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중안면에 대한 생체계측학적 연구; 노화에 따른 코의 계측치 변화
김순흠,조동인,김철근,최현곤,신동혁,엄기일,전현수,송우철,고기석 대한미용성형외과학회 2012 Archives of Aesthetic Plastic Surgery Vol.18 No.2
The objective of this study is anthropometric analysis of nose and mid-face in Korean. This study was based on extensive sample size and variable measurement points. Total 3,000 healthy volunteers (18 to 79 years of age) were took two standardized photographs (frontal and lateral view). And 21 items were measured per person. Age groups were classified into three as young, middle-aged, and elderly. Average nasal length was around 4 cm and height was 5 cm. Female was 5~6% smaller than male. Facial width was 3.5 times larger than nasal length. Nasal length reduced by 5% as get older. Nasofrontal angle was 141°and nasolabial angle was 92°. Nasal width was 39mm and intercanthal distance was 35 mm. The significant age-related changes were eyeball depth (se-pu) and intercanthal distance. The characteristic senile change of male mid-face was downward deflection of soft tissue but female was soft tissue atrophy. The goal of augmentation rhinoplasty is not filling up sellion point depression but superior shifting of that point. Similarity between nasal length and width was another interesting finding of Korean nose. The results of this study will represent typical values of Korean nose and facilitate exact prediction of surgical results.
Thermo-Splint를 이용한 불안정한 관골궁골절에 대한 효과적인 고정방법
김순흠,이수향,최현곤,신동혁,엄기일,송우철 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.1
Purpose: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture.Methods: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo- splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively.Results: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. Conclusion: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.
김순흠,김나연,이수향,최현곤,신동혁,엄기일,이정용,송우철,고기석 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.2
Purpose: The objective of this study is anthropometric analysis of mouth and lower face of Korean. The relationship of soft-tissue to underlying bony structures determine the overall aesthetics of the face. The goal of aesthetic surgery of the face is to achieve the ideal normal and enhance the aging face. The purpose of present study was to determine the change of the morphology of the mouth and lower face based on soft-tissue landmarks according to age group to facilitate prediction during aesthetic surgery. Methods: The standardized photographs of 2,018 healthy volunteers(18 to 79 years of age; 1,070 males, 948 females) were investigated. Age groups were classified into young, middle-aged, and elderly groups. Five and seven items were measured on frontal and lateral view photographs, respectively. Individual dimensions were compared in the three age groups and between males and females. Results: The width of mouth is 4.5 times larger than that of philtrum. Most of measured data decreased with age. However, woman's lip width of the mouth somewhat increased from the young to elderly. The width of lower face is 2.5 times larger than mouth in young age group and increased slightly from the young to middle- aged and thereafter slightly decreased to elderly group. Upper lip was more higher than lower lip and male lip was more higher than female. But male and female lip height is similar at old age. Conclusion: Most of Koreans showed prominent lower face because of the development or protrusion of the mandible. And the descent of soft-tissue around the mouth was one of the significant characteristics of senile change. The posterior retrusion of the subnasal was an another characteristic. This study will help to elucidate the age-related dimensional differences of the human being and to provide useful information for clinical applications in oral and aesthetic surgery.
김순흠,최재구,김준범 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.8
An aneurysm occurs in association with trauma, atherosclerosis, infection and congenital diseases. Among these, the traumatic arterial aneurysms developed from blunt trauma, crushing injury, perforation, and lacerations of vessels. Generally, most traumatic arterial aneurysms are false type, so called pseudoaneurysm. A pseudoaneurysm occurs by incomplete laceration of the vessel wall or partial division of the vessel. The vascular injury will make hematoma and fibrosis of neighboring tissues. After two to eight weeks post-trauma, the organized hematoma is liquefied and the fibrous tissue acts as an aneurysmal sac. We have experienced a case of dorsalis pedis artery pseudoaneurysm associated with arterial cannulation. So, we report a case of traumatic pseudoaneurysm with a review of literature.
Modified Free Wrap-around Flap을 이용한 수무지 재건술의 치험 1예
김순흠,김준범,최재구 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-
Traumatic loss of the thumb presents significant functional disability because thumb makes 40% to 50% functional capacity of the hand. So, its loss results in severe dysfunction of the hand especially for pinching and grasping. There are several microsurgical methods to reconstruct the amputated and severely injured thumb such as toe-to-thumb transfer and free wrap-around flap surgery.Development of precise operating microscope, microneedles, sutures and the basic principles of microvascular physiology initiate the early era of thumb reconstruction by free microvascular single transfer of toe with or without adjacent tissue to hand. The free wrap-around flap has been taken from big toe including nail, skin, soft tissue and neurovascular pedicle with or without bone graft and used for the reconstruction of circumferential soft tissue loss of the thumb with some preservation of skeletal structure. We experienced the degloving injury of left thumb from the base of proximal phalanx. The bony skeleton was relatively intact except the proximal phalange bone fracture at interphalangeal joint level. The degloved soft tisssue was heavily crushed. So, we harvested the free wrap around flap from left greater toe including distal phalange bone. And then, transfered to injured left thumb. The oppositional function of the reconstructed thumb was good for pinching and grasping. The patient had no gait problem and he could keep his weight in standing position. The result was satisfactory functionally and cosmetically, and the goal of wrap-around flap to minimize donor site morbidity was well accomplished. Here, we report the clinical experience of modified free wrap around flap for the thumb reconstruction.