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최희윤,류재만,조임철 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.1
Lacrimal obstruction is associated with lacrimal duct injury, posttraumatic scars, infection and congenital anormaly etc. There are now available a variety of surgical methods depending on the site of obstruction. Dacryocystorhinostomy is the treatment of choice for patients with nasolacrimal duct obstruction. The various modified procedures were introduced to perform a dacryocystorhinostomy since Toti. The nasolacrimal duct obstruction is characterized by epiphora and mucopurulent material discharge from the lacrimal sac clinically. The preoperative dacryocystography combined with lacrimal scintillography provide the most comprehensive anatomic and functional assessment of the drainage system avilable. Authors have experienced one case of bilateral nasolacrimal duct obstruction associated with lacrimal mucocele and got satisfactory results using dacryocystorhinostomy. So we could report them with reviews of the relative references.
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가토에서 복합조직이식 생착율 향상에 미치는 약제효과에 대한 실험적 연구
류재만,김잉곤,조임철 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.2
Since Konig first employed a piece of auricular scapha to restore an alar defect, composite grafts have become popular in the repair of small and moderate sized defects. But the use of composite grafts in facial reconstruction has been limited because of it's size. Thus many attempts such as precise approximation, lowering the temperature of a transplant or enlarging contact surface areas etc. have been made clinically and experimentally to improve the survival area of composite graft. But previously pharmaclolgic enhancements of composite graft survival have not been tried. Two agents that have demonstrated efficacy in skin flap survival, reserpine and isoxsuprine were investigated for their effect on composite graft survival. The full thickness auricular composite grafts, 1.5cm in diameter were created and reattached in the midportion of rabbit auricle. The survival areas were assessed at 14 days and the grafts were biopsied on the 1st, 7th and 14th days postoperatively for histopathologic examination. The drug treated groups produced a large increase in graft survival area over the control group. In histopathologic examination, the reserpine group showed a marked vascular proliferation and the isoxsuprine group showed telangiectasis and congestion.
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조임철,류재만,김잉곤 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.3
Mucoceles are chronic, expansile, cyst-like lesions of the paranasal sinuses. Intracranial invasion of mucocele is a rare but serious event. We observed a giant intracranial mucolele arising from the frontoethmoidal sinus probably. The patient described frontal headache as his chief complant. Physical examination findings included proptosis, inferolateral displacement of left eyeball, widened intercanthal distance, swelling in the left medial canthal region and lower midface retrusion. We approached surgically using a bicoronal flap and frontal craniotomy. After the mucocele and all pathologic sinus mucosae were removed, we reconstructed the orbital roof defect with split calvarial bone grafts. Thus the etilology, diagonsis, and treatment of paranasal sinus mucoceles were reviewed.
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거대설증을 동반한 경부의 cystic hygroma의 치험례
조임철,최희윤 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.4
Lymphangioma of tongue is a benign growth of lymphatic tissue that is present at birth or develops in early childhood, which may cause serious alterations in oral growth and development. The cystic hygroma is the most common of the lymphangioma and it is found predominantly in the region of the head and neck. Strictly speaking, none of methods of treatment for the management of lymphangiomas, including injection of sclerosing agents, radium or irradiation, aspiration and surgery, have been successful to date. A case of cystic lymphangioma extending from the neck to the tongue is reported. A six-year-old female was admitted because of swelling of the tongue. At that time, the tongue reportedly reached the extraoral size of 7×5×2.5cm and a soft, diffuse swelling of left anterior neck was revealed. The removal of cystic mass including left neck dissection and partial glossectomy were undertaken. Thus we reported such a rare case and reviewed the lymphangioma.
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피부손상 치유시 진피층내 Fibronectin, Type I 및 Type III Collagen의 발현에 대한 면역전자현미경적 연구
엄기일,조임철,김잉곤,정호심,이선우,류재만 韓國非破壞檢査學會 1998 Archives of Plastic Surgery Vol.25 No.7
This study was focused on the localizations or expressions of fibronectin and interactions of fibronectin with type I and type Ⅲ collagen in the new forming tissues during wound healing in rat skin. Adult male rats(SPrague-Dawley strain), 150∼200 gm weight, were used for experimental animals. And the experimental animals were divided into 3 or 4 groups by passed days after incision of back skin. The specimens were obtained and immunohistologically stained for electron microscopy from each of groups and the specimens were observed with the electron microscope (Hitach-600 Model). The results obtained were as follows. 1. Strong positive reactions for type I collagen are seen in the new forming tissue at day 3 after incision of skin, and moderate reactions at day 5 and day 7 after incision of skin. 2. The weak reactions for type Ⅲ collagen are seen at day 3 and day 5 after incision in the new forming tissues of skin. And the type Ⅲ collagen reaction at day 7 are more increased than that of other groups. 3. Fibronectin expressions are seen moderately at day 5 and day 3 groups, and strong at day 5 group, but at day 7 group reactions are rapidly decreased. It is suggested that type I and Ⅲ collagens are gradually increased from the beginning of wound healing to the time of the new fibrous tissues formation. The great activities of the fibronection are seen within processes of the new tissue formation for wound healing events.
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척골측 전박부피판을 이용한 동측 요골측 전박유리피판 공여부의 복원
권영익,안희창,최봉근,이신규,조임철,엄기일 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.1
The purpose of this study is to introduce a new method to reduce the donor morbidity of radial forearm free flap using ulnar forearm flap, and to evaluate its usefulness and results. 6 patients underwent radial forearm free flap designed by authors and we repaired radial forearm flap donor defect using ulnar forearm flap following ablative surgery for oropharyngeal cancers from June 1995 to February 1997. Radial forearm flap was designed just proximal to wrist crease, and its vascular pedicle was placed in the center of flap. Donor defect was repaired with V-Y fashion closure using ulnar artery axial pattern fasciocutaneous flap. Mean closing time of donor site was 30 minutes. and mean healing period of donor site was 10 days. There was no difficulty in closure. All donor sites healed completely without complication. Limitation of motion was not noticed in the wrist and forearm. We conclude that repair of radial forearm flap donor defect using ulnar forearm flap is new excellent method to prevent the prominent scar of forearm in cases of conventional skin graft for donor defect, and provide rapid healing of wound with low risk of complication
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