단중족골중에서 자가 장골 이식후 이식골의 운명과 환자의 만족도

우상현,박진철 大韓成形外科學會 2002 Archives of Plastic Surgery Vol.29 No.6

전완부에서 미리 확장된 동맥화 정맥피판을 이용한 안면부 화상반흔의 교정

우상현 대한성형외과학회 2001 Archives of Plastic Surgery Vol.28 No.1

바다에서 건진 절단된 하지 원위부의 재접합

우상현,오경석,Woo, Sang Hyun,Oh, Kyoung Sok 대한미세수술학회 2000 Archives of reconstructive microsurgery Vol.9 No.2

A case of distal lower leg replantation, in an elderly patient, was successfully performed after retrieval of the amputated limb from 3 hours of immersion in seawater. Due to the patient's age, bony union was delayed and functional nerve recovery was unsatisfactory. After massive saline irrigation of the amputated part, employing a catheter through the main artery, as well as, prophylactic antibiotics to prevent infection by Aeromonas, there were no postoperative complications. Despite the issue of age, immersion of an amputated part into seawater is not a contraindication of replantation.

미세수술을 이용한 무지의 재건

우상현 대한수부외과학회 2011 대한수부외과학회지 Vol.16 No.2

Compared with non-microsurgical reconstruction of the thumb, microsurgical reconstruction can provide more desirable postoperative results regarding to the function as well as appearance. Toe transfer in one of its forms offers many of the best ways to reconstruct defects of the thumb. For reconstruction of the pulp, nail, and the first web space, microsurgical transfer of required tissues provides excellent sensory restoration leaving little morbidity at the foot. For composite defect of the partial thumb amputations, wrap-around procedure and trimmed great toe transfer is one of the best options in cosmesis. Trimmed great toe transfer technique is to circumvent the lack of motion of the wrap-around flap. In cases of loss of the entire thumb, preliminary procedure is inevitable to avoid foot morbidity. After distant groin flap and autogenous bone graft, secondary toe-to-hand transfer is possible with great toe or second toe. Regarding to operation timing, preoperative planning is very important to induce rapport formation between patient and doctor. In case of malignant tumor resection, immediate reconstruction is much better than delayed reconstruction. Transfer of all parts of the great toe imparts some morbidity to the foot, but the effect when evaluated with gait studies is generally minimal. Certainly, the tradeoff of a thumb for the loss of the great toe is usually well-accepted by the patient. The primary disadvantage of these techniques is their inherent complexity and,although they offer superb reconstructive options in patients with loss of all or part of the thumb, their application should probably be limited to those practitioners with experience. 목적: 무지에 발생한 다양한 결손에 대하여 미세수술을 이용한 재건수술의 적응증,수술 방법, 술 후 결과, 각 방법의 장단점과 합병증 등에 대해 살펴보고, 절단 위치와절단된 조직의 종류에 따라 가장 적합한 수술 방법을 찾아보고자 한다. 대상 및 방법: 지난 20년간, 무지에 발생한 외상, 선천성 기형, 악성 종양 절제술 후결손부의 재건을 시도한 경우 중에 미세수술을 이용한 무지재건술을 받은 환자를 대상으로 하였다. 무지의 부분 결손은 지절간 관절 원위부에 발생한 수질부, 조갑부, 원위지골을 포함한 복합조직 결손, 그리고 제1수지간부의 연부조직 결손으로 구분하여각각 가장 비슷한 성질을 가진 적합한 조직을 전이하여 재건하였다. 무지의 근위지골에서 절단된 경우에는 포장 주위 피판이나 다듬은 족무지 전이술이 적합하다. 중수지관절 근처에서 절단된 경우에는 중족골 골두에서 경사 절골술과 족저판 단축으로 과신전 관절을 굴곡 관절로 변환시켜 제2족지나 족무지를 전이하는 것이 좋다. 또한 중수골의 결손이 심한 경우에는 미리 골이식과 원거리 피판으로 연부조직을 보충한 후족무지 전이술을 하는 것이 공여부의 이환을 줄일 수 있다. 결과: 수술 성공률은 95% 이상으로 피판 생존 시 술 후 만족도는 비미세수술적 방법보다 기능이나 미용적인 면에서 우월하였다. 결론: 미세수술을 이용한 무지재건술을 시행할 때 수술의 실패는 공여부의 또 다른장애를 초래하므로 한정된 수술 적응증과 적합한 수술 시기의 선정이 중요하다. 재건될 무지는 반드시 미적으로 기능적으로 우수해야 하며, 술 후 발생할 수 있는 공여부와 수혜부의 합병증을 최대한 줄이도록 노력해야 한다.

수지 첨부 손상시 미세 수술을 이용한 즉시 재건술

우상현,설정현 대한성형외과학회 2003 Archives of Plastic Surgery Vol.30 No.2

During the recent 8 years, 45 fingertip injuries were reconstructed with immediate microsurgical free flap in 36 patients. There were 21 patients of pulp reconstruction (great toe pulp flap 8 cases, pulp flap from the second toe 3 cases, innervated arterialized venous flap 5 cases and first web space flap 5 cases) for pulp defect proximal to the most distal palmar crease of the fingers, 5 cases of onychocutaneous flap for thumb nail reconstruction, and 10 cases of partial toe transfer(partial great toe transfer 8 cases and second toe wrap-around procedure 2 cases). Overall survival rate of flap transfer was 97.2%(35/36). The static 2-point discrimination averaged 8mm in pulp reconstruction of the thumb, 12mm in index and 16mm for other fingertip reconstruction. There was 1-2mm atrophy of the nail width after onychocutaneous flap for thumb nail reconstruction. The subjective satisfaction of self-assessment score on the new fingertip was 85 and 88 of the thumb reconstruction in function and appearance, respectively. The score of the index was higher than that of other fingers. Immediate microsurgical reconstruction of the fingertip injuries provides many advantages over other procedures such as single stage reconstruction, early exercise and shortened convalescent period, and high satisfaction score by self-assessment in both functional and aesthetic aspects. Therefore, immediate microsurgical reconstruction of fingertip injury is a safe and reliable procedure in case of limited indications.

혈관외로 유출된 Mitomycin-C에 의한 조직괴사 예방을 위한 Dimethly Sulfoxide와 Sodium thiosulfate의 효과

우상현,최병철,김기형,설정현,정태은 영남대학교 의과대학 1996 Yeungnam University Journal of Medicine Vol.13 No.2

Extravasation of toxic chemotherapeutic 'agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and 11 were 20 mice treated dimethyl sulfoxide and sodium.

AISI-4340 변형률 속도 변화에 따른 인장, 압축형 JC 구성방정식 변수에 관한 연구

우상현,이창수,박이주,Woo, Sanghyun,Lee, Changsoo,Park, Leeju 한국군사과학기술학회 2017 한국군사과학기술학회지 Vol.20 No.4

In this study, the experimental methods are compared for obtaining the parameters of the Johnson-Cook constitutive model. The parameters used for numerical simulation are very important in making an accurate estimation of numerical simulation. So, the testing method of obtaining the parameters is also very important. We compared the difference of conventional method, compression method and tensile method of AISI-4340 steel at various strain rate by using MTS, SHPB and SHTB. Taylor impact test and M&S were carried out to compare differences among these three types of JC constitutive parameter.

Ti-6Al-4V 변형률 속도 변화에 따른 인장, 압축형 JC 구성방정식 변수의 변화

우상현,이창수,박이주,Woo, Sang-Hyun,Lee, Chang-Soo,Park, Lee-Ju 한국재료학회 2017 한국재료학회지 Vol.27 No.1

This paper is concerned with a test method that can be used to investigate the parameters of the Johnson-Cook constitutive model. These parameters are essential for accurately analyzing material behavior under impact loading conditions in numerical simulation. Ti-6Al-4V alloy (HCP crytal structure) was used as a specimen for the experiments. In the $10^{-3}-10^3/s$ strain rate range, three types of experimental methods (convention, compression and tension) were employed to compare the differences using MTS-810, SHPB and SHTB. Finite element analysis results when applying these parameters were displayed along with the experiment results.

급성 수부 손상시 즉시 족지 전이술

우상현,김학수 大韓微細手術學會 2002 Archives of reconstructive microsurgery Vol.11 No.1

단중족골증에서 자가 장골 이식후 이식골의 운명과 환자의 만족도

우상현,박진철 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.6

The purpose of this study was to analyze the fate of intercalated bone graft and the satisfaction of patients with brachymetatarsia of the 4th toe on the clinical results after one-stage lengthening with autogenous iliac bone graft. In last 6 years, 30 feet in 17 patients with brachymetatarsia were corrected with one-stage operation that was composed of Z-plasty of skin, extensor tendon and intercalated iliac bone graft, which appeared as ball-and- socket figure at the metatarsophalangeal joint. The length of harvested iliac bone graft was 18mm in average(14-23 mm) and there was bone resorption about 1.1mm(0.1- 3.0), (7.1%) postoperatively. Postoperative digital fluoroscopy showed 83%(25/30) new joint(pseudojoint) formation of intercalated iliac bone grafts between proximal phalangeal bone and metatarsal bone. The objective functional evaluation with AOFAS scale was 89.4 in average(80- 100) and subjective satisfaction on the aesthetic aspect was also high. There was no neurovascular impairment nor recurrence of brachymetatarsia even after one-stage lengthening with intercalated iliac bone graft.