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.

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.

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

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.

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.

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

문자/상징 지표를 활용한 요한복음 4:18의 pe,nte ... a;ndraj와 nu/n o]n e;ceij에 대한 의미 재고

송승인 평택대학교 피어선기념성경연구원 2020 피어선 신학 논단 Vol.9 No.2

본 논문의 목적은 요한복음 4:18에 등장하는 두 표현 pe,nte ... a;ndraj와 nu/n o]n e;ceij의 의미가 무엇인지를 살피는 것이다. 본 논문은 크게 두 부분으로 나누어지는데 전반부는 이 두 표현의 의미에 대한 학자들의 여섯 가지 주요 의견을 검토한다(다섯 번 결혼하고 이혼한 부도덕한 여인으로 해석, a;ndraj를 “남편들”이 아니라 “연인들”로 해석, 앗수르 정복 후 사마리아에 정착한 다섯 지역 사람들의 이방 신들을 상징, 역사상 사마리아 사람들을 지배했던 제국들과 그들의 신들을 상징, 계대 결혼 제도, 경제적 이유로 다섯 번 결혼). 본 논문의 후반부에서는 이 여섯 가지 가능성 중 가장 설득력 있는 해석을 찾기 위해 6개의 상징/문자 지표를 활용한다. 첫 번째 지표는 물이나 물과 관련된 이미지가 문자적으로 뜻이 통하는지의 여부이다. 두 번째 지표는 제안된 해석(문자적이든 상징적이든)이 인접 문맥과 잘 어울리는지의 여부이다. 세 번째 지표는 인접 문맥에 다른 상징적 표현들이 있는지의 여부이다. 네 번째 지표는 속해 있는 내러티브 속에서 물이 강조가 되었는지의 여부이다. 다섯 번째 지표는 인접 문맥에 비교적 상세한 지리적 연대기적 정보가 등장하는지의 여부이다. 마지막 여섯 번째 지표는 인접 문맥에 상징이 사용되었음을 암시하는 단어가 있는지의 여부이다. 이 분석을 통해 우리는 이 여섯 가지 지표 중 첫 번째(남편 어휘가 문자적으로 뜻이 통하는지의 여부), 두 번째(제안된 해석이 인접 문맥과 잘 어울리는지의 여부), 다섯 번째(인접 문맥에서 비교적 상세한 지리적 연대기적 정보가 있는지의 여부) 지표는 문자적 해석을, 세 번째(인접 문맥에 다른 상징적 표현들이 있는지의 여부), 네 번째(속해 있는 내러티브 속에서 남편이 강조가 되었는지의 여부), 여섯 번째(인접 문맥에 상징이 사용되었음을 암시하는 단어가 있는지의 여부) 지표는 상징적 해석을 지지함을 알게 된다. 그리고 이 여섯 지표의 상대적 중요도에 따라 필자는 요한복음 4:18의 경우 이 여섯 가지 지표들 중 두 번째 지표인 “제안된 해석이 인접 문맥과 잘 어울리는지의 여부 지표”가 가장 중요한 지표로 작용한다고 평가하고, 따라서 요한복음 4:18의 pe,nte ... a;ndraj와 nu/n o]n e;ceij가 문자적으로 해석되어야 한다고 결론 내린다. 그리고 위에서 열거한 여섯 가지 해석들 중 네 가지 문자적 해석들 가운데 “다섯 번 결혼하고 이혼한 부도덕한 여인으로 해석”이 “제안된 해석이 인접 문맥과 잘 어울리는지의 여부 지표”와 가장 잘 어울림을 관찰한다. 이 분석에 근거해 필자는 이 다섯 남편이 문자적으로 해석되어야 하며(좀 더 구체적으로는 이 여인을 다섯 번 결혼하고 이혼한 부도덕한 여인으로 해석해야 하며), 이 본문을 사마리아 여인이 예수를 선지자로 확인할 수 있도록 하는 예수의 인식 능력을 보여주기 위한 요한복음 저자의 문학적 장치라고 해석한다. The purpose of this article is to examine the meaning of the two expressions, pe,nte ... a;ndraj and nu/n o]n e;ceij, in John 4:18. The article is divided into two main sections. The former half examines the six opinions of scholars on the meaning of these two expressions (interpreting as immoral woman who has been married and divorced five times, interpreting a;ndraj not “husbands” but “lovers”, symbolizing foreign gods of five people from five different regions who settled in Samaria after the conquest of Assyria, symbolizing the empires and their gods who ruled the Samaritans in history, the marriage based on levirate law, five marriages for economic reasons). In the latter half of this article, I use my six literal/symbolic indicators to find the most convincing interpretation among these six possibilities. The first indicator is whether the water or water-related image makes sense literally. The second indicator is whether the proposed interpretation (literal or symbolic) coheres well with its immediate context. The third indicator is whether other symbolic expressions are present in context. The fourth indicator is whether water is highlighted in the narrative in which it belongs. The fifth indicator is whether relatively detailed geographic or chronological information is present in the immediate context. The final sixth indicator is whether vocabulary suggesting the use of symbols is present. Through this analysis, we find that the first indicator (whether the vocabulary of husband makes sense literally), the second indicator (whether the proposed interpretation coheres well with its immediate context), and the fifth indicator (relatively detailed geographic or chronological information is present in the immediate context) support the literal interpretation and the third indicator (whether other symbolic expressions are present in context), the fourth indicator (whether husband is highlighted in the narratives in which it belongs), the sixth indicator (whether vocabulary suggesting the use of symbols is present) support the symbolic interpretation. And according to the relative importance of these six indicators, I evaluate that the second indicator, “the indicator of whether the proposed interpretation coheres well with the immediate context”, is the most important indicator and conclude that pe,nte ... a;ndraj and nu/n o]n e;ceij in John 4:18 should be interpreted literally. Of the six literal interpretations listed above, I observe “interpreting the Samaritan woman as an immoral woman who has been married and divorced five times” best matches the “indicator of whether the proposed interpretation coheres well with the immediate context.” Therefore based on this analysis, I interpret the five husbands literally (more specifically, interpret this woman as an immoral woman who has been married and divorced five times), and see this text as the literary device of the evangelist to demonstrate the supernatural power of Jesus that helps the woman identify Jesus as the prophet.

항공기범죄에 대한 형사법적 대응방안

송승은(Song Seung Eun) 한국형사정책학회 2017 刑事政策 Vol.29 No.1

We have come to rely tremendously on the convenience afforded by air travel, however as much as advancements in air travel have made better more convenient for us, we cannot fail to look at the other side of it. The rise air traffic improved the impetus of terrorist groups providing them with a new objective and another means for acts of violence and crime. This study will look at the structure of a legal system that will aid aviation security and prevent hijacking and implement this system as a legal mechanism for the prevent of terrorism in the air. The current Aviation Safety Act, and Aviation Security Act seems to have many problems which do not meet the practical needs in Korea, because there were not enough consideration on civil aviation system in Korea, but only regarded the relevant international conventions and foreign practices on it. Now it is necessary to amend several provisions in Aviation Safety Act, and Aviation Security Act to enhance more practical efficiencies in its implementation through systematization of the provisions on crime which may happen during aviation. UAVs(Drones) are used attack aircrafts equipped with weapons like missile. The legal problems and conflicts with other legal system that can occur with the increasing uses if the UAVs. The new effective regulation in domestic legal system on the use of the UAVs must be needed. The universality principle is applicable to the aircraft crime as the hostage crime, and if a person who has committed the crime of hostage taking after aircraft hijacking, the punishment must be strengthen.

사기죄의 처분행위와 처분의사

송승은(Song, Seung-Eun) 한국법이론실무학회 2018 법률실무연구 Vol.6 No.3

사기죄는 사람을 기망하여 재물의 교부를 받거나 재산상의 이익을 취득하거나 제3자로 하여금 취득하게 함으로써 성립한다. 사기죄가 성립하려면 기망행위, 피기망자의 착오와 처분행위, 재물의 교부 또는 재산상의 이익 취득, 그리고 재산상의 ‘손해발생’이 있어야 한다. 여기서 처분행위란 피기망자가 그 의사에 기초하여 직접 재산상 손해를 초래하는 작위 · 부작위 또는 수인을 말한다. 재물에 대한 처분행위는 점유를 이전하는 교부이고, 재산상 이익에 대한 처분행위는 재산상 이익의 이동으로 직접 손해를 야기하는 작위 또는 부작위이다. 처분행위는 기술되지 아니한 구성요건요소로서 기망에 의한 착오와 재산상의 손해라는 사기죄의 요건을 연결하는 기능을 한다. 또한 자기손상행위인 사기와 타인손상행위인 절도를 구별하기 위해 처분행위의 요소로서 처분의사가 필요하다. 그리고 처분의사의 내용은 사기죄가 본래 피기망자로 하여금 처분행위의 결과를 모르게 속이는 것을 내용으로 하는 범죄라는 점과 자기손상범죄로서의 사기죄의 본질로부터 처분결과에 대한 인식이 요구되는 것은 아니라는 점에서 처분행위 인식설이 타당하다. 이에 따라 서명사취 사례와 환급금 사기의 경우 피기망자는 처분문서에 관한 서명 · 날인행위 또는 현금인출기 작동행위를 한다는 인식이 있으므로 처분의사가 인정되어 사기죄가 성립한다. 다만 환급금 사기의 경우 특별법인 통신사기피해환급법이 우선 적용된다. A person who defrauds another, thereby taking property or obtaining pecuniary advantage from another, shall be punished by imprisonment for not more than ten years or by a fine not exceeding 20 million won. For fraud to take place, there must be deceptive behavior, error and disposition of the defrauded person, the pecuniary advantage or property, and the occurrence of damage. The act of disposition refers to the act or omission of a person who causes the damage directly to the property based on the will. Disposition acts as a component element that is not described, and functions to link the requirements of fraud, such as error and property damage. It is also necessary to dispose of fraud as an element of disposition to distinguish fraud as a self-damaging act from theft as a damaging act. Fraud is an offense that essentially involves deceiving a defrauded person without knowing the consequences of the disposition. And the nature of fraud, which is a self-damage offender, does not require recognition of the consequences of disposition. So the disposition behavior awareness theory is valid. In the cases of signature swindling and refund fraud the defrauded person is aware of the fact that he/she is signing and sealing the disposal document or acting as an ATM. In this cases, the intention of disposition is recognized and a crime of fraud is established. In the latter case, ‘the special act on the prevention of loss caused by telecommunications-based financial fraud and refund for loss’ is applied before the Criminal Code.