• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.549-552
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• 2008

An eight-month-old, intact female Jindo, weighing 9 kg with a one-day history of acute bloody diarrhea was referred. Plain abdominal radiographic findings included evidence of a soft tissue tubular mass within the dilated colon. In ultrasonographs, a target-like mass was identified with multiple hyperechoic and hypoechoic parallel wall layers. A barium enema showed a large radiolucent filling defect within the colon and a completely occlusive lumen. On the basis of these images, ileocecocolic and colocolic intussusception was diagnosed. Surgical manual reduction, resection and anastomosis were performed. The patient recovered normally without any complications or recurrence.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.86-89
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• 1997

Neurofibromatosis, now termed neurofibromatosis type I, is known as a congenital and familial disease presenting abnormalities of the skin, nervous system, bones, and soft tissue. We experienced a case of extremely large neurofibromatosis which developed on the orbital and temporal region of a 24-year-old man. The tumor was widely excised including normal skin margin, outer table of cranium, a part of zygoma and maxilla. Bony defect was reconstructed by rib bone graft and secondary cosmetic correction of blepharoptosis was performed using supratarsal fixation in postoperative 6 months.

• Journal of Korean Foot and Ankle Society
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• v.18 no.1
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.32-38
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• 1997

PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.348-348
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• 1997

A 48 year old man, has been suffering from a growing chondrosarcoma of sternum which has deeply invading the anterior mediastinum: He underwent wide resection of the chest wall tumor including a 4 cm free margin of normal tissue on all portions. The tumor as 15 × 16× 10cm in size arising from sternum and include both proximal one third of the clavicle and the 1 st, 2nd, and 3rd coital cartilages. The resected skeletal defect in the anterior wall was very large after wide resection of the'tumor and reconstructed due to paradoxical chest wall movement with sandwich like method of double over lapping Marlex mesh and methylmethacreylate, and steel wires. The soft tissue reconstructive procedure was dont with myocutaneous flap transposition use of pectoralis muscle. But the patient go infected with tuberculosis in the mediastinum two months after the operation. We had removed all of previously inserted prosthetics and performed curettage and drainage. Recently we experienced a case with giant chondrosarcoma of the sternum associated with tuberculous mediastinitis. The patient had an uneventful postoperative course and was discharged with adjuvant treatment such as antituberculous medication for 1 year.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.248-252
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• 1997

A 48 year old man, has been suffering from a growing chondrosarcoma of sternum which has deeply invading the anterior mediastinum: He underwent wide resection of the chest wall tumor including a 4 cm free margin of normal tissue on all portions. The tumor as 15 $\times$ 16$\times$ 10cm in size arising from sternum and include both proximal one third of the clavicle and the 1 st, 2nd, and 3rd coital cartilages. The resected skeletal defect in the anterior wall was very large after wide resection of the'tumor and reconstructed due to paradoxical chest wall movement with sandwich like method of double over lapping Marlex mesh and methylmethacreylate, and steel wires. The soft tissue reconstructive procedure was dont with myocutaneous flap transposition use of pectoralis muscle. But the patient go infected with tuberculosis in the mediastinum two months after the operation. We had removed all of previously inserted prosthetics and performed curettage and drainage. Recently we experienced a case with giant chondrosarcoma of the sternum associated with tuberculous mediastinitis. The patient had an uneventful postoperative course and was discharged with adjuvant treatment such as antituberculous medication for 1 year.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.439-445
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• 2008

Purpose: Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma in adult. As to this date, tissue development, treatment and prognosis of the tumor has not been definitely clarified, however, it has been reported that wide surgical resection of the tumor along with the radiotheraphy and chemotheraphy is needed for treatment. In MFH with high recurrence rate, the reconstruction method and points to be considered for reconstruction in recurrent case were studied in 10 patients who were treated in our hospital. Methods: From August of 1991 to August 2007, location of tumor, initial mass size, 1st recurred period, lymph node metastasis, recurrence rate, treatment modality, complication, reconstruction in recurrent defect, and follow up period was studied in 10 patients who underwent reconstruction at our Plastic surgery department following wide excision. Results: The average age was 62.8(46 - 73) years old, average follow up period was 7.7(1 - 17) years. Various reconstructions has been performed for recurrent cases and postoperative chemotheraphy and radiotheraphy was done. As for reconstruction in recurrent cases, After wide excision, local flap was performed in 6 cases, and free flap in 2 cases. After radiotherapy, osteoradionecrosis was occurred in 4 cases. Recurrence rate was 1 - 5(2.6) times and reconstruction due to recurrence was 7 out of 10 cases(70%). Conclusion: The treatment modality of MFH is not yet defined. Due to it's high recurrence rate, radiotherapy and chemotherapy is commonly combined with surgery. Even still, additional excision and reconstruction may be required. Therefore, possibility of re-operation must be considered when performing every excision and reconstruction; in case a recurrence or osteoradionecrosis occurs. Free flap coverage should be left as the last resort, according to the principle of reconstruction. Nevertheless, if the defect is large or osteoradionecrosis is present, it will benefit greatly to the patient's quality of life.

• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.39-47
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• 2007

With the advent of microsurgery, perforator free flap is nowadays considered the first choice for reconstruction of the extensive defect of the extremities because of their moderate thickness. Among them, anterior (anterolateral and anteromedial) thigh perforator free flaps provide the first choice for reconstruction of various soft tissue defects of the extremities with many advantage such as its large, uniform thickness, long vascular pedicle with proper vessel size and minimal donor site morbidity. But, it has still some criticism of unreliable perforators which makes us very careful in elevating the flap. Between March of 2006 and February of 2007, we treated 7 patients of soft tissue defects in the hand and lower extremities with anterior thigh perforator free flap at Hallym and DongGuk University Hospital. We performed 6 anterolateral thigh perforator free flaps based on the descending branch of lateral circumflex femoral artery (LCFA) and 1 anteromedial thigh perforator free flap based on the innominate branch of the LCFA. While approaching for the anterolateral thigh free flap, we happen to meet the cases which we should change into the anteromedial thigh free flap uneventfully on the operating field. In contrast to the original design of anterolateral thigh free flap, we had to harvest the anteromedial thigh perforator free flap in 1 case. All the anterior thigh perforator free flaps survived completely except 1 case of partial necrosis due to venous congestion. Donor sites were closed primarily and healed uneventfully within 2 weeks. Patients were satisfied with the functionally and aesthetically acceptable results. Although doppler sonography is strongly recommended preoperatively in planning the anterior thigh perforator free flaps, we should always remember the variation in vascular anatomy and be ready to change the flap choice from the anterolateral to anteromedial intraoperatively. we provide a review of the literature and present our series of anterior thigh perforator free flaps for reconstruction of the extremities.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.33-43
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• 2008

Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.