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        열장장부 이음법을 이용한 구순열성형술

        배남석,김영석,박병윤 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.5

        The widely prevailing Millard's rotation-advancement flap method is characterizes with the upper lip scar on a philtral column and that it is less conspicuous than LeMesurier's or Tennison's metheds. Nowadays, straight line closure methods are employed together with the Millard's. However there are still some problems which are a straight line closure that goes against the principle of plastic surgery, a noticeable scar, tenting of the peak of Cupid's bow, a short lip tendency, and depression of the lip when the muscle contracts. In this respect, we designed two or three small trapezoid skin flaps on the cleft side and the same number of releasing incision lines on the non-cleft side and then let them interdigitate one another. We called it dovetail cheiloplasty. The muscle work was done by suturing one third of the cleft side muscle to the dissected dermis of the non-cleft side skin flap just under the philtral dimple. Our patients had a primary incomplete, a microform type cleft lip or a secondary cleft lip deformity. The result of employing this method showed an inconspicuous scar, a shorter lip, and a natural formation of the philtrum. We believe this method induces the improvement of straight line closure with respect to the quality of scars and the morphology of an upper lip.

      • KCI등재

        내유방혈관 관통지에 대한 해부학적 연구

        임성윤,송현석,배남석,박명철 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.1

        Purpose: As a recipient vessel, internal mammary vessels have many advantages for microvascular reconstruction of the breast. But the approach is time consuming and results in large morbidities. However, the perforating branches of the internal mammary vessels can be used to minimize such demerits. The purpose of this cadaver study is to clarify the location and diameter of the perforating branches of internal mammary vessels and to prove that they are safe and reliable recipient vessels. Methods: We studied 11 formalin-fixed cadavers and dissected their anterior chests bilaterally. The chests were exposed using midline presternal incisions. We dissected and found all perforators at subfascial planes under loupe magnification. The number, external diameter, and the distance from the midline were measured. Result: The mean external diameter of the arterial perforators was 1.32mm and the mean external diameter of the venous perforators was 1.48mm. The largest arterial and venous perforators were most frequently found in the second intercostal space. The mean distance from the midline to the perforator was evaluated; the artery averaged 1.95cm and the vein averaged 2.08cm. Conclusion: This study will be helpful when using the internal mammary perforating vessels as a recipient vessel during breast reconstruction.

      • KCI등재

        간이식에서 간동맥 문합술

        박명철,박동하,배남석,왕희정,김봉완,김치선 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.1

        Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed from February 2005 to May 2008. Male to female ratio of the liver transplantation recipients was 3.4:1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92mm and mean artery length was 24.25mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re-anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

      • KCI등재

        악성흑색종에 대한 14년간의 임상적 고찰

        박동하,박명철,배남석,이일재,서승조 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.3

        Purpose: Recently, the incidence of malignant melanoma has been steadily increasing. Malignant melanoma is already known to have poorer prognosis than other primary skin cancers. Despite the poor prognosis, it is relatively less known to the public so that a number of patients visit hospital carrying advanced stage tumor. Yet, extensive study about malignant melanoma is currently insufficient, and specific guidelines and statistical figures in Korea are almost inexistent. Therefore, authors reviewed patients with malignant melanoma who have visited our hospital for last 14 years. Methods: Between January 1994 and January 2008, 62 patients were diagnosed with malignant melanoma at our hospital. A retrospective study was performed with data from patients' charts and biopsy results. Annual incidence, mean age of onset, gender, tumor location, tumor thickness, pathologic ulceration, clinicopathologic subtype, and clinical AJCC stage were evaluated. Analysis of factors associated with survival were performed using the Cox proportional hazard model. Kaplan - Meier method was used to generate survival curves. Results: Clinicopathologic features of 62 patients (32 male, 30 female) with average age of 57 years were evaluated. Most lesions were found in lower limb, and the most common subtype was acral lentiginous melanoma. We could also find that age, tumor thickness, and clinical stage were the only significant prognostic factors. Conclusion: Clinicopathologic features of malignant melanoma were analyzed in this study, but the result is not ready to be generalized because the number of cases is too small. Further study must be performed to report clinical guidelines for prognosis and treatment for malignant melanoma patients in Korea.

      • KCI등재

        구개열과 동반된 선천성 구개 기형종 1례

        송현석,박동하,배남석,박명철 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.4

        Purpose: The oral teratoma is found approximately in live birth at the rate from 1:35,000 to 1:200,000. In a review of literature 16 cases of midline teratoma with cleft palate were reported. We report a case of congenital palatal teratoma with cleft palate in a 1-year-old girl. Methods: A 1-year-old girl was admitted our institution for the closure of cleft palate. On the intraoperative findings there was 4×1×0.5cm sized hairy soft mass at the midline and complete cleft palate. We did incisional biopsy intraoperatively and its pathology revealed heterotopic brain tissue. The excision of remaining mass and palatoplasty with Sommerlad's method were performed. The final pathology of the mass was mature cystic teratoma.Results: After the operation there were neither recurrence nor oronasal regurgitation.Conclusion: We report for one patient with congenital palatal teratoma associated with cleft palate and obtained an excellent result.

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