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은석찬,정철훈,서동국,조우성 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2
Augmenatation rhinoplasty may be effectively accomplished with alloplastic materials. However, certain circumstances mandate the use of autologous grafts(e.g., dorsal augmentation that exceeds 8 mm and patient intolerance of alloplastic implants). Rib or costal cartilage graft have gained wide-spread use in rhinoplasty. Rib cartilages are pliable and soft but they easily undergo warpage, whereas solid bone graft frequently lead to an unnatural hardness of the nasal tip and dorsal resorption. The rib/costal cartilage combination graft(=autogenous chondro-osseous rib grafting) are excellent alternatives. In this study 12 patients received 14 rib grafts harvested in the 7th or 8th rib. Materials were used as cantilevered dorsal onlay grafts, columellar struts, and tip grafts. During 8 months of follow up periods, most patients have firm and stabilized nasal dorsum with soft and mobilized tip without prominent complications such as infection, protrusion, mobilization, etc. In conclusion, this autogenous chondro-osseous rib grafting technique can be an effective and safe method in the primary or secondary rhinoplasty.
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595nm 색소레이저(Vbeam?)를 이용한 비후성 반흔의 치료
김승현,이내호,양경무,정성모,노시균 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2
Hypertrophic scars are relatively common, but they remain very difficult to treat and induce functional and psychologic morbidity. Many treatment modalities have been advocated in the past. But none of these are satisfactory with unpredictable result, long treatment interval and sometimes unacceptable side effects.Recent use of the flashlamp-pumped pulsed-dye laser(585nm) has been shown to be effective in the treatment of various traumatic and surgical scars with improvement in scar texture, color and pliability with minimal side effects. 80 patients with 95 hypertrophic scars which had little response to usual conservative treatment and resulted from trauma, operation, skin graft donor sites, and burns were treated with Vbeam(595nm) pulsed dye laser(Candela Laser Corporation, Wayland, Mass). The mean number of treatment was 2.2. Period of follow-up vary from 2 month to 16 months.The 595nm Pulsed Dye Laser can effectively improve scar pliability and texture and decrease erythema and associated symptoms yielding cosmetically and functionally acceptabel clinical results. Complications such as hypopigmentation, ulcer and infection were not seen.
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박정민,김석권,이근철,배혜란,나서희,이민혁 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2
Keloids represent a dysregulated response to cutaneous wounding that results in an excessive deposition of extracellular matrix. However, the molecular mechanisms underlying this pathologic deposition of extracellular matrix still remain to be elucidated. In this study, the effects of anti-keloid drugs (triamcinolone, 5-FU, bleomycin, verapamil) on the expression of fibronectin and TGF-β and its receptor in keloid fibroblasts were evaluated in vitro. Human keloid fibroblasts(KFs) and normal human dermal fibroblasts(NHDFs) were isolated from earlobe keloids. Immunoprecipitation and Western blot of fibronectin, ELISA of TGF-β secretion and Western blot of TGF-β receptor were performed using the primary cultured fibroblasts treated with various drugs. TGF-β secretion was increased in keloid fibroblasts compared to NHDFs. TGF-βpromoted fibronectin synthesis in keloid fibroblasts. These results substantiate the hypothesis that the elevated levels of TGF-β play a potential role in keloid pathogenesis. 5-FU suppressed profoundly TGF-β secretion. Triamcinolone and verapamil inhibited significantly fibronectin synthesis and secretion, and also suppressed TGF-β receptor expression in keloid fibroblasts. In conclusion, it is postulated that the combination of low dose of 5-FU and triamcinolone or verapamil may be useful in keloid treatment by the additive effect of different anti-keloid action.
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김명철,오석준,장영철,조백현,이종욱 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2
Because the Korean nose has a flat dorsum and depressed tip, tip projection procedure has frequently been performed as an ancillary procedure of dorsal augmentation. Although various materials have been used for tip plasty, an ideal technique has not yet been described. The authors performed classic augmentation rhinoplasty using a silicone implant to correct flat dorsum. Alloderm(Life Cell Corporation, the Woodlands, Texas), acellular human dermis, was used for soft and smooth projection of the nasal tip. From January of 2000 to August of 2003, 20 patients underwent this procedure in Department of Plastic and Reconstructive Surgery. The patients were followed up for 2 to 26 months. Postoperative course was uneventful. Although partial graft resorption was noted in 3 patients, long-term follow-up showed good results. Alloderm usage for tip plasty allows natural contour of the nasal tip, decreases donor site morbidity, and obviates time consuming procedures for graft harvesting. In conclusion, Alloderm graft could be an appropriate alternative in tip projection procedure.
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장충현,오갑성,조민수,서상원,홍윤기 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2
The authors presented ‘A study on the knowledge about the field of plastic surgery(I)’ decade ago. Since then, the cognition toward a plastic surgery might be altered by the evolution of internet and social atmosphere taking count of outward appearance. Therefore the authors studied again about the cognition to the plastic surgery. The subjects were total 1812 of high school and college students residing in Seoul, Korea from October through December in 2003 and 1812 students are consisted of 839 male and 973 female. The contents of questionnaire are as follows: 1. The cognition to the plastic surgery. 2. The cognition to the difference between plastic surgery and orthopedic surgery. 3. The cognition to the operation performing in the filed of plastic surgery. 4. The known operation kinds of plastic surgery. 5. The experience of plastic surgery operation. We compared the results of this survey with that in 1992. The results of research showed 15.1% increase in the cognition to the plastic surgery, 5.6% increase in the cognition to the difference between plastic surgery and orthopedic surgery and 9% increase in the cognition to the operation performing in the filed of plastic surgery. In the known operation kinds of plastic surgery, a double-eyelid operation was the most well known and followed by rhinoplasty and augmentation mammoplasty, but in 1992, a double-eyelid operation was followed by rhinoplasty and rhytidectomy. In the experience of plastic surgery operation, the result showed 6.3 %, which has more than doubled in the last 10 years. Increase of the cognition to the plastic surgery is inspired, but that results is localized to aesthetic field.
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