혈관 비틀림이 백서 천층하복부 동맥의 초미세문합에 미치는 효과

서미현,김성민,어미영,강지영,명훈,이종호,Seo, Mi-Hyun,Kim, Soung-Min,Eo, Mi-Young,Kang, Ji-Young,Myoung, Hoon,Lee, Jong-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.5

Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with $90^{\circ}$ twisting, 4) experimental II (EA2) with $180^{\circ}$ twisting, and 5) experimental III (EA3) with $270^{\circ}$ twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0 $Ethilon^{(R)}$ (Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular $clamps^{(R)}$ (S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than $180^{\circ}$ twisting must be prevented in clinical practice.

급성림프모구성 백혈병의 조기진단 시 구강병변 양상을 통한 감별의 중요성

서미현,하지영,허경회,조영아,김성민,최진영,Seo, Mi Hyun,Ha, Ji Young,Huh, Kyung Hoe,Cho, Young Ah,Kim, Soung Min,Choi, Jin Young 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2

Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment. Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth. A 12-year-old man visited for molar pain during 3 months. He was diagnosed with having a possibility of hematopoietic malignancy, showing the loss of lamina dura, destruction of bony crypt, and high attenuation in the bone marrow. He was referred to department of pediatrics, additional study, including peripheral cell morphology and bone marrow exam, were performed, and diagnosed as acute lymphoblastic anemia. Despite chemotherapy to cure leukemia, he was expired 8 months after initial diagnosis. The purpose of this report is to promote and evoke the awareness regarding an initial examination of the dentist to make an effort to acquire accurate knowledge and information about life-threatening disease in usual dental practice.

치조정 골 소실이 심한 경우와 치간 사이 공간이 부족한 경우에서의 미니 임프란트 식립

서미현,유충규,이은경,정다운,서제덕,정일혁,Seo, Mi-Hyun,Yoo, Chung-Kyu,Lee, Eun-Kyung,Jung, Da-Unn,Suh, Je-Duck,Chung, Il-Hyuk 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.1

Purpose: This study presents the use of mini implants for fixed restoration and implant supported overdenture to enable the practitioner to overcome the anatomic obstacles of ridge width and narrow interdental space. Patients and methods: This study consisted of 9 patients who required single implants for one or two teeth replacement and 1 patient who required implant supported overdenture after mandiblectomy, iliac bone graft due to ghost cell tumor. The ages ranged from 29 to 70 years (mean 51). All patients were in good health. Clinical and radiographs were taken pretreatment, postoperatively, during rehabilitation, and at follow ups. Results: Total implant survival rate was 94.7%. One implant was removed due to its mobility as a result of bad bone quality (Type IV) and patient's carelessness (Heavy smoker). All patients except one reported complete satisfaction regarding to function, aesthetics, and phonetics. Radiographic follow up every 3months postoperatively showed success in achieving function and maintaining marginal bone level. Conclusion: Clinician can overcome both severe ridge deficiency and small interdental space with mini implant.

구강악안면재건을 위한 외측상완피판의 해부학적 고찰

서미현,김성민,강지영,명훈,이종호,Seo, Mi Hyun,Kim, Soung Min,Kang, Ji Young,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.4

The lateral upper arm flap (LUAF) was initially described by in 1982 by Song et al. as a simple skin flap, addressing the availability of cutaneous nerves for anastomoses. Katsaros et al., reported the use of a lateral upper arm skin flap, but also considered using it as a composite graft. The LUAF for the oral and maxillofacial reconstruction has several advantages over other flaps, such as constant anatomy, good color match and texture, thin design and plasticity. There is no functional limitation in the donor arm, such as strength and extension, and donor defects can be closed primarily with a linear scar, even when a flap of up to 8 cm in width is taken. For a better understanding of LUAF as a routine reconstructive option in moderate defect of maxillofacial region, the constant anatomical findings must be learned and memorized by young doctors during the specialized training course for the Korean national board of oral and maxillofacial surgery. This article review the anatomical basis of LUAF with Korean language.

구강악안면 영역의 말초신경 재생을 위한 비복신경의 외과적 해부학

서미현,박정민,김성민,강지영,명훈,이종호,Seo, Mi-Hyun,Park, Jung-Min,Kim, Soung-Min,Kang, Ji-Young,Myoung, Hoon,Lee, Jong-Ho 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.2

Peripheral nerve injuries in the oral and maxillofacial regions require nerve repairs for the recovery of sensory and/or motor functions. Primary indications for the peripheral nerve grafts are injuries or continuity defects due to trauma, pathologic conditions, ablation surgery, or other diseases, that cannot regain normal functions without surgical interventions, including microneurosurgery. For the autogenous nerve graft, sural nerve and greater auricular nerve are the most common donor nerves in the oral and maxillofacial regions. The sural nerve has been widely used for this purpose, due to the ease of harvest, available nerve graft up to 30 to 40 cm in length, high fascicular density, a width of 1.5 to 3.0 mm, which is similar to that of the trigeminal nerve, and minimal branching and donor sity morbidity. Many different surgical techniques have been designed for the sural nerve harvesting, such as a single longitudinal incision, multiple stair-step incisions, use of nerve extractor or tendon stripper, and endoscopic approach. For a better understanding of the sural nerve graft and in avoiding of uneventful complications during these procedures as an oral and maxillofacial surgeon, the related surgical anatomies with their harvesting tips are summarized in this review article.

안면동종이식의 현황고찰과 전망

서미현,이정아,오진실,김성민,명훈,이종호,Seo, Mi Hyun,Lee, Jung A,Oh, Jin Sil,Kim, Soung Min,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.5

Advances in immunosuppressive treatments and microsurgical techniques have rendered composite tissues allotransplantation (CTA), such as heteregeneous or non-organ tissues, possible in humans. CTA has evolved dramatically since the first successful rat hind limb allotransplantation. Numerous clinical applications including face, hand, trachea, larynx, and vascularized joint have been performed. Although composite tissue allografts are still in their infancy, they have opened a new era in the field of transplantation surgery and pathology, so that maxillofacial reconstructive surgeons may occasionally be faced with the challenge of diagnosing skin refection of a composite tissue allograft. Facial allotransplantation (FAT) is a new surgical technique that could be considered as a new paradigm in facial reconstruction. Since the first human FAT had been achieved in 2005, 17 cases have been reported in the world up to date. However, many problems such as life-long immunosuppression, immune rejection, ethical problems and psychological problems are remained, so facial CTA is new reconstructive option with no general acceptance. The authors reviewed the indications, the results of 17 cases and their complications, and additional consideration factors in this article, and intended to raise the awareness of oral and maxillofacial surgeons in this type of facial transplantation.

상악동 거상술 시 Waters' Projection의 유용성에 대한 임상적 연구

서미현,김성민,하지영,이정근,명훈,이종호,Seo, Mi Hyun,Kim, Soung Min,Ha, Ji Young,Lee, Jeong Keun,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2

Purpose: Maxillary sinus elevation has been widely used to enable insertion of endosseous implants in severely resorbed maxilla. Maxillary sinusitis after this procedure was considered to be the major drawback, therefore, preoperative evaluation of paranasal sinus is considered to be important. In order to evaluate the condition of the sinus, we used Waters' projection. In this study, asymptomatic patients were evaluated by Waters' view, and compared to timing to assess the sinus cavity. Methods: The retrospective study was based on 14 patients who were performed sinus elevation surgery in Seoul National University Dental Hospital. These patients did not show any signs of maxillary sinusitis. These patients were taken Waters' view at preoperative, postoperative 1 day, 3 months, 6 months. In Waters' view, presence of air fluid level, radiopacity of sinus wall, or radiopacity of entire maxillary sinus were evaluated. The density, and sinus dimension changes were assessed using Adobe Photoshop CS5$^{(R)}$ (Adobe Systems Inc., San Jose, CA, USA). Results: Findings of Waters views in patients with clear maxillary sinus at preoperative time were followed by elevated sinus floor with transplanted bone, mucosal swelling, and air fluid level. At postoperative 3 months, and 6 months, the radiographic findings were similar to preoperative state. By contrast, patients with preoperative mucosal swelling, or haziness in sinus cavity showed radiopacity entire sinus in Waters' view. In cases of the patients who were treated with simultaneous treatment to mucosal swelling, good status of sinus cavity were found. Conclusion: Although Waters' projections provide the limited information, and is less sensitive method compared with computed tomography, it is simple, easy, and economical method to assess of maxillary sinus. We suggest using Waters' view as radiographic routine tool for evaluation of sinus condition, especially in the sinus elevation surgery.

치아 외과적 발거 전 혈액검사의 필요성과 이의 정책적 제시

서미현,김성민,오진실,명훈,이종호,Seo, Mi Hyun,Kim, Soung Min,Oh, Jin Sil,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.5

Purpose: The third molar extraction is one of the mostly performed procedures in the department of oral and maxillofacial surgery. In most of dental clinic or hospital, the third molar extraction used to be frequently performed in an office-based surgery, and most patients did not have specific medical history with young ages. Medical history taking are dependent on the only way by asking to the patients about their individual conditions. Therefore, as the specialists of the oral and maxillofacial surgery in the field of dentistry, we suggest a new policy that the preoperative lab must be performed routinely before extraction of the third molar. Methods: This study is based on 1,096 patients who have been managed with third molar extractions, from March 2008 to September 2011 by a single surgeon. The preoperative lab, including complete blood count, coagulation panel, chemistry and serology, was performed before any surgical procedures. The results were informed to the patients regardless of their abnormalities, and any abnormalities related to the surgical procedures, such as platelet count and coagulation factors, were checked and corrected safely. Results: Through the preoperative blood test, systemic diseases that the patients had not recognized before, such as anemia, leukopenia, fatty liver and chronic renal disease, were identified. Patients with acute or chronic leukemia, Hepatitis B, and HIV positive, were also detected as a small number. Also, the possibilities of the cross-infection between dentists and patients or between patients and patients, and any other emergency situations can be prevented; as well as the public health condition can be improved, too. The patients were satisfied with low cost preventive blood test and high quality of medical services. Conclusion: Therefore, routine medical lab testing, including history taking are needed before an office-based minor surgery, such as third molar extractions, and these results were suggested as a new policy in the field of dentistry.

관골궁 골절의 정복시 수술 중 C-Arm 사용의 유용성: 증례보고

서미현,천강용,윤준용,유충규,이은경,이원덕,서제덕,Seo, Mi-Hyun,Cheon, Kang-Yong,Yun, Jun-Yong,Yoo, Chung-Kyu,Lee, Eun-Kyung,Lee, Won-Deok,Suh, Je-Duck 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography, CT to evaluate preoperative state. Gilles approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.

국제회계기준의 도입이 기업가치를 제고하는가?: 이익품질과 가치관련성에 대한 분석

서미현 ( Mi Hyun Seo ),최국현 ( Kuk Hyun Choe ) 한국생산성학회 2013 生産性論集 Vol.27 No.1

Korea adopted International Financial Reporting Standards(hereafter "IFRS") to provide higher quality of accounting information. We examine the effect of earnings management with mandatory IFRS adoption in Korea on accounting transparency by means of the analyses of various accruals. Also, We assesse value relevance of changes of net assets and net income by comparing the effects on capital stock valuation before and after mandatory IFRS adoption. We examine the differences of earnings management with mandatory IFRS adoption. We find that several discretionary accruals decrease after mandatory IFRS adoption. This result indicates that IFRS provides high-quality accounting information. By the way, we can`t find the evidence of the difference of earnings management based on real activities. Secondly, for the period after IFRS adoption we find net income and changes of net income are less relevant to capital stock valuation. This result suggests that value relevance of net income and changes of net income decreases after IFRS adoption. Possible explanations to these findings are that market reacts to signals about noise of earnings quality, or adjustment of stock price follows as found in previous studies.