Biomedical subjects

Kyung Suck Koh

Publications and source records attributed to Kyung Suck Koh.

5 recordsLinked to original sources

PubMed2005

Unilateral complete cleft lip repair: orthotopic positioning of skin flaps.

The ideally repaired cleft lip should provide a symmetrical Cupid's bow, philtrum, and minimal scar. In the appearance of the upper lip, the philtrum plays a key role. The most popular method for unilateral cleft lip repair is the rotation-advancement technique introduced by Millard. This technique requires the rotation of the noncleft side flap in unilateral cleft lip. As the vertical discrepancy between the peaks of Cupid's bow is increased, the scarring becomes more evident. Also, where it crosses the philtral column in the oblique extension of the upper lip, it becomes apparent for the eye to notice. Thus, many surgeons have tried to modify this technique to improve the symmetry of the philtral columns. The philtral dimple is composed of centrally located thin dense subcutaneous tissue bordered by thick loose subcutaneous tissue producing the philtral columns laterally. The aim of this surgical modification is to form a more natural looking philtrum using its original anatomical structure. The tissue defect after rotation of the noncleft side flap is filled with the C flap, not the advancement skin flap from the cleft side. The C flap helps to form the upper philtral column into a more straight appearance. The skin flaps of the cleft side and noncleft side are placed either side of the philtral column, and the skin flap from the columella is not used for the repair of the philtrum. Twenty-five patients with unilateral complete cleft lip were repaired using this technique from 1996 to 1999. Adequate alignment of the Cupid's bow and symmetric philtral appearance were obtainable.

Cleft Lip↗

PubMed2004

Ultrasound-assisted lipoplasty treatment for axillary bromidrosis: clinical experience of 375 cases.

Bromidrosis is a condition of abnormal offensive body odor caused mostly by apocrine gland secretion from the axilla. Although no morbid sequelae are known, the odor can be disturbing enough to cause social impairment and psychological distress. Medical care is available but is temporary and yields limited clinical benefit. Surgical treatment may provide a more definite remedy through reduction of the apocrine gland. However, there are risks for complication following surgical treatment such as subdermal excision, subcutaneous shaving, en bloc excision, and liposuction. The search for a less invasive but still effective procedure has led the authors to use ultrasound-assisted liposuction, which has reduced the risk of complication and recurrence. The purpose of this article was to evaluate the long-term outcome of ultrasound-assisted liposuction for the treatment of bromidrosis. From August 1998 to September 2002, 375 consecutive patients underwent ultrasound-assisted liposuction for bromidrosis of the axilla. The average age of the patients was 25.7 years (range, 15 to 55 years) and the average follow-up period was 18.8 months (range, 7 to 56 months). Subjective complaints of recurrences were noted in 22 patients (5.9 percent) and secondary ultrasound-assisted liposuction was performed, resulting in no further complaints. Complications other than recurrences were mild skin sloughing (3.2 percent), hematoma (1.3 percent), subcutaneous band (0.3 percent), and hypesthesia of the hand (0.3 percent), all of which healed spontaneously. Through a questionnaire that was answered by 264 patients, a subjective satisfaction rate was measured. Among the completed questionnaires, 91.7 percent reported satisfactory reduction of odor. Ultrasound-assisted liposuction to treat bromidrosis of the axilla provides advantages such as rapid recovery, less restriction of movement, unnoticeable scars, and a low rate of recurrence. The long-term outcome supports the benefits of this procedure. The authors recommend the use of ultrasound-assisted liposuction as first-line treatment for bromidrosis of the axilla.

Adolescent↗

PubMed2004

Treatment of nonsyndromic bilateral coronal synostosis using a multiple bone flap rotation-reposition technique.

Brachycephaly is the result of premature fusion of the bilateral coronal suture. Various surgical procedures have been devised to manage brachycephaly, but there is no standard surgical method in brachycephalic treatment. Suboptimal results may be related to the tendency of misdirected bone growth of the remaining cranium in brachycephaly. Therefore, the abnormal growth vectors should be corrected toward a more normal configuration. Between 1997 and 2001, three nonsyndromic brachycephalic patients were treated using the described procedure. The cranial remodeling procedure used consists of supraorbital bar advancement and the rotation-reposition of multiple frontoparietal bone flaps. The frontoparietal bone was cut into seven segments consisting of two upper frontal, two lower frontal, one anterior parietal (T-shaped), and two posterior parietal segments. Each lower frontal segment was rotated 180 degrees and transposed with the corresponding contralateral upper frontal segment. Each upper frontal segment was then transposed to the upper margin of the supraorbital bar. The posterior margin of the frontal segment was not fixed (floating forehead). Anterior parietal and two posterior parietal segments were trimmed and repositioned to the original position. The postoperative follow-up period ranged from 17 to 52 months (mean = 30 months). The cranial configuration obtained after the operation was considerably improved, approaching a normal shape in all cases. The mean length of frontal advancement was 11 mm (range: 7-15 mm). The preoperative mean value of the cephalic index was markedly raised to 104.7 (range: 100-111). The postoperative (at last follow-up) mean value of the cephalic index was 89.2 (range: 86.3-94.3). A better skull contour could be obtained easily by converting abnormally directed long upward and transverse dimensions to short anteroposteriorly directed dimensions. Cranial remodeling using repositioned multiple bone flaps can produce excellent results functionally and esthetically in brachycephaly.

Cephalometry↗

PubMed2002

Modified right liver graft from a living donor to prevent congestion.

BACKGROUND: Right liver grafts without middle hepatic vein (MHV) drainage reconstruction resulted in severe congestion of the anterior segment (AS) in our early experience of adult-to-adult living donor liver transplantation (LDLT). However, a detailed strategy for preventing such congestion or the necessity of MHV reconstruction has not been discussed in LDLT using a right lobe graft. METHODS: From July 1997 to February 1998, two of five right lobe grafts without MHV drainage reconstruction were complicated with severe congestion of the AS. Thereafter, 42 adult recipients who received right liver grafts with sizable MHV tributaries underwent the reconstruction of MHV drainage. All sizable (>5 mm in diameter) MHV tributaries were preserved during donor hepatectomy and were reconstructed with the recipient's autogenous interposition vein grafts at the bench surgery. The reconstructed vein grafts of this modified right lobe graft were anastomosed to the stump of the MHV and/or left hepatic vein of the recipient after graft revascularization. RESULTS: Serial Doppler ultrasonography, which was regularly checked until 30 days posttransplant, revealed the patent interposition vein graft in 38 of 42 recipients (patency rate 90.5%). In these 38 recipients, no evidence of congestion in the AS was recognized on enhanced computed tomography, while providing enough functioning liver mass comparable to an extended right lobe graft. Also, congestion-related graft injury, such as an infarct of the AS, was not observed in these recipients. CONCLUSIONS: Our early experience indicated the necessity of MHV drainage reconstruction in right lobe grafts, which do not have MHV trunk in certain instances. However, preoperatively, it is difficult to predict the degree of AS congestion of the right liver graft without MHV drainage reconstruction. We suggest aggressive reconstruction of MHV drainage tributaries of the AS, under the circumstances that sizable MHV tributaries are encountered, to prevent possible congestion-related complications.

Adolescent↗

PubMedDate not supplied

Columellar lengthening using the interdigitation of triangular flaps.

The most common and striking feature of the bilateral cleft lip nose deformities is a short columella. This problem can be resolved by lengthening the columella. In this article the authors lengthen the columella using the interdigitation of triangular flaps in the upper lip tissue. The columellar elongation is made by an advancement of nostril tissue and an interdigitation of the triangular flaps. Our method shows good aesthetic results. The triangular flaps that are intersected without excision make the columellar base pyramidal and medially directs the alar bases, narrowing the width of the nostril sills. Though the optimal columellar lengthening procedure can vary according to the deformed anatomy of the nose and lip, this method deserves to be considered especially in patients who have sufficient tissue in their nostril sills.

Child, Preschool↗