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안덕선,한재식 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.2
The zygomatic region is the one of the important aesthetic sight in establishing the oval contour of the face. The purpose of this study is to evaluate the degree of malar prominence by measuring axial and vertical angle of zygoma and zygomatic arch. The author has measured and studied the 50 Korean human skulls composed of both sexes and 100 zygomatic arch X-ray views taken from those patients who had admitted for the evaluation of the facial injury and whose age was ranged from 20 to 63 years. The measurement by goniometer has been by the author exclusively. The results were as follows ①axial and vertical angle of zygoma measured from skull were 113.2˚±4.5˚and 159.6˚±12.1˚②axial angle of zygomatic arch also measured from the skull was 147.2˚±6.8˚③axial angle of zygoma measured from X-ray view were 126.8˚±7.1˚ in men and 123.5˚±8.2˚in women ④inclination angle of zygoma measured from X-ray view were 13.8˚±5.4˚ in men and 13.6˚±6.1˚in women in the shape of zygoma. And the flat form was more common than that of convex form. This study would provide the useful guideline for plastic surgery by presenting the fundamental normative data of degree of malar prominence.
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안덕선,한승규,구상환,한재식 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.5
This retrospective study includes consecutive 54 Blow-out fractures patients to whom underwent surgical correction (June 1988-Feb 1994) and 25 patients have been followed up for more than 1 year. The diagnoses of blow out fracture was made through a physical examination, X-ray, and CT and It is confirmed at the time of surgery. Initial physical examination revealed limitation of ocular motion and diplopia in all 25 patients, and infraorbial nerve hypoestesia in 18 patients, and enophthalmos in 1 patient. There were 27 patients who had associated ocular injury including subconjunctival hemorrhage, angle recession and iris sphincter damage. and the three most common causes of blow-out fractures were traffic accident, fist blow and fall down. The latent period between injury and surgical intervention was average of 8 days and the longest time was 12 days. Surgical approach was done by subciliary incision and autogenous (10 cases) or synthetic (37 cases) implant was inserted over the fracture site in 47 patients. The floor and medial wall of orbit were the frequent site of blow-out fracture in this retrospective study. Among 28 patients who have been followed up for more than 1 year, 3 patients had diplopia persistently which developed only when the patient was tired, and 5 patients had late developed enophthalmos. We found that early surgical reduction of blow-out fracture with implant gave a favorable results without any significant complications.
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가토에서 강화된 신생혈관을 가진 이차적 근-피부피판에 대한 실험적 연구
한재식,김우경,김영조,이병일,한승규 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.2
There are occasions when standard techniques of reconstructive surgery for traumatic injury, tumor resection, and correction of congenital anomalies cannot be used as a result of the unavailability of tissues, absence of healthy vascular pedicle or excessive morbidity in donor area. It is established that autogenous skin, muscle, bone, and other composite tissue can retain their viability in varying degree as a prefabricated `flap with vascular pedicle implantation and the survival rate of these flaps has increased with tissue expansion or PGE₁ infusion. The purpose of this study was to demonstrate the reliability of the secondary or prefabricated rectus abdominis musculocutaneous flap, and to evaluate the effect of the several factors on the survival routes of these flaps. Fifty New Zealand white rabbits weighing from 250 to 350 gm were used for the study. On the abdominal area bipedicled skin flaps are elevated as a random pattern flaps and were prefabricated using with rectus muscle. The fifty flaps were studied. They were divided into the five groups as follows; group I, 10 ×4 cm classic axial pattern transverse rectus abdominis muscle (TRAM ) flaps were made as a control group (n = 10); groupⅡ, 10 ×4 cm random pattern bipedicled skin flaps were prefabricated using right rectus muscle with the delay procedure(n = 10); group III, 5 ×4 cm prefabricated musculocutaneous flap were made same as group II on the right, side, tissue expansion was performed on the left side (n = 10); group IV, same procedure was performed as group II, and in addition postoperative intravenous infusion of PGE?? was given(n = 10); group V, same procedure was performed as group III, and in addition postoperative intravenous infusion of PGE₁ and tissue expansion was performed(n = 10). Flap survival rates of each group were evaluated and compared. The following results were obtained: 1. Survival rates of prefabricated flaps were lower than that of classic axial pattern flaps regardless of using tissue expansion and PGE₁ infusion(p < 0.05). 2. In making a comparison between flap with and without PGE₁ infusion, survival rates of prefabricated flaps infused with PGE₁ were higher than that of flaps without PGE₁ infusion. 3. The prefabricated flaps managed with tissue expansion had higher survival rates than that of flaps without using tissue expansion. 4. The survival rates of prefabricated flaps managed in combination with tissue expansion and PGE₁ infusion were significantly higher than that of other groups except control group. In conclusion, this study demonstrated the significance of combiring use of tissue expansion and PGE₁ infusion in a prefabricated musculocutaneous flaps as a reliable method.
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Mayer-Rokitansky-Kuster-Hauser 증후군 환자에서 전층 피부 이식술을 이용한 질성형술 치험례
한재식,이종문,정원균 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5
Mayer-Rokitansky-Kuster-Hauser Syndrom is characterized by the absence of the vagina and the uterus, the presence of apparently normal tubes and ovaries, feminine appearance, normal female secondary sexual characteristics, a normal 46, XX karyotypes, and a feminine psychosexual orientation. Absence of the vagina results from an embryological arrest in the development of the lower portion of the Mullerian system. Various methods of surgical treatment for the vaginal absence in this syndrom have been introduced but the ideal method to restore the original dimension and function of the normal vagina was not found. The two cases reviewed in this paper were all treated with modified McIndoe operation using full thickness skin grafts. Postoperatively both women were satisfied without complications, i,e. lack of skin graft, bleeding, urethrovaginal fistula, perforation of the rectum, rectovaginal fistula and significant vaginal stricture. This paper reveals the satisfactory results that were uniformly good.
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