구강재건을 위한 요골전완 유리피판의 해부학적 고찰

김성민,서미현,강지영,어미영,명훈,이석근,이종호,Kim, Soung-Min,Seo, Mi-Hyun,Kang, Ji-Young,Eo, Mi-Young,Myoung, Hoon,Lee, Suk-Keun,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.1

Reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. The radial forearm free flap (RFFF) is a thin, pliable soft tissue flap with large-caliber vessels for microvascular anastomosis. Its additional advantages include consistent flap vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with a tumor resection. For a better understanding of RFFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of RFFF in the Korean language.

구강 및 안면재건을 위한 광배근 유리피판의 해부학적 고찰

김성민,정영언,어미영,강지영,서미현,김현수,명훈,이종호,Kim, Soung-Min,Jung, Young-Eun,Eo, Mi-Young,Kang, Ji-Young,Seo, Mi-Hyun,Kim, Hyun-Soo,Myoung, Hoon,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.6

The latissimus dorsi myocutaneous flap (LDMF) was initially described at the turn of the century by Tansini et al, and latissimus dorsi myocutaneous free flap (LDMFF) was also first described for the coverage of a chronically infected scalp by Maxwell et al. As a pedicled flap, LDMF has been often used for breast reconstruction and for soft tissue replacement near the shoulder and the lower reaches of the head and neck. LDMFF is a flat and broad soft tissue flap with large-caliber thoracodorsal vessels for microvascular anastomosis. A skin paddle of the LDMFF can be more than $20{\times}40$ cm, so very large defects in the oral cavity and outer facial region can be covered by this LDMFF. Other advantages include consistent vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with tumor resection. For a better understanding of LDMFF as a routine reconstructive procedure in large defects of the oral cavity and facial legion, anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of LDMFF with Korean language.

혈관 비틀림이 백서 천층하복부 동맥의 초미세문합에 미치는 효과

서미현,김성민,어미영,강지영,명훈,이종호,Seo, Mi-Hyun,Kim, Soung-Min,Eo, Mi-Young,Kang, Ji-Young,Myoung, Hoon,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.5

Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with $90^{\circ}$ twisting, 4) experimental II (EA2) with $180^{\circ}$ twisting, and 5) experimental III (EA3) with $270^{\circ}$ twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0 $Ethilon^{(R)}$ (Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular $clamps^{(R)}$ (S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than $180^{\circ}$ twisting must be prevented in clinical practice.

구강재건을 위한 족배동맥피판의 해부학적 고찰

김성민(Soung-Min Kim),강지영(Ji-Young Kang),어미영(Mi-Young Eo),명 훈(Hoon Myoung),이석근(Suk-Keun Lee),이종호(Jong-Ho Lee) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.3

The dorsalis pedis artery (DPA) was renamed from the anterior tibialis artery after it passed under the extensor retinaculum, and DPA travels between the extensor hallucis longus and extensor digitorum longus muscle along the dorsum of the foot. After giving off the proximal and distal tarsal, arcuate and medial tarsal branches, DPA enters the proximal first intermetatarsal space via the first dorsal metatarsal artery (FDMA), which courses over the first dorsal interosseous muscle (FDIM). For detailed knowledge of the neurovascular anatomy of a dorsalis pedis artery flap (DPAF) as a routine reconstructive procedure after the resection of oral malignant tumors, the precise neurovascular anatomy of DPAF must be studied along the DPA courses as above. In this first review article in the Korean language, the anatomical basis of DPAF is summarized and discussed after a delicate investigation of more than 35 recent articles and atlas textbooks. Many advantages of DPAF, such as a consistent flap vascular anatomy, acceptable donor site morbidity, and the ability to perform simultaneous flap harvest using oral cancer ablation procedures, and additional important risks with the pitfalls of DPAF were emphasized. This article will be helpful, particularly for young doctors during the special curriculum periods for the Korean National Board of Specialists in the field of oral and maxillofacial surgery, plastic surgery, otolaryngology, orthopedic surgery, etc.

구강악안면 재건을 위한 미세혈관 문합술의 종류

이정아(Jung-A Lee),강지영(Ji-Young Kang)어미영(Mi-Young Eo),명 훈(Hoon Myoung),김명진(Myung-Jin Kim),이종호(Jong-Ho Lee),김성민(Soung-Min Kim) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.4

A reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. For a better understanding of oral and maxillofacial reconstructive procedures, basic and advanced microvascular anastomosis techniques must be learned and memorized. The aim of this article was to clarify and define the microvascular anastomosis methods, such as primary closure after an arteriotomy, end to side anastomosis, end to end anastomosis, and side to side anastomosis with an artery and vein. This review article discusses the basic skills regarding microvascular anastomoses with brief schematic diagrams in the Korean language. This article is expected to be helpful, particularly to young doctors in the course of the Korean national board curriculum periods for oral and maxillofacial surgery.

전자빔을 조사한 7대 3 비율의 수산화인회석과 인산삼칼슘 혼합무기물의 골재생 효과

김성민 ( Soung Min Kim ),어미영 ( Mi Young Eo ),강지영 ( Ji Young Kang ),명훈 ( Hoon Myoung ),최은경 ( Eun Kyung Choi ),이석근 ( Suk Keun Lee ),이병철 ( Byung Cheol Lee ),이종호 ( Jong Ho Lee ) 한국조직공학·재생의학회 2012 조직공학과 재생의학 Vol.9 No.1s

The aim of this study is to evaluate the effect and potential of electron beam (E-beam) irradiation treatment to the new bone formation in the rat calvarial bony defects by using of 7 to 3 ratios of hydroxyapatite (HA, Bongros(R), Bio@ Co., KOREA) and tricalcium phosphate (β-TCP, Sigma-Aldrich Co., USA) mixed with type I collagen (Rat tail, BD Biosciences Co., Sweden). We used 1.0 MeV linear accelerator and 2.0 MeV superconductive linear accelerator (power 100 KW, pressure 115 kPa, temperature - 30~120oC, sensor sensitivity 0.1~1.2 mV/kPa, generating power sensitivity 44.75 mV/kPa, supply voltage 5±0.25 V) with different irradiation dose, such as 1, 30, 60 kGy. Bilateral, standardized transosseous circular calvarial defects, 6.0 mm in diameter, were made in a total of twenty-one, 8-weeks-old, male Sprague-Dawley rats, weighing 270-300 g. In six different experimental groups, the defect of every three rats was filled with E-beam irradiated bony mixtures, which different energy and dose, and that of rats without E-beam irradiated bony mixtures can be compared with our previous results. The other three rats were used as sham group. Rats were sacrificed after 4, 8, and 16 weeks, and grafted healing specimens were studied by clinical and radiographic (standardized plain film, Kodak Co., USA) findings, histomorphologic staining with hematoxylin and eosin (H & E), FE-SEM (field-emission scanning electron microscopy), and TEM (transmission electron microscopy) findings. The large particular size of HA was changed to small particles after E-beam irradiation, to which small particle of TCP was engaged to small sixed HA with organic collagen components in SEM findings. Abundant endothelial cells with pericytes were found around inner portions of grafted healing bone and many couplings of osteoblast with osteoclast in TEM findings were found in every experimental groups.