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탈신경지배(Denervation)가 혈관화 근판에 미치는 영향에 대한 실험적 연구
육홍미,정전은 고려대학교 의과대학 1992 고려대 의대 잡지 Vol.29 No.1
Since the free vascularized muscle flap was experimentally introduced by Tamai in 1970, it has become a useful clinical procedure in the field of reconstructive surgery. It provides functioning skeletal muscle in an area where it is absent. However, clinical applications have far preceeded critical experimental documentation of the functional capabilities of replanted muscle, and the investigations of the recovery process of transferred muscle has yield equivocal results. So, this study was designed to investigate the volumetric and histologic change of the vascularized muscle flap and effect of denervation. In 120 rats, vascularized gastrocnemius muscle flap was elevated and resutured to the original defect. In group 1, sciatic nerve was cut and reapproximated with nerve suture. In group 2, flap was elevated, but nerve was left untouched. In group 3, flap elevation and nerve severence without reapproximation was done to produce denervated flap. In group 4, only nerve transection and reapproximation was done. After 1, 4 and 8 weeks, weight of gastrocnemius muscle flap and the diameter of the muscle fiber was measured, and histologic change was observed. The results are as followings ; 1. After 8 weeks, the weight of muscle is 68±8.4% of normal contralateral muscle in group 1, 72±4.0 % in group 2, 32±2.8 % in group 3 and 93±8.9 % in group 4. There was no statistical difference between group 1 and group 2 (p>0.05). 2. The mean and the median of the diameter of the muscle fiber was 20.73 μm and 21 μm in normal, 13.98 μm and 17 μm in group 1 after 8 weeks, 14.42 μ and 14 μ in group 2, 8.15 μ and 8 μ in group 3, and 16.65 μ and 17 μ in group 4. The diameter of muscle fiber seemed to be decreased after denervation and increased after reinnervation. 3. In histologic examinations, there was only atrophic change in most of the sample. The central location of nucleus, fragmentation, hyaline degeneration and replacement with connective tissue were confined to the periphery of the flap.
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육홍미,윤진호,김한중 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.2
In 1976,Dr C.Radovan designed an implantable, inflatable device with a semirigid backoplate and a self-sealing remote injection port, and the modern era of soft-tissue expansion began. This technique provides a quantity of tissue of similar color, texture and other specific quantity for reconstruction of adjacent defects, and makes donor site closure easy. During the period February, 1985 to May,1986, we used tissue expanders to treat 12 patient with soft tissue defect, 5 scalp, 3 upper extremity, 2 lower extremity and 2 trunk in location. All cases were successfully reconstructed without major complicarion. Here, presentative case reports are presented and the management and prevention of complications are discussed.
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Glutaraldehyde로 처리된 이종 및 자가 미세혈관 이식에 대한 실험적 연구
육홍미,윤진호,우동훈,김한중,김대섭 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3
During microvascular procedures there frequently arises a need for a vascular graft. In this study the efficacy of preserving microvascular heterografts with glutaraldehyde tanning was investigated. These were compared with nonprepared autografts. Autogenous non-prepared rat femoral arterial grafts and glutaraldehyde-tanned rabbit femoral arterial grafts were interposed in fat femoral arteries. Ninty-one per cent and 74per cent patency rates were achieved respectively at 4weeks. This study has shown that glutaraldehyde tanning reduces the antigenicity of rabbit femoral arteries used as heterografts in the rat. This reduction in antigenicity prevented necrosis of the rabbit femoral the tendency to thrombosis, but as unacceptable occlusion rate (26% occluded) persisted. We assumed that thrombosis occurred because of incomplete reduction of the antigenicity of the heterografts. The exact mechanism resulting in occlusion of glutaraldegyde-tanned grafts is not known. Further work is therefore required to establish a tanning technique which can reduce antigenicity without leading to occlusion and without and without rendering the graft the difficult to use.
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육홍미,김한중,윤진호 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.4
Mucoceles were chronic, expansile, cyst-like lesions of the paranasal sinuses. In this article, a case of a 48-year-old male with ethmoidal mucocle was presented. He had a mass on left medial canthal area and complained pain, proptosis, inferolateral displacement of the left eyeball and ophthalmoplegia. Definte diagnosis was made by computed tomography and exenteration through an exteral ethmoidectomy approach was successful. This report covers the review of ethmoid mucocele, also.
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트롬빈을 이용한 피부이식 공여부 창상처지에 관한 임상적 관찰
이강원,육홍미,윤진호,김한중 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.3
A split thickness skin graft was used for treatment of skin defect on burn wound and others, but there were many problems with donor site care. The goal of donor site care is rapid reepithelization without infection, decrease of pain, and early control of bleeding. To solve this problem, many treatment methods have been reported, but satisfying results have not been introduced. According to the effectiveness of thrombin, which directly produced a blood clot on capillary and small vessel oozing, we used thrombin application on donor site dressing of split thickness skin gaft. We were able to obtain a good effect of thrombin application in the treatment of split thickness skin gaft donor site by decreased infection rate, pain, relief, and early reepithelization.
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