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이종량,하재성,이유진,서정오,전건수 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.5
The ischial area is the most common site for the development and recurrence of pressure sore in the paraplegic patient. The gradual evolution in surgical treatment of pressure sore has led to the presently accepted surgical objectives : First, en-bloc excision of the all ulcerated area. Second, resection of any existing bony prominence. Third, resurfacing and padding of the defect with healthy and well vascularized tissues. In recent years, muscle and musculocutaneous flaps have been used to provide large, reliable soft tissue units. We have used the biceps femoris, semimembranosus, and semitendinosus muscles with overlying skin as a large hamstring myocutaneous flap and have advanced it in a V-Y manner to close 7 cases of ischial pressure sores. Among them, 4 cases were primary cases with a large, deep ulcerated lesion and the rest were recurrent cases after coverage with semitendinosus muscle. We obtained the following advantages: 1) It is extremly relible and sturdy. 2) It is a large flap and therefore can cover a large defect. 3) It can provide sufficient padding, even if there is marked muscle atrophy. 4) It preserves options for future use.
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이종량,하재성,이유진,서정오,전건수 大韓成形外科學會 1992 Archives of Plastic Surgery Vol.19 No.5
The reconstruction of the bilateral cleft lip is a very difficult problem in the department of the plastic surgery. Although many authors have tried to repair the bilateral cleft lip, still there are no procedures that satisfy all surgical objectives for the bilateral cleft lip. From Jajnuary 1990 to July 1991, we had experienced 6 cases of the complete bilateral cleft lip which were reconstructed by the Black method. The follow up study was carried out by 6 months to 2 years. The followings were the results. 1. The symmetricity was good and the tension of the upper lip was low. 2. No tissue was discarded, and it could preserve the natural vermilion white line. 3. It enabled functional lip movement by repairing the muscle primarily and making deep labiogingival sulcus. 4. It made the scar on the philtral ridge and full apperarance of the upper lip. 5. It preserves option for future columella lenthening by using the fouked flaps.
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화상환자에서 혈청중 가용성 Interleukin-2 Receptor의 변동
이희성,이유진,이종량,백광진,하재성,전건수 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2
Cell-mediated immunity frequently becomes severely impaired after burn. However, the cause of postburn immune dysfunction is unclear and controversy exists over both pathophysiology and clinical relevance of these abnormalities. This study was undertaken to invstigate the immune responses in vivo of patients with burn. Levels of soluble IL-2R, a sensitive marker of T-cell activation, were measured in 26 patients with burn. Serum soluble IL-2R levels in patients with burn were significantly higher than those of normal controls. Serum soluble IL-2R levels were correlated closely with the severity of the burn. The burn patients were classified according to the outcome. Patients with fatal outcom always showd a higher soluble IL-2R levels than survivors. Postburn sera significantly suppressed mitogen-indeced lymphocyte proliferation. These data indicate that soluble IL-2R might be useful parameters for monitoring of the clinical course in burn patients.
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전건수,서정오,박준용,강동훈,이종량,하재성,정성균 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.2
More recently, the copper vapor laser was introduced as an alternative source of pulsed yellow light at 578 nm and green light as 511 nm. The 578 nm option corresponds with a peak in the absorption of oxyhemoglobin and a diminished absorption by melanin and is able to selectively destroy an abnormal vessel with little damage to overlying epidermis. Whereas th green light at 511 nm is used to treat the benign pigmented lesions. As using manual method(spot by spot, tracing), the "gated" exposure of 0.2 sec "on time" and 0.1 sec or 0.2 sec "off time" was used and the power range was 6∼15 J/㎠, fluences between 7 and 12J/㎠ was reported to be appropriate for most vascular lesions. For pigmented lesions, a short dwell time is best, with the power chosen to give a fluence between 6 and 15 J/㎠(6 J/㎠ equals 236 milliwatts and 10 J/㎠ is 393 milliwatts). The spot sizes were 150, 267, 400, and 1000microns. The treatment of individual vessel disease(ie, telangiectasia) was conducted using a tracing technique. For the treatment of Port-wine stain, the tracing and shuttered technique could be employed. In the treatment of melanin rich lesions, end-point was further and complete darkening of the entire lesion, and the end-point for treatment of lower melanin content lesion was less obvious. As using autolase scanner, pattern densities were 500, 625, 750, and 1000㎛ center to center separation between treatment spots. For vascular lesions. 750 ㎛ was appropriate and for pigmented lesions, 500 and 625 ㎛ were chosen and the power range was 6∼16J/㎠. The result was evaluated according to the criteria of Gilchrest in Nevus flammeus. From January 1991 to June 1992, we had experienced 615 cases of the vascular lesions and the benign pigmented lesions, which were treated by the Copper vapor laser. The follow up study was carried out from 4 months to 20 months. Data from the 462 patients who could be followed up were evaluated and analyzed. Through the Copper vapor laser, the authors obtained satisfactory results with little complications. The study results were as follows : 1. Among vascular lesions, nevus flammeus was 39 cases, telangiectasia 51 cases, hemangiona 47 cases. Among pigmented lesions, melasma was 101 cases, freckles 94 cases, Ota's nevus 53 cases, lentigines 5 cases, and others 72 cases. 2. Treatment effect : In the 137 cases of vascular lesions, 110 cases(80.0%) showed excellent or good results and 27 cases(20%) showed fair or poor results. In the 325 cases of pigmented lesions, 200 cases(61.5%) showed excellent or good results and 125 cases(39.5%) showed fair or poor results. 3. Side effects occured in 30 cases(6.5%) : In vascular lesions, hypertrophic scar was 3 cases(2.1%) and hyperpigmentation 10 cases(7.3%). In pigmented lesions, hyperpigmentation was 17 cases(5.2%) and hypertrophic scar was none.
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