유리 횡복직근피판술을 이용한 지연 유방재건술; 즉시 유방재건술과의 비교

전명곤,안희창,Jun, Myung-Gon,Ahn, Hee-Chang 대한미세수술학회 2001 Archives of reconstructive microsurgery Vol.10 No.1

The numbers of breast cancer are increasing in Korea and the needs for breast reconstruction are also parallel with cancer frequency. The purpose of the study is to define the different state and condition between the delayed reconstruction and the immediate reconstruction of breasts and to suggest how to get more satisfactory outcome. The study included 22 patients who underwent delayed breast reconstruction using transverse rectus abdominis myocutaneous(TRAM) free flap from December, 1990 to January, 2001. Their ages ranged from 28 years to 58 years. We have used internal mammary artery and vein as a recipient vessel in 13 patients because of fibrosis and severe scarring in the axillary region and thoracodorsal artery and vein in 9 patients. When we used internal mammary artery with recipient vessel, we would use contralateral deep inferior epigastric artery with donor vessel. We obtained satisfactory result without any flap loss, and most patients satisfied with shape and volume of reconstructed breast. We found that delayed breast reconstruction have some differences compared with immediate breast reconstruction. First, we remove fibrotic and scar tissue as much as possible to achieve satisfactory shape of breast. Second, we plan preoperative design in standing position to obtain symmetrical recreation of inframammary fold. Third, we use internal mammary vessel in many cases with recipient vessel for microvascular anastomosis. Fourth, patients with delayed breast reconstruction feel more satisfaction than patients with immediate breast reconstruction do. Finally, economic burden is much higher in the delayed case than in the immediate case because of no coverage with insurance.

노인에서의 미세수술에 의한 재건술

전명곤,박봉권,안희창,Jun, Myung Gon,Park, Bong Kweon,Ahn, Hee Chang 대한미세수술학회 2000 Archives of reconstructive microsurgery Vol.9 No.1

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

Al_(2)O_(3)-MgO계 캐스터블 내화물의 내침식성 향상

전명곤,연상흠,양정훈,김재준,황규홍,정두화 慶尙大學校 經營行政大學院 2004 工學硏究院論文集 Vol.20 No.-

To improve the mechanical and chemical properties of unfired Al_(2)O_(3) castables which is widely used in metal line of steel-making ladle, the ρ-Al_(2)O_(3) and /or fine MgO was added as a matrix powders and the degree of spinel formation was studied. Because the spinel was formed at the contact areas between Al_(2)O_(3) and MgO particles and the volume of in-situ formed spinel increased more abnormally at the site of Al_(2)O_(3) particles than MgO side, Al_(2)O_(3) aggregates was more recommendable than MgO aggregates. And to compare the degree of spinel formation in the Al_(2)O_(3)-MgO castable refractories, ultrafine SiO_(2) and Al_(2)O_(3) powders were added and their effects on physical properties such as permanent volume expansion and cold crushing strength were examined. For ρ-Al_(2)O_(3) binder, it could be replaced the alumina cement so that the CaO content could be reduced, but low compressive strength and firing shrinkage inhibit it's application to castables. But MgO powders should be added and the finer the MgO powder, the better the residual expansion and in-situ Spinel formation was observed. And due to Spinel formation and dense microstructure, CA_(6) phase would not formed around alumina aggregates during corrosion so that the corrosion resistance was much more increased.

당뇨족 환자에서 족부 보존을 위한 전략적 치료

전명곤,안희창,박봉권 大韓成形外科學會 2001 Archives of Plastic Surgery Vol.28 No.2

Cement Burner용 Ultra low cement castable

전명곤,강해성,윤은석 한국시멘트협회 2005 시멘트 심포지움 Vol.32 No.-

Blow-In 안와 골절의 임상적 분석 및 치료

성건용,전명곤,안희창 대한성형외과학회 2004 Archives of Plastic Surgery Vol.31 No.5

Blow-in orbit fracture is relatively rare fracture which is an inward displacement of the orbital rim or wall fragment, resulting in decreased orbital volume. The objective of this article is to analyze blow-in fracture status of orbit and to suggest appropriate management in this unusual fracture. The study included 23 cases who had treatment of blow-in fractures of orbit from July, 1995 to June, 2001. Their ages ranged from 4 years to 63 years. There were 17 males and 6 females. The diagnosis of blow-in fracture was accomplished with physical examination, ophthalmologic examination, plain X-ray, and facial CT scan. According to Antonyshyn's classification, we classified them into 2 large groups which were pure type and impure type. Pure type blow-in fractures are relatively uncommon and 5 cases were documented in a series of 23 patients. Impure type fractures included the orbital rim and 18 cases were documented. Clinical symptoms of blow-in fractures were proptosis, limitation of eyeball movement, diplopia, blepharoptosis, subconjunctival hemorrage and blindness. 2 patients with globe rupture and blindness underwent enucleation due to direct injury by bony segment. We conclude that early and appropriate surgical treatment with complete examination is very important to prevent blepharoptosis, proptosis, limitation of eyeball movement and optic nerve compression. However, when globe rupture and blindness by direct injury of bony segment happened, the operation of enucleation was needed in this particular case.

소아에서의 미세수술에 의한 재건술

안희창,전명곤,김정철 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

Microsurgical reconstruction is necessary for children to correct severe trauma and congenital or acuqired deformity. The aim of this study was to evaluate whether or not microsurgical reconstruction is a safe and reliable operation in children and to analyze the differences of microsurgical reconstruction in children compared to adults. The study included 12 children who underwent 13 microsurgical reconstructions among a total of 251 cases of microsurgical reconstruction from May, 1986 to August, 1998. Their ages ranged from 24 months to 14 years and 8 months. There were 7 males and 6 females. The involved sites were 9 legs, 3 hands and 1 face. The causes of microsurgical reconstruction were 9 traumas, 2 congenital anomalies, 1 acquired deformity and 1 cancer. The applied flaps were 4 scapular flaps, 2 rectus abdominis muscle flaps, 1 de-epithelized groin flap, 1 lateral arm flap, 1 forearm tendocutaneous flap, 1 forearm tendocutaneous flap, 1 latissimus dorsi muscle flap, 1 fibula flap, 1 second toe transfer, and 1 wrap-around flap. All patients have had normal growth of the donor and recipient sites without specific complications during an average 2 years follow-up. We concluded that microvascular reconstruction is a very useful and reliable procedure in children if it is performed in consideration of each child's specific characteristics and conditions.

포스터 85 : 자동화 압입시험을 이용한 압력용기강 다층용접부의 파괴인성 천이특성 평가

조한서,이봉상,양원존,전명곤,홍준화 대한금속재료학회 ( 구 대한금속학회 ) 2000 대한금속재료학회 학술대회 개요집 Vol.2000 No.0