Gynecomastia의 성형외과적 교정예

함기선(Ki Sun Ham),임풍(Poong Lim),빈주원(Joo Won, Bin) 대한외과학회 1974 Annals of Surgical Treatment and Research Vol.16 No.8

口蓋破裂 患者에 對한 言語障碍 調査

咸基善(Ki Sun Ham),林豊(Poong Lim),賓注源(Joo Won Bin) 대한외과학회 1975 Annals of Surgical Treatment and Research Vol.17 No.7

건의 치유

정상훈,임풍 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

All hand surgeons recognize that peripheral adhesions are frequently associated with the tendon healing process. Although these adhesions have been considered an essential_coures of tendon healing, the frequent incidence of poor digital function follwing tendon repair has been more perplexing and frustrating to the hand surgeon. But it has stimulated a new interest in determining the factors associated with the formation of tendon adhesion, and so a tremendous amount of research has been carried out in the areas of tendon healing, nutrition, biomechanics, and the pathophysiology of tendon adhesions. Recent studies on the intrinsic, healing capacity of the tendon suggest that adhesions may constitute a nonessential inflammatory response at the site of injure and important clinical advancements have been made in suture techniques, sheath preservation or reconstruction, and the postoperative mobilization of repaired tendons. The surgical repair of injured tendons and the attempts by the surgeons to control and alter the formation of adhesions by mechanical, biochemical, and biophysical technique are based on such an understanding of the mechanism of tendon healing. This paper reviews briefly the contributions of prominent researchers in the field of tendon healing in a comprehensive series of essays reporting the current concepts in the management of these difficult injuries.

당뇨토끼의 도서형 피판의 재혈관화에 pentoxityline이 미치는 영향

안상태,이광철,김동진,우장호,정경설,임풍 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.7

The rate at which neovascular blood supply achieves the capability of sustaining survival of the flap, independent of the original vascular supply, has been extensively investigated. However, the exact time and route of neovascularization remains debatable. Evidence emphasizing the importance of revascularization from the bed over that from the wound edges also remains confusing. Diabetes mellitus induces morphologic and functional changes within small blood vessels as well as within the cellular and acellular constituents of bloods ,giving rise to a hyperviscous and hypercoagulable state. Pentoxifyllline lowers blood viscosity effectively and therefore has a salutary effect on the movement of bloods especially within small vessels. This experiment was desinged to investigate the effects of pentoxifylline administration on the revascularization of island flap in alloxan-induced diabetic rabbits. Twenty rabbits were divided into 4 groups: normal group, normal-pentoxifylline treated group, diabetic group, diabetic-pentoxifyllne treated group. The diabetic was maintained under insulin regimens which controlled serum glucose levels between 200 and 300㎖/㎗. A 10㎎/㎏ of pentoxifylline was administered intraperitoneally twice a day throughout the experimental period. A 3×4㎝ sized island flap including perichondrium was elevated from the dorsum of rabbit ear 4 weeks after induction of diabetes. The vascular pedicle of the flap was ligated 5 days after the flap elevation. The eryhrocyte deformability, the survival area and vascular network of the flap were examined 7 days after the pedicle ligation.The tissue oxygen pressure was measured at the center of the flap before and after the flap elevation and pedicle ligation. The results were as follows; 1.The flap survival of diabetic rabbit was decreased significantly compared with that of rabbit and increased significantly after pentoxifylline treatment(p<0.05). 2.The tissue oxygen pressure (PtiO₂) after flap elevation and after pedicle ligation were decreased significantly compared with that before flap elevation in all groups(p<0.05) 3. The erythrocyte deformability was decreased significantly in diabetic rabbit and increased significantly after pentoxifylline treatment in normal and diabetic rabbits(p>0.05) 4. In diabetic rabbit, the vascular network was scanty and revascularization was blocked by necrotic tissue around the flap margin. In pentoxifylline treated diabetic rabbit, fine vessels were increased and a few vascular connections at the flap margins and a few perforators from the ventral side were noticed. These results demonstrate that 1)reduced erythrocyte deformability caused by diabetes may reduce the revascularization of island flap.2)the revascularization from the flap margin was mainly affected by diabetes, 3)these can be restored by administration of pentoxifylline. On the basis of this experiment, we recommend the administration of pentoxifylline when anticipating microvacular free flap or island flap procedures in diabetic patients.

우측두부에 발생한 피지선암 1례 : CASE REPORT

최종우,한기택,임 풍 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.3

Sebaceous gland carcinoma on the scalp and face is an uncommon, local malignant appendageal tumor of the skin. It is characterized by a tendency of local recurrence and occasional metastasis. This tumor is infrequently diagnosed. A principal reason for this difficulty is the nonspecific clinical and gross pathologic appearance of the lesion. Usual clinical lesion of sebaceous gland carcinoma on the scalp and face is a firm, raised, nontender nodule which is pink to yellowish color in gross appearance. Histopathologically, sebaceous gland carcinoma shows the pleomorphic sebaceous cells which is charicterized by an irregular shaped louble, considerable variation in the shape and size of their nuclei, clear and foamy cytoplasm and frequent mitosis. We report a case of sebaceous gland carcinoma on the scalp and review it.

대퇴박근 근피판을 이용한 Fournier's gangrene치험례

이석기,이종원,이형주,임풍 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

Fournier's gangrene is a progressive tissue necrosis of scrotum, this disease commonly occured in alcoholics and diabetic patients. 60 year old patient shows toxic symptom and even sepsis, but the scrotal content is to be spared. The treatment of this disease is adequate debridement and administration of sensitive antibiotics. If the scrotal content is exposed, the defect can be covered with skin graft, local flap, etc. But, when the scrotum shows marked fibrosis or inflammation, myocutaneous flap is inevitable. We experienced one case of scrotal defect due to Fournier's gangrene, which was successfully covered with gracilis myocutaneous flap.

하악골에 발생한 Juvenile Active Ossifying Fibroma의 치험례

조문제,이종원,변준희,김경현,임풍 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.1

Juvenile active ossifying fibroma is a rare, benign, fibro-osseous tumor that is frequently found at the time of molar teeth development. In the case of a 5 year-old male described, the tumor was located from the sigmoid notch to the mental foramen of the left mandible. The surgical procedure of the enucleation with a Sonotec and of the rib bone graft was presented. The tumor is one form of fibro-osseous lesion of the mandible. We reviewed about the classification and differential diagnosis of the osseous fibr-osseous lesion of the mandible.

변성근이 흰쥐의 말초신경재생에 미치는 영향

정성한,이백권,정상훈,위성신,임풍 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.6

Injuries to peripheral nerves still present one of the most challenging surgical problems. Many efforts have been made to overcome this problem using end-to-end anastomosis or nerve graft where direct reapproximation is impossible. But a live nerve autograft has many disadvantages : donor site morbidities, the restricted quantities of the donor nerve, and the sacrifice of a functioning nerve. Therefore, in many instances substitutive grafts have been tried to replace the autogenous nerve graft. Many reports suggest that the results of these substitutes such as degenerated muscle graft and various tube grafts are as effective as a nerve graft. Those using degenerated muscle graft show empty basement, membrane tubes for the ingress of Schwann cells or growth factors released from the distal nerve stump. Many evidences exist to suggest the possibility that such growth factors can be released from skeletal muscle tissue and that they are effective in vivo. The purpose of this study is to investigate the role of degenerated skeletal muscle in rat peripheral nerve regeneration. Thirty male Wistar adult rats weighting between 20O and 250 gm were divided into three groups: 1) the fascial tube graft group(n=10), in which a 10mm length tube of fascia was grafted to a 10mm length of left sciatic nerve defect; 2) the degenerated muscle wrapped in its fascia graft group(n=10), in which a 10mm length of degenerated muscle being frozen and thawed was grafted coaxially to the same length of nerve defect; 3) minced degenerated muscle wrapped with its fascia graft group(n=10), in which a 10mm length of minced degenerated muscle being wrapped with its fascia was grafted to the same length of nerve defect. After 60days, the outcome was assessed through general evaluation, histology, and walking track analysis. The results were as follows. 1. The gross functional recovery, such as toe spread and dorsi flexion of ankle, was observed in 13% of the fascial tube graft group, 44% of the minced degenerated muscle and fascia graft group, and 63 % of the degenerated muscle and fascia graft group. 2. Sciatic functional index(SFI) of the fascial tube graft group was -88.3±2.4(12% recovery), minced degenerated muscle and fascia graft group -58.8±6.0(41% recovery), and degenerated muscle and fascia graft group -52.2±2.6(48% recovery). There were significant differences of sciatic functional index between each group(p<0.05). 3. The total number of myelinated axons infiltrated into the grafts : in the fascial tube graft group was 4060.1±267.5; minced degenerated muscle and fascia graft group 5039.4±268.7; and degenerated muscle and fascia graft group 5376.7±269.6. The total number of myelinated axone in the distal segment was 2248.2±164.4 for fascial tube graft group, 3293.7±282.4 for minced degenerated muscle and fascia graft group, and 3838.0±273.1 for degenerated muscle and fascia graft group. All values were significantly different between each group(p<0.05). Our results show that the minced degenerated muscle graft promotes much more axonal regeneration than the fascia tube graft, but less than the degenerated muscle graft. From this study, it is suggested that besides structural effect(empty basement membrane), some possible neuronotrophic factors can be released from degenerated skeletal muscle and stimulate peripheral nerve growth in vivo.

안저골절(Blowout Fracture)의 치험예

빈주원,함기선,임풍 大韓成形外科學會 1974 Archives of Plastic Surgery Vol.1 No.1

As physicians were have the obligation to restore the injured patient to the best possible condition from the stand point of appearance, function and return him to a useful and active life as soon as possible. Orbital fractures are increasing with the escalation in the number of automobile accidents and the automation in the industry. The proper treatment of blowout fractures of orbit is part of the working knowledge of the experienced plastic surgeon. Recognitions of the problems and early diagnosis have done much to prevent permanent disability and deformity. Surgical exploration reveals the typical blowout fracture of orbit through the thin portion of the orbital floor with intrapment of the inferior rectus muscle and fascial expansions. Surgical disengagement of the muscle and repair of the floor by a thin silastic sheet sucessfully relieved the patient's complaints such as diplopia and enophthalmos. Here, selective, proved workable method of repair of blowout fractures have been presented and illustrated.

Gynecomastia의 외과적 치료

함기선,조문제,빈주원,임풍 大韓成形外科學會 1975 Archives of Plastic Surgery Vol.2 No.1

Gynecomastia which is not uncommon in clinic implies a circumscribed, potentially reversible enlargement of the male breast which results from a combination of changes in the breast, including a nonencapsulated increase of connective tissue, proliferation of the ducts of the mammary gland, increased vascularity, and infiltration by chronic inflammatory cells. There is, however, no evidence that persistence of mammary tissue in the male can truly be considered a premalignant condition. Methods of treatment of gynecomastia that have been advocated are X-ray therapy, endocrine treatment and operation. Most observers believe that X-ray therapy offers no improvement of the condition and may be dangerous, and hormone treatment has been disappointing. Surgical removal of the enlarged breast tissue offers the most effective methods for the correction of the gynecomastia. In Department of Plastic Surgery in St. Mary's Hospital, Catholic Medical College, five cases of gynecomastia have been satisfactorily treated by simple surgery with preservation of the nipple and areolar tissues through the classical incision of periareolar line described originally by Webster. Authors report the five cases of gynecomastia in this paper and brief review of gynecomastia followed.