• Title/Summary/Keyword: 궤양

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Various Flap for Treatment of Radiation Ulcer and Osteoradionecrosis (골괴사를 동반한 만성 방사선 궤양의 치료를 위한 피판술)

  • Yun, In Sik;Lee, Won Jai;Jeong, Hii Sun;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.174-180
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    • 2008
  • Purpose: While radiotherapy remains an essential part of the multidisciplinary treatment of cancers, it may cause unwanted consequences such as tissue break down and chronic non-healing wounds as a result of hypoxia, hypovascularity, and hypocellularity. The conservative treatment of osteoradionecrosis was effective only in the early stages or has a limited result. The surgical treatment of osteoradionecrosis includes various local fasciocutaneous flaps, local myocutaneous flaps and different kinds of free flaps with cancellous bone graft or alloplastic material after removal of all devitalized tissue. This study reviews recent cases of osteoradionecrosis in Severance hospital and investigates the use of various flaps for reconstruction of osteoradionecrosis. Methods: From 2000 to 2006, a total of 29 patients, nine men and twenty women with a mean age of 60.4 years were identified and included in the study. Fasciocutaneous flaps were used on 7 patients and myocutaneous flaps were used on the remaining patients. Mean follow-up period was 10.4 months. Results: In the fasciocutaneous flap group, we noted two complications including total flap failure and a partial flap necrosis. In the myocutaneous flap group, four complications were noted including a partial flap necrosis and 3 cases of wound dehiscence. Considering the complications noted in this study, the natural history of progression to flap necrosis appeared to follow the following sequence of events: marginal flap necrosis, infection, wound dehiscence, flap floating and partial flap necrosis, serially. Conclusion: Successful surgical treatment of osteoradionecrosis includes wide radical debridement and reconstruction with a well vascularized flap like myocutaneous flap or fasciocutaneous flap.

Subphrenic Abscess Due to Retained Gauze (체내에 남은 거즈가 원인인 횡경막 하 농양)

  • Hwang, Eui-Doo;Won, Tae-Hee;Kim, Si-Wook;Na, Myung-Hoon;Yu, jae-Hyun;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.105-107
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    • 2004
  • Eighty-four-year old man who had lapalotomy for stomach ulcer perforation 35 years ago was admitted for left lower chest discomfort. Chest X-ray and CT showed a large mass with air fluid level in left lower lung field. The tentative diagnosis was infected bronchogenic cyst. After a thoracotomy, the mass was confirmed as elevated diaphragm and subphrenic abscess with a foreign body, retained surgical gauze. The pus and gauze were located between stomach and diaphragm. His hospital course was smooth and uneventful, he was discharged with good outcome on postoperative day 9.

Aortic Root Replacement with Homograft in Behcet's Disease -A Case Report- (베체씨 병에서의 동종 이식편을 이용한 대동맥 근위부 치환술 - 1례 보고 -)

  • Moon, Hyeon-Jong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.92-96
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    • 1997
  • The prognosis of Behfet's disease characterized by recurrent orogenltal ulcers and ocular and skin lesions depends upon the complications in the central nervous system, the gastrointestinal tract And the vascular system. Cardiac involvement, especially aortic regurgitation, is quite uncommon and hemodynamic instability is usually treated with ope heart surgery. But serious postoperative complications had been reported in many cases, which are prosthetic valve detachment, paravalvular leakage, conduction disturbance, and false aneurysm. Many efforts to prevent the complications have been made such as application of cryopreseved homograft. We have described an experience of root replacement with homograft in d 39 year-old male patient for prosthetic valve detachment because of Behfet's aorlitis with a review of the literatures regarding treatment, complication, and prognosis.

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Lateral Arm Free Flap for Small Sized Diabetic Foot Ulcer around Toes (족지 주위의 작은 크기의 당뇨 족부 궤양에 대한 외측 상완 유리 피판술)

  • Jung, Heun-Guyn;So, Gwang-Young;Kuk, Woo-Jong;Kim, Hee-Dong
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.28-35
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    • 2008
  • The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

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Vibrio anguillarum infection in rainbow trout Oncorhynchus mykiss during seawater adaption (해수순치 무지개송어 (Oncorhynchus mykiss)의 Vibrio anguillarum 감염증)

  • Kim, Si-Woo;Kim, Jong-Oh;Kim, Wi-Sik;Kim, Do-Hyung;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.27 no.2
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    • pp.133-137
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    • 2014
  • We examined the cause of a disease outbreak in rainbow trout Oncorhynchus mykiss, which were adapting to a seawater in an aquaculture farm in Jeju on April, 2013. Most of the diseased fish showed a severe ulcer on the skin, enlarged spleen, expanded stomach and hemorrhage of abdominal and pyloric region. Although no parasites, fungi or viruses were isolated from diseased fish, over 200 same bacterial colonies were isolated from liver, spleen and kidney. Nucleotide sequences of the 16S rDNA gene of the bacterium in this study showed 100% identity with Vibrio anguillarum. This study is the first report of V. anguillarum infection in rainbow trout during sea adaption in Korea.

The biological and biochemical characteristics of a Vibrio sp., causative agent of intestinal necrosis of flounder larvae (Paralichthys olivaceus) (넙치, Paralichthys olivaceus 자어(仔魚)에서 분리(分離)한 장관백탁증(腸管白濁症)의 원인균(原因菌)인 Vibrio sp.(INFL group)의 생물학적(生物學的) 및 생화학적(生化學的) 특성(特性))

  • Lee, Jung-Baik;Rho, Sum;Song, Choon-Bok
    • Journal of fish pathology
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    • v.8 no.2
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    • pp.99-109
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    • 1995
  • The diseased larvae of the flounder, Paralichthys olivaceus, were sampled several times from a fish hatchery located in Cheju Island between December, 1991 and April, 1992. They turned out to be infected with Vibrio sp. and diagnosed as intestinal necrosis of flounder larvae(INFL) based on morphological, biological, and biochemical examinations. INFL was known to be caused by the live food organism infected with Vibrio sp. The optimal growth conditions of the isolates for temperature, pH, and NaCl concentration were $20\sim30^{\circ}C$, 6~8, and 2~4%, respectively. In the drug sensitivity test, the isolates were sensitive to oxytetracycline, nalidixic acid, kanamycin, and novobiocin, but resistant to ampicillin, erythromycin, spiramycin and sulfa-drug.

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특집 II - 동북아시아 구제역 발생상황과 국내 발생 바이러스의 특징

  • Park, Jong-Hyeon
    • Journal of the korean veterinary medical association
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    • v.46 no.6
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    • pp.527-543
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    • 2010
  • 구제역은 소 돼지 사슴 면양 산양 고라니 노루 등 우제류 동물에서 발생하는 제1종 가축전염병으로 빠른 시간내에 동물의 입 발굽 젖꼭지 등에 수포를 형성하는 것이 특징이다. 감염된 소의 혓바닥, 잇몸, 입술, 입 내부점막, 주둥이에 크기가 다양한 수포가 형성된다. 심한 경우에 혀 전체 넓은 부위에서 궤양이 형성될 수 있다. 수포는 24시간이내에 정상적으로는 파열되며, 그 수포액은 $10^8/ml$의 역가를 갖는 바이러스를 함유한다. 상피가 떨어지고, 유연이 심해지며, 타액이 입 주변에 흔건히 흘러내린다. 입 주변 병변과 동시 또는 이어서 수포가 발굽에 형성되며, 부분적으로 발굽갓띠 또는 제부의 갈라진 틈에서 생성되어 통증과 파행의 원인이 된다. 수포는 보통 유두와 유방에 발생되며, 때로는 세균성 유방염을 발생시킨다. 생산성의 감소는 보통 25% 정도로 추정된다. 돼지는 초기에 파행, 발열, 의기소침, 식욕부진이 있다. 소 보다 발굽에서 더욱 증상이 심하다. 유두, 유선, 콧등에 수포가 형성된다. 혀의 병변은 소보다 심하지 않다. 잠복기가 2~14일 (소에서의 약 6.2일, 돼지에서는 약 10.2일)로 짧고, 전파가 매우 빠르며 경제적 피해가 크기 때문에 국제 교역에서도 규제대상이 되는 질병이다. 구제역의 병인체는 피코르나바이러스과 아프토바이러스속에 속하는 구제역 바이러스로 현재까지 7개의 혈청형(A, O, C, Asia 1, SAT 1, SAT 2 및 SAT 3)이 알려져 있다. 이 전염병은 동물전염병 중에서 가장 악명 높은 전염병이다. 세계동물보건기구 (OIE)에서도 각 국간에 국제적인 위협을 최소화하기 위하여 질병의 발생을 보고해야 하는 질병으로 특별 관리하고 있다. 2006년 이후 최근까지 아시아 지역에서 지속적으로 많은 발생을 보이고 있다. 금년 들어 중국, 대만, 일본, 몽골, 우리나라까지 발생되어 이 질병의 위험성에 대하여 다시 한번 생각하게 하였다. 구제역의 재발방지를 위하여 최근 동북아시아 지역의 발생상황과 향후 구제역의 발생억제 또는 발생시 긴급 대응을 위하여 해야 할 일은 무엇인지 알아보자.

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Poncirin alleviates the symptoms of dextran sulfate sodium-induced colitic mice (Poncirin의 dextran sulfate sodium 유도 마우스 궤양성 대장염 증세 감소 효과)

  • Kim, Jong-Bin;Cho, Woong;Han, Ar-Reum;Seo, Eun-kyung;Lee, Kyung-Tae
    • Korean Journal of Pharmacognosy
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    • v.39 no.2
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    • pp.104-109
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    • 2008
  • We previously reported that anti-inflammatory properties of poncirin, isolated from fruit of Poncirus trifoliata, might be the result from the inhibition of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), tumor necrosis $factor-{\acute{a}}$ ($TNF-{\alpha}$) and interlukin-6 (IL-6) expression via the down-regulation of $NF{-\kappa}B$ binding activity. In this study, we investigated whether poncirin has an inhibitory effect on the production of pro-inflammatory mediators ex vivo and whether poncirin could relieve the symptoms of dextran sulfate sodium (DSS)-induced colitis in mice model of inflammatory bowel disease. Poncirin significantly inhibited the productions of NO, IL-6 and $TNF-{\alpha}$ in lipopolysaccharide (LPS)-induced mouse peritoneal macrophage. In addition, poncirin-treated mice when compared to control mice not receiving treatment recovered better from the weight loss caused by DSS-induced colitis. Changes in disease activity index (DAI) of poncirin-treated mice were also more favorable than for control mice and were comparable with mice treated with a typical anti-inflammatory-drug, 5-aminosalichylic acid (5-ASA). In addition, suppression of plasma NO and IL-6 productions of poncirin-treated mice was also observed in DSS-induced colitis. These results suggest that poncirin has potentially useful anti-inflammatory effects mediated by suppression of inflammatory mediator productions.

Oral Amelanotic Malignant Melanoma in a Dog: Melan A Immunohistochemical Findings (개에서 발생한 구강 멜라닌결핍 악성흑색종 예 : Melan A 면역화학조직 염색 고찰)

  • Kang, Min-Hee;Park, Chul;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.612-615
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    • 2009
  • A 10-year-old intact male mixed breed dog was presented with a three-month history of massive oral mass. Physical examination revealed extending mass from the right upper gingiva. No metastasis was found at the time of presentation. Histopathologic examination of biopsied tissue from the oral mass was consistent with a neuroendocrine tumor with generalized epithelioid cells and few spindle cells. There were highly mitoses and no visible melanin granules with H&E staining. Immunohistochemical staining for Melan A was performed on section of tumor and was strongly positive. Diagnosis was made as amelanotic malignant melanoma based on histopathology with Melan A immunohistochemistry. This case study indicates that the Melan A immunohistochemical staining may be valuable to diagnose amelanotic malignant melanoma in dogs.

The histological and immunohistochemical effects of acua-acupuncture of Bletillae rhizoma extract on the duodenal ulcer induced by HCl-aspirin (백급수침이 HCl-aspirin으로 유발된 십이지장 궤양에 미치는 조직학적 및 면역조직화학적 연구)

  • Ku, Seo-kwang;Lee, Hyeung-sik;Kim, Jong-dae;Lee, Jae-hyun
    • Korean Journal of Veterinary Research
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    • v.40 no.1
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    • pp.153-165
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    • 2000
  • To identify, the effects of acua-acupuncture of Bletillae rhizoma extract on the duodenal ulcer induced by HCl-aspirin in rats, the changes of histological profiles, number of mucous-producing goblet cells (PAS-positive cells), and morphology and/or number of chole-cystokinin (CCK)-8 and serotonin-immunoreactive (IR) cells in the gastrointestinal tract were observed after acua-acupuncture of Bletillae rhizoma extract on Ganshu locus ($BL_{14}$). Samples were collected at 1, 3 and 5 days after treatment. Histologically, very severe injury, atrophy of villus, necrosis of epithelial cell and hemorrhage, to the duodenal mucosa including epithelium were observed in HCl-aspirin administrated control groups, and these injuries were increased with time intervals. But in acua-acupuncture groups and nontreated normal groups, no gross lesion of ulcer was demonstrated and histologically minor injury to the apex of villas epithelium was observed. Compared to the PAS-positive cells of the control groups, those of the acua-acupuncture groups were increased. Severe degranulation of CCK-8- and serotonin-IR cells were observed in the control groups but these phenomena seldom occur in the acua-acupuncture groups. Serotonin-IR cells were significantly decreased in control groups but increased in the acua-acupuncture groups compared to control groups. However, these degranulation of IR cells of the aqua-acupuncture groups were less severe than those of normal groups, and number of serotonin-IR cells were lower than those of normal groups but these phenomena were decreased with time intervals and in 5 days after treatment, they were observed like those of normal groups. These result indicated that acua-acupuncture of Bletillae rhizoma extract would be accelerated the healing of the duodenal ulcer but the functional mechanisms were unknown.

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