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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.
대상포진환자의 말초혈액내 면역세포의 정량과 Natural Killer ( NK ) 세포 활성치에 관한 연구
우종설(Chong Seul Woo),정영철(Young Chul Jung),허충림(Choong Rim Haw),임수덕(Soo Duk Lim) 대한피부과학회 1983 대한피부과학회지 Vol.21 No.4
By recent advance of immunologic techniques, it made possible to measure the immune cells and NK cell activity in peripheral blood of various immune altered eonditions. NK cell activity is related not only to malignancies but also to viral infectiona. The facts that the impairment of cell mediated immunity inducea the herpes zoster infection and frequent association with herpes zoster in the patienta with malignancy promote author to atudy the alteration of immune cells and NK cell activity in peripheral block. So author evaluated irnmune cells and NK cell activity of 18 patients with berpes zoster. The results are as follows; 1. The mean value of T cells, T cells showed significant differences between patients group(58.4-i-6.9%, 33.7-+11.7%) and normal healthy control group (68. 6+ 4. 7yo, 44. 2+-7. 0%) but T,' and B cells showecl no significant between patientagroup(6.9-+2.4%, 12.5+-5.7%) and.controlgroup(7.8-1.5%, 13.9-+2.3g%), statistically. 2. The mean value of NK cell activity in patients with herpes zoster group (62. 9+-ll. 2%) showed no significance cornpaired with the mean value of normal healthy control group(57. 9+-l4. 8%), statiatically.
상악골 전절제술 및 안와내용물 적출술 후 횡복직근 유리피판을 이용한 3차원적 재건에 대한 치험례
이승렬,우종설 대한두개안면성형외과학회 2009 Archives of Craniofacial Surgery Vol.10 No.1
Purpose: Extensive midface defect following total maxillectomy with orbital exenteration and cheek skin resection should be three dimensionally reconstructed with a large flap that have a sufficient volume of tissue and multiple skin islands. We describe our transverse rectus abdominis myocutaneous(TRAM) free flap with three skin islands which was successfully used in this situation. Methods: A 58-year-old man was performed enbloc total maxillectomy including orbital contents and wide cheek skin because of invasive maxillary squamous cell carcinoma. He was immediately reconstructed with TRAM flap that was designed not vertical but transverse fashion for providing sufficient skin area. Also, deepithelialization procedure making for multiple skin islands was done in flap insetting period when appropriate modification according to the intraoperative situation was possible. Dead space was completely obliterated by bulky muscular tissue, and three skin islands were used for lining of lateral nasal wall, palatal surface, and cheek skin restoration. Results: Postoperative course was satisfying. Maintaining of proper ipsilateral nasal airway, loss of rhinolalia and oronasal regurgitation of food particles, and restoration of cheek contour were successfully obtained. Conclusion: We report clinical experience of threedimensional reconstruction using free TRAM flap after total maxillectomy with orbital exenteration.