Nd:YAG 레이저를 이용한 피부혈관종의 치료

현원석,문구현,방사익,오갑성 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.6

Although Nd:YAG laser(1064nm) showed good reduction effects on treatment of cutaneous hemangioma, its use was limited because of non-selective laser absorption and complications such as scar formation. So, we applied different modalities of Nd:YAG laser for more effective and safe treatment.We applied Nd:YAG laser to 9 patients with hemangioma on upper eyelid, cheek, back, arm, and parotid area from February, 1999 to February, 2002. The age at treatment ranged from 4 months to 4 years. Nd:YAG laser was irradiated both inside of the hemangioma by using a bare fiber through a 16G Tefflon cannula and outside of it by cooling the skin with a ice-cube. Nd:YAG laser was irradiated directly into the lesion through the bare fiber and safely to the skin through the ice cube.The mean number of treatment was 1.8, and the time interval between the next treatment was 4.5 months. The mean follow-up period was 13.5 months. Six patients showed almost full regression. Two patients had surgical excision after laser treatment, and one showed slow regression to be in the clinical observation.

Nd YAG 레이저를 이용한 피부혈관종의 치료

현원석,문구현,방사익,오갑성 大韓成形外科學會 2003 Archives of Plastic Surgery Vol.30 No.6

악성흑색종에서 Ki-67과 Proliferating Cell Nuclear Antigen의 표현에 관한 연구

현원석,민경원,김재중 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.5

Although malignant melanoma is a rare skin cancer in Orientals, it is a very lethal disease in plastic surgical field. The tumor grading and prognostic factors of malignant melanoma commonly used are the size of the nuclei, cellular irregularities, loss of polarity, degree of mitosis and peripheral tissue infiltration. But, the parameters mentioned above show poor correlation with prognosis. Recently, the proliferation cell antigen activities are used as a tumor grading and prognostic factors in some tumors. Using immunohistochemical study, we examined the proliferation cell antigen activity, of Ki-67 and proliferating cell nuclear antigen(PCNA) in malignant melanoma and melanocytic nevus. There was a significant correlation between histologic parameters related to prognosis(Breslow index and mitotic rate) and PCNA as well as Ki-67 expression. And positive antigen activity of PCNA and Ki-67 in malignant melanoma was higher than that of PCNA and Ki-67 in benign melanocytic nevus. Although we can not tell that the maximun nuclear density value of PCNA and Ki-67 is a superior prognostic parameter over Breslow index, PCNA and Ki-67 expression is a good parameter for tumor grading in malignant melanoma.

비대칭이 심한 양측성 구순열의 일차교정술

김진환,김석화,현원석 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Deformity of severe asymmetric bilateral cleft lip which has complete cleft on one side and microform cleft on the other side resembles that of the unilateral cleft lip deformity with mild vermilion deformity on the other side. But, severe asymmetric bilateral cleft lip is quite distinct from the unilateral cleft lip. First, severe asymmetric bilateral cleft lip has no anatomical landmark of Cupid's bow due to peaking of the microform cleft side. Second, even though the notching of vermilion on the microform cleft site accentuates the vermilion tubercle, the volume of vermilion tubercle is deficient due to the incontinuity of the orbicularis oris muscle. So, it is hard to obtain symmetric appearance of the Cupid's bow and adequate volume of vermilion tubercle without approximation of the orbicularis oris muscle in the midline. 11 severe asymmetric bilateral cleft lip patients were operated with modified Millard's method for bilateral cleft lip in one stage from August 1994 to April 1997 in our Hospital . It was possible to obtain symmetric Cupid's bow and adequate size of vermilion tubercle with accurate union of the orbicularis oris muscle.

피부에 발생한 악성 흑색종으로 림프절 절제를 시행한 환자의 치료 성적

김철중,김지아,최영진,김정한,남석진,양정현,현원석,문구현 대한외과학회 2006 대한외과학회 학술대회 초록집 Vol.2006 No.5

턱교정수술의 패러다임 변화-선수술의 보급과 미용적 양악수술의 증가

박상훈,현원석,이중규,이양구 대한미용성형외과학회 2010 Archives of Aesthetic Plastic Surgery Vol.16 No.1

Orthognathic surgery became more popular because people are more interested in facial profile changes and are more receptive to surgery. As people seek beauty as well as function in maxillofacial surgery, patient’s aesthetic demand becomes higher. Considering these big changes, one of the major reasons is surgery-first orthognathic approach (SFOA), which removes pre-surgical orthodontic treatment. Pre-surgical orthodontic time has been a great barrier to patients in terms of time and social rehabilitation. By SFOA, patients can get surgery as soon as they make up their mind; Patients from abroad can get surgery and get back to their country; They can go back to their work more easily because their occlusion is more acceptable. Surgery first orthognathic approach is still developing in practice and principle. However, as it is based on patient’s need, it will play a greater part in the field of orthognathic surgery. Surgery first orthognathic approach together with aesthetic two jaw surgery are expected to change the paradigm in orthognathic surgery. (J Korean Soc Aesthetic Plast Surg 16: 9, 2010)

최소절개를 통한 천측두근막채취법과 이를 이용한 이개 거상술

전용훈,현원석,하범준,오갑성 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.4

The superficial temporal fascia is a thin, pliable, well- vascularized flap that is useful in elevation of the reconstructed ear of the microtia. However, the elevation of the superficial temporal fascial flap by conventional T or zigzag incisions in temporal region frequently leaves a conspicuous scar, hair thinning and alopecia. To overcome these problems, we harvested the superficial temporal fascia as a random pattern flap using only a retroauricular skin incision line for the ear elevation. Thereafter, the cartilage framework was elevated including superficial temporal fascia and superficial mastoid fascia underneath: dissection plane was continuous with the superficial temporal fascial flap harvest and dissection was performed just beneath the superficial mastoid fascia under the framework. A carved costal cartilage block was grafted at the posterior wall of the concha and covered with the harvested superficial temporal fascial flap, followed by a full-thickness skin graft.From June 2001 to December 2001, 9 patients (male 8 and female 1), who ranged from 9 to 26 years in age, underwent ear elevation using this method. The skin grafts was successful and the appropriate auriculocephalic angle was preserved in all cases. We did not find any complications such as infection, graft loss or cartilage extrusion in the 3 to 9 months follow-up period and the patients were satisfied with their cosmetic results.This method was easy to perform and did not leave any other scar in the temporal hear-bearing area and the results have been favorable.

전두부 골간단 이형성증의 광범위한 수술적 치료

장의석,문구현,임소영,현원석,방사익,오갑성,변재경 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.3

Frontometaphyseal dysplasia is a rare genetic syndrome first described by Gorlin and Cohen in 1969. This disease affects the skeletal system and connective tissue, and could be characterized by hyperostosis of the skull, prominence of supraorbital ridges, additional skeletal and extraskeletal abnormalities. It is believed that the condition is an X-linked dominant trait with severe manifextations in males and extreme variability in females.We described a case of 15-year-old boy manifested a pronounced supraorbital ridge associated with exorbitism. He also had bilateral progressive hearing deficit, thoracic spine scoliosis, chest wall deformity, bilateral maxillary sinusitis and both 5th finger arachnodactyly.The patient underwent a fronto-temporo-orbital cranioplasty through a coronal incision. The frontal bone including supraorbital region, orbital lateral rim and temporal bone were extensively contoured with burr. And then, burring of the medial aspect of lateral orbital wall was made to increase both orbital volume for correction of exorbitism.Postoperative results show well corrected prominent supraorbital ridge, hyperostosis of frontotemporal bone and exorbitism. The patient was satisfied with the improved appearance. No recurrence occurred during the 6 months of follow-up period. We report this case as it shows esthetically good result without any complication.

선천성 동정맥기형의 선택적 색전술 후 수술적 제거

김성덕,문구현,방사익,오갑성,현원석 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.6

Arteriovenous malformation(AVM) is an abnormal communication between an artery and a vein and often causes significant hemorrhage or cosmetic problems. Treatment of these vascular anomalies is hazardous and has high incidence of recurrence. A multidisciplinary team approach is required in the assessment and treatment of the lesion, and preoperative angiography with superselective embolization followed by resection is required. The authors performed nine cases of the wide resection of the congenital arteriovenous malformation(7 on the head and neck, 2 on the trunk) between April 1998 and January 2002. All patients underwent preoperative embolization with n-butyl 2-cyanoacrylate at 1 week before operation. Preoperative embolization resulted in significant devascularization of the AVM thus leading to minimal bleeding during operation. After resection, direct closure were performed in 6 cases, skin graft in 1 case, free transverse rectus abdominis musculocutaneous flap in 1 case, and tissue expansion using tissue expander in 1case. There was one complication related with embolization procedure in temple AVM patient. No recurrence has been recognized during the follow-up period, which ranges from 16 to 61 months. Preoperative embolization with n-butyl 2-cyanoacrylate and surgical resection of the AVM provided excellent long-term palliation in patients with congenital AVM.

부견갑부 유리 피판을 이용한 소아의 손, 발등 재건

김석한,현원석,이지혁,문구현,방사익,오갑성,Kim, Sukhan,Hyon, Wonsok,Lee, Jihyuck,Mun, Goohyun,Bang, Saik,Oh, Kapsung 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.1

Because traumatic tissue damage on hands and feet often lead to loss of function, permanent deformity, prompt and adequate reconstruction is essential. For children, future growth, as well as function and esthetics, must be taken into account. Several techniques have been employed to reconstruct hand and foot dorsum defects of children. However, skin graft and muscle free flap with skin graft cannot prevent contracture and will interfere with normal growth. Fasciocutaneous free flap reduces contracture and enables early physical therapy, decreasing the need for additional surgical intervention. Parascapular flap is particularly suitable because it has reliable pedicle and is relatively thin. There is little functional loss in the donor site, and also simultaneous extensor tendon reconstruction of hand and foot is possible. The disadvantage of this technique is that postoperative defatting is needed to adjust volume. Our department has achieved satisfactory results using this approach, and would like to report 13 cases of hand and foot reconstruction using parascapular flap in patients under the age of 15 (from March, 1998 to May, 2003).