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          소아성형외과 영역에서의 통원수술: 5년간의 체험례

          임소영,현원석,하범준,오갑성 대한성형외과학회 2002 Archives of Plastic Surgery Vol.29 No.1

          The popularity of elective day surgery has increased significantly over the past two decades. Potential advantages of day surgery are alleviation of parental burden on time and money, less social disruption for the child and family due to the shorter period hospitalization and the absence of overnight stay. Between January of 1996 and December of 2000, we studied 391 cases that underwent day surgery(age 1mo.-15.0yrs). This practice is reviewed with regard to initial assessment, preparation for surgery, postoperative complications and management, and immediate follow-up by telephone visit. Up to 28% of all pediatric plastic surgical cases were performed on day-care basis mainly in laser therapy and excision of benign soft tissue mass. The incidence of postoperative minor medical complications was 3.1 In addition, we reviewed 14 patients who underwent ambulatory surgery with syndactyly and/or polydactyly of the hand.Then we compared 3 parameters(hospital charge, postoperative complications and degree of postoperative satisfaction in parents) with those of 84 inpatient children who underwent the same surgical procedures. As results, ambulatory surgery group is more economical than inpatient surgery group with postoperative satisfaction higher than inpatients surgery group with negligible complications.And based on a 5-year experience of authors, day-surgery system in pediatric plastic surgery is safe, effective and in the best interest of a select but significant proportion of children requiring elective operation.

        • KCI등재

          광대뼈 축소성형술 시 합병증의 예방과 불만족스러운 결과에 대한 해결방안

          양정학,이지혁,양두병,정재영 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.4

          Purpose: Reduction malarplasty is a popular aesthetic surgery for contouring wide and prominent zygoma. However a few patients complain postoperative results and want to revise the midfacial contour. We analyzed the etiology of unfavorable results and treated unsatisfied midfacial contours after reduction malarplasty. Received August 20, 2007 Revised April 16, 2008 Accepted May 26, 2008 Address Correspondence: Ji Hyuck Lee, M.D., Department of Plastic and Reconstructive Surgery, Dongdaemoon Hospital, Medical College of Ewha Womans University, 70 Jongno 6-ga, Jongno-gu, Seoul 110-783, Korea. Tel: 02)760-5133/ Fax: 02)760-5430/E-mail: leejihyuck@nate.com *본 논문은 2006년 제 61차 대한성형외과학회 학술대회에서 구연 발표하였음. Methods: Total 53 patients were performed secondary operation for correction of unfavorable results after primary reduction malarplasty from elsewhere. Midfacial contour was evaluated with plain films and three- dimensional computed tomography. Unfavorable midfacial contours were corrected by secondary malarplasty. Flaring of zygomatic arch was reduced with infracturing technique and prominent zygomatic body was reduced with shaving. Drooped or displaced zygoma complex has been suspended to higher position and fixed with interosseous wiring. As adjuvant procedure, autologous fat injection has been performed in the region of depressed zygomatic body region. Results: The etiology of unfavorable midfacial contour after reduction malarplasty was classified into 7 categories: undercorrection of zygomatic arch(n=8), undercorrection of zygomatic arch and undercorrection of zygomatic body(n=6), undercorrection of zygomatic arch and overcorrection of zygomatic body(n=28), overcorrection of zygomatic body(n=3), simple asymmetry(n=4), malunion(n=2) or nonunion(n=2). Slim and balanced malar contour was achieved with treatment. And most of the patients were satisfied with the results of the surgery. Conclusion: To prevent the unfavorable results after reduction malarplasty, complete analysis of facial contour, choice of appropriate operation technique, precise osteotomy under direct vision, and security of zygoma position are important. Purpose: Reduction malarplasty is a popular aesthetic surgery for contouring wide and prominent zygoma. However a few patients complain postoperative results and want to revise the midfacial contour. We analyzed the etiology of unfavorable results and treated unsatisfied midfacial contours after reduction malarplasty. Received August 20, 2007 Revised April 16, 2008 Accepted May 26, 2008 Address Correspondence: Ji Hyuck Lee, M.D., Department of Plastic and Reconstructive Surgery, Dongdaemoon Hospital, Medical College of Ewha Womans University, 70 Jongno 6-ga, Jongno-gu, Seoul 110-783, Korea. Tel: 02)760-5133/ Fax: 02)760-5430/E-mail: leejihyuck@nate.com *본 논문은 2006년 제 61차 대한성형외과학회 학술대회에서 구연 발표하였음. Methods: Total 53 patients were performed secondary operation for correction of unfavorable results after primary reduction malarplasty from elsewhere. Midfacial contour was evaluated with plain films and three- dimensional computed tomography. Unfavorable midfacial contours were corrected by secondary malarplasty. Flaring of zygomatic arch was reduced with infracturing technique and prominent zygomatic body was reduced with shaving. Drooped or displaced zygoma complex has been suspended to higher position and fixed with interosseous wiring. As adjuvant procedure, autologous fat injection has been performed in the region of depressed zygomatic body region. Results: The etiology of unfavorable midfacial contour after reduction malarplasty was classified into 7 categories: undercorrection of zygomatic arch(n=8), undercorrection of zygomatic arch and undercorrection of zygomatic body(n=6), undercorrection of zygomatic arch and overcorrection of zygomatic body(n=28), overcorrection of zygomatic body(n=3), simple asymmetry(n=4), malunion(n=2) or nonunion(n=2). Slim and balanced malar contour was achieved with treatment. And most of the patients were satisfied with the results of the surgery. Conclusion: To prevent the unfavorable results after reduction malarplasty, complete analysis of facial contour, choice of appropriate operation technique, precise osteotomy under direct vision, and security of zygoma position are important.

        • KCI등재

          만성 감염성 창상에 대한 변형 음압요법과 은이온 제재의 이용

          박건욱,정재호 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.4

          Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Received November 29, 2007 Revised April 2, 2008 Accepted April 28, 2008 Address Correspondence: Jae Ho Jeong, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University Hospital, 317-1 Daemyung 5-dong, Nam-gu, Daegu 705-717, Korea. Tel: 053)620-3481/ Fax: 053)626-0705/E-mail: jhjeong@med.yu.ac.kr *본 논문은 2005년 제 58차 대한성형외과학회 학술대회에서 포스터 발표되었음. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility. Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Received November 29, 2007 Revised April 2, 2008 Accepted April 28, 2008 Address Correspondence: Jae Ho Jeong, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University Hospital, 317-1 Daemyung 5-dong, Nam-gu, Daegu 705-717, Korea. Tel: 053)620-3481/ Fax: 053)626-0705/E-mail: jhjeong@med.yu.ac.kr *본 논문은 2005년 제 58차 대한성형외과학회 학술대회에서 포스터 발표되었음. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.

        • KCI등재후보
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        • KCI등재

          하악 우각부 미용 성형술 : 임상적 응용과 병발증

          민병국(Byoung Kuk Min), 김창수(Chang Soo Kim), 양윤석(Yun Seok Yang), 민성기(Seong Kee Min), 엄인웅(In Woong Um) 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.2

          악안면부의 기형은 기능 및 심미적인 매우 중요한 문제이며, 이러한 면에서 현대 악안면 영역의 성형술은 기능 및 사회심리적으로 많은 기여를 한다는 것은 사실이다.악안면 성형술 중 하악 우각부에 대한 관심은 19 세기 후반부터 교근비대증 ( Masseter Hypertrophy ) 으로 표현되었으며, 안모의 심미적인 영향에 대한 평가는 동양에서 하악골의 변형과 함께 비중있게 다루어지고 있다. 교근비대 또는 협부비대의 원인은 악성 및 양성종물, 악습관에 의한 생리적 비대, 감염, 선천적기형 등이 있을 수 있으나, 환자가 호소하는 주소는 안면의 비대칭 또는 사각형의 안모등이므로 이에 대한 수술의 주도니 목적은 심미적인 면이 대부분을 차지한다고 볼 수 있다.그러므로 안모개선 등 수술 후의 결과에 대한 깊은 관심이 요구되며,따라서 혈종이나 감염, 필요할 것으로 사료되어 문헌고찰과 함께 증례보고를 하는 바이다. The bulging of mandibular angle area, frequently, make some difficulties in social life due to its appearance, especially in oriental nations So many authors had reported its causes and surgical techniques for correction since late 19th century withy with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possile complications

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          Inhibitory effects of Caesalpinia sappan on growth and invasion of methicillin-resistant Staphylococcus aureus

          Min,,Seung-Ki,Kim,,Kang-Ju,Yu,,Hyeon-Hee,Jeong,,Seung-Il,Cha,,Jung-Dan,Kim,,Shin-Moo,You,,Yong-Ouk 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.3

          소목의 메티실린 내성 황색포도구균(MRSA)에 대한 항균활성을 측정하기 위하여 소목이 MRSA의 성장을 억제하고, 또 인체치은섬유아세포에 MRSA침입을 억제하는지 조사하였다. 소목의 클로로포름, 부탄올, 메탄올과 물 추출물은 표준균주인 황색포도구균과 MRSA이 항균작용을 보였다. 메탄올 추출물은 클로로포름, 부탄올과 물 추출물에 비해 높은 항균작용을 나타내었다. 소목의 MRSA이 항생제에 대한 감수성을 증대시키는지 관찰한 결과 엠피실린과 옥사실린의 최소억제 농도를 메탄올 추출물은 현저히 감소시켰다. 인체치은섬유아세포에 대한 MRSA침입이 억제되는지에 대해 조사한 결과 소목의 메탄올 추출물의 농도 증가에 따라 세균의 침입이 억제되었고, 80㎍/ml이상농도에서는 세균침입이 거의 억제되는 것을 관찰할 수 있었다. 결과적으로 소목의 메탄올 추출물은 MRSA에 항균작용을 보이며, 항생제 감수성을 증대시키며, 인체치은섬유아세포의 침입을 억제하는것으로 보아,항생제 내성 균주인 황색포도구균에 대한 항미생물 효과를 나타내는 것으로 생각되며, 차세대 항생제개발의 가능성을 암시한다 하겠다.

        • KCI등재

          RETROSPECTIVE CLINICAL STUDY OF TRACHEOSTOMY IN ORAL AND MAXILLOFACIAL SURGERY ; 31 CASES

          Kim,,Chang-Soo,Um,,In-Woong,Min,,Seong-Kee,Min,,Byung-Kook,Yang,,Yun-Seok 大韓顎顔面成形再建外科學會 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1

          기관절제술은 기도확보를 위해 다양한 임상적 상황에서 행해지는 술식으로 1546년에 Brasabola에 의해 처음 성공적으로 시행되었다. 기관절제술의 적응증으로는 상기도 폐쇄의완화, pulmonary toilet의 촉진, ded space의 감소 및 mechanical ventilation의 장기 사용시 등을 들 수 있겠다. 그동안 term에도 변화가 있었는데, 1718년까지는 "bronchotomy"란 term이 사용되었고 그후 "tracheotomy"란 term이 사용되었으나 1820년 이후에는 "tracheostomy"란 term이 나오게 되어 현재 이 두가지 term 이 구별없이 사용되고 있다. 기도폐쇄를 야기시킬 수 있는 악안면 부위의 외상 혹은 여러가지 질병의 증가 추세로인해 구강외과의사가 기관절제술을 시행해야할 상황을빈번히 맞게 된다. 이에, 본 교실에서 기관절제술을 시행한 31명의 환자에 대한 임상적 고찰을 통해 숙련된 기관절제술 및 그 처치능력의 중요성을 보고하는 바이다. Tracheostomy may be used to assure airway protection in various clinical situation. It, as a known operation, has a history spanning 2000 years. The first clear account of a successful tracheostomy was recorded in 1546 by Brasavola. Until 1718 the term "bronchotomy" was used to describe the procedure. Heister then introduce the term "tracheotomy and this was later adopted and popularized by Trousseau about 1830. The term "tracheostomy" appeared in medical literature after 1820 and the two terms "tracheostomy" and "tracheotomy" are used interchangeably today. Indications include relief of upper airway obstruction, facilitation of pulamonary toilet, diminution of dead space and need for prolonged mechanical ventilation. The extent of indication of tracheostomy has a tendency to increase, thus oral and maxillofacial surgeons have some opportunities to face a situation that require tracheostmy. So, we reported retrospective study of 31 cases of tracheostomy patient in oral and maxillofacial surgery with reference review to reveal the significance of surgical skill and management capability of emergercy state maxillofacial surgery patients.

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