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범진식,김현철,이종욱,오석준,정철훈,손유리 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.2
It has been generally believed that male pattern baldness occurs in woman who has elevated level of androgen. Since the introduction of tissue expansion technique by Dr. Neumann in 1957, it has showed the excellent result in the treatment of scalp defect. In this paper, 3 female patients with male pattern baldness were operated b using tissue expanders & deepithelization technique of anterior border of the flap. They all have normal level of testosterone & no virilizing symptom. All cases were successfully reconstructed with natural figure of anterior hair line. The major advantage of tissue expansion is that it generates new hair-bearing scalp. The increases in vascularity which occurs during expansion allows large, safe flap. Donor sites are also relatively easily closed. The disadvantages of the expansion include the need for two or more surgical procedures and multiple office visits. There is also cosmetic defect as the expanders become larger. In conclusion, male pattern baldness that is characterized by M-shaped frontotemporal recession can occur in woman who has normal level of androgen. Tissue expansion & deepithelization technique of anterior border of the flap was the most valuable technique in the correction of male pattern baldness.
이차성 정맥성 허혈 후 피부판 생존에 미치는 PG E₁의 효과
정철훈,이종욱,범진식,오석준,신형식,손유리 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.4
PG E₁ has been proven to be useful in the treatment of vascular disease of the lower leg because it induces vasodilatation of the peripheral vessel and platelet diaggregation and enhances red blood cell deformability. The effect of PG E₁ on tissue injury caused by secondary venous ischemia was evaluated in skin island flaps of 40 Sprague-Dawley rats. Primary ischemia was produced by arterio-venous occlusion with vascular clamps for 2 hours after the 3×5㎝ sized skin island flap based on the right superficial inferior epigastric vessels was elevated. Twenty four hours later, secondary ischemia was inflicted by venous occlusion for 6 hours. The rats were divided into 4 groups according to the timing of administration of PG E₁ or saline and each group had 10 rats. Normal saline(1.5 cc/kg) was injected at the beginning of secondary ischemia in group Ⅰ and PG E₁ 3 ㎍/kg(500 ng/kg/min) was injected intravenously at the end of primary ischemia in group Ⅱ. The same dose of PG E₁ was given at the beginning of secondary ischemia in group Ⅲ and at the end of secondary ischemia in Group Ⅳ. Normal saline or PG E₁ was injected through the left femoral vein. The full thickness skin biosies(0.5×0.5cm sized) were obtained from five rats each in group Ⅰ,Ⅱ and Ⅲ at the end of secondary ischemia and were examined under the light microscope with the H&E stain. The survival of skin flap that was assessed at 7 days after secondary ischemia showed all or none phenomenon. Group Ⅱ,Ⅲ,Ⅳ had a higher survival rats than the control group Ⅰ, but only group Ⅲ had statistical significance(P<0.005). The histologic findings of ischemic injury of the tissue such as vasodilatation, congestion, extravasation, thrombosis, endothelial cell disruption were decreased significantly in group Ⅲ compared to group Ⅰ. But neutrophil infiltration, one of the histologic findings of ischemic injury of the tissue, was increased in group Ⅲ. In conclusion, the survival rate of skin island flap based on the superficial inferior epigastric vessels increased significantly when PG E₁ was injected through contralateral femoral vein at the beginning of secondary venous ischemia. In case with venous thrombosis after free flap or digital replantation, it's fundamental treatment is revision of occluded vein as soon as possible. But if we detect venous occlusion early and administer PG E₁,it is able to decrease tissue damage.
정철훈,오석준,이종욱,전훈봉,범진식 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.4
Syndactyly is one of the most common malformations occurring in the hand. the child born with a syndactylized hand may be handicapped for life if successful surgery is not carried out. Syndactyly is frequently associated with other anomalies, of which congenital constriction ring, heart anomalies, orodigital anomalies, and hemangioma. The aim of surgery is to construct a web or commissure and cover any defects on the sides of the fingers. Unsatisfactory results may be due to subsequent web contractures of the divided fingers. Fifty-three cases of syndactyly in twenty-nine patients were corrected by the authors' method. Authors used a large dorsal rectangular flap with a somewhat wider proximal base than distal end, and small volar triangular flap with lateral relaxing incisions for interdigitation of flaps and reconstruction of web space, and performed zig-zag incision for division of syndactylyzed fingers.
이철범 한양대학교 의과대학 1998 한양의대 학술지 Vol.18 No.2
Arterial complications of the thoracic outlet syndrome are uncommon and are estimated to occur in less than 5% of cases with a diagnosis of the thoracic outlet syndrome. However, they are potentially much more serious than the more common neurologic manifestations, and in some cases they may lead to loss of the limb. Prompt recognition and appropriate management are important to prevent disability and even potential limb loss. Only a few series with large numbers of cases have been previously reported, so that the surgical strategy remains controversial regarding the optimum mode of access, which bony element to excise, and the management of thromboembolic complications. The aim of this article is to define more precisely the indications for surgery and the surgical methods to adopt.