안면 피부의 나이에 따른 변화에 대한 형태학적 연구

송중원,강대영 대한병리학회 1993 Journal of Pathology and Translational Medicine Vol.27 No.4

족관절 골절 형태에 따른 조기 재활의 임상결과

송중원,이호승,서상교,류창현,Song, Joong Won,Lee, Ho Seong,Seo, Sang Gyo,Ryu, Chang Hyun 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.1

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

횡문근육종의 미세형태학적 변화

송중원,전광수,곽정식,조태환 慶北大學校 醫科大學 1985 慶北醫大誌 Vol.26 No.1

저자들은 횡문근육종의 미세구조의 변화를 관찰하여 종양세포 근섬유의 형성과정과 진단적 의의가 있는 초미형태학적 변화를 규명하기 위해 5례의 횡문근육종을 전자현미경적으로 관찰하였으며 그 결과를 요약하면 다음과 같다. 횡문근육종 세포들은 근섬유를 함유한 세포들과 함유하지 않은 세포들로 구별되었다. 근섬유를 함유한 세포들은 당원과립과 mitochondria가 풍부하였으며 actin, intermediate filament, myosin이 소량으로 불규칙하게 배열된 것으로 부터 불완전한 Z-line을 형성한 세포들까지 분화의 정도가 다양하였다. 근섬유를 함유하지 않은 세포들은 mitochondria, RER, Golgi장치가 잘 발달되었으며 당원과립이 풍부하였고 지방적이 나타나 있었다. 그리고 이들 세포의 일부에서 국소적으로 직경 약 20nm의 myosin이 발견되었다. 이상의 소견으로 보아 원시간질세포에서 횡문근육종세포로 분화될 때 myosin이 먼저 형성될 것으로 생각되며 따라서 미분화된 종양세포에서 myosin의 확인은 횡문근육종의 진단에 도움을 주는 소견으로 생각된다. The authors studied ultrastructures of the rhabdomyosarocoma cells to clarify the process of development of myofibrils and to find out the structures which had diagnostic value. Five cases of human rhabdomyosarcoma of variable types were examined by light and eletron microscopes. The results obtained were summarized as follow: Most of the tumor cells had myofibrils, but some tumor cells did not have. These tumor cells having myofibrils showed plenty glycogen particles and mitochondria. The degree of differentiation of myofibrils was variable from those composed of irregularly arranged actin, intermediate filament and myosin to those composed of well organized fibrils including Z-line. The tumor cells which did not contain myofibril showed well developed Golgi complexes, plenty mitochondria, rough ER, glycogen particles, and lipid droplets. Some myosin filaments measuring 20nm in diameter, were found in these cells. The results suggested that myosin would be appeared in early stage of differentiation of rhabdomyosarcoma cells from primitive mesenchymal cells. And detection of myosin in undifferentiated mesenchymal tumor could be diagnosed as rhabdomyosarcoma.

전두사골 수막뇌류 및 Saethre-Chotzen증후군에 의한 안와격리증의 치험

송중원,한기환,박성근,강진성 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2

본 교실에서는 전두사골 수막뇌류에 의한 안와격리증 2례는 두개내 접근으로 수막뇌류 절제술을 실시함과 동시에 두 개외 접근으로 안와내벽 및 외벽 절골술로써 교정하였으며 Saethre-Chotzen 후군에 의한 1례는 두개골 성형술과 U형 절골술로 교정하여 비교적 만족할 만한 결과를 얻을 수 있었기에 보고하는 바이다. The authors experienced two cases of mild hypertelorism with frontoethmoidal meningoencephalocele and one with Saethre-Chotzen syndrome. The first and second cases, which had nasofrontal and nasoethmoidal meningoencephalocele respectively, were corrected by resection of the meningoencephalocele, repair of the dura, and calvarial bone graft intracranially, and combined medial and lateral orbital wall osteotomy with augmentation rhinoplasty with calvarial bone grafts extracranially. To stabilize the orbital contents medially, a split osteotomy of the lateral orbital wall and interpositional bone graft were done in order to avoid step deformity of the lateral orbital rim. The third case, Saethre-Chotzen syndrome characterized brachycephaly, hypertelorism, ptosis of the eye lid, maxillary hypoplasia, lower set frontral hair line, and partial cutaneous syndactyly was corrected by a Modified Marchac technique for remodelling the forehead and a subcranial U-osteotomy for mild hypertelorism. Maxillary hypoplasia was corrected effectively by advancement on the medial portion of the U-shaped bony segment. Augmentaton rhinoplasty with calvarial bone graft and chip bone grafts on the anterior nasal spine was done simultaneously. A large amount of nasal bone grafts in two cases were absorbed, and then augmentation rhinoplasty using silicone implant was performed after 6 months, 12 months respectively. In mild hypertelorism with associated deformity, a extranial osteotomy with augmentation rhinoplasty and correction of associated deformities can offer good aesthetic results.

대흉근 근피판으로 큰 안면부결손을 치료한 경험

송중원,강진성 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.4

The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoralis major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commisure and the other is after resection of a huge fibrous mass and destructed facial bones caused by chronic osteomyelitis.

원위기적 표재성 비복동맥 도서형 근막피판을 이용한 족부 재건

송중원,최동원 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

The human foot plays an important role in supporting the body when standing and walking. Soft tissue defects caused industrially or by car accidents may expose small joints and tendonds of the foot, therefore, reconstruction for proper coverage is very important. However, large soft tissue defect on the foot presents a challenging task due to poor circulation and lack choice for reconstruction for large soft tissue defects on the foot. Nevertheless, free flaps for the lower extremities continue to have the highest failure rates compared to other body regions. The distally based superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The artery gives off small branches to the skin in the lower two thirds of the leg. The artery anastomoses with septocutaneous branches from the peroneal artery. The advantages of this flap are as follows: 1. Easy and quick performance 2. More reliable blood sup fascia is included in the flap 3. Large flaps may be raised safely and the flaps are versatile 4. The arc of rotation is wide, therefore the flap may cover the nonweightbearing heel, Achilles tendon, malleoli, dorsum ankle, and weightbearing heel The authors have successfully elevaated 10 distally based superficial sural artery island flaps in reconstructing the soft tissue defect on the weightbearing heel, ankle, dorsum and nonweightbearing heel. The size of the flap ranged from 5×4cm to 12×7cm. All donor site defects were closed directly except 2 cases. The distally based superficial sural artery fasciocutaneous island flap appears to be an easy and useful alternative for reconstruction of the foot in selected patients.

대흉근 근피판으로 큰 안면결손을 치료한 경험

송중원(Joong Won Song),이동훈(Dong Hoon Lee),강진성(Jin Sung Kang) 대한두경부종양학회 1986 대한두경부 종양학회지 Vol.2 No.1

The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoral.is major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commissure and the other is after resection of a hugε fibrous mass and destructed facial bones caused by chronic osteomyelitis.

한국인 귀의 생체계측치

강진성,송중원 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.4

The role of ears on the face and head has major functional and cosmetic aspects. Because of its delicady and complexity, to describe the ear adequately is very difficult but accurate surface measurements of normal Korean ears are essential for surgeons, faced with the necessity of partial or complete construction of anomalous Korean ears. For this reason anthropometry of normal Korean ears is needed. The authors measured the size of the auricle, the location and level of the auricle and the inclination and protrusion of the ear. The authors also studied the type of the lobule and the posterior view of the helix. The study comprised 1,012 healthy koreans from birth to adult, including 507 males and 505 females. Statistical analysis of these results offers chronological growth development of the size of the ears and valuable information about the geography and the shape of healthy Korean ears. The results area as follows; A: Size of ears 1. Mean values and standard errors in adults. a: Length of ears in males 64.5±4.9mm and females 59.1±2.8mm. b: Width of ears in male 33.4±1.6mm and females 32.7±2.1mm. 2. Auricular index in males 52, females 55. B: Geography of ears (Mean vealues for adults) 1. Ear location a. Index in males 50 and females 48. 2. Ear level a. index: In males 58 and females 60. b. Upper edge of the ears: 80%, at the lateral point of the eyebrow. Lower edge of the ears: 70%, at the lower edge of the nasal ala. c.Level of porion to Leiber test: Normal 99.5% 3. Inclination: In males 17˚±5˚ and females 16˚±5˚ 4. Protrusion: In males 28˚±13˚ and females 27˚±12˚ C: Shape of posterior view of the helix Inclined inward; the most common 45% Shape of lobule Round, or round & flat; the most common 25%, and 24% respectively.

Le Fort l과 Ⅱ절골술을 이용한 Binder증후군의 치험

강진성,한기환,김승한,송중원 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.3

The authors have had satisfactory results in two cases of binder's syndrome by using a combined Le Fort I and II osteotomy with a calvarial bone graft in the nasal dorsum and perinasal fossa. A combined Le Fort I δ II osteotomy was performed through paranasal and buccal vestibular incisions. We were able with a Le Fort I advancement to convert a class III occlusion to a normal occlusion and a Le Fort II advancement to correct the nasomaxillary hypoplasia without disrupting the dental arch. The paranasal incision, which remained inconspicous, had several advantages, not only is the Le Fort II osteotomy and augmentation of the nasal dorsum and lateral wall, more easily performed, but also through a V-Y advancement, the shortage of soft nasal tissue is eliminated. However, we observed a marked resorption of the nasal bone graft due to excessive skin tension on the nasal dorsum, so consequently, a secondary augmentation with a silicone implant was needed.

액취증에 대한 피하지방층 삭제술 중 수공법과 Inaba법의 비교

오두종,한기환,강진성,송중원 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.1

Various surgical methods for the treatment of osmidrosis have been descirbed for many years. Two basic types can be identified : one method that removes skin and subcutaneous tissue altogether : the other method that removes only subcutaneous tissue without removal of skin. The former had problems such as prolonged healing, scar formation, restriction of shoulder movement, and incomplete cure, so the latter has become a better solution in surgical treatment of osmidrosis because it leaves more favorable scars and excellent results. The authors compared the two surgical methods which remove the apocrine and eccrine glands without removal of skin : One is a manual method where two incision lines parallel to skin crease are made in the axilla and the underneath of the skin is removed by scissors, and another is Inaba's method wgere one small incision line is made in the axilla and the underneath of the skin is removed by subcutaneous tissue shaver. Comparative studies were made grossly and microscopically. The authors reviewed 15 patients who were treated by the manual method in right axilla and inaba's method in the left axilla from April 1988 to October 1989. They were 10 females and 5 males with the mean age of 22years. Follow up studies were carried out for at least one and half years up to 3 years after the operation. The results were as follows : 1. The operation time was 14 minutes shorter in Inaba's method. 2. There were no significant differences in hair growth, sweating and histologic findings. 3. The scar was more inconspicuous in Inaba's method than in manual method. 4. All the patients were satisfied with the results : no recurrence of odor, good wound healing and favorable scars. In summary, we have obtained excellent results in both methods but the Inaba's method is simpler and easier, leaves more inconspicuous scar and saves time.