유리 족지이식을 이용한 무지재건술

조병채 大韓成形外科學會 1996 Archives of Plastic Surgery Vol.23 No.1

The thumb is functionally, and cosmetically the most important finger of the hand, and performs 40-50% of the hand functions. The requirements of the reconstructed thumb are oopposability, stability, sensibility, and appearance. Advantages of the toe transfer are 1) similar length, shape, and skin texture, 2) provision of good sensation and functional ability, 3) a one stage operation. Disadvantages are 1) sacrifice of the toe, 2) long operative time. We used the great toe and the second toe for the reconstruction of the thumb. From March 1990 to October 1994, We treated 13 patients with thumb defect. Causes of thumb defect were trauma in 12 cases and congenital hypoplasia in 1 case. 11 cases were male, 2 cases were female. Procedures were great toe modified wrap-around transfer in 9 cases, partial great toe transfer in 2 cases, total great toe transfer in 1 case, the total second toe transfer in 1 cases. The mean follow up period was 29 months(form 7 to 63 months). The results were summarized as follows: 1 The average two-point discrimination of the reconstructed thumb tip was 6mm and pinching power showed 70 percent compared to normal site. 2. The great toe modified wrap-around transfer without iliac bone graft provided the best cosmetic result in distal part amputation of the interphalangeal joint. 3. The total great toe transfer provided good cosmetic and excellent functional results in amputation from the proximal part of the interphalangeal joint to the distal part of the metacarpophalangeal joint. 4. The total second toe transfer was a good procedure in the complete absence of the first ray or in children.

개선된 Noordhoff 방법을 이용한 양측성 구순열의 교정

조병채,이용직 대한성형외과학회 2006 Archives of Plastic Surgery Vol.33 No.4

Purpose: The authors accessed the anthropometric measurements of fourty non-cleft normal a three-month- old infant and using this obtained data as a basic guideline, authors applied the modified Noordhoff technique for the treatment of bilateral cleft lip.Methods: Over a period of 10 years, a total of 21 bilateral cleft lips were operated. 13 cases of complete and 8 cases of incomplete bilateral cleft lip and palate. In the complete type of bilateral cleft palate, elastic head cap and passive intraoral appliance were applied at 1 to 2 week of age for 2 months duration. The definitive cheiloplasty was performed at 3 months of age using the modified Noordhoff technique. Results: After a follow-up period ranging one to nine years, most patients presented with cosmetically and functionally satisfying results, with an exception of two cases where an undesired peaking effect of the vermilion and dimpling of the vermilion mucosa was encountered. Conclusion: Accessing the anthropometric measurements of fourty non-cleft normal three-month-old infant and using this obtained dara as a guideline, the modified Noordhoff technique can be applied to either complete or incomplete bilaterally cleft lip providing more naturally pleasing and cosmetically satisfying scars that lie in harmony with the philtral ridges, lip tubercle positioned just below the vermilion and a distinct white line and Cupid's bow.

Tradition and Future of the Korean Society of Plastic and Reconstructive Surgeons

조병채 대한성형외과학회 2016 Archives of Plastic Surgery Vol.43 No.1

측두삼각 V-Y 전진피판을 이용한 매몰이의 수술적 교정

조병채,양정덕 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.1

A new approach is introduced for the correction of cryptotia using a large triangular flap, which is designed on the temporal scalp and skin over the auricle. The posterior limb of the triangular flap was continued to the mastoid area at the mid-portion of the auricle. The abnormal insertion of the auricular intrinsic muscles was detached. A sharply curved antihelical crus or a contraction of helical cartilage was corrected. After providing ample skin to maintain the auriculocephalic sulcus by inferior advancement of the flap, the donor was closed primarily. From 1999 to 2003, a total of 13 cases of 11 patients with cryptotia were treated. Nine were unilateral and two bilateral. In the nine patients of unilateral cryptotia, three were on the left and six were on the right side. The follow-up period was three months to one year with relatively favorable results. There were no postoperative complications, such as necrosis or infection of the flaps. In conclusion, the main advantages of the author's proposed technique are simple and easy design, provision of enough skin to the upper and posterior portion of the auricle, sufficient depth of the auriculocephalic sulcus, correction of cartilage deformities with unrestricted access, and no need for additional skin grafting. Problems encountered were the development of a visible scar on the donor site and lowered hairline by advancement of the temporal triangular flap.

당뇨병성 망막증

조병채 梨花女子大學校 醫科大學 醫科學硏究所 1987 EMJ (Ewha medical journal) Vol.10 No.2

Cervicofacial Lymphatic Malformations: A Retrospective Review of 40 Cases

조병채,김재봉,이정우,최강영,양정덕,이석종,김용선,이종민,허승,정호윤 대한성형외과학회 2016 Archives of Plastic Surgery Vol.43 No.1

Background Lymphatic malformation (LM) is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment. Methods In this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment. Results Suspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2–V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients. Conclusions LM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient’s symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM.

혈청 칼슘 농도가 담즙내 칼슘 농도의 변화에 미치는 영향

조병채,김영진,박용검,지경천,이정효,장인택,김상준,한기정,백광진 중앙대학교 의과대학 의과학연구소 1998 中央醫大誌 Vol.23 No.1

The purpose of this study was to investigate the relationship between the increased serum calcium changes induced by short-term intravenous calcium infusion and the resultant subsequent changes on total and ionized calcium concentration [Ca_TOT] and [Ca^2+]level, and on bile acid changes in the T-tube bile. Ten patients underwent cholecystectomy, common duct exploration, and T-tube insertion. Serum and biliary calcium concentration were measured over an 7-hour period, before, during, and after a 4-hour intravenous infusion of 10% calcium gluconate. During the infusion, serum total calcium[Ca_TOT] increased from 2.17±0.27 mmol/L to 2.30±0.22 mmol/L and serum free ionized calcium[Ca^2+] increased from the preinfusion state, 1.29±0.10 mmol/L to 1.34±0.15 mmol/L. After the infusion, 60 minite later, biliary total calcium [Ca_TOT] increased from 1.54±0.23 to 1.95±0.37 mmol/L and biliary ionized calcium [Ca^2+] increased from 1.08±0.18 to 1.20±0.09 mmol/L. When the data pooled, increased serum total calcium[Ca_TOT] showed significant correlation with serum ionized calcium[Ca^2+] And also serum ionized calcium[Ca^2+] correlated with biliary total calcium[Ca_TOT] And as to bile acid, increased biliary ionized calcium[Ca^2+] related to decreased bile acid. These results support the hypothesis that calcium is freely permeable at biliary excretory system, and that serum ionized calcium level is one of the determinant elements of biliary calcium level.

Fabrication of Stable Cartilage Framework for Microtia in Incomplete Synchondrosis

조병채,이정헌,최강영,양정덕,정호윤 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.2

The synchondrosis between the sixth and seventh costal cartilage is usually used for the base frame in autogenous ear reconstruction. If the synchondrosis is loose, a variety of modifications can be devised. This report introduces new methods for these problems. In cases of incomplete synchondrosis, only the surface of the base block margin was smoothly tapered without carving for the removal of the conchal deepening. The secure fixation of the two segments (helix and antihelix) to the base block using fine wire sutures gave stability to the unstable basal frame. After confirming that all the segments were assembled in one stable piece, the remaining conchal deepening of the basal framework was removed, and the outer lower portion of the basal cartilage was trimmed along its whole length. A total of 10consecutive patients with microtia, ranging from 8 to 13 years old, were treated from 2008 to 2009. The follow-up period was 6 months to 2 years. Despite incomplete synchondrosis, the stable frameworks were constructed using the authors’ method and aesthetically acceptable results were achieved. The proposed method can provide an easy way to make a stable cartilage framework regardless of the variable conditions of synchondrosis.

지연처치후 동맥화된 족배 정맥 건피판을 이용한 수부의 재건

조병채,이동훈,Cho, Byung-Chae,Lee, Dong-Hoon 대한미세수술학회 1999 Archives of reconstructive microsurgery Vol.8 No.1

저자들은 1994년부터 1997년까지 수부에 급성 연부조직 손실과 신근건 결손을 가진 2명의 환자에 대해 지연처치후 동맥화된 족배 정맥 건피판술을 시행하였다. 피판의 생존 표면적은 2명 모두 100%였다. 피판 크기는 각각 $10{\times}10cm,\;6{\times}6cm$였다. 술후 2주째 능동적 굴곡운동과 수동적 신전 운동을 시작하였고 점진적인 저항운동을 5주간 실시하였다. 피판은 수부의 정상 피부와 비슷한 색깔과 피부상태를 보였다. 지연처치후 동맥화된 정맥 건피판은 순수 정맥피판이나 동맥화된 정맥피판보다 큰 피판을 만들 수 있으며 동맥화후 정맥피판의 생존율을 높여 복합 피판이 가능하게 하며 공여부의 주 동맥을 보존할 수 있고 얇은 조직을 얻을 수 있으며 피판을 심부 박리 없이 쉽게 거상할 수 있는 장점을 가진다. 단점으로는 두 단계의 수술이 필요하고 공여부 반흔과 족지의 신전이 약해질 수 있다. We report two patients whose acute soft tissue and tendon defects in the hand were treated by the dorsalis pedis tendocutaneous delayed arterialized venous flap between 1994 and 1997. The surviving surface area was 100% in both patients. The flap size was $10{\times}10cm\;and\;6{\times}6cm$. At two weeks postoperatively, active flextion and passive extension commenced, and progressive resistance exercises were performed for an additional 5 weeks. Flaps showed a similar color match and skin texture compared with the normal skin of the hand. Advantages of the tendocutaneous delayed arterialized venous flap are developing a larger flap than can be obtained with pure venous flap or arterialized venous flap, increasing survival rate of the arterialized venous flap which permits using a composite flap, preservation of main artery of the donor site, taking thin non-bulky tissue and easy elevation without deep dissection. The disadvantages are the requirement of a two stage operation, donor site scarring and weak extension of the toe.

The Correction of a Secondary Bilateral Cleft Lip Nasal Deformity Using Refined Open Rhinoplasty with Reverse-U Incision, V-Y Plasty, and Selective Combination with Composite Grafting: Long-term Results

조병채,최강영,Jung Hun Lee,양정덕,정호윤 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.3

Background- This article presents long-term outcomes after correcting secondary bilateral cleft lip nasal deformities using a refined reverse-U incision and V-Y plasty or in combination with a composite graft in order to elongate the short columella. /Methods- A total of forty-six patients underwent surgery between September 1996 and December 2008. The age of the patients ranged from 3 to 19 years of age. A bilateral reverse-U incision and V-Y plasty were used in 24 patients. A composite graft from the helical root was combined with a bilateral reverse-U incision in the 22 patients who possessed a severely shortened columella. The follow-up period ranged between 2 and 10 years. /Results- A total of 32 patients out of 46 were evaluated postoperatively. The average columella length was significantly improved from an average of 3.7 mm preoperatively to 8.5 mm postoperatively. The average ratio of the columella height to the alar base width was 0.18preoperatively and 0.29 postoperatively. The postoperative basal and lateral views revealed a better shape of the nostrils and columella. The elongated columella, combined with a composite graft, presented good maintenance of the corrected position with no growth disturbance. A composite graft showed color mismatching in several patients. Twenty-six patients demonstrated no alar-columella web deformity and satisfactory symmetry of the nostrils. Four patients experienced a drooping and overhanging of the corrected alar-columella web. /Conclusions- A bilateral reverse-U incision with V-Y plasty or in combination with a composite graft was effective in correcting secondary bilateral cleft lip nasal deformity.