Reduction Clitoroplasty with Preservation of the Dorsal Neurovascular Pedicle in a 6-Year-Old Female: A Case Report

박효천,김원우,김훈남,예현정 대한미용성형외과학회 2016 Archives of Aesthetic Plastic Surgery Vol.22 No.2

A 6-year-old female presented to our hospital with clitoromegaly. On physical examination, she demonstrated evidence of precocious pubic hair and clitoromegaly. The relaxed clitoris measured 3.7 cm in length. Her uterus was undetectable on diagnostic transvaginal ultrasonography and abdomen-pelvis computed tomography (CT) with otherwise normal-appearing internal female genitalia. We planned reduction clitoroplasty with preservation of the dorsal neurovascular pedicle to maintain sensitivity of the glans clitoris. After surgery, the patient demonstrated good recovery. The parents of the patient were satisfied with the surgical results. The patient was discharged without complications on hospital day 6.

Sleeve technique을 이용한 미세혈관 문합술의 실험적 연구

박효천,백봉수 慶北大學校 醫科大學 1983 慶北醫大誌 Vol.25 No.1

Replantation or transplantation of composite tissues using microsurgical technique have been fairly common for plastic surgeons and the development of free flaps based on microvascular surgery has reduced the number of operations, days of hospitalization and total expenses. In spite of many advantages of microsurgery it still entails certain disadvantages. It is time consuming and moreover technically difficult to achieve. Therefore simplification of the anastmosing procedures of microvessels has been a desirable goal. In 1978, Lauritzen developed a new anastomosing technique which he called "Sleeve Anastomosis". The new anastomosis is performed by inserting one vessel into the other using two extraluminal sutures and is easier to perform, time saving and equally reliable as the conventional and to end anastomosis. Before clinical use of the microvascular sleeve anastomosis, an animal study was carried out and the results was very attractive.

Partial Breast Reconstruction Using Various Oncoplastic Techniques for Centrally Located Breast Cancer

박효천,김홍열,김민철,이정우,정호윤,조병채,박호용,양정덕 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5

Background: As the breast cancer incidence has increased, breast-conserving surgery hasreplaced total mastectomy as the predominant procedure. However, centrally located breastcancers pose significant challenges to successful breast-conserving surgeries. Therefore, weperformed partial mastectomy and oncoplastic procedures on centrally located breast canceras a means of partial breast reconstruction. The authors examined and evaluated thefunctional and aesthetic usefulness of this reconstruction method. Methods: From January 2007 to June 2011, 35 patients with centrally located breast cancerswho underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques suchas purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic proceduresincluded volume replacement procedures with an adipofascial, thoracoepigastric, intercostalartery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results: Mean patient age was 49 years, and mean follow-up period was 11 months. In cases ofsmall to moderate-sized breasts and resection volumes <50 g, volume displacement procedureswere performed. In cases of resection volumes >50 g, volume replacement procedures wereperformed. In cases of larger breasts and smaller resection volumes, glandular reshaping wasperformed. Finally, in cases of larger breasts and larger resection volumes, reductionmammaplasty was performed. This reconstruction method also elicits a high patient satisfactionrate with no significant complications. Conclusions: In centrally located breast cancer, oncoplastic surgery considering breast sizeand resection volume is safe and provides appropriate aesthetic outcomes. Therefore, ourmethod is advisable for breast cancer patients who elect to conserve their breasts and retain anatural breast shape.

Cutaneous Horn in Premalignant and Malignant Conditions

박효천,김원우,김훈남,여현정 대한두개안면성형외과학회 2016 Archives of Craniofacial Surgery Vol.17 No.1

Cutaneous horns are conical, circumscribed protuberances formed by densely layered keratin. These lesions originate from basal keratinocytes and may manifest as benign, premalignant, or malignant cutaneous pathology in chronically sun-damaged areas. Complete surgical excision with histologic examination is needed for potential malignancy. In this report, we describe two elderly women presenting with solitary facial cutaneous horns, which were respectively diagnosed as actinic keratosis and squamous cell carcinoma.

A Giant Keratoacanthoma Treated with Surgical Excision

박효천,박한나라,김훈남,여현정 대한두개안면성형외과학회 2015 Archives of Craniofacial Surgery Vol.16 No.2

A keratoacanthoma is a rapidly growing cutaneous tumor that spontaneously involutes in most instances. A giant keratoacanthoma is a rare variant and are characterized by lesions larger than 20 mm in diameter. We report a 56-year-old man with a rapidly growing tumor of the right cheek, which was diagnosed as keratoacanthoma. The mass was excised completely under general anesthesia, followed by Limberg flap for reconstruction. Intraoperative frozen section histology suggested the lesion to be a well-differentiated squamous cell carcinoma, whereas final histopathology was consistent with keratoacanthoma. We herein report the first case of a giant keratoacanthoma treated with surgical excision in Korea and discuss the clinical and histopathological features of keratoacanthoma, with a review of the literature.

안검하수의 치료

안기영,백봉수,박효천 大韓成形外科學會 1985 Archives of Plastic Surgery Vol.12 No.1

The aim of this thesis is to study 20 cases of blepharoptosis who were followed-up among many patients who received ptosis surgery at Kyungpook National University Hospital from Jan. 1980 to April 1984. To obtain the best surgical results in blepharoptosis, it was necessary to select the appropriate operation form each case according to levator function, the amount of ptosis, its etiology, as well as other factors. In cases of 4.1mm or more levator function, the author attempted to resect the levator muscle, but in cases of between 3mm and 4mm, the combination of levator muscle resection and frontalis sling was selected. On the other hand, in cases of 3mm or less levator function the fontalis sling was selected combined with fascia lata. The results were as follows; 1. The ratio of congenital versus acquired ptosis was 17 : 3. 2. Among 17 cases of congenital ptosis, male versus female was 11 : 6, and monocular versus bi-ocular was 9 : 8. Among 9 cases of congenital monocular ptosis, Lt. versus Rt. eye incidence was 5 : 4. 3. Among 3 cases of acquired ptosis, the causes were traumatic, neurofibromatosis, and birth injury respectively in each separate case. 4. In 5 of the congenital cases, blepharophimosis was combined, and in 4 strabismus was observed. 5. In the amount of ptosis, 7 cased were belew 2mm, 3 cases between 2.1∼4,9mm, and 10 cases above 5mm. In the measurement of the lavator muscle function, 7 cases were belew 3.0mm, 2 cases between 3.1∼4mm, and 11 cases above 4.1mm. 6. The best results were obtained by the levator muscle resection: Which was done for the patients with more than 4.1mm of levator muscle function. Good to excellent results were obtained in 8 cases among 10 cases. 7. The combination of levator muscle resection and frontalis sling was done for the patients with levator muscle function of 3.1mm∼4mm, and gave poor results. 8. Undercorrection and lid fold deformity were the most common types, except for lid lag and lagophthalmos in sleeping.

自家 助軟骨을 利用한 先天性 小耳症의 再建

金仁圭,白鳳壽,朴曉天 大韓成形外科學會 1984 Archives of Plastic Surgery Vol.11 No.1

Microtia is the auricular hypoplasia exceeding the usual cupping deformity and it varies from a structure in which the main auricular components are recognized by a small vertical ridge to formless except for the lobular compartment. One may find an associated atresia of the external auditory caual, maldevelopment of the middle ear, first and second branchial arch syndrome, hypoplasia of the maxilla and mandible, and cleft lip and palate. Those patients who have a hearing disturbance can be devastated not only from the functional but from the psychological stand point. The reconstruction of the auricle is difficult and a challenging field for plastic surgeons. Seven cases of microtia were reconstructed with frameworks made from autogenous rib cartilage and the results are as follows: 1. Six cases were reconstruced in three or four stage and one case in one stage. 2. All cases were male and unilateral on the right in four cases. The age distribution was from six to forty seven years. 3. There was no significant differences in length, width, inclination, altitude or distance between the reconstructed and normal ears. 4. Four of seven cases were combined with one, or more than one of the following anomalis a preauricular pit, an auricular appendage, a prominent ear, hypoplasia of mandible and maxilla, epicanthus and a cleft palate. 5. There was no postoperative complication, except two cases of hypertrophic scaron the chest donor site. 6. The one-stage operation seemed to be a time-reducing, fascinating procedure but reported cases were few, and the follow up period was too short to evaluate it.

先天性 眼瞼 缺損의 治療

朴曉天,朴興吉,金大河,吳錫俊,李世一 大韓成形外科學會 1979 Archives of Plastic Surgery Vol.6 No.2

Coloboma, or a congenital notch in the lid margin of eyelid, is a triangular gap with rolled edges which is without lashes or glands. It is usually unilateral and the most common site is at the junction of the inner and middle thirds of the upper lid. Associated congenital anomalies of the eye, lid and face esp. benign dermoid are common. Exposure keratopathy usually becomes a problem when approximately 30% or more of the lid is absent. With larger upper lid colobomas the cornea may become inadvertently traumatized and ulceration with scarring is not uncommon in these cases where exposure keratopathy develops. The optimal time for surgery is when general anesthesia is no longer a serious risk. There are many methods to treat eyelid defect. Reconstruction of an eyelid or even part of it requires a minimum of three elements; an outer layer of skin; an inner layer of mucosa; and a semi-rigid skeleton interposed between them. The upper lid is the most difficult to reconstruct as it must be movable. Authors report two cases of coloboma. One is situated on the inner half of the upper lid and the other on bilateral upper eyelids. The patients were treated by Abbe full thickness flap of lower eyelid with good result.

Cleft Lip Nose의 矯正

朴曉天,李世一,吳錫俊 大韓成形外科學會 1980 Archives of Plastic Surgery Vol.7 No.2

Nasal deformity remains a major problem for the patient with repaired cleft lip.Despite the incorporation of nasal repair techniques into some methods for primary cleft lip repair,the need for secondary nasal revision remains.Numerous methods of rhinoplasty have been proposed for cleft lip nose deformity,and the list is growing ever year.This testified to the complexity of the problem,and to the necessity of further improving surgical techniques.No single procedure which has been developed to date has given sufficiently good results to provide a standard approach to the problem of the cleft lip nose deformity.The surgical approach dectated by the degee of deformity,so the plastic surgeon must be familiar with the wide range of available methods in order to choose the appropriate procedure for each individual patient's deformity. However,no matter how varied the deformities,as pointed out by Lindsay and Farkas the common denominator is the malposition of the nostril of the affected side.Therefore,a major goal is to make the nortrils symmetrical.To achieve this,an attempt is first made to correct the alar cartilage,which is the framework of the nostril.Next,the surgeon has to correct the position of the alar base (usually misplaced downnards and laterally),as well as that of the sunken nostril floor. Authors corrected four unilateral cleft lip nose deformities by suture fixation of the alar cartilage reverse-U incision of Tajima with good result.

前膊部 上皮樣肉腫의 治驗例

박효천,이세일,최춘곤 대한성형외과학회 1978 Archives of Plastic Surgery Vol.5 No.2

Epithelioid sarcoma is a peculiar form of sarcoma that has repeatedly been confused with a variey of beign and malignant diseases, especially a granulomatous process, a synovial sarcoma, or an ulcerating squamous cell carcinoma. The tumor occurs chiefly in young adults and adolescents and predominates in male. The soft tissues of the hand, the forearm, and the pretibial region are the most frequently affected sites. It tends to grow in a nodular or multinodular manner along fibrous structures such as tendons and fascia. Microscopically, the tumor consists of irregular nodular masses of large, deeply acidophilic polygonal or epithelioid cells merging with spindle cells. The tumor recurred in 85 percent of Enzingers cases and metastasized in 30 percent. Cure may be achived by wide local excision at early stage of disease. Authors report a case of epithelioid sarcoma on flexor surface of right forearm. The patient was 26 year old male. The nodular walunt sized tumor was widely excised and the defect was covered with medium split thickness skin graft from thigh.