근피판을 이용한 욕창의 치험례

허우회 圓光大學校 醫科學硏究所 1987 圓光醫科學 Vol.3 No.2

Pressure sores would be treated by various methods such as local skin flap, muscle flap with split thickness skin graft and myocutaneous flap, also generally agreed that sores should be operated by suffient padding. So currently musclocutaneous flap is widely used. Six patients(9 sites of sores) were treated by use of myocutaneous flap, Gracilis(2 case), TFL (2 case), Gluteus maximus(5 case).

大口症 1 例

허우회 圓光大學校 醫科學硏究所 1987 圓光醫科學 Vol.3 No.2

Macrostomia(Transverse facial cleft) is rare congenital deformity in frequency of about 1.5% of all facial clefts. Bilateral transverse facial cleft is in frequency of about one per 10 of transverse clefts. I presented one case of bilateral transverse facial clefts without anyother aural or mandibular anormaly, who was operated by use of Double Z-pla-sty with muscle inforcement.

筋 轉移를 利用한 안면신경임비의 外科的 矯正例

崔碩鉉,曺伯炫,申智浩,許宇會 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.1

Man is endowed with the ability to show emotions and feeling through facial expressions. The permanent paralysis of 7th nerve, which is responsible for the bulk of the facial expressions, can not only lead to loss of facial expressions, but also the psychological trauma from this loss can be devastating. The goal of the plastic surgeon is then, to restore as much as possible the lossed function so that the patient can attempt to lead a normal social life. The goals of therapy, because of its utmost importance should be reviewed. Maintaining an acceptable appearance while at rest should be the initial goal. Also it is important to remember that there must be symmetry with voluntary motion as well as retention of controlled emotions. In achieving these goals, certain surgical precausion must be observed, e.g., there must be intact blood and nerve supply, adequate flap size, and avoidance of tension or angulation which could impair blood circulation. Although there are numerous methods of surgical correction, none will result in complete recovery. And thus, the method must be carefully selected and tailored to suit each patient. During the one year period between January through December of 1982, we encounted 4 patients who complained of wide palpebral fissure and/or deviation of mouth angle. They were diagnosed as having unilateral facial palsy and surgical correction using temporalis muscle or maseter muscle transfer was performed. In all cases, satisfactory results were obtained.

생쥐 피부창상의 치유과정에 미치는 Glucan의 효과

조백현,허우회,최석현 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.2

In an attempt to investigate the effect of glucan, i.e., RES stimulating agent, on the repair process of skin wound, we made simple skin wound in mice and then glucan was given intraperitoneally at dose of 10mg until taking specimen. The specimen were taken from wound area at various intervals and histological and enzym histochemical stains were done for the light microscopic examination. The results obtained were as follows. 1. The glucan-treated wound showed more proliferation of macrophages and granulation tissue with decreased acute inflammatory exudates in the early than did control wound. 2. The glucan-treated wound showed more increase of acid and alkaline phosphatase and α-naphthyl acetate esterase activities than did control wound, but no changes in ATPase activities. From these results, it may be concluded that glucan promotes repair process of skin wound.

합병증을 동반한 다발성 욕창환자에서 Total Thigh Flap을 이용한 임상치험예

신지호,허우회,이명철,최석현 大韓成形外科學會 1986 Archives of Plastic Surgery Vol.13 No.3

It is generally agreed that the treatment of pressure sores should include the removal of bony prominence and sufficient padding by use of local skin flaps, muscle flaps covered with split thickness skin grafts and musculocutaneous flaps. In some paraplegics who have pyarthrosis of the hip, osteomylitis of the femur and multiple pressure sores, there are many difficult problems that the extensive ulcers are not amenable to conventional procedures. This is the report fo two paraplegic with pyarthrosis, dislocation of the hip and osteomyelitis of the femur caused by the extension of infection from a trochanteric pressure sore. They also have a sacral sores. In this report, we describes the successful use of two total thigh flaps with review of literatures.

自家肋骨移植과 側頭筋轉移를 이용한 일측성 안면발육부전의 矯正例

신지호,허우회,이명철,최석현 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.4

In recent years, according to the develpment of the medical techniques and growing of the national income, patients with congenital and acquired facial and cranial anomalies tend to visit the plastic clinics in great number. Regardless of the cause, facial asymmetry and unbalance were disqualified for external appearance and restricted mantal status as well as general social activities. Correction of facial asymmetry has been studied by numerous scholars furthermore, autogenous bone or cartilarge graft, dermis-fat graft, tube or local flap and silicone fluid injection had been used. Adult male patient with facial asymmetry due to the developmental insufficiency of zygomatic bone, zygomatic arch, maxilla and mandible furthermore, masetter muscle and neigbouring soft tissue was operated by autogenous rib graft on the mandible and zygomatic region, and by ipsilateral temporalis muscle transfer on the zygomatic arch and the cheek. The end result was satisfactory.

人胎兒 皮膚血管의 微細構造에 關하여

최석현,허우회,최재권,박성식 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.3

Developing blood vessels from the skin of human fetuses with 12 weeks gestation were examined by electron microscopy. And the following results were obtained. Capillaries consisted with endothelial cells and pericytes were the only blood vessels present in this stage, and the diameters of the capillarise were varied from 3 to 30 micro-meter. Capillary, below 5㎛ in diameter, consisted 3∼4 endothelial cells which contained a few pinocytotic vesicles, rough endoplasmic reticulum, and few cytoplasmic processes except junctional area. Endothelial cells were connected each other by junctional complexes and where it covered flaps of cytoplasm extending either into the lumen or outwards between pericyte processes. In some cases a cell protruded into the capillary lumen and connected with endothelial cells by junctional complexes. Pericytes were ensheathed the capillary incompletely. In capillary from 5 to 10㎛ in diameter, endothelial cells contained well developed rough endoplasmic reticulum, Golgi complex, and many pinocytic vesicles. Membrane limited, electron dense rod shaped bodies of approximately 0.1㎛ in diameter which consisted with microtubules with 15nm in diameter, and microfilaments, 10nm in diameter, were also found in the endothelial cytopasm. Endothelial cell with mitotic figure was also appeared. Peg-like cytoplasmic processes of pericyte were occasionally seen inserted into socket like indentation of the underlying endothelial cells, and reverse situation was also encountered. In capillary of 10㎛ or more in diameter, endothelial cells contained well developed cytoplasmic organells, and pericytes were consisted of two or more layers but no smooth muscle cells were found.

좌골신경손상 흰쥐의 가자미근과 내측비복근 위축에 대한 전기자극 효과

박병림,허우회,유병표,김영우,김대영 대한성형외과학회 1992 Archives of Plastic Surgery Vol.19 No.3

This experimental study includes the effect of intermittent electrical stimulation of the muscle on the atrophic response of peripherally denervated muscles. Rats(Sprague -Dawley, 240-260gm) were subjected to a severance of the sciatic nerve and mechanical properties of contraction including contraction time, half relaxation time and maximum twitch tension, maximum tetanic tension and fatigue index were observed on the slow(soleus m.) and fast(medial gastrocnemius m.) muscles 10days after serverance of the sciatic nerve. Experimental groups were divided into three groups : control group(CONT) immediately after severance of sciatic nerve, denervation group(DN) 10days after severance of sciatic nerve, and denervation plus eletrical stimulation group : (DN-ES) denervation combined with intermittent eletrical stimulation of muscles directly. Optimal frequency of electrical stimulation was 20㎐ for soleus muscle and 40㎐ for medial gastrocnemius muscle under 0.5ms of pulse width and supramaximal intensity. In DN group, muscle weight and mechanincal properties of contraction were significantly decreased compared with the control group. In DN-ES group, however, muscle weight and mechanincal properties were significantly increased compared with the denervation group. These data indicate that intermittent electrical stimulation of muscles may be useful in decreasing the muscle atrophy in peripherally denervated muscles.

대둔근도근피판과 대토근막장근피판을 이용한 다발성 욕창의 치험례

신지호,허우회,최석현,조백현 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.4

The principles of the operation of the pressure sores which frequently encountered in the patients with cord injury are the removal of bony prominence and sufficient padding by use of soft tissue, in order to prevent from recurrence. Currently, musculocutaneous flap is widely used. In the treatments of patients with multiple pressure sores, simultaneous treatments of all pressure sores by one stage operation have some difficult problems. In C.N.U. hospital, we designed the donor flap at the middle of straight line between great trochanter and ischial area, made the Gluteus maximus island musculocutaneous flap and transferred the flap to sacral sore to treat the patient that multiple pressure sores were developed in sacral, greater trochanteric and ischial area. After then, secondary defect of donor site, greater trochanteric pressure sore and ischial ulcer were closed by Tensor Fascia Lata musculocutaneous flap of which donor defect was repaired by primary closure. The end result was satisfactory with that simultaneous closure of three pressure sores can be achieved in relatively short time. And we would like to report our case with review of literatures.

백서피부의 화상 손상에 따른 효소조직화학적 변화

조백현,김영길,허우회,최석현 大韓成形外科學會 1983 Archives of Plastic Surgery Vol.10 No.2

The purpose of this study was to investigate the sequential changes of enzyme activities in severely burned skin of rat at intervals of 2 hours, 8 hours, 1 day and 3 days by histochemical methods. The results obtained were as follows. 1. Acid phosphatase activity was found to be transient increase in dermis and mild decrease in epidermis, hair follicle and sebaceous gland at 2 hour after burning. The activity was not seen in skin after 8 hours. 2. Alkaline phosphatase was found to be decreased in blood vessel and dermal papillae of hair follicle at 2 hour after burning and then was progressively decreased after 8 hours. 3.α-naphtyl acetate esterase activity was found to be decreased in epidermis, dermis and hair follicle at 2 hours after burning and was not seen in skin after 8 hours. There was no significant changes in sebaceous gland after burning.