대흉근 근피판으로 큰 안면결손을 치료한 경험

송중원(Joong Won Song),이동훈(Dong Hoon Lee),강진성(Jin Sung Kang) 대한두경부종양학회 1986 대한두경부 종양학회지 Vol.2 No.1

The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoral.is major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commissure and the other is after resection of a hugε fibrous mass and destructed facial bones caused by chronic osteomyelitis.

족관절 골절 형태에 따른 조기 재활의 임상결과

송중원,이호승,서상교,류창현,Song, Joong Won,Lee, Ho Seong,Seo, Sang Gyo,Ryu, Chang Hyun 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.1

Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

골반부에 발생한 다발성 거대 종양성 석회증

양보규(Bo Kyu Yang),이승림(Seung Rim Yi),송중원(Joong Won Song) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.5

종양성 석회증은 대사장애나 기저질환과 무관하게 석회성분의 침착을 일으키는 질환으로 원인은 명확하게 밝혀지지는 않았으나, 동양인에게는 드물게 발생하는 질환으로 알려져 있다. 저자들은 양측 고관절부와 둔부 및 천추부에 걸친 골반부에 다발성으로 발생한 거대 종괴를 주소로 방문하여 타 질환과의 감별을 위한 진단적 검사를 시행하고, 절제술로 치료한 거대 종양성 석회증을 문헌고찰과 함께 보고하고자 한다. Tumoral calcinosis is a very rare disease in which calcium deposit is accumulated on soft tissue around joints without specific metabolic disorder of calcium or predisposing illnesses. Its causes have not been revealed clearly, and the disease has been known to occur rarely among Asian patients. We report a case of a multiple giant tumoral calcinosis patient who complained of painful masses in the groin region as well as in both buttocks and sacral area. The patient was evaluated to differentiate with other causes and have been treated with surgical excision. We present this case with a review of literature.

증상이 있는 거골 골연골병변의 비수술적 치료 결과

김진수(Jin Soo Kim),이호승(Ho Seong Lee),서상교(Sang Gyo Seo),송중원(Joong Won Song),서동교(Dong-Kyo Seo),류창현(Chang Hyun Ryu) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.2

목적: 최근 거골 골연골병변에 대한 적극적 수술이 행해지고 많은 보고가 있지만, 비수술적 치료에 대한 보고는 많지 않다. 본 연구는 거골 골연골병변에 대한 비수술적 치료의 경과를 보고하고자 한다. 대상 및 방법: 2003년부터 2013년까지 수술을 권유 받았으나 시행 받지 않고 2년 이상의 관찰을 시행한 104명을 대상으로 후향적 연구를 진행하였다. 자기공명영상 또는 컴퓨터 단층촬영을 통해 병변 위치, 크기, stage를 확인하였다. 최종 추시 시 단순 방사선 영상을 시행하여 관절염 진행 여부를 확인하였으며, 운동의 제한 여부를 조사하고, visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) scale, SF-36을 측정하였다. 결과: 최종 추시 시 관절염의 진행은 없었으며, 2명(2.4%)의 환자만 원하는 운동의 제한을 호소하였다. 평균 VAS는 내원 시 4.3에서 1.1로 감소하였다(p<0.001). 평균 AOFAS scale는 83.3에서 92.5로(p<0.001), 평균 SF-36도 52.6에서 72.9로 호전되었다(p<0.001). 결론: 거골 골연골병변은 일시적 증상이 있더라도 호전되는 경우가 많고, 관절염으로의 진행이 드물기 때문에 거골 골연골병변 환자의 치료 시 충분한 비수술적 치료가 선행되어야 한다. Purpose: Although reports on operative treatment of osteochondral lesion of the talus (OLT) are increasing, to the best of our knowledge, there have been only a few reports on non-operative treatment of OLT. The purpose of this study is to report the prognosis of non-operative treatment for OLT patients. Materials and Methods: This retrospective study included 104 patients (57 male, 47 female) with OLTs having a follow-up period of more than two years, between 2003 and 2013. The location, size, and stage of the OLT were confirmed by magnetic resonance imaging or computed tomography. At the final follow-up, simple radiographs confirmed the progression of osteoarthritis. We surveyed the limitations of sports activity, visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) scale, and SF-36. Results: There were no patients with progression of osteoarthritis at the final follow-up. Only two patients (2.4%) complained the limitation of desired sports activity. The mean VAS significantly decreased from 4.3 (range, 0-8) to 1.1 (range, 0-4) (p<0.001). The mean AOFAS scale significantly improved from 83.3 (range, 41-100) to 92.5 (range, 65-100). Moreover, the mean SF-36 also improved from 52.6 (range, 30.0–91.0) to 72.9 (range, 40.6-97.0) (p<0.001). Conclusion: Sufficient non-operative treatment is initially recommended to OLT patients because pain, in general, improves in most cases despite the presence of symptoms. Moreover, it’s worth noting that the progression to osteoarthritis is rare.

발음성 고관절에 대한 변형된 장경대 연장술의 치료

이승림 ( Seung Rim Yi ),김성완 ( Seong Wan Kim ),송중원 ( Joong Won Song ) 대한스포츠의학회 2012 대한스포츠의학회지 Vol.30 No.2

안면 피부의 나이에 따른 변화에 대한 형태학적 연구

송중원,강대영 대한병리학회 1993 Journal of Pathology and Translational Medicine Vol.27 No.4

횡문근육종의 미세형태학적 변화

송중원,전광수,곽정식,조태환 慶北大學校 醫科大學 1985 慶北醫大誌 Vol.26 No.1

저자들은 횡문근육종의 미세구조의 변화를 관찰하여 종양세포 근섬유의 형성과정과 진단적 의의가 있는 초미형태학적 변화를 규명하기 위해 5례의 횡문근육종을 전자현미경적으로 관찰하였으며 그 결과를 요약하면 다음과 같다. 횡문근육종 세포들은 근섬유를 함유한 세포들과 함유하지 않은 세포들로 구별되었다. 근섬유를 함유한 세포들은 당원과립과 mitochondria가 풍부하였으며 actin, intermediate filament, myosin이 소량으로 불규칙하게 배열된 것으로 부터 불완전한 Z-line을 형성한 세포들까지 분화의 정도가 다양하였다. 근섬유를 함유하지 않은 세포들은 mitochondria, RER, Golgi장치가 잘 발달되었으며 당원과립이 풍부하였고 지방적이 나타나 있었다. 그리고 이들 세포의 일부에서 국소적으로 직경 약 20nm의 myosin이 발견되었다. 이상의 소견으로 보아 원시간질세포에서 횡문근육종세포로 분화될 때 myosin이 먼저 형성될 것으로 생각되며 따라서 미분화된 종양세포에서 myosin의 확인은 횡문근육종의 진단에 도움을 주는 소견으로 생각된다. The authors studied ultrastructures of the rhabdomyosarocoma cells to clarify the process of development of myofibrils and to find out the structures which had diagnostic value. Five cases of human rhabdomyosarcoma of variable types were examined by light and eletron microscopes. The results obtained were summarized as follow: Most of the tumor cells had myofibrils, but some tumor cells did not have. These tumor cells having myofibrils showed plenty glycogen particles and mitochondria. The degree of differentiation of myofibrils was variable from those composed of irregularly arranged actin, intermediate filament and myosin to those composed of well organized fibrils including Z-line. The tumor cells which did not contain myofibril showed well developed Golgi complexes, plenty mitochondria, rough ER, glycogen particles, and lipid droplets. Some myosin filaments measuring 20nm in diameter, were found in these cells. The results suggested that myosin would be appeared in early stage of differentiation of rhabdomyosarcoma cells from primitive mesenchymal cells. And detection of myosin in undifferentiated mesenchymal tumor could be diagnosed as rhabdomyosarcoma.

전두사골 수막뇌류 및 Saethre-Chotzen증후군에 의한 안와격리증의 치험

송중원,한기환,박성근,강진성 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2

본 교실에서는 전두사골 수막뇌류에 의한 안와격리증 2례는 두개내 접근으로 수막뇌류 절제술을 실시함과 동시에 두 개외 접근으로 안와내벽 및 외벽 절골술로써 교정하였으며 Saethre-Chotzen 후군에 의한 1례는 두개골 성형술과 U형 절골술로 교정하여 비교적 만족할 만한 결과를 얻을 수 있었기에 보고하는 바이다. The authors experienced two cases of mild hypertelorism with frontoethmoidal meningoencephalocele and one with Saethre-Chotzen syndrome. The first and second cases, which had nasofrontal and nasoethmoidal meningoencephalocele respectively, were corrected by resection of the meningoencephalocele, repair of the dura, and calvarial bone graft intracranially, and combined medial and lateral orbital wall osteotomy with augmentation rhinoplasty with calvarial bone grafts extracranially. To stabilize the orbital contents medially, a split osteotomy of the lateral orbital wall and interpositional bone graft were done in order to avoid step deformity of the lateral orbital rim. The third case, Saethre-Chotzen syndrome characterized brachycephaly, hypertelorism, ptosis of the eye lid, maxillary hypoplasia, lower set frontral hair line, and partial cutaneous syndactyly was corrected by a Modified Marchac technique for remodelling the forehead and a subcranial U-osteotomy for mild hypertelorism. Maxillary hypoplasia was corrected effectively by advancement on the medial portion of the U-shaped bony segment. Augmentaton rhinoplasty with calvarial bone graft and chip bone grafts on the anterior nasal spine was done simultaneously. A large amount of nasal bone grafts in two cases were absorbed, and then augmentation rhinoplasty using silicone implant was performed after 6 months, 12 months respectively. In mild hypertelorism with associated deformity, a extranial osteotomy with augmentation rhinoplasty and correction of associated deformities can offer good aesthetic results.

대흉근 근피판으로 큰 안면부결손을 치료한 경험

송중원,강진성 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.4

The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoralis major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commisure and the other is after resection of a huge fibrous mass and destructed facial bones caused by chronic osteomyelitis.

한국인 안검의 생체계측지

박동만,송중원,한기환,강진성 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5

Plastic surgeons who frequently deal with trauma and deformity of the eyelids and orbits, need have an abundant knowledge of the accurate anatomical morphology and acceptable proportion of them. The normal value of the anatomical morphology and function of the eyelid has not yet been standardized in Korea. The authors measured anthropometry of normal Korean eyelids and statistically analysed in 2,151 individuals including 1,078 male and 1,073 female. Statistical analysis of these measurements offers valuable information about the chronological growth, size, and shape of healthy Korean eyelids. The results are as follows : 1. There was no significant statistical difference between the right and left sides in all measurements. 2. The growth of the eyelid reached the adult level at about 20 years of age and then the growth can be divided into 3 patterns, the first one slowly increased, the seconded one was a stationary, and the last one slowly decreased. 3. The following statistics were recorded for males and females. The cornea-lateral canthal distance was 7.9mm and 7.3mm, the diameter of the cornea was 13.8mm and 13.6mm cornea-medial canthal distance was 7.8mm and 7.5mm the horizontal dimension of the palpebral fissure was 29.7mm and 28.4mm, the vertical dimension of the palperbral fissure was 7.9mm and 8.0mm, the slant of the palperbral fissure was 9.5 degrees an 10.6 degrees, the intercanthal distance was 36.5mm and 37.2mm, the width of the glabella was 24.4mm,. and 24.1mm, the interpupillary distance was 66.1mm and 63.9mm, the ectocanthion-superior margin of the palpebral fissure distance was 14.9mm and 14.2mm, the endocanthion-superior margin of the palpebral fissure distance was 14.9mm and 14.2mm, the height of the opened upper eyelid was 10.3mm and 10.0mm, the height of the closed upper eyelid was 18.2mm and 18.1mm, levator function by the Berke's method was 16.2mm and 15.6mm, MLD was 7.2mm and 7.1mm, and MRD1, was 2.7mm and 2.6mm respectively. 4. The vertical dimension of the palpebral fissure, slant of the palpebral fissure, and height of the double eyelid fold were greater in females than males. The intercanthal distance and width of the glabella was nearly the same in males and females and other measurements were greater in males than females. 5. A double eyelid fold was seen in about 36% of males and 50% of females. The average height of the double eyelid fold with the eye closed in 20 year old females was 5.2mm and 30 to 50 year old females was 5.5mm. The most frequent shape of the double eyelid fold was type 5. 6. The epicanthus was present in 58.1% in this series and existed in over 90% under age 10, but disappeared in about 90% of the people over 50. The most frequent shape of the epicanthus was tarsalis type.