푸르니에 괴저 환자에서 유경 전외측 대퇴부 천공지 피판을 이용한 음낭 재건

오흥찬,배성환,이재우,김주형,남수봉 대한요로생식기감염학회 2013 Urogenital Tract Infection Vol.8 No.2

Purpose: We have many choices of surgical methods with scrotal reconstruction after Fournier’s gangrene. From the aesthetic perspective, the reconstruction method with anterolateral thigh perforator pedicled flap is better than other options. We report our experience with postoperative results and aesthetics of the anterolateral thigh perforator pedicled flap. Materials and Methods: From November 2011 to May 2013, 4 patients underwent anterolateral thigh perforator pedicled flaps. The authors checked the aesthetic results and occurrence of complications at follow-up exams.Results: There was no total or partial necrosis of flap among the four patients. The only complication was wound dehiscence followed by infection that healed secondarily during the follow-up period. Conclusions: Anterolateral thigh perforator pedicled flap is a very useful choice for surgery at the defect caused by Fournier’s gangrene because it is relatively thin, offering an excellent aesthetic result.

피부제거 없이 시행한 높은 쌍꺼풀의 교정

오흥찬,윤동주,최수종,배용찬,강철욱,최치원 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.5

Purpose: Double - eyelid operation is one of the most common cosmetic operations among Korean patients. In such operations, however, the complexity of and individual differences in the patients' anatomical structures may cause various complications, such as asymmetry, retraction of the eyelid, and the occurrence of a high fold. A high fold occurs frequently, and its correction is not very simple. Many methods have been developed to correct it, and among these, the operation involving the excision of the skin between the previous double - eyelid line and the new double - eyelid line is usually selected by plastic surgeons. In many cases, however, patients have insufficient eyelid skins for this operation. In this study, the authors introduce an operation procedure for high - fold correction that does not involve skin excision Methods: From June 2005 to June 2009, 246 cases were treated with this procedure. After the incision of the new double - eyelid line, dissection was done between the previous scar tissue and the levator aponeurosis. Then the orbital septum, orbital fat or the retro - orbicularis oculi fat was slid down and sutured with a tarsal plate. Such sutures were repeated at four to five points, including the lateral and medial limbus, to prevent the reattachment of the previous scar and to create a new double - eyelid line at the end of the orbital septum. Results: Most of the high - fold patients were satisfied with the procedure described above. Their previous scar was hidden under the new double - eyelid line after the operation. In the six cases, the scar was visible in the patients who had a very high and deep inner line. As such, scar revision was undertaken three months after the operation. It is known that scar revision is also required after an operation involving skin excision in the case of a very high inner - eyelid line. Conclusion: This method is an appropriative procedure for high - fold correction for patients who have insufficient upper - eyelid skin.

소아나 협조가 힘든 환자에서 봉합사 제거가 쉬운 봉합법

남수봉,오흥찬,강철욱,최수종,배용찬 부산대학교 병원 암연구소 2009 부산대병원학술지 Vol.- No.25

안면부에 발생한 동정맥루의 치험례

최수종,오흥찬,배용찬,남수봉,문재술,오창근,김창원 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3

Purpose: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision.Methods: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed.Results: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination.Conclusion: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.

In Vitro Inhibitory Effect of Licoricidin on Human Cytochrome P450s

김선주,오흥찬,김정아,이성호,이상규 사단법인 한국질량분석학회 2014 Mass spectrometry letters Vol.5 No.3

Licoricidin isolated from Glycyrrhiza uralensis is known to have anticancer, anti-nephritic, anti-Helicobacter pylori,and antibacterial effects. In this study, a cocktail probe assay and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were used to investigate the modulating effect of licoricidin on cytochrome P450 (CYP) enzymes in human livermicrosomes. When licoricidin was incubated at 0-25 μM with CYP probes for 60 min at 37oC, it showed potent inhibitoryeffects on CYP2B6-catalyzed bupropion hydroxylation and CYP2C9-catalyzed diclofenac 4’-hydroxylation with half maximalinhibitory concentration (IC50) values of 3.4 and 4.0 μM, respectively. The inhibition mode of licoricidin was revealed as competitive,dose-dependent, and non-time-dependent, and following the pattern of Lineweaver-Burk plots. The inhibitory effect oflicoricidin has been confirmed in human recombinant cDNA-expressed CYP2B6 and 2C9 with IC50 values of 4.5 and 0.73 μM,respectively. In conclusion, this study has shown the potent inhibitory effect of licoricidin on CYP2B6 and CYP2C9 activitycould be important for predicting potential herb-drug interactions with substrates that mainly undergo CYP2B- and CYP2C9-mediated metabolism.

광범위한 안와하벽골절에서 속눈썹밑 절개 및 비강 내 내시경적 접근을 동시에 사용한 재건술

최수종,오흥찬,남수봉,배용찬,강철욱 대한두개안면성형외과학회 2009 Archives of Craniofacial Surgery Vol.10 No.2

Purpose: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The purpose of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of Medpor® through subciliary approach. Methods: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor® through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient‘s charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. Results: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. Conclusion: The ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor® through subciliary approach can be considered one of the appropriate technique for extensive inferior blowout fracture.

침윤성 지방종을 동반한 대퇴부의 거대 피부 지방종성 모반의 치험례

남수봉,오흥찬,이재우,강철욱,최수종,배용찬 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.24

Purpose : Nevus lipomatosus cutaneous superficialis is a rare type of benign soft tissue tumor, which appears as nodules of various size, and it is mainly located on lower extremity, buttock or thigh. Since the condition was first described by Hoffman and Zurhelle in 1921, a number of cases have been reported in Korea. However, nevus lipomatosus cutaneous superficialis combined with infiltrative lipoma is a very rare case. So we report the experienced case of huge multiple nevus lipomatosus cutaneous superficialis combined with infiltrative lipoma around the muscle layer. Methods: A-52-year old male presented with small masses on lateral surface of left thigh. These masses have appeared since he was approximately 10 years old approximately and tended to conjoin each other. Because of no specific symptoms, he didn't take any treatment before visiting PNUH. As the conjoined masses growing, it made discomfort in the ordinary life. The lesion was cerebriform tumor (30cm x 25cm). During the operation under general anesthesia, we removed completely the masses with lipoma that involved muscle layer. And then we covered the area of exposured muscle and fascia with artificial dermis(Surederm) and reconstructed with using procedure of split thickness skin graft. Results: The subcutaneous fat was dissected and the masses were resected with fascia and some fatty layer that involved muscle layer around gluteus maximus muscle. In the histologic finding, the clusters of fat cells were scattered at papillary dermis and reticular dermis, and a quarter of dermis was replaced by adipose tissue. Conclusions : Although we couldn't find out the relationship between the infiltrative lipoma and nevus lipomatosus cutaneous superficialis. We experienced the unreported case of nevus lipomatosus cutaneous superficialis accompanied with infiltrative lipoma which invaded around gluteus maximus muscle and spermatic cord. With this cases, we hope it would help the mechanism of nevus lipomatosus cutaneous superficialis with additional investigation of the relationship or sequence between this disease and infiltrating lipoma.

근피피판과 천공지피판을 이용한 둔부 주위 욕창 재건술의 술후 결과에 대한 고찰

배성환,남수봉,김경훈,이재우,오흥찬,최수종,배용찬 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.6

Purpose: Perforator flaps have been widely used for reconstruction of pressure sores because they have many benefits, especially reducing tension. Otherwise in order to prevent recurrence of a pressure sore, sufficient thickness of a flap is desirable, so a musculocutaneous flap is also useful for reconstruction of a pressure sore. Therefore, the authors considered about the postoperative results of reconstruction of pressure sores between using perforator flaps and musculocutaneous flaps. Methods: In this study, 33 patients (46 flaps) who underwent reconstructive operation of pressure sores from January 2007 to February 2011 were reviewed. Patients operated by using perforator flaps were 18 (18 flaps), and musculocutaneous flaps were 17 (28 flaps). We studied postoperative complications and recurrence. Results: We experienced five patients (10 flaps) with complications or recurrences who were operated using musculocutaneous flaps and one patient using a perforator flap. One case using a perforator flap stemmed from dehiscence caused by a urinary fistula occurring in two months after the surgery. Among ten cases using musculocutaneous flaps, one case was caused by total necrosis of flap, five cases by partial necrosis of flap and dehiscence,and four cases by recurrences during follow-up period. Conclusion: Even if more cases were required, it can be more considerable to operate using the perforator flap rather than the musculocutaneous flap to reduce the complication or recurrence of pressure sore.

전외측 대퇴부 천공지 유리피판술의 실패 원인과 합병증

강경동,이재우,김경훈,오흥찬,최치원,최수종,배용찬,남수봉,김정일,추기석 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.1

Purpose: Anterolateral thigh(ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. Methods: 84 patients that treated with ALT perforator free flap from December 2004 to 2008 & February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from 3 × 4 to 12 × 18 cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. Results: Of the 84 patients, partial necrosis of flaps were occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And 5 patients experienced total flap necrosis because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. Conclusion: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time are considerable to prevent flap necrosis. And operators should be needed careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.

6례의 Angiosarcoma 환자에 대한 경과 분석

송경호,남수봉,김경훈,최치원,오흥찬,최수종,배용찬 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.6

Purpose: Angiosarcoma is a rare and aggressive malignant soft tissue tumor. Due to a lack of the established optimal treatment modalities, however, an extensive resection followed by an early detection has been reported to be the best treatment of choice. We analyzed the clinical course of six patients, hence attempted to contribute to making a treatment plan for patients with angiosarcoma. Methods: Six patients who have been surgically treated between 2005 and 2010 are included. Through a retrospective analysis of the medical records, we evaluated the pattern of disease detection, a past history,time span between the detection and the primary surgery,surgical treatment modalities, time span between the primary surgery and the recurrence/metastasis, the sites of metastasis and the secondary treatment modalities. Results: The mean age of patients was 70.5 years; all male; and the sites were the scalp. Four patients underwent the reconstruction using a local flap with a skin graft and two patients using a free flap. The mean period elapsed until the primary operation since the identification was 7.3 months and until a recurrence or a metastasis occurred following the primary operation was 12 months. Four patients had pulmonary metastasis. As a secondary therapy, four patients underwent the radiotherapy and one was treated with the chemotherapy. At the present, five patients died and one undergoes a monitoring of the clinical course. Conclusion: It would be mandatory to shorten the length of hospital stay and to return patients to their daily lives as the earliest as possible using relatively simpler surgical methods, thus attempting to give them opportunity to resume their previous normal life.