비골 골절 형태의 입체적 분석에 있어 3D 영상과 비교한 단순방사선영상 및 2D CT 영상의 정확도

한동길,김태섭,박대환,심정수,이용직,Han, Dong Gil,Kim, Tae Seob,Park, David Dae Hwan,Shim, Jeong Su,Lee, Yong Jig 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2

Purpose: The nasal bone fracture is known as the most common facial fracture, with the postoperative results and the patient's satisfaction known to be lower than other facial fractures. The patient's satisfaction is firstly related to the accurate comprehension of the spatial relationship in the fractured nasal bone and secondly to the accurate reduction based on accurate comprehension. The aim of this study is to evaluate the objective usefulness of the three-dimensional (3D) imaging. Methods: The survey was conducted on 10 randomly selected cases of nasal bone fractures among the 46 cases with 3D computed tomography (CT) during the past one year. It was requested upon 4 plastic residents and 4 plastic surgeons to draw 3D aspect of fractured nasal bone directly on the printed photos of cadaver nasal bone, based on simple X-ray and two-dimensional (2D) CT. They were compared with the real fractured nasal bone aspects based on the 3D image and marked the difference in the 10-point scale of 0 to 10. Results: The average score of the 4 residents was 1.62 and that of the 4 surgeons was 4.47 out of 10 by simple X-ray. The average score of the 4 residents was 5.67 and that of the 4 surgeons was 7.25 out of 10 by 2D CT. Conclusion: It was surmised that the precise analysis and accurate comprehension of the spatial relationship of the fractured nasal bone using the 3D image, as based on the 2D CT images, can produce more favorable satisfaction levels in the patients.

기능성 복합운동법을 통한 만성요통자의 요부근력향상과 통증감소

한동길,이종원,구정완 대한인간공학회 2008 대한인간공학회 학술대회논문집 Vol.2008 No.10

본 연구는 만성 요통자를 대상으로 8 주간 기능성 복합운동 프로그램을 적용하여 대상자들의 주관적 통증의 감소와 요부 신전근력에 미치는 영향을 규명하고자 한다. 이를 위하여 서울특별시에 소재하는 M 휘트니스 센터에서 개인트레이닝을 요청한 회원들 중 3 개월 이상의 만성요통이 있는 회원(남:10 명, 여:10 명)들을 대상으로 실험을 하였다. 피실험자들을 복합운동군(실험군)과 단순운동군(대조군)으로 분류하여, 기능성 복합운동 프로그램(이하 복합운동)과 헬스기구를 사용한 운동(이하 단순운동)을 각각 적용하였다. 각각의 운동 프로그램 적용 전, 4 주 후, 8 주 후에 기능적 손 뻗음 정도, 요부척추신전근육의 근력 그리고 요통을 측정하였다. 기능적 손 뻗음 정도의 측정은 Functional reach test(FRT), 근력은 Medx lumbar extension machine(Medarex inc, Princeton, NJ, USA) 그리고, 통증 수준은 시각적 사상 척도(Visual Analog Scale ; VAS)를 이용하였다. 그 결과 단순운동군과 복합운동군 모두 통증을 완화시키고 기능적 손뻗음 정도와 요부근력을 향상시킨다는 결과가 도출되었으나(p<.05), 실험 기간 동안 운동 그룹 간에 유의한 차이를 발견할 수 없었다. 하지만 요부근력의 평가결과 단순운동군보다 복합운동군이 기간에 따른 향상도에서 유의한 의미를 발견할 수 있었다.(p<.05)

수지첨부 손상재건을 위한 수지부 역혈행성 도서형 피판술

한동길,안기영,박대환,Han, Dong-Gil,Ahn, Ki-Young,Park, Dae-Hwan 대한미세수술학회 1998 Archives of reconstructive microsurgery Vol.7 No.2

Reverse digital artery flaps were performed successfully to resurface the fingertip defect in 13 patients as noninnervated pattern and in 12 patients as innervated pattern from March 1993 to February 1996. No loss of flap in this series was noted. Refinements in flap design and surgical technique resulted in favourable functional and ethetic results. The average two-point discrimination of the reconstructed fingertip was 7.2mm and 4.5mm in the noninnervated and innervated flaps, respectively. This flap is an one of the ideal and reliable option for reconstruction of fingertip defects.

반나절 비강충전이 비골 골절 수술결과에 미치는 영향

한동길,김태섭,Han, Dong Gil,Kim, Tae Seob 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2

Purpose: Closed reduction and nasal packings for 3-7 days is usual procedures in managing nasal bone fracture. Most patients experience several discomfort owing to lack of nasal breathing. There are many reports concerning how to reduce patient's discomforts or complications. But it is obvious that the duration of nasal packing is 3-7 days. The aim of this study is evaluate the effect of half day nasal packing in results of nasal bone fracture. Methods: The study was performed on 97 nasal bone fracture patients who had simple nasal bone fractures from January to June 2012. The incidence, cause, patient's discomfort and satisfaction with half day nasal packing are analyzed according to patient's medical records and questionnaire at each nasal packing removal, postoperative 4 weeks. Results: Young male patients, especially the teenagers and the twenties were the common age group, and physical violence was most common cause of injury. A total of 78 out of 97 patients were male. In 92 cases, closed reduction were applied. Approximately, 87% of the patients were satisfied with the outcomes. Conclusion: Half day nasal packing is considered as an effective method to minimize patient's discomfort owing to prolonged absence of nasal breathing with maintenance of stability.

나이에 따른 안검의 생체계측치

박대환,송철홍,안기영,한동길 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.6

The extensive knowledge of accurate anatomical morphology and acceptable proportion of the eyelid and orbit should be needed for plastic surgeons. The normal morphological and functional values of eyelids and orbits are variable according to races, sex and ages, and there are a few articles concerning them in Korea yet. The author measured eigt items of morphological and functional values of eyelids in Koreans and statistically analyzed them in 498 individuals including 234 males and 264 females. We divided them into nine age-related groups and measured the values. Especially, we subdivided 10 to 19 year-old group into three subgroup concretely because most of the values in the 10 to 19 year-old group reach the peak level of growth. The mean values in adults were recorded as follows: The horizontal dimension of the palpebral fissure was 27.0 ± 1.8 mm in males and 26.8 ± 1,7 mm in females and the vertical dimension of the palpebral fissure was 8.0 ± 1.0 mm in female. The slant of the palpebral fissure was 7.9 ± 2.4 degrees in males and 8.8 ± 2.3 degrees in females and the height of the opened upper eyelid was 12.4 ± 2.4 mm in males and 12.0 ± 1.9 mm in females. The height of double fold in closed eye was 6.6 mm in males and 6.5 mm in femals and the intercanthal distance was 38.4 ± 3.0 mm in males and 38.2 ± 2.8 mm in females. The interpupillary distance was 64.6 ± 2.9 mm in males and 63.6 ± 2.9 mm in females. A double fold was seen in 36.1% of Korean. The average height of the double fold in closed eye was about 6.5 mm. The epicanthus present in 58.6% of Korean eyes and the most commom type was epicantus tarsalis. The growth of eyelids reached the peak level at teenager in a great portion. After the peak level, the changing pattern of eyelids could be divided into 3 groups; the first one was increasing more, the second was stationary, and the third was decreasing gradually. The peak levle of growth reached at 10 to 13- year-old in the vertical dimension of the palpebral fissure, at 14 to 16-year-old in the intercanthal distance, at 17 to 19-year-old in the horizontal dimension of the palpebral fissure.

내시경을 이용한 안저골절의 치료

안기영,박대환,이재욱,한동길 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.1

Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of fracture site, blind dissection of orbital floor. In order to address this shortcoming we have explored the use of endoscopic techniques in orbital floor dissection to allow direct visualization of incarcerated soft tissue and entire fracture components. We have applied this technique in9 clinical cases without complication. To accomplication. To accomplish this technique, a rigid 4mm, 30 degree down-angled endoscopy was inserted into not only the maxillary sinus but also the orbit. The operating field in the maxillary sinus was kept visually clear by infusing saline, fine suction and irrigation. Other surgical instruments used included a antrum trocar with cannula, smallforcep, rongeurs, Freer periosteal elevators, fine suction tip. The postoperative courses were satisfactory in all cases. The use of endoscope provided an expanded field of vision, direct manipulation of hemiated orbital soft tissue and allowed us to make the accurate realignment with exact replacement of orbital component.

눈 주위 근육 피판의 선택적 이용에 의한 안검하수의 교정 및 합병증

한동길,송철홍,장경수,박대환,이재욱,안기영 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.3

Eighty-three cases with severe blepharoptosis were treated by the superiorly based muscle flaps around eye including orbicularis oculi muscle, frontalis muscle, levator muscle. The selection of the muscle flaps were done in accordance with the levator function of patients. The orbicularis oculi muscle flap technique in 32 patients who have 2-5 mm levator function, 21 cases of the interdigitated orbicularis oculi-frontalis muscle flap for 1-3 mm levator function, frontalis muscle flap technique for less than 2 mm levator function, 22 cases of levator muscle resection for 2-8 mm levator function, 7 cases of levator plication for 5-9 mm levator function. The majority of patients recorded as satisfactory results. There has been no complete failure but there were 14 cases of undercorrection, 4 cases of overcorrection, 2 cases of exposure keratitis, 3 cases of corneal erosion, 2 cases of sensory loss, hematoma, loss of wrinkle and a few cases of eyelid deformity such as notching, entropion, fading or unnatural fold. The orbicularis oculi muscle technique or the interdigitated orbicularis oculi-frontalis muscle flap technique offers several advantages over conventional frontalis muscle flap technique such as being a simple with a good operative field, single incision on supratarsal fold, no depression on the forehead, no risk of neurovascular injury and relatively easy technique with less complication. The levator resection or levator plication could offer good results by careful selection of patients. In conclusion, we would like to say that the interdigitated frontalis orbicularis oculi muscle flap technique is best in cases with less than 2 mm levator function, orbicularis oculi muscle flap technique in 2-4 mm levator function, levator resection in 4-8 mm levator function, levator plication in more than 8mm levator function.

악안면골 골절에 대한 Conventional CT와 Three-dimensional CT간의 진단성적 비교

한동길,박대환 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.1

Despite advances in radiology-- including CT scanning --three-dimensional (3D)nature of facial bone fractures must be inferred by the spatial imagination of the physician. Thus, in order to assess the usefulness of 3D-CT,3D-CT reformations were obtained in 24 patients presenting with facial injuries of differing severity from 7.1993 to 5. 1995. The 3D images were compared with high resolution CT, including multiplanar reformations, and assessed under the headings of fracture detection, extent and displacement using a single scoring system. 3D was valuable in extensive facial fractures, providing a clear demonstration of fracture extent and fragment displacement. 3D was equally useful in the diagnosis of malar complies fractures and mandible fractures. However, 3D was much less useful in the diagnosis of orbital blow-out fractures and minor trauma, in which little or no fragment displacement had occurred, than conventional CT. In conclusion, when used as part of a high resolution CT examination, 3D imaging can provide useful information to surgeon in cases of severe facial trauma.

반가(班家)의 촬영시점을 중심으로 한 한국전통살림집 사진 표현에 관한 연구

한동길 ( Dong Kil Han ),김철현 ( Chul Hyun Kim ) 한국사진학회 2010 AURA Vol.0 No.22

Korean has taken western culture without condition as the modern society has changed rapidly. But we don`t care much about our traditional culture. This research was started to show the way how we understand the vanishing Korean traditional housing and express them in the form of pictures. A picture that is expressed by objective analysis about the architecture, insight and experience of a photographer is called photography of architecture. Now we record variety architecture in different purposes by photographing. These record need to have both objectivity and artistry. The photography has existed with us since it came from western hemisphere. It means that we have followed their standards in photography. It is different that we take a picture with good understanding our traditional architecture or not. It can be different that the feeling and analysis of a picture depend on how you record the life of today. In this respect, we need another standard in taking pictures of our traditional housing. Korean traditional houses were built and influenced by naturalism, feng shui, confucian ideas, and Buddhism etc. They have unique culture with Gu-deul which is from the northern area and Ma-roo from the southern area together in one structure. Also they have front yards which are unoccupied by plants and the back yards with lots of trees and flowers. All the rooms are airy through the eaves naturally and inside the rooms have soft sunlight through window paper. For the above mentioned statements, it can be helpful to take a picture of Korean traditional housing with objectivity and artistry by analyzing the point of photographing in architectural, cultural, and environmental.

좌골부 욕창의 치료

박대환,한동길,안기영 대구효성가톨릭대학교 1996 연구논문집 Vol.53 No.2

Ischial ulcers are the most common of all pressure ulcers, probably because they directly overlie the points of maximum pressure on the sitting surface. Furthermore, they are among the most common secondary ulcers for the same reason. Also, ischial ulcers are frequently complicated by abnormal lesional bursae, by extension, fistula toward the perineum, urethra, or peritoneal cavity. Urethrograms or panendoscopy are necessary prior to surgery and must remove all irreversibly damaged tissue. Consequently any surgical plan for ischial ulcers must take into account the effects of bone removal on weight bearing and positioning, and must provide stable, durable soft tissue cover intelligently designed to be reliable in the event of a recurrence. From April 1990 to April 1993, we had reconstructed 15 cases of ischial ulcers. In 13 cases of primary ulcers, inferior gluteil thigh flip (7 case), transpositin flap(2 case), ischiectomy and direct closure (3 cases), gluteus maximus myocutaneous island flap(1 case) was done. In 2 cases of secondary ulcers, V-Y advancement flap of biceps femoris and semitendinosus and gracillis muscle flap were done each other.