微細血管吻合術을 利用한 大網의 遊離移植術

安相泰,仁豊 최신의학사 1983 最新醫學 Vol.26 No.4

연구개인두의 기능검사를 위한 내시경 및 측면활동투시법의 비교관찰

임풍,조문제,함기선,안상태 大韓成形外科學會 1982 Archives of Plastic Surgery Vol.9 No.1

In a quite large propotion of the repaired cleft palate patients, speech disturbance such as hypernasality and articulation defect are developed, most of which are caused by velopharyngeal incompetence. Though multiplicity of factors are involved in providing intelligible speech, complete, rapid, correctly timed reduction of velopharyngeal portal area is essential. In the patients with incompetence, information concerning the mechanism of attempted closure is vital to choosing appropriate therapy whether by secondary surgical procedures, prosthetic devices, or speech therapy. Because of the variability of velar and pharyngeal wall movement among this population, the importance of appreciating movement of the portal in three dimensions cannot be overemphasized. The most effective way of determining velopharyngeal function during phonation is direct and indirect visual assessment of the portal area. The authors have used fiberoptic nasopharyngeal endoscopy for transverse plane, and lateral pharyngeal cineradiography for sagittal plane in 31 patients with speech disturbance following palatoplasty. The findings are compared with each other and aerodynamic study. The results are as follows; 1) Although there was a some difference between the methods, about 30 per cent of 31 cases revealed velopharyngeal competence. 2) Among the cases showing velopharyngeal incompetence, 3 of 21 cases in lateral cineradiography and 6 of 24 cases in endoscopy were showed no nasal emission in aerodynamic study. 3) The findings of these three methods were not correlated intimately but about 50 percent of similarity was observed between them.

표피성장인자의 국소도포가 토끼 귀의 허혈창상 치유에 미치는 영향

임풍,위성신,이천희,안상태 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.5

Topical applications of epidermal growth factor (EGF) have been reported to be effective in the treatment of partial and full thickness skin wounds, second degree burns, incision wounds, and chronic ulcers. Because of lack of proper animal model, effects of EGF on ischemic ulcer wound healing have not yet been proven experimentally. The purpose of this experiment is a quantitative evaluation of the effect of topical EGF on ulcer wound healing in the modified rabbit ear ischemia model. Using 20 New Zealand white rabbits, both ears of 10 animals were made ischemic by ligating all major vessels supplying the ears. The ears of the remaining 10 animals served as normal ears. Two, 8mm diameter, full thickness ulcers were made on the ventral surface of each ear. In all the rabbits, ulcers of one ear were treated daily with gel containing 5㎍ of EGF and those of another ear were treated with the same amount of EGF-free gel. Blood flow was measured by hydrogen clearance technique in all the ears at the 3rd and 7th postwounding day. Vascularities were visualized by microfil technique in the normal and ischemic ears of 4 additional animals at the 3rd and 7th postwounding day. At the 7th postwounding day. tissue containing the ulcer wound was harvested and flexed in 10% formalin. Histologic section cross the center of the wound was stained with Masson's trichrome stain. The diameter of wound gap was measured by using calibrated lens micrometer and the areas of the new epithelium and granulation tissue were measured by using image analyzing system. The results were as follows; 1. Throughout the experimental period. blood flow was decreased markedly in the ischemlc ears compared to that in the normal ears. 2. Wound diameter was increased and the amount of new epithelium and granulation tissue were markedly decreased in the ischemic ears compared to those in the normal ears. 3. In the normal ears, the amount of new epithelium and granulation tissue were markedly increased in the EGF treated ulcers compared to those In the control ulcers. 4. In the ischemic ears, wound gap was decreased and the amount of new epithelium and granulation tissue were increased significantly in the EGF treated ulcers compared to those in the control ulcers. Summarizing these results, daily applications of EGF facilitate wound healing in ischemic ulcer as well as in normal ulcer and result in effective functional repair by increase in thickness of new epithelium and granulation tissue rather than epithelial migration in one layer.

게재불가

안상태,황건 大韓成形外科學會 2002 Archives of Plastic Surgery Vol.29 No.2

재관류 손상에서 조직 및 혈장의 인터루킨-8 농도에 미치는 CD18 단세포군항체의 역할

강낙헌,김선옥,김재덕,양성열,안상태 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.2

It remains a problem that successful revascularization and reperfusion after ischemia are associated with high systemic complication rates and severe local tissue injuries. With prolonged ischemia, there is damage to tissue from anoxia, but further injury may occur after reperfusion. The activation of leukocytes and endothelial cells during reperfusion causes neutrophil adhesion in capillaries, resulting in plugging and further ischemia, Alternativety, neutrophil adhesion to endothelium leads to the migration of neutrophil with local edema formation, hemorrhage and thrombosis. Some chemotactic and activating factors are needed to propel neutrophils to the site of local inflammation. The chief cytikines that induce a pro-adhesive state in endothelium are tumor necrosis factor-α(TNF-α), interleukin-1 β(IL-1 β) and endotoxin or lipopolysaccharide(LPS). Similarly, TNF- α,and to a lesser extent interleukin-8(IL-8), is the important stimulus that acts on neutrophils and other leukocytes to alter their adhesion. The purpose of this study was to evaluate the pathogenetic role of IL-8 after perfusion with CDl8 monoclonal antibody(CDl8 mAb), the blocking antibody of neutrophil adherence, on reperfusion injury in rat epigastric island skin flap. A 6 ×3 cm-sized island skin flap was made on the abdomen. The epigastric pedicle was occluded for six hours with ambient temperature. Fifteen minutes before reperfusion, the flap was perfused with saline and CDl8 mAb(1 mg/kg). For evaluation of IL-8 levels, tissue fluid and serum were obtained at 4, 8, 12 and 24 hours after reperfusion. IL-8 concentrations of the CDl8 mAb group in the tissue fluid were significantly decreased at 8, 12 and 24 hours compared to the control group(P < 0.01), but the difference between the two groups was not significant at 4 hours after reperfusion IL-8 concentrations of the CDl8 mAb group in the serum were significantly decreased over time compared to the control group(P < 0.05, p < 0.01). Form the above results, we concluded that blocking neutrophil adherence using CD18 mAb within the peak level of IL-8 at 4 hours after reperfusion may be a better method of reducing reperfusion injury to the island skin flap.

표피성장인자 연고의 국소도포가 당뇨 흰쥐의 피판 생존에 미치는 영향

임풍,조성필,손주영,안상태 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.6

The topical application of epidermal growth factor (EGF) has been reported to be effective in the treatment of partial and full thickness skin wounds, second degree burns, incision wounds, and chronic ulcers. However, its effect on skin flap survival in diabetic patients has not yet been defined. The purpose of this experiment was to study whether EGF has a beneficial effect on the survival of distal skin flaps with impending necrosis in diabetic rats. 2×7cm sized skin flaps, which were insulated from their recipient bed, were made on the dorsum of 20 normal and 20 streptozotocin-induced diabetic rats. Half the animals in each group were treated with EGF ointment(10μg/g), and the other half were treated with ointment base only as control groups. Ointment was applied twice a day for five days. On the fifth postoperative day, the surviving flap area was measured using an image analysis system and histological changes were observed from the distal end of the surviving flap. The surviving areas(5.18±1.00cm2) of the diabetic control flaps were significantly decreased compared to those (7.83±1.67cm2) of the nomal control flaps. A significant enhancement of skin flap survival was observed in normal (8.42±0.14cm2) and diabetic (7.21±1.58cm2) rats after topical application of EGF. Flap survivial in EGF treated diabetic rats was approximately the same as that in normal control rats. Thick epidermis, prominent skin appendages, increased capillaries and fibroblasts, and linear organization of collagen fibers were obsered in EGF treated flaps.

Augmentation of a Thin Lip by Using a Deepithelialized Orbicularis Oris Myocutaneous Flap : A Case Report

안상태,이재웅,함기선 대한성형외과학회 1980 Archives of Plastic Surgery Vol.7 No.2

피막확장운동이 실리콘주머니 주위피막의 미세구조에 미치는 영향

안상태 가톨릭대학 (가톨릭신학대학) 대학원 1985 가톨릭大學醫學部 論文集 Vol.38 No.4

모의실험을 통한 피스톤 슬랩 충돌 가진력 해석 ( Analysis on Piston Slap Impact Force by Simulation )

안상태,김양한,이동수 대한기계학회 1998 대한기계학회 춘추학술대회 Vol.- No.-

성인의 천미추부 종괴

조길환,이백권,장도명,김영진,안상태 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3

We developed an animal model to recreate the condition of an open fracture in communication with the maxillary sinus. We then studied wound healing of the sinus wall structures following fracture in the presence of autogenous bone and alloplastic implant. This model is designed to simulate the repair of an orbital floor fracture in humans. The New Zealand White rabbit was used as the animal model. Standardized 8mm defects were made bilaterally in the maxillary sinuses to include bone and mucosa in 36 rabbits. Two different implants and autogenous calvarial bone graft were placed in the soft-tissue pockets to obturate the defects, exposing one surface of the implant to the open sinus. Medpor porous polyethylene, silicone and calvarial bone implant were compared. Animals were killed at 1, 2 and 8 weeks after implantation. Gross examination of the specimens for the amount of mucosal closure and implant tissue fixation was performed. Histological sections were evaluated for bone and soft-tissue morphology juxtaposed to the implant. Complete closure of the mucosal defect was demonstrated with each type of implant. Medpor implants showed both vascular and soft-tissue ingrowth into pores by week 1. Bone ingrowth was seen by week 2. Closure of the Medpor obturated defects occurred more rapidly than in the silicone group. The Medpor implants and calvarial bone demonstrated bone and soft-tissue fixation, callus formation and maturation, while mature overlying mucosa was reconstituted over the defects. Silicone implants demonstrated a fibrous tissue reaction within 1 week of implantation and they never became fixed to bone or soft tissue. Maxillary sinus wall regeneration occurred in all defects. This study supports clinical observations of maxillary sinus wall regeneration in humans. Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.