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차상면,최희윤,엄기일,김잉곤,류재만 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.4
Various surgical method have been used in an attempt to achieve a normal - looking growth of hair in scalp alopecia. A variety of flaps have been applied both for primary closure and for secondary repair, but flaps very seldom result in the correct direction of hair growth. In case of more extensive scalp alopecia, the shifting of flaps would only mean to move one denuded area to another, owing to inelasticity of the scalp tissue. Split-skin grafts still have to be used in such cases, which will remain hairless. Nowadays, tissue expansion became the one of the most popular technique in the field of plastic surgery since it k was first introduced by Dr. Neumann, who attempted an ear reconstruction using a latex ballon with a valve and a connector tube lying outside the skin in 1957 and Radovan, who introduced more safer and controllable soft tissue expansion. In this paper, 15 cases of scalp alopecia were operated by using tissue expansion from September, 1988 to September, 1990. All cases were successfully reconstructed with 4 major complication. This complications were hematoma, infection, wound separation, tissue necrosis. Here, presentative case reports are presented and the management and prevention of complications are discussed.
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차상면,류재만 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.5
This study was undertaken to elucidate the possible contributory effect of vessel anastomosis to the patency rates in bacteria infection and local crush injury model in the rabbit. Bilateral(n=30) and unilateral(n-15) groin flaps were elevated on isolated vascular pedicle, and rendered trauma(n=15), infection(n=15), infection and trauma(n=15), infection and trauma with heparin(n=15). After the episode, an arterial anastomosis was performed on both side, then perfusion reestablished. Vascular patency rate with local crush injury was low in comparision with control group. A high correlation was found between patency test performed at 20 minutes and at 2 days after blood flow reestablishment. It was found that the presence of infection did not significantly lower the patency rate. Systemically administered heparin improved traumatized vessel patency.
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차상면,류재만 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.5
The possible added detrimental effect of microvascular anastomosis after ischemial was studied in an experimental model. Vessels were examined after warm ischemia using intravital microscopy of groin flap of an anesthetized rabbit. Our model demonstrates that micorvascular anastomoses don't include a vulnerable microvascular patency factor. These findings suggest that non-traumatized blood vessels develped thrombosis due to ischemia alone and island flap rendered ischemic by clamp, have the same percent viability, but clamp damage as a potential cause of decreased survival must also consider in long ischemic time. The clinical importance of early diagnosis and treatment of ischemic tissues is emphasized.
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차상면(Sang Myun Cha),최희윤(Hee Youn Choi) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.1
Lymphangioma is a benign, growth of lymphatic tissue that is present at birth or develops in early childhood, which may cause serious alterations in growth and developmemt. The problems with facial lymphangioma is usually releated directly to their size and to the area of the face which is involved. The lesions themselves may range from small, localized blemishes to huge facial masses involving both soft tissue and underlying bone and causing great distortion and asymmetry. The facial bones are seldom involved, but the natutal evolution of an individual lesion often cannot be accurately predicted when the child is first seen. Any changes in the underlying facial bone could be due either to a direct growth of the lesion into the bone, or secondary to pressure of the lesion growing outside the bone itself. A case of cystic lymphangioma extending from the neck to the tongue is reported. A six-year-old female was admitted because of swelling of the tongue. At that time, the tongue reportedly reached the extraoral size of 7x5x2.5cm and a soft, diffuse swelling of left anterior neck was revealed. The removal of cystic mass including left neck dissection and partial glossectomy were undertaken. The another case of lymphangioma is located on mandibular cheek. A twenty nine-year-old male was admitted because of palpable mass of the left mandibular area and fissure of palate. The radical excision of mass with mandibulectomy of body were undertuken. Thus we reported such a rare case and reviewed the lymphangioma.
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최희윤,차상면,엄기일,박진석,류재만,김잉곤 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.6
This retrospective study comprised 565 patients with facial bone fractures caused by various accidents and treated in the department of Plastic and Reconstructive Surgery. Hanyang University hospital during past 5 years from January 1988 to December 1992. The medical records of these 565 patients (687 fractures) were reviewed and analyzed retrospectively in order to obtain the clinical pattern and understand the therapeutic tendency. The statistical items were the prevalent time, age, sex, and distribution of cause, fracture sites, the acompanied injuries, the intervals among the accident ,arrival and operation, and the treatment methods with fixation materials. The following results were obtained. 1. It was noted that facial injuries were decrased by 6.6% per year. The injuries were most frequently occurred in May and November (11.0%, 10.4%) and between 16:00 and midnight. 2. The Mean age of patients was 29.3 years, and age range was 2 to 78 years. Most injuries occurred in young male with the highest incidence in the third decade of life. Males predominated more than female in the ratio of 5:1. 3. Traffic accidents(41%) were the commonest cause of injuries, but it was noted that the pattern is declining slightly. 4. 687 facial fractures in 565 patients were classified. The most common sites were nasal bone, followed by mandible, zygoma, orbit, and maxilla. 5. Associated soft tissue injuries were combined in 278 patients(49.2%), and fractures other than facial bone were developed in 104 patients(18.4%). 6. Treatment for facial bone fracture consisted of open reduction(63.4%), closed reduction(29.4%), and conservative treatment(4.4%). 7. The complication rate was 54% and the most common complicationin was the eye problems, followed by local infection and asymmetry. Author's results were compared and added with data of 2 papers about facial bone fracture reported from Hanyang University from 1962 to 1987. The trend in changes of facial bone fracture during past 21 years was observed.
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변태호,류재만,차상면,정파종,김잉곤 大韓成形外科學會 1994 Archives of Plastic Surgery Vol.21 No.6
There are approximately 1000 patients who undergo mastectomies each year in Korea. But only a small minority of the patients have breast reconstruction. Because, the breast to women represents more than just a physiological importance, survival only cannot be the best treatment. Therefore the final stage of a treatment program must be reconstruction. The purpose of this study is to evaluate the understanding of Koreans on breast reconstruction following mastectomy and to find out what other factors can be as important as survival. 87 breast cancer patients(stage I and II a ) mastectomized between January 1, 1991 and December 31, 1992 in Seoul were selected for our study on the understanding of breast reconstruction, and in particular, autogenous tissue transfer.62 breast cancer patients answered our questionnaires. The ages of the patients ranged from 23 to 73 years(mean age 46 years). According to our survey, the most deformities on the figure and then the limitation on activities requring physical exposure. Another interesting point was the fear of their body image on their husbands and the fear of their husbands having an affair. When asked if they had any in formation on breast reconstruction, 27 out of the 62 patients answered that they had any information on breast reconstruction, 27 out of the 62 patients answered that they had none. Only 5 of the 62 patients received information from their surgeons. The emotional difficulties of mastectomized women following breast cancer should be emphasized as much as survival. This study indicates, that most women had hardly any information on reconstructive surgery following mastectomy and that this resulted from the inadequated education of the patient by the general surgeon who believes that a disease-free state can be sufficiently fulfilled by simply removing the cancer.
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최희윤,류재만,김잉곤,차상면,엄기일 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.2
Some patients requesting abdominal contour surgery may have all their deformity below the semicircular line. These patients were treated by the traditional procedure, but these patients has nerve satisfied because of long and wide scar. From a study of the deformities of each layer of the abdominal wall, we have categorized three types of abdominoplasties. For each type, we used a different surgical technique, aiming to sculpture the abdomen and treat each layer according to the deformity present in each patient. By classifying the various problems and by using the different approaches, only the specific deformities of the abdominal wall need be corrected. The results were judged good excellent by the surgeons and patients because of the more natural appearance of the final results.
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