• The Korean Journal of Nuclear Medicine
• /
• v.25 no.2
• /
• pp.237-244
• /
• 1991

$^{99m}Tc-DMSA$ renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of $^{99m}Tc-DMSA$ renal scan as the groups of symmetric and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of normal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119.4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent $^{99m}Tc-DMSA$ and IVP concommitantly. Among 85 cases of PD in $^{99m}Tc-DMSA$ renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with symmetric small size in $^{99m}Tc-DMSA$ renal stan.

• Korean Journal of Head & Neck Oncology
• /
• v.22 no.2
• /
• pp.175-178
• /
• 2006

Pulsed dye laser(PDL) is originally designed for the treatment of vascular lesions but also effective in improving the quality and appearance of surgical scars. Recently, 595nm Pulsed dye laser(V-beam laser), which has the advantage of deeper tissue penetration and lesser amount of purpura, is spotlighted as a new option for the treatment of surgical scar. The authors treated a surgical scar of a female patient with V-beam laser for 3 times between 4 and 12 weeks after surgery. Subjective satisfaction was improved with visual analogue scale (VAS) and objective improvements were found in parameters of vascularity, pliability and height with Vancouver Scar Scale(VSS). We report the effectiveness of V-beam laser in surgical scar of Asian patient and plan the prospective study with larger scale.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.30 no.2
• /
• pp.124-127
• /
• 2019

Vocal fold scarring is an intractable phonosurgical condition. The number of patients with vocal fold scars is increasing with the aging of society and with the increasing application of laryngeal microsurgery. Many methods are available to treat these, including voice therapy, stem cells, regenerative scaffolds, and growth factors. However, no standard treatment strategy has yet been established, and novel techniques are required. Basic fibroblast growth factor has been shown to be effective for the treatment of mild chronic vocal fold scarring. The combined use of basic fibroblast growth factor and regenerative scaffolds is currently under investigation. Here, we report a female patient in whom vocal fold scarring developed after two laryngeal microsurgeries. We performed laryngeal microsurgery to remove the scar tissue and used basic fibroblast growth factor and a collagen scaffold to promote healing. The patient's voice quality was greatly increased, and she was content with her voice after 2 years of follow-up. This is the first report of this methodology in Korea and is presented along with a review of the literature.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.571-576
• /
• 2010

Purpose: Reconstruction of soft tissue defects of the foot often requires free-flap transfer. Free muscle flap transfer and skin grafts on the muscle has been an option for these defects. Here we present our experiences of foot reconstruction using an endoscopy-assisted free muscle flap harvest. Methods: Using endoscopy-assisted free muscle flap harvests, four patients with soft tissue defects of the foot were treated with a free muscle flap and skin graft. The gracilis muscle was used for two patients and the rectus abdominis muscle for two. A single small transverse skin incision was placed on the lower abdomen for the rectus abdominis muscle. A small transverse skin incision on the proximal thigh was the only incision for harvesting the gracilis muscle flap. The small incisions were enough for the muscle flap to be pulled through. Results: The flaps survived successfully in all cases. Contours were good from both functional and aesthetic aspects. No breakdowns or ulcerations of the flap developed during long-term follow-up. Resultant scars were short and relatively hidden. Functional morbidities such as abdominal bulging were not noted. Conclusion: Endoscopy-assisted harvest of muscle flap and transfer with skin graft is a good option for soft tissue defects of the foot. Morbidities of the donor site can be minimized with endoscopic flap harvest. This method is preferable for young patients who want a small donor site scar.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.3
• /
• pp.624-629
• /
• 1998

The complications of endotracheal intubation are inevitable, of which postintubation tracheal stenosis may be required for surgical resection with primary reconstruction. Before surgery, several less invasive therapeutic modalites including bougie dilatation, stenting, and Nd-YAG laser incision are still available in use. Especially, good results were noted in selected patients with lengthy scars of less than 1cm and without tracheomalacia using endoscopic laser incision and dilatation. We report a case of a 54 yr-old woman with postintubation tracheal stenosis who was successfully treated by endoscopic Nd-YAG laser incision and esophageal balloon catheter.

• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.845-850
• /
• 2011

Purpose: In general, orientals including Korean, have a mesocephalic face whereas Caucasians, among the western, have a dolichocephalic face. Unlike the western, in orientals including Korean, prominent malar bones are recognized as stubborn and unattractive appearance. That is why reduction malarplasty is one of the most popular aesthetic surgical procedure in Korea. Many surgical methods to reposition prominent malar bones have been performed by means of a coronal incision or a combined incisions, using both the intraoral and the external incision. Bicoronal approach has advantage such as wide operative field, easy to maintain symmetry and possibility of combining facial lift but has shortcoming, such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral approach has advantages of short operative time, simplicity of procedure and no external scar. But this approach is associated with problems of cheek drooping, limited exposure and difficulty in making symmetry. Methods: During 8 years, we performed a reduction malarplasty without internal fixation through an minimal intraoral incision and dissection in 39 patients. Results: The patients were followed for 46 months, with satisfactory results and no cheek drooping. There was no patient who want to revise the inappropriate operative result such as asymmetry and incomplete correction. Conclusion: We conclude that minimal intraoral incision and dissection could acquire satisfactory result of reduction malarplasty along with prevention of cheek drooping.

• Archives of Plastic Surgery
• /
• v.32 no.4
• /
• pp.408-415
• /
• 2005

Following a transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction, denervated state of the flap causes the flap skin prone to thermal injury, calling for special attention. During the last 5 years, 69 breast reconstruction with 72 free TRAM flaps, were performed. Four out of thesse 69 patients sustained burn injury. Heat sources were a warm bag(n=2), heating pad(n=1) and warming light (n=1). The thermal injuries occured from 2 days to 3 months following the reconstruction. Three patients healed with conservative treatment, but one patient required debridement and skin graft. Initially 3 out of 4 patients with the burn had shown superficial 2nd degree burn with small blebs or bullae. However all 4 patients healed with scars. Mechanism of burn injuries of the denervated flap are known to be resulting from; 1) loss of behavioral protection due to denervation of flap with flap elevation and transfer, 2) loss of autonomic thermoregulatory control with heat dissipation on skin flap vasculature contributing to susceptibility of burn injury. 3) changes of immunologic and normal inflammatory response increasing thromboxane, and a fall in substance P & NGF (nerve growth factor). Including the abdominal flap donor site, sensory recovery of the reconstructed breast varies individually from 6 month even to 5 years postoperatively. During this period, wound healing is delayed, resulting in easier scarring compared to that observed in the sensate skin. Patients should be carefully informed and warned of possible burn injuries and taught to avoid exposure to heat source at least until 3 years postoperatively.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.655-658
• /
• 2006

Purpose: The main goals of correcting syndactyly of the hand are to form normal web appearance and to prevent motor dysfunction. We modified the original three-square-flap to improve interdigital web space and to reduce the wound healing problem due to tension. Methods: From July 2005 to February 2006, three cases of moderate to minor syndactyly were treated using modified three-square-flap. These flaps were made in such as way that the A flap from dorsal side, the B flap from the interdigital surface, and the C flap from the volar side. We modified the design of dorsal A flap as a hourglass shape instead of square shape to make normal hourglass shaped interdigital web and to reduce the tension of closure with other two flaps(B and C flap). The B and C flap were made as square shape. Results: During 4 to 10 months follow-up period, acceptable esthetic results were obtained without any specific complication, using our modification of the three-square-flap. Conclusion: Our method showed more satisfactory web appearance and was safe to use even in the cases of syndactyly secondary to burns and post-traumatic scars because of excellent blood circulation.

• Archives of Plastic Surgery
• /
• v.33 no.6
• /
• pp.769-772
• /
• 2006

Purpose: Benign symmetrical lipomatosis(Madelung's disease) is a disease of uncertain etiology that manifests as massive lipomatous deposits in specific area of the body. It is usually located on the neck, shoulder, proximal regions of the extremities and the abdomen. Madelung's disease is found many in middle-aged, Mediterranean man. Imaging using either computed tomography or magnetic resonance imaging is often recommended. Dietary restriction provides no relief of disease. Abstinence with alcohol may delay further progression but does not regression tumor mass. The objective of this study is to prove effectiveness of liposuction for treatment of benign lipomatosis. Methods: We conducted liposuction as a treatment for benign lipomatosis. After general anesthesia, We conducted power assisted liposuction and amount of suctioned volume was about 2500 cc. After surgery, we did compressive dressing and then followed by pressure garment. Results: Six months after surgery, patient was examined for follow up at outpatient department. Recurred lipoma was not observated. Patient was satisfied with result.Conclusion: The only effective therapy for Madelung's disease is surgical removal but recurrence could be occurring. Also multiple surgical scars will be visible. We report a patient with multiple large lipomatosis successfully treated with liposuction.

• Archives of Plastic Surgery
• /
• v.33 no.5
• /
• pp.563-569
• /
• 2006

Purpose: In the correction of cleft lip, there have been various methods to minimize recurrence of the nasal deformity after primary nasal surgery. After cheiloplasty and primary nasal surgery, we tried to elongate the columella of the cleft side, to stretch the vestibular lining of cleft side, and to elevate the alar cartilage of the cleft side with a molding prong. Methods: We had fifteen cleft lip patients; 12 unilateral cases(6.3-8.2 months), and 3 bilateral cases(3 - 7.5 months). Immediately after primary repair of the cleft lip, the toboggan shaped molding prong was located to deep inside of vestibular web of the cleft side. It was persistently suspended by a silicone tube which was connected to the prong and the frontal scalp. The results were analyzed with $Photoshop^{(R)}$ photogrammetrically for 6 - 48 months with on average of 20.6 months. We measured the proportion index of columellar length-interalar distance for three times(preoperation, immediate postoperation, and postoperation) on the nasal base views. Results: In unilateral, the index had a significant increase statistically between preoperation(10.73) and immediate postoperation(23.96). It is supposed that columellar length was reconstructed to 105.80% of normal side. But, it was decreased to maintain 87.7% of normal side in postoperation(20.54). The results were similar in bilateral. The linear scars by suture penetrating nose skin were not discernable. Conclusion: In summary, placement of the molding prong could elongate the reconstructed columella with some relapse postoperatively.