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범진식,오석준 대한미용성형외과학회 1997 Archives of Aesthetic Plastic Surgery Vol.3 No.1
Intralesional belomycin injection has been an effective treatment of recalcitrant warts since 1970. A 1 U/ml solution of bleomycin sulfate in normal saline or lidocaine solution was injected intralesionally in 72 warts of 33 patients on the hands, forearm, feet, and face. Dosage of bleomycin was dependent on the size of warts, usually 0.1 to 0.15 cc of solution. All patients was permitted to wash the treated area without care. 59 (81.9%) of 72 warts were cured after one injection, 12 (16.7%) warts after two or three bleomycin injections. One large wart was not cured. Most patients experienced minimal painful discomfort for two to three days after one to two days of injection, but did not take the analgesics. There was no evidence of systemic and local toxicities. The most responsive warts shoed hemorrhagic black eschars that separated after 2 to 3 weeks and healed with very little or no scar tissue. Intralesional bleomycin injection is a reliable and useful alternative for the treatment of warts.
자가 Fibrin Glue와 연골세포를 이용한 연골조직 공학 기법에 관한 연구
홍성표,범진식,박재경,김진영,이두형 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3
Neomorphogenesis of cartilage using chondrocyte-polymer constructs is a potential source for development of cartilage reconstruction. Current tissue engineering techniques of neocartilage rely on in vivo implantation of polymer-chondrocyte constructs. The purpose of this study was to find a way to bioengineer cartilage in vitro by entrapping chondrocytes in a molded autologous fibrin glue. Chondrocytes isolated from the cartilage of rabbit joints were combined with fibrinogen extracted by a single cryoprecipitation of autologous plasma, and they were then polymerized with thrombin to create a fibrin glue with a final cell density of 2.5x10?? cells/ml. The collagen for a control study was used as a polymer. The polymer-chondrocyte constructs were cultured for 4 weeks and the fibrin-chondrocyte constructs molded in the shape of a human ear were cultured for 6 weeks in vitro. Morphometric, histochemical, and histomorphometric analysis including glycosaminoglycan quantitation confirmed the following results: 1) Highly-concentrated autologous fibrinogen was easily extracted by a single cryoprecipition of autologous olasma. 2) The fibrin-chondrocyte constructs demonstrated the presence of actively proliferating chondrocytes with the production of cartilaginous matrix(collagen and glycosaminoglycan) at 1 week after culture, as well as gross and histologic evidence similar to those of normal cartilage at 3∼4 weeks after culture. 3) The collagen-chondrocyte constructs demonstrated lower degrees of hardness and transparency, as well as a lower density of cells and glycosaminoglycan during the culture period. 4) Neocartilage generated from fibrin-chondrocyte constructs in the shape of a human ear nearly retained their original configuration and size without degeneration for 6 weeks of culture in vitro. This study demonstrated a novel method for bioengineering the molded cartilage in vitro using autologous fibrin glue as a matrix scaffold. The generated cartilage showed gross and histologic evidence similar to those of normal cartilage, retaining the original gross dimension. With further refinement, this may be a new application of tissue engineering for the reconstruction of cartilage.
Jin Sik Burm,이지민,강상윤,박준 대한미용성형외과학회 2023 Archives of Aesthetic Plastic Surgery Vol.29 No.4
Background Surgical scars subjected to excessive tension tend to widen and become hypertrophic due to strong mechanical stretching forces. In this study, we evaluated the clinical outcomes of combined intraoperative and postoperative long-term tension reduction techniques for the revision of scars subjected to excessive tension. Methods In total, 64 cases (62 patients) underwent scar revision and were followed for 6 months or more. The long-term tension reduction technique included intraoperative subcutaneous fascial and deep dermal closure using nonabsorbable nylon sutures and postoperative long-term skin taping for 3 to 8 months. The final scars were objectively evaluated using our Linear Scar Evaluation Scale (LiSES, 0-10 scale), which consisted of five categories: width, height, color, texture, and overall appearance. Results All 64 cases healed successfully, without early postoperative complications such as infection or dehiscence. The follow-up period ranged from 6 months to 6 years. The LiSES scores ranged from 5 to 10 (mean: 8.2). Fifty-one cases (79.6%) received a score of 8 to 10, which was assessed as “very good” by the evaluator. Two cases with a score of 5 (3%) showed partial hypertrophic scars at the last follow-up visit. All patients were highly satisfied with their final outcomes, including the two patients who experienced partial hypertrophic scars. Conclusions A combination of intraoperative and postoperative long-term tension reduction techniques can achieve the goal of long-term dermal support and satisfactory aesthetic outcomes for scar revision in areas subjected to excessive tension.
범진식,홍성표,이두형 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5
Pulmonary embolism is a serious complication of medical disorders and it has high mortality rate. More than 90% of pulmonary emboli orginate from the deep vein thrombosis of the lower extremities. In surgical patients, venous stasis is the most important factor of the deep vein thrombosis, especially due to prolonged immobilization intraoperatively and postoperatively. We experience a case of pulmonary embolism developed after the deep vein thrombosis which was developed ipsilaterally to the donor site of full-thickness skin graft in a 38-year-old patient who had complained of the hypertrophic scar contracture of the left fifth finger and the palm. The patient is managed with medical treatment and it's condition is improved, but local symptoms are remained even at sixth month after the management.
이식피부의 질감에 대한 연구 : 표피각질층의 수분함량에 대하여
범진식,홍성표,장충현,이두형 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5
In the grafted skin, the water contained in the superficial portion of the stratum corneum plays an important role in determining the texture match and flexibility of grafts skin with microstructure of skin surface. We evaluate the water content, hygroscopicity and water holding capacity of grafted skin in 78 patients grafted on the face and the palm by skin surface Hydrometer(SKICON-100, IBS Inc. Japan) and the correlation between their parameters of normal donor skin and normal recipient skin, and study the nature of the texture match of grafted skin and it's attributing factors. The results are as follows : 1. The parameters of grafted skin are lesser than those of normal recipient skin. 2. The parameters of grafted skin are higher than those of normal donor skin. 3. The parameters of full thickness grafted skin are higher than those of split thickness grafted skin. 4. Closer the donor site is placed to the recipients site, higher the parameters of grafted skin are. 5. Younger the patients are, higher the parameters of grafted skin are. In the grafted skin, the water contained in the superficial portion of the stratum corneum plays an important role in determining the texture match and flexibility of grafts skin with microstructure of skin surface.
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.