횡복직근 유리 피판술로 재건된 가슴에서의 감각 회복에 대한 임상적 고찰

안희창,성건용,최승석,황원중,Ahn, Hee-Chang,Sung, Kun-Yong,Choi, Matthew Seung-Suk,Hwang, Won-Joong 대한미세수술학회 2005 Archives of reconstructive microsurgery Vol.14 No.2

The purpose of this study is to introduce a sensory restoration in reconstructed breast with free TRAM flap to evaluate recovery aspect and recovery quantity. 144 patients underwent breast reconstruction with free TRAM flap by authors and were followed up at the out patient clinique. We discovered that sensory of operated breast was recoverd. We divide the breast into 5 region (upper medial, lower medial, upper lateral, lower lateral, nipple areolar complex) for examining the sensory restoration. Sense of upper medial region & upper lateral region is recovered more quickly than other region. Touch sensation was recovered more quickly than pain sensation, temperature sensation, vibratory sensation. After about 1 year all protective sensation was recovered in all patient. We discovered that severe postop scar and irradiation of breast is related to delayed sensory recovery, age and size of flap is not related to sensory recovery.

하지에서의 역행성 지방근막 피판술: 유리피판술을 대치할 수 있는가?

이영진,안희창,최승석,황원중,Lee, Young Jin,Ahn, Hee Chang,Choi, Methew Seung Suk,Hwang, Weon Joong 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.1

A soft tissue defect of the lower leg or foot presents a challenging problem. Reconstructive surgeon should be armed at all points of wound site, tendon and bone exposure, injury of major vessel and so on in the lower limb. We reconstructed the defects of lower legs and feet of 25 patients between February, 1997 and December, 2003. Applying reversed adipofascial flap with skin graft on a soft tissue defect of the lower leg or foot is challenging. We did a comparative study of 25 reversed adipofascial flaps with 51 free flaps. All 25 cases of reverse adpofascial flap reconstruction were successful except for a partial loss of skin graft in 3 occasions. The reversed adipofascial flap had a merit of a short operation time and hositalization, a high success rate and minimum complications. Besides major vessels in the lower leg are better preserved and donor morbidity is minimal. However, the flap is unmerited in reconstructing a hug hallowed defect and in the leg with poor blood circulation and once previous surgery. The operators may consider the feasible substitution of reversed adipofascial flap for free flap before applying in the lower leg.

횡복직근 유리 피판술후 공여부 합병증과 이환율

안희창,성건용,조동인,최승석,Ahn, Hee Chang,Sung, Kun Yong,Jo, Dong In,Choi, Seung Suk 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1

Transverse rectus abdominis muscle (TRAM) free flap is widely used for breast reconstruction, however donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. For the purpose of minimizing donor-site morbidity, there has been a surge in interests in muscle sparing free TRAM flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. The purpose of this study is to investigate complication and morbidity after muscle sparing free TRAM flap. Between August, 1995 and May, 2003, there were 108 cases of muscle sparing free TRAM flap of breast reconstruction. There was no abdominal hernia. There were 4 cases of dog ear, 3 cases of marginal necrosis of apron flap, 2 cases of asymmetry of umbilicus. At 1 year after operation, most patients feel comfortness in physical exercise. Muscle sparing free TRAM flap provides ample amount of well vascularized soft tissue with small inclusion of rectus abdominis muscle and fascia. Also it minimizes donor-site morbidity with rapid recovery of abdominal strength.

기욘씨관 압박 증후군에서의 척골 동맥의 폐색

안희창,김종도,이장현,최승석,Ahn, Hee-Chang,Kim, Jong-Do,Lee, Jang-Hyeon,Choi, Seung-Suk 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6

Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

동과자가 Glucose Oxidase로 손상된 혈관내피세포에 미치는 영향

서은아 ( Eun A Seo ),최승석 ( Natthew Seung Suk Choi ),이병찬 ( Byung Chan Lee ),이재규 ( Jai Kyoo Lee ),이강창 ( Kang Chang Lee ),정종길 ( Jong Gil Jeong ),신민교 ( Min Kyu Shin ),송호준 ( Ho Joon Song ) 대한본초학회 2003 大韓本草學會誌 Vol.18 No.2

N/A Objectives : It has been demonstrated that oxidative stress of oxygen radicals is involved in vascular disorder. The aim of this study was to evaluate the cytotoxicity of glucose oxidase (GO) and protective effect of herb extract on GO-induced cytotoxicity in the cultured vascular endotherial cell (VEC) of mouse. Methods : Cytotoxic effect of GO and protective effect of Benincasae Semen (BS) were performed by MTT assay, after cultured VEC were incubated in the media containing 1-30 mU/ml GO for 6 hours. Results : GO decreased cell viability in dose-and time-dependent mannner, and BS increased cell viability decreased by GO-induced cytotoxicity in these cultures. Conclusion : From above the results, GO has cytotoxic effect, and herb extract, BS is very effective in blocking GO-induced cytotoxicity in cultured VEC.

개방성 하지 골절에서 음압 상처 치료 후 지연성 연부조직 재건술에 대한 치료 결과

박기철(Ki-Chul Park),김홍식(Hong-Sik Kim),오정한(Jeong-Han Oh),최승석(Seung-Suk Choi) 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.2

목적: 하지의 개방성 골절에서 음압 상처 치료 후의 지연성 연부조직 재건술의 임상적 결과에 대해 알아보고자 하였다. 대상 및 방법: 2007년 6월부터 2011년 2월까지 15명의 환자에서 발생한 16예의 개방성 하지 골절을 대상으로 하였다. 남성이 13명, 여성이 2명이었으며, 평균연령은 39.0세(7-65세)였다. 본 연구에서는 음압 치료 후 시행한 지연성 연부조직 재건술의 이식편 상태, 기능적 결과, 골유합 및 창상 감염 등의 합병증에 대해 확인하였다. 결과: 수상 후 평균 29.3일(9-50일)간 음압 상처 치료를 시행하였으며, 수상 후 평균 36.1일(21-60일)에 연부조직 재건술을 시행하였다. 5예에서 피부이식술, 8예에서 유리 피판술 그리고 3예에서 국소 피판술을 시행하였으며, 최종 추시 시 이식편의 실패는 관찰되지 않았다. 골유합은 평균 5.2개월(3-8개월)에 관찰되었으며, 2예에서 지연 유합이 발생하였으나 최종 추시 시 골유합을 확인할 수 있었다. 결론: 동반 손상으로 인해 조기 연부조직 재건술을 시행할 수 없는 개방성 하지 골절에서 음압 상처 치료 후 지연성 연부조직 재건술을 시행하는 것은 이식편의 실패, 골절 부위의 불유합 등의 합병증을 줄일 수 있어 유용한 치료 대안으로 생각한다. Purpose: To evaluate the delayed soft tissue coverage after previous negative wound therapy in treating wounds associated with open lower extremity fracture. Materials and Methods: Between June 2007 and February 2011, delayed soft tissue coverage of open lower extremity fractures after previous use of a negative pressure vacuum device, were performed in 15 consecutive patients. Patients included 13 male and 2 female, and their mean age was 39.0 (7-65) years old. Information on the time from injury to definitive wound coverage, type of coverage, functional result, bone union, and complications such as infection were collected. Results: The vacuum-assisted closure devices was applied for an average of 29.3 (9-50) days, and the mean time from injury to definitive wound was 36.1 (21-60) days. Skin graft coverage was performed in 5 cases, free flap in 8 cases, and local flap in 3 cases. The mean time to radiographic union was 5.2 (3-8) months and delayed union occurred in 2 cases. Conclusion: Delayed soft tissue coverage after previous negative wound therapy was considered an alternative treatment method in open lower extremity fractures associated with severe concomitant injury.

두피에 발생한 혈관육정의 치험례

최승석,유석근 大韓成形外科學會 2002 Archives of Plastic Surgery Vol.29 No.6