• Title/Summary/Keyword: 치유경과

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Clinical Course of Aplasia Cutis Congenita (선천성 피부 무형성증의 임상 경과)

  • Kim, Ji-Young;Lee, Yeon-Kyung;Ko, Sun-Young;Kim, Kyung-A;Shin, Son-Moon
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.359-364
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    • 2011
  • Purpose: Aplasia cutis congenita (ACC) is a rare condition characterized by a localized absence of skin, and it can be associated with other congenital anomalies. This study was done to evaluate clinical course and outcome of ACC in neonates. Methods: Based on the medical records, we retrospectively reviewed 8 neonates diagnosed with ACC at Cheil General Hospital and Women's Health Care Center, Kwandong university College of Medicine from January 2004 to December 2010. We classified ACC by Frieden's classification and analyzed the patient's demographic data, clinical course and outcome. Results: Among 8 patients with ACC, 5 patients were classified to group 1; scalp ACC without anomalies and 3 patients to group 7; ACC localized to extremities without blistering. Defect size was from 0.3 cm to 1.5 cm, limited in the superficial skin or subcutaneous tissue without associated anomalies. Defects were healed under conservative treatment with mild scar formation within four months. Conclusion: ACC could be diagnosed easily through physical examination in neonates. All cases showed good clinical outcome without surgical treatment. However because of small numbers and small sized defects of cases, further study including lesions of large size is needed.

IMPEDANCE AUDIOMETRY IN RELATION TO CHRONIC MAXILLARY SINUSITIS (만성 상악동염이 중이기능에 미치는 영향)

  • 문영일;박연아;김영주;조은아;서명숙
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.12.2-12
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    • 1987
  • 만성 상악동염은 동점막의 복잡한 변화를 일으키고, 만성증으로 지속되는 비분비물 및 비점막의 염증이 이관에 파급되어 중이에 영향을 미치며 그 치유경과를 늦추게 한다. 저자는 만성 상악동염에서 동점막의 비후정도가 이관 및 중이에 미치는 영향을 알아 보고자, 1986년 1월부터 3월까지 이화여자대학교 의과대학 부속병원 이비인후과에 비폐색 및 비루를 주소로하여 내원한 환자중 만성 상악동염으로 진단된 16세 이상의 성인 환자를 대상으로 검사하였다. 동점막 비후정도에 따라 비정상군을 경도(2~3mm), 중등도(4mm이상), 고도(상악동 전체혼탁) 3군으로나누어 각각 40예를 조사군으로 하고 동점막의 두께가 0~1mm인 경우를 정상대조군으로 하여 40예를 GSI 28 AUTO TYMP를 사용하여 screening audiometry, tympanometry, acoustic reflex threshold (ipsilateral and contralateral)를 시행하여 다음과 같은 결과를 얻었다. 1) 남녀의 비는 1 : 2.6이고 21세에서 30세군이 53예(33.0%)로 가장 많았다. 2) 증상발현기간은 6개월 이내가 42.5%로 가장 많았다. 3) Tympanogram의 분포에서 비정상적 type으로 나오는 비율이 정상군과 비정상군중에서 경도군이 각각 22.5%이었고 중등도군이 30.0%, 고도군이 50.0% 순이었다. 4) 등골근반사역치는 정상군과 비정상군 사이에 차이가 없었다. 5) 등골근무반사율 역시 정상군과 비정상군 사이에 차이가 없었다.

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Arthroscopic Anterior Cruciate Ligament Reconstruction with Remnant Bundle Preservation (남아있는 다발을 보존한 전방십자인대 재건술)

  • Ahn, Jin-Hwan;Lee, S.H.
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.87-96
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    • 2009
  • 최근 전방십자인대 손상의 치료에 남아있는 인대 다발이 이식건의 생물학적 치유를 도우며 고유 수용감각(proprioception) 기능을 유지할 뿐만 아니라 슬관절의 전방 전위 억제의 생역학적 기능을 가지는 것으로 연구되고 있다. 이러한 이론을 바탕으로 남아있는 전방십자인대를 보존하는 노력들은 다양하게 시도되고 있다. 전방십자인대 손상의 자연 경과는 아직도 논란이 되고 있으나 선택적인 환자에 있어서 보존적 치료는 비교적 좋은 결과를 얻을 수 있으므로 불필요한 재건술을 줄일 수 있다. 최근 시도되고 있는 선택적 다발 재건술 및 남아있는 다발을 보존하는 전방십자인대 재건 수술 수기들은 다양한 방법으로 시도되고 있으며 남아있는 다발을 보존하는 장점이 있으나 협소한 적응증을 가진다. 저자들의 남아있는 다발을 보존하는 전방십자인대 재건술은 자가 슬괵건을 이용한 단일다발 재건술을 시행하면서 잔존하는 이완된 다발에 봉합사를 통과시킨 후 봉합사를 추가적인 터널 없이 bioabsorbable cross pin (RIGIDfix system, Mitek, Johnson & Johnson, USA) 구멍을 통하여 당기고 고정하는 방법이다. 전방십자인대 재건술시 남아있는 다발을 보존하는 방법은 이식건의 생물학적 치유을 촉진하고 또한 경골 부착부에 남아있는 기계수용체를 보존하므로 기능적 회복에 도움이 될 것으로 기대된다. 저자들의 방법은 비교적 광범위한 적응증을 가지며 적은 합병증으로 남아있는 다발을 효과적으로 보존할 수 있는 술식으로 전방십자인대 수술시 좋은 치료 선택의 하나로 사료된다.

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Remodeling of the Epidermis during Skin Wound Healing in Bombina orientalis (무당개구리 (Bombina orientalis) 피부 상처치유과정 중 표피의 재형성)

  • Jeong, Moon-Jin;Moon, Myung-Jin
    • Applied Microscopy
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    • v.29 no.2
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    • pp.201-209
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    • 1999
  • Remodeling of epithelial cells during wound healing in the skin of the Korean fire-bellied toad, Bombina orientalis, were examined using the scanning and transmission electron microscopical analyses. Artificial wounds were induced on the dorsal surface of the skin by excision, and reared in special cages with normal diets for up to 31 days after injury. From 4 days after wounding, regenerated epithelial cells are more rapidly migrated to wounding area, and remodeling of tissue components are proceeded gradually. Especially, formation of basal lamina between regenerated epithelium and dermis, and reconstruction of cellular junctions such as desmosomes (among the regenerated epithelial cells) and hemidesmosomes (between basal epithelial cells and basal lamina) are detected through fine structural analysis from 10 days after injury. Parakeratosis of regenerated epithelial cells observed during 16 to 19 days after wounding.

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Review of Numerical Approaches to Simulate Time Evolution of Excavation-Induced Permeability in Argillaceous Rocks (점토질 퇴적암 내 굴착영향영역 투수특성의 시간경과 변화 파악을 위한 수치해석기법에 대한 고찰)

  • Kim, Hyung-Mok;Park, Eui-Seob
    • Tunnel and Underground Space
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    • v.30 no.6
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    • pp.519-539
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    • 2020
  • We reviewed numerical approaches to assess a hydraulic properties of excavation-disturbed zone (EDZ)created in argillaceous sedimentary rocks. It has been reported that fractures in the sedimentary rocks containing expansive clays are gradually closing due to swelling and their permeabilities are evolving to the level of in-tact rock, which is known as a self-healing or self-sealing process. The numerical approaches introduced here are capable of simulating spatio-temporal variation of EDZ permeability during long-term operation of a repository by including the self-healing characteristics of fractures, which wa observed in laboratory as well as in-situ experiments, The applicability of the numerical approaches was verified from the comparison to in-situ measurements of EDZ permeability at underground research laboratories.

Local Rifampicin Instillation Therapy for Suppurative Bacillus Calmette-Guérin Lymphadenitis (BCG 접종에 의한 화농성 림프절염의 Rifampicin 국소 주입 요법)

  • Kim, Mee Jeong;Jang, Seong Hee;Ahn, Young Min;Kang, Mi Kyoung;Kim, Sang Jae
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.454-458
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    • 2002
  • Purpose : Bacillus Calmette-$Gu\acute{e}rin$(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis. Methods : The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis. Results : Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt. Conclusion : Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.

The Effect of Microcurrent Stimulation on Expression of BMP-4 After Tibia Fracture in Rabbits (미세전류가 토끼 경골의 골절 후 BMP-4 발현에 미치는 영향)

  • Cho, Mi-Suk
    • The Journal of the Korea Contents Association
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    • v.10 no.3
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    • pp.196-203
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    • 2010
  • This study aimed to examine the effect of microcurrent stimulation on expression of Bone Morphogenetic Protein(BMP) 4 after tibia fracture in rabbits. The twenty four adult 6 month old New Zealand white rabbits weighting 2.5~3.5 ㎏ were used. Twenty four rabbits with tibia fracture were randomly divided into control and experimental groups. Each group was divided into four subgroups, based on the duration of the experiment (3, 7, 14, 28 days). The experimental groups received microcurrent stimulation of 20~25 ${\mu}A$ intensity with surface Ag-AgCl electrode (diameter 1cm, Biopac, U.S.A.) for 24 hours a day. Cathode of the microcurrent stimulator located on the tibia directly, anode of it did on the gastrocnemius muscle. After evaluation, the test results are as follows: Comparisons of immunohistochemical observation of BMP-4 in 7 days after tibial fracture show that there was shown to be a moderate positive reaction (++) on concentric circles of Harversian system and the interstitial lamella in the control group, while there was a very strong positive reaction () on concentric circles of Harversian system and interstitial lamellain the experimental group. These results suggest that applying non-invasive constant microcurrent stimulation on fractured bone is helpful to bone healing.

EFFECT OF INDUCTION CHEMOTHERAPY ON FLAP SURVIVAL RATE IN MICROSURGERY (종양수술전 화학요법이 미세수술시 피판생존율에 미치는 영향)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.6
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    • pp.421-429
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    • 2003
  • Purpose : Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. Materials and Methods: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. Results: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. Conclusion: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.

The Usefulness of Postoperative Pinhole Bone Scintigraphy in the Assessment of Prognosis after Multiple Drilling or Vascularized Bone Graft in Patients with Avascular Necrosis of Femoral Head (다발성 천공술 및 혈관 부착 골이식술을 시행한 대퇴골두 무혈관성 괴사의 예후: 수술 후 바늘구멍 골신티그라피의 유용성)

  • Chung, Yong-An;Kim, Sung-Hoon;Chun, Kyung-Ah;Park, Young-Ha;Sohn, Hyung-Seon;Chung, Soo-Kyo;Song, Mun-Kab
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.405-412
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    • 1999
  • Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.

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A Comparative Study of Initial Healing Process in White Rats after Gingivectomy using $CO_2$ Laser of different watts (($CO_2$)레이저를 이용한 백서의 치은절제술시 출력에 따른 초기 치유과정의 비교)

  • Cho, Kyoo-Sung;Hong, Sung-Jae;Choi, Seong-Ho;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.27 no.3
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    • pp.603-619
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    • 1997
  • The use of laser in the treatment of soft tissue minimizes hemorrhage, provides better view of the operating field, and thereby minimizes operating time. Also, there will be far less post-operative swelling, pain and scar formation, and sterilizing effect are shown in some portions of the wound site. All these advantages of laser therapy contribute to its widespread use in the field of medicine and dentistry. Regarding such facts, we used CO2 laser of different watts in gingivectomy for white rats to compare initial healing process. For the control group, the least amount of output in performing gingivectomy(4watts) was offered, and for the experimental group, 6watts was given. Animals were sacrificed on the second, third days, 1 weeks, 2 weeks, and 3 weeks after operation, and their specimens were histologically analyzed. The following results were obtained: 1. Blood clot of small size was observed in both the control and experimental groups after two days, and no more thereafter. 2. In both the control and experimental groups, the inflammation zone size was the greatest after two days, and it decreased gradually to become almost invisble by the second week. The experimental group showed larger size of inflammation zone during second and third days: however, there was no difference after one week. 3. Granulation tissue in both the control and experimental groups showed gradual maturation with time, and by the second week, it was almost replaced by normal connective tissue. By the third week, complete healing pattern was observed. The experimental group showed larger granulation tissue than the control group until the third day, but there was no significant difference after one week. 4. In both the control and experimental groups, gingival epithelialization began on the second day. After one week, regeneration of rete peg and partial formation of junctional epithelium were observed: by the second week, keratinization of oral sulcular epithelium began, and it was completed by the third week.

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