광주전남지역 정상신생아의 상부 구순 계측치와 형태에 대한 연구

조안영,양정열,이승찬,천지선 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background and objectives : The face is the one of the most variable parts of the body and characterized not only by separated part but also by interrelation of the parts. Especially, in the case of bilateral cleft lip and palate, compared with unilateral case, it is necessary to establish the facial anthropometry in newborns, because of current trend of early intervention, such as fetal surgery, lip adhesion, and nasoalveolar molding device. Millard presented the concept of rotation advancement for unilateral cleft lip repair, and, thesedays, this method of cleft lip closure is acknowledged as the most optimal principle. However, it can produce a scar that crosses the upper one third of the philtrum obliquely. The purpose of this study is to determine the configuration of the vermillion tubercle, the Cupid's bow, and the philtrum, and to suppose that which anthropometric data and proportional index could be significant to determine the configulation of the philtrum in case of bilateral cleft lip and other deformity, which can't identify the philtral shape. Materials and Methods : 74 newborn infants, who were full-term normal infant In Gwangju-Jeonnam area were examined from April to June 2003. Mean gestational ages were 39 weeks. Mean birth weight was 3.3 Kg. Five anthropometric data, which were base of columella to tubercle, nasal base to Cupid's bow peak, Cupid's bow to commissure, philtrum, peak to peak, and mouth width were measured. And the proportional indexes of each data were evaluated. Morphologic parameter, which were the shape of vermillion tubercle, the Cupid's bow, the philtrum, were analized. Results : Mean values of five anthropometric data were 14.1±2.2, 10.5±2.7, 16.5±2.5, 6.9±1.8, and 26.7±4.9 each. And the one of these, Philtral width, peak to peak, and 7 proportional indexes which were ①/④, ②/④, ③/④, ⑤/④, ④/③, ④/②, ④/① have a significance according to 3 types of the philtral shape. The most common shape of vermillion tubercle is protrusion type (89.2%), and that of Cupid's bow is normal type (52.7) and that of philtrum is parallel from nostril base to vermilion border (70.7%). Conclusion : My study supplies the plastic surgeon and others with specialized interests in the craniofacial surgical area with fundamental normative population data that will help them decide what IS abnormal. And corrective surgery of the face and cranium is becoming so precise that the techniques and data detailed in this paper are essential to its further development.

의료 서사로 본 소록도: 의료적 망탈리테 역사의 관점에서

조안영 한국의료윤리학회 2024 한국의료윤리학회지 Vol.27 No.1

출간된 소록도 환자들의 내러티브 탐구를 통해 그들의 망탈리테를 들여다보았다. 심전황의 『소록도 반세기』, 국립 소록도병원에서 발간한 소록도 구술자료집, 환자들의 수필과 소설, 외부 관찰자들이 소 록도를 소재로 쓴 문학작품들을 통해 의료영역에서 현재까지 유효한 정서와 그 배경, 역사적 맥락을 살 펴보았고, 이에 관한 의미와 제언을 첨언하는 방식으로 분석하였다. 정부에서 초청한 다미안 재단의 대 표로 소록도에서 1967년부터 5년간 근무한 벨기에 성형외과 의사, 반드루겐 부룩의 진술을 비롯해, 1979년 소록도의 역사를 처음 집대성한 심전황 환자의 글을 통해 당시의 의료와 관련된 내러티브들을 살펴볼 수 있었고, ‘의료조무원제도’와 ‘의학강습소’라는 제도가 소록도에 끼친 영향 등을 탐구하였다. 이를 토대로 ‘소록도’라는 한 단어 속에는 수많은 깊고, 높은 삶이 들어있다는 것을 이번 연구를 통해 다 시 확인하는 계기가 되었다. Sorokdo (‘Sorokdo’ is used as a proper noun instead of the Sorok Island) was explored by means of mentalité through the patients' narrative inquiry. Shim Jeon-hwang's "Sorokdo, Half-century", “Oral History series of Sorokdo” published by the Sorokdo National Hospital, Essays and Novels which were written by patients, and literature from external observers were used as materials to evaluate. The unique sentiment, background, and historical context that have been valid to these days in the clinical field were studied and the value, the consideration and the suggestion were added in this paper. The narratives related to medical care at the time through statements by a Belgian plastic surgeon, Van Droogenbroeck and Patient-historian, Shim Jeon-hwang were explored. As a representative of the Damian Foundation, Van Droogenbroeck was invited by the government. He had worked in clinical field as a official plastic surgeon for 5 years from 1967. As a patient of Sorokdo, Shim Jeon-whang wrote the compiling history of Sorokdo in 1979. The role and impact of the "Medical Assistance System" and "Medical Training Center" was considered.

골 이형성 소견을 보이는 양배추귀(Cauliflower Ear)에 대한 수술적 체험

천지선,양정열,김규보,조안영,이승찬 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

Acute auricular hematoma is a common problem in wrestlers, boxers and secondary to trauma such as traffic accident. Early intervention can be limited to simple incision and drainage. Delay in treatment may allow the growth of ectopic fibroneocartilage derived from the damaged perichondrium and it can subsequently cause the unsightly cauliflower ear. Few paper deal with histopathologic analysis of removed excess cartilage fragment. Usual findings are cartilagenous tissue surrounded by fibrous tissue with hemosiderin deposits or cicatrix and foci of cartilage formation. But this case shows degenerative cartilage with osseous metaplasia and it has a stony hard consistency and is clinically a rare disease. The ear cartilage were exposed anteriorly and posteriorly. The deformed cartilage and bony tissue were removed and shaved to restore a normal form. The elevated cutaneous flap was sutured and silastic drainage was applied. We described histopathologic finding and surgical treatment of cauliflower ear with osseous metaplasia.

안면부에 발생한 조직 기원 불명의 낭성병변과 섬유증식으로 구성된 종괴에 대한 치험례

이승찬,천지선,양정열,조안영 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

Unknown-natured cystic structures on face refers to a very rare tumor. We report a case of unknown-natured cystic structures on face in a 31 years old woman. She had complained palpable mass of left cheek for 5 years. Radiographically, a dense inhenced mass of left maxillary area showed mild protruding external surface without cortical destruction. The maximum diameter of mass was 3.5cm. Microscopically, the mass was composed of unknown-natured cystic structures devoid of lining cell and fibrosis of cystic wall. The mass was successfully removed via subciliary incision. No tumor recurrence has been reported during the follow-up period. We described surgical approach, MR imaging finding, histopathological and immunohistochemical findings of this tumor.

안면부 피부암 절제 후 발생한 결손 부위에 V-Y-S 피판을 이용한 재건술

김규보,천지선,이승찬,조안영,양정열 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.5

Purpose: There are many methods for the reconstruction of the facial defect after an excision of a skin cancer; such as skin graft, local flap, free flap, etc... Skin graft has its' limitations; it could remain in different color with in regards of the recipient to donor, with an unfavorable scar. Free flap can lead to big donor site morbidity with long operation time and uncontrolled scar as a disadvantage factor. Compared to the prior, local flap offers several merits; sufficient blood supply, good tissue quality and short operation time. We revised 'V-Y-S flap' for the facial defect, which proved to have favorable outcomes.Methods: Total 7 V-Y-S flaps were performed to patients with skin cancers(six squamous cell carcinoma and one basal cell carcinoma). Two of these flaps were combined with composite grafts, one with full thickness skin graft. Six patients were female and one male. The average diameter of defects after excision was 2.3cm. The follow-up period was 18 months maximally. Results: We treated seven facial skin cancers with 'V-Y-S flap'. There were no flap necrosis, cancer recurrence and scar contracture as a result. Furthermore, this method also offers a favorable central scar line that is parallel to the nasolabial fold and the nasojugal groove, especially in the nasolabial area and superomedial side of the cheek. With this method, we could cover a maximum diameter of 4cm facial defect. Conclusion: In conclusion, it is suggested that V-Y- S flap is a useful mehtod to cover facial defects after the excision of a skin cancer.