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RISS 인기검색어
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- 저자 : 柳在德 (검색결과 67 건)
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柳在德,閔大泓,張寅奎 최신의학사 1969 最新醫學 Vol.12 No.7
It is often on the alert as to the facial nerve damage as one gets laceration of the face. Nevertheless, we used to neglect to seek for the possible coincidental damages to the parotid gland or duct, even when the facial lacerations involved the posterior cheek region. Although the injuries of parotid gland can be healed without the major complication, those of parotid duct have usually been complicated with the long-standing fistula formation. We present here a case who wassuccessfully treated by surgery for his`salivary fistula of the cheek following the primary repair of a laceration. Various methods of treatment for the parotid duct injury are also discussed.
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근막 및 동ㆍ정맥 혈관경을 이식하여 생성시킨 2차적 도서형 복합피판에 관한 연구
卓寬哲,柳在德 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5
A fascio-vascular pedicle based on the epigastric vessels was developed in a rat model to determine if it could be used as a "universal carrier"to revascularize a new composite flap. The effects of time course. carrier size and flap ischemia on the revascularization process were studied. A 2.5×4cm or 1×4cm fascial patch pedicled on the vessels was transferred under bipedicled 2.5×4, 6, or 8cm abdominal panniculo-cutaneous flaps. At different time intervals. the flap was raised as an island flap connected only by its vascular bundle then stured back in place. The skin perfusion by dermofluorometry and flap survival area, while the narrow carrier had only 71%. The wide carrier induced relatively faster and better revascularization(p<0.05). Moderate ischemia promoted revascularization(P<0.01). An india ink injection study and histologic examination model for prefabrication of complex new composite flaps and for studying the process of revascularization between the laryers. Based on these findings and further investigations, we are conductiong clinical applications of the prefabrication and free transfer of the seconsdary island flap in humans.
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申晙,卓寬哲,李英浩,柳在德 大韓成形外科學會 1977 Archives of Plastic Surgery Vol.4 No.2
Branchial cysts, sinuses and fistulas were so named because of their supposed embryologic derivation from the branchial arches. Although the explanation of their origin has been handed down in the literature and texts for many years, there was not a great deal of evidence to support this hypothesis. branchial cysts and sinuses have been of interest ever since they were first reported by hunczowski in 1989. However all discussions of the embryological origin of anomalies in the lateral neck regions were dated to the publication, in 1832, of studies by von Ascherson of all the cases of lateral cervical anomalies available at that times. His conclusion was that these lesions resulted from failure of closure or obliteration of the branchial clefts. In 1912 Wenglowski reinvestigated and concluded that branchial cysts arose from the remnants of the thymic duct. But this theory has reputed by many as untenable although Meyer agreed with him. More recently King(1949) believed that it would be better to name these cysts according to their anatomical position or pathologic entity, such as, lateral lympho-epithelial cysts of the neck. In 1959, Bhaskar and Bernier reviewed the histologic features of 168 cases and concluded that these cysts arise from epithelial inclusions in lymph nodes. Although it is not the purpose of this paper to discuss at any great length the possible embryologic development of branchial cysts and sinuses, believing that the long time usage of the terms "Branchial cysts and fistulas" makes them permanent in our literature, these two conditions were considered separately because of significant differences in the history and objective findings. Author reviewed the patients with branchial cysts, sinuses and fistulas who were admitted treated in Yonsei medical center during the period between 1965 and 1976 and evaluated clinical patterns, proper management and discussed possible embryologic origin. there have been 55 cases of branchial cysts, sinuses and fistulas in that period. The following results were obtained: 1. Incidence was ordered as follow; preauricular sinuses, lateral cervical cysts, lateral cervical sinus group, preuricular cyst. 2. Females were affected 3 times more than males in preauriculr cysts and lateral cervical sinus group. 3. Left side was predominant in lateral cervical sinus group and bilateral in volvement was overall 6%. 4. Preauricular lesions and lateral cervical were always evident at birth or just after birth. however, lateral cervical cysts were evident in 2nd and 3rd decade. The average age of onset for the lateral cervical cysts was 16.7% years. 5. Recurrence was higher in sinus group than cysts group in 2 to 4 times. 6. the presenting symptom in most of all the preauricular sinuses was small opening on crus of helix. 7. In most cases of the lateral cervical cyst, mass was presented in the upper 1/3 of the neck along the anteromedial border of the Sternocleidomastoid muscle. 8. In most cases of the lateral cervical sinuses and complete fistulas, the cutaneous oriffice was located in the lower one thirds of the neck, in reaching the pharynx, passed betweem the internal and external carotid artery. Internal openings were found uniformly in the region of the base of the supratensillar fossa. 9. Usually combined with acute oro-pharyngeal inflection, such as U.R.I., tensillitis, sinusitis, caries especially in cyst group. 10. Combined congential anomalies were cleft lip; 1 case, microtia; 1 case and accessory ear; 1 case. 11. Frequently mis-diagnosed as T.B. lymphadenitis or thyroglossal duct cyst especially in lateral cervical cysts.(47%) 12 Management was sufficient with complete excision of firtulous openings and tracts or cysts through single skin incision or two transverse incision 13. No specific complications except post-operative would infections. 14. Microscopically the sinus tracts showed lining epithelium of columnar type throughout of the major portion. the cyst wall and distal extremity of the sinus tract revealed st. squamous epithelium. Lymphoid tissue was uniformly present beneath epithelial lining in either cyss and sinus tract.
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김지연,탁관철,류재덕 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.6
In a bilateral cleft lip, the deformity is very complex and severe due to prolabium with the small vermilion border and the absence of the functional muscular fibers, the short gingivolabial sulcus, prominent premaxilla, the absence of nasal floors and the short or non-existent columella etc. So a satisfactory reconstruction of the lip in the functional and cosmetic aspect is very hard with the usual lip repair method. If a bilateral cleft lip is corrected with the unilateral cleft lip repair method step by step, there are disavantages and it is well as time consuming and for this reasons a simultaneous, correction of bilateral cleft lip is preferred by many surgeons today. The Millard's rotation-advancement method and the Manchester's method are representative operative procedures for the simultaneous repair of the bilateral cleft lip in a single stage. In the former, the postoperative scar is prominent in Korean and it is not enough to prevent whistling deformity. In the latter, In the latter, it is not enough to obtain natural philturm and to prevent whistling deformity, too. The authors modified the Manchester's method for compensation of these shortages. The incision was made with V-shape on prolabium as in the mexican modification of the Manchester's method which had been presented by Viale-Gonzalez. To make pout vermilion and tubercle, muscle flaps were elevated from both sides lateral segments, turned down and cross-sutured behind the vermilion of prolabium. Fora philtral dimple, the subcutaneous tissue of prolabium was fixed to premaxilla with suture. This modification of the single stage bilateral lip repair method was applied to 5 patients with complete and incomplete or bilaterally complete cleft lip deformity and followed up for 3 months to 62 months. cosmetically and functionally excellent results were obtained without complications.
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