• Journal of Trauma and Injury
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• 제20권1호
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• pp.52-56
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• 2007

Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

• Archives of Plastic Surgery
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• 제42권2호
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• pp.173-178
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• 2015

Background Various focal heating devices are popular in Korea under the cultural influence of the traditional ondol under-floor method of home heating. These devices can cause severe burn-like injuries resulting from device malfunction or extended with low heat contact. In addition to injuries under these high heat contact, burns can be occurred by low heat exposure with prolonged periods despite the devices are properly functioning. In order to develop strategies to reduce the duration of periods of illness due to low-temperature burns, we analyzed and compared treatment methods and therapeutic periods for this type of injury. Methods This retrospective study included 43 patients burned under low heat conditions. Patients were divided into an operative group and a conservative group. The patients in the operative group underwent at least one surgical excision, and were further subdivided into early and late visit groups. The conservative group was treated only with dressings. We compared the treatment periods between the operative group and the conservative group, and also compared the preparation periods and treatment periods between the two operative groups. Results The average treatment period was significantly shorter in the operative group (P=0.02). In the early visit operative group, both wound preparation and treatment were briefer than in the late visit group. Conclusions We recommend that early proper burn care and early surgical intervention, including appropriate excision, are feasible ways to reduce the treatment period of lowtemperature burn patients.

• Ocean and Polar Research
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• 제30권4호
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• pp.467-472
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• 2008

Antarctic krill has a strong proteolytic enzyme system, which comes from a combination of several proteases. This powerful activity can be easily detected by krill's superior post mortem autolysis. Mammalian skin consists of epidermis and dermal connective tissue, and functions as a barrier against threatening environments. A clot in a wound site of the skin should be removed for successful skin regeneration. Epithelial cells secrete proteases to dissolve the clot. In previous studies Antarctic krill proteases were purified and characterized. The proteolytic enzymes from Antarctic krill showed higher activity than mammalian enzymes. It has been suggested that these krill clean up the necrotic skin wound to induce a natural healing ability. The enzymes exhibited additional possibilities for several other biomedical applications, including dental plaque controlling agent and healing agent for corneal alkali burn. Considering that these versatile activities come from a mixture of several enzymes, discovering other proteolytic enzymes could be another feasible way to enhance the activity if they can be used together with krill enzymes. Molecular cloning of the krill proteases should be carried out to study and develop the applications. This review introduces possible roles of the unique Antarctic krill proteases, with basic information and suggestion for the development of an application to skin regeneration.

• 한국안광학회지
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• 제13권4호
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• pp.161-169
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• 2008

목적: 알칼리 화상 후 초기 임상적 손상반응의 진행과 치료를 위한 각막 재생의 이해를 높이기 위하여, 화학적 손상 후 동반하는 다양한 인자에 대한 면역조직화학적 변화를 조사하였다. 방법: 알칼리 화상을 입은 각막의 자가치유과정을 면역형광염색법과 H-E 염색, 그리고 TUNEL assay를 통해 면역조직화학적 측면에서 관찰하였다. 결과: 화상 후 각막의 치유는 진행되었지만 각막기질(stroma)과 내피세포의 세포사는 지속적으로 관찰되었다. 각막가장자리의 혈관신생과 손상된 각막의 ${\alpha}$-SMA의 발현은 알칼리 화상 3일 후부터 나타났으며, 각막기질에서의 콜라젠 III(collagen III)의 형성과 콘드로이친황산(chondroitin sulfate)의 발현은 ${\alpha}$-smooth muscle actin(${\alpha}$-SMA)와 transforming growth factor-${\beta}$(TGF-${\beta}$)의 발현증가와 일치하는 결과를 얻었다. 결론: 각막혼탁을 막기 위해서는 알칼리 화상 후 3일 이내에 혈관신생, 콜라젠 및 콘드로이친황산의 형성을 억제하는데 주력하는 치료가 효과적일 것이라 사료된다. 이 연구는 알칼리 화상을 입은 각막의 치유과정에 있어서의 면역조직화학적 지식을 제공함으로써, 각막의 재생을 촉진하는 치료제의 개발과 이용에 초석이 되리라 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권3호
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• pp.182-188
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• 1993

A technical refinement for oral commissure reconstruction is presented. The oral commissure has an important role in oral sphincteric function. Once lost, the oral commissure is very difficult to restore and therefore, reconstruction of the oral commissure requires prevention of this function as well as prevention of microstomia. Trauma and tumor excisions are the most frequent reasons that will necessitate reconstruction of the oral commissure. Direct approximation of the wound margins after resection of the corner of the mouth could easily induce microstomia and difficulty in opening. Thus case presented here deals with distortion of noraml mouth angle and acquired microstomia due to burn and tissue deface following shotgun and explosive wounds. The a mucosal flap approach was used to rehabilitate a natural looking mouth angle showing satisfactory results function and esthetic wise.

• BMB Reports
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• 제48권11호
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• pp.618-623
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• 2015

FK506 binding protein 12 (FK506BP) is a small peptide with a single FK506BP domain that is involved in suppression of immune response and reactive oxygen species. FK506BP has emerged as a potential drug target for several inflammatory diseases. Here, we examined the protective effects of directly applied cell permeable FK506BP (PEP-1-FK506BP) on corneal alkali burn injury (CAI). In the cornea, there was a significant decrease in the number of cells expressing pro-inflammation, apoptotic, and angiogenic factors such as TNF-α, COX-2, and VEGF. Both corneal opacity and corneal neovascularization (CNV) were significantly decreased in the PEP-1-FK506BP treated group. Our results showed that PEP-1-FK506BP can significantly inhibit alkali burn-induced corneal inflammation in rats, possibly by accelerating corneal wound healing and by reducing the production of angiogenic factors and inflammatory cytokines. These results suggest that PEP-1-FK506BP may be a potential therapeutic agent for CAI.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.765-774
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• 2011

Purpose: Many facial burn patients suffer from hyperpigmentation and its treatment has been challenging. Vitamin C (ascorbic acid) has important physiologic effects on skin, including inhibition of melanogenesis, promotion of collagen biosynthesis, prevention of free radical formation, and acceleration on wound healing. The purpose of this study is to evaluate the effectiveness of Vitamin C iontophoresis for the treatment of postburn hyperpigmentation. Methods: The authors performed a retrospective analysis of 93 patients who were admitted for the treatment of facial burn from February 2008 through February 2010. Among them, 51 patients were treated with Vitamin C iontophoresis to control postburn hyperpigmentation and 42 patients were not. Experimental group was chosen 20 of 51 patients who had been treated with Vitamin C iontophoresis and had normal facial skin on the comparable contralateral aesthetic unit. Control group was chosen 20 of 42 patients who were not treated with Vitamin C iontophoresis and had also contralateral normal aesthetic unit. The resulting color of 20 patients who were treated with Vitamin C iontophoresis was compared with the color of the contralateral normal facial skin using a digital scale color analysis. Results were analyzed with Wilcoxon signed rank test. Results: The analysis revealed significant improvement of hyperpigmentation in the experimental group compared to control group. The difference of intial value and the value in 6 months showed significant change. Mean (${\Delta}^{initial}$-${\Delta}^{6month}$) of experimental group was 11.61 and control group was 7.23. Thus, the difference between the experimental group and the control group was 4.38. Therefore, Vitamin C iontophoresis revealed significant improvement of hyperpigmentation in the experimental group compared with control group. Conclusion: Vitamin C iontophoresis is an effective treatment modality for postburn hyperpigmentation.

• Archives of Plastic Surgery
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• 제36권3호
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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.

• Archives of Plastic Surgery
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• 제39권6호
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• pp.649-654
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• 2012

Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow. Methods A retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The patients' data including age, sex, cause of injury, wound dimensions, timing of flap coverage, postoperative elbow motion, and complications were investigated. Results Between 2001 and 2012, 16 patients were treated at our hospital. The mean age was 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral arm flaps, and 4 radial forearm flaps. The average defect size was 183.5 $cm^2$ (range, 28 to 670 cm2). Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days). The mean postoperative active elbow flexion was $98^{\circ}$ (range, $85^{\circ}$ to $115^{\circ}$). Partial flap failure occurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%), hematoma (23.5%), seroma (35.3%), and wound infection (5.9%). Conclusions Flap selection for elbow reconstruction is determined by the defect size and the extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a single-staged, reliable, and relatively simple procedure that permits initiation of early rehabilitation, thereby improving a patient's functional outcome.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XII)
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• pp.92-94
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• 2003

각질세포의 배양법이 개발 후 피부 결손 부위의 치료에 인체 각질세포를 배양하여 얻어진 표피를 이식하는 방법부터 세포부유물을 도포하는 방법들은 Trypsin 처리 과정을 거치면서배양된 세포의 부착능력을 가진 단백질이 손상되어 성공적인 피부 재생이 불가능하다. 본 실험에서는 이러한 효소처리의 단점을 보완하기 위해서 고분자 미립구에 세포를 효소처리 과정없이 동물실험을 한 결과 21일 후에는 대조군에 비해서 표피가 완벽하게 재생되었고 이식 후 세포의 부착면적을 늘리고 생착율을 높일 수 있었다. 이 연구에서 효소처리 없이 고분자 미립구에서 배양된 세포를 이용한 인공피부 재생이 효과적인 것을 보여주었다. 이러한 모델은 앞으로 화상이나 궤양으로 인한 피부 손실 부위 치료에 사용될 수 있을 것으로 생각된다.