이하선 종양의 임상적 고찰

신극선(K.S. Shin),오석준(S.J. Oh),이영호(Y.H. Lee),유재덕(J.D. Lew) 대한외과학회 1973 Annals of Surgical Treatment and Research Vol.15 No.3

미용외과적 측면에서 본 안면부 종양 제거후 재건술에 대한 임상적 고찰

이영호(Y H Lee),신극선(K S Shin),안정용(J Y Ahn) 대한두경부종양학회 1988 대한두경부 종양학회지 Vol.4 No.1

Skin replacement in large cheek defects after excision of benign or malignant tumor on the face is a challenging task. The physical characteristics of cheek skin are matched best by adjacent skin. Various methods of reconstructing of the facial surface such as forehead flap, distant flap, or a full thickness or split thickness skin graft have replaced adjacent tissue for coverage in many cases. We have reviewed ten cases of aesthetic reconstruction of the face after resection of the facial skin tumor within the last 5 years. The first group of 3 patients were reconstructed with split thickness skin graft from the scalp or lower abdomen. The second group of patients were reconstructed with cheek flap. The third group of 3 patients were reconsturcted with cervicofacial flap. The last 2 patients were reconstructed with nasolabial flap & island falp respectively. The advantages from our experience with various method of coverage are its hidden donor area & good color match with the facial skin & increased success rate.

한국 여성유암의 임상적 고찰

이경식(Kyong Sick Lee),김병로(Byung Ro Kim),신극선(Keuk Shun Shin),유민철(Min Chul Yoo),황규철(K.C. Whang) 대한외과학회 1972 Annals of Surgical Treatment and Research Vol.14 No.2

유두-유륜 재건술

이명선,정윤구,이혜경,신극선 大韓成形外科學會 1989 Archives of Plastic Surgery Vol.16 No.6

The nipple-areola complex is a crucial aesthetic unit of the breast. It is especially important in women because the breasts embody feminity and sexuality. Congenital and acquired deformities or absence of the nipple-areola would result in significant and long-lasting psychological trauma and altered body image. The authors reconstructed nipple-areola using a local flap with a subcutaneous base for nipple reconstruction and full thickness skin graft from the upper inner thigh for areolar reconstruction. We present our experiences using this method in six patients who received modified radical mastectomy due to breast cancer, one patient with nipple necrosis after surgery for correction of inverted nipple, two patients with nipple necrosis who received subcutaneous mastectomy due to paraffinoma, and one patient with hypoplastic nipple due to hermaphroditism. Also we conluded as follows; 1.The procedure is simple. 2.This method is widely applicable to various conditions. 3.The color match is satisfactory and donor site morbidity is minimal. 4.In inverted nipple, the fibromuscular bands have to be released.

Cortisone Vitamin A 및 Vitamin E 가 백서 창상치유에 미치는 영향

신 준,신극선,유재덕,김정술 대한성형외과학회 1978 Archives of Plastic Surgery Vol.5 No.2

Although a large number of factors, both within the patient and in his environments, have been alleged to alter the course of wound healing, only a few are of real clinical significance due to a plethora of uncontrolled observation and poorly designed experiments. Therefore, this experiment was designed to study the effect of Cortisone, Vitamin E on wound healing which were relatively well recognized for us, by using of sponge biopsy technique. Cortisone is one of anti-inflammatory steriod and it has an inhibitory effect on wound healing, and inflammation dominates the phase of healing which the effect of Cortisone appears. The most commontly accepted explanation for the effect of Cortisone on wound healing is that it prevents the inflammatory phase which is somehow essential to the healing process. And the major effect of Cortisone appeared to be the preventione of capillary proliferation and fibroplasia. The ability of Vitamin A is the labilizing of lysosome through an action on lysosomal membranes. Thus excessive dosage of Vitamin A have been reported to increase inflammatory reactions. And Vitamin A and Cortisone have antagonistic effects upon the lysosomal menbrane. Vitamine E, a name given to a series of related tocopherols which have analogus biological effects, is now known to a lysosomal labilizer, which would place it in the group of compounds such as glucocorticoids and aspirin, which are antiinflammatory agents and depressants to wound healing. And the authors made linear skin incision on the back of rats as long as about 6cm, and dissected both side of subcutaneous layer under the panniculus carnosus. And four polyvinyl sponge discs were inserted under the panniculus carnosus. Cortisone, Vitamin A and Vitamin E were injected on schedule and biopsy was done including sponge disc on POD 3,7 and 14. And the resultts of light microscope are summerized as follows. 1) Vitamine A increased inflammatory reaction in early stage of wound healing and inflammatory cells were slightly decreases as appearing collagen fibers. In the result Vitamin A was revealed in mild accelerator on wound healing. 2) Vitamin E and Cortisone decreased the number of inflammtory cells and capillary proliferation in early stage of wound healing than in control group. And especially, collagen fiber and fibroblast were decreased significantly than in control group. Therefore Vitamin E and Cortisone showed the effect of inhibition of wound healing.

수부 피부결손의 외과적 치료측면에서의 임상적고찰

신극선,황영중,이영호,박철 大韓成形外科學會 1987 Archives of Plastic Surgery Vol.14 No.4

The hand which needs delicate form and performs a multitude of functions demands quick and adequate treatment in the care of skin defect. In the case of inadequate treatment, secondary changes result in not only anatomical deformity but funcitonal abnormalities as well. During a period of 6 years, from January 1980 to December 1985, we have treated a total of 337 patients in Yonsei University Medical Center, Severance Hospital, Department of Plastic Surgery for skin defects resulting from acute trauma including burns and for correction of secondary deformities. The results were as follows, 1. Burns were the cause of 75.8% of acute injuries and 91.3% of secondary deformities, and thus was the most common cause. 2. The operation of acute injuries were most commonly done on the 7th-15th day after the injury (66 cases, 46.8%). In the case of secondary deformities, they were most commonly treated 1 year after the injury (84 cases, 42.8%) 3. The degree of severity in secondary deformities was related to not only the cause of injury but also the elapsed time after the onset of injury, and so it is the best way for functional recovery that treated as fast as possible. 4. Skin grafting was most commonly used (259 case, 77.1%) in treatment of hand injuries and favorable results were obtained in most skin defect of hand due to burn and mild to moderate degree secondary deformities with short elapse time after onset of injury.

근판 혹은 근피판을 이용한 하퇴 경골 前部의 외상성 및 골수염성 피부결손의 치험예

박철,유재덕,신극선 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.3

A retrospective review was carried out ten muscle and musculocutaneous flaps in the leg performed for traumatic and osteomyelitic defects in two groups of patients. One group of four patients with soft tissue defects resulting from trauma. Three of the four healded uneventfully; in one case, delayed healing was resulted due to minor loss of muscle flap. The second group of five patients with defects resulting from chronic osteomyelitis. Four of the five healded relatively well; in one case, major loss of the flap was resulted due to hematoma. This series illustrates that the technique of muscle and musculocutaneous flap transposition can provide a safe, relatively shaightfoward method of cover for defects of the leg from trauma and chronic osteomyelitis with predictable result.

3-S 기법을 이용한 유방축소 성형술

신극선,정섬,이혜경 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.3

During the past decade, reduction mammoplasty has undergone a process of evolution and improvement as related to its three surgical goals : (1) safe transposition of NAC. (2) sufficient reduction of volume, and (3) aesthetically acceptable results. But most reduction mammoplasty techniques still resulted in a long transverse scar on the chest wall which often represent a problem especially in the hypertrophic condition. In 1957, Arie proposed a vertical subareolar scar technique for mastopexy, furthemore Lassus(1980, 1977, 1987), Marchac(1980), Peixoto(1980), and Basile (1984) contributed to reduce the transverse scar length. We modified these previosly proposed techniques and present our experiences with reduction mammoplasty using the 3-S technique. Our conclusions were as follows : 1. Determination of resection margin is easy and simple. 2. Location of the new nipple is lower than other methods. 3. Lower portion of the breast skin is converted to the chest wall skin by formation of a new inframammary crease at a higher level. 4. Vertical scar length is 7-8cm, which is longer than the previosly determined 5-6cm as ideal length. 5. The indication has a broad spectrum. 6. This method is simple and safe.

안면골 골절에 대한 임상적 고찰

신극선,이영호,김규호,김진철 大韓成形外科學會 1977 Archives of Plastic Surgery Vol.4 No.2

The facial bones are composed of several protuberance and arches(orbital rim, nasal pyramid, zygomatic arch and maxilla) and are apt to be damaged by the accidents. According to the intellectual development of the human, the social life is constantly complicated more than ever. The means of transportation has been increasing in scale and size, consequently the automobile accidents has also increasing the same as the transportation has been. Moreover the means of transportation has been expressed as the moving weapon which became very serious problem. Braunstein(1957), in a study of 1000 automobile accidents, reported that the head and face area were involved in 72.3% and that 7.2% of these also sustained fracture of one or more facial bones. The accurate diagnosis and treatment of the facial injurie swere always very important, but the interest of this field was very weakened. During recent years, numerous articles have documented the steady increase in the incidence of facial bone fracture which have been observed within the framework of our mobile and violent society. Authors reviewed and evaluated clinical patterns and proper management of facial bone fracture patients who were admitted and treated in Yonsei Medical Center from March, 1, 1973 to Setember 30, 1977. There were 245 cases of facial bone fractures in that period. The following results were obtained. 1. Monthly incidence of facial bone fracture showed 32 cases in May at the most and at the least in January 15 cases. 2. During this period, a total of 245 patients with fractures of the facial bones were admitted to the hospital. The sex incidence revealed 206 patients(84.1%) in male and 39 patients (15.8%) in female. The great incidence of the fracture occurred in the age of between 10 to 40 years. 3. Traffic accidents ranked the top as the cause of facial bone fracture. 4. Mandibular fractures were most common facial bone fracture(33.5%) during that period. 37 patients had multiple facial bone fractures. 5. Associated bracture is as follow in order of frequency. 1) Skull; 22 cases. 2) Upper extremities; 21 cases. 3) Lower extremities; 19 cases. 6. Soft tissue injury is as follow order of frequency. 1) Facial and peripheral laceration; 74 cases. 2) Severe skin abrasion and contusion, central; 5 cases. 3) Eye injury; 5 cases. 7. Life threatening associated injury as follow in order of frequency. 1) Cerebral contusion; 33 cases. 2) Airway obstruction; 8 cases. 3) Hemo-pneumothorax; 6 cases. 8. Almost 50% of the cases were treated within 48 hours after injury. 18(7.3%) patients were treated conservatively. 9. Closed reduction alone was done for 81(33.1%) cases of our patients, while 37(15.1%) done open reduction. 10. Complications are as follows. 1) Fever; 7 cases. 2) Local infection; 6 cases. 3) Pulmonary; 4 cases. 4) Death; 4 cases. Three out of four cases died from severe head injury and one case secondary to in traabdominal viscus rupture.

TURN-OVER FLAP을 이용한 재건술 치험 예

정섬,박철,신극선 大韓成形外科學會 1990 Archives of Plastic Surgery Vol.17 No.5

Currently numerous types of flaps are used in the correction and reconstruction of a variety of congenital anomalies as well as posttraumatic deformities. Selection of an ideal flap for each case depends on a multitude of factors but the site of the anomaly or defect can be considered the most important. In 1978 Pakiam reported the local reverse dermis flap, thereafter Leonard(1980), Mahler(1981), Thatte(1980) and Ramakrishna(1988) also reported their experiences using similar principles of "turn-over" flaps in a variety of cases. We used this method in a case of failed hypospadia correction as well as case of unstable scar formation with bone exposure on the left anterior tibia and obtained complete survival of each flap in addition to cosmetically satisfactory results. There has yet to be a report in this country using this safe and simple one-stage reconstructive method.