Chronic Ulcerating Lesions due to Limited Form of Wegener’s Granulomatosis on the Face: Cosmetic Consideration

송승한,김순제,김주학,강낙헌 대한미용성형외과학회 2012 Archives of Aesthetic Plastic Surgery Vol.18 No.2

Wegener’s granulomatosis (WG) is a systemic disease characterized by necrotizing granulomas and vasculitis involving the upper and lower respiratory tract as well as the kidneys. Limited form of WG usually involves the head and neck, lacks renal involvement, and may not progress to generalized disease. We report the case of limited form of WG who presented not systemic symptom but several times relapsed multiple ulcerating lesions on the face, uveitis and keratoconjunctivitis. A 23 year-old female initially presented with ulcerative skin lesions on the left cheek and nose. The skin lesion had commenced as an ulcerative and nodulopapular lesion on her right cheek initially, 8 months ago. Subsequently, there was progression of the disease to her left cheek and nose. The patient was treated with oral prednisolone and oral cyclophosphamide. Two weeks later, skin lesion had started to heal, oral prednisolone tapered to 15mg. Eight weeks later, all of skin lesions were healed well. With silicone gel sheets and Laser therapies, we gained excellent cosmetic results. In the aesthetic aspect, early recognition of rare variants of limited form of WG, facial chronic ulcerative wounds that are nonresponsive to conservative treatment, is very important as appropriate therapy can prevent facial mutilation.

직접 절제와 피부 재배치를 이용한 내안각 췌피 교정술

송승한,이은정,오현배,정성균 대한미용성형외과학회 2011 Archives of Aesthetic Plastic Surgery Vol.17 No.1

Recently, new epicanthoplasty methods with reduced scarring have been developed, such as skin redraping method, periciliary epicanthoplasty, etc. Although these methods increase the length of horizontal palpebral fissure, the remnant skin and orbicularis oculi muscle portion that covers one third of medial canthus reduce satisfaction of aesthetic outcome. In order to overcome this limitation, the authors performed redraping after direct excision of medial orbicularis oculi muscle and excess skin to correct epicanthal fold. From April of 2006 to March of 2009, the authors performed medial epicanthoplasty using direct excision and redraping method to correct epicanthal folds in the eyelids of 72 Asian patients. The epicanthoplasty was performed combining with incisional or non-incisional double eyelid operation, ptosis correction, augmentation rhinoplasty and lateral canthal lengthening. Mean follow up was 11 months(6 months to 2 years). Most of the patients were satisfied with the results. Our technique has delivered esthetically superior results with minimal postoperative scar and no major complication. The advantages of our direct excision and redraping technique are as follows: 1) simple in design, 2) versatile in its application, 3) double fold looks clear especially in the medial 1/3 by eliminating the redundant skin and orbicularis muscle.

내안각 상부에 발생한 염증성 근섬유모세포종의 치험례

송승한,강낙헌,서광선 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3

Purpose: Inflammatory myofibroblastic tumor(IMT) is characterized by clonal proliferation of myofibroblastic spindle cells and accompanied by lymphoplasmacytic infiltration. IMT is an uncommon lesion reported to arise in various organs, and is believed to be a reactive inflammatory condition. IMT forms a spectrum of lesions ranging from benign, infection-related lesions to low- grade malignancies, capable of local recurrences and rarely distant metastasis. IMT occurs mostly in the lung, but rarely in the craniofacial region. Methods: A 28-year-old male with painless swelling in the medial canthal area was referred to our department for the last 2 months. A 2cm sized mass was palpated. He was treated with complete local excision. Results: In the study by computerized tomography, a 2.0×0.8×1.0cm mass was found in the subcutaneous tissue layer. Grossly, the mass was well-circumscribed, smooth-surfaced, flesh colored, and hard. The tumor was well demarcated from the other tissues. Histopathologic examinations showed bland spindle- shaped cells loosely arranged with scattered lymphoid cells. Immunohistochemical examinations demonstrated a positive reactivity for alpha-SMA and a negative reactivity for desmin and CD34. No recurrence was noted 12 months after surgery.Conclusion: Emphasis is given to complete resection of the tumor for both diagnostic and therapeutic purposes. Further evaluation to find other lesions in different sites should be considered. Continued follow-up is recommended.

전전뇌증(Holoprosencephaly)의 증례보고

송승한,강낙헌 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.4

Purpose: Holoprosencephaly(HPE) is a rare developmental defect due to incomplete cleavages of the prosencephalon during the third week of fetal development. Chromosomal anomalies, genetic syndrome, teratogen, or genetic disorder of non-syndromic HPE are usually accepted as etiology. The consequences of prechordal mesoderm defect are varying degrees of deficit of midline facial development, especially the median nasal process(premaxilla), and incomplete morphogenesis of the forebrain. We experienced a case of lobar HPE with complete cleft lip and palate. Methods: A female newborn infant was born at 38+6 weeks’ gestational age via NSVD. The infant’s birth weight was 3.6kg, height 52cm, and head circumference 32.5cm, showing microcephaly, flat nose, median complete cleft lip & palate, and hypotelorism, along with defects of midfacial development including losses of premaxilla, philtrum, nasal septum, and columella. Results: There were no specific findings noted from the head and neck X-ray and tests for endocrine and metabolic disorders, but clinical characteristics of midface and dysgenesis corpus callosum on brain MRI were seen, so that this case was diagnosed with HPE.Conclusion: HPE is divided into three categories of alobar, semilobar, and lobar prosencephaly according to the degree of cerebral hemisphere separation. Assesment of patient’s brain abnormality and malformation is essential in determining the extent and benefit of surgical intervention. This case was included in the lobar type HPE which shows relatively good prognosis compared with other types and reconstruction of median complete cleft lip & palate and midfacial defects will be performed.

Adult-Type Intrathoracic Xanthogranuloma: Excision and Reconstruction Using a Latissimus Dorsi Muscle Flap

송승한,경현우,강낙헌,오상하,김경희 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.1

Propeller Dorsal Intercostal Artery Perforator Flap for an Extensive Defect on the Back Following Malignant Peripheral Nerve Sheath Tumor Resection: A Case Report

송승한,권혁동,김순제,김주학,경현우,오상하,양호직,하유석 대한수부외과학회 2021 대한수부외과학회지 Vol.26 No.1

Posterior trunk defects have been a challenging anatomical area to cover in reconstructive surgery. The use of local myocutaneous flaps has been described extensively in the literature to cover these defects, but these techniques are associated with significant donor-site morbidity, including functional loss of muscle units. Freestyle perforator flaps enable local tissue recruitment with skin of a similar color and texture in diverse anatomic areas, but there is a shortage of case series on posterior trunk defects using propeller dorsal intercostal artery perforator (DICAP) flaps, particularly when the defects are extensive. In this report, the authors present a successful case of a DICAP propeller flap for an extensive defect on the upper back following a malignant peripheral nerve sheath tumor resection.

도상형 복합미간부피판을 이용한 비근위부 및 내안각부 재건

송승한,강낙헌,이승렬,오상하,서영준 대한두개안면성형외과학회 2007 Archives of Craniofacial Surgery Vol.8 No.2

Purpose: It is difficult to reconstruct nasal root defects because of complicated anatomy and function of the nose and eyelids, donor site morbidities, and aesthetic results. So, choosing suitable one of various reconstructive methods is very important and difficult. We report the island composite glabellar flap as an alternative reconstructive method of proximal nasal and medial canthal area. Methods: From May 2005 to January 2007, we performed 8 cases of the island composite glabellar flap to reconstruct the defects in proximal nasal and medial canthal area after resection of skin cancer. The flap was elevated with the nasal skin, subcutaneous fat tissue, and procerus muscle based on the dorsal nasal branch of the angular artery. The flap donor site was closed in a V-Y fashion. Results: This result was satisfactory in point of color, texture and donor site scar. There was no major complication such as wound disruption, hematoma, and atrophy of flap. But flap bulkiness was observed in one case. Conclusions: This island composite glabellar flap has several advantages in reconstruction of proximal nasal and medial canthal defects. This flap has reliable vascular pedicle and can be moved to multiple direction and has more mobility than other local flaps. Also, aesthetic outcome of the donor and the recipient site was good. We believe that this flap is a useful technique as a treatment of proximal nasal and medial canthal defects

부정경쟁방지법상 이른바 ‘저명상표 희석범죄’의 기수시기

송승은 충남대학교 세종지적재산권연구소 2020 The Journal of Law & IP Vol.10 No.1

오늘날 저명상표는 세계 각국에서 보편적으로 보호되고 있는데,우리나라도 이와 같은 국제적인 추세에 맞추어 부정경쟁방지 및 영업비밀보호에 관한 법률(이하 ‘부정경쟁방지법’이라 한다)에서 저명상표를 보호하고 있다. 부정경쟁방지법 제2조 제1호 다목은 “국내에 널리 인식된 타인의성명,상호,상표,상품의 용기•포장,그 밖에 타인의 상품 또는 영업임을 표시한 표지와 동일하거나 유사한 것을 사용하거나 이러한 것을사용한 상품을 판매•반포 또는 수입•수출하여 타인의 표지의 식별력이나 명성을 손상하는 행위”를 부정경쟁행위의 한 종류로 정의하고,이를 위반한 자는 3년 이하의 징역 또는 3천만원 이하의 벌금에 처한다(제18조 제3항 제1호). 이렇게 형사처벌의 대상이 되는 저명상표 희 석행위를 이른바 ‘저명상표 희석범죄’라 한다. 부정경쟁 방지법상 저명상표희석 범죄가 성립하려면 표지의 저명 성, 동일 또는 유사한 표지의 사용,식별력 또는 명성의 손상(희석화)의요건을 갖추어야 한다. 그러나 그 사용이 비상업적 사용 등 대통령령이 정하는 정당한 사유에 해당하면 법령에 의한 행위로써 정당행위에해당하여 위법성이 조각된다고 본다. 그리고 저명상표 희석범죄의 구성요건은 식별력 또는 명성의 손상 가능성(위험)을 명시하고 있지 않으므로,법문언상 구체적 위험범이 아니라 침해범으로 해석하여야 한다. 따라서 저명상표의 식별력 약화 또는 명성의 손상이 현실적으로 발생한 때에 기수범이 성립한다고 본다. 그렇지만 저명상표 희석행위는 혼동 여부와 관계없이 소유자의 개인적 이익을 침해하는 것이기 때문에 이에 대해 형사처벌을 가하는 것이 지나친 규제라는 의문이 있다. 형벌은 매우 강력한 제재수단이므로최후의 수단이어야 한다. 형법의 보충성,형벌의 최후수단성이라는 대원칙은 부정경쟁행위와 관련된 형사책임에 있어서도 예외일 수는 없다. 따라서 저명상표 희석범죄의 구성요건에 대한 엄격해석을 통해 명확성,보충성원칙과의 조화로운 해법이 모색되어야 할 것이다.

플립러닝 전략적 수업 설계 및 방법론

송승아 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.3

온라인 수업과 오프라인 수업의 결합 형태인 블렌디드 러닝에서 더 나아가 예습 중심의, 학습참여자 중심의 수업형태를 플립 러닝(Flipped Learning) 이라 한다. 플립 러닝은 예습으로 수업 준비가 완료된 학생들을 대상으로 오프라인 수업 시간에 토론과 문제해결과정에 집중할 수 있다는 장점에도 불구하고 이에 대한 정보가 많지 않아 많은 교수자의 참여를 현재까지는 이끌어 내지 못하고 있다. 따라서 본 연구는 교수자가 단순한 지식 전달자에서 벗어나 전문성을 갖춤과 동시에 전략적으로 수업을 구성 및 설계하는데 필요한 준비사항, 실제 과목을 운영함에 있어서 유용하게 사용될 방법론, 그리고 플립러닝 상황 하에서의 오프라인 팀 활동 활성화 방법을 연구하고자 한다. 또한 추가적으로 플립 러닝의 장단점을 살펴보며, 플립 러닝을 위해 도입한 여러 장치들의 효과들을 살펴보고 그 개선점 및 적용 시 주의사항에 대해서도 논의함으로써 향후 경영학에서 더 나아가 여러 사회과학 과목들에 플립 러닝 방법론 적용이 가능하도록 이상적인 플립러닝 적용 모델을 제안하고자 하였다. The key purpose of flipped learning is to encourage students in students’ oriented active learning and to gain students first exposure to material outside of class using online materials. Despite many strong points of flipped learning method, mix of online and offline class, it is still hard to find useful guidelines on how to design classes and lectures based on professionalism and strategies. Thereby this paper pursues to research strategic class design methods, off-line team discussion skills and pre-requisites for running flipped learning classroom. Besides this paper discusses the pros and cons of flipped learning, the effects of various teaching methods and matters that require retention applying flipped learning methods. The strategic flipped learning in-class design suggested in this paper will play an important role to promote ‘deep and active learning’ through flipped learning as in the other social science major classes as it did in management major.

누가복음의 문맥에서 본 ‘비둘기 같은 성령’(눅 3:22)의 의미 연구

송승인(Seung-In Song) 한국복음주의신약학회 2018 신약연구 Vol.17 No.3

본 논문의 목적은 누가복음 3:22에서 성령이 비둘기로 묘사된 의미를 고찰하는 것이다. 네 복음서 기자 모두는 예수께서 요한에게 세례를 받으시는 순간에 하늘로부터 성령이 그의 위에 비둘기 같이 강림하셨다고 기록한다. 1) 필자는 고대 지중해 문화에서 비둘기가 온유함의 상징이었고 그것이 이 본문의 배경이라고 주장한다. 비둘기가 온유함, 부드럽고 애정이 넘침, 교활하지 않고 단순함을 표현한다는 사실은 예수 자신의 말씀 한 구절에서 예시된다(마 10:16). 그러한 비둘기의 특성은 누가복음 3:22의 인접 문맥에서 성령의 활동에 대한 묘사에도 반영되어 있다(4:1, 18-19). 한편, 세례 요한은 예수의 사역을 ‘불과 성령으로 세례를 베풂’(눅 3:16)으로 특징짓고, 회개하지 않는 사람들에 대한 심판이 메시아 사역의 핵심이라고 파악했다. 하지만 예수에 대한 세례 요한의 이러한 판단이 오해였음을 누가는 그의 복음서에서 반복적으로 지적한다. The purpose of this paper is to examine the meaning of the image of the Holy Spirit as a dove in Luke 3:22. All the Gospel writers bear witness that the Holy Spirit came down from heaven like a dove when Jesus was baptized by John. I focus on the theological implications of the imaging of the Holy Spirit as a dove, especially in the literary context of Luke’s Gospel in this study. I claim that behind this dove lies the notion of literature of the ancient Mediterranean that the dove is a symbol of meekness. This under-standing is consistent with Jesus’ mention of dove in Matthew 10:16, which signifies the animal’s character as gentleness, affec-tionateness, guilelessness, and simpleness. The dove-like characters are reflected in a pair of references to the Holy Spirit and the minis-try of Jesus in 4:1 and 18-19 as well. Based on this understanding of the Holy Spirit, another mention of the Holy Spirit in 3:16 (“the baptism of the Holy Spirit and fire”) turns out to be ironic; although John the Baptist proclaimed that Jesus is the Messiah, his character-ization of Jesus’ ministry as fiery judgment reveals his mis-understanding of Jesus.