• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권1호
• /
• pp.64-68
• /
• 2002

저자등은 치조열이 있는 성인 환자의 골결손에서 회복이 어려운 비익기저부의 지지와 구개비강누공(oronasal fistula)의 폐쇄등을 위하여, 형성된 defect 부위의 비강쪽 점막을 이용하여 nasal layer 형성하고 장골의 피질골과 해면골을 채취하여 파열된 piriform aperture 좌,우측 골에 fissure bur를 이용하여 양쪽에 수평홈을 형성하고, 채취한 피질골을 양측 홈사이에 설합과 같이 밀어 넣어 piriform aperture를 재건하여 연결시키고, 그 아래로 해면골을 이식된 피질골에 누르며 다져 충전하는 방법을 사용하여 비익기저부의 회복에 양호한 결과를 얻었기에 문헌고찰과 함께 증례들을 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권6호
• /
• pp.565-580
• /
• 2000

This study was designed to evaluate the influence of cultured epidermal tissue graft and the administration of transforming growth factor(TGF)-${\beta}_3$ on maxillary growth in surgically created palatal defects. A total of 155 rats were divided into 2 groups according to surgical timing : postnatal 2 weeks(n=95), 4 weeks(n=40) and control(unoperated) group(n=20). The postnatal 2-week surgical group was subdivided into 3 groups according to repair methods: conventional surgery(Von Langenbeck technique)group(n=23); cultured tissue graft group(n=25); and full thickness skin graft group(n=25). Additionally, recombinant human TGF-${\beta}_3$ was administered(30ng or 150ng) on collagen matrix in surgically created palatal defects during surgery(9 conventional surgeries, 9 cultured tissue grafts) in 2-week-old rats. The results showed that all types of surgical treatment decreased maxillary growth compared with the control(unoperated) group(p<0.0001). On the other hand, the tissue graft group, whether cultured tissue or grafted skin, contributed to increased maxillary growth(p<0.0001).And exogenous TGF-${\beta}_3$ might play a role in connective tissue proliferation and new bone generation during wound healing on palatal defects. Our results suggest that grafting cultured epidermis with collagen matrix decreases the scar tension on maxillary growth more than conventional palatal surgery does. Therefore, exogenous TGF-${\beta}_3$ may contribute to accelerate wound healing on palatal defects.

• Archives of Plastic Surgery
• /
• 제33권3호
• /
• pp.335-340
• /
• 2006

Lower palpebral bags and tear trough grooves are the common signs of aging. Weakness of the orbital septum, atrophy of the orbicularis oculi muscle, slackness and laxity of the lower lid skin are the main causes of these aging changes. Tear trough groove with skeletonization of the lower orbital rim can not be corrected easily by the conventional lower blepharoplasty, but the augmentation of the volume, can be an effective method. Lower lids provide a well vascularized recipient site, which is vital for proper grafting of fat to occur. We treated tear trough groove with free fat graft of surgically removed orbital fat. Surgical excision of the fat pad and septal reinforcement with free fat graft below the levator labii superioris alaeque nasi muscle were performed to correct tear trough groove. This technique was performed in 29 consecutive individuals from October, 2001 to January, 2005. Palpebral bags and tear trough groove were corrected concomitantly and obtained a youthful attractive midface with no secondary hollowness of lower lid and irregularity. The overall results obtained were satisfactory without any complications. Recurrence of tear trough deformity due to grafted fat absorption was not noted during the 7 months of the follow-up period. The authors conclude that the procedure is safe and effective in selected patients.

• Archives of Plastic Surgery
• /
• 제40권6호
• /
• pp.711-714
• /
• 2013

Background The most common cause of skin graft failure is the collection of blood or serous fluid underneath the graft. In our study, we describe the use of silicone tube for tie-over dressing to secure the skin graft margins with the aim of decreasing loss of the skin graft, particularly in grafting of deep wounds. Methods Between March 2008 and July 2011, we used this technique in 17 patients with skin defects with depths ranging from 3.5 to 8 mm (mean, 5.5 mm). First, the skin graft was sutured with 3/0 silk suture material from its corners. Then, a silicone round drain tube was sutured with 3/0 absorbable polyglactin 910 over the margins of the graft. Finally, long silk threads were tied over the bolus dressing, and the tie-over dressing was completed in the usual fashion. Results The mean follow-up was 7 months (range, 2-10 months) in the outpatient clinic. Graft loss on the graft margins due to hematoma or seroma was not developed. The results of adhesion between the graft and wound bed peripherally was excellent. Conclusions In our study, we suggest that use of a silicone tube for additional pressure on the edges of skin grafts in case of reconstruction of deep skin defects.

• Journal of Chest Surgery
• /
• 제45권3호
• /
• pp.148-154
• /
• 2012

Background: The adequate management of mild to moderate dilatation of the ascending aorta during cardiac operations remains controversial. In this study, we present the short-term outcomes of 90 patients undergoing ascending aortic wrapping with a Dacron graft during other cardiac operations. Materials and Methods: From March 2008 to January 2011, 90 consecutive patients underwent treatment for ascending aortic aneurysm using the external wrapping technique during the concomitant procedure. The study group consisted of 49 male and 41 female patients with a mean age of $58.7{\pm}13$years. The primary cardiac surgical procedures were coronary artery bypass grafting (CABG) in 3, aortic valve replacement in 2, and aortic valvuloplasty in 85 patients (isolated in 62 and combined with CABG or mitral valvuloplasty in 23). The ascending aorta diameter was measured using a computed tomography scan within 4 weeks after surgery, and was compared with the preoperative value. Results: The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within a month after surgery from $46.4{\pm}4.3$ mm to $33.0{\pm}3.5$ mm (p<0.05). There was no early mortality or major surgical complication. During the mean follow-up period of $15.4{\pm}5.2$ months, there was only one late death caused by septic multiorgan failure. Conclusion: Dacron wrapping of the ascending aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of moderately dilated ascending aorta in selected patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제32권6호
• /
• pp.524-529
• /
• 2006

For the repairing of bone defect, autogenous or allogenic bone grafting remains the standard. However, these methods have numerous disadvantages including limited amount, donor site morbidity and spread of diseases. Tissue engineering technique by culturing stem cells may allow for a smart solution for this problem. Adipose tissue contains mesenchymal stem cells that can be differentiate into bone, cartilage, fat or muscle by exposing them to specific growth conditions. In this study, the authors procured the stem cell from buccal fat pad and differentiate them into osteoblast and are to examine the bone induction capacity. Buccal fat-derived cells (BFDC) were obtained from human buccal fat pad and cultured. BFDC were analyzed for presence of stem cell by immunofluorescent staining against CD-34, CD-105 and STRO-1. After BFDC were differentiated in osteogenic medium for three passages, their ability to differentiate into osteogenic pathway were checked by alkaline phosphatase (ALP) staining, Alizarin red staining and RT-PCR for osteocalcin (OC) gene expression. Immunofluorescent and biochemical assays demonstrated that BFDC might be a distinguished stem cells and mineralization was accompanied by increased activity or expression of ALP and OC. And calcium phosphate deposition was also detected in their extracelluar matrix. The current study supports the presence of stem cells within the buccal fat pad and the potential implications for human bone tissue engineering for maxillofacial reconstruction.

• Archives of Plastic Surgery
• /
• 제40권3호
• /
• pp.259-262
• /
• 2013

After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

• 패션비즈니스
• /
• 제6권5호
• /
• pp.72-86
• /
• 2002

Recently the fashion design has been expressed mixing trend of antipodal concept. There are shown disorganization of existing standard with eclectism, pursued more sensational fashion by the sense of unease. And there are spreaded body exposure in producing on a commercial scale for sex, are shown the phenomenon by wearing innovation inner-wear in private area are exposed out. The purpose of this study are to consider preponderantly the fashion design using corset, shown up as the motive of costume design from 1990's to 2002's, define the character of molding. and extend the width of understanding of modern fashion. The results of the study are as follows: 1. The trend of deconstructionism as one line of fashion world in the 1990's make into outer garment of inner-wear, corset has been using the main item of infra costume. The past corset was existed innerwear, but it is revived various forms by transforming outer garment of body expression consciously. 2. Corset look is shown double faced factory of the beauty of tradition and decadence, vulgarity and nobility, concealment and exposure, and are expressed boldly the free consciousness outer about woman's sex with the improvement of woman's social position. 3. The molding character of Corset look divided Eroticism, Fetishism, Deconstructionism. Futurism. The trend of Corset look design is the emphasized sexual part of lace-up and cutting line of corset, and various details of see-through, kitsch, glitter look. Therefore, the trend of Corset look will be applied the modern fashion and used as motif of new design, affected the inspiration of more developed design with grafting of up-to-date fabrics and processing technique.

• Archives of Plastic Surgery
• /
• 제32권6호
• /
• pp.777-781
• /
• 2005

Syndactyly and polysyndactyly are one of the most common congenital anomalies of upper limb. Although there are many surgical approaches, most of them require skin graft for covering the raw surfaces. Therefore these methods involve many disadvantages such as grafted skin contracture, web recurrence, skin graft loss and long operation time, and the grafted hyperpigmented skin and donor site of skin graft, which lead to poor results aesthetically. The authors treated seven cases with a Hayashi's new method in four patients. In this method, tissue of interdigital space are regarded as forming 4 facets of a two piled cube. A dorsal rectangular flap on dorsum of interdigital web makes a new interdigital space. One side of divided digit is coverd with lateral based plantar flap and the other side of divided digit is covered with subcutaneous pedicled flap and remnant web skin. The authors could obtain natural deep interdigital space without web recurrence and scar contracture in 7 cases. Moreover this method does not require skin grafting, accordingly produces better aesthetic results without hyperpigmentation and donor site scaring. Therefore we report this operation technique, which might be used as one of the standard in surgical correction of syndactyly and polysyndactyly.

• Archives of Plastic Surgery
• /
• 제40권5호
• /
• pp.564-569
• /
• 2013

Background Scalp defects may be caused by various etiological factors, and they represent a significant surgical and aesthetic concern. Various surgical techniques can be applied for reconstructive work such as primary closure, skin grafting, pedicled or free flaps. In this article, the authors share their clinical experience with scalp operations using the technique of local flaps and discuss the application of this method from the perspective of not only the size of the defect, but also in relation to the anatomical area, quality of surrounding tissue, and patient's condition. Methods During the period from December 2007 to December 2012, 13 patients with various scalp defects, aged 11 to 86 years, underwent reconstruction with local pedicle flaps. The indications were based on the patients' condition (age, sex, quality of surrounding tissue, and comorbidities) and wound parameters. Depending on the size of the defects, they were classified into three groups as follows: large, 20 to 50 $cm^2$; very large, 50 to 100 $cm^2$; extremely large, 100 $cm^2$. The location was defined as peripheral (frontal, temporal, occipital), central, or combined (more than one area). We performed reconstruction with 11 single transposition flaps and 1 bipedicle with a skin graft on the donor area, and 2 advancement flaps in 1 patient. Results In all of the patients, complete tissue coverage was achieved. The recovery was relatively quick, without hematoma, seroma, or infections. The flaps survived entirely. Conclusions Local flaps are widely used in scalp reconstruction since they provide healthy, stable, hair-bearing tissue and require a short healing time for the patients.