내측 족저부 감각 유리피판을 이용한 조직결손 재건술

이훈범,탁관철,Lee, Hoon-Bum,Tark, Kwan-Chul 대한미세수술학회 1994 Archives of reconstructive microsurgery Vol.3 No.1

Pulp and palm of the hand and heel of the sole are anatomically unique. Satisfactory reconstruction of these areas presents the plastic surgeon with many challenges and requires durable and sensible skin coverage, minimal donor morbidity and reliable operative procedure. We presents 7 clinical cases of sensate instep free flap transfer in this paper during the last 2 years. Three cases were soft tissue defects due to crushing and avulsion injury on the pulp of finger. 1 case was unstable scar and redundant flap after reconstruction of soft tissue dect of palm and 1 case was contracture of first web of hand. One case was a soft tissue defect due to avulsion injury on heel. Lastly, one case was chronic osteomyelitis with open wound on lateral malleolar area. Follow-up period ranged from 3 months to 2 years. Through the whole follow-up period, all flaps were viable and durable to persistant stress or weight bearing and were sensible enough to porotect the recocstructed area from injuries and maintain functions. In conclusions, the instep free flap should be considered as a valuable tool in reconstruction of hand and extremity requiring durability and sensation.

검색 기능을 지원하는 SMIL 플레이어의 개발

이훈범(Hoon-Bum Lee),백인구(In-Gu Baek),한기준(Ki-Joon Han) 한국정보과학회 2000 한국정보과학회 학술발표논문집 Vol.27 No.2Ⅰ

현대 사회는 웹이라는 것을 통하여 수많은 정보들을 얻을 수 있으며 시간과 공간을 초월하고 있다. 이러한 정보들 가운데 이미지, 동영상, 오디오, 텍스트 등을 실시간으로 동시에 제공받는 것은 아직도 웹 상에서는 한계가 있다. 이러한 한계를 극복하기 위해 W3C(World Wide Web Consortium)에서 XML 어플리케이션의 하나로서 SMIL(Synchronized Multimedia Integration Language)이란 표준화한 방안과 기술을 개발하였고, 이러한 표준화된 SMIL을 바탕으로 기존의 디지털 T.V, VOD, 웹 상에서의 멀티미디어 프리젠테이션 등과 같은 분야와 연계하고자 하는 연구가 활발히 진행되고 있다. 그러나, 리얼시스템사의 G2나 애플사의 QuickTime과 같은 SMIL을 지원하는 상용 플레이어들을 비롯한 기존의 다양한 SMIL 플레이어에는 SMIL 문서를 검색할 수 있는 해결책을 제시하지 못하고 있다. 현재와 같은 기하급수적인 웹의 발전은 기본적인 웹의 기능 외에 웹에 대한 다양한 검색 기능이 제공되면서부터 이며 웹의 이러한 발전 과정을 미뤄 볼 때 SMIL 또한 이러한 검색 기능의 제공은 필수적이라 할 수 있다. 그러므로, 본 논문에서는 기존의 SMIL 플레이어들이 지원하지 못했던 검색 기능을 지원하기 위해 SMIL에서 의미를 가지는 엘리먼트와 컨텐트를 가지고 인덱스를 구축하고, 또한 이를 이용하여 산재해 있는 SMIL 문서와 문서내의 미디어 객체 등에 대한 검색을 수행한 후 선별적으로 디스플레이할 수 있게 하는 검색 기능을 갖는 SMIL 플레이어를 설계 및 구현한다.

척골측 전완부 감각유리 피판술을 이용한 요도협착의 치료

허재영,이훈범,탁관철,Hur, Jae-Young,Lee, Hoon-Bum,Tark, Kwan-Chul 대한미세수술학회 2001 Archives of reconstructive microsurgery Vol.10 No.2

In the treatment of urethral stricture, many problems still remain with the current methods making it a field of further exploration for reconstructive surgeon. Furthermore, when total or multiple strictures of the penile urethra exist, the methods of surgery become difficult due to a necessity for a long neourethra. Introduction of vascularized free flap has broadened the choice and improved the results of reconstruction for the urethra. The authors used a sensate ulnar forearm free flap in a patient with multiple penile urethral strictures for reconstruction. Uroflowmetry, 30 months after surgery, revealed that maximal flow rate was 15.5 ml/sec, average flow rate was 9.5 ml/sec, and voided volume was 157 ml. A urethrogram was performed 30 months postoperatively and a good result was achieved. The ulnar forearm free flap used by the authors are thin and pliable and is good for providing sufficient length to reconstruct the neourethra for a long urethral defect.

확장된 박근 유리 피판을 이용한 족관절 및 족배부 연부조직 결손의 치유

김석원,김광섭,서동완,이훈범,정윤규,Kim, Sug Won,Kim, Kwang Seop,Seo, Dong Wan,Lee, Hoon Bum,Chung, Yoon Kyu 대한미세수술학회 2000 Archives of reconstructive microsurgery Vol.9 No.2

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

생비골 유리 피판술을 이용한 수부의 복합조직 결손의 재건

탁관철,강상윤,박윤규,이훈범,박병윤,Tark, Kwan-Chul,Kang, Sang-Yoon,Park, Yun-Gyu,Lee, Hoon-Bum,Park, Beyoung-yun 대한미세수술학회 2000 Archives of reconstructive microsurgery Vol.9 No.1

The advent of free bone flaps has made successful replacement of extensive areas of bone loss in the upper and lower extremities. The microvascular free bone flaps have faster healing without bony absorption or atrophy and can heal in the hostile environment of scarred bed or infection. Since the fibula free flap introduced by Taylor and colleague in 1975, it has been used extensively for skeletal reconstruction of extremities. In 1988, the folded vascularized fibula free flap was first described as a technique to reconstruct significant long bone defect of upper and lower extremities. During the same time, the fibular free flap has evolved to become most preferred choice of mandibular reconstruction. Up to present day, few reports have been made on the fibular free flap used for reconstruction of injured hand containing metacarpal bone and soft tissue defect. We present here our new and unique experiences with vascularized fibular osteocutaneous free flap as useful and satisfactory one for reconstruction of hand with composite defects.

백서 피부에서 스테로이드 및 비스테로이드 소염진통제가 급성 창상 치유 및 콜라겐 형성에 미치는 영향

한창동(Chang Dong Han),이환모(Whan Mo Lee),이훈범(Hun Bum Lee),한명훈(Myung Hoon Hahn),유환욱(Whan Wook Yu) 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.4

피부절제기 ( dermatome ) 를 이용한 Thin Split - thickness Skin Graft에 의한 백반증의 치료

조한경 ( Han Kyoubg Cho ),한승경 ( Seung Kyung Hann ),이훈범 ( Hoon Bum Lee ),조성환 ( Sung Hwan Cho ),박윤기 ( Yoon Kee Park ) 대한피부과학회 1996 대한피부과학회지 Vol.34 No.5

Vitiligo is a common aquired progressive leukoderma. Various procedures have been employed for those patients not responsive to medical therapy. Split-thickness skin grafting(STSG) has been used for the treatment of vitiligo for over three decades, but it did not gain popularity as it had some postoperative complications. We employed improved methods to three selected stable, nonprogressive vitiligo patients, And we evaluated its effectiveness, complications. All patients showed good attachment and repigmentation. Observed complications were uneven surface and hyperpigmentation of recipient site and milium on donor site. This method can be an the alternative treatment for patients with stable type of vitiligo. (Kor J Dermatol 1998;34(5): 756-761)

복직근 및 박근 근피판술을 이용한 골반 및 서혜부 연부조직 결손의 재건

이재화,정윤규,김주봉,유대현,황성관,이훈범,김석원 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Many operations for the reconstruction of the pelvic area have been studied until now. The local muscle flap is often used for the closure of these complex wound. But, these local muscle flaps may not be available for reconstruction due to the factors of infection, radiation, and surgical trauma. Since rectus abdominis muscle and gracilis muscle were introduced, their use has been steadily increased for the reconstruction of soft tissue defect of the pelvic area. Inferiorly based rectus abdominis muscle flap and the gracilis muscle flap have been adopted for well-vascularized soft tissue coverage of the defect of pelvis and groin area. These techniques were utilized in seven patients. Of these patients, rectus abdominis muscle flap was used on four patients and three patients were treated with gracilis muscle flap. Among these, chronic osteomyelitis of pelvic bone has been managed with inferiorly based rectus abdominis muscle flap in three patients. No complication has been found. The mean postoperative follow-up period was 26 months, with a range of 12 to 39 months. In conclusion, these muscles are functionally expandable , and provide adequate tissue volume with sufficient blood supply away from the zone of injury, and readily transposed into the pelvis and groin area through subcutaneous tunnel, and serve as an antibiotic delivery system that aids in the eradication of infection. These findings suggest a reconstructive option for the defect of pelvis and groin, and/or bone infection in this area.

전박피판을 이용한 상지 및 하지의 재건

이상헌,나동균,이훈범 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.6

Yang Guofan(1978) and others were the first to report the fasciocutaneous forearm flap based on the radial and ulnar arteries. The combination of bone and nerve or the flap elevated as an island or free flap greatly increased its versatility and thus was used extensively in reconstructions of the head and neck, upper and iower extremity and penis. We used the forearm flap in upper(2 cases) and lower (5 cases) extremity reconstructions and obtained satisfactory results. In four cases, a saphenous vein graft was used to correct defects of the radial artery, and in two cases a reverse radial forearm flap and reverse ulnar forearm flap were used.

이중 K강선을 이용한 불안정한 관골궁 분절골절의 교정

박병윤,유대현,이훈범 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.6

Among the different types of facial bone fractures, Zygomatic fractures are the second highest occurring type of fractures. The Zygomatic fracture usually involves fracture of its' arch. The Zygomatic arch has the important role of not only maintaining the facial aesthetics and the shape of the temporal area but also helps in maintaining the anterior posterior diameter of facial bone in cases of frequently encountered comminuted facial bone fractures. Thus an inaccurate reduction of zygomatic arch leads to an undercorrection and results in asymmetry or depression of zygomatic area. A Majority of zygomatic arch fracture is treated by closed reduction methods such as Gillies or Dingman method. It also possible to treat this condition by restricting the movement of mastication and preventing the external forces. However, there have been cases where the arch segment has been displaced to become a floating arch. In such cases the open reduction has been utilized in order to obtain an accurate reduction. We have devised a new fixation method for this type of zygomatic arch fracture by using two K-wires avoiding the extensive open reduction. The method involves first K-wire to be inserted into the stable zygomatic bone, then exposed portion of that wire is bent in about 90 angle in direction parallel to the zygomatic arch. second K-wire is then inserted into the unstable zygomatic arch segment and fixate onto the first K-wire. Our experience using the double K-wire method has shown remarkable results in fixation of unstable zygomatic arch segment prevent undercorrection. We feel this method provides a safer viable option to riskier open reduction techniques.