뮐러근과 올림근널힘줄로 구성된 복합피판의 전진술에 의한 눈꺼풀처짐의 치료

백봉수,석정훈,최원석,양완석 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.2

Purpose: Even in a small levator resection for blepharoptosis, 10-13mm of Müller's muscle and levator aponeurosis is resected. To solve the problem, Müller's muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study is to evaluate the effectiveness of the Müller's muscle-levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: From 2003 to 2008, 107 patients(183 eyes) underwent the advancement procedure of the Müller’s muscle-levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2-3mm of distal flap stump was left after trimming up to 5mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes(88.3%) showed a normal level of upper eyelid margin(MRD1 4.1-5.0mm) or less than 1mm ptosis(MRD1 3.1-4.0mm). 10 eyes(6.9%) showed 1-2mm ptosis(MRD1 2.1-3.0mm). 7 eyes(4.8%) showed more than 2mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5-6mm of composite flap advancement and 20% had about 3mm of the flap stump trimmed with 8-9mm of composite flap advancement (shortening of the levator complex). Conclusion: Müller’s muscle-levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning Müller’s muscle; it is more physiological; it is reproducible and it is predictable-with gratifying results for blepharoptosis.

유륜주위절개를 이용한 유방축소술

백봉수,이신일,신동필,박재우,조병채 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.4

눈꺼풀처짐을 수반한 눈구석벌어짐증

백봉수,지소영,최재일,석정훈,양완석 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.4

Purpose: Blepharoptosis is often associated with telecanthus and the presence of epicanthal fold in telecanthus is one of unique features in Asian eyelids. The purpose of this article is to define telecanthus and pseudotelecanthus, and to determine optimal surgical procedure depending on classification of telecanthus. Methods: Among 187 patients with blepharoptosis who had the advancement procedure of the Muller’s musclelevator aponeurosis composite flap for ptosis, 55 patients underwent Flowers' split V-W plasty concomitantly with shortening the medial canthal tendon for correction of telecanthus from September 2003 to January 2011. Among them, 52 patients were followed up for 16 months. We newly defined telecanthus because Mustarde ratio is inaccurate to measure in certain cases and then made a definition of pseudotelecanthus. Besides, we also classified telecanthus into mild, moderate and severe types based on its severity. Results: Telecanthus is defined when the ICD (inner canthal distance) is greater than 110% of normal ICD. Pseudotelecanthus is a telecanthus like a wide skin bridge formed between the eyes because of the epicanthal fold in the normal ICD. Flowers' split V-W plasty combined with shortening medial canthal tendon was very effective in mild and moderate telecanthus with almost invisible scar and no recurrence occurring. In severe types, however, it showed high incidence (28%) of incomplete correction of telecanthus. Conclusion: New definition of telecanthus can be easily applied to any case and we think the classification of telecanthus is useful to select an appropriate operative procedure. Split V-W plasty with shortening of medial canthal tendon is a very effective procedure in mild and moderate telecanthus. Besides, it is also effective in improving the treatment outcomes of ptosis in cases of blepharoptosis associated with telecanthus.

벨마비 환자의 예후와 신경생리 검사소견의 관련성

백봉수,박성파,서정규 대한신경과학회 1999 대한신경과학회지 Vol.17 No.5

제 24 차 학술대회 : 48. Marginal ulcer 24 예에 대한 임상적 고찰

백봉수,이철상,김부연,나도헌 대한외과학회 1972 대한외과학회 학술대회자료집 Vol.- No.-

Limberg氏 皮膚瓣과 Dufourmentel氏 皮膚瓣의 使用

白鳳壽 大韓成形外科學會 1977 Archives of Plastic Surgery Vol.4 No.2

Many elliptical defects which surgeons create after excision of skin lesions can be closed directly but as the lesion increase in size, the long axis of the ellipse may be too long for the local anatomy or cosmetic result and the short axis may be too wide to permit direct sutures. In such cases, surgeons can create rhomboid defects instead of elliptical defects and use the Limberg flap or Dufourmentel flap as a local flap. One advantage of the Limberg flap is the simplicity of the design, all angles being 60° or 120°, all sides being equal. Dufourmentel flap is more difficult to learn and to plan than the Limberg flap but in closing defects with the acute angle of which lies between 60° and 90°, Dufourmentelflap is of use. The design and application of the limberg & Dufourmentel flap will be described separately. Author applied these flaps for the rhomboid defects after excision of the basal cell carcinoma on the cheek, decubitus ulcer on the sacrococcygeal area and skin ulcer on the lower anterior leg and results are reported.

膽囊切除術 및 Roux-en-Y 總輸膽管 空腸吻合術의 實驗的 硏究

白鳳壽 고려대학교 의과대학 1972 고려대 의대 잡지 Vol.9 No.2

The various procedures are available for decompression of obstruction of the bile ducts and the choice of a particular operation in a given situation depends on the nature of the lesions, and local and general condition. Each procedure has its own advantages and disadvantages. Author performed Roux-en-Y cholodochojejunostomy with cholecystectomy as a measure of biliary decompression in 6 dogs about 2 weeks after complete ligation of the common bile duct. Changes of hematologic pictures, biochemical changes of serum components, bacteriological findings of bile, reflux of intestinal contents and histopathological findings of hepatobiliary system were observed. Following results were obtained. 1. In hematology, leukocytosis and anemia were observed in the ligated common bile duct group and Roux-en-Y group. 2. There was no remarkable change of total serum protein in the 3 groups but A/G ratio was most reversed in the Roux-en-Y group. Serum cholesterol was moderately increased in the ligated common bile duct group but returned to normal level in the Roux-en-Y group. Serum alkaline phosphatase was markedly increased in the ligated common bile duct group and it was slightly decreased in the Roux-en-Y group. G. O. T., serum total bilirubin and thymol turbidity test were moderately increased in the ligated common bile duct group but it returned to almost normal level in the Roux-en-Y group. However, G. P. T. was markedly elevated in the ligated common bile duct group but was decreased to almost normal level in the Roux-en-Y group. 3. There was no growth of bacteria in the bile of the control and ligated common bile duct group and 4 out of the 6 dogs had positive cultures in the Roux-en-Y group. E. coli were demonstrated most frequently. 4. Reflux of the intestinal contents into the bile duct was noted in 2 out of the 6 dogs. 5. The most remarkable findings of the liver in the ligated common bile duct group were bile stasis and ductal cell proliferation. Prominent bile pigmented granules in the Kupffer's cell, the bile plugs in canaliculi and centrilobular bile stasis were observed. Infiltration of the inflammatory cells and proliferation of collagen fibers were moderate. In the Roux-en-Y group, slight bile pigmented granules in the Kupffer's cell, moderate proliferation of bile ductules and slight infiltration of the inflammatory cells with proliferation of collagen fibers were observed but centrilobular necrosis of the hepatic cell was rather prominent. 6. 3 out of the 6 dogs had moderate infiltration of inflammatory cells in the common bile duct. 7. There was no specific findings in the kidney except slight cloudy swelling of the tubules in. the 3 dogs.

血管腫의 治療

白鳳壽 慶北大學校 醫科大學 1978 慶北醫大誌 Vol.19 No.2

1976年부터 1978年 9月까지 體驗한 血管腫 45例의 臨床的 考察을 하여 다음과 같은 結果를 얻었다. 1. 性別 頻度는 男子 14例 女子 31例로 女子에 頻發하였다. 2. 頭部 및 頸部에 發生한 血管腫이 25例로 67%를 차지였다. 3. 매장혈관종이 22例로 가장 많았고 포르트와인 血管腫 및 海綿狀血管腫이 各各 10例를 차지하였다. 4. 포르트와인血管腫 10例의 治療로 階段切除術 2例, 稙皮術 5例, 回轉皮層瓣 3例中 回轉皮??瓣을 利用하였던 例에서 가장 좋은 成績을 보여 주었다. 5. 매장혈관종 22例 中 10例에 프래드니소론을 投與 하였던 바 2例에서는 血管腫이 消失되고 6例에서는 退縮現象이 있었으나 2例나에서는 아무 變化가 없었으며 같은 期間 中 投藥을 하지 않고 觀察하였던 7例났에서는 3例만 退縮現象이 나타났다. 6. 海綿狀血管腫 10例中 6例에서 切除手術을 施行하였으나 完全治療된 것은 2例 뿐이였다. No matter what kind of methods may be tried for the treatment of an extensive facial heman gioma, the results offer no much improvement and sometimes refer him or her to a beautician for camouflage with cosmetis. Fortunately God gave a 80∼90% chance of spontaneous involution for the strawberry hemangioma by the age of 5 years and strawberry hemangioma is the commonest type of hemangiomas. However, when plastic surgeons confronted with patients with another type of hemgioma or not involuted strawberry hemangioma, they should do something for the patients eventhough they shake their heads sadly after sending the patients. They consider excision and sikin grafting, advancement or rotation flap, serial excision, sclerosing agents, compression methods and irradiation but they hesite to select any method. Author experienced 45cases of hemagnioma from Jan. 1976 to Sept. 1978 and results were as follows. 1. Of 45 cases, 31 were female and 14 were male. 2. 25 cases had hemangiomas on the head and neck. 3. The commonest type was strawberry hemangioma as 22cases, and portwine and cavernous type had same incidence as 10caese. 4. Of 10cases of portwine hemangioma, serial excision in 2cases, excision and split thickness skin graft in 5cases and advancement or rotation flap in 3cases were performed and flap cases had best results. 5. Of 22 cases of strawberry hemangioma, prednisolone medication was given 10 cases. 6 cases had signs of involution and 2 cases had complete involution but 2 cases had no change. However, 7 observation cases without medication had sign of involution in 3 cases. 6. Operation was done in 6 cases of cavernous hemangioma but complete cxcision was not possible in 4 cases

膽囊切除術 및 Roux-en-Y 總輸膽管 空腸吻合術의 實驗的 硏究

白鳳壽 고려대학교 의과대학 1972 고려대학교 의과대학 잡지 Vol.9 No.2

門脈高血壓症에 對한 脾腎靜脈吻合術의 臨床的 考察

白鳳壽 首都醫科大學 1966 수도 의대 잡지 Vol.3 No.1