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절단된 반대측 수부의 환지를 이용한 절단된 무지의 재건술의 증례보고
최수종,장기영,Choi, Soo-Joong,Chang, Kee-Young 대한미세수술학회 2006 Archives of reconstructive microsurgery Vol.15 No.2
The function of the thumb is critical to overall hand function. The thumb enables motions such as pinch, grip, fine manipulation and allows to circumduction and opposition. It's loss is a serious problem not only from cosmetic point of view but also functional. Therefore, we should make every effort on thumb reconstruction. Many methods of thumb reconstruction from simple osteoplasty to complex microsurgical reconstruction have been reported. We should understand merits and demerits of each method and choose proper method on case by case. When both hands are injured and there is no option but to amputate one hand and the thumb of another hand is lost, spare part flap from the thumb of the amputated hand to another hand can solve cosmetic problem, functional problem and donor morbidity. We report a case of amputated thumb which has been reconstructed with amputated ring finger of the contralateral hand using spare part flap concept.
최근 6년간 경험한 악성 흑색종의 임상병리조직학적 유형 분석
최수종,배용찬,문재술,남수봉,오창근,곽희숙,김창원 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.5
Purpose: Malignant melanoma is a fatal tumor arising in the melanocytic systems of the skin. The incidence of malignant melanoma, formerly considered a rare tumor in Korea, is observed to increase. The aim of this study is to analyze the clinical and histopathological pattern of malignant melanoma in one institute.Methods: Thirty patients with ages ranging from 33 to 80 years, diagnosed as malignant melanoma at our skin tumor department, were enrolled in a retrospective study over a 6 year period(2000. 9-2006. 7). The analyzed data included age, sex, location, duration before diagnosis, clinical type, level of invasion, and stage.Results: The cases were identified and analyzed by clinical and histopathologic study. The male to female ratio was 1:1.7. Lower extremities(especially, feet) were favored sites. The majority of cases were acral lentiginous melanoma(40%), followed by nodular melanoma (36.7%), superficial spreading melanoma(20%) in this study. Clark level IV was predominant in histopathologic study. There was merely narrow gap among each stage by AJCC.Conclusion: The clinicopathological characteristic of melanoma in our patients is quite different with that in the West. In this retrospective study, primary lesions of the foot were predominant with melanoma, and a high percentage of these were classified pathologically as acral lentiginous melanomas. Patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than Western patients. These suggest that malignant melanoma has a worse prognosis in our patients than in the West. So, further organized prospective studies are needed to approach the prudent and accurate diagnosis and management of melanoma in Korea.
광범위한 안와하벽골절에서 속눈썹밑 절개 및 비강 내 내시경적 접근을 동시에 사용한 재건술
최수종,오흥찬,남수봉,배용찬,강철욱 대한두개안면성형외과학회 2009 Archives of Craniofacial Surgery Vol.10 No.2
Purpose: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The purpose of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of Medpor® through subciliary approach. Methods: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor® through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient‘s charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. Results: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. Conclusion: The ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor® through subciliary approach can be considered one of the appropriate technique for extensive inferior blowout fracture.
최수종,오흥찬,배용찬,남수봉,문재술,오창근,김창원 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3
Purpose: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision.Methods: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed.Results: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination.Conclusion: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.
Sphingosine-1-Phosphate (S1P)가 이식지방의 생존에 미치는 영향
윤동주,최수종,최치원,남수봉,배용찬,Yoon, Dong-Ju,Choi, Soo-Jong,Choi, Chi-Won,Nam, Su-Bong,Bae, Yong-Chan 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.6
Purpose: Autologous fat grafting is a popular procedure for the correction of the soft tissue depression and deformity. But there are several issues required to be carefully considered in relation to this procedure, mainly about the unpredictability and the low survival rate of the grafted fat due to absorption and partial necrosis. Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator that has been proposed to promote angiogenesis and to regulate the differentiation of adipose derived stromal cells (ASCs). In this study, we analyzed the viability of the grafted fat tissue mixed with S1P into each 12 nude mice (cann.cg-fox1nu/crlori) compared to the group of mice grafted fat tissue only. Methods: Human aspirated fat was grafted subcutaneously into the backs of 8-week-old nude mice with or without S1P. Eight weeks later, the grafted fat was harvested and the weight and volume were checked. The fat was stained with hematoxylin-eosin and 4',6-diamidino-2-phenylindole. Results: S1P group weighed significantly more than the control group (p=0.009), and the volume from the S1P group was considerably larger than that of the control group (p=0.004) either. In histological features, the surviving layer of the S1P group was thicker than the control group and microvasculature appeared to be prominent in the S1P group, especially in the outer layers. Conclusion: These findings suggest that S1P plays a vital role in the soft tissue augmentation, potentially providing a novel point of the control in adipose tissue for microfat graft.
안와내벽파열골절의 내시경적 사골동내 충전에 따른 안와용적 변화
김경훈,최수종,배용찬,남수봉,강철욱 대한두개안면성형외과학회 2009 Archives of Craniofacial Surgery Vol.10 No.1
Purpose: Endoscopic transnasal correction of the medial orbital fractures cannot be enable to confirm the reduction degree of orbital volume without imaging modalities. We have intended through this study to make a quantative analysis of preoperative orbital volume increment and the reduction degree of that after ethmoidal sinus packing by using CT scan. Methods: In this retrospective study, 22 patients were selected to evaluate the postoperative volume reduction, who took 2 CT scans which are pre- and postoperative under the same protocol. The postoperative CT scan was carried out in about 5 days after the operation with the packing inserted into ethmoidal sinus. The length of bony defect on each section was measured by PACS program and the area of defect was calculated by summing lengths on each section multiplied by the thickness of the section. When the outline of orbit on the slice is drawn manually with a cursor, PACS program measures the area automatically. Orbital volume was calculated from the sum of the area multiplied by the section thickness. Results: The mean dimension of fractured walls was 2.86 ± 0.99 ㎠. The mean orbital volume of the unaffected orbits was 22.89 ± 2.15 ㎤ and that of the affected orbits was 25.62 ± 2.82 ㎤. The mean orbital volume increment of the affected orbits was 2.73 ± 1.13 ㎤. After surgery, the mean orbital volume of the unaffected orbits was 22.46 ± 2.73 ㎤ and the mean orbital volume decrease on the surgical side was 2.98 ± 1.07 ㎤. The estimated correction rate was 118.30%.