연구발표초록 ( 공정시스템 (Ⅰ) ) : 전로조업의 동적 모사

윤상엽,이인범,장근수 ( S . Y . Yun,I . B . Lee,K . S . Chang ) 한국화학공학회 1990 추계학술발표회 Vol.- No.-

유방수술에서 조직접합제(2-Octylcyanoacrylate, Dermabond?)의 사용

윤상엽,심형보 대한미용성형외과학회 2006 Archives of Aesthetic Plastic Surgery Vol.12 No.2

This study is to compare a tissue adhesive, 2-octylcyanoacrylate (Dermabond), with conventional wound closure techniques for vertical reduction mammaplasty. Twenty patients presenting large breast from November to December 2005 were enrolled into this prospective clinical trial study. These patients' breasts were randomly assigned to treatment with either 2-octylcyanoacrylate or 5-0 monofilament sutures. Photography taken at six months after treatment were rated by two plastic surgeons and six layperson blinded to the method of closure. There was no significant difference between the two groups for appearance scores based on a visual analog scale(81.9mm for 2-octylcyanoacrylate versus 75.7mm for 5-0 monofilament sutures). The length of time for periareoalr repair was decreased in the 2-octylcyanoacrylate group(2.7 minutes for 2-octylcyanoacrylate versus 8.3 minutes for 5-0 monofilament sutures, p<0.001). The patients' satisfaction rate in the 2-octylcyanoacrylate group was high. Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for vertical reduction mammaplasty is an acceptable alternative which includes several advantages to conventional suturing with a comparable cosmetic outcome.

겨드랑이 절개를 이용한 가슴확대 수술 후 발생한 보형물의 위치이상 교정방법

윤상엽,강민구 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.2

흰쥐의 복직근피부피판에 일으킨 허혈-재관류 손상에서 CD18의 발현

윤상엽,이택종,홍준표 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.6

Purpose: This study was to evaluate the expression pattern of CD 18(leukocyte adhesion glycoprotein) in ischemia-reperfusion injury of TRAM flap of rats. Through this study, we can obtain more information about ischemia-reperfusion injury. We want to develop specific medicine to improve the survival rate of TRAM flap in the future.Methods: A TRAM flap supplied by a single pedicle superior epigastric artery and vein was elevated on 60 Sprauge-Dawley rats. The rats were divide into 6 groups (each group n=10); Group O: sham, no ischemia-reperfusion injury, Group I: 2 hour reperfusion after 4 hour ischemia, Group II: 4 hour reperfusion after 4 hour ischemia, Group III: 8 hour reperfusion after 4 hour ischemia, Group IV: 12 hour reperfusion after 4 hour ischemia, and Group V: 24 hour reperfusion after 4 hour ischemia. This study consisted of gross examination for flap survival and flow cytometry study of CD18 on neutrophils.Results: The gross measurement of the flap showed different survival rate in group I(71%), II(68%), III(37%), IV(34%) and V(34%). All experimental groups showed an increase in the expression of CD18 compared to group O. The expression of CD18 was rapidly increased in ascending order in group I, II and III. But, the expression of CD18 was maintained in group IV and V. Conclusion: The results can be implemented in the study to develop drugs which are capable of reducing ischemia-reperfusion injury in microsurgical breast reconstruction.

젊은 한국인 남성의 유두 유륜 복합체의 모양과 위치

윤상엽,심형보 대한성형외과학회 2005 Archives of Plastic Surgery Vol.32 No.6

The absence of the nipple-areolar complex(NAC) in men are seldom stated, as a result of trauma, burn, mastectomy, or after the correction of extreme bilateral gynecomastia. A total of 50 healthy men aged 21 to 27 years were examined. We recorded the configuration (dimensions and shape) and the location of the NAC with respect to fixed skeletal anatomic landmarks. Of the 50 subjects examined, 44 had oval and 6 had a round NAC. The mean diameter for a round NAC was 24.3 mm. The center of the NAC was in the fourth intercostal space in 41 volunteers and in the fifth intercostal space in 9 of the subjects. To localize the NAC on the chest wall, at least three reproducible measurements proved to be necessary, composed of a horizontal line(distance from the midsternal line to the nipple, A), a medial oblique line(distance from the sternal notch to the nipple, B) and a lateral oblique line(distance from the acromioclavicular joint to the nipple, C). Using these three parameters, we recommend that the appropriate location can be calculated derived from the circumference of the chest.

지방흡입 복부성형술에서 장액종 합병증의 경험

윤상엽 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.1

The popularity of abdominoplasty appears to be increasing. Lipoabdominoplasty consist of liposuction around abdominal subcutaneous fatty tissue and excision of lower abdominal flap. This procedure allows aggressive thinning and sculpting of abdominal flap, while preserving neurovascular supply to the abdominal skin. As a result, the flap necrosis which is one of the serious postoperative complications requiring the secondary touch can be avoided. From May 2007 to August 2008, 20 women and 2 men underwent the lipoabdominoplasty and were highly satisfied with no significant complications, such as pulmonary embolism, deep vein thrombosis and distal necrosis. Between 130 and 4,660cc(average, 1,310cc) were obtained through liposuction. The abdominoplasty flap weight fluctuated between 170 and 1,240g(average, 488g). Patients can return to normal activity within a few weeks. Three complications of seroma occurred in our series. To prevent these complications, we recommend the Baroudi’s stitches. This lipoabdominoplasty is an effective and safe alternative means without flap necrosis.

지방형 여성형유방증에 대한 새로운 분류와 1000증례

윤상엽,강민구 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.6

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

정맥마취를 이용한 지방흡입복부성형술

윤상엽,강민구,이한나 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.3

Careful attentions to design, liposuction, adequate positioning of the incision, musculofascial plication, umbilicoplasty and meticulous closure are very critical for optimal outcomes of abdominoplasty. In addition to the above factors, the mode of anesthesia is also an important factor. The ability to perform abdominal cosmetic surgery in the intravenous setting provides a more comfortable environment for patients, ease of scheduling for surgeons and less complications related to anesthesia. Between May 2007 and November 2008, 11 patients underwent lipoabdominoplasty under epidural anesthesia and 19 patients under local anesthesia with intravenous anesthesia. The results of these approaches were evaluated in terms of procedure time, length of hospital stay, rate of complications and level of patient satisfaction. There were no complications related to anesthesia (cardiac problem, deep vein thrombosis, fat emboli, and pulmonary embolism) and no surgery(flap loss or wound dehiscence) except 3 seroma cases. All intravenous anesthesia patients reported adequate postoperative pain and nausea control. Patients in both groups were generally pleased with the results of surgery. Advantages of lipoabdominoplasty using intravenous anesthesia included a low incidence of nausea and vomiting, and reduction or elimination in the risk of serious complications as a deep vein thrombosis.

피부 밑 진피피판법과 관통봉합 및 쌈지봉합을 이용한 심한 함몰유두 교정

윤상엽,강민구 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.3

Purpose: Severe type of inverted nipple(cannot be pulled out above the areola plane by manipulation, grade III) usually cannot be corrected by a relatively simple purse- string suture technique. Most patients want to avoid visible scars. To treat the severe case and avoid visible stigma, we introduce this invisible dermal flap method. Methods: This new surgical procedure makes bilateral incisions on the sidewall of nipple and dissections vertically to free the ducts from the contracted tissues. After dissection, the tunnel is formed. We insert “dermal flaps” into the tunnel underneath nipple base. Then through-and-through sutures are performed vertically(6 o’clock and 12 o’clock positions) and the purse-string suture is added with 4-0 nylon. Results: We had treated 35 primary inverted nipples (grade III) in 27 patients and 13 recurrent nipples in 7 cases. The results were excellent in 45 nipples(93.7%). All but 3 recurred cases was fully or very satisfied with the results. Conclusion: This technique is effective for the correction of severe inverted nipples and recurrent cases. We can avoid the visible scars on the areola surface.

변형된 오면체 모양 절제법을 이용한 남성 유두축소술

윤상엽,강민구 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.6

Purpose: Male hypertrophic nipples can lead to psychological distress and physical discomfort. The authors present a new technique of male nipple reduction and describe its advantages Methods: The neonipple is designed to reduce diameter and height of nipple while preserving the subdermal plexus. After the central wedge excision, additional four triangular section of nipple skin is excised. One of the remaining two flaps is amputated partially and both flaps were approximated using 4-0 PDS and 6-0 Nylon sutures. Results: From December 2007 to January 2009, 52 nipple reductions were performed in 30male patients (mean = 29.5 years). Postoperative recovery was rapid and few complications were observed. The mean diameter of the hypertrophic nipple was 9.1±2.5mm(range, 7 to 15mm). The mean diameter of the neonipple was 5.0±0.7mm(range, 4 to 6mm), with an average reduction of 3.8±0.6mm(range, 2 to 11mm). In follow-up, the neonipple had a natural appearance, with less projection and an inconspicuous scar. Conclusion: The wedge and triangular skin excision and partial amputation are easy to perform and yields consistent results. This technique decreases both the diameter and height of any size nipple and can be modified to meet patients' preferences.