• Journal of Chest Surgery
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• 제32권2호
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• pp.206-210
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• 1999

기관재건술 후 발생한 심부 종격염 2례에 대해 흉골절제, 대위망 자유이식 혹은 전치술, 근피성형술을 병행하여 좋은 결과를 얻었기에 보고한다. 증례 I은 8세된 남아에서 흉골 정중절개로 전방기관성형술을 실시한 후 심부 종격염과 흉골 골수염이 발생한 경우였으며, 증례 II는 50세된 여자에서 상부 흉골의 부분 정중절개로 기관절제 및 단단문합을 실시한 후 종격농양과 흉골 골수염이 발생한 경우였다. 치료는 두례 모두 배농을 시키고 일정기간 세척한 다음, 골수염이 생긴 흉골을 광범위 절제하고 대위망으로 종격을 덮은 후 양측 대흉근을 피부와 함께 박리하여 전흉벽을 재건하였다. 이때 증례 I의 경우는 대위망을 분리한 뒤 횡격막을 통해 종격부위에 위치시켰으며 (in-situ pedicled grafting), 증례 II의 경우는 대위망을 자유이식편으로 만들어 우횡경동맥과 외경정맥에 연결한 후 피하출구을 통해 상부종격에 위치시켰다 (free grafting). 양례 모두 술후 쾌회복하였으며 외래를 통해 추적관찰 중이다.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.17-25
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• 2023

A variety of reduction labiaplasty techniques have been introduced to date, but no single technique will offer the optimal solution for every patient. Rather, the technique should be chosen based on anatomical, configurational, and technical considerations, as well as on patients' personal preferences regarded maintenance of the labial rim, maintenance of labial sensitivity, and prevention of iatrogenic thickening of the labium. We reviewed, defined, and assessed labial configurational variety, neurovascular supply, reduction techniques, and patient's preferences as the considerations relevant to the choice of labiaplasty technique. Based on this review, an algorithm was constructed that leads to a choice of reduction technique through five decisions to be made regarding (1) resection or (partial) retention of the labial free rim, (2) the measure of required labial width reduction, (3) labial vascular status, (4) prevention of iatrogenic labial thickening, and (5) preservation of labial sensibility. The choice of techniques includes edge trimming, central spindle form de-epithelialization or full-thickness resection, and three modifications of the wedge resection or de-epithelialization technique. These three modifications comprised a modified anterior resection or de-epithelialization combined with posterior flap transposition, a custom flask resection or de-epithelialization, and a modified posterior wedge resection or de-epithelialization combined with anterior flap transposition. Use of the five decisional steps and the inclusion of modifications of all three conventional reduction techniques offer an improved algorithm for the choice of labioplasty technique.

• 대한기관식도과학회지
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• 제3권2호
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• pp.327-331
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• 1997

One of the most difficult airway problems is a subglottic stenosis combined with a tracheal stenosis. Laryngotracheal stenosis has not been completely solved with classic methods like cricotracheal split with autogenous cartilage graft, thyrotracheal anastomosis, and free hyoid or hyoid-sternohyoid myo-osseous flap reconstruction. A 28-near-old male patient who had had laryngotracheal stenosis was successfully treated by laryngotracheal reconstruction using vascularized clavicle. This method has a several advantages: the vascularized clavicle harvesting in the same operative fields, one stage operation, less restenosis due to plentyful blood supply, md prevention of airway collapse due to a clavicle provided framework. It is too early to make a definite conclusion, but the authors suggested that this method could become one of the most effective methods of laryngotracheal stenosis.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.439-445
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• 2008

Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

• Archives of Reconstructive Microsurgery
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• 제3권1호
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• pp.90-96
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• 1994

1. 교통사고 등으로 인한 외상성 골노출이 8례로 가장 많았으며, 원인으로서는 교통사고가 7례이었고 1례는 기계사고 이었으며, 부위 별로는 하지 경골이 7례, 종골이 1례이었다. 2. 2례의 만성 골수염에서는 유리조직 이식술과 함께 골소파술 및 정주 항생제 요법을 병행하였다. 3. 총 10례중 9례에서 완전 생존하여 90%의 성공률을 보였다. 4. 공여부위에 대한 합병증은 소량의 혈종을 형성한 1례에서 2차 탐구술과 흡인술을 시행하였으며 합병증없이 치유되었다.

• International Journal of Aeronautical and Space Sciences
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• 제7권2호
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• pp.110-120
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• 2006

There have been developed many structural and fluid rotorcraft analysis models in rotorcraft community, and also lots of investigations have been conducted to combine these two models. These investigations turn out to be good at predicting the airloads precisely, but they have not taken the blade nonlinear deflection into account. For this reason, the present paper adopts a sophisticated structural model which can describe three-dimensional nonlinear deflection of the blade. And it is combined with two types of aerodynamic model. First one is generalized Greenberg type of finite-time aerodynamic model, which is originally established for a fixed wing, but later modified to be suitable for coupled flap-lag-torsional aeroelastic analysis of the rotor blade. Second aerodynamic model is based on the unsteady source-doublet panel method coupled with a free wake model. The advantages of the present method are capabilities to consider thickness of the blade and more precise wake effects. Transient responses of the airloads and structural deflections in time domain are mainly analyzed in this paper.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권4호
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• pp.221-226
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• 2016

Spindle cell carcinoma (SpCC) is referred to as a variant of oral squamous cell carcinoma. It is also known as "sarcomatoid squamous cell carcinoma" because it consists of normal squamous carcinoma cells with spindle-shaped cells that appear similar to a sarcoma. The term, "second primary tumor" (SPT) or "double primary tumor", is proposed for a second tumor that develops independently from the first. SPTs can present as either synchronous or metachronous lesions. Synchronous SPTs are defined as tumors occurring simultaneously or within 6 months after the first tumor. The patient in this case, whose primary tumor was in the tongue, was diagnosed with SpCC with metastases to both neck lymph nodes. This case also exhibited a second primary cancer as a synchronous lesion in the thyroid gland, which is uncommon. All carcinomas, both in the tongue and thyroid gland, were removed surgically, and especially in the tongue, an anterolateral thigh free flap was performed successfully to replace the defect.

• 대한족부족관절학회지
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• 제12권2호
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• pp.156-162
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• 2008

Purpose: Open fractures of the foot and ankle require prompt repair of the wound due to the complexity of anatomy, insufficiency of soft tissues and inadequate blood supply. Early flaps and skin grafts are used for this purpose yet general condition of the patient as well as local wound environment often precludes such treatment options. Vacuum- Assisted Closure (VAC) is recently being used in such cases. This study was done to validate the use of VAC together with silver antimicrobial dressing materials in contaminated open fracture wounds. Materials and Methods: We have selected 10 patients with Gustillo-Anderson type III open fractures of the foot & ankle treated with VAC and silver antimicrobial dressing materials from March 2007 to January 2008. The relationship between duration of treatment with wound size, contamination, and degree of soft tissue damage was analyzed. Results: The average age of patients was 36.6 years. The average amount of VAC application time was 23.4 days. Silver dressing materials were used for 16.8 days. Average wound healing time was 51.9 days. Statistically significant relationship was found between wound size, VAC application time and silver dressing material application time. No complications such as osteomyelitis were found after treatment. Conclusion: VAC technique is recently being used in open fractures with wide skin and soft tissue defects, producing good results. A wide array of dressing materials such as silver dressing is in development. We have incorporated the VAC technique together with silver dressing materials in the treatment of open fractures and achieved complication free results.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.31-35
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• 2012

Background : Orbital roof fractures are frequently associated with a high energy impact to the craniofacial region, and displaced orbital roof fractures can cause ophthalmic and neurologic complications and occasionally require open surgical intervention. The purpose of this article was to investigate the clinical features and treatment outcomes of orbital root fractures combined with neurologic injuries after early reconstruction. Methods : Between January 2006 and December 2008, 45 patients with orbital roof fractures were admitted; among them, 37 patients were treated conservatively and 8 patients underwent early surgical intervention for orbital roof fractures. The type of injuries that caused the fractures, patient characteristics, associated fractures, ocular and neurological injuries, patient management, and treatment outcomes were investigated. Results : The patients underwent frontal craniotomy and free bone fragment removal, their orbital roofs were reconstructed with titanium micromesh, and associated fractures were repaired. The mean follow up period was 11 months. There were no postoperative neurologic sequelae. Postoperative computed tomography scans showed anatomically reconstructed orbital roofs. Two of the five patients with traumatic optic neuropathy achieved full visual acuity recovery, one patient showed decreased visual acuity, and the other two patients completely lost their vision due to traumatic optic neuropathy. Preoperative ophthalmic symptoms, such as proptosis, diplopia, upper eyelid ptosis, and enophthalmos were corrected. Conclusions : Early recognition and treatment of orbital roof fractures can reduce intracranial and ocular complications. A coronal flap with frontal craniotomy and orbital roof reconstruction using titanium mesh provides a versatile method and provides good functional and cosmetic results.