한센병의 외과적 치료

박향준(Hyang Joon Park),안성열(Sung Yul Ahn),김종필(Jong Pill Kim) 대한피부과학회 2002 대한피부과학회지 Vol.40 No.9

N/A N/A

나병의 미모소실증에 대한 단모 미세이식술

박향준(Hyang Joon Park),안성열(Sung Yul Ahn) 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.4

N/A Background:Madarosis or loss of eyebrows is one of the complications in leprosy, which takes expressions out of the face and is considered as a stigma of leprosy in society. So the patients with leprosy are usually eager to have the situation corrected through various methods such as tatoo or surgery including scalp flap or hair transplantation. Objective:To describe the use of single hair transplantation for the correction of madarosis in patients with leprosy. Methods:An elliptical donor strip was removed with a No.10 blade from the occiput. It was sectioned into small slices and subsequently into single hair micrografts. Then these micrografts were inserted into preformed slits of eyebrows using hair implantation device. Results:Excellent cosmetic results and high patient satisfaction were seen in almost all patients. Reoperations were done in 3 patients due to partial sparsity or unnatural shape of the eyebrows. There were no complications except for pruritic papules which developed from the transplanted areas in 2 patients with eyebrow tatoos. Conclusions:Single hair transplantation proved to be useful in the reconstruction of eyebrows in patients with leprosy and provided superior cosmesis to other grafts despite a technically difficult and time-consuming procedure. (Korean J Dermatol 2000;38(4):462~465)

한센병 환자의 파라핀종에 대한 수술적 치료 경험

정영인 ( Young In Jeong ),최광현 ( Kwang Hyun Choi ),주민숙 ( Mihn Sook Jue ),안성열 ( Sung Yul Ahn ),박향준 ( Hyang Joon Park ) 대한피부과학회 2015 대한피부과학회지 Vol.53 No.2

Background: Ulnar nerve palsy leads to thumb-web depression, hypothenar flattening, and inter-digital depression in patients with leprosy. To camouflage these deformities, patients used to inject paraffin or silicone oil into the areas of muscle atrophy associated with thumb-web depression and hypothenar flattening. After several years and decades, paraffinomas eventually resulted in extensive inflammatory fibrosis and recalcitrant recurrent ulcers at the injection sites. Objective: The aim of this study is to compare the results of different surgical treatments for paraffinomas in patients with leprosy, and to find out the most effective treatment method that has a low recurrence rate. Methods: Between January 2000 and December 2012, 47 patients with paraffinomas who had visited the Korean Hansen Welfare Association Hospital were enrolled to participate in the study. The number of paraffinomas was 56, and the mean age of the patients was 73 years. A retrospective evaluation of the cosmetic results and recurrence rate was performed. Results: Of the 56 surgically treated paraffinomas, 30 lesions were treated using primary closure, 20 lesions were treated with skin graft, and 6 lesions were treated with skin flap. The cosmetic outcomes, which were assessed using a four-point grading scale, were excellent in 10.7% (6/56), good in 25% (14/56), fair in 38% (21/56), and poor in 28% (15/56) of the patients. There were no significant differences among the three surgical procedures with respect to the cosmetic results. The recurrence rate was 33% (10/31) in the primary closure group, 50% (10/20) in the skin graft group, and 17% (1/6) in the skin flap group. There were no significant differences in the recurrence rate among the three surgical procedures. Conclusion: The extensive and aggressive curettage of lesions is very important to reduce recurrence rate. When the older age of the patients is considered in conjunction with the simplicity of the operation and the total operation time, primary closure is considered the treatment of choice both cosmetically and practically.(Korean J Dermatol 2015;53(2):89∼95)

Rhombic Transposition Flap을 이용한 Bowen 병 치험

조재훈 ( Jae Hoon Cho ),명재욱 ( Jae Wook Myung ),박영민 ( Young Min Park ),김형옥 ( Hyung Ok Kim ),안성열 ( Sung Yul Ahn ) 대한피부과학회 2004 대한피부과학회지 Vol.42 No.8

외과적 절제술과 피부이식술로 치료한 유두유륜 과각화증

강정민(Jung Min Kang),조보현(Bo Hyun Cho),김계정(Kea Jeung Kim),강형재(Hyung Jai Kang),안성열(Sung Yul Ahn) 대한피부과학회 1993 대한피부과학회지 Vol.31 No.5

Hyperkeratosis of the nipple and areola is a rare skin disordr characterized clinically by thickening and discoloration of the skin of the areola and/or nipple and pathoiog cally by papillomaosis or acanthosis-nigricans like changes. We report a case of hyperkeratosis of the nipple and areola occuring in a woman with no underlying endocrinopathy and no other additional hyperkeratotic conditions. Ttie iresent case seems to be the nevoid form by the Levy-Franckel classification. Treatment with topical medications including steroids and keratolytic agents produced no improvement. Therefore we recommeneded surgical excision because the paient was greatly disturbed by the appearance of the lesions. Surgical excision and full thickness skin graft were performed sucessfully. (Kor J Dermatol 1993; 31(5): 835-838)

Posterior Calf Fasciocutaneous Flap을 이용한 하지 연부조직의 재건

안성열,임동훈,조용근 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.3

Reconstruction of soft tissue defects of the lower leg and foot continues to challenge plastic surgeons. Significant open wounds of the distal third of the lower leg that require some form of vascularized flap have historically been covered with distant random cross leg flaps, or more appropriately, with micro surgical tissue transfers. Since the clinical work of Ponten in 1981, fasciocutaneous flap has been shown that fascia has a rich vascular plexus. The axial pattern blood supply of the fasciocutaneous flap of the posterior calf was characterized by a dominant subfascial descending cutaneous branch of the popliteal artery. Besides this, the sural and the geniculate artery were composed of this flap. We used the posterior calf fasciocutanous flap in 12 cases of lower extremity reconstruction and obtained satisfactory results except one. We concluded that advantages of this flap are that it is easy to raise, reliable, versatile, and capable of harvesting a broad flap. The addition of this technique in reconstructive surgery has been a very useful in repairing soft tissue defects of lower leg.

癩種樣癩患者 鼻汁內의 癩菌

安成烈,徐舜鳳 中央醫學社 1977 中央醫學 Vol.33 No.6

Multiple nasal blows and skin smears for Mycobacterium leprae were taken from 146 patients suffering from lepromatous leprosy in various stage of the disease as follows; untreated patients 25 cases, exacerbated patients 13 cases, relapsed patients 35 cases, treated patients 73 cases, and the relevant B.I. and M.I. results compared. Of those patients with multi-bacillary skin smears results, 61%(89) were found to have positive nasal blows also. All of the untreated and exacerbated patients had positive nasal blows. Most of the relapsed , patients and only small portion of the treated patients had positive nasal blows. In most cases the B.I. of the nasal blow was lower than that of the skin sm-ear. There were 3 exceptions. In all untreated cases the B.I. of both nasal blow and skin smear was found to be higher than that of the other stage of disease. In each of the stages of the disease there was a much wider variation in the B.I. of nasal blow than that of skin smear. Positive nasal blows were found in most of the patients having a skin smear B.I. of 3-6. In 69.9%(102) of the patients, the M.I. of the nasal blows was 0% and the highest M.I. found was 15%. In 54.8%(80) of the patients, the M.I. of the skin smear was 0%. The highest M.I. found was 20%. Generally, the M.I. of the skin smears was found to be higher than that of the nasal blows. Of the 7 patients where the nasal blow M.I. was found to be higher than that of the skin smear, 5 were in the untreated and exacerbated stage of the disease.

지선모반 (脂腺母斑) 에서 발생한 Syringocystadenoma Papilliferum 과 기저세포암의 1 예

안성열,정선립 대한피부과학회 1977 大韓皮膚科學會誌 Vol.15 No.4

A case of nevus sebceous of Jadassohn, which has developed on the frontal hair-line of scalp of 31 male patient since birth and associated with syrignocystadenoma papilliperum and basal cell carcinoma on excisional biopsy, showing soft yellowish 3.2*4com sized flat verucous plaque is reported.

토안치료에서 Permanent Medial tarsorrhaphyI의 재조명

안성열,박향준,김종필 대한나학회 2003 대한나학회지 Vol.36 No.2

관상절개를 이용한 관골골절 정복에 관한 임상적 고찰

안성열,임동훈,조용근 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.3

The zygoma is located at the midlateral portion, forms the malar eminence in the face and the two adjacent bones, the zygomatic arch and inferior portion of the infraorbital rim are relatively weaker than other facial bones, and as a result, the zygoma is highly incidental to multiple traumas. In the past, Gillies method?(temporal approach) was used commonly for the treatment of zygoma fractures but now open reuction and internal fixation is the treatment of choice because the zygoma fractures are frequently diplaced by muscle pulling. Dingman method?, 2 points fixation, has now been used more favorably since the advent of the miniplate which can more effectively resist the deforming force than wire. Accurate anatomic restoration of the displaced zygomatic arch to the original site is important because the zygomatic arch is the key site to establish the zygomatic contour and antero-posterior projection of the face. In case of zygoma fractures, accurate reduction and stable fixation under the direct vision of fracture sites becomes significant after thorough study through the axial C-T scans. In our series, we operated 26 cases of displaced zygoma tripod fracture and the results was relatively good. Thus, we concluded that exact anatomic restoration using the coronal approach is a safe and definite procedure about the treatment of complex zygoma fracture.