• 기본간호학회지
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• 제12권2호
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• pp.215-222
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• 2005

Purpose: To identify the incidence of cutaneous injury in clinical nurses. Method: From Feb.1 to 28, 2005, 276 clinical nurses were surveyed by questionnaire. Results: 1. Of the nurses, 53.6% had at least one incidence of cutaneous injury, and the mean number of injuries was 1.34. A higher incidence rate for cutaneous injury was found in nurses who were under the age of 25, unmarried and who had less than 3 years career experience. 2. The major causes of injury were syringe needles at 65.0%, and medical instrument were next followed by sharp objects or blades. The injuries occurred when the nurses were rearranging equipment after care (25.2%), taking blood samples (22.8%), separating syringes and needles (17.1%), during surgical operations (14.2%), and distribution of medications, treatments and recapping of needles (5.7% each). The hands were the most common body parts injured, and the most prevalent pathogens contaminating the instruments causing the injury were HBV syphilis, HCV and HIV in that order. 3. Of the injured nurses, 77.9% did not report the accident and 25.8% did not receive any treatment because there were no pathogens, it was a bother or there was difficulty reporting the incident. Conclusion: To reduce cutaneous injuries, intensive training and supervision may be needed for those of nurses under the age of 25, unmarried and with less than 3 years career experience.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9813-9815
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• 2014

Background: This analysis was conducted to evaluate the efficacy and safety of cisplatin based chemotherapy for treating patients with cutaneous squamous cell carcinoma. Methods: Clinical studies evaluating the efficacy and safety of cisplatin based regimens on response and safety for patients with cutaneous squamous cell carcinoma were identified using a predefined search strategy. Pooled response rates (RR) of treatment were calculated. Results: In cisplatin based regimens, 4 clinical studies which including 50 patients with advanced cutaneous squamous cell carcinoma were considered eligible for inclusion. Regimens included cisplatin, doxorubicin, or vindesine. Pooled analysis suggested that, in all patients, the pooled RR was 60% (30/50) in cisplatin based regimens. Nausea and vomiting were the main side effects. No grade III or IV renal or liver toxicity were observed. No treatment related death occurred with the cisplatin based treatments. Conclusion: Evidence based analysis suggests that cisplatin based regimens are associated with a good response rate and acceptable toxicity for treating patients with cutaneous squamous cell carcinoma.

• 대한두개안면성형외과학회지
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• 제15권1호
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• pp.36-39
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• 2014

Leiomyosarcoma is a rare form of soft tissue neoplasm, with only 1% to 5% occurring in the head and neck region. Current recommended treatment suggests surgical excision with a wide lateral margin, but no definite guidelines regarding excisional margin have been established yet. Recently, complete excision with a narrow surgical margin has been recommended, and the authors present a case of cutaneous leiomyosarcoma on the face that was successfully managed by complete removal with a narrow excisional margin. A 74-year-old woman presented with a 3 cm sized, rapidly growing cutaneous mass on her right preauricular area. Preoperative biopsy of the skin lesion suggested a cutaneous leiomyosarcoma. The authors performed complete surgical excision with a 1 cm lateral margin, and the resulting skin defect was repaired with bilateral V-Y advancement local flaps. Histopathology and immunohistochemistry evaluation confirmed a moderately differentiated cutaneous leiomyosarcoma, with negative margin involvement. The patient refused of any additional treatment, but showed no locoregional recurrence during the 1.5 years of postoperative follow-up period. With a regular postoperative follow-up, cutaneous leiomyosarcomas may be successfully treated with a narrow surgical margin.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.231-236
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• 2021

Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.

• Archives of Plastic Surgery
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• 제50권2호
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• pp.153-155
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• 2023

The vascular anatomy of the deep inferior epigastric artery perforator (DIEP) flap has been well studied in the planning for autologous breast reconstruction. Preoperative imaging with computed tomography angiography (CTA) provides accurate assessment of this vascular anatomy, which varies widely across patients. Several papers to date have described their encounter with an anomalous "epiperitoneal" or "peritoneo-cutaneous" perforator during flap harvest, a perforator that pierces the posterior rectus sheath from a peritoneal origin, to traverse rectus abdominis and supply the DIEP flap integument. In the course of over 3,000 CTA assessments of the vascular anatomy of the abdominal wall, we have encountered dominant peritoneo-cutaneous perforators in 1% of cases, and smaller perforators seen in many more cases, approaching 5% of cases. With increasing sensitivity of imaging, we also describe a unique case of multiple large bilateral peritoneo-cutaneous perforators, and present these findings in the context of DIEP flap harvest. It is critical to recognize these peritoneo-cutaneous perforators preoperatively to avoid mistaking them for a DIEP during the raising of a DIEP flap. The routine use of preoperative CTA enables the safe identification of individual vascular anatomy, including significant peritoneo-cutaneous perforators.

• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.139-142
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• 2011

Background: Lung cancer is responsible for substantial proportions of cutaneous metastasis from internal malignancies. The aim of this study was to evaluate the clinical manifestations and outcomes of cutaneous metastasis in Korean lung cancer patients. Methods: On a retrospective basis, we analyzed medical records of all patients diagnosed with lung cancer from 2000 to 2006. Results: Cutaneous metastases were found in 10 of 4,385 patients. The number of cases was highest for squamous cell carcinoma. However, there was no metastasis from 754 cases of small cell carcinomas. Cutaneous metastasis was detected during staging work-up in 4 patients and it was the presenting sign of recurrence post-operative in 2 patients. Average time from the diagnosis to discovery of cutaneous metastasis was 16.3 months and median survival was 8.5 months (range, 1.8~19.1 months). Conclusion: Physicians should be acquainted with clinical manifestations and outcomes of cutaneous metastasis from lung cancer to detect new, recurrent cancer, or disease progression, and to administer appropriate and prompt management.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.1-8
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• 1997

Recently prostaglandin $E_1(PGE_1)$ has been shown to ensure flap survival by producing vasodilation of the peripheral vessels and platelet disaggreation. However, direct observation and detailed quantitative studies of the effects of $PGE_1$ on the cutaneous microcirculation have not been reported. In the present study, we investigated cutaneous microcirculatory changes in the rabbit ear chamber(REC) with an intravital microscope following intravenous administration of $PGE_1$. The results obtained in this study indicate that $PGE_1$ administered intravenously at a rate of 200ng/kg/min might act directly on the vessels and cause dilatation of metarterioles and capillaries without affecting vasomotion and systemic blood pressure. Clinically in order to evaluate the effect of an intravenous administration of $PGE_1$ on the cutaneous microcirculation, cutaneous blood flow, skin temperature and transcutaneous $Po_2$ in the pedicle or free flap of operated patients were evaluated by the combination of several measurements following the administration of $PGE_1$. The present study suggests that improvement of cutaneous microcirculation by $PGE_1$ may enhance the survival rate of flap or replantation. Both vessel arterial ischemia and venous congestion are main factors of tissue necrosis in the flap surgery. Vasodilatory or antithrombotic agents have been used in salvage of flap necrosis. However, the therapeutic effects of those drugs are still not well elucidated. Recently prostaglandin $E_1(PGE_1)$ has been shown to ensure flap survival by producing vasodilatation of the peripheral vessels and platelet disaggregation[1-3]. Emerson and sykes[4] have obtained significant improvement in the flap survival in the rat using $PGI_2$. Suzuki et al.[5] have reported prolonged flap survival length by using $PGE_1$ in the rabbit and concluded that $PGE_1$ improved the microcircuration in the flap. However, direct observation and detailed quantitative studies of the effects of $PGE_1$ on the cutaneous microcirculation have not been reported. In the present study, we investigated microcirculatory changes in the rabbit ear chamber[6,7] with an intravital microscope following intravenous administration of $PGE_1$.

• 한국임상수의학회지
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• 제35권4호
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• pp.150-154
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• 2018

A 9-month-old, castrated, male Labrador Retriever was referred for generalized progressing cutaneous reddish mass lesions with bleeding, scale, crust, and pruritus. On the basis of histopathological findings and the results of immunochemical staining, cutaneous nonepitheliotropic B-cell lymphoma was identified. A cyclophosphamide-doxorubicin-vincristine-prednisolone (CHOP)-based chemotherapy regimen was initiated, and the patient initially showed partial response to vincristine and $\text\tiny{L}$-asparaginase, but the cutaneous lesions progressed gradually. After the first cycle of the CHOP-based protocol, lomustine was administered instead. The cutaneous lesions showed partial response to lomustine, but the treatment did not stop the progression of cutaneous lymphoma. The patient was euthanized due to neurologic signs, including reduced consciousness and seizures, 53 days after initial presentation. The postmortem histopathological examination showed systemic metastasis involving the lymph nodes, skin, kidney, ureter, liver, brain, temporal muscle, diaphragmatic muscle, conjunctiva, and oral cavity.

• The Korean Journal of Pain
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• 제19권2호
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• pp.292-295
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• 2006

The diagnosis of chronic abdominal pain due to abdominal cutaneous nerve entrapment can be elusive. Tenderness in patients with abdominal pain is naturally assumed to be of either peritoneal or visceral origin. Studies have shown that some patients suffer from prolonged pain in the abdominal wall and are often misdiagnosed, even after unnecessary and expensive diagnostic tests, including potentially dangerous invasive procedures, and treated as having a visceral source for their complaints, even in the presence of negative X-ray findings and atypical symptoms. Abdominal cutaneous nerve entrapment syndrome is rarely diagnosed, which is possibly due to failure to recognize the condition rather than the lack of occurrence. The accepted treatment for abdominal cutaneous nerve entrapment syndrome is a local injection, with infiltration of anesthetic agents coupled with steroids. Careful history taking and physical examination, in conjunction with the use of trigger zone injections, can advocate the diagnosis of abdominal cutaneous nerve entrapment and preclude any unnecessary workup of these patients. Herein, 3 cases of abdominal cutaneous nerve entrapment syndrome, which were successfully treated with local anesthetics and steroid, are reported.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.608-613
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• 2015

Background The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. Methods We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC flap (n=14) between 1995 and 2013. Morbidity was classified into hospitalization, medical, or flap-related complications. Functional outcomes were classified into oral re-alimentation and decannulation time. Results The overall flap-related complication rate was higher in the PMMC flap group (n=8, 57.1%; P=0.019), but the medical morbidity rate was higher in the cutaneous free flap group (n=68, 80%; P=0.006). The rate of pneumonia was higher in the cutaneous free flap group (n=48, 56.5%; P=0.020). Pulmonary premorbidity was the variable most significantly associated with pneumonia (odds ratio=3.012, P=0.012). There was no statistically significant difference in oral re-alimentation and decannulation time between the two groups. Conclusions Although the functional superiority of free flaps has been reported in many studies, our results do not support this hypothesis. One limitation of our study is the relatively smaller flap size and fewer PMMC flap cases compared with the cutaneous free flap group. The low postoperative medical morbidity incidence rate in the PMMC flap group was clinically significant; however, the free flap group had more flap-related complications. Thus, PMMC flaps should be considered a viable option, especially for patients with pulmonary premorbidities.