유아의 하악골에 발생한 비골원성 섬유종의 치험례

공봉택,김응춘,서인석,하지운 한림대학교의료원 1989 人間科學 Vol.13 No.10

3차원 전산화 단층촬영술을 이용한 안구돌출증의 외과적 치료의 평가에 관한 연구

공봉택,최희윤 한양대학교 의과대학 1995 한양의대 학술지 Vol.15 No.1

이상에서, 저자는 성형용 인조점토을 채워서 측정한 안와용적의 실측치에대한 3-D CT를 이용한 영상계측치의 정확도를 검증한 바, 0.95%와 1.36%차이만을 보이므로 영상계측치를 실측치로 간주해도 무방하며, 나아가 임상적용의 일환으로 3차원 전산화 단층촬영에의한 측정치를 안구돌출증환자에게 적용시켜 술전, 술후 평가지표를 얻음으로써, 수술후 호전된 외과적 치료효과를 보다 객관적으로 평가할 수 있었고, 수술전 상태를 미리 파악할 수 있어서 술전계획은 물론 술식응용에도 매우 유용하였다. 더불어 앞으로 안와이외에 다른 부위의 변형에도 적용할 수 있을 것으로 사료되며, 특히 인접 구조물의 밀도가 비슷하여 영상에서의 경계가 불분명한 부위도 적용할 수 있게되기를 기대해 본다. Computer software enabling three-dimensional(3-D) image to be produced from a series of conventioal CT sections has been developed and usefully applied to the complex bony structure like an orbit for three-dimensional reformatting and measuing the orbital volume, and so on. Since the high accuracy of measurements using 3-D CT and computer to real measurements has reported, has been emphasized recenly the valueof 3-D CT scanning in the evaluation of surgical correction of orbital deformities such an exophthalmos due to disease or cosmetics purely. In this study, we compared the measurements using 3-D CT scanning with real measurements of the orbital volume in artificial skull carefully and were informed that 3-D CT measurements could be regarded as real measurement, thus providing an oppotunity for improved treatment plan, procedure, and prudential evaluations before and after operation. Following results were obtained. 1. Volume % differences of bony orbit between real measurement and using 3-D CT scanning were 1.36% difference in the left orbit and 0.95% difference in the right orbit. 2. Applied to clinical cases with exophthalmos, the preoperative volume of 12 operated orbits was 23.7cc in average(17.9-27.2cc), the postoperative volume was 27.0cc in average(21.4-29.8cc) and the expanded volume of the bony orbit was 3.4cc average(2.6-4.9cc) with 3-wall expansion and 1.8cc with lateral wall expansion. Total reducing effect was estimated by adding the increases orbital volume to the removed fat volume and it was 4.65cc in average(2.8-7.4cc) which showed 19.9% decompression effect in average(10.3-32.9%). As a result, the improvement in exophthalmometer was 3.5mm in average(2.0-7.0mm).

Preauturing Technique을 이용한 피부결손의 직접 재건술

공봉택,김응춘,서인석,하지운 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.2

According to the increase of skin defects by accident and operation for malignant skin disease, congenital giant nevus, and acquired skin lesions, reconstruction methods take a growing interest in plastic and reconstructive surgeon or others. Especially new techniques such as tissue expander by Neumann, Radovan and Austad, ISLE by Sasakin and presuturing by Liang et al., have developed through the animal experiments, cadaveric studies and clinical experiences, because various biomechnical properties of skin have studied extensively since 1960. We ve obtained good results in 13 patients who had a large skin defect with aiding of presuturing technique which may have otherwise required a skin graft or flap. This technique is based on biomechnical properties of skin which allow skin to stretch beond its inherent extensibility and practiced by Marc D. Liang, et.al.So, we are willing to report the practical results with review of the literatures for presuturing technique and its mechanism.

선천성 EARLOBE 기형의 치험례

하지운,공봉택,박규남,서인석 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.2

The earlobe cleft may be divided into congenital and traumatic types. The congenital earlobe cleft is rare and less common than the traumatic cleft. Congenital earlobe cleft shows various shapes and that can be classified according to the location and shapes. Yamada classified the cleft according to the location, anterior, posteior and double lobe type. On the contrary, Kitayama classified the cleft according to the shapes, longitudinal, transverse, triple and defective type. The methods of repair are selected depending on the types and shapes, and the important thing is to make a round lobar shape without decreasing the amount of tissue by geometric operative clesign. We have experienced 9 cases of congenital earlobe clefts which had various shapes, 3 longitudinal types, 2 transverse types, 2 double lobe types and 2 defective types. We used Z-plasites for the correction of most of the double lobes, longitudinal and transverse type, square flap for longitudinal, anterior type which have shortage of earlobe tissue, and the two flaps for defective type earlobe, and simple closure in selective case. The result was good and satisfactory without complications.

안검 변형 및 결손의 재건술

조세홈,공봉택,이효련 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4

It is very hard to obtain accurate reconstruction in eyelid defects & deformities. Eyelid has special function and anatomy, so we should restore original function and anatomy. We choose appropriate operation for reconstruction of eyelid defect & defomity according to age, size of defect, severity of deformity, degree of functional defect. A total 51 of patients were reviewed from Aug. 1987 to Mar.1994.Mean follow up period was 13 months The classification was as follow:neoplasm excision:2, trauma:31, burn scar contracture:5, cicatrical contracture:2,congenital:1 The operative method:skin graft:15,composite graft: 17, transposition flap:8, tissue expander:4,advancement flap:4, Mustarde's flap:4, Tenzel flap:2, Limberg flap:2,eye brow island flap:1. Complications were recurence of ectropion: 6,partial necrosis:1, flap bulkiness: 1,infection:1 The purpose of our study was to achieve anatomic configuration, adequate tissue supplement, appropriate operation according to age, preventive method for ectropion especially in old age, symmetric correction and adequte functional recovery.

수지간 반흔구축을 동반한 화상성 합지증에 대한 임상적 연구

오석준,공봉택,서인석,하지운 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.4

It would seem to be true that a burn injury, especially a hand burn, is one of the most miserable disasters one can aquire. Burnt hands are apt to bring about many sequelae from simple disfigurement and deformity to severe functional dis-ability, although many excellent surgeons offer their endless efforts to treat these disabilities. The author reviewed and analyzed 97 patients of post-burn syndactyly with interdigital scar contracture, who were operated on with numerous surgical procedures and followed up at the Department of Plastic and Reconstructive Surgery in Hallym University from January 1982 to December 1989. The following results were obtained: 1)The most common cause of hand burns was a scalding burn in 33 cases(35%), next was a steam burn(25%), contact burn(20%) and a flame burn(13%) in that order. 2)Males(59.8%) were affected more often than females(40.2%) in the ratio 1.5: 1 and the most frequently affected age was from 7 months to 2 years, being 40.2% of the burn cases. 3)The frequency of postburn syndactyly in each web space was as follows: the second(35.0%), the third(31.3%), the fourth(27.0%), and the first (6.7%)in that order. 4)The time interval between the burn injury and any operative procedures is 3.0 years on an average, and age group for which operative procedures were most commonly used was the age from 2 to 5 years. 5)The most common type of surgical procedure was release and grafting (76%), and next was Z-plasty(18%), rotational flap(3%) and Y-V/V-M plasty(3%) in that order. 6)The initial management of burnt hands were performed at the home(43%), next at a small general hospital(36%), and a few(20%) at the hand care unit with specialized medical personnel and equipment.