• The Korean Journal of Pain
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• 제12권2호
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• pp.246-249
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• 1999

Postherpetic neuralgia (PHN) is defined as the persistence of pain after recovery from herpes zoster (HZ), when the rash has healed, usually after about 4 weeks. PHN is the most feared complication of herpes zoster and remains one of the most common and intractable chronic pain disorders. Recent evidence has shed some light on the possible mechanism of pain, and on the prophylactic and treatment approaches to PHN, but there is no secure therapy. This report is a case of a 70-year-old male with PHN, affecting the 8th to 10th thoracic dermatomes. Patient complains of allodynia and hyperalgesia on the affected skins. After sympathectomy, antidepressant, anticonvulsant, and capsaicin ointment application, much pain relief was achieved, but allodynia remained at the subcostal area about $7\times3 cm^2$ in size. We decided to remove the painful area. Skin excision was done under local anesthesia. After skin excision, the pain was decreased and patient did not complain of pain for 10 months.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.539-544
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• 2008

Purpose: There have been limited reports on breast reconstruction after excision of phyllodes tumor. This paper reports four patients who had immediate reconstruction of the breast following excision of phyllodes tumor. Methods: We retrospectively reviewed the medical records of 14 patients from March 2000 to March 2008. Clinical data were analyzed including age, presenting symptoms and signs, type of surgery and metastasis. Results: The mean age was 38.6 years. The mean follow-up period was 40.6 months. Reconstruction was performed with latissimus dorsi musculocutaneous flap in 3 patients and transverse rectus abdominis musculocutaneous flap in 1 patient. Other cases were covered with skin graft or primary repair. 2 local recurrent cases were noted. Conclusion: The breast affected by phyllodes tumor must undergo complete excision. Followed by mastectomy, immediate reconstruction of breast improved cosmetic results, and allowed a wider surgical excision margin of tumor.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.753-758
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• 2007

Purpose: Penoscrotal extramammary Paget's disease is a rare cutaneous malignancy that primarily affects the elderly. To prevent local recurrence, adequate surgical excision with its intraoperative frozen section, proper reconstruction, and careful follow-ups are required. The present study describes the treatment of patients with penoscrotal extramammary Paget's disease, focusing on the reconstruction after the ablation of lesion. Methods: Nine patients were selected who had undergone a local pedicle flap procedure due to the large defects after ablation of extramammary Paget's disease of the penoscrotal area, during the period of 1999 to 2005. Wide excision combined with intraoperative frozen sectioning was performed, and the penoscrotal wound was reconstructed with a local skin flap. Three flaps were chosen depending on the size of the defect. If the defect size was small and the scrotal tissue was adequate, scrotal flap(n=5) was enough for its reconstruction. However, as there were large defects with insufficient remnant scrotal tissue, a groin flap(n=2) or an anterolateral thigh flap(n=2) were performed. Results: There were no complications with the postoperative wound. Furthermore, no local recurrence was noted during two to six years of follow-up period (mean average 3.7 years). Conclusion: For the resurfacing the penoscrotum at large defects after ablation of extramammary Paget's disease, we performed reconstruction with a local flap. In the aspect of both function and cosmetic concerns, the results were satisfactory.　

• Archives of Plastic Surgery
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• 제38권5호
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• pp.679-682
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• 2011

Purpose: Neurofibromas of neuroectodermal origin are commonly found in Von Recklinghausens disease or neurofibormatosis type 1. It is an autosomal dominant disease caused by mutation of the long arm of chromosome 17. It can present from small nodules to disfiguring giant tumor. Plexiform neurofibroma is benign in most cases, but it could be transformed into malignant tumor, which requires surgical excision. To cover the defects after the excision, a number of surgical correction methods are available. This study is to report a surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap for extensive defects after surgical excision of neurofibrona. Methods: Data of five neurofibroma patients with an average age of 39 including medical history, physical examination, computed tomography, and magnetic resonance imaging were checked. No disease other than neurofibroma were detected. Biopsy on the excised tissues was performed. The follow-up period was 7 to 27 months. Results: The average size of defects after complete excision of neurofibroma was $13{\times}10{\sim}25{\times}15$ cm. Defects were covered by anterolateral thigh free flap, while donor sites were covered by local flap, split thickness skin graft and regional flap. Throughout follow-up, there were no complication, relapse, or any abnormalities. Conclusion: Despite various surgical correction methods are applicable to defects after excision on disfiguring plexiform neurofibroma, coverage of massive defects is still challenging in plastic and reconstructive surgeon. We have made five successful cases of surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap.

• Radiation Oncology Journal
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• 제34권3호
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• pp.177-185
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• 2016

Purpose: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Materials and Methods: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. Results: All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. Conclusion: PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.

• 대한골관절종양학회지
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• 제11권2호
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• pp.126-133
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• 2005

목적: 화상흔, 만성골수염 등의 고위험인자를 동반하는 경우가 많으며 예후가 서구에 비해 나쁜 것으로 알려진 우리나라의 사지에 발생한 편평세포 상피암의 치료 결과를 알아보고자 하였다. 대상 및 방법: 1993년 8월부터 2002년 9월 사이에 본원에 내원당시 원격전이가 없었고, 치료 후 36개월 이상 외래추적 관찰이 가능하였던 20예를 대상으로 광범위 절제술 및 절제연을 얻기 힘든 사지 말단부나 신경, 혈관계를 침범한 경우에는 절단술을 시행하였다. 평균 연령은 57.2세였고, 남자와 여자는 각각 16명과 4명이었다. 병기는 TMN Stage를 이용하여 분류하였고, 절제한 병변의 조직학적 분화도를 측정하였다. 결과: 평균 48.3개월(36~84개월)간의 외래 추적 결과 총 6예(30%)에서 전이가 있었다. 근접 림프절로의 전이가 3예, 원격전이가 3예였으며 원격 전이 장소로는 폐가 3예, 흉추가 1예였다. 최종 추시 상 생존은 18예였고 5년 생존률은 50%였다. 국소재발이 3예에서 있었으며 재발된 평균 시간은 11개월(4~18개월)이었다. 합병증으로 광범위 절제술 시행 후 이식 피부의 부분적인 착상 실패가 2예가 있었다. 광범위 절제술을 시행한 군은 평균 1.9번의 수술을 받았고, 절단술을 시행한 군은 평균 1.3번의 수술을 받았다. 결론: 우리나라에 상대적으로 흔한 사지에 생긴 화상 반흔이나 만성 골수염에 속발한 편평 세포 상피암은 높은 전이율을 보였으며, 광범위한 절제연을 확보할 수 있는 경우 절단술과 비슷한 예후를 보이는 것으로 사료된다.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.583-588
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• 2010

Purpose: Angiosarcoma is a tumor of mesenchymal origin with an extremely high rate of metastasis and invasiveness. This tumor is notorious for its very poor prognosis, although surgical excision followed by radiation therapy is considered to be effective by many. The authors experienced three angiosarcoma patients with their tumors removed and wounds covered with split-thickness skin grafts and/or latissimus dorsi free flaps. Methods: Three patients were admitted to our hospital showed plaques of different morphology. Based on their medical records, these patients were classified by sex, age, type of reconstruction, recurrence, and further treatment after surgical removal. Results: All patients were male, with a mean age of 72 years (range, 66 to 77 years). Split-thickness skin grafts with latissimus dorsi free flaps were performed on two cases, and of these two cases, cervical lymph node biopsy was done in one case, and radical neck dissection was done in the other. In all cases, radiation therapy was done within two weeks of tumor removal. Distant metastasis occurred without local recurrence in two of the cases. Lung was the first organ affected by metastasis. In the remaining case, the tumor recurred locally 6 times, and additional excision was necessary. All patients died due to local recurrence and lung metastasis. Conclusion: Irregular margins and high recurrence and metastasis rates cause a poor prognosis in large angiosarcoma of the scalp. Radiotherapy and chemotherapy should be strongly considered in large angiosarcomas.

• 대한골관절종양학회지
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• 제14권1호
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• pp.68-72
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• 2008

유척색종은 전세계적으로 소수의 증례만이 보고될 정도로 매우 드문 종양으로서 척색종과 조직학적으로 매우 유사한 소견을 보이지만 구간 골격에 위치하는 척색종과 달리 유척색종은 구간외 골격 조직에 발생한다. 또한 국소적으로 재발하는 것으로 알려져 있다. 저자들은 2개월 전 서혜부 연부 조직 종양으로 국소 마취하에 단순 절제술을 시행받은 후 재발하여 광범위 절제술을 재시행하였던 유척색종 증례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다. 척색종의 전이를 배제하기 위하여 골주사 검사를 시행하여 골병변이 없음을 확인하였고, 절제된 조직의 종양 세포는 면역조직화학 염색상 Epithelial membrane antigen(EMA), S-100 단백질, vimentin, cytokeratin에 양성반응을 보였다.

• Journal of Chest Surgery
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• 제49권2호
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• pp.134-137
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• 2016

A mass excision surrounding the bronchial stump was performed to exclude malignancy in a 42-year-old man who had undergone a right lower lobectomy for lung cancer. The mass was identified as a cicatricial fibroma. Cicatricial fibromatosis, which is desmoid fibromatosis that arises in a surgical scar, is a well-known clinical condition. It consists of histologically benign neoplasms. Their occurrence after thoracic surgery is extremely rare. Biopsy or excision of suspicious lesions is very important for diagnosis. R0 resection remains the principal outcome for intrathoracic desmoid fibromatosis. We report that a cicatricial fibromatosis in the subcarinal space was removed after suspicion of local recurrence at the bronchial stump follwing lobectomy for lung cancer.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.502-508
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• 2017

Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.