다공성 폴리에틸렌판(Medpor)을 이용한 안와파열골절의 재건

유현욱,손대구,최동원,한기환 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.8

A retrospective study was performed on 64 patients who underwent orbital blow-out fracture reconstruction with autogenous or Medpor implant following blunt facial trauma between 1992 and 1997. Hospital records were reviewed especially for preoperative and postoperative diplopia, enopthalmos and extraocular muscle movement limitations between the autogenous material group and Medpor implant group. The autogenous material used was mostly conchal cartilage graft. The average follow-up period was 36 months with a range of 5 to 64 months. There was no significant statistical difference between both groups on incidence of postoperative complications of diplopia, enophthalmos and extraocular muscle movement limitations. Postoperative infection, ectropion, implant extrusion and migration were absent in both groups. The use of Medpor implant for orbital blow-out fracture reconstruction was associated with a low incidence of complication. In addition, the Medpor implant is readily available, easy to use, cut, contour, position, fixate and has no potential for graft resorption, and precludes the need to harvest an autogeneous graft. In conclusion, Medpor is a stable and reliable substitute for autogeneous graft reconstruction of the orbital blow-out fracture.

실리콘판과 실리콘접착제로 만든 비삽입물

한기환 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.1

Augmentation rhinoplasty now involves flat noses as well as saddle or deviated noses. Creation of an accurate nasal implant is critical for augmentation rhinoplasty in such cases. The author has devised a new method to create implants. First, an ideal nasal patters is made from a xeroradiogram of a profile of the face. A silicone sheet (0.06 inch in thickness) is then tailored to this pattern and mounted on a stone model of the patient's nasal impression. Silicone adhesive is squeezed onto both sides of the silicone sheet and cured. Finally a carving of the outer surface of the implant is done with a #11 blade. Consequently a nasal implant is composed of silicone sheet and silicone adhesive. The results of the clinical experience of augmentation rhinoplasty with this implant are as follows: 1. A shaping of the implant with the same angle and size of the preoperative design. 2. The undersurface of the implant has contact with the patient's nasal contour. 3. A smooth and natural curvature of the nose. 4. Easy carving because the implant is attached firmly to the stone model. 5. Preoperative discussion with the patient is possible. 6. A saving of operative time because the implant is perfectly shaped preoperatively 7. Less expense than other types of silicone implants. 8. The making of the implants is easier for inexperienced workers. 9. The disadvantages are that it is more time consuming and is a staged production

자가연골이식을 이용한 비첨성형술

박동만,송중원,강진성,한기환 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.4

Nasal tip projection is essential to good nasal aesthetics. As a rule, suturing the domes of the alar cartilages together or insertion of a silicone implant or cartilage graft on the nasal tip has been performed for nasal tip projection. Orientals have a bulbous nasal tip, a flaring nostril, and a small alar cartilage so the suture technique can't give satisfactory results. The implant has limitation in size for the use of nasal tip augmentation and can elicit tissue reaction resulting in the extrusion of the implant. To achieve a more natural tip and to prouce predictable and satisfactory nasal tip projections, through open rhinoplasty, we have performed combined techniques of approzymationg the alar cartilage and a multi-layered autogenous onlay cartilage graft on the tip harvested from the nasal septum or auricular concha in 17 patients with cleft lip-nose deformities, flat noses including bulbous tips, and post traumatic nasal deformities. In 7 of the 17 cases augmentation rhinoplasty with either a silicone implant or a calvarial bone graft was performed simultaneously. The follow-up intervals ranged from 5 to 23 months. The results, considered good to excellent by both patient and surgeon, are as follows ; 1. The average increase in nasal lengthening is 4.0㎜ and the columellar height is 3.4㎜ and the alat width was decreased by 3.4㎜ compaired to the presugical condition. 2. The changes of nasofacial angles and nasolabial angles were from 31.1 degrees to 34.7 degrees and from 91.5 degrees to 95.7 degrees, respectively. 3. The nasal index and inferior triangle index improved remarkably. The pre-and postoperative nasal indexes were 102.2 and 85.3, and the inferior triangle indexes were 262.8 and 194.7 4. Types of nostrils changed into typo Ⅱ in Farkas calssification and the inclination of the nostrils was 63.3 degrees which is Caucasian type. 5. With time, the nasolabial angle tended to be somewhat reduced and the nasal tip was slightly pointed. 6. The postoperative scar in Gilles' incision was less visible than Fruber's incision. 7. Postoperative complications were linear scars along the long alar rim incisiona in two cases and a minimal auticular deformity in 1 case where the total conchal artilage was harvested.

5年間 經驗한 顔面骨折의 臨床的 考察 : A 5-Year Survey

韓旗煥,李悳熙,河芝耘,李永吉,姜振聲 대한성형외과학회 1980 Archives of Plastic Surgery Vol.7 No.2

정신지체아 두발 중 중금속 함량 III - 수은과의 관련성 -

한기환,장봉기,박순우,김두희,Han, Ki-Hwan,Jang, Bong-Ki,Park, Soon-Woo,Kim, Doo-Hie 대한예방의학회 1989 Journal of Preventive Medicine and Public Health Vol.22 No.3

정신지체와 인체내 수은 함량과의 관련성을 보기 위해 정신지체아 297명(가정이 있는 아동이 다니는 특수학교 1개교의 132명과 고아로 구성된 특수학교의 165명)을 대상으로, 학업성적이 중위권 이상인 일반 국민학교 학생 117명을 대조군으로 하여 두발 중 수은 함량을 원자흡광광도계를 사용하여 측정, 비교해 보았다. 발 중 수은 함량의 연령에 따른 차이는 없었다. 정신지체아에서 대조군에 비해 두발 중 수은량이 유의하게 높았다(남자 지체아 : 3.02ppm, 남자대조군 : 2.20ppm, 여자 지체아 : 2.76ppm, 여자 대조군 : 2.02ppm). 가정이 없는 정신지체아의 경우 수은 함량이 날자가 3.27ppm, 여자가 3.04ppm으로써 대조군의 남자 2.20ppm, 여자가 2.02ppm에 비해 각각 통계학적으로 유의한 차이가 있었으며, 가정이 있는 정신지체아군은 남자가 2.76ppm, 여자가 2.31ppm으로써 남자는 대조군과 유의한 차이가 있었으나 여자는 대조군에 비해 수치는 다소 높았으나 통계학적 유의성은 없었다. 그리고 가정이 없는 정신지체아가 가정이 있는 경우에 비해 유의한 차이가 있었다. 그러나 정신지체 정도와 두발 중 수은 함량과는 유의한 차이가 없었다. 동반 질환은 Down씨 증후군, 전간, 뇌성마비, 자폐증 등이 있었으며, 남자의 경우에서는 Down씨 증후군과 뇌성마비를 동반한 경우, 여자에서는 Down씨 증후군과 자폐증을 동반한 경우에 대조군에 비해 통계학적으로 유의하게 높았다. 그리고 동반된 질환이 없는 경우가 대부분이나 이들고 대조군에 비해 유의하게 높았다. 동반된 장애유형은 언어장애가 40.4%로 가장 많았고 지체부자유, 정서장애의 순이며 중복장애자는 두발중 6ppm이 초과되는 6명중 66.7%, 3-6ppm군에서는 10.4%, 3ppm이하군에서는 15.7% 이었다. 본 연구의 결과로 볼 때 정신지체아군에서 수은에 노출될 기회가 더욱 많았을 것이며 이것이 정신지체의 한 인자로 작용했을 가능성을 배제할 수는 없을 것으로 추측된다. 이에 따라 이들의 생활공간에 대한 환경조사, 식생활 및 식습관 조사 등을 통해 정신지체와 수은과의 인과관계를 밝혀 나가야 할 것으로 생각된다. The relationship between mercury level of hair and mental retardation was investigated. The 297 subjects with mental retardation were drawn from two schools providing special educational services, one, consisted of children living in an orphan home, another, children with parents. The 117 centre] subjects were drawn from whom had got average or above average academic achivement in a regular elementary school. Hair sample were taken from the nape of the neck and the mercury analysis was carried out on an atomic absorption spectrophotometer(IL 551). There was no relationship between mercury contents and age, and there was a statistically significant difference in mercury contents between male and female in the mentally retarded children living with parents. Children in the retarded group had significantly higher mercury contents compared with control group except the female group with parents. Also, the mercury levels in the retarded group living in an orphan home were significantly higher than that of the retarded group with parents. The concomitant diseases were Down's syndrome, epilepsy, cerebral palsy and autism. There were statistically significant differences in hair mercury levels in the cases of accompanying Down's syndrome and cerebral palsy in male and Down's syndrome and autism in female compared with the control group of the same sex. The most accompanying handicap was speech disturbance(40.7%) and the others were crippled, emotional disturbance etc. The percentages of double handicap were 66.7% among 6 persons exceeding 6ppm of their hair mercury contents. 10.4% among $3{\sim}6$ ppm and 15.7% among the group of 3ppm or less. The findings of this study suggest that the more opportunities of exposure to mercury in mentally retarded children may have occurred, so it can not be excluded the possibility of mercury as a contributing factor to mental retardation. Therefore, the causal relationship between mercury levels and mental retardation should be established through the examinations about their living environments, dietary pattern, eating habit etc.

지질 및 지반기술사 교육 세션 : 양산단층지역의 지질 및 지구물리학적 연구

한기환,이철규,이강일,하성호,정희석 대한지질공학회 2015 대한지질공학회 학술발표회논문집 Vol.2015 No.1

굴 껍질을 이용한 도전성 폴리에틸렌 필름에 대한 연구

한기환,심용식,박정환,정미화,전병철,정용찬 한국고분자학회 2004 한국고분자학회 학술대회 연구논문 초록집 Vol.29 No.2

소아의 골에 부착시킨 실리콘 귀

강진성,손대구,한기환 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

Osseointegrated titanium implants and skin-penterating abutments placed in the upper portion of the mastoid mastoid process have been used in 2 pediatric patients who have hemifacial microsomia and in 1 for congenital microtia for the retention of silicone rubber auricular prostheses. The surgery was performed in one stage. During the procedure, implants made out of two commercially pure titanium are gently placed in the bone. The skin-penetrating abutments are placed in the implant, with subcutaneous tissue reduction aimed at reducing mobility between the implant and the skin. Two months after the operation, the healing has normally reached the point at which the prostheses can be made and attached to the implants. The follow-up time is still short and the number of implants too few for a firm conclusion that the one stage procedure is safe and reliable for pediatric patients. However, there has been no contact with the dura mater or the wall of the sigmoid sinus within the cortical shell of the mastoid process during the procedure. Neither adverse skin reaction around the penetration nor instability of the implant have been. The success of implants in children provides the possibility of early implant use, thereby reserving autogenous reconstruction. The surgical procedure as well as the fabrication of the prostheses is presented in detail.

사무소 건축물의 적적 급수량 산정을 위한 실태조사 연구 - 대전지역을 중심으로 -

한기환,김희권,조병선 대한건축학회지회연합회 2002 대한건축학회연합논문집 Vol.3 No.4

잇몸과다노출미소의 새로운 교정 방법: 상순거근봉양술

한기환,박병주 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.3

For decades, many surgical techniques have been devised for correction of the gummy smile including mucosal resection, myectomy, the implant spacer technique, and osseous shortening of the alveolar-maxillary complex in case of vertical maxillary excess. However there are several problems in those techniques: the mucosal resection and the myectomy tends to recur, there would be the morbidity of the implant in the implant spacer technique, and the osseous shortening of the alveolar-maxillary complex is a procedure for the long face syndrome. Our technique is freeing the levator labii suprioris muscles and cinching them to the anteroinferior nasal septal cartilage for loss of muscle action. Seventeen patients(14 females and 3 males; mean age, 24 years) underwent operations. Preoperative photogrammetric analysis indicated the range of gum exposure when smiling was 2.0-9.0mm(mean, 3.8mm) and the maxillary lip length in repose was 17.0-29.0mm(mean, 23.1mm). Three to 31 months(mean, 12 months) after the operation, the results were analysed using the Wilcoxon signed ranks test. The postoperative gum exposure was ranged 0.0-4.0mm(mean, 0.4mm) (-3.4mm, p<0.05). And the maxillary lip length was elongated about 4%(+1.0 mm, p<0.05). Results were also analyzed clinically by the ordinary scale method. The gum exposure when smiling was excellent and the nature of the smile was good. Upper lip stiffness developed in all patients, but resolved completely within 1 month after the operatio. Hypesthesia of the upper lip was noted in 8 cases, but also disappeared within 2 months. Additionally, this technique resulted in narrowing of the interalar distance. Our technique is effective in correcting a gummy smile, but would not be recommended for patients with an abnormally narrow interalar distance.