• Archives of Plastic Surgery
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• 제38권2호
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• pp.143-147
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• 2011

Purpose: A Tessier classification number 7 cleft is an uncommon malformation that results from a failure of mesenchymal fusion within the maxillary and mandibular prominences of the 1st pharyngeal arch. Many operative techniques of the number 7 cleft repair have been proposed to restore function and improve aesthetics. Fifteen patients underwent repair of a number 7 cleft over 13 years by a modification of the surgical Technique, and an appraisal of the operative outcome is reported herein. Methods: A retrospective review was conducted involving 15 patients with number 7 clefts who underwent surgery from 1996 to 2009. The changes in surgical technique included skin closure, attachment of the orbicularis oris muscle, and position of the repaired commissure; the changes were analysed with a review of the medical records and the outcomes of surgery were analysed via photographs. Specifically, the technique of skin closure was changed from the a Z-plasty to a linear closure, the orbicularis oris muscle overlapped attachment was replaced by a side-to-side approximation with horizontal mattress sutures, and the position of the repaired commissure was changed from 1 mm laterally to 1 mm medially in reference to the non-cleft side. Results: A Z-plasty caused additional cutaneous scarring, an overlapped attachment of the orbicularis oris muscle caused a thick oral commissure, and the repaired commissure migrated to the lateral side, so a 1 mm, laterally-positioned commissure caused asymmetry. The altered procedure included a linear skin closure, a side-to-side orbicularis oris muscle approximation, and a 1 mm, medially-positioned commissure, which together resulted in a good outcome. Conclusion: The altered procedure for repair of a number 7 cleft as described herein, yields a short scar, no functional problems with the orbicularis oris muscle, a thin oral commissure, and symmetry of the repaired commissure.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.18-24
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• 2012

Background : Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods : A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results : The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions : Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.221-224
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• 2009

Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

• 한방안이비인후피부과학회지
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• 제29권1호
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• pp.93-102
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• 2016

Objective : This study performed to evaluate that duration of acne scars effects on Qualitative Global Acne Scarring Grading System(QGASC) grade changing and treatment duration. Also this study performed to evaluate the relationship between dysmenorrhea and acne scars, and the effects of each treatment on treatment duration and Korean Acne Grading System(KAGS) and QGASC grade.Methods : 95 patients with acne scars were understood by medical records and case photos, and we evaluated pre and post acne scar grade based on KAGS and QGASC. We analyzed data by SPSS 22 for windows program, and figured out the relation between duration of acne and QGASC grade and treatment duration by Spearman correlation analysis, and performed Mann-Whitney U-test to figure out the relation between dysmenorrhea and QGASC grade. We performed Wilcoxon test to evaluate that treatment of acne scars effects on KAGS grade and QGASC grade, and performed Kruskal-Wallis test to figure out the difference of each treatment which effects on KAGS grade and QGASC grade, and performed Post-hoc analysis to figure out the group comparison.Results & Conclusions : QGASC grade depending on duration of acne was statistically significance. Subcision and Microneedle Therapy System(MTS) and pharmacopuncture were significantly improved acne scars. Other treatments were significantly more effective than subcision and pharmacopuncture combined treatment. Treatment duration of Subcision and MTS combined treatment was significantly most shortest than other treatment.

• Journal of Pharmaceutical Investigation
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• 제36권5호
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• pp.339-342
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• 2006

This study was designed to prepare an animal model for partial thickness bum wound which can be employed for testing topical therapy. We first evaluated whether rabbit ear and mouse back skin wound model could differentiate the wound healing process in terms of degree of re epithelialization, required days for complete wound closure, presence of scarring. $2^{nd}$ degree wet bum were prepared on mouse back skin and rabbit ear by applying 5 mL hot water($85{\pm}0.1^{\circ}C$) for 7 see followed by 5 mL ice-cold 0.5% acrynol solution for cooling and disinfecting the inflicted area. After removing the dead epidermis layer at 24 hr, tested dressings were applied for specified time and wound progression was investigated. In mouse model, wound contraction was the primary wound closing mechanism, which is quite different from human wound healing process. In rabbit ear model, epidermal regeneration was the major wound healing process rather than wound contraction and the difference in wound healing property among tested dressings could be clearly demonstrated. A rabbit ear model could differentiate the wound progression among open, occluded and epidermal growth factor(EGF) treated wound. Four sites of circular wound(diameter: 1 cm) on the anterior part of rabbit ear could be employed for the comparative wound healing study. For obtaining reproducible bum wound, degree of bum depth and bum sites should be carefully controlled in addition, employing rabbits of same strain and weight. The result suggests that rabbit ear could be employed as a reliable and human-resembled wound model.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.13-17
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• 2005

1. 우측(右側) 수지(手指) 3-4지에 $2.0{\times}2.0cm$의 수포와 $6.0{\times}4.0cm$의 발적(發赤)이 형성된 2도 화상의 환자를 5회의 환부자침(患部刺鍼)만으로(총 11일) 흉터 없이 완치되는 효과를 얻었다. 2. 피부 손상의 경우, 환부주위(患部周圍)에 자침(刺鍼)하여 십이피부(十二皮膚)의 기혈(氣血)소통을 원활히 해주면 우수한 치료효과가 있음을 알 수 있었다. 따라서 욕창(褥瘡)이나 창상(創傷)등에서도 훌륭한 치료 효과가 기대된다. 2. 화상의 정도가 심한 경우는 사순청양음(四順淸凉飮) 같은 청열해독작용(淸熱解毒作用)과 통리대소편(通利大小便)하는 처방을 사용 하여 내외동치(內外同治)하면 효과가 극대화되리라고 사료된다.

• 대한소아치과학회지
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• 제27권4호
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• pp.485-489
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• 2000

점액종은 점액소를 함유한 낭종으로서, 인접 조직으로 선분비물이 유출되거나 소타액선관이 폐쇄되어서 형성된다. 다른 질환과의 감별진단 후 완전히 낭종을 제거해야만 완전 치유가 이루어지며, 절개 배농이나 흡입은 단지 일시적인 방법일 뿐 반드시 재발한다. $CO_2$ Laser를 이용한 구강영역에서의 치료 시 장점으로는 우수한 지혈효과, 우수한 시야확보, 인접조직 손상의 최소화 뿐만 아니라, 작은 혈관과 림프관을 봉쇄하는 능력이 있어 창상치유시 나타나는 염증과정의 초기 증상들을 차단하기 때문에 술후 감염 감소, 술 후 종창 및 동통 감소 등이 나타나며, 반흔조직 및 창상수축의 감소 등이 있다.

• Archives of Pharmacal Research
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• 제29권11호
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• pp.977-983
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• 2006

The objective was to devise an animal model of myocardial infarction (MI) against which cardioprotective drugs might be tested. We describe the effects of nimesulide, a COX experience with development and validation of such a model. The rabbit was chosen in preference to rodents because its heart and cardiac circulation more closely resemble those of human. Thus, the cardiovascular system of anaesthetized male rabbits, 1 to 1.5 kg (n=11), was stressed by a single bolus intravenous injection of isoprenaline (ISP), 65 mg/kg. The effects of the injection were followed for sixteen days and were evaluated in four ways: 1) measurements of creatinine kinase isozyme and troponin-I (TPI) in serum 2) Electrocardiographic (ECG) changes (ST elevation and Q wave development) 3) Cardiac histopathology observed in tissue sections of the isolated of the heart. The histopathological analysis showed that rabbit heart on 2nd day after ISP injection showed changes of coagulation necrosis. Day 4 total coagulation with the loss of nuclear and striation associated with heavy interstitial infiltrate of neutrophils was found. Day 8 after infarction showed collagen deposition with capillary channels in between the remaining islands of myocytes in the infarcted area. On the 16th day scarring was complete. Coronary perfusion rates (CPR) and heart rate (HR) of the infarcted and nimesulide (a COX-2 inhibitor) treated rabbits displayed significant improvement (n=11) on each corresponding day after infarction as compared to the infarcted and saline treated rabbits (P<0.05). All four indices revealed similarities with effects commonly associated with MI in humans.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.649-654
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• 2011

Purpose: Split-or full-thickness skin grafts are used to reconstruct palmar skin and soft tissue defects after trauma or to release burn scar contracture on the hand. Glabrous skin defects should be substituted with similar skin to preserve function and aesthetics. The authors report their experiences with a technique that uses a full-thickness graft taken from glabrous skin on the ulnar edge of the palm for the reconstruction of soft tissue defects of the hand. Methods: During a three-year period from 2007 to 2010, 22 patients with burn scar contracture and 12 patients with post-traumatic skin defects on their hands were treated with full-thickness skin graft operations. The palmar skin and soft tissue defects after release of burn scar contracture or debridement of post-traumatic wounds were reconstructed with full-thickness skin grafts harvested from the ulnar border of their palms. All donor-site wounds were primarily closed. Results: The followup periods ranged from 3 to 25 months. Contractures of the hand were corrected without recurrence, and the grafts showed relatively good contour and color match to the adjacent fields. There were no reported complications such as significant color change or hypertrophic scarring. The grafted skin showed an average 5.9 mm static two-point discrimination obtained in fingertip reconstruction cases, indicating satisfactory reinnervation. Conclusion: Glabrous full-thickness grafts harvested from the palmar ulnar border is a very useful way of reconstructing soft tissue defects on hands, including fingertips, for function restoration, favorable aesthetic results, and low donor-site morbidity.