• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.13-26
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• 2001

Cleft lip and/or palate is the congenital orofacial malformation most commonly occurred in humans, The disease is multifactorial and is probably caused by genetic and/or environmental factors, So, there are many problems in research concerning etiology and in treatment of the disease, Even the most practiced and sophisticated methods of surgical repair are necessarily followed by scar contraction and fibrosis, which result in skeletal defects, dental abnormalities, cosmetic disfigurement, and speech impairment, As a result, Fetal surgery can be considered but practiced rarely when the deformity is not fatal to life, And treatment of cleft palate is performed in the form of medicine projection into uterus in animal experiments, Many studies show that growth factor and its receptor emerge from the developing palate; and the epidermal growth factor receptors have a important role in craniofacial development and in palatal fusion, The palatal morphogenesis of the avine is different from the mammal's; it takes the form of physiologic cleft palate, Recently, cleft palate fusion experiment was performed when the avine were in the period of palate formation through the exogenous TGF-β3 addition, and it showed that the exogenous TGF-β3 makes fusion of divided palate through certain process when cleft palate is occurred in palatal formation, In this study, I had the conformation of the fusion of cleft palate through the addition of TGF-β in case of chicken embryo, and observed the effect of TGF-β in EGF receptor distribution, And the following is the results of this study, 1. In case of the TGF-βl and β3 addition group, there was the decrease of EGFR(Epidermal Growth Factor Receptor) immunoreactivity in mesenchymal cells beneath the medial edge epithelium and also in epithelial mesenchymal interface which is between medial edge epithelium and nasal septum in 72 hours, 2, The immunoreactivity of the control group resembles that of normal chicken embryo palate in development, 3. In the view through fluorescence confocal microscopy, there was confluence in TGF-β3 addition group, This shows that the confluence induced by exogenous TGF-β3 is related to EGFR expression in palate of chicken embryo, which is a physiologic cleft palate model.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.11-16
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• 2000

Many efforts are made to achieve satisfactory cosmetic and functional result in the repair of cleft lip. However, repair may be complicated in many cases by distortion of the vermilion border, obliteration of the normal contour of the philtrum, and eclabium in spite of many methods used in these days. To achieve better results in cleft lip repair, thorough understandings of the relationship between the surface morphology of the upper and lower lip and the underlying musculature is necessary but reports about this topic is rare. So, our studies were performed on the full-thickness upper lips containing both philtral ridge up to columelar base and lower lip, 4 post-mortem specimens of 2 females and 2 males aged from 16 to 42, using serial histological sections taken in the transverse and vertical planes under light microscopy. Thorough understanding of the anatomical relationships is established and on the basis of our findings, we can postulate some criteria to create a normal and natural philtrum in a patient with a cleft lip, it would be necessary to restore the normal deep muscle attachments and superficial dermal attachments of the orbicularis muscle, to close the lip without tension, to restore thickness of the philtral ridge, and to minimise nonelastic scar tissue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.78-82
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• 2001

Background : The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. Methods : Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. Results: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is $48.63{\pm}21.12ml$ and second day is $23.92{\pm}19.53ml$ and third day is $7.82{\pm}5.32ml$ and group II of first day $60.45{\pm}22.65ml$ and second day is $22.14{\pm}13.21ml$ and third day is $7.32{\pm}6.25ml$. III group of first day $58.16{\pm}10.13ml$ and second day is $21.27{\pm}11.72ml$ and third day is $7.13{\pm}4.90ml$. 5. Infusion of group I is mean PRC $1.08{\pm}0.91$ pint, FFP $1.03{\pm}0.75$ pint, crystalloid $2562.23{\pm}1345.53ml$ and group II is mean PRC $1.05{\pm}0.89$ pint, FFP $1.71{\pm}0.78$, crystalloid $2650.47{\pm}1096.36ml$ and group III is mean PRC $1.79{\pm}1.45$ pint, crystalloid $3295.43{\pm}1472.432ml$.

• Archives of Plastic Surgery
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• v.35 no.1
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• pp.110-115
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• 2008

Purpose: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. Methods: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo-splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively. Results: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. Conclusion: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.43-50
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• 2004

One of the major advantages of microsurgical reconstruction for defects of the hand is that these techniques allow for selection of the most ideal tissue to reconstruct a particular defect, thus optimizing the functional and aesthetic outcome. The dorsalis pedis free flap is an excellent reconstructive tool for various hand reconstructions. It has a reliable vasculature with vessels that are relative large on a long pedicle. It provides thin pliable tissue and be innervated by deep peroneal nerve. Coupled with its thinness and pliability, it is ideal for innervated cover of critically sensitive area, especially such as the hand. Thus it can be used as a cutaneotendinous flap, or an osteocutaneous flap. Otherwise, the major criticism with this flap is related to its uncertain vascularity and the donor defect. It is the purpose of this paper to outline our technique of flap elevation and donor site closure and to indicate our current use of this flap in hand reconstruction. We have treated 10 cases (6 burn scar contracture cases, 4 acute hand trauma cases) of hand reconstruction from Dec. 3, 1997 to Mar. 4, 2004 using dorsalis pedis free flap. The key points for sucess in terms of a viable flap and acceptable donor site are the preservation of the critical dorsalis pedis-first dorsal metatarsal vascular axis and the creation of a viable bed for grafting. In addition, we substituted preserved superficial fat skin graft for split thickness skin graft and wet environment was offered for good graft take. Preserved superficial fat skin is defined as composite graft containing epidermis, dermis and superficial fat layer. With sufficient care in flap elevation and donor site closure, a good graft take of preserved superficial fat skin under wet environment can be achieved with no functional disability and minimal cosmetic deformity in donor site. This flap has proved itself to be a best choice for hand reconstruction.

• Current Optics and Photonics
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• v.1 no.1
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• pp.51-59
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• 2017

In addition to its typical use for skin rejuvenation, fractional laser irradiation of early cancerous lesions may reduce the risk of tumor development as a byproduct of wound healing in the stroma after the controlled injury. While fractional ablative lasers are commonly used for cosmetic/aesthetic purposes (e.g., photorejuvenation, hair removal, and scar reduction), we propose a novel use of such laser treatments as a stromal treatment to delay tumorigenesis and suppress carcinogenesis. In this study, we found that non-ablative fractional laser (NAFL) irradiation may have a possible suppressive effect on early tumor growth in syngeneic mouse tumor models. We included two syngeneic mouse tumor models in irradiation groups and control groups. In the irradiation group, a thulium fiber based NAFL at 1927 nm was used to irradiate the skin area including the tumor injection region with 70 mJ/spot, while no laser irradiation was applied to the control group. Numerical simulation with the same experimental condition showed that thermal damage was confined only to the irradiation spots, sparing the adjacent tissue area. The irradiation groups of both tumor models showed smaller tumor volumes than the control group at an early tumor growth stage. We also detected elevated inflammatory cytokine levels a day after the NAFL irradiation. NAFL treatment of the stromal tissue could potentially be an alternative anticancer therapeutic modality for early tumorigenesis in a minimally invasive manner.

• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.68-73
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• 2021

Purpose: A large defect by fourth-degree burns in the upper limb requires flap reconstruction. Since severe vascular damage and decrease in blood circulation after vascular anastomosis can occur in defects caused by fourth-degree burns. Because of the disadvantages, it is difficult to apply free flap surgery to fourth-degree burns. We reconstructed a upper extremity using the pedicled Latissimus Dorsi (LD) flap in two stages. The purpose of our study is to review our experience and suggest two-staged pedicled Latissimus Dorsi (LD) flap in fourth-degree burns of upper extremities. Methods: A retrospective review was performed from 2016 to 2019, on a total of 12 fourth-degree burn patients undergone two-staged pedicled LD flap surgery as reconstruction of upper extremities in our hospital. We reviewed the location of the injury, etiology, TBSA (%), size of burns requiring flap surgery, period from 1st surgery to secondary division surgery, complications. Results: Using two-staged LD flap as a primary reconstruction, the outcome is satisfactory. This flap preserves the elbow joint and maintains the length of the forearm. We obtain low donor-site morbidity, simplicity and a small incision in the donor site. Conclusion: Using two-staged LD flap in fourth-degree burns of upper extremity is effective, such as preserving elbow joint and maintaining the length of the forearm. Successful reconstruction was achieved with excellent cosmetic results with reducing a postoperative scar, donor-site morbidity. Due to these advantages, two-staged pedicled LD flap can be an optimal option for reconstruction of fourth-degree burns in the upper limb.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.522-529
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• 2018

Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.369-375
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• 2007

Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.1-6
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• 2017

Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.