• Archives of Plastic Surgery
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• v.36 no.3
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• pp.336-340
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• 2009

Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.36-39
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• 2024

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

• Journal of the Korean Society of Clothing and Textiles
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• v.23 no.7
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• pp.980-986
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• 1999

This study was done to ivestigate the fabrics thatminimized harmfulness of UVB(ultraviolet B) and that might product Vit. {{{{ {D }`_{3 } ^{ } }} by UVB. Twelve female subjects wearing in three different types i.e fabric A(UVB 100% protection) fabric B(UVB 50% protection) and bikinii were exposed to outdoor environment (Air Temp : 25℃, 42% R,H Air velocity : 0.13m/s UV does :6KJ/m2) Blood samples were taken 24 hours before the after the experiment in order to examine concentration of vit.{{{{ {D }`_{3 } ^{ } }} in the blood. During the experiment axillary temperature skin temperature of 7 areas(forehead Chest Upper arm, Hand Thigh Lower leg, Foot) were measured. The more irradiated areas by UVB were the more the concentration of serum 25(OH){{{{ {D }`_{3 } ^{ } }} were significantly. Mean skin temperature was significantly low levekl in wearing the fabric of UVB 50% protection (p<0.001) Axillary temperature was significantly high level in wearing the fabric of UVB 50% protection (p<0.001). Therefore the fabric of UVB 50% protection intercepts the radiation and has advantage to give off body heat over other fabrics

• Fashion & Textile Research Journal
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• v.2 no.5
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• pp.398-404
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• 2000

We examined the effect of individual sweating responses on thermoregulatory responses induced by heat of sorption, immediately after the onset of sweating. The present study consists of two experiments. In experiment 1, made of 100% cotton (C) and 100% polyester (P) clothing were exposed in the chamber at ambient temperature (Ta) of $27.2^{\circ}C$ and relative humidity (rh) raised from 50% to 95% at five different increase rates of environmental vapor pressure (VP). The increase rate of clothing surface temperature (Tcs), peak Tcs and peak time showed significant correlation with the increase rate of environmental VP in C-clothing (p<0.05). In experiment 2, seven female subjects were studied during leg water immersion ($35-41^{\circ}C$) for 70min in Ta of 27.2 and 50%rh. There were significant positive correlations in the increase rate of clothing microclimate VP vs. changes in Tcs, skin blood flow, mean skin temperature and mean body temperature (p<0.05). The present results showed that individual clothing microclimate VP had significant effects on thermoregulatory responses induced by heat of sorption wearing C ensembles.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.191-196
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• 2017

Basal cell carcinoma (BCC) comprising several lesions is not uncommon, but nonsyndromic multiple BCCs with parotid invasion are rare entities. We present two cases of multiple sporadic, nonsyndromic BCCs, and one of these cases is a unique case of parotid invasion associated purely with actinic keratosis. In Case 1, a 79-year-old female presented with multiple skin lesions on the face and left hand. All lesions were completely removed by surgery. The pathologic results showed lesions consistent with BCC and some lesions consistent with actinic keratosis. After 8 months, the patient presented with skin lesions in bilateral temporal areas and left cheek area. Surgical excision of the lesions was performed, and the biopsy results were squamous cell carcinoma in situ and actinic keratosis. In Case 2, a 43-year-old woman presented with multiple skin lesions on the face, scalp, right chest, abdomen and right leg. All lesions were completely removed by surgery. Pathologic evaluation confirmed the diagnosis of BCC. BCC is rarely metastatic, but it can lead to severe disfiguration or destruction. It is important to diagnose and treat BCC at an early stage.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.155-161
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• 1988

The usefulness of hypertermia for cancer therapy have well been established. The purpose of the present investigation was to ascess the effect of step-up $(42^{\circ}{\rightarrow}44^{\circ}C$ sequence) and step-down $(44^{\circ}{\rightarrow}42^{\circ}C$ sequence) heating on the skin of the hind foot of the mouse. Hyperthermic treatments were given by immersion the hind foot of the mouse in circulating water baths. Skin response was studied by the leg reaction, which was scored according to a numerical scoring system proposed by Urano et al (1980). The results were as follows 1. The skin damage of $44^{\circ}C$ control group was more severe than $42^{\circ}C$ control group (P<0.05), except for 15 min. heating group. 2. The Skin damage of step-down group was more severe than step-up group (P<0.05). 3. The skin damage of $44^{\circ}C$ control group was more severe than step-up group when there is no difference in $44^{\circ}C$ heating time of step-up group from $44^{\circ}C$ control group (P<0.05). 4. In step-down group, the skin damage was more severe than $44^{\circ}C$ control group after preheating 45 min at $44^{\circ}C$ (P<0.05). Therefore, the above findings suggest the normal tissue damage by step-up heating was correlated with heating time of post step-up. The dropping of heating temperature in late phase had more severe damage of the skin than that in early phase during hyperthermia, and so contineous control of satisfactory temperature should be considered as the one of the most important factor for prognosis, complications of clinical hyperthermia

• Archives of Plastic Surgery
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• v.43 no.3
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• pp.284-287
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• 2016

Epithelioid hemangioendothelioma (EHE) is a well-differentiated and rare vascular tumor. Systemic metastases are uncommon. Herein, we present a patient with skin metastasis of pulmonary EHE (PEH) that was treated by wide excision. A 76-year-old male was evaluated due to pulmonary thromboembolism and a solitary pulmonary nodule. A biopsy was performed and pathological examination of the mass confirmed EHE. No metastasis was observed. The patient returned to care approximately two years later due to a painful nodule in the right lower leg. A skin biopsy showed metastatic EHE from the lung. We used a safety margin of 1 cm based on clinical experience, because no prior case had been reported regarding the resection margin appropriate for primary cutaneous EHE and skin metastases of PEH. At four months after surgery, the patient recovered without complications or recurrence. Skin metastasis of PEH is extremely rare, and only two cases have been reported in the literature. In this case, we report a rare case of PEH with histologically diagnosed skin metastasis that was successfully treated by curative resection. It is expected that this case report will provide a helpful contribution to the extant data regarding PEH metastases.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.67-70
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• 2012

Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.784-788
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• 2006

Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.36-40
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• 2002

Purpose : Our clinical experiences in distally based sural artery island flap is presented to show the usefulness and the reliability as an alternative to flaps currently used for defect in lower extremity. Materials and Methods : From February 1998 to September 2001, nine cases of soft tissue defects in the lower leg, the foot, and around the ankle were treated with distally based sural artery island flap. The cause of the wound was trauma in 6 cases, and osteomyelitis in 3 cases. Defects were located at the lower leg in 2 cases, at the foot in 3 cases and around the ankle in 4 cases. The results were retrospectively analyzed. Results : The defect size ranged from $3{\times}3cm\;to\;20{\times}3cm$. Among 9 cases, 7 cases survived and 2 cases were failed. Flap failure was due to not including the deep fascia in one case and due to extensive soft tissue damage in the other case. Both failed cases were reoperated with the split thickness skin graft. Conclusion : The advantages of distally based sural artery island flap follows (1) reliable blood supply, (2) ease of flap elevation, (3) preservation of the major arteries, (4) less donor site morbidity. Owing to the advantages of this flap, we think it is useful for the soft tissue coverage of the lower leg, the foot and around the ankle. Also we believe it will continue to gain acceptance and use in the majority of lower leg reconstruction.