비골골절에 대한 임상적 분석

임광열,안성민,황소민,정용휘,송제니퍼김,김홍일 대한두개안면성형외과학회 2011 Archives of Craniofacial Surgery Vol.12 No.2

Clinical Analysis of the Nasal Bone Fracture Kwang-Ryeol Lim, M.D., Hong-Il Kim, M.D., Sung-Min Ahn, M.D., So-Min Hwang, M.D.,Yong Hui Jung, M.D., Jennifer K. Song, M.D. Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital, Busan, Korea Purpose: Nasal bone fracture is the most common facial fracture. Although nasal bone fractures are considered to be minor injuries, the incidence of post-traumatic nasal deformity remains high. This study is designed to support management and patient satisfaction by classifying the simple nasal bone fracture, and survey the care method and result, which is compared with other studies. Methods: From May 2008 to April 2010, 334 patients with simple nasal bone fractures visited our hospital. The incidence, cause, types of nasal bone fracture, treatment, and complications are analyzed according to clinical examination, patient's record and radiographic images. Results: The mean age of patients was 30 years old, with 74% of the patients having been male, and 26% were female. The highest incidence of this fracture was between late teens to late twenties. The causes of nasal bone fracture were the following: having slipped or fallen down(39%), violence(16%), sports accident(14%), traffic accident(11%), industrial accident(6%), and others(16%). Patient's radiographic images were analyzed by Stranc and Robertson classification, frontal impact plane I was 38%, plane II was 16%, plane III was 1%, lateral impact plane I was 21%, plane II was 21%, and plane III was 3%. On average, surgical treatment was performed 7.2 days after trauma under general anesthesia. Closed reduction of nasal bone fracture was performed in 99% of patients. In patients with septal injuries, septal management was performed in 76.7% of cases. Aesthetic surgery was done on same time in 24% of patients. There were some complications, such as residual nasal deformity(7.2%), nasal obstruction(0.9%) and hyposmia(0.3%). Conclusion: According to this study, nasal bone fractures occurred commonly in physically active age groups(age 15~29 years), as a result of having slipped or fallen down, at afternoon and at night time. And it could be treated successfully by closed reduction and septoplasty by 7 days after trauma. (J Korean Cleft Palate Craniofac Assoc 12: 81, 2011)

비골골절 시 골절정복과 동시에 시행된 융비술

임광열,송제니퍼,김형도,황소민,정용휘,안성민 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2

Purpose: The nasal bones are the most common fracture sites of the facial bones, and a careful reduction may still result in secondary deformities, such as saddle nose, deviated nose, hump nose etc,requiring secondary cosmetic rhinoplasty. Therefore, this study examined the clinical characteristics of nasal bone fractures to propose guidelines for patient selection and surgical procedures to achieve more satisfactory results and to prevent secondary deformities with simultaneous augmentation rhinoplasty and bony reduction. Methods: The study was based on 26 out of 149 nasal bone fracture patients who underwent simultaneous augmentation rhinoplasty with bony reduction between May 2008 and April 2009. Retrospective analysis was performed according to the clinical data, surgical techniques and postoperative results. Results: Of the 26 patients, there were 15 males and 11 females. The incidence according to the Stranc’s classification revealed that 62% of patients were injured by a frontal impact and 38% by a lateral impact. Frontal impact plane I (50%) was the most frequent type. At the follow up, 18 (81.2%) out of 22patients were satisfied with their postoperative outcome, and the remaining 4 patients were fair. No one was dissatisfied. However, 5 cases in 3 patients (23%) had some complications; minimal implant deviation in 2 cases, minor irregularity on the nasal dorsum in 2 cases and palpable implant movement under palpation in 1 case. None of these cases required surgical correction. Conclusion: With the proper guidance, simultaneous augmentation rhinoplasty with bony reduction can prevent secondary deformities and satisfy the cosmetic outcomes. (J Korean Cleft Palate Craniofac Assoc 11: 77, 2010)

Correlation between the time elapsed after liposuction and the risk of fat embolism: An animal model

임광열,조정민,윤청민,이근철,이상윤,주미하 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.1

Background Liposuction has become one of the most frequently performed procedures in the field of aesthetic surgery. Fat embolism syndrome after liposuction can easily be overlooked or underestimated; however, occasionally, fulminating fat embolism syndrome can develop and lead to a critical situation within 2–3 days after lipoplasty. Changes over time in the amount of circulating fat particles and the histology of major organs have not yet been studied. Methods This study was conducted using 18 male Sprague-Dawley rats aged 12 weeks and weighing 500–628 g (average, 562 g). Fifteen rats were used as the experimental group and 3 as the control group. Under general anesthesia, tumescent-technique liposuction was performed at the lateral flank areas and abdomen for 1 hour. Blood, lung, and brain tissue specimens were obtained at 1 hour, 1 day, and 2 days after the liposuction procedure. Results The average number of fat particles in the blood samples was 25,960/dL at 1 hour, 111,100/dL at 24 hours, and 21,780/dL at 48 hours. The differences between study groups were statistically significant. Both intravascular and extravascular fat particles with inflammation were seen in all 15 rats, as were inflammatory cell infiltration, hemorrhage, and consolidation with shrinkage of the lung alveoli. Conclusions These results imply that there is a strong possibility of fat embolism syndrome after liposuction in real clinical practice, and the first 24–48 hours after the operation were found to be the most important period for preventing pulmonary embolism and progression to fulminating fat embolism syndrome.

비골 골절에서 외측 비골 절골술의 적용

임광열,송제니퍼김,황소민,정용휘,조가형,Lim, Kwang Ryeol,Song, Jennifer K.,Hwang, So Min,Jung, Yong Hui,Cho, Ka Hyung 대한두개안면성형외과학회 2012 Archives of Craniofacial Surgery Vol.13 No.2

Purpose: Who may dare to state that optimal choice of treating nasal bone fracture is closed reduction? Few decades of authors' experience in nasal bone fracture has lead to believe that more active and assertive approach in nasal bone fracture by performing simultaneous lateral osteotomy may be applied in proper indications to acquire more accurate reduction and cosmetically satisfying result. Methods: From May 2008 to October 2009, among 241 nasal bone fracture patients, 20 patients underwent simultaneous lateral osteotomy with nasal bone fracture reduction. Followed by rigid septal correction, nasal cavity is packed to stabilize the fracture segment for safer osteotomy. Through intranasal incision, in selected cases of difficult reduction or for cosmetic purposes, various types of lateral osteotomy was performed corresponding to the fracture anatomy, conditions of the nasal cavity. Postoperative nasal packing was retained for one week and nasal dorsum splint for 3 weeks. Results: Lateral osteotomy was utilized for difficult cases of closed reduction, for correction of wide nose, hump and deviation in 9, 5, 2, and 4 cases, respectively. Patient satisfaction was scaled 90% in satisfaction and moderate in 10% (2 cases), complaining of mild nasal tip deviation. Physicians detected 2 cases of apparent deformity with patient recognition; one patient with mild step deformity at the osteotomy site and the other patient with minimal implant mobility. Conclusion: By accompanying profound understanding of the fracture anatomy, more active and assertive approach in nasal fracture reduction can be coincide with simultaneous lateral osteotomy to reduce the rate of secondary deformity and to obtain more cosmetically satisfying result.

공기밸브형 맥동연소기의 동적 특성에 관한 실험적 연구

임광열,최병륜,오상헌 대한기계학회 1987 대한기계학회논문집 Vol.11 No.5

본 연구에서는 실용적 설계및 이론해석에 필요한 동적 거동에 관한 현상규명 및 기초자료를 제공하기위해, 기하학적 형상변화에 따른 맥동연소의 안정성 및 흡입공 기량의 측정을 통한당량비의 범위를 관찰하고, 연소실과 배기관, 공기유입관, 연료노 즐실에서의 압력을 각각 동시측정해서 동적거동에 관해 고찰하고, 작동주파수에 관한 간단한 실험식의 확립과 추력성능에 관한 실험을 행했다. The experimental study was carried out to investigate the performance characteristics of the aero-valved pulsating combustor designed to increase the practical applications of the system. The geometric effect on the stable condition and the dynamic behavior of the system is identified. The equivalence ratio, the inflammability limit, the operating frequency, and thrust were also measured when the system oscillated stably. It is found that while the operating condition is sensitive to the diameter of the inlet pipe and the length of the tailpipe, the maximum value of the turn down ratio was obtained up to 3.2. The measured air flow rate shows that the equivalence ratio increases monotonously with the increasing fuel flow rate and decreasing air inlet diameter and tailpipe length. The measured operating frequency can be approximated by the simple linear equation and the discrepancy is within five percent. The system produced the maximum total thrust of 14N and the minimum specific fuel consumption of 0.155 Nm$^{3}$/h.N when the total thrust was 13N.

다양한 융비술 후 발생한 비근부 연부조직 결손의 치험

임광열,안성민,오경석,정용휘,황소민 대한미용성형외과학회 2009 Archives of Aesthetic Plastic Surgery Vol.15 No.2

To reconstruct the defect of nasal dorsum, factors such as skin color, texture and thickness should thoroughly be considered for more natural appearance. Authors would like to present 8 cases of soft tissue defect developed after augmentation with various materials that were treated with satisfactory results. This study is based on 8 patients who visited our clinic for the treatment of soft tissue defect on nasal radix after augmentation rhinoplasty. The materials used for augmentation were silicone implant in 5 cases, autologous microfat in 2 cases, and paraffin in 1 case. Guideline for treatment of soft tissue defects developed after augmentation as follows; 1. Soft tissue defects by silicone implant are treated with dressing or closure of the defect after removal of implant. 2. In cases of soft tissue defect after autologous microfat injection, conservative treatment can be recommended at first to increase the chance of microfat survival and infection control. Skin was resurfaced by scar healing or using the advancement local flap. 3. In paraffin injection case, conservative removal of foreign body and several months' wound dressing will obliterate dead space by granulation tissue and minimize the skin defect by wound contraction. Skin defect was reconstructed by advancement local flap.

폐타이어로부터 회수한 카본블랙을 이용한 폴리스티렌으로부터 스티렌 단량체의 회수

임광열(Kwang Yuel Lim),전현철(Hyun Chul Jun),이해평(Hae Pyeong Lee),김희택(Hee Taik Kim),류경옥(Kyong Ok Yoo) 한국공업화학회 2000 공업화학 Vol.11 No.8

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관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료

이용재,이동주,임광열,김명구,Lee, Yong-Jae,Lee, Tong-Joo,Lim, Kwang-Yul,Kim, Myung-Ku 대한관절경학회 2004 대한관절경학회지 Vol.8 No.2

목적: 견관절의 전방 불안정성이 있는 환자에서 관절경하 생체흡수형 knotless anchor를 이용한 치료 결과를 객관적 및 주관적 평가를 통하여 알아보는데 있다. 대상 및 방법: 2003년 1월부터 2003년 6월까지 본원에서 외상성 견관절 전방 불안정성에 대하여 관절경하 생체흡수형 knotless anchor를 이용하여 Bankart복원술을 시행하고 평균 12개월 추시된 15예를 대상으로 하였다. 환자 구성은 남자가 14명, 여자가 1명이었으며, 평균 연령은 24세 (16세${\sim}$42세)였다. 평균 추시 기간은 14개월(12개월${\sim}$18개월)이었다. 수술시간은 같은 저자에 의해 2002년 1월부터 2002년 10월까지 suture anchor 술기를 이용하여 관절경하 Bankart 복원술을 시행한 20예와 비교하였다. 결과: 수술 후 탈구의 재발이나 아탈구의 발생은 없었으며 Rowe등에 의한 기능적 평가에서 평균 89.4점이었고 환자의 주관적 만족도는 평균 87.5였다. 최종 추시시의 견관절 운동 범위는 각각 굴곡이 평균 171도, 외회전이 평균 54도로 측정되었고 전 예에서 결과에 만족하였으나 3예에서 운동시 불안감각이 남아 있었다. 수술시간은 suture anchor 술기를 이용한 Bankart 복원술에서 1개의 매듭 당 평균 25.5분이 소요되었지만, 생체흡수형 knotless anchor를 이용시 1개의 anchor당 소요 시간은 평균 16.5분으로 의미 있게 감소됨을 알 수 있었다(P<0.05).결론: 견관절 전방 불안정성의 원인인 Bankart병변의 치료에 있어 knotless anchor 술식은 관절낭의 적절한 긴장을 획득하고 수술 시간을 단축하는 장점이 있으며 탈구나 아탈구의 재발없이 견관절 불안정성을 치료할 수 있는 유용한 방법으로 사료된다. Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

콧등에 발생한 화골성 근염 -1예 보고-

송제니퍼김,황소민,임광열,정용휘,안성민 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.1

Purpose: Myositis ossificans is a benign condition of heterotopic bone formation that still requires more of its pathologic explanation. The lesions are localized predominantly to the high - risk sites of injury, involving flexor muscles of the upper limbs and thigh, but rarely in the head and neck area. Methods: A case of 44 – year - old male patient presented with a palpable hard mass on nasal dorsum. Patient experienced a similar lesion on upper limb few years ago. On computed tomographic image, the lesion presented focal definite increase in opacity compatible to adjacent bone densitiy on nasal dorsum. Results: The lesion was excised under open rhinoplasty incision. The pathologic report revealed focal bone formation and calcification within skeletal muscle. Conclusion: We describe a unique and only case of a myositis ossivicans on nasal dorsum which is indifferent from previous concept.

Is Rectosigmoid Vaginoplasty Still Useful?

김석권,박지원,임광열,이근철 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.1

Background The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. Methods From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients’ records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. Results All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. Conclusions Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.