Poly-N-acetyl-glucosamine이 당뇨병 쥐에서 창상치료에 미치는 영향

양호직,윤치선 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.2

Purpose: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. Methods: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1h), 24 hours(24h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). Results: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1h treatment than the 24h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. Conclusion: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.

백서의 복직근판에 있어 Prostaglandin E₁이 근판생존에 미치는 영향

정지원,양호직,신영진 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.4

Flap survival is critical to the success in reconstructive surgery, there have been many investigations to increase the blood supply to the flaps such as surgical delay and pharmacologic delay. Prostaglandin(PG) is released from various tissues including blood vessel in response to physical stimulus. Among the Prostaglandins, PGE₁ has been proven to be a vasodilatation property and many authors have demonstrated its effect to increase blood supply after random cutaneous flap surgery. Clinically, however, muscle flap or musculocutaneous flap is more significantly used in reconstructive surgery and hemodynamic effects of PGE₁ of this type of flap are still not documented. The authors designed the random muscle flap to study the hemodynamic effects of PGE₁ of the muscle flap. Superior based rectus muscle flap was elevated from rats and the superior epigastric artery, its major vascular pedicle, was ligated to create the random-type muscle flap. Twenty two rats were divided into two experimental groups and each group had 11 rats ; Group Ⅰ : No drugs Group Ⅱ : PGE₁ injection group for 7 postoperative days intraperitoneally The average muscle flap survival rate of group Ⅰ was 46±3.0 precent and it had a higher survival rate than the control group(23±4.3%). The muscle flap survival rates showed significant differences between the two groups (p < 0.005) This study shows that the administration of the PGE₁, in clinical usage of the rare random muscle flap with a pedicle injury or musculocutaneous flap with the risk of distal cutaneous flap necrosis, such as TRAM flap, which might be much safer and popular.

하악골 체부에 발생한 골연골종의 증례보고

이준혁,양호직,박미자,김종구 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.6

Osteochondroma is a relatively common benign tumor of skeleton, occurring most often in the metaphyseal region of long bone. However, it is very rare in the facial bone, expecially in the mandible body.We report a case of osteochondroma on the left mandible body in a 9-years-old male, which has been present for 2 years. It was successfully removed by surgery. On pathologic examination, it was diagnosed as osteochondroma consisting of bony structures covered with a cartilaginous cap, the typical composition of osteochondroma.

원발성 뇌회상 피부의 치험례

박성훈,양호직,김종구 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.4

Purpose: Cutis verticis gyrata(CVG) is a morphologic syndrome, typically occurring on the scalp, characterized by varing development of permanent folds and furrows conferring a corrugated or convoluted appearance which resembles the outer surface of the cerebrum. Cutis verticis gyrata can be categorized into primary and secondary types according to various etiologic factors and associated conditions which cause disease process. Methods: We report a case of essential primary cutis verticis gyrata in a 24-year-old male who did not have any other underlying or associated conditions. Results: After we made an incision to the galea aponeurotica of patient's scalp four times under local anesthesia, we dissected along the subapponeurotic layer and adjusted the flaps each other, and then sutured the flap. Conclusion: After the operation, the clear margin disappeared and it did not recur.

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

이명준,양호직,김종환 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.1

Background: Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods: After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results: A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions: If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

A New Technique for Conchal Cartilage Harvest

김준영,양호직,정지원 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.2

The goal of auricular cartilage harvest is to obtain a sufficient amount for reconstruction and to minimize the change in ear shape. The cartilage can be harvested by a posterior or anterior approach, and each method has advantages and disadvantages. The posterior approach presents the advantage of scar concealment, but there are limits to the amount of cymba cartilage that may be harvested. In contrast, the anterior approach may cause a noticeable scar. However, as cartilage is collected, the anterior approach provides a view that facilitates the preservation ear structure. In addition, it is possible to obtain a greater amount of cartilage. From January 2014 to December 2015, we harvested auricular cartilage graft material in 17 patients. To prevent the development of trapdoor scars or linear scar contracture, short incisions were made on the superior border of the cymba and cavum. Two small and narrow incisions were made, resulting in suboptimal exposure of the surgical site, which heightens the potential for damaging the cartilage when using existing tools. To minimize this, the authors used a newly invented ball-type elevator. All patients recovered without complications after surgery and reported satisfaction with the shape of the ear.

Medifoam B?와 음압 요법에 의한 욕창의 보조적 치료

이준혁,양호직 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.5

Pressure sore is usually developed by repeated or persistent pressure given to fixed regions. Due to increase in old ages, paraplegia or quadriplegia by traffic accidents and industrial accidents, the incidence of pressure sore is increasing. V.A.C.(vacuum assisted closure, KCI Inc, U.S.A.) has been highly effective for accelerating wound healing, however, high cost and the use of special equipment have been preventing it from popular use.We applied the negative pressure of wall suction (100-150mmHg) with Medifoam B(Hydrophilic polyurethane foam, Ildong Pharm, Co., Korea) on pressure sore wound instead of expensive dressing foam of V.A.C. So, we could accelerate wound healing without special equipment or incurring high cost.We were able to reduce the cost to 10% with Medifoam B and wall suction dressing compared with V.A.C. In this aspect, the technique explained above seems to be clinically useful.

다제내성(多劑耐性)을 지닌 균주에 감염된 상처에서 Nanocrystalline Silver(Acticoat?) 드레싱의 효용

정태광,양호직 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.6

Purpose: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methicillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying Acticoat(Smith & Nephew Healthcare, Hull, England)dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing.Methods: Nanocrystalline silver dressings(Acticoat??) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying Acticoat?? dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(×1000). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, Acticoat?? was placed in a square shape and cultured for 72 hours at 37°C, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA.Results: There are the large amount of declination of bacterial counts with statistical significance after Acticoat dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of Acticoat dressing.Conclusion: We believe that Acticoat dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.

좌골신경에서 발생한 거대 신경초종의 치험례

박지훈,양호직,정태광,이혜경,김종환 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.6

Purpose: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. Methods: A 65 - year - old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well - defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. Results: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. Conclusion: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.

풍선 달린 카테터를 이용한 안저 파열 골절 정복의 선택적 사용

박성훈,양호직 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.6

Purpose: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with Medpor using group to complication rate.Methods: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with Medpor implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between Medpor implant group and balloon catheter using group. Results: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups.Conclusion: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.