원위기저 도서형 천비복동맥 근막피판으로 하지 재건 시 과급정맥문합의 이용

하영인,최환준,최창용,김용배 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.2

Purpose: Distally based superficial sural artery island flap has some disadvantages such as postoperative flap edema, congestion, and partial necrosis of the flap margin. Venous congestion is an area of considerable concern in distally based superficial sural artery fasciocutaneous flap and is one of the main reasons for failure, particularly when a large flap is needed. However, we could decrease these disadvantages by means of venous superdrainage. Methods: From June of 2006 to June of 2007, a total of two patients with soft tissue defects of lower one third of the leg underwent venous supercharging distally based superficial sural artery island flap transfer. The distal pivot point of this flap was designed at septocutaneous perforator from the peroneal artery of the posterolateral septum, which was 5cm above the tip of the lateral malleolus. Briefly, this technique is performed by anastomosing the proximal end of the lesser saphenous vein and collateral vein to any vein in the area of the recipient defect site.Results: No venous congestion was noted in any of the two cases. No other recipient or donor-site complications were observed, except for minor wound dehiscence in one case. In 3 to 6 months follow-up, patients had minor complaints about lack of sensation in the lateral dorsal foot. Conclusion: The peroneal artery perforator is predictable and reliable for the design of a distally based superficial sural artery island flap. Elevation of the venous supercharging flap is safe, easy, and less time consuming. In conclusion, the venous supercharging distally based superficial sural artery island flap offers an alterative to free tissue transfer for reconstruction of the lower extremity.

깨물근하 농양

하영인,박은수 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.6

Purpose: The masserteric space is an important tissue compartment of the face, but a disease in it is difficult to diagnose and treat. The submasseteric abscess is located between the masseter muscle and mandibular ramus with different appearances such as sepsis, infection, or tumor. Especially the common misdiagnosis of submasseteric abscess is acute or chronic parotitis. The purpose of this report is to pay special attention to the possible diagnosis of submasseteric abscess for the symptoms of unilateral cheek swelling and tenderness that accompany marked trismus.Methods: A 11-year-old boy came to our hospital because of facial swelling, tenderness, and trismus in a history of left cheek swelling and toothache. We diagnosed his case as submasseteric abscess by CT scan and surgical intervention was performed. Under general anesthesia, the abscess was opened by the intraoral incision and considerably massive pus was drained. Results: Swelling, tenderness, and trismus became to subside during postoperative 10 days and general condition and vital signs became stable. After 6 months, CT scan showed that both masseteric muscles were symmetric and there was no periosteal reaction of the mandible. Conclusion: In conclusion, submasseteric abscess is a rare infection with the symptoms of cheek tenderness and marked trismus. A detailed medical history and clinical examination of a patient as well as computed tomography(CT) are important tools in the accurate diagnosis and efficient treatment of the submasseteric abscess. Adequate drainage, removal of cause, and antibiotic infusion are the management of choice.

초음파 지방흡입술과 풀아웃법을 이용한 액와부 부유방의 치료

하영인,박은수 대한미용성형외과학회 2010 Archives of Aesthetic Plastic Surgery Vol.16 No.3

Treatment of accessory breasts with simple excision, diamond-shaped excision, or Y-V technique provides insufficient aesthetic results. Therefore, we hereby present an effective surgical method to provide aesthetic and satisfactory results. Fifteen women between the ages of 18 and 48 years were treated with the method. Incision was made within the natural wrinkle line in the axillary fold, and ultrasound assisted liposuction was performed through the incision. For natural lining of axilla, accessory breast tissues were removed with pull-out method. Average follow up period for the patients was 8 months. All patients(total 15 patients, 25 accessory breasts) who underwent the operation with ultrasound assisted liposuction and breast tissue excision by pull-out method did not show any major complications such as skin necrosis, hematoma or scar contracture. The method could minimize scar and reduce contour problem after the operation. The patient's satisfaction was high, as they stayed in hospital for only 3 days and returned to full activities in a week. This can be an excellent method to treat accessory breast tissue and parenchyme.

수부동맥 관통 피판을 이용한 손가락끝 절단의 재건

하영인,정성균,신호성,박은수,박장우,최환준 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.4

Purpose: Fingertip injuries are the most common hand injuries and may lead to significant disability. Knowledge of fingertip anatomy is mandatory to treat these injuries effectively. All surgical techniques used for coverage of fingertip injuries must be based on the nature of the injury and the patient’s age. Many authors have studied the method of fingertip reconstruction because goals of these treatments should include maintaining length, sensibility, motions, and appearance. The purpose of this study is to evaluate the effect of digital artery perforator flap for fingertip reconstruction without aesthetic and functional problems. Methods: From November 2006 to March 2007, the authors performed fingertip reconstruction on 3 fingers of 3 patients, aged between 41 to 54 years (average age, 47 years) using digital artery perforator flap. Results: All fingers recovered successfully and there were no necrosis of the flap. We followed up 3 cases more than 5 months. Light touch and temperature sensation could be detected in all flaps and the static two-point discrimination test was 8 mm. Conclusion: This flap is an alternative choice for coverage of fingertip defects. This method also takes short time to procedure and to recovery. The digital artery perforator flap has never been reported in Korea, however it is considered as a useful method for treatment of fingertip injury.

요추 추간판 탈출증 812수술례에 대한 임상적 고찰

하영일,조해동,유영락,김남규,정환영 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.2

The purpose of this study on the surgical results for lumbar intervertebral disc herniation is to analyze the unique feature of the series which seems to be sufficient to represent Korean patients suffering from these diseases. A total of 812 lumbar discectomies had been performed from May, 1972 to December, 1978 at Hanyang University Hospital. The most outstanding unique feature was the level of the lesion. The L₄-L_(5), interspace was affected in 87.6%. while the most of the other series showed almost same incidence between L₄-L_(5), and L_(5)-S₁, interspaces. The results of this analysis are as follows: 1) The incidence ratio of male to female was 1.3: 1. 2) Most were in the 4th and 5th decade (53.5%). The duration was over one year in 64.6% of cases. 3) Traumatic origin was 37.8% of cases. Post-delivery, convulsive and unknown etiology were 2.2%, 0.7% and 59.3% of cases, respectively. 4) The level of the lesion was predilected at L₄-L_(5) interspace with the incidence of 87.6%, while L_(5)-S₁, interspace was affected in 25.4% of cases. Single lesions were 70.8% and the multiple 29.2% of cases. 5) False positive findings of myelogram were 1.2% of cases. 6) Surgical results were gratifying in 92.3% of cases. 7) The incidence of postoperative complications was 3.3% of cases, which were mainly stitch abscesses. 8) The 7 out of 812 cases were associated with spinal tumors.

고속도로 비상주차대 설계기준 개선방안 연구

하영일,오영태,김영선(Kim, Young-Sun) 대한교통학회 2010 대한교통학회 학술대회지 Vol.63 No.-

부보상 문제의 혼합 이진 이차 문제로의 모형화를 통한 해법

하영아,임세호,홍성필 대한산업공학회 2022 대한산업공학회 춘계학술대회논문집 Vol.2022 No.6

흉추부에 발생한 고립성 골수증 : 증례보고

하영일,송관영,김충현,임홍재 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.11

A rare case of spinal cord compression caused by a solitary myeloma situated at the level of 12th thoracic vertebra is discussed Plasma cell neoplasms have been classified as multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma arising in the soft tissue than the bone. The solitary myeloma should be included in the differential diagnosis of various type of bone tumor and considered as something completely seperated from multiple myeloma even though it developes a disseminated disease with all the characteristics of multiple myeloma in a few years. The authors report this 54-year old male patient suffered from chronic back pain due to solitary myeloma of the thoracic spine and operated on transpedicular fixation to prevent more severe neurologic deficits following radiotherapy. Special emphasis on clinical characteristics between solitary and multiple myeloma, diagnosis, management and prognosis of plasma cell disorder are reviewed with literatures.

The Two Debating Waves International Relations

하영일 대전대학교 지역협력연구원 2004 지역학연구 Vol.3 No.1

이 글은 국제관계이론에 있어서의 idealism과 realism을 비판적으로 분석한 것이 다 국제정치학에서 사용되는 두 전통적인 개념들은 서로 뚜렷하게 상반되는 관 점을 가지고 있다. 현실주의는 국가이익의 추구를 국제관계의 기본행위로 규정하 고 power politics를 중시 · 합리화한다. 반면에 global harmony를 강조하는 이상주의 는 권력(힘) 대신에 도덕성을 국제관계의 기준으로 삼는다. 그러나 이상주의 모델 은 지나치게 유토피아적이고 순진하여 실제 국제사회를 설명하는 데 역부족이며, 보수적이고 제국주의적인 현실주의 모델은 국가들간의 경제적 상호의존이 절대 적인 지금의 국제환경을 이해하는 데 분명한 한계를 갖고 있다 인간의 사회적 행위는 개인적 필요성 , 이기적 욕구와 사회적 명분이 타협하면서 만들어진 규범 내에서 행해진다. 인간집단인 국가의 대외적 행위도 넓은 의미에서는 이에서 벗 어나지 않는다. 말하자면, 국가이익이 대외정책의 일차적 기준이 되나 이것은 국 제도덕이란 합의된 규범과 타협하여 국가행위를 지배하게 되는 것이다. 이 글은 idealism과 realism의 개념을 역사적, 비판적으로 분석해 냉전 이후 변화된 세계질 서에 대해 심층적 이해를 도모하고자 한다. At first sight the contrast between Realism and Idealism seems to be clear and obvious. Like the light and shade of world order schools, realism is assumed to emphasize power, while idealism is thought of as harmony. Power, to the realists, is the essence of politics. This view recommends the use of amoral and power-oriented politics and places the highest priority on the pursuit of one’s practical interests. Unlike the realist view which argues that politics sho미 be played in a realistic fashion, the idealist view argues that power can be tamed in terms of moral principles, fair and just laws, and harmony, and that there could be a harmony of interests among peoples and states, making it possible to establish a condition of perpetual peace. These resulting pictures of the world offered by the rival perspectives are thereby very different. Realists see humans as naturally aggressive, and tend to conclude that this was the cause 이warfare among states. They hold that the world is naturally one of conflict, in which all are compelled to fight to defend their own interests. Politically, economically, and if need be, militarily, individuals struggle against each other to secure supremacy. Even those who are not naturally aggressive need to be∞me so in order to defend themselves against those that are. Therefore, mutual suspicion and mutual hatred condemn mankind to a deadly struggle: a struggle that, rt is believed, is reflected in the wider conflicts among states. That is to say, the realists assume that there is no essential harmony 이 interests among nations; instead, they posit that nation-states often have conflicting national objectives, some of which lead to war (Dougherty & Pfaltzgraff, p. 84). Idealists hold a different view of human nature. It is not that they deny the existence of widespread conflict; nor that many individual humans are prone to aggression" or may even enjoy the delights of war. They adopt, however, a less sceptical approach to the possibility of containing and redirecting these tendencies. Sometimes the idealists believe that humans are basically "good, "considerate, " ”peaceful" , or that they are morally colorless so that education, right environment, α the right structure of society æn render them good (Heα, p. 33). They denounce the futlity and destructiveness of conflict, affirming that it is possible for humans to live in peace with one another if only they transform their own attitudes, α they create the right institutions. They also believe that it is especially important for the rulers themselves, who control the destiny of their people and are often responsible fα making war, to reform their conduct 50 as to publish a more harmonious and peaceful world. As a result, the idealists are those who would extend the reign of polis-type justice throughout the world conversely, the realists are those who know no such thing æn be done, and were one to attempt it, a terrible war for hegemony followed by the peace of empire would be the likely result. Hence, "Idealism (Utopia) and Realism (Reality)," as E. H. Carr puts it in his remarkable book The Twenty Years’Crisis: 1919-1939, "are thus the two facets of politice science" (p. 10).

카이모파페인에 의한 요추추간판 탈출증 효소치료에 대한 임상적 연구

하영일,유영락,정환영 한양대학교 의과대학 1986 한양의대 학술지 Vol.6 No.1

The intradiscal injection of chymopapain has been performed for the treatment of lumbar disc herniation in 490 patients since 1984. The patients were examined with CT, CTMM and oil or water - soluble myelography as well as neurological examination. The discography was performed in every case only to observe whereabouts of the contrast medium. Under the aid of the fluoroscopic image intensifier, posterolateral discographic needling was performed with double needle technique using a short 18-gauge and long 22-gauge needle. Following results were obtained. 1) Follow-up of 420 cases showed excellent in 188 cases (44.88%), good in 172 cases (40.9%), fair in 50 cases (11.9%) an unchanged in 10 cases (2.4%), respectively. 2) There are good results in chemonucleolysis on three or four interspaces as well as one or two interspaces. 3) The history of previous surgical discetomy was not a contraindication as long as routine procedure was strictly undertaken. 4) The spine CT is preferable to other diagnostic studies for evaluation of hernated lumber disc. 5) The postinjection-spinal-instability developed in 392 (80%) of the 490 cases for three to four days but it disappeared within 1 week. 6) In discography, there are epidural leak in 82 cases (19.5%) of patients but were not related with the outcome of the chemonucleolysis. 7) 274 cases (90%) showed the narrowing of the intervertebral disc space at 3 monts after chemonucleolysis. 8) Lumbar chemonucleolysis has been performed in 490 cases without serious complications such as anaphylaxis and/or immediate profound hypotention. In conclusion, lumbar chemonucleolysis with chymopapain was very useful under strict precaution.