• 대한관절경학회지
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• 제12권1호
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• pp.66-68
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• 2008

최근 관절경 시술시 절제, 지혈, 수축(Shrinkage)을 효과적으로 수행할 수 있는 고주파 에너지를 이용한 bipolar radiofrequency system이 사용되고 있다. 저자들은 전방 십자 인대 재건술 후 방사선 사진상 관절 내 금속성 이물질을 발견, 이물질 제거술을 시행하여 bipolar radiofrequency system의 probe에서 분리된Tip을 제거하였다. 이후 견관절 견봉성형술 과정에서 Tip의 분리를 2예 추가적으로 경험하여 이를 보고하는 바이다.

• 구강회복응용과학지
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• 제24권2호
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• pp.183-192
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• 2008

미디어, 인터넷, 상업용 광고 등 사회의 각 분야에서 미용에 대한 관심이 고조되는 상황에서 오늘날, 치과 보철수복은 단지 저작 기능을 회복시키는 것뿐만이 아니라 특히 심미적 관점에서 웰빙이나 삶의 질 향상에도 크게 기여하고 있다. 35세의 남성 환자로써 1) #11, 23의 금속-도재수복물의 도재 파절 2) 안모 수평기준선에 비해 기울어진 상악전치 절단연 3) 안모 수직기준선인 안모 정중선에 비해 편위된 치열정중선 4) 상악 전치의 대칭성 상실을 주소로 내원하였다. 환자는 임플란트 수복을 포함하여 전통적인 고정성 보철 치료로 안모 개선을 요구하였다. 일반적으로 상악 전치부에서 전통 보철이나 임플란트 보철 시술 목적 중의 하나가 치아구도, 치아-안모구도, 그리고 안모구도에서 치열이 매력적으로 그리고 아름답게 느껴지도록 심미 보철물을 제작해 주는 것이다. 본 증례에는 연조직과 경조직의 증대술과 성형술을 바탕으로 교정과, 구강악안면외과, 그리고 보철과가 협진을 통해 자연치와 임플란트를 이용한 금속-도재 수복물로써 기하학적 측면에서 치열의 심미성을 향상시킨 결과를 얻었기에 이를 보고하는 바이다.

• 대한두경부종양학회지
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• 제12권2호
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• pp.224-229
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• 1996

Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

• Journal of Chest Surgery
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• 제43권2호
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• pp.199-203
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• 2010

세균성 대동맥류는 드물지만 높은 사망률을 보인다. 세균성 동맥류의 표준적인 치료는 수술적인 방법이지만 그 결과는 실망스럽다. 높은 사망률에 관련된 위험인자로는 대동맥류의 파열과 대동맥류가 신동맥의 상방에 위치하는 경우를 들 수 있다. 세균성 대동맥류의 치료는 대동맥류 제거, 주변 조직의 제거, 감염 부위에서 떨어지게 동맥을 재건하는 수술적 치료와 항생제 치료이다. 신동맥 상방의 대동맥류의 경우는 신동맥 또는 주변 장기로 가는 혈관들의 재이식이 필요하며 인조혈관과 관련된 합병증의 위험성으로 인하여 치료 결과가 좋지 않다. 저자들은 55세 남자 환자에서 신동맥 상방의 감염성 대동맥류를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.337-343
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• 2014

Background The reconstruction of large skin and soft tissue defects on the lower extremities is challenging. The skin graft is a simple and frequently used method for covering a skin defect. However, poor skin quality and architecture are well-known problems that lead to scar contracture. The collagen-elastin matrix, Matriderm, has been used to improve the quality of skin grafts; however, no statistical and objective review of the results has been reported. Methods Thirty-four patients (23 male and 11 female) who previously received a skin graft and simultaneous application of Matriderm between January 2010 and June 2012 were included in this study. The quality of the skin graft was evaluated using Cutometer, occasionally accompanied by pathologic findings. Results All 34 patients showed good skin quality compared to a traditional skin graft and were satisfied with their results. The statistical data for the measurement of the mechanical properties of the skin were similar to those for normal skin. In addition, there was no change in the engraftment rate. Conclusions The biggest problem of a traditional skin graft is scar contracture. However, the dermal matrix presents an improvement in skin quality with elastin and collagen. Therefore, a skin graft along with a simultaneous application of Matriderm is safe and effective and leads to a significantly better outcome from the perspective of skin elasticity.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.486-492
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• 2014

Background We conducted this study to identify the correlation between the time to surgery and that to recovery from postoperative diplopia. Methods In the current single-center, retrospective study, we enrolled a total of 11 patients (n=11) who were diagnosed with white-eyed blowout fracture and underwent surgical operation at our institution between January 2009 and January 2013. To identify the correlation between the time to surgery and that to recovery from postoperative diplopia, we divided our patients into the three groups: the group A (time to surgery, <2 days) (n=4), the group B (time to surgery, 3-7 days) (n=4) and the group C (n=3) (time to surgery, 8-60 days). Then, we compared such variables as sex, age, signs of soft tissue injury, preoperative nausea/vomiting, the degree of preoperative diplopia and the side of the fracture on computed tomography scans between the three groups. Results In our series, mean age at the onset of trauma was nine years (range, 5-16 years); the mean time to surgery was 30 days (range, 2-60 days); and the mean follow-up period was one year (range, 6 months-2 years). Our results showed that the time to recovery was shorter in the patients with a shorter time to surgery. Conclusions We found that the degree of recovery from impaired ocular motility and diplopia was the highest in the patients undergoing surgical operations within 48 hours of the onset of trauma with the reconstruction of the fracture sites using implant materials.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.115-119
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• 2008

Purpose: We reconstructed the skin defect of hands exposing tendons and/or bone with distally based ulnar artery flap and report our cases. Materials and Methods: Between March 2005 and September 2007, 6 cases of skin defect were reconstructed with distally based ulnar artery flap. Defect site were 5 cases of hand dorsal side and 1 case of hand volar side. The average defect size was $3{\times}3\;cm^2$. There were 4 men and 2 women and mean age was 55.5 years. We evaluated the viability of flap, postoperaive complication, healing time, patient's satisfaction. Results: There was no flap failure in 6 cases. But 1 case with recurrent discharge was healed with several times adequate debridement and delayed suture. 1 case with flap edema which might be due to venous congestion was healed with hand elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence was found in follow up period. Cosmetic results as judged by patients were that 3 cases are good and 3 cases are fair. Conclusion: Distally based ulnar artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Distally based ulnar artery flap is useful method for the skin defect of hands because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

• Archives of Reconstructive Microsurgery
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• 제22권1호
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• pp.33-37
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• 2013

Purpose: The concept and development of perforator free flaps have led to significant advances in microsurgery. Ongoing developments in perforator free flap surgery are aimed at reducing complications and improving surgical outcomes. The aim of this study was to evaluate the effectiveness and application of supermicrosurgery in free flap surgery. Materials and Methods: A total of 267 patients with soft tissue defects of the lower extremity due to various etiologies from January, 2007 to January, 2013. The patients received either an anterolateral thigh free flap (n=83), a superficial circumflex iliac artery free flap (n=152), an upper medial thigh free flap (n=19), or a superior gluteal artery perforator free flap (n=13). Microanastomosis was performed using a perforator-to-perforator technique, either end-to-end or end-to-side. Results: The mean postoperative follow up period was eight months (range: one to 16 months) and flap loss occurred in 11 cases out of 267. All cases of flap loss occurred within two weeks of surgery due to either arterial insufficiency (n=5) or venous congestion (n=6). Conclusion: Supermicrosurgery enables the selection of the most efficient perforator for microanastomosis at the defect site. It also reduces the time required for dissection of recipient vessels, and reduces the possibility of injury to major vessels. Microsurgery using a vessel of less than 1 mm has been reported to increase the risk of flap failure; however, using the most advanced surgical tools and developing experience in the technique can produce success rates similar to those found in the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.223-227
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• 2004

A malignant sarcoma of soft tissue that arises near but not in a joint, most often in an adolescent or young adult, is typically slowgrowing, and may escapes notice until it causes pain. The diagnosis of this tumor can be suspected by X-ray or imaging, made by biopsy, and confirmed by chromosome studies. Cytogenic studies reveal a translocation between the X chromosome and chromosome 18 in the tumor cells. The most common treatment for the tumor is surgery to remove the entire tumor, nearby muscle, and lymph nodes. Synovial sarcoma tends to recur locally and to involve regional lymph nodes. Distant metastasis occurs in half cases. The well-documented and adequately followed cases are currently lacking and this report described an instance of Synovial sarcoma good result after treatment and review of literature.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.50-53
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• 2012

Purpose: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. Methods: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. Results: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. Conclusion: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.