• Archives of Plastic Surgery
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• 제45권6호
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• pp.564-571
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• 2018

Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.

• 대한임상검사과학회지
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• 제43권1호
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• pp.12-18
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• 2011

The purpose of this study was to evaluate the significance of higher than normal mean corpuscular volume (MCV) and lower than normal mean corpuscular hemoglobin concentration (MCHC) in 20 patients. The hemoglobin (Hb), red blood cell indices (MCV, MCH, MCHC,), red cell distribution width (RDW), serum ferritin, serum iron (Fe) and total iron binding capacity (TIBC) were measured and the transferrin saturation were calculated. 18 (90.0%) cases were categorized as chronic diseases. Chronic renal failure, malignancy, and bleeding were all related to the cases. The mean values of hemoglobin was $9.5{\pm}2.14g/dL$; the MCV was $29.0{\pm}2.8fL$; the MCH was $30.9{\pm}1.0pg$; the MCHC was $31.2{\pm}0.5%$; the RDW was $17.0{\pm}3.6%$; serum Fe was $39{\pm}21{\mu}g/dL$; the TIBC was $219.7{\pm}108.8{\mu}g/dL$; transferrin saturation was $19.2{\pm}9.9%$ and ferritin was $445.5{\pm}499.6{\mu}g/L$ in the patients. The WHO criteria for hemoglobin of patients confirms anemia in 18 of the 20 (90.0%) cases. Anemia of chronic disease was shown in 11 (73.3%) cases; acute gastric ulcer with hemorrhage in 1 (6.7%) case; iron deficiency anemia in 1 (6.7%) case; 2 patients (13.3%) were of normal cases. There were changes in the baseline Hb level results of the 19 (95.0%) cases while no change was shown in 1 case. As a result, diseases associated with anemia and bleeding where the MCV is higher than the normal range and MCHC is lower than normal range are considered relevant findings.

• 대한족부족관절학회지
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• 제28권3호
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• pp.102-106
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• 2024

A reverse sural flap is a surgical procedure to repair soft tissue defects, usually in the ankle region. This procedure involves moving a tissue flap from the calf to cover a defect in the ankle. The flap is turned 180° so that the tissue around the wound is supplied with blood by the vessels at the base of the flap, typically preserving the sural nerve and artery. This method is particularly valuable when thick and robust tissue is required to cover defects resulting from traumatic injuries, chronic wounds, or post-skin tumor removal when the local tissue is insufficient for direct closure. In this case, a patient who had undergone surgery for a chronic ulcerative lesion on the Achilles tendon three years prior to presentation at the authors' hospital was treated using a half-width reverse sural flap. Modifications to the sural flap design may be crucial considering the surgical history, blood supply, and defect size around the lower leg. In particular, previous surgeries for lower leg fractures or ligament damage may limit blood supply and require flap design modifications.

• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.159-164
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• 2010

Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

• 한국임상약학회지
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• 제7권1호
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• pp.40-44
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• 1997

Helicobacter pylori(HP) has been implicated as the cause of acute and chronic gastritis, peptic ulcer, and gastric carcinoma. To date the most successful treatment in eradicating HP is known to be the combination of two or more antibiotics with an anti-ulcer drug. In this study, in vitro antimicrobial activity against two was assessed, when proton pump inhibitors (PPIs), omeprazole and lansoprazole, were added to antibiotics at different concentrations. The assays in the absence of PPIs gave minimum inhibitory concentration(MIC) value of 0.63 mg/l for amoxicillin, 4 mg/l for tetracycline, 0.08 mg/l for clarithromycin and 0.16 mg/l for azithromycin. At the concentrations of 125 mg/l, 25 mg/1 and 0.5 mg/l of omeprazole, and the concentrations of 31.25 mg/l, 6.25 mg/l and 1 mg/l of lansoprazole, the MICs of clarithromycin and azithromycin were reduced by $50\%$. Also, lansoprazole at the highest concentration 31.25 mg/l reduced the MIC of amoxicillin by $50\%$, and omeprazole at the highest concentration of 125 mg/l reduced the MIC of tetracycline by $50\%$. In conclusion, the in vitro combination of PPIs and antibiotics led to improvement in the MIC of antibiotics against HP associated gastric disease.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.141-144
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• 2013

Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.

• Journal of Oral Medicine and Pain
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• 제33권3호
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• pp.241-246
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• 2008

편평태선은 피부와 점막에 발생하는 흔한 만성 염증성 질환으로 정확한 원인은 잘 알려져 있지 않으나 종종 감염과 관련 되어있다. 다양한 박테리아 중 Helicobacter pylori(H. pylori)는 위염, 위 십이지장 궤양 그리고 위암과 관련되어 있다. 위궤양과 구강 궤양들의 조직학적 특징의 유사성을 고려할 때 H. pylori는 구강 점막궤양의 발생과 관련 있음을 추론할 수 있다. 따라서 미란성 구강편평태선의 발생에 H. pylori가 관련 있는지를 조사하기위해 이 연구를 수행하였다. 미란성 구강편평태선을 가진 환자의 타액을 중합효소연쇄반응에 의해 분석한 결과 21명의 환자 중 16명(76.2%)에서 H. pylori가 검출되었고, 대조군은 44명 중 11명(25%)에서 H. pylori가 검출되어 통계적 유의성을 나타내었다(P>0.001). 이상의 결과를 종합해 볼 때 타액내 H. pylori는 미란성 구강편평태선의 발생에 원인이 될 수 있음을 추론할 수 있었다.

• 대한수의학회지
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• 제22권1호
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• pp.53-58
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• 1982

Stomachs from 3,354 fattening pigs were examined at slaughter during the period from September 1980 to August 1981. Pigs of both sexes and $Landrace{\times}Hampshire$ crossbreds were included in the present studies, and they weighed about 60-120kg. Gross pathologic alterations of the stomach were classified as normal, epitnelial change, erosion, ulcer and scar formation. Representative tissue sections were taken from the stomach lesions at random and fixed in 10% buffered formalin. Cut sections were stained with hematoxylin and eosin, and examined histopathologically. The results obtained in the present studies were as follows. 1. In the seasonal prevalence of gastric ulceration, severe ulceration with erosion was shown during the Autumn and Winter, whereas mild ulceration was mainly shown during the Spring and Summer. 2. Of the 3,354 stomachs of the pigs, 20.8% were found to be normal. Of the rest, 40% had epithelial changes, followed by erosion (24.7%), ulcer (13.6%) and scar formation (0.9%), respectively. 3. In the prevalence of ulcers in the different regions of the stomach, the fundic region had the highest rate (61.6%) of ulceration, followed by cardiac (21.7%), esophageal (15.0%) and pyloric region (1.7%). 4. The principal gross changes were severe epithelial changes with keratotic proliferation in the esophageal region, and in the fundic region severe folding of the stomach wall was covered with bloody mucous exudates. 5. Main histopathological changes were inflammatory cell infiltrations in most cases, hemorrhages in acute ulcers and prominent proliferation of granulation tissues in chronic ulcers.

• 한방안이비인후피부과학회지
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• 제12권1호
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• pp.387-395
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• 1999

This observation was aimed to evaluate the clinical manifestations and clinical incidence of $Beh{\varsigma}et's$ Disease. It was records of patients seen in the period between January 1992 and December 1998 at the Department of Dermatology, Oriental Medical Hospital, Kyung Hee University. $Beh{\varsigma}et's$ Disease is a chronic, systemic disease which manifests itself as recurrent, multiple lesions in many organs, including the skin. The clinical features of $Beh{\varsigma}et's$ Disease are important as there is no reliable method of laboratory diagnosis. The results were summarized as follows; 1. The total number of patients were 34, including $42\%$ male and $52\%# female. 2. The pick incidence of age group was 30 to 39($44\%$). 3. The most frequent duration was from 2 years to 5 years($41\%$). 4. According to Diagnostic Criteria of the $Beh{\varsigma}et's$ Disease Research committee of Japan, there were $41\%\;of\;Incomplete\;type,\;29\%\;of\;Suspected,\;24\%\;of\;Complete,\;6\%$ of Passible. 5. The most common major symtom is a oral u1cer($91\%$), and there were erythema nodosum like lesion($79\%$), genital ulcer($56\%$), problem of the eyes($38\%$). 6. The most common minor symtom was arthritis($32\%$). 7. The first main symtom were oral ulcer($50\%$), erythema nodosum like lesion($26\%$), problem of the eyes($18\%$). 8. There were 2 cases of Intestinal $Beh{\varsigma}et's$ Disease and 5 cases of uveitis. 9. The most frequently treated prescription was Eunhwasagantang which occupied 79 of all, Gamisopunghwalhultang($44\%$) a.nd Gamipadoksan($41\%$), Gamiguakjungsan($24\%$) in that order of frequency.

• 대한간호학회지
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• 제51권3호
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• pp.280-293
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• 2021

Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ² = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.