• Archives of Plastic Surgery
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• 제44권2호
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• pp.150-156
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• 2017

Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.755-760
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• 2009

Purpose: Breast surgeons usually insert tissue expander or implant beneath the subpectoral - subglandular dual plane in breast reconstruction. But sometimes it happens unsatisfactory lower pole fullness, asymmetric inframammary fold and breast shape because there is implant migration due to the pectoralis major muscle contraction and gravity. To solve all the problem like these, we introduce implant breast reconstruction using AlloDerm$^{(R)}$(LifeCell Corp., Branchburg, N.J.) sling. Methods: The AlloDerm$^{(R)}$ sling was used in 13 patients and 18 breasts for implant breast reconstruction. After mastectomy, costal and lower sternal insertion of pectoralis major muscle was detached. Rehydrated AlloDerm$^{(R)}$ was sutured to the chest wall and serratus anterior fascia at the level of inframammary fold downward and to lower border of the pectoralis major muscle upward like crescent shape with tension free technique after implant insertion into the subpectoral - subAlloDerm dual pocket. Results: We make satisfactory lower pole fullness, symmetric inframammary fold and breast shape. In conclusion, patients obtain relatively natural breast shape. There was no complication except one case of capsular contracture and one case of breast cellulitis. Conclusion: Implant breast reconstruction using AlloDerm$^{(R)}$ sling makes easy to get natural breast shape through satisfactory lower pole fullness, symmetric inframammary fold and implant positioning.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.562-570
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• 2014

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four transfemoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown.

• 동의생리병리학회지
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• 제22권1호
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• pp.51-59
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• 2008

The following conclusions were obtained from the studies on Bangpuntongseongsan both from the documents and Hyungsang medicine. Bangpungtongseong-san was created by Yu Wan-so to relieve both interior and exterior of disease from the pathogenic fire, and it cures wind syndrome and dry syndrome. Bangpungtongseong-san is of light herbal combination and it works in the upper part of the body and is mainly applied to skin disease. Perspiration without harming the exterior and purgation without hurting the interior shows that it is not a severe prescription belonging to meditation therapy. It is mostly used for curing the disease of internal heat caused by over drinking and consuming heavy food, and it has special relationship with Yangmyung meridian. It is mentioned in the chapters of spirit, head, face, eye, ear, nose, throat, skin, hair, prescription, wind, dryness, fire, internal damage, epidemic infectious disease, carbuncle and cellulitis, ulceration, and pediatrics of ${\ulcorner}$Donguibogam${\lrcorner}$. It is usually applied to those who belong to Yangmyung type of the six meridian types or wind type, who has excessive heat, people with red complexion, reddened nose, pimples over the face and nose, coarse heel, loss of hair due to wind-heat, and to those who tend to have dandruff. Through examination over the cases treated with Hyungsan medicine, Bangpungtongseong-san was found efficacious in bloodshot eyes, brandy nose, loss of hair, various skin problems, tetanus, acute alcoholism, paralysis of hand and foot, deafness, and tinnitus.

• 대한소아치과학회지
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• 제2권1호
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• pp.67-75
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• 1975

The conserative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the development of the occlusion in the permanent dentition. The purpose of this study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth and surgical intervention in the cases with a parulis, fistula or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observation at 3-month intervals postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Radiographiclly, 14 cases revealed normal features, in 6 cases slight rarefaction was observed in the periapical and interradicular region, and marked periapical and interradicular rarefaction was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failurese. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac.

• 대한임상독성학회지
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• 제7권2호
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• pp.105-112
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• 2009

Purpose: There have been local wound complications in patients who have received first aid after venomous snake bites. Yet first aid in relation to local wound complications has not been well studied. Methods: We conducted a 5-year retrospective study of 111 snake bite patients who visited the emergency departments of several medical centers between January 2004 and December 2008. We categorized the patients into those who had complications with inadequate first aid, those who had complications without first aid those who had complications with adequate first aid. We compared the genera characteristics and the laboratory and clinical findings of the three groups. Results: The ale o female ratio was 1.36. The most common bite site was fingers. The most common systemic symptom was dizziness (6.3%) and the most common complication was rhabdomyolysis (23.4%). The inadequate first aids group had more local complications (cellulitis, skin necrosis) than did the group with adequate first aid or the group with no first aids. Conclusion: Inadequate first aid after snake bite leads to local complications, so we must be careful to administer first aid after snake bite and evaluate this first aid in elation to local complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.538-542
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• 2007

Sweet syndrome is characterized by acute onset of fever. neutrophilic leukocytosis, painful erythematous plaque on the face and extremities, infiltration of mature neutrophils in the dermis. Cutaneous lesion and clinical symptoms rapidly improve after treatment with systemic corticosteroids. The cause of sweet syndrome is unknown but the associations with hypersensitivity to bacteria, virus, or tumor antigen have been reported. Sweet syndrome itself can be a premonitory manifestation of malignancy, so diagnostic work up for other internal malignancy is recommended. Because of fever and leukocytosis, cutaneous infections are important differentials. Sweet syndrome can be divided into 4 categories according to associated disease and symptom. (Idiopathic Sweet syndrome, Parainflammatory Sweet syndrome, Paraneoplastic Sweet syndrome, Pregnacy associated Sweet syndrome.) Sweet syndrome is relatively rare disease and the association with myelodisplastic syndrome has been reported. We report a case of Sweet syndrome associated with myelodisplastic syndrome which has initial manifestation of odontogenic buccal cellulites.

• 한국한의학연구원논문집
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• 제10권2호
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• pp.1-21
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• 2004

1) Objective External treatments have various curative effects. So it had been used to cure various patients. But, it has a limited sphere of application in the present South Korea. Therefore we would like to bring out its sphere of application and detailed method in the oriental medicine classics. 2) Methodologies We have researched external treatment history according to below the procedure. (1) Making a related words list: We have used existing external treatments technical books to make a list. It has been connected with external treatments. It includes not only technical terms, but also general terms. (2) Searching sentence: We have searched sentence that contain terms that related with external treatments. (3) Analysis of related sentence: We have searched and classified sentence by disease. (4) Analysis of external treatment methods. 3) Conclusions From long time ago people have used external treatment to cure various disease. According to the ${\ulcorner}Nei-Jing{\lrcorner}$, hot compress therapy, fumigation therapy and bathing therapy had been used to cure blockage syndrome, muscle disease, carbuncle and cellulitis. Thereafter, a sphere of external treatment had gradually enlarged. (1) After all its sphere had included dermatologic, psychologic, internal, ophthalmic, otolaryngologic, obstetrics, gynecologic, pediatric and surgical diseases. (2) External treatment methods have contained hot compress therapy, fumigation therapy, bathing therapy, application therapy, medication bag therapy, medication plug therapy, medication massotherapy, aroma therapy and so on. (3) Medication types of external treatment have contained ointment, juice, infusion, powder, suppository and so on.

• Archives of Plastic Surgery
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• 제34권1호
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• pp.111-114
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• 2007

Purpose: Dystrophic calcification occurs in damaged or devitalized tissues in the presence of a normal calcium and phosphorus metabolism. There are many reports on dystrophic calcification caused by injections of various types of drugs. The aim of this report is to highlight the fact that dystrophic calcification can be caused by the injection of a foreign body for aesthetic augmentation. Methods: This case report describes a patient presenting with dystrophic calcification caused by an injection of an unknown foreign body approximately 50 years ago. An 80-year-old man had localized cellulitis with swelling and ulceration on the dorsum of the left hand. The radiographs demonstrated a $5{\times}3.5{\times}1.7cm$ lesion between the first and second metacarpal bones and a $5{\times}2.5{\times}1.5cm$ lesion in the hypothenar region. The laboratory data and physical examinations were generally within the normal limits. The microscopic examination revealed dead bone fragments and dense collagenous tissue with dystrophic calcification. Results: After surgically removing the masses, the resulting defects were treated with an abdominal flap. The result was satisfactory in terms of symptoms and appearance. Conclusion: This case suggests that dystrophic calcification can be caused by an injection of a foreign body for aesthetic augmentation.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.271-276
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• 2018

60세 남성이 3개월간 좌측 새끼손가락이 붓고 그곳의 발적 증상을 주소로 내원하였다. 과거력 상 특이 소견은 없었고, 균 배양 검사상 methicillin-resistant Staphylococcus aureus가 검출되었다. 반코마이신을 투여 후, 피부 병변이 악화되면서 전신 수포와 낙설이 발생하였다. 우리는 처음에 약물 발진 의진 하에 항생제를 반코마이신에서 테이코플라닌으로 변경하였다. 하지만 피부 조직검사 결과는 Staphylococcal scalded skin syndrome (SSSS)으로 나왔다. 수일 후, 환자는 전신 피부증상 호전되어 퇴원하였다. 우리는 건강한 성인에서 발생한 국소적 양상의 SSSS에 대해 보고하고자 한다. 이는 오진하기 쉬운 증례로서, 정확한 진단을 위하여서는 조기에 조직학적 검사가 중요할 것으로 생각된다.