다양한 피판술을 이용한 두안면부 피지선암의 치료

김다앎,유용아,강낙헌,오상하 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.1

Purpose: Sebaceous carcinoma is a rare malignant tumor that occurs mostly in head and neck regions. Early diagnosis and treatment are necessary because it tends to be locally aggressive and goes through distal metastasis with fast progression. This study presents reliable surgical methods for sebaceous carcinoma in head and neck regions. Methods: Three patients were included in this study. First, a 61-year-old woman visited the hospital with a yellow-colored, slowly growing mass on the left ala. A 54-year-old woman had a brown-colored mass on her right preauricle. Last case was a 62-year-old man who had a yellow-colored mass on his scalp. CT scan and punch biopsy were done. All cases were diagnosed as sebaceous carcinoma. The lesions were resected with 10 mm safety margin and various regional flaps were used for reconstruction. Results: Histological examination revealed sebaceous differentiation and local invasions. Postoperatively, all patients did not suffer from complication and no recurrence was found. Conclusion: We recommend early wide excision with an enough safety margin, and a regional flap as a treatment of sebaceous carcinoma. (J Korean Cleft Palate Craniofac Assoc 11: 58, 2010)

이마피판에서 피판 노출면의 인조 콜라겐막을 이용한 관리

김다앎,오상하,서영준,양호직,정승원,Kim, Da-Arm,Oh, Sang-Ha,Seo, Young Joon,Yang, Ho Jik,Jung, Sung Won 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.1

Purpose: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors' modification to overcome this problem, using artificial collagen membrane. Methods: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. Results: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. Conclusion: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.

Bulbous Tip Correction Focusing on Skin Soft Tissue Envelope in Asian Rhinoplasty

김다앎,정재용,오상하 대한미용성형외과학회 2014 Archives of Aesthetic Plastic Surgery Vol.20 No.3

Background Correction of a bulbous tip is a difficult procedure in Asians, because their lowerlateral cartilage is relatively small and structurally weak to support the thick skin softtissue envelope (SSTE). Therefore, lower lateral cartilage manipulation alone yieldsinadequate bulbous tip correction. In this study, authors aim to provide a newbulbous tip definition reflecting nasal tip SSTE and categorization with a suitablesurgical procedure. Methods One hundred sixty-three patients with tip rhinoplasty between January 2009 andDecember 2012 were studied who had a tip lobular width greater than 60% of the alar base width. Depending on cartilage size and characteristics of the nasal tipsuperficial musculoaponeurotic system (SMAS) with SSTE thickness, the followingclassifications were made: Group I: thin SSTE with a large lower lateral cartilage,Group II: thick SSTE with a small lower lateral cartilage, Group IIa: thick SSTE withloose SMAS, and Group IIb: thick SSTE with dense SMAS. We evaluated the degree of surgical improvement by comparing pre- and postoperative photographs. Results After comparing pre- and postoperative photos, we observed improvements in tipbulbosity by 11.7% in Group I (n=41), 11.9% in Group IIa (n=64), and 7.1% in GroupIIb (n=58). ConclusionsIn Asians, nasal tip bulbosity is often due to excess SSTE. Therefore, a bulbous tipshould be defined and evaluated based on its underlying SSTE. Adequate soft tissue resection in addition to lower lateral cartilage support and manipulation are warrantedto achieve a refined tip.

The Impact of Molecular Weight of Conjugated Polymers on the Performance of Organic Cathode Lithium-ion Batteries

김다앎,송이슬,육찬호,이원호 한국고분자학회 2023 한국고분자학회 학술대회 연구논문 초록집 Vol.48 No.1

Effect of Conjugated Polymer Molecular Weight on Organic Cathode Lithium-ion Battery Performance

김다앎,육찬호,이원호 한국고분자학회 2023 한국고분자학회 학술대회 연구논문 초록집 Vol.48 No.2

변형된 대둔근 V-Y 전진 피판을 이용한 재발성 좌골부 욕창의 재건

이승렬,김다앎,오상하 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.6

Purpose: Recurrent ischial pressure sore is troublesome for adequate soft tissue coverage, because usually its pocket has a very large deep space and adjacent donor tissue have been scarred in the previous surgery. However, the conventional reconstructive methods are very difficult to overcome them. Modified gluteus maximus myocutaneous V - Y advancement flap from buttock can be successfully used in these circumstances. Methods: From February 2007 to October 2008, modified gluteus maximus myocutaneous V - Y advancement flaps were perfomed in 10 paraplegic patients with recurrent ischial pressure sore. The myocutaneous flap based on the inferior gluteal artery was designed in V - shaped pattern toward the superolateral aspect of buttock and was elevated from adjacent tissue. Furthermore, when additional muscular bulk was required to obliterate dead space, the flap dissection was extended to the inferolateral aspect which can included the adequate amount of the gluteal muscle. After the advanced flap was located in sore pocket, donor defect was repaired primarily. Results: The patients’ mean age was 46.9 and the average follow - up period was 12.4 months. The immediate postoperative course was uneventful. But, two patients were treated through readvancement of previous flap due to wound dehiscence or recurrence after 6 months. The long - term results were satisfied in proper soft tissue bulk and low recurrence rate. Conclusions: The modified gluteus maximus myocutaneous V - Y advancement flap may be a reliable method in reconstruction of recurrent ischial pressure sore, which were surrounded by scarred tissue because of its repetitive surgeries and were required to provide sufficient volume of soft tissue to fill the large pocket.

안각동맥의 해부학적 고찰과 임상적 적용

우종설,김다앎,오상하,김동운 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.6

Purpose: Although there are many ways to perform midface reconstruction, several difficulties exist for selecting the appropriate method, because of its anatomical and functional complexities, donor site morbidities, and poor aesthetic results. Various flaps based on the angular artery can overcome these limitations of the traditional reconstruction methods. The purpose of this study is to suggest an alternative reconstructive method for the midface using various flaps based on the angular artery. Methods: We investigated the relationship between the angular artery and its surrounding structures through cadaveric studies and then applied the findings clinically. As a result, we were able to perform reconstruction with a retroangular flap for defects of the lower half of the nose and the lower eyelid. In addition, defects of the upper half of the nose and the medial canthal area were reconstructed by using island composite glabellar flap. Received April 3, 2008 Revised April 23, 2008 Accepted May 22, 2008 Address Correspondence: Sang-Ha Oh, M.D., Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, 640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea. Tel: 042)280-7387/Fax: 042)280-7384/ E-mail: djplastic@cnu.ac.kr *본 논문은 충남대학교 학술연구비 지원에 의해 연구되었음. Results: The angular artery was reliable as a pedicle, whether it was used antegrade or retrograde. All the wounds were successfully closed, with the exception of minor complications such as partial skin necrosis and flap bulkiness. The aesthetic outcomes for the donor and recipient sites were satisfactory. Conclusion: The angular artery has diverse relationships with its surrounding structures according to its course of travel, and if a surgeon has a precise understanding of its anatomical location, we believe that retroangular flap and island composite glabellar flap may improve the treatment of midface defects.