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인두피판 수술후 발생한 이차성 인후강 부전교합증의 교저예
함기선,원영택 大韓成形外科學會 1982 Archives of Plastic Surgery Vol.9 No.1
In assessing portal function, we have to use both direct and indirect objective methods. Among the direct measures of endoscopic, radiological and ultrasound studies, the endoscopic examination may be more reasonable one. Surgeons seem to be well aware of wide variety of ways to treat velopharyngeal incompetence. It is more complex problem to lead normal speech in cleft palate patients with distorted speech, because it includes not only physiological and anatomical prerequisites but also habitual and environmental factors. On the aspect of anatomical and physilogical factors the size of port plays an important role to achieve normal port function in surgery of pharyngeal flap. Even skillful surgeons could have been experienced occasionally inappropriate portal function following secondary surgery. In this case, the patient had complained about speech disturbance and hypernasality despite of previous pharyngeal flap operation for velopharyngeal incompetence. The nasendoscopic examination revealed marked discrepancy in size between the right and left lateral ports. We had applied a newly designed surgical procedure, bilateral muco-salpingopharyngeal muscle transfer, to correct the size discrepancy of lateral ports. Although further evaluation and follow-up study with accumulation of cases are necessary to reach a conclusion, the objective evaluation assessed by nasendoscopic, aerodynamic and articulatory tests were good enough to recommand trial of this procedure to the patients with uncontrolled velopharyngeal incompetence following pharyngeal flap operation.
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원영택,김진철,함기선 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.2
A total of 124 cases of facial dermabrasions with 4 underlying conditions of small pox scar, traumatic tattoo, acne scar and irregular bumpy scars were performed during the last 10 years at Cntholic Medical College and Center in Seoul, Korea. Most of patients received a trial dermabrasion followed after its clinical evaluation by generalized face procedures 6 months intervals for better results. Facial edema after dermabrasion was increased for 3rd postoperative days with same pattern regardless of the depth in superficial planing, however edema lasted longer in deeper planing. Discharge from the wound continued up to 2nd postoperative days and acutely decreased on the 3rd postoperative day and ceased completely on the 5th post operative day. Crust formation began on the average of 4.8 days in superficial planing and on 5.1 days in deeper planing. The cracking of crusts appeared from the site of movable portions such as cheek on the 7th postoperative day in superficial planing and 8.4 days in deeper planing. After long term follow-up, the percentage of acceptability was 70% and 68% in the opinion of the patients and their relatives or 95% and 90% in the opinion of the surgeon and nurses. The complication rate showed 13.4% of all cases.
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원영택,위성신,김진철,함기선 大韓成形外科學會 1982 Archives of Plastic Surgery Vol.9 No.3
There is nobody who does not have a desire to preserve a relatively youthful appearance. Anyhow, many surgical methods for correction of the signs of aging have been developed. The westernized women's activity, modernized self esteem, improved economical condition and understanding of the aesthetic plastic surgeyr make it possible annual increase of the patients of plastic surgery in Korea. The face lifting procedure is somewhat difficult and fearsome operation to the unexperienced surgeon. The authors had performed 42 cases of rhytidectomy procedure during last 10 years from 1972 to 1981. Following results were obtained; 1. The ages of the patients were in the range of 40 to 56 years, with an average of 48 years. The operations wree female patients. All of them wree female patients. 2. Ancillary procedures were combined with author's rhytidectomy in 31 cases. 1) Blepharoplasty·······14 2) Forehead lifting·······6 3) Aug. rhinoplasty······3 4) Aug. mentoplasty······2 5) Scar revision······4 6) Dermabrasion······2 3. The patient's rating of the final result were as follows; Excellent:6, Good:28, Fair:4, and Poor:0 cases 4. the complications were as follows; 1) numbness······14 2) scar······6 3) undercorrection······4 4) earlobe deformity······4 5) hair loss······2 6) pain (occipital)······1 7) asymmetry······1 8) burn······1 There were something differences in the incidence of complication in our series compare to abroad. Our major complications were not hematoma, nerve injury, and skin loss but scar, earlobe deformith and skin slough. The possible causes of these condition were suggested.
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실리콘에 감작된 임파구의 배양액에 의한 섬유모세포의 기능적 이상발현
한상배,변준희,원영택,김환묵,최향석,이종원,이종건 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.3
Fibrous capsular contracture has been considered as a major side effect of breast silicone implant. The etiology of fibrous capsular contracture has not been fully determined. In the present study, we tried to determine the indirect effect of immune system in fibroblast function which plays a major role in fibrous capsular contracture. For preparation of conditional medium of lymphocytes, mouse(ICR) splenocytes were cultured for one day. Two kinds of conditioned medium, silicone conditioned medium(SCM) and silicone free normal conditioned medium(NCM), were prepared from splenocyte cell suspension cultured on silicone gel coated surface and naked surface, respectively. Mouse fibroblasts(NIH 3T3) were cultured in usual culture dish. Conditioned medium of 25% concentration was added. On day 2 after innoculation, cell number, thymidine incorporation and proline uptake of fibroblasts were measured. The results were as follow; 1) There was no difference of fibroblast number by cultivation in SCM of splenocytes compared with that in fresh medium(FM). 2)There was significant increase of DNA synthesis of fibroblasts in SCM compared with that in FM(p < 0.001). 3) There was significant increase of collagen synthesis of fibroblasts in SCM compared with that in FM(p < 0.01) and in NCM(p < 0.001). 4) The functional activities of DNA and collagen synthesis mediated by same number of fibroblast were calculated to be significantly increased in SCM compared with that in NCM and in FM (p < 0.001). In conclusion, fibroblasts cultured in SCM had a higher potential to synthesize macromolecules such as collagen and DNA. We can postulate that SCM may contain certain amount of unknown growth stimulant of fibroblasts, which is produced by silicone gel sensitized murine splenocytes.
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