멀티빔 자료를 이용한 실체 소나 이미지 구현

정철훈(Chul-hoon Chung),김진후(Jin-hoo Kim),김동휘(Dong-hwi Kim),김성보(Sung-bo Kim) 한국마린엔지니어링학회 2006 한국마린엔지니어링학회 학술대회 논문집 Vol.2006 No.-

This paper describes how to generate stereoscopic sonar images by using multibeam data. Both parallel and crossing methods were used to create stereoscopic vision of the seafloor. Stereoscopic sonar images might provide reality and more detailed information of the target and the seafloor topography.

두경부 악성종양 환자에서 유리조직이식 후 시행한 혈류장애 구제술

장용준,정철훈,이종욱,조우성,김진환,노영수,Chang, Yong-Joon,Chung, Chul-Hoon,Lee, Jong-Wook,Joe, Woo-Sung,Kim, Jin-Hwan,Rho, Young-Soo 대한미세수술학회 2008 Archives of reconstructive microsurgery Vol.17 No.1

Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.

상악골절제술 후 유리피판을 이용한 안면중앙부 재건

김결희,정철훈,장용준,노영수,Kim, Kyul-Hee,Chung, Chul-Hoon,Chang, Yong-Joon,Rho, Young-Soo 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.5

Purpose: Maxillectomy for malignant tumor resection often leads to functional and aesthetic sequalae. Reconstruction following maxillectomy has been a challenging problem in the field of head and neck cancer surgery. In this article, we described three dimensional midface reconstructions using free flaps and their functional and aesthetic outcomes. Methods: We reconstructed 35 cases of maxillectomy defects using 9 radial forearm free flaps, 7 lattisimus dorsi musculocutaneous free flaps, 6 rectus abdominis musculocutaneous free flaps, 4 fibular osteocutaneous free flaps, and 9 anterolateral thigh free flaps, respectively. We classified post-maxillectomy defects by Brown's classification. 1 Articulation clarity was measured with picture consonant articulation test. Swallowing function was evaluated with the University of Washington quality-of-life Head and Neck questionnaire by 4 steps.2 Aesthetic outcomes were checked to compare preoperative with postoperative full face photographs by 5 medical doctors who did not involve in our operation. Results: The average articulation clarity was 92.4% (100-41.9%). 27 (81.9%) patients were able to eat an unrestricted diet. Aesthetic results were considered excellent in 18 patients (51.4%). Functional results were best in the group reconstructed with fibular osteocutaneous free flap. Considering the range of wide excision, aesthetic results is best in the group reconstructed with anterolateral thigh free flap. Conclusion: The free flap is a useful technique for the reconstruction of the midface leading to good results, both functionally and aesthetically. Especially, because osteocutaneous flap such as fibular osteocutaneous free flap offered bone source for osteointegrated implant, It produces the best functional results. And perforator flap like as anterolateral thigh free flap reliably provides the best aesthetic results, because it provides sufficient volume and has no postoperative volume diminution.

전두골에 발생한 호산구성육아종의 치험례

장용준(Yong Joon Chang),정철훈(Chul Hoon Chung),심승현(Seung Hyun Shim) 대한두경부종양학회 2010 대한두경부 종양학회지 Vol.26 No.2

Purpose :Eosinophilic granuloma is a rare benign tumor that is characterized histologically by the presence of destructive granulomas containing numerous Langerhans, cells. The most common presentation of eosino-philic granuloma is a painful, immobile scalp mass in the frontal and parietal bones occurring predominantly in children and adolescents or young adults. We report a representative case of eosinophilic granuloma. Meth -ods :A 16-year-old woman complained of an enlarging fixed scalp mass without pain and tenderness which mea-sured 3×4.5cm at the frontal area, which had been found incidentally 2 months before. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing oste-olytic lesion. The tumor and surrounding bony edges were completely removed via a bicoronal approach. The bony defect was reconstructed with bone cement. Results :The tumor was involved frontal bone and dura mater. We confirmed the tumor by the documentation of Birbeck’s granules by electron microscopy. There is no evidence of local recurrence during postoperative 1.5 years. Conclusion :The present case shows the characteristic fea-ture of frontal bone involvment of the eosinophilic granuloma. The prognosis of eosinophilic granuloma depend on age at diagnosis and number of bones involved. We consider that best choice of treatment for eosinophilic gra-nuloma is surgical excision.

이개유리피판을 이용한 비 결손부 재건

남동우,이종욱,범진식,장영철,정철훈,오석준,Nam, Dong-Woo,Lee, Jong-Wook,Burm, Jin-Sik,Chang, Young-Chul,Chung, Chul-Hoon,Oh, Suk-Joon 대한미세수술학회 1996 Archives of reconstructive microsurgery Vol.5 No.1

The nasal ala and columella represent a difficult location for reconstruction, especially when defect area is covered with scar. Local flap, such as forehead flap or nasolabial flap, may result in additional facial scarring and bulkiness that require multiple thinning revisions. Recent delineation of vascular territories of the ear has allowed the use of vascularized auricular free flap in the reconstruction of large ala and columella defects. Authors reconstructed two cases of full thickiness defect of the ala and columella with auricular free flap. The pedicle of this flap is the superficial temporal artery and vein. The donor vessels were anastomosed to the facial artery and vein. The results were satisfactory cosmetically and functionally.

유리피판을 이용한 설재건 후의 기능평가

박성호(Sung Ho Park),정철훈(Chul Hoon Chung),이종욱(Jong Wook Lee),장용준(Yong Joon Chang),노영수(Young Soo Rho) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.2

Objectives :Ablation of carcinoma of the tongue leads to deficits in speech and swallowing, but none to date has provided all of the qualities of mobility and sensation to simulate the complex function of the tongue. The au-thors evaluated postoperative swallowing and pronouncing function in patients who underwent tongue recon-struction using free flap. Material and Methods :This is a retrospective review documenting the outcome of 42 patients between January of 1991 and August of 2008. We classified patients according to the size of resection of the tongue like as 7 partial glossectomy, 25 hemiglossectomy, 2 subtotal glossectomy, and 8 total glossectomy. Swallowing function was graded into 4 point scale and pronouncing function was analyzed using picture con-sonant articulation test. Aspiration was evaluated with videofluoroscopic swallowing study. Results :The av-erage points for swallowing function were 3.43 in partial glossectomy, 3.52 in hemiglossectomy, 3 in subtotal glossectomy, and 2.63 in total glossectomy. The percentage of consonants correct showed 76.5% in partial glos-sectomy, 72.29% in hemiglossectomy, 47.69% in subtotal glossectomy, and 29.94% in total glossectomy. As-piration was noted in 3 patients(1 hemiglossectomy and 2 total glossectomy) and 2 total glossectomy patients were taken permanent feeding gastrostomy. Conclusion :Free flap gave us proper volume in tongue reconstruc-tion and showed good result in preserving swallowing function. Swallowing function difference according to the size of defect showed no statistical significance, whereas articulation function was shown to decrease in accuracy as the size of defect was larger.

이개 주변 악성종양의 광범위절제술 후 이개의 보존 2례

김창우(Chang Woo Kim),노영수(Young Soo Rho),이종욱(Jong Wook Lee),장용준(ong Joon Chang),정철훈(Chul Hoon Chung),김결희(Kyul Hee Kim) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.1

Wide excision for curative treatment of malignant tumor on periauricular area often leads to loss of the ex-ternal ear. But the auricle has rich vascular supply, Conservation of auricular contour is possible through salvage and engineering of remained auricular tissue. We experienced two cases of auricular salvage after wide excision of malignant tumor. In the first case, we performed two-staged technique. In first step, we covered soft tissue defect on periauricualr area with the anterolateral thigh free flap and remained auricle was floating over the flap after split-thickness skin graft was applied on it’s posterior raw surface because it's survival was not confirmed. Second step was reposition of remained auricule on the anterolateral thigh flap. In the second case, we packed in periauricular dead space and external auditory canal with temoporalis muscle and temporoparietal fascial flap and then covered the flap with split thickness skin graft. In these two cases, there were no recurrence of tumors and we obtained cosmetically & functionally satisfactory results.

다양한 방법을 이용한 전두부 두개골 재건술

이종욱,이동락,오석준,정철훈 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.1

Bone defects and deformities of forehead from acute trauma, sequelae of trauma, congenital anomalies, tumor resection can be reconstructed with autogenous bone graft, alloplastic material and sometimes bone remodeling. Each of these methods has advantages and disadvantages, so an adequate method for each case is to be selected. From January 1987 to February 1991, 8 cases in 7 patients with bone defects or deformities of forehead have been reconstructed with various methods : Four of 8 cases have been reconstructed with autogenous bone graft, 3 cases with methymethacrylate, 1 case by frontal bone repositioning and bone graft. Using the adequate method for each case, no serious complications have been encountered and we obtained satisfactory results in terms of contour of the forehead.

수부의 압궤상 또는 절단상 후의 무지대립기능 재건을 위한 건이행술

이종인,이동락,오석준,정철훈 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.1

Loss of opposition of the thumb consititutes a significant disability. Restoring opposition is one of the most important components in hand surgery. Opposition may be lost as a result of nerve injury, poliomyelitis or leprosy, peripheral neuritis, or loss of local tissue about the thumb. Many articles have been written on opponensplasty for the hand following nerve injury or nerve infection. Articles on opponensplasty of the hand after crushing or amputation injury are rare. This paper deals with opponensplasty for the hand secondary to crushing or amputation injury. We experienced thirteen patients who lost their opposition function. Six patients lost the ability of opposition of thumb due to crushing injury and seven patients due to amputation injury. We performed tendon transfer to restore opposition in 14 cases of 13 patients. Used motors were as follows : extensor carpi ulnaris in 5 cases, flexor digitorum superficials in 4 cases, extensor indicis proprius in 3 cases and flexor digitorum prefundus and palmaris longus in 1 case respectively. Satisfactory functions were restored in all but one case

창상치유를 위한 자가 표피이식술

안경식,범진식,정찬민,이종욱,오석준,정철훈 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.3

Application of epidermal grafting to the raw surfaces is an alternative treatment to split-thickness skin grafting. Blisters are produced by the suction device at a negative pressure of 200-300mmHg for 3-4 hours. Epidermal sheet of blister roofs was grafted on the raw surfaces. Excellent epithelization was seen in eight patients with raw surfaces caused by burn, trauma, infection of graft donor site, defect of grafted skin. The advantages of this method is easy and simple procedure with little discomfort, no complications like milia, inclusion cyst on the recipient site, and no scarring in the donor sites.