The role of peer-reviewed journals in esthetic surgery

동은상,정하윤 대한미용성형외과학회 2021 Archives of Aesthetic Plastic Surgery Vol.27 No.1

Why should we write scientific papers? It is often thought that research manuscripts are written by scholars and professors at universities. Cosmetic surgeons in private practice often feel no need to publish papers. However, as doctors, we are scientists who practice medicine. Furthermore, the internet is flooded with medical information—and, all too often, misinformation. In this piece, as editors, we would like to discuss the importance of writing articles on esthetic plastic surgery to be published in peer-reviewed journals, with a focus on two perspectives.

비중격-비성형술: 내시경적 접근 및 코 지지선의 보강

동은상 대한미용성형외과학회 2010 Archives of Aesthetic Plastic Surgery Vol.16 No.3

Septorhinoplasty in Asians is very challenging in terms of shortage of septal cartilage. Many cases in correction of dorsal and caudal septal deformities requires septal surgery including cartilaginous graft. Septoplasty is a well-known procedure which preserves majority of quadrangular cartilage, however, it is hardly adopted in Asians. The preoperative evaluation is accomplished using nasal endoscopy. The posterior and inferior chondrotomy for septal swinging-door procedure can be performed under endoscopic view. Also, the precise amount of bony spur and excessive cartilage can be excised. Endoscopy is also indispensable to precise hemostasis and turbinoplasty. Asian septoplasty is usually performed with maximal central submucous resection leaving critical L-strut, because surgeons need as much cartilages as possible for proper graft. In caudal septum, posterior septal angle loses its integrity after swinging-door procedure, and also loses the tip projection. This should be reinforced. Furthermore, in patients who have weak septal cartilage, key stone area needs to be reinforced by unilateral or bilateral spreader graft at the same time. Proper bilateral strut at the posterior septal angle continuous with spreader graft at rhinion may confirm the newly made solid L-strut. This solid caudal septum will be the new nasal base for the next tip plasty.

L-Shaped Columellar Strut in East Asian Nasal Tip Plasty

동은상,Yeon-Jun Kim,Man Koon Suh 대한성형외과학회 2013 Archives of Plastic Surgery Vol.40 No.5

Background Nasal tip support is an essential consideration for rhinoplasty in East Asians. There are many techniques to improve tip projection, and among them, the columellar strut is the most popular technique. However, the conventional design is less supportive for rotating the tip. The amount of harvestable septal cartilage is relatively small in East Asians. For an optimal outcome, we propose an L-shaped design for applying the columellar strut. Methods To evaluate the anthropometric outcomes, the change in nasal tip projection and the columella-labial angle were analyzed by comparing preoperative and postoperative photographs. The anthropometric study group consisted of 25 patients who underwent the same operative technique of an L-shaped strut graft using septal cartilage and were followed up for more than 9 months. Results There were statistically significant differences between the preoperative and postoperative values in the nasal tip projection ratio and columella-labial angle. We did not observe any complications directly related to the L-shaped columellar strut in the anthropometric study group. Conclusions The L-shaped columellar strut has advantages not only in the controlling of tip projection and rotation, but in that it needs a smaller amount of cartilage compared to the conventional septal extension graft. It can therefore be an alternative technique for nasal tip plasty when there is an insufficient amount of harvestable septal cartilage.

한국인의 미소에 대한 계측지와 분석

동은상,박승하,구상환,김우경 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.4

Smile reconstruction for facial paralysis is one of the most difficult fields of plastic and reconstructive surgery. The purpose of this study is to analyze the directional amount and degree of normal smiles; the movement of the upper lip and the nasolabial fold. The author has measured 40 normal subjects using a mask type ruler. The vectors of indicated points were measured on the upper lip and the nasolabial fold. Besides the intrasubjective and intersubjective variations, the author was able to get the following meaningful outcomes through this study. The results of this study : 1) The average movements of the oral commissure, upper lip and nasolabial fold were 11.2mm, 7.4mm, and 8.3mm respectively. 2) The average angles of the movements of the above-mentioned parts to the horizontal line were 40.4, 40.2 45.4 respectively. 3) The greatest movement occurred at the oral commissure and the differences between left and right side were negligible and insignificant. It is the author's conclusion that the study results provide quite useful guiding references in planning reconstructive surgery of facial paralysis as it presents fundamental data on the normal smiles of the Koreans.

백서에서 단-측면 신경문합술의 실험적 연구

이동근,김우경,이병일,김응구,동은상 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.7

We investigate the efficacy of the end-to-side neurorrhaphy, and an alternative reconstructive method for the wide nerve gap comparing with the state of normal, denervated,and nerve graft. Thirty Sprague-Dawley rats were divided into 3 group of each 10 rats. In the right side of all groups, nerve branch to the gastrocnemius muscle was severed and the distal ending of the nerve was sutured was sutured to the lateral side of the tibial nerve after round excision of the epineurium. In the first group(normal control group), left side was untouched. In the second(denervated group), left side was sectioned at the distal 5mm from bifurcation of branch to gastrocnemius from sciatic nerve. In the third group(nerve graft group), left side was sectioned at two points, 5 mm and 15 mm distal to bifurcation of the branch to gastrocnemius nerve from sciatic nerve, and then cut ends were anastomosed again as a nerve graft. 5 months later, all animals were subject to electrophysiologic tests and histologic examination including the number of nerve fibers and the changes of muscle fibers. In the group I, the conduction velocity of the end-to-side neurorrhaphy side was delayed comparing to the normal control side(p < 0.05). But, there was no significant difference between end-to-end neurorrhaphy and nerve graft. In histologic finding, the amount of nerve fibers in the end-to-side neurorrhaphy was 50.8% of normal control(p <0.01), and 48.6% of nerve graft side(p <0.006). The histolgic findings of the gastrocnemius muscle in the stat of the end-to-side neurorrhaphy were similar to findings of the nerve graft side, and though slightly decreased size and deformed shape of the muscle fibers were noted, the architecture of the normal muscle configuration was sustained. In conclusion, these results demonstrated the end-to-side neurorrhaphy conducted the electrical stimuli and allowed the regeneration of axons from lateral surface of healthy main peripheral nerve. Therefore, end-to-side neurorrhaphy was thought to be and alternative method for the reconstruction of the wide nerve gap.

은호기성 Nucleolar Organizer Regions(Ag-NoRs)을 이용한 세포의 증식능과 피부종양의 악성도와의 상관관계에 대한 연구

동은상,김우경,한상규,이종문 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.2

Skin neoplasms have been easily diagnosed by clinical findings and histopathologic findings. But skin neoplasms have variable clinical characteristics according to individual variations. Recently, several markers for proliferating cells have been found and, with antibodies to these markers, immunohistochemical studies have been performed. However, almost all of these markers require freshly frozen tissues for evaluation; therefore retrospective study of formalin fixed tissues is impossible. Nucleolar organizer regions(NORs) are DNA Ioops encoding ribosomal RNA production detectable by the argyrophilia(Ag-NORs) of associated proteins. This enables us to investigate paraffin embedded tissues and thus retrospective studies is possible, and the simplicity of stain method enables us to access easily. The mean number of Ag-NORs are correlated with the growth fraction and may have diagnostic and prognostic value in other tumors(such as prostatic cancer, breast cancer, lymphomas and skin neoplasms etc.) Materials were as follows; 20 cases of Seborrheic keratosis as benign neolasms. 15 cases of Actinic keratosis and 13 cases of Bowen's disease as precancerous lesions, 22 cases of Basal cell carcinoma and 27 cases of Squamous cell carcinoma as malignant neoplasms. And the calculation of Ag-NORs was based on visual summatioin of dark-stained dots in randomly selected 100 uncleuses, and statistic analysis was done by t-test and Scheffe's test. The result was as follows; 1. The mean mumbers of Ag-NORs was turned out to seborrheic keratosis 3.2, actinic keratosis 4.7, bowen's disease 4.5, basal cell carcinoma 5.1 and squamous cell carcinoma 5.9. 2. The cell proliferating activities were significantly increased as degree of malignancy increassed as observed by Ag-NORs (P<0.05)

내시경을 이용한 비강내 접근법과 속눈썹밑 절개를 동시에 이용한 안와내벽 재건술

장현,동은상,원창훈,윤을식 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.5

Purpose: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach.Methods: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with Medpor insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture.Results: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. Conclusion: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

수근관증후군의 고해상도초음파 소견과 근전도 및 임상증상과의 상관관계

신용원,동은상,윤을식,김우경 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.4

Several imaging methods are helpful in the diagnosis of carpal tunnel syndrome and they are, for example, traditional X-ray, CT and MRI, etc. CT and MRI have their advantage in direct visualization of structural abnormality of the carpal tunnel and median nerve, but these two modalities are expensive and take much time. Recently, high resolution ultrasonography has been reported to be effective in the study of musculoskeletal system. We designed a case control study to assess the diagnostic value of high resolution ultrasonography. Ninety-six hands of 48 patients, who were confirmed of diagnosis by self-administered questionnaires and electrodiagnostic test, underwent high resolution ultrasonographic studies. We compared sonographic findings with EMG data and patients' severity scores of self-questionnaires. Proximal swelling of median nerve at the entrance of the carpal tunnel correlated with the nerve conduction data. And compression of the median nerve under the transverse carpal ligament correlated with the subjective symptoms. Although ultrasonography is not an ideal method in diagnosis of carpal tunnel syndrome, it may be helpful for estimating the symptom severity and nerve conduction deficit.

Recurrent Extranodal NK/T-Cell Lymphoma Presenting as a Perforating Palatal Ulcer and Oro-Nasal Fistula

박강균,동은상,남궁식,한정규,한승규,김우경 대한두개안면성형외과학회 2016 Archives of Craniofacial Surgery Vol.17 No.3

Nasal-type extranodal natural killer/T-cell lymphoma (ENKTL) is a rare disease presenting with non-specific symptoms, typically originating in the nasal cavity, palate, or midfacial region. Oral cavity is an extremely rare site for this type of lymphoma. In this report, we present a case of palatal perforation and oro-nasal fistula as a manifestation of recurrent ENKTL. Complicated disease entity should be considered when surgeons deal with palatal perforation and oro-nasal fistula.

유방재건 후 Skate 피판을 이용한 유두재건술의 장기추적결과

김덕열,동은상,윤을식,손길수 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.4

Purpose: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. Methods: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, followup period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. Results: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were 17.0 ± 13.99%, 25.0 ± 12.70%, 30.0 ± 12.57% and 30.8 ± 12.49% at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. Conclusion: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.