• Archives of Plastic Surgery
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• 제45권5호
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• pp.425-431
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• 2018

Background The umbilicus makes an important contribution to the natural appearance of the abdomen. To date, studies on its position in Korean women are lacking, and no standards have been established. The purpose of this study was to investigate the position of umbilicus in Korean women and to review changes in its position after ipsilateral pedicled rectus abdominis musculocutaneous (IP-RAM) flap. Methods This research consisted of two studies. In first study, 100 females who visited the emergency department with gastroenteritis between 2007 and 2011 were included. In second study, 40 women who underwent IP-RAM flap in the same period were included. Using abdominal computed tomography, we measured the distance between xiphoid process and umbilicus, represented by value a, and the distance between umbilicus and symphysis pubis, represented by value b. Thus, the location of the umbilicus was represented by the ratio a/b. The data were analyzed using Pearson correlation test and paired t-test. Results In study 1, the mean value of a/b was 1.07. Pearson correlation test revealed a significant correlation between age and a/b. In study 2, the mean value of a/b was 1.16 in preoperative measurements and 1.01 in postoperative measurements. The paired t-test showed a significant difference between preoperative and postoperative measurements, indicating cephalic migration of the umbilicus after surgery. Conclusions The natural position of the umbilicus showed caudal migration with aging. Additionally, in a comparison of preoperative and postoperative measurements in patients who underwent IP-RAM flap, cephalic migration of the umbilicus was observed after surgery.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.175-178
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• 2021

The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.371-374
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• 2019

Umbilical preservation can be challenging, particularly in complex cases involving simultaneous ventral hernia repair and abdominoplasty. Although the umbilicus serves no functional purpose, removal of the umbilicus can draw unwanted attention to the abdominal area and can cause emotional distress to patients. There are several well documented options for umbilical reconstruction. We present a new umbilical reconstruction technique relevant for such cases. This neoumbilicoplasty allows for preservation of the original umbilicus with relocation and reconstruction using local flaps. The technique is relatively simple and the time needed is minimal. The result is a natural, well positioned umbilicus using the principles of spare part surgery.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.653-655
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• 2007

Purpose: The umbilicus is an important aesthetic component of the abdomen. Its absence is both cosmetically and psychologically distressing to the patient. Umbilical reconstruction should always be aimed at creating an umbilicus of sufficient depth and good morphology with less scarring. The C-V flap developed for nipple reconstruction was used in an inverted fashion in case of umbilical reconstruction. The aim of this article is to report our experience of scarred umbilical reconstruction using inverted C-V flap. Methods: A 22-year-old woman presented with contracted scar tissue in the umbilical region because she had undergone surgical correction of an umbilical hernia at 5 year of age. Pedicle of the inverted C-V flap was based cephalically. For enhancing depth of the umbilicus, three anchoring sutures to linea alba were done at both lateral and caudal aspects of the umbilical tube. Primary closures were done at donor sites of the V flaps and bolster sutures were done in the caudal direction of the inverted umbilical tube. Results: The patient was satisfied with the appearance of umbilicus. Major complications such as dehiscence, infection, and delayed healing did not occur. Conclusion: The inverted C-V flap is easy and simple technique, and it can produce a satisfactory reconstruction of umbilical structure.

• Archives of Plastic Surgery
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• 제42권3호
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• pp.351-355
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• 2015

The absence or disfigurement of the umbilicus is both cosmetically and psychologically distressing to patients. The goal of aesthetically pleasing umbilical reconstruction is to create a neoumbilicus with sufficient depth and good morphology, with natural-looking superior hooding and minimal scarring. Although many reports have presented techniques for creating new and attractive umbilici, we developed a technique that we term the "four flaps technique" for creating a neoumbilicus in circumstances such as the congenital absence of the umbilicus or the lack of remaining umbilical tissue following the excision of a hypertrophic or scarred umbilicus. This method uses the neighboring tissue by simply elevating four flaps and can yield sufficient depth and an aesthetically pleasing shape with appropriate superior hooding.

• 한국동물위생학회지
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• 제41권1호
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• pp.47-49
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• 2018

A 2-month-old female Holstein Friesian calf was noted to leak urine from the umbilicus during urination. She urinated through both the umbilicus and the urethra. A conduit from the umbilicus to the bladder was identified with ultrasonography. Uroperitoneum was ruled out because blood urea nitrogen and creatinine were within reference ranges. Surgery was performed to resect the patent urachus. Urachitis was identified during surgery. Dexamethasone and an antibiotic were used for the inflammation and postoperative cares. Meloxicam was substituted for dexamethasone since the calf showed side effects to dexamethasone. The calf recovered completely and there was no urine leakage from the umbilicus.

• 대한한의학회지
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• 제34권3호
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• pp.1-12
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• 2013

Objectives: This was study about identifying fine seed herbs that are highly mixed together: Celosiae Semen, Celoisae Cristatae Semen, Cuscutae Semen, Perillae Semen. Methods: In non-distinctive herbs through sensory test, we can find accurate discriminative points by using a stereoscope. As a result, a new discriminative key was completed. Results: We identified a comparison of herbs which are mixed up in distribution. 1) In the case of Celosiae Semen and Celoisae Cristatae Semen, Celoisae Cristatae Semen which is mixed up is bigger and more glossy and especially have the sunk umbilicus. 2) In the case of Cuscutae Semen and Perillae Semen, Perillae Semen is discriminated by characteristic morado netting surface and impression of fruit stalk in the single-ended. 3) In the case of Cuscutae Semen which is distributed in three species, we discriminated by beak shape, location of umbilicus and vomiting thread shape or not when put in water. (1) Cuscuta chinensis has a weak beaky shape, an umbilicus in center and is vomiting thread shape when put in water. (2) C. australis has very weak beaky shape, an umbilicus beneath and is vomiting thread shape when put in water. (3) C. japonica has clear beaky shape, an umbilicus beneath and is not vomiting thread shape when put in water. Conclusions: A stereoscope can be effectively used for identifying fine seed herbs hardly distinguishable by sensory tests.

• Archives of Aesthetic Plastic Surgery
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• 제23권1호
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• pp.1-10
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• 2017

Background Creating a natural-looking umbilicus during closure of the donor-site in abdominally based free flap breast reconstruction is a factor of satisfaction for both the patient and surgeon. We present a simple method of umbilical transposition that results in an aesthetic, natural-looking umbilicus. Methods From March 2011 to November 2014, fifty three consecutive female patients received abdominal flap breast reconstruction. Twenty patients (from March 2011 to February 2013) underwent umbilical transposition through a cross like incision in the abdominal flap, with fascial fixation sutures but no dermal flaps. Thirty three patients (March 2013 to November 2014) received umbilical transposition in the following method. An oval-shaped incision is made at the location of the new umbilicus on the abdominal flap. This oval is deepithelialized, and full-thickness incisions are made at the 2, 6, and 10 o'clock directions to create three triangular dermal flaps. These are pulled down to the abdominal fascia using sutures that pass through the umbilical stalk and the abdominal fascia at the 3, 9, and 12 o'clock directions. This results in an umbilical stalk lined with dermal flaps, creates a natural periumbilical concavity, and anchors the abdominal flap inward to minimize tension. The cranial flap enhances superior hooding. Results Patient and surgeon satisfaction, surveyed 2 months after surgery with a satisfaction scoring system, were higher in the dermal flap group. Conclusions The technique using three dermal flaps in an oval skin incision is simple, relatively easy to learn, and results in an aesthetic, natural-looking umbilicus.

• 대한방사선치료학회지
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• 제29권2호
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• pp.27-32
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• 2017

목 적: 고주파 온열암 치료에 의한 부작용 중에서 가장 주의하여할 것 중의 하나는 피부에 나타날 수 있는 화상이다. 특히 배꼽처럼 요철이 있는 부위에는 환자가 느끼는 열감이 크기 때문에 치료를 중단하는 경우가 발생한다. 이에 배꼽부위의 요철을 상쇄시키기 위한 보상체를 제작하고 온도 및 열감을 감소시키고자 한다. 대상 및 방법: 고주파 온열암 치료기(EHY-2000, Oncotherm Kft, Hungary)를 이용하여 본원에서 치료받은 환자를 대상으로 배꼽을 중심으로 4개 부위(배꼽 속, 배꼽 바로 옆, 배꼽아래 5 cm 지점, 등)의 온도를 5회에 걸쳐 측정하였다. 온도계(TM-100, Oncotherm Kft, Hungary)를 4개의 부위에 부착하고 치료 전, 치료 후 5분, 15분, 25분, 35분, 50분의 온도를 측정하였다. 이때 사용한 보상체는 바셀린, 볼루스, 레진으로 각각 같은 방법으로 측정하였다. 결 과: 일반적 치료 시 배꼽 속 온도변화는 평균 34.65도에서 42.9도로 변화하였다. 배꼽 바로 옆은 32.20도에서 37.00도까지 변화하였으며 배꼽아래는 31.90도에서 34.41도로 변화하여 배꼽속의 온도변화가 가장 큰 것으로 나타났다. 배꼽 속에 보상체 물질을 삽입한 경우의 배꼽 속 온도변화는 볼루스가 5.42도, 바세린이 6.55도, 레진이 6.83도로 측정되었다. 온도상승 검증을 위한 귀무가설의 유의확률은 각각 0.0108, 0.034, 0.019로 기각되었다. 결 론: 고주파 온열암 치료 시 환자가 느끼는 열감은 치료의 중단을 가져올 수도 있는 중요한 인자로서 배꼽과 같은 요철부위에 보상체를 사용 시 열감을 줄일 수 있었다. 보상체는 개인마다 요철의 모양이 다르기 때문에 맞춤제작이 가능한 레진이 유리하며, 온도를 낮출 뿐 아니라 환자가 느끼는 열감 또한 상당히 감소하는 것으로 나타났다. 추후 열전달 모델의 개발이 가능하다면 치료 시 나타나는 열감을 줄이며 보다 정확하고 편안한 치료를 제공 할 수 있을 것으로 사료된다.

• 한국방사선학회논문지
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• 제13권5호
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• pp.691-698
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• 2019

건강증진센터를 방문한 환자를 대상으로 CT 지방측정 위치에 따른 내장지방 면적과 Inbody로 측정한 내장지방 면적의 차이를 비교하여 보았다. CT 지방측정에서 L4-5와 CT Umbilicus 위치에서 측정한 내장지방 면적은 남 여 성별에 다른 차이는 없었다. 또한, CT 지방측정 위치에 따른 내장지방 면적과 Inbody로 측정한 내장지방 면적과의 상관관계에서 CT 내장지방 면적과 Inbody로 측정한 내장지방 면적 간의 차이가 없었다. CT 내장지방 측정 위치는 남자 L4-5, L5-S1 위치, 여자 L3-4, L4-5, L5-S1, Umbilicus 위치에서 높은 상관관계를 보였다. Inbody 내장지방 면적과 CT 내장지방 면적 관계 간의 연구를 할 때 CT L4-5 위치의 내장지방 면적과 비교하는 것을 제안한다.