• 한국지역지리학회지
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• 제4권2호
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• pp.1-14
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• 1998

부산의 도시화에 관한 지리학적 논문은 그리 많지 않다. 그리고 도시화의 기본적인 패턴을 제시하고 있는 연구도 거의 없는 설정에 있다. 본 연구는 1970년부터 1994년까지외 교통량의 변화를 중심으로 부산시 도시화의 기본적인 패턴을 규명하고자 하는 것이다. 부산시는 동쪽과 남쪽에 해안을 두고 서쪽으로는 낙동강을 끼고 있으며, 서북쪽이 산지로 둘러싸인 배산임해(背山臨海)의 대상형(帶狀型) 지형이기 때문에, 교통량은 남북방향의 주간선도로인 중앙로에 집중되어 있다. 대량의 차량이 중앙로로 집중하여 도시 전체의 교통에 상당한 영향을 미치게 되고 간선도로의 원활한 운영은 부산시 교통문제의 큰 과제가 되고 있다. 이러한 남북체제에서 시간이 지남에 따라 이것을 보완하여 동서체계가 확립된다. 그러나 부산은 우리나라에서 최악의 도로율을 가지고 있는 도시로서 교통문제가 가장 심각한 도시 문제의 하나로 등장하고 있다. 교통량에 관한 지리학적 연구는 이러한 것을 해결하는데도 도움이 될 수 있을 것이다. 부산의 도시화는 하위계층의 중심지가 그 인근의 상위계층 중심지의 기능을 분담하면서 진행되고 있다. 시간이 지남에 따라서 지역간의 교통량의 차이가 점점 커지고 있다. 이것은 도시화가 진행되면서 도시내부의 계층구조가 더욱 뚜렷해 진다는 것을 말하는 것이다. 또한 도시화는 세포분열과 같은 진행과정을 거치면서 지역차가 커지고, 계층구조가 더욱 명백해지는 현상이라는 것을 나타내고 있다.

• Applied Microscopy
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• 제29권1호
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• pp.83-94
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• 1999

미세혈관 수술의 발달로 수지동맥의 재접합술이 성행함에 따라 혈관벽의 구조에 관한 연구들이 활발하지만 수지의 미세동맥과 모세혈관에 관한 연구는 드물다. 이에 저자는 흰쥐 수지의 충양근 안에 있는 미세동맥과 모세혈관의 구조를 전자현미경으로 관찰하여 보고하고자 한다. 1. 흰쥐 충양근 내의 미세동맥 (small arterioles)은 그 직경이 $12\sim20{\mu}m$로 중막이 한 층의 평활근세포로 구성된 종말소동맥 (terminal arteriole) 형태였는데 인체의 종말소동맥$(30\sim35{\mu}m)$에 비해 직경이 작았으며, 모세혈관은 직경이 $5\sim8{\mu}m$로 비슷하였다. 2. 모든 미세동맥 및 모세혈관의 내막을 구성하는 내피세포는 연속형 (continuous type)이었고, 따라서 전체 세포질내에 포음소포(pinocytic vesicles)가 많이 관찰되었다. 3. 모세혈관 주위에서 자주 혈관주위세포(pericytes)가 관찰되었는데 철관주위세포의 긴 들기가 내피세포의 일부를 싸는 경우도 많았으며 이들은 기저판에 의해 둘러싸여 있었다. 4. 내피세포들 사이에는 여러 가지 형태의 접촉이 있었으나 특히 폐쇄띠 (tight junction)를 가장 많이 관찰할 수 있었다. 미세동맥의 내피하층은 기저판 아래에서 매우 불규칙한 양상으로 나타났는데 곳곳에 내피세포와 중막을 구성하는 평활근세포의 막이 꽉 붙어 관찰되었다. 5. 미세동맥의 중막을 구성하는 한 층의 평활근세포의 세포질은 많은 filaments가 있어 균질성으로 보이는 균질성 영역 (homogeneous area)과 mitochondria, 조면내형질망, 골지복합체, polyribosome 등이 관찰되는 핵 주위의 비균질성 영역 (non-homogeneous area)으로 구분되었다. 6. 미세동맥의 외막은 섬유모세포의 아주 가느다란 돌기들로 형성되어 있었으며 군데군데 교원섬유들이 관찰되었다.

• 한국산학기술학회논문지
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• 제14권9호
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• pp.4313-4319
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• 2013

본 연구는 흑혈류영상 획득에서 고속스핀에코기법의 신호소실 현상을 이용하여 검사시간을 최소화시켜 환자의 불편을 줄이고 진단적 가치를 유지하고자 하였다. 연구방법은 흑혈류영상을 획득한 환자 32명을 대상으로, 기존의 이중역전회복기법과 새로운 기법인 고속스핀에코기법을 각각 적용한 후, 기법에 따른 혈류의 신호소거 차이를 알아보기 위해 T1, T2 강조영상에서 내경동맥 내강의 SNR과 CNR을 비교 평가하였다. 연구결과, SNR은 고속스핀에코기법이 이중역전회복기법 보다 T1, T2 강조영상에서 11.49%(4.73), 13.66%(6.03) 낮았으며, CNR은 고속스핀에코기법이 T1 강조영상에서 8.69%(15.04) 높았고, T2 강조영상에서 7.55% (13.17) 낮았으나, 통계적 수준에서 두 기법간의 SNR과 CNR의 차이는 유의하지 않았다. 그러므로 흑혈류영상 획득 시 고속스핀에코기법을 이용한다면 진단적 가치는 유지하면서 검사시간을 최소화하여 환자의 불편을 줄일 수 있다고 판단된다.

• 대한방사선기술학회지:방사선기술과학
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• 제27권2호
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• pp.7-12
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• 2004

MDCT는 비침습적인 방법으로 관상동맥 질환을 검사하는데 유용하다고 알려져 있다. 하지만 영상의 질에 있어서 환자의 심장박동이 결정적인 영향을 주게 된다. 특히 심장박동이 불규칙하거나 조기 심실수축 환자일 경우 영상을 재구성하는데 있어 왜곡 현상이 증가하여 진단에 어려움을 초래한다. 최근 본원에서 심장박동이 불규칙한 환자에서 영상 재구성시 불규칙한 R-R 간격을 조정한 후 얻은 영상이 artifact가 감소하는 현상을 경험한 바 있다. 따라서 본 연구에서는 다양한 교정 방법(disable, inesrt, R-R interval 교정)이 영상의 질에 어떤 영향이 있는지를 알아보고자 한다. 심박동이 불규칙한 24명의 환자에서 교정방법에 따라 영상을 재구성한 결과 R-R Interval 조정에서 통계학적으로 유의한 결과를 얻을 수 있었다(p<0.05). 본 연구에서는 R-R Interval 조정에서 가장 우수한 영상을 얻을 수 있었으며, 향후 심장 질환의 진단에 도움을 줄 수 있는 기초연구로서 그 가치가 충분하리라 사료된다.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.191-196
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• 2007

Purpose: Gluteal perforator is easily identified in the gluteal region and gluteal perforator flap is a very versatile flap in sacral sore reconstruction. We obtained satisfying results using the gluteal perforator flap, so we report this clinical experiences with a review of the literature. Methods: Between November of 2003 and April 2006, the authors used 16 gluteal perforator flaps in 16 consecutive patients for coverage of sacral pressure sores. The mean age of the patients was 47.4 years (range, 14 to 78 years), and there were 9 male and 7 female patients. All flaps in the series were supplied by musculocutaneous arteries and its venae comitantes penetrating the gluteus maximus muscle and reaching the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus arising from gluteal muscles. Patients were followed up for a mean period of 11.5 months. Results: All flaps survived except one that had undergone total necrosis by patient's negligence. Wound dehiscence was observed in three patients and treated by secondary closure. There was no recurrence during the follow-up period. Conclusion: Gluteal perforator flaps allow safe and reliable options for coverage of sacral pressure sores with minimal donor site morbidity, and do not sacrifice the gluteus maximus muscle and rarely lead to post-operative complications. Freedom in flap design and easy-to perform make gluteal perforator flap an excellent choice for selected patients.

• Archives of Plastic Surgery
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• 제34권1호
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• pp.52-59
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• 2007

Purpose: The venous flap is used as an alternative method to the standard free flap for the management of small and thin soft tissue defects. Especially, the venous flap has advantages of being thin, easy harvest and various donor sites, as well as it having lower morbidity. Yet their clinical applications have been limited by their unstable postoperative course and also by their complications such as partial necrosis. The aim of this study is to extend the clinical indications of venous flaps with using various methods. Methods: From May 2005 to March 2006, total of 19 patients(21 cases) underwent various venous flaps for soft tissue defects as a result of trauma(15 cases), facial skin cancer(3 cases), chronic ulcer(1 case) and surgical wound for congenital anomaly(2 cases). The arterialized venous free flap were applied in 18 cases, the pure venous free flap was applied in 1 case and the pure venous pedicled flap were applied in 2 cases. Among them, two flow-through arterialized venous free flaps were applied that used the great saphenous vein to reconstructed major arteries as well as the injured skin and soft tissues in the arm. All the flap were harvested from the volar wrist(11 cases), dorsum of foot(5 cases), thenar(2 cases), and medial thigh(3 cases). Results: The sizes of the flap ranged from $0.75cm^2$ to $264cm^2$(mean size: $40.06cm^2$). The follow-up period ranged from two to twelve months. In the majority of cases, we obtained satisfying results, which was the excellent reconstruction of skin and soft tissue defects and especially in the case of limb salvage, replantation and cancer reconstruction. However, there were 5 cases of partial necrosis and 2 cases of complete failure. The donor sites were closed primarily in 7 cases and wound closure with skin graft were in 14 cases. Conclusion: We conclude that the venous flap will not only be useful for reconstruction of small defect in the hand and foot, but also be useful for various other clinical indications.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.369-375
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• 2011

Purpose: Many hemostatic agents and dressings have been tested with variable degree of success. Chitosan has a positive charge, it attracts red blood cells, which have a negative charge. Our goal is to test the efficacy of new developed chitosan-based hemostatic materials in providing durable hemostasis in a high-flow arterial wound model. Methods: We compared each group with SD rats motality tests and in vitro blood compatibility test by blood clotting index (BCI). We devided the SD rats into 6 groups (N =15) by type of hemostatic agents. A: 100% nonwoven chitosan (degree of the deacetylation: 90%). B: 50% N-acetylation on nonwoven of chitosan gel (degree of the deacetylation: 50%). C: 60% N-acetylation on nonwoven of chitosan ge (degree of the deacetylation: 40%)l. D: Cutanplast$^{(R)}$. E: HemCon$^{(R)}$ F: Gauze. In vivo test, a proximal arterial injury was created in unilateral femoral arteries of 90 anesthetized SD rats. Each materials was made same size and thickness then applied to the injury site for 3 minutes. In vitro test, we compared each group with BCI in human blood. Results: In vivo test, group A showed lower motality rate of 46% than any other groups, Group B and C showed lower motality rate of 60% than group D and E's motality rate of 66%. In vitro test, BCI of group A ($30.6{\pm}1.2$) and B ($29.3{\pm}1.0$) were showed nearly about group D ($29.1{\pm}1.8$) and E ($27.4{\pm}1.6$). Group C ($37.1{\pm}2.0$) showed higher BCI than group A and B, it means group C decreased blood clotting. Conclusion: In conclusion, this study suggests a newly developed chitosan-based hemostatic materials induced durable hemostasis and increased blood clotting, and are considered as effective biologic hemostatic agents.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.391-395
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• 2010

Purpose: Given that the critical nature of the microvascular anastomosis to what is often a long and difficult reconstructive operation, trainees need to have a high level of microsurgical competence before being allowed to perform microsurgery on patients. Some artificial substitutes and dead or live animal models have been used to improve manual dexterity under the operating microscope. Yet, most surgeons are not equipped with such models, so search for easy available and appropriate microsurgical practice model have been an issue. Umbilical artery, placental vessels and gastroepiploic arteries have been previously suggested as a microsurgical training model, which involves other surgical departments. The purpose of this article is to introduce that saphenous vein specimen obtained from varicose vein surgery is useful and has many advantages as training model for the practice of microvascular anastomosis. Methods: The conventional technique using perforation/inversion method with a metallic stripper is widely performed for varicose vein patients. The stripper is inserted through disconnected safeno-femoral junction and retrieved at the knee or the medial side of ankle. The length of saphenous vein specimens removed is about that of one's leg and inversed from inside out. Obtained saphenous vein specimens are re-inversed and cleansed with normal saline, to be readily available for microsurgical practice. Preserved in a squeezed wet saline gauze and refrigerated, frozen or glycerated specimens were investigated into their comparative quality for microsurgical practice. Results: Varicose vein surgery remains one of the common operations performed in the field of plastic surgery. Convenient informed consent regarding the vessel donation can be easily signed. The diameter of the obtained saphenous vein is as variable as 1.5 to 6 mm, which is already stripped, and is in sufficient length corresponding to that of patient's leg. Vessels specimens were available for microsurgical practice within 1 week period when preserved with squeezed wet saline gauze, and the preservation period could be extended monthly by freezing it. Conclusion: Saphenous vein obtained from varicose vein patients provide with variable size of vessel lumen with sufficient length. The practice can be cost effective and does not require microsurgical laboratory. Additionally there is no need of involving other surgical departments in acquiring vessel specimens. Furthermore, simple preservation method of refrigerating for a week or freezing with squeezed wet saline gauze for a month period, allow the saphenous vein obtained after varicose vein surgery as an excellent model for the microsurgical practice.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.783-787
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• 2010

Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

• Journal of Chest Surgery
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• 제40권6호
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• pp.455-458
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• 2007

4개월 전 요추 4, 5번 추궁절제술을 시행받은 40세 남자환자가 호흡곤란과 하지부종을 주소로 내원하였다. 우측하복부에서 박동성 종괴가 촉진되었고 기계잡음이 청진되었다. 흉부단순촬영에서 심비대소견이 관찰되었고, 복부 전산화 단층촬영에서 제5요추 위치의 총장골동맥과 정맥간에 가성동맥류를 동반한 동정맥루가 존재하였다. 복부정중절개를 하여 동맥류를 통한 동정맥 누공의 일차봉합을 시도하여 상,하부 대동맥과 대정맥 감자결찰 후 동맥류를 절개하였으나 대량출혈이 발생하여 누공봉합에 실패한 후 동맥류를 봉합하였다. 동맥치환술로 수술계획을 변경한 후 동맥류에 연해있는 대동맥과 양측 총장골동맥을 절단봉합한 후, 인공도관을 이용하여 동맥을 재건하였고, 동맥류는 총장골정맥에 붙어있는 상태에서 축소성형술을 시행하였다. 환자는 수술 후 별다른 합병증 없이 8일째 퇴원하였고, 이후 별다른 문제없이 24개월간 추적관찰 중이다. 일반적으로 요추궁절제술 후 발생한 동정맥루에서는 누공봉합술을 시행하나 본 증례에서는 동맥치환술과 동맥류 축소성형술을 시행하였기에 문헌고찰과 함께 보고하는 바이다.