유방확대술을 위한 자가지방이식술: 시술방법과 유방영상소견

윤을식,서보경,이안,조규란,우옥희,차상훈,김영식 대한초음파의학회 2008 ULTRASONOGRAPHY Vol.27 No.4

Autologous fat injection is one of the methods utilized for augmented mammoplasty methods. In this surgical procedure, the fat for transfer is obtained from the donor site of the patient’s own body by liposuction and the fat is then injected into the breast. We report here cases of three patients who underwent autologous fat injection. Two of the patients had palpable masses that were present after surgery. The serial imaging findings and surgical method of autologous fat transfer are demonstrated. 유방확대술의 하나인 자가지방이식술은 환자 자신의 몸에서 지방흡입으로 지방 세포를 얻어 유방 내 여러 곳에 주입하는 성형수술방법이다. 저자들은 유방 자가지방이식술을 시행 받은 3명의 환자들을 보고하고자 한다. 이들 중 2명은 수술 후 유방 내 촉지성 종괴를 가지고 있었다. 본 보고에서는 유방 자가지방이식술의 시술방법과 시술 후 유방영상소견을 보여주고자 한다.

유방보형물 연관 역형성대세포림프종의 국내 현황

윤을식 대한의사협회 2021 대한의사협회지 Vol.64 No.1

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a unique type of lymphoma caused by breast implants. Concerns about BIA-ALCL have increased worldwide, and three domestic cases have been reported in South Korea. However, the incidence of the disease is not clear, and the risk probability has been reported to be up to 1/3,000. The most important factor in BIA-ALCL is the texturing of the implanted devices. Since the type of texturing is heterogeneous among products and companies, it is important for physicians to be aware of the spectrum of products and their implied risk. The pathophysiology of BIA-ALCL is presumed to be a combination of chronic inflammation related to the microenvironment and genetic predisposition. Further studies will allow accurate diagnosis and prognosis of the disease. The prognosis of BIA-ALCL is favorable if patients with late seroma or pericapsular masses are diagnosed early and complete surgical removal is achieved. Accurate diagnosis includes cytology or pathology with immunohistochemistry, including the CD30 protein and anaplastic lymphoma kinase. An essential factor in surgical success is radical excision with total capsulectomy. However, there is no evidence for prophylactic removal of a textured implant without symptoms. Careful examination and consultation should precede the implant removal, which can lead to deformity or complications. Domestic collaboration among healthcare providers for diagnosis and treatment is needed along with active reporting and registration of suspected patients. Finally, worldwide cooperation and improved awareness leading to regular surveillance are crucial in the era of BIA-ALCL.

미용수술에 있어 환자안전을 위한 수술 전후 고려사항

윤을식,강상규 대한의사협회 2015 대한의사협회지 Vol.58 No.9

Maintaining patient safety in and outside the operating room is a major concern of plastic surgeons. Circumventing preventable complications is essential, as public acknowledgement and interest in the complications of cosmetic surgery rises. The plastic surgery patient is generally considered a safe candidate for surgery, but his or her health may have masked problems, and generally superficial surgery can still be subject to the common risks of surgery. Patient education and information on the procedure and the risks, benefits, and alternatives can help avoid surprise and confusion if a complication does occur. Peer-review systems in the form of weekly or monthly morbidity reporting conferences can help identify practice patterns that increase risks and can ultimately improve patient safety. After reviewing a patient’s medical history, doing a thorough physical examination and review of systems, and pertinent laboratory or radiographic testing, the physician should select the patient’s appropriate classification from the anesthesiologist’s physical rating. Preparation and consideration for the common risks of plastic surgery should help to improve perioperative safety.

두피 신장기를 이용한 두발 재건술 및 남성형 대머리의 치료

윤을식,구상환,박승하,안덕선,손병규 대한미용성형외과학회 1998 Archives of Aesthetic Plastic Surgery Vol.4 No.1

Ultra Pulse CO₂ 레이저를 이용한 여드름 반흔 치료

윤을식,구상환,박승하,손병규 대한의학레이져학회 1998 대한의학레이져학회지 Vol.2 No.1

남성형 탈모증의 외과적 수술요법

윤을식 한국의학사 1997 診斷과治療 Vol.17 No.12

인칭검사를 이용하여 부분 절개를 시행한 수근관 증후군 환자의 추적관찰

윤을식,구자혜,김동휘,강윤규,황미령,동은상 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.6

Purpose: Complete release of the transverse carpal ligament(TCL) is accepted as the standard treatment for carpal tunnel syndrome(CTS). However, loss of grip and pinch power are reported in some patients after complete release of the TCL. This study was designed to evaluate the effectiveness of complete versus partial carpal tunnel release by using the inching technique.Methods: Nineteen patients(a total of 27 hands) who each had a confirmed diagnosis of CTS were selected from September 2002 to February 2003. The cases were divided into three groups(mild, moderate and severe) based on preoperative electrodiagnostic studies. The patients with partial carpal tunnel syndrome were classified into the mild or moderate groups, while patients with complete carpal tunnel syndrome were classified into the moderate or severe groups. Patient oriented data (functional and symptomatic) were collected and electrophysiologic studies were undertaken preoperatively and postoperatively(on the 2nd week, 1st month, 3rd month and 6th month after surgery).Results: In this study, the mild and moderate groups showed both good functional and symptomatic results and improvements in electrophysiologic studies.Conclusion: Carpal tunnel syndrome patients classified into mild or moderate groups based on nerve conduction studies, and whose precise compression sites were pinpointed using the inching technique, can be treated by partial carpal tunnel release.

내족저변 격막 피판의 해부학적 고찰 및 임상적 적용

윤을식,김정배,계민석,동은상,한승규,이병일,구상환,박승하,김우경,Yoon, Eul-Sik,Kim, Jung-Bae,Kae, Min-Seok,Dhong, Eun-Sang,Han, Seung-Kyu,Lee, Byung-Il,Koo, Sang-Hwan,Park, Seung-Ha,Kim, Woo-Kyung 대한미세수술학회 2002 Archives of reconstructive microsurgery Vol.11 No.1

Several investigators have reported clinical experience of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of the hand and digits. Jayme and Hamilton first described the anatomy of superficial branch of medial division of the medial plantar artery used in this flap through cadavaric study in 1997. But, they had a few cases for this flap and there was no anatomic study in Korean. We experienced the reliability of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of hand and digits through an anatomic study (20 fresh specimens dissected) and clinical application (17 patients). An anatomic study revealed that there were differences in diameter and length of the vessels between Korean and Caucasian. The diameter of vessels in Korean is larger than Caucasian one in each area. Based on this anatomic knowledge, we could harvest this flap safely, and have performed reconstruction on 17 patients with soft tissue defects of hand and digits using a thin, flexible medial plantar septo-cutaneous flap similar to the volar aspect of the hand and digits in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitants, or the subcutaneous veins. The mean size of the flap was $2.82cm{\times}4.15cm$. All the flaps survived without significant complications. A medial plantar septo-cutaneous flap possesses several advantages : (1) It is very thin in comparison with other standard free flap; (2) it has two draining venous pathways; (3) it provides a good color and texture match for hand and finger; (4) a good recovery of protective sensation is achievable.

연부 조직 증대를 위한 Restylane?과 진피섬유아세포의 혼합

윤을식,고한웅,한승규,김우경 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.1

부안각 경결막 절개를 통한 안와 골절의 정복

안덕선,박승하,구상환,윤을식 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.3

Orbital fracture represents one of the common lesions encountered today with our modern mechanized life. Reduction of these fracture is important in preventing the untoward complications that may ensue such as diplopia and enopththalmos. Although various types of incision have been employed to approach the orbital floor and infraorbital rim, subcilliary and transconjunctival approach are most commonly used. The subcilliary approach has been used for a number of years successfully although it does have shortcommings such as cutaneous scar and ectropion in many cases. The conventional transconjunctival approach provides limited exposure, so it can be used only with small fractures. In order to avoid above problems, it is preferable to use a paracanthal transconjunctival incision: however, it is combined with severance of the lower limb of the lateral canthal tendon approximately 2mm from the canthus. We have used this technique in fifty one cases with diagnosis varying from blow-out fracture to extensive facial fracture. We found that this approach provides good exposure and gives an excellent postoperative result with a concealed apparent cutaneous scarring and no scleral or corneal complications and visualization of the orbital floor and rim with minimal morbidity and insignificant cosmetic impact. In contrast to previously reported similar approaches, it is simple to use in traumatic and congenital lesions that go beyond the orbital floor.