요추부 천공지 유리피판을 이용한 대전자부 결손의 재건 - 증례보고 -

허찬영,백룡민,민경원,은석찬,Heo, Chan-Yeong,Baek, Rong-Min,Minn, Kyung-Won,Eun, Seok-Chan 대한미세수술학회 2007 Archives of reconstructive microsurgery Vol.16 No.1

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

방사선조사 창상에 대한 지방유래 줄기세포의 효과

허찬영 ( Chan Yeong Heo ),이은혜 ( Eun Hye Lee ),강혜인 ( Hye In Kang ),김인아 ( In Ah Kim ),은석찬 ( Seok Chan Eun ),백롱민 ( Rong Min Baek ),민경원 ( Kyung Won Minn ) 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

Radiation-induced skin wound is a unwanted complication of radiation therapy in cancer patients. Because a putative potential stem cell population within the adipose tissue has been found to possess therapeutic potentials, we authors sought to determine the effect of adipose tissue-derived stem cells(ADSCs) on radiationinduce skin wound. Sprague-Dawley rats were divided into two groups. Adipose tissue-derived stem cells were isolated from the inguinal fat pads and expanded ex vivo for three passages. All groups received 25 Gy of gamma irradiation as a single dose to the back of the rats using a cobalt-60 teletherapy unit. After four weeks of radiation, syngeneic ADSCs were delivered into the subcutaneous area of irradiated wounded skin area in experimental group. Acute skin reactions were assessed and at the endpoint of the study. Light microscopic findings were assessed. Clinically and histopathologically, radiation skin reactions were lower than control group(p<0.05). ADSCs was found to be efficacious in preventing epidermal atrophy, dermal degeneration and hair follicle atrophy. In conclusion, ADSCs could be used as useful cell therapeutics to repair and regenerate the wound of irradiation damage.

지방유래 줄기세포가 이식된 Vicryl Mesh의 섬유화와 육아조직 형성에 미치는 영향

허찬영 ( Chan Yeong Heo ),하현정 ( Hyun Jung Ha ),김지회 ( Ji Hoe Kim ),정의철 ( Eui Cheol Jeong ),은석찬 ( Seok Chan Eun ),백롱민 ( Rong Min Baek ),김석화 ( Suk Wha Kim ),민경원 ( Kyung Won Minn ) 한국조직공학·재생의학회 2010 조직공학과 재생의학 Vol.7 No.1

Vicryl mesh consists of polyglactin 910, a synthetic absorbable copolymer made from 90% glycolide and 10% L-lactide. The empirical formula is (C2H2O2)m(C3H4O2)n. The mesh is knitted from uncoated and undyed fiber identical in composition to that used in Vicryl sutures, which has been found to be inert, nonantigenic, nonpyrogenic and to elicit only a mild tissue reaction during absorption. It may be used wherever temporary wound or organ support is required, particularly in instances in which compliant and stretchable support is desired. Successful use is reported for instance as support for the correction of breast deformity. Because a putative potential stem cell population within the adipose tissue has been found to possess therapeutic potentials, we authors sought to determine the effect of adipose tissue-derived stem cells(ADSCs) on Vicryl mesh implantation. Sprague-Dawley rats were divided into two groups one is control, given the surgery of simple Vicryl mesh implantation and the other is stem cell group, given the surgery of mesh implantation and ADSCs(N=12 for each group). Before the surgery ADSCs of stem cell group were isolated from the inguinal fat pads and expanded ex vivo for three passages. Control group received multi-folded Vicryl mesh implantation to the back of the rats and Stem cell group received the surgery of Vicryl mesh implantation and ADSCs. After four weeks of operation, matrix formation, capillary density and collagen production were assessed quantatively under the light microscope. ADSCs led to a statistically significant increase in fibrosis and mature scar formation compared with the control group in histologic examination (p < 0.05). ADSCs was found to be efficacious in promoting fibrosis and scar maturation leading volume replacement on experimental Vicryl mesh implantation. This study might be used as useful volume replacement with Vicryl mesh for correcting breast deformity after conservative surgery.

최근 5년간 유리 피판술을 이용한 하지재건의 분석

백승준,허찬영,오갑성,Baek, Seong-Jun,Heo, Chan-Yeong,Oh, Kap-Sung 대한미세수술학회 1999 Archives of reconstructive microsurgery Vol.8 No.2

The lower extremity injuries are extremely increasing with the development of industrial & transportational technology. For the lower extremity injuries that result from high-energy forces, particularly those in which soft tissue and large segments of bone have been destroyed and there is some degree of vascular compromise, the problems in reconstruction are major and more complex. In such cases local muscle coverage is probably unsuccessful, because adjacent muscles are destroyed much more than one can initially expect. Reconstruction of the lower extremity has been planned by dividing the lower leg into three parts traditionally The flaps available in each of the three parts are gastrocnemius flap for proximal one third, soleus flap for middle one third and free flap transfer for lower one third. Microvascular surgery can provide the necessary soft tissue coverage from the remote donnor area by free flap transfer into the defect. Correct selection of the appropriate recipient vessels is difficult and remains the most important factor in successful free flap transfer. Vascular anastomosis to recipient vessels distal to the zone of injury has been advocated and retrograde flow flaps are well established in island flaps. Retrograde flow anastomosis could not interrupt the major blood vessels which were essential for survival of the distal limb, the compromise of fracture or wound healing might be prevented. During 5 years, from March 1993 to Feb. 1998, we have done 68 free flap transfers in 61 patients to reconstruct the lower extremity. From analysis of the cases, we concluded that for the reconstruction of the lower extremity, free flap transfer yields a more esthetic and functional results.

통합적 인적자원관리 유형에 따른 노사협력과 기업성과에 관한 연구

황보작(Jak Hwang-Bo),허찬영(Chan-Yeong Heo),주용준(Youg-Jun Ju) 한국철도학회 2011 한국철도학회논문집 Vol.14 No.3

국소피판술을 이용한 두경부 동정맥기형의 재건 증례

윤민지(Min Ji Yun),은석찬(Seok-Chan Eun),허찬영(Chan-Yeong Heo),장학(Hak Chang),백롱민(Rong-Min Baek) 대한두개저학회 2010 대한두개저학회지 Vol.5 No.2

Arteriovenous malformation is one of high flow vascular malformations. A 15-year-old-man presented with an inflamed temporoparietal scalp arteriovenous malformation after series of embolization. The lesion was dissected widely on subgaleal layer, individually ligated, and divided. And then the entire mass was totally removed and reconstructed with scalp rotation flap. We report a case of arteriovenous malformation with complete surgical removal and aesthetical reconstruction.

최근 10년간 안면부 피부종양에 관한 임상적 관찰

허찬영,오갑성 인제대학교 1999 仁濟醫學 Vol.20 No.1S

1989년 3월부터 1998년 12월까지 만 10년 동안 인제대학교 의과대학 서울 백병원 성형외과에 내원한 환자중 병리조직 검사 결과 안면부 피부 종양으로 확진된 336예를 대상으로 연령 및 성별에 따른 분포. 안면부 미적 단위를 기준으로 한 종양의 종류와 발생 빈도를 조사하였다. Background: This is the first report of study deals with facial skin tumors evaluated by facial aesthetic zones. Objective: The purpose of this study is to investigate a recent 10 year period(1989-1998) of clinical observation of skin tumors on the face Method: We reviewed 336 cases of facial skin tumors January 1989 to December 1998, at Inje University Seoul Paik hospital. Results: 1) In the 336 cases of facial skin tumors, 312 cases(92.9%) were benign tumors, and 25cases(17.1% ) were malignant tumors. 2) Among the 336 cases, the most common tumor was epidermal inclusion cyst, which followed by intradermal nevus, lipoma, dermoid cyst, epidermoid cyst, neurofibroma, cavernous hemangioma, compound nevus, congenital melanocytic nevus, basal cell carcinoma, pilomatricoma, nevus sebaceus. 3) Tumor incidence of distribution by facial aesthetic units, the most common site was buccal area, which followed orbital, labial, auricular, frontal, neck, supraorbital, temporal, nasal, parotid-masseteric, infraorbital, mental, scalp.

심한 안검하수에 있어서 측두근막과 Tutoplast Dura를 이용한 전두근 현수법

허찬영,백롱민,백세민 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.4

Patients with a poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle to mechanically raise a droopy eyelid Frontalis suspension procedure using a temporalis fascia or Tutoplast Dura was performed on 36 ptotic eyelids of 23 patients(age range 2-37 years) with a poor or absent levator function. The author used a surgical technique based on a modified Fox`s method. Satisfactory results were achieved in 42 lids according to the criteria of Jordan after an average follow-up of 23 months. No serious complication was seen immediately postoperative and during the follow-up period. Temporalis fascia and Tutoplast Dura appear to be effective and safe alternative sling materials for frontalis suspension surgery.

최근 10년간 안면부 피부종양에 관한 임상적 관찰

허찬영,오갑성 인제대학교 1999 仁濟醫學 Vol.20 No.1

비타민 C가 백서의 임의형 피판 생존에 미치는 영향

허찬영,고라용,백롱민,오갑성,최준 大韓成形外科學會 2000 Archives of Plastic Surgery Vol.27 No.2

Vitamin C acts as a antioxidants and as free radical scavengers in biological systems. The objective of this study was to examine whether the administration of vitamin C could improve the skin flap survival. Sprague-Dawley rats(n=40) were divided into 4 groups (n=10); normal saline, vitamin C 200 mg/day, vitamin C 500 mg/day, vitamin C 1000 mg/day were injected subcutaneously to each group (n=10). A classic caudally based random flap (2x7cm) was elevated on the dorsum of rats and then sutured to its normal position. On the 3rd, 7th, 14th days postoperatively each animal was evaluated for percentage area of flap survival by paper template technique, thereafter rate were sacrificed and we obtained tissue from the distal ends of the flap. Following is our results. 1) The experimental group treated with vitamin C revealed an increased rate of random pattern skin flap survival compared with the control group (p<0.005). 2) There was correlation of vitamin C dosage with flap survival rate (Spearman's correlation coefficient=0.971). 3) The biopsy of the control group showed extensive atrophy and necrosis. However, New capillary proliferation and collagen deposition were noted in the vitamin C 200 mg and 500mg treated group. In the vitamin 1000 mg group, microscopic findings were very alike compared with normal rat skin texture. Finally, we concluded that the Vitamin C supplement increases survival rate of random pattern flap in rat skin flap model, and flap survival is correlated with vitamin C dosage.