조직확장술을 이용한 두피재건

양순재 대한미용성형외과학회 1995 Archives of Aesthetic Plastic Surgery Vol.1 No.1

융비술에 사용된 Expanded Polytetrafluoroethylene(Gore-Tex^(�))의 문제점

양순재,이장현,탁민성 大韓成形外科學會 2004 Archives of Plastic Surgery Vol.31 No.1

전두사골 수막뇌류 치험 1례

김용배,이승욱,양순재 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.3

A meningoencephalocele is a herniation of the brain, its coverings or both, through a defect in the skull (Cranium bifidum). This malformation has an estimated incidence of 1 to 3 per 10,000 live births and approximated 75% are located in the occipital region. We experienced one case of frontoethmoidal meningoencephalocele associated with agenesis of corpus callosum. A brief review of related literatures is given.

가토의 대퇴정맥결손부에 이식된 PTFE도관의 조직학적 변화

김현수,김석권,양순재 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.1

In this study, 42 Polytetrafluoroethylene prostheses (Gore Tex: internal diameter 1.5 mm, length 8 mm, fibrilar length 30μm, wall thickness 0.2 mm) were used to reconstruct the vascular gap of rabbit femoral vein. To enhance the patency rate and promote the healing process, the prostheses were connected to rabbit femoral vein by means of stair-like sleeve anastomosis. The specimens were obtained in 12 hours (n=4), 1 day (n=4), 3 days(n=4), 1 week (n=10), 2 weeks (n=10), 3 weeks(n=10). After determination of patency, the specimens were prepared with H&E stains and investigated under microscope. After 1 week, endothelial-like cells were observed around anastomotic area from the adjacent vein. After 3 weeks, all microvenous grafts were completely covered by endothelial lining. The anastomotic area was more prominent in the endothelial lining than in the central area. There was some evidence of migrating cells from adjacent soft tissue through micropores of PTFE prostheses. Overall patency rate of PTFE prostheses connected by stair-like sleeve anastomosis was 85.7%. We concluded stair-like sleeve anastomsis of PTFE prostheses in the rabbit femoral vein result in better overall patency rate than end-to-end anastomosis.

넓은 골용기를 가진 코의 성형술

이진호,이승욱,양순재 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

The nose at the central portion of the face greatly affects the one's appearance as well as playing a functional role. In terms of aesthetic surgery, rhinoplasty is divided into several areas of correction such as the nose dorsal view status on the frontal view, lateral height, the features of the nasal dorsum and columella tip, the columella on the worm's eye view and finally, the preferable facial portion linked to the frontal part of the mandible for the patient's appropriate facial aesthetic rhinoplasty. Efforts topward the careful consideration of the above classified nasal parts and the proper operation to bring about satisfactory results have constantly been the great concerning subject by plastic surgeons. In practising various rhinoplasties, a great number of those who desire augmentation rhinoplasty to fix their flat noses are observed to have wider bony vaults than catilagenous vaults, and blunting of the nasomaxillary angel. In these cases, augmentation rhinoplasty alone could provide satisfactory results for the flat nose, due to the emaining silhouette of the widened broad bony vault. Therefore, the authors began performing the simultaneous operation with bilateral V-osteotomy of the nasal bones along the bony buldging and augmentation rhinoplasty with silastic implant under direct visual identification, using a fiberoptic angulated retractor and electric reciprocating saw. In V-osteotomy, an inward-medially displaced triangular bony segment width is 9-10mm in the lower pyriform aperture side. Because of the intact nasal mucosal lining, the triangular bony segment's survival was not disturbed. The patients original bony vault was broad, nose dorsum was flat, and nasomaxillary angle was blunted. After V-osteotomy and augmentaion rhinoplasty, the broad bony vault was well corrected and showed well proportioned contouring with the cartilagenous vault.

안검하수 교정술에 대한 임상적 고찰

박성진,박종섭,이영만,양순재 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.3

Blepharoptosis is referred to a congenital or acquired drooping of the upper eyelid due to a weakness of the levator or Muller's muscle. Not only can this cause a cosmetic blemish, but vision can be affected if the eyelid encroachs on the pupillary space. The management of blepharoptosis mainly depends on the degree of blepharoptosis and the amount of levator function. The result of the surgical correction of the blepharoptosis is determined by the nature of blepharoptosis, operative method, operative method, poerator's technique and postoperative care. Authors had experienced 32 patients of blepharoptosis from June, 1983 to June, 1987. We have followed up 27 patients (38 eyes). When the function of the levator muscle was 4 mm or more, the patient was treated by levator resection (12 patients, 16 eyes), and when the function of levator muscle was 3 mm or less, the patient was treated by frontalis suspension (8 patients, 13 eyes) and frontalis muscle transfer technique (7 patients, 9 eyes). The results were obtained as follow; 1. The ratio of congenital versus acquired blepharoptosis was 20;7. Among cases of congenital blepharoptosis, monocular versus bi-ocular was 9;11, and right versus left eye incidence was 5;4 Among 7 cases of acquired blepharoptosis, all cases were monocular and traumatic origin and right versus left eye inciedence was 4;3. 2. In the function of the levator muscle, 16 cases were 4 mm or more, and 22 cases were 3 mm or less. 3. In postoperative complication, incidental lagophthalmos in sleeping and ptotic change at upward gaze were noted in all cases, but these symptom were improved from 2 to 4 month after operation. Exposure keratitis were found in 4 cases, asymmetrical lid fold deformity were noted in 2 cases, postoperative cataract was found in 1 case, and recurrent blepharoptosis was found in 1 case. 4. At the cases of severe weakness of the function of levator muscle, the result of method of frontalis muscle transfer technique was more effective and excellent than that of frontalis suspension because the former was suspected more sustained and stable fixation and dynamic effect than the latter.

악안면 외상에 대한 임상통계학적 연구

박병일,박종섭,심희상,양순재 大韓成形外科學會 1988 Archives of Plastic Surgery Vol.15 No.3

This retrospective study comprised 2,081 patients with maxillofacial trauma sustained in various accidents and treated in the Department of Plastic and Reconstructive Surgery at the Soon Chun Hyand University Hospital between July 1978 and June 1987. Although the etiology of facial injuries varies from one geographical area another according to the development and type of the prevalent transportation system, car accidents probably cause more facial injuries than any other modality in most modern countries. Frequently, the patient with a face injury has concomitant injuries of several organ system. The timely diagnosis and initial treatment of these associated injuries, combined with the need for careful sequential planning, may require a highly sophisticated consideration of the total medical situation in the patient. The following results were obtained. 1) An increase of facial injuries of 23% per year was noted. September and July(13.3%, 12.5%) were associated with the highest incidence rates between 6:00 p.m. and midnight. 2) The extremes of age in the study range from 1 year to 66 years with a mean 31.5 years. Predictably, most of the injuries occured in young males with the highest incidence in the 20 to 30 year age group. Male pedominanted more than female, 2.8:1. 3) The moving vehicle accidents (49.5%0 were responsible for the majority of trauma; the interpersonal violence (21.4%) was the next most common cause. 4) Types of maxillofacial trauma were facial bone fractures (28.4%) and facial soft tissue injuries(71.6%) 5) A total of 912 classified facial fractures were diagnosed in the 592 patients. In our patients, the most common fractures were found in the mandible followed by nose, zygoma, maxilla, and orbital rim. 6) The most common facial soft tissue injuries were facial laceration(60.5%) followed by facial contusion, facial abrasion and soft tissue loss. 7) The most common site of facial laceration was forehead followed periorbital area, cheek, lips, and oral mucosa. 8) Closed reduction was used for 36% of the patients of facial fractures, while 43% of parients were required open reduction and 18.8 % were needed both closed and open reduction. 9) The infection on the operative sites and Post-traumatic psychosis associated with complications were occured in the highest rates (20.4%, 15.1%).

前頭部 毛狀線(Hair line) 및 눈썹再建 治驗例

方裕鉉,金容培,朴鍾燮,梁淳在 大韓成形外科學會 1981 Archives of Plastic Surgery Vol.8 No.2

Loss of anterior hair-bearing scalp with obliteration of the hairline and loss of eyebrows are common in facial burns. The resulting esthetic deformity is obvious and of great psychological import to the patient. The area of loss is often large in this region. Small free "hair transplants" are inadequate because of poor vascularity of the recipient site, which leads to loss of many of the grafts. Further, the final appearance after multiple grafts of this type is often sparse and stubbly. For restoration of the hairline, especially when the area is large, authers are using the "Bilateral Large Scalp Flaps" modified to bipedicle "Visor" sclap flap and single-stage of arterialized scalp flaps. Loss of portion of the eyebrows may occur with facial burn injury. Total loss of the eyebrows is uncommon, but when this happens it results in an obvious esthetic defect that is difficult to camouflage with only surface cosmetics. The use of such cosmetics may be particularly disturbing for male patients. When the temporal scalp and underlying superficial temporal artery are present, total eyebrow replacement is possible using an island pedicle flap of scalp.

무모두피의 재건을 위한 조직확장술의 이용

이영만,황일면,박성진,최석현,양순재 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.2

Tissue expansion has undeniable usefulness for providing an alternative source of specialized tissue and even allowing simultaneous closure of donor sites. Recently, tissue expansion became the one of the most popular technique since soft tissue expansion for reconstruction of microtia was attempted by Neumann() in 1957 using an implanted inflatable envelope with an external tube for injections. The use of the tissue expansion technique in head and neck reconstruction was described by Argenta etal in 1983, and Manders et al. presented three cases of pediatric scalp reconstruction utilizing expansion in 1984. In this paper, the authors used 7 tissue expanders to treat 6 alopecia patients with various causes from march, 1990 to april 1994. All cases were successfully reconstructed without major complication. We have determined that the method is safe, simple, and reliable and provides excellent aesthetic results and high patient acceptance and satisfaction. In conclusion, we would like to present that tissue expansion was the most valuable procedure for scalp reconstruction.

변형된 국소피판을 이용한 화상 반흔의 치료

엄순찬,스즈키 시게히코,니시므라 요시히코,김용배,양순재 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.8

Application of local flaps for releasing postburn scar contracture has been limited because of a problem of invisible loss, difficulty to obtain the satisfactory result against correction of limitation of motion and possibility of contour deformity. However, proper use of local flaps, accurate designs and complete wound compression for a long term after operation enable to obtain good results in correction of some cases of postburn scar contracture. It will be related to reduce unsightly scaring when contractures are released. For this purpose, we have used a modified planimetric Z-plasty, a subcutaneous pedicle flap, a new classification V-Y plasties which was proposed based on the new concept and their combination. Proper application of local flaps corresponding to the degree of contracture and shape of burn scar have enabled to increase the use of local flaps against correction of postburn scar contracture during our past 15 years, from 1982 to 1997, we treated 235 cases of postburn scar or scar contracture in various regions except for the face. Of these, 177 cases were applicated with local flaps and we could have a good results in both aspects of function and appearance. We report our operative methods, a criterion to application of local flaps and representative results.