• Title/Summary/Keyword: 피부괴사

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Thumb Reconstruction with a Free Neurovascular Wrap-Around Flap from the Big Toe (족무지 유리 피부편을 이용한 수무지 재건)

  • Lee, Kwang-Suk;Chae, In-Jung;Hahn, Seung-Beom
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.72-80
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    • 1994
  • There are several methods to reconstruct an amputated or lost thumb such as toe to thumb transfer, pollicization and other variety of free flaps. In 1980, Morrison and O'Brien advocated reconstruction of the thumb with a free wrap-around flap from the big toe to recreate a stable, sensate and functional digit, including the nail. From March, 1982 to December, 1992, thirty cases of thumb reconstructions were performed using the wrap-around procedure at Korea University Hospital. 1. 29 cases of total 30 cases were successful and can be obtained the excellent results in functional and cosmetic aspect. 2. In postoperative complications, one case is graft failure, six cases in partial skin necrosis, one case in malunion, 15 cases in resorption of grafted bone piece were come out. 3. Even if the 1st metacarpal neck amputation is occurred, thumb reconstruction with a free neurovascular wrap-around flap was also possible, however, the limitation of the mobility of the reconstructed thumb and resorption of grafted bone piece were come out. We concluded that cosmesis and fuctional results were quite satisfactory despite of some complications. The thumb reconstruction with a wrap around free flap from the big toe in thumb amputated patients is the excellent method in the cosmetic and functional aspect and can be considered as the most useful method because of less morbidity to the donor site and the operator should be trained to get the meticulous microsurgical technique and to detect the complications.

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Stevens-Johnson Syndrome : A Case Report (스티븐 존슨 증후군 : 증례보고)

  • Song, Yongho;Lee, Nanyoung;Lee, Sangho;Jih, Myeongkwan;Lim, Yujin;Yoon, Youngmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.455-460
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    • 2017
  • Stevens-Johnson syndrome (SJS), an extremely severe acute hypersensitivity reaction, causes extensive necrosis on the skin and the mucous membrane. SJS is a disease of unknown cause that can occur in all age groups. It is thought to be caused by drug allergy or induced by bacterial infection. Epidermal surface invasion of less than 10 percent is called SJS, and invasion of more than 30 percent is called toxic epidermal necrolysis. Although it is rare with an incidence of 1 - 2 cases per million people per year, it has effects on tooth development and therefore on children who are in a growth phase. The purpose of this case report is to examine the effect of SJS on tooth development in children. In general, eruption of the upper and lower 1st molars and lower central incisors starts at 6 - 7 years of age. Root development also occurs at this time. In the case reported here, SJS occurred in a 6-year-old patient. Although the patient's SJS was completely cured, he still suffers from aftereffects. Developmental abnormalities in the patient's teeth were observed only in teeth for which root development had been completed at the time. The purpose of this case report is to illustrate how to diagnose such systemic diseases by intra-oral features and to recognize and resolve tooth development problems associated with the disease.

Histopathological changes in fingerlings of Japanese flounder, Paralichthys olivaceus, with severe scuticociliatosis (스쿠지카섬모충에 중감염된 넙치 (Paralichthys olivaceus) 치어에 대한 병리조직학적 관찰)

  • Lee, Nam-Sil;Park, Jeong-Hee;Han, Kyu-Sik;Huh, Min-Do
    • Journal of fish pathology
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    • v.7 no.2
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    • pp.151-160
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    • 1994
  • In order to elucidate the patterns of tissue damage evoked by the scuticociliatids, eighteen fingerlings of Japanese flounder, Paralichthys olivaceus, heavily infected with an unidentified scuticociliatid were histopathologically examined. Skin layer with the underlying musculature were severely necrotized due to the infestation of the ciliates. However in the early lesions, both dermis and myofibres remained relatively intact compared with other surrounding loose connective tissues. Mild damages were found in more dense tissues. One or more scuticociliatids were recognized in the blood and lymph vessels of the loose connective tissues with or without destructive changes. Many of nerve trunks or ganglia were also parasitized with less marked histological damage in the parenchyma. Dura and its adjacent tissues in the spinal cord were severely necrotized with massive accumulation of the ciliates in subdural space. The parasitic invasion in the central nervous system was usually confined to the cortical region. In the gill, variable degenerative changes were occurred due to the invasion of the ciliates recognized in the blood vessels of branchial arches or primary filaments. From these results, it was strongly suggested that the scuticociliatids are very actively penetrated into the deep tissues mainly through the severe destruction of the loose connective tissue components and that the vascular system could play a role in the rapid distribution of the ciliates to the remote tissues or organs.

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Esophageal Reconstruction for Hypopharyngeal Stricture After Severe Corrosive Injury (부식성 하인두 협착시 식도재건술)

  • 변정욱;구본일
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.48-54
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    • 1997
  • Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

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Biological characterization of Tenacibaculum maritimum isolated from cultured olive flounder in Korea and sensitivity against native plant extracts (한국의 양식넙치에서 분리한 Tenacibaculum maritimum의 특성과 자생식물 추출물에 대한 감수성)

  • Jang, Yeoung-Hwan;Jeong, Joon-Bum;Yeo, In-Kyu;Kim, Ki-Young;Harikrishnan, Ramasamy;Heo, Moon-Soo
    • Journal of fish pathology
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    • v.22 no.1
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    • pp.53-65
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    • 2009
  • Tenacibaculum maritimum (formerly Flexibacter maritimus) is the aetiological agent of an ulcerative and necrotic disease commonly called tenacibaculosis in marine fish. Tenacibaculosis is an economically important disease in a great variety species in Jeju Island cultured fish and leading to this pathogen initially affected by skin, mouth, fins, tail causing severe necrotic and ulcerative lesions on the body surface. In the present study, A-7 strain was isolated from Paralichthys olivaceus showing symptoms of tenacibaculosis and identified as T. maritimum by morphological, biochemical and molecular biological analysis. T. maritimum A-7 is experimentally infected through immersion route in Paralichthys olivaceus which the disease outbreaks in land-based fish tanks of Jeju Island. Up to data a number of treatments proposed for the tenacibaculosis outbreaks are based on the immersion administration of drugs in tank. Oxytetracycline is the most widely used disinfectants in fish farms. However, most of fish farms manager and consumers have expressed concern as bioaccumulation in tissue and its environmental. In addition, this antimicrobial compounds is expensive in fish farmers. The overcome of this problem is desired the application of natural plant derived products. To obtain as 70% EtOH extract antimicrobial compounds against tenacibaculosis from 35 species of Jeju Island native plants were screened for antimicrobial activity against T. maritimum. In the present study were identified most of the plant extracts were better antimicrobial activity against T. maritimum.

Simulation of the High Frequency Hyperthermia for Tumor Treatment (종양치료용 고주파 열치료 인체적용 시뮬레이션)

  • Lee, Kang-Yeon;Jung, Byung-Geun;Kim, Ji-won;Park, Jeong-Suk;Jeong, Byeong-Ho
    • Journal of the Korea Convergence Society
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    • v.9 no.3
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    • pp.257-263
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    • 2018
  • Hyperthermia supplies RF high-frequency energy above 1MHz to the tumor tissue through the electrodes. And the temperature of the tumor tissue is increased to $42^{\circ}C$ or more to cause thermal necrosis. A mathematical model can be derived a human body model for absorption and transmission of electromagnetic energy in the human model and It is possible to evaluate the distribution of temperature fields in biological tissues. In this paper, we build the human model based on the adult standard model of the geometric shape of the 3D model and use the FVM code. It is assumed that Joule heat is supplied to the anatomical model to simulate the magnetic field induced by the external electrode and the temperature distribution was analyzed for 0-1,200 seconds. As a result of the simulation, it was confirmed that the transferred energy progressively penetrates from the edge of the electrode to the pulmonary tumors and from the skin surface to the subcutaneous layer.

Reconstruction of the Lower Extremities with the Gracilis Muscle Flap (박근 유리조직을 이용한 하지 재건술)

  • Lee, Jun-Mo;Lee, Ju-Hong
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.62-67
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    • 1998
  • The gracilis muscle is well suited to small and medium-sized soft tissue defects that cannot be adequately handled by simple rotational flaps and it will conform well to irregular contours, can be split longitudinally at both ends to allow cavities and awkwardly shaped spaces and can be transferred in part or in whole. The gracilis muscle used as a free muscle or musculocutaneous flap is small with a long, narrow contour and its vascular pedicle is a terminal branch of the medial femoral circumflex artery and vein. The aims of soft tissue reconstruction are to cover soft tissue defects, to clear up infection and to prepare for further surgical procedures. Authors have performed 12 gracilis muscle flaps in the lower extremities at Chonbuk National University Hospital from June 1994 through March 1998. The results were as follows. 1. 11 cases of 12(91.7%) were sustained from the crushing injury and secondary complications from the traffic accident. 2. The microsurgical anastomosis of one artery and two veins have performed in 6 cases(50%) of 12 and 11(91.7%) cases of 12 were successful at the third postoperative week and in the final result. 3. Gracilis muscle flap is the infetion-resistant and aesthetically acceptable performed in the lower leg 1/3 and the foot.

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Chemical burns of the oral mucosa caused by Policresulen: report of a case (Policresulen 오용에 의한 구강 궤양의 발병 증례 및 화학화상에 대한 고찰)

  • Jung, Jung-Woo;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.109-114
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    • 2013
  • Chemical burn on the oral mucosa is caused by contact with various chemical products and manifests with localized mucositis, keratotic white lesions, bleeding, and painful tissue surface due to the coagulation of the tissue. Policresulen ($Albothyl^{(R)}$) is a topical antiseptic, commonly used over-the-counter drug for vaginitis, thrush and stomatitis. This drug is highly acidic with pH 0.6, and can act as a strong corrosive agent to oral mucosa. When inadvertently used in oral cavity, it may cause chemical burns of oral mucosa, resulting necrosis and bleeding surface resembling to erythema multifome. A 56 years old female patient presented with the chief complaints of painful ulcerations on the tongue, the upper and lower lips. On intraoral examination, an erythromatous, erosive or ulcerative surface covered with inflammatory exudates or bleeding crust is observed on the anterior half of the tongue and the upper and lower lips. She has occasionally applied the policresulen solution topically on the tongue to relieve pain from recurrent focal glossitis for about 10 years. In this time she applied it broadly and repeatedly to the tongue, the upper and lower lips for the purpose of pain relief by herself without instruction by physician or dentist. After cessation of policresulen application, the oral mucosa was rapidly recovered with use of topical steroids. In 2 weeks the lesions subsided completely. In summary, inadvertent use of $Albothyl^{(R)}$ on oral mucosa may result in chemical burn, causing mucosal erosion, ulceration and inflammation. It can be recovered by topical use of corticosteroid for 2 weeks after cessation of using $Albothyl^{(R)}$.

Urethroplasty of Urethral Defect with Longitudinal Tubed Flap of Scrotal Skin after Fournier's Gangrene (Necrotizing Fascitis) (회음부 괴사성 근막염후 발생한 요도 결손의 치료를 위한 음낭피부 종축관피판을 이용한 요도성형술)

  • Min, Hee-Joon;Roh, Tai-Suk;Kim, Ji-Ye;Kim, Sug-Won
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.667-670
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    • 2010
  • Purpose: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. Methods: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap ($6{\times}2.5\;cm$) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. Results: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. Conclusion: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.

Resurfacing of the Open Wound of the Hand With Free Arterialized Venous Flap (유리 동맥화 정맥피판을 이용한 수부의 재피복술)

  • Woo, Sang-Hyun;Kim, Seong-Eon;Jeong, Jae-Ho;Lee, Kyung-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.303-313
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    • 1994
  • Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages: (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operarive field. But, we also have some disadvantages of difficult handling of the pliable veins and the uncertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.

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