pick 병 1례를 보고하는 바이다.

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Research on the Multi-electrode Plasma Discharge for the Large Area PECVD Processing

  • Lee, Yun-Seong;You, Dae-Ho;Seol, You-Bin
    • 한국진공학회:학술대회논문집
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    • 한국진공학회 2012년도 제42회 동계 정기 학술대회 초록집
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    • pp.478-478
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    • 2012
  • Recently, there are many researches in order to increase the deposition rate (D/R) and improve film uniformity and quality in the deposition of microcrystalline silicon thin film. These two factors are the most important issues in the fabrication of the thin film solar cell, and for the purpose of that, several process conditions, including the large area electrode (more than 1.1 X 1.3 (m2)), higher pressure (1 ~ 10 (Torr)), and very high frequency regime (VHF, 40 ~ 100 (MHz)), have been needed. But, in the case of large-area capacitively coupled discharges (CCP) driven at frequencies higher than the usual RF (13.56 (MHz)) frequency, the standing wave and skin effects should be the critical problems for obtaining the good plasma uniformity, and the ion damage on the thin film layer due to the high voltage between the substrate and the bulk plasma might cause the defects which degrade the film quality. In this study, we will propose the new concept of the large-area multi-electrode (a new multi-electrode concept for the large-area plasma source), which consists of a series of electrodes and grounds arranged by turns. The experimental results with this new electrode showed the processing performances of high D/R (1 ~ 2 (nm/sec)), controllable crystallinity (~70% and controllable), and good uniformity (less than 10%) at the conditions of the relatively high frequency of 40 MHz in the large-area electrode of 280 X 540 mm2. And, we also observed the SEM images of the deposited thin film at the conditions of peeling, normal microcrystalline, and powder formation, and discussed the mechanisms of the crystal formation and voids generation in the film in order to try the enhancement of the film quality compared to the cases of normal VHF capacitive discharges. Also, we will discuss the relation between the processing parameters (including gap length between electrode and substrate, operating pressure) and the processing results (D/R and crystallinity) with the process condition map for ${\mu}c$-Si:H formation at a fixed input power and gas flow rate. Finally, we will discuss the potential of the multi-electrode of the 3.5G-class large-area plasma processing (650 X 550 (mm2) to the possibility of the expansion of the new electrode concept to 8G class large-area plasma processing and the additional issues in order to improve the process efficiency.

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악교정수술환자에서 폴리메틸메터크릴레이트(아테콜$^{(R)}$) 주입을 통한 융비술 (PMMA MICROSPHERES (ARTECOLL$^{(R)}$) INJECTION FOR NASAL RIDGE AUGMENTATION IN THE ORTHOGNATHIC SURGERY)

  • 옥용주;김명진;팽준영;명훈;황순정;최진영;이종호;정필훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권4호
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    • pp.329-334
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    • 2005
  • Polymethyl-methacrylate(PMMA; Artecoll$^{(R)}$) microspheres suspended 1 : 3 in a 3.5% collagen solution has been used as an injectable implant for long lasting correction of wrinkles and minor skin defects. The patients with mandibular prognathism have increased necessity for nasal augmentation. Usually these patients usually get an additional rhinoplasty after orthognathic surgery. The purpose of this study is to evaluate the result of PMMA injection for nasal ridge augmentation simultaneously with the orthognathic surgery. PMMAs were injected to the nasal dorsum of 13 patients with mandibular prognathism to augment the nasal ridge at the end of the orthognathic surgery. The cephalometric X-ray and clinical facial photograph were taken at 2, 4 and 6 months after operation. Using S-N line, we calculated the change of soft tisuue on the nasal ridge and also investigated the degree of patients satisfaction at 6 months after operation. Most of the patients were satisfied with their nasal ridge height status from moderate to good degree. The average amount of nasal ridge augmentation was $1.4{\pm}0.5$ mm immediately after operation, $1.2{\pm}0.4$ mm at 2 months after operation. The postoperative nasal ridge height seemed to be remained stable after 2 months. Intraoperative PMMA injection is considered to be simple and effective technique which can be used for the minor augmentation of nasal ridge in the orthognathic patients.

흰쥐의 감염된 전층피부결손에 미치는 은 함유 드레싱제재와 폴리우레탄 폼 드레싱제재의 비교관찰 (Comparative Study of Acticoat® & Allevyn® on Infected Full-thickness Wound of the Rat Skin)

  • 곡낙수;김한구;김승홍;김우섭;배태희;김미경
    • Archives of Plastic Surgery
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    • 제34권2호
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    • pp.169-175
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    • 2007
  • Purpose: $Allevyn^{(R)}$(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. $Acticoat^{(R)}$(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, $Acticoat^{(R)}$ and $Allevyn^{(R)}$ on infected full-thickness wound healing in rat. Methods: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with $Allevyn^{(R)}$, n=40), group III(dressing with $Acticoat^{(R)}$, n=40). A $15{\times}15mm$ square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. Results: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. Conclusion: $Acticoat^{(R)}$ is an effective tool in the treatment of infected wound.

구강암과 구인두암의 절제술 후 전완유리피판술을 이용한 재건술 (Reconstruction with Radial Forearm Free Flap after Ablative Surgery for Oral Cavity and Oropharyngeal Cancers)

  • 조광재;천병준;선동일;조승호;김민식
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.41-46
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    • 2003
  • Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性) (National Survey of Injury and Poisoning on a Representative Sample Population of Koreans)

  • 김정순;김성수;장성칠
    • Journal of Preventive Medicine and Public Health
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    • 제27권3호
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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