• Archives of Plastic Surgery
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• 제50권1호
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• pp.59-62
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• 2023

A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

• Archives of Reconstructive Microsurgery
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• 제12권1호
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• pp.38-43
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• 2003

Purpose : Various free flaps and pedicled island flaps are effective for reconstruction of soft tissue defect developed after tumor excision. We want to know the advantage of dorsalis pedis island flap for reconstruction of soft tissue defect caused by soft tissue tumor excision. Materials and Methods : Between 1992 and 2002, we performed 4 dorsalis pedis island flap procedure for reconstruction of soft tissue defect of lower limb developed after soft tissue tumor excision. Average age was 54.7 years old $(40{\sim}68)$, and male 2 cases, female 2 cases. The kinds and number of soft tissue tumors were 2 squamous cell carcinoma and 2 malignant melanoma. The procedures that we performed were all dorsalis pedis island flap. The analysis for the result of treatment was retrospectively accessed by physical examination and questionnaire for whether the change of symptom after operation, range of adjacent joint motion. Also we reviewed associated complication after operative treatment. Results : All dorsalis pedis island flaps were alive. There is no problem for activity of daily living, no skin necrosis and no limitation of motion of adjacent joint. In 1 case of them, the patients died of distant metastasis. Conclusion: Dorsalis pedis island flap procedure as a pedicled island flap procedure is very effective and easy operative procedure for reconstruction of soft tissue defect of lower limb developed after tumor excision compared to free flap procedure because there is no need for microvascular surgery, we can obtain relatively large flap and the lesion and flap donor site locate in the same limb.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.11.1-11.5
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• 2018

Background: Squamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate. Case presentation: In the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications. Conclusion: Discussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.

• Clinical and Experimental Pediatrics
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• 제51권1호
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• pp.67-72
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• 2008

목 적 : 본 연구는 HLA가 일치하는 부모로부터 동종조혈모세포이식을 시행받은 소아의 이식 결과를 분석하고자 하였다. 방 법 : 1999년 4월부터 2005년 10월까지 성모병원 조혈모세포이식센터에서 급성 백혈병으로 1차 관해 후 HLA가 일치된 부모로부터 조혈모세포이식을 시행받은 환아 7명(급성 림프모구성백혈병 4명, 급성 골수성백혈병 3명)을 대상으로 하였다. 이식 시 중앙연령은 5세(범위, 1-11세; 남아 2명, 여아 5명), 공여자의 중앙연령은 35세(범위, 30-41세; 남자 5명, 여자 2명)이었다. 이식 후 대상 환아의 생착, 급성이식편대숙주병, 만성이식편대숙주병, 이식관련 사망, 재발, 이식관련 합병증과 생존율 등을 분석하였다. 결 과 : 이식부터 마지막 추적관찰까지 중앙기간이 69.5개월(범위, 18.8-96.5개월)이었다. 이식을 받은 7명의 환아들은 모두 생착이 되었고 호중구와 혈소판의 생착은 이식 후 각각 11일(범위, 10-16일)과 26일(범위, 13-39일)이었다. Grade II의 급성 이식편대숙주병은 3명(43%), grade III의 급성 이식편대숙주병은 1명(14%)에서 발생하였다. 광범위 만성이식편대숙주병은 2명(28%), 제한적 만성이식편대숙주병은 1명(14%)에서 발생하였다. 이식 후 재발은 1명(14%)이었고 이식관련 사망은 1명(14%)이었다. 대상 환아의 이식 후 5년 전체 생존율은 $83{\pm}15%$이었다. 결 론 : 소아 급성 백혈병에서 HLA가 일치하는 부모자식간 동종조혈모세포이식의 결과는 HLA가 일치하는 형제간 조혈모세포이식의 결과와 비견할 수 있으며 동종조혈모세포이식이 필요한 환아에서 형제뿐만이 아니라 부모의 HLA를 검사하면 조혈모세포 공여자 선정의 가능성이 높아진다.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.564-569
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• 2013

Background Scalp defects may be caused by various etiological factors, and they represent a significant surgical and aesthetic concern. Various surgical techniques can be applied for reconstructive work such as primary closure, skin grafting, pedicled or free flaps. In this article, the authors share their clinical experience with scalp operations using the technique of local flaps and discuss the application of this method from the perspective of not only the size of the defect, but also in relation to the anatomical area, quality of surrounding tissue, and patient's condition. Methods During the period from December 2007 to December 2012, 13 patients with various scalp defects, aged 11 to 86 years, underwent reconstruction with local pedicle flaps. The indications were based on the patients' condition (age, sex, quality of surrounding tissue, and comorbidities) and wound parameters. Depending on the size of the defects, they were classified into three groups as follows: large, 20 to 50 $cm^2$; very large, 50 to 100 $cm^2$; extremely large, 100 $cm^2$. The location was defined as peripheral (frontal, temporal, occipital), central, or combined (more than one area). We performed reconstruction with 11 single transposition flaps and 1 bipedicle with a skin graft on the donor area, and 2 advancement flaps in 1 patient. Results In all of the patients, complete tissue coverage was achieved. The recovery was relatively quick, without hematoma, seroma, or infections. The flaps survived entirely. Conclusions Local flaps are widely used in scalp reconstruction since they provide healthy, stable, hair-bearing tissue and require a short healing time for the patients.

• 한국수산과학회지
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• 제3권1호
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• pp.19-26
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• 1970

1969년 여름 부산수산대학 양어장에서 1963년 일본으로부터 도입하여 길러온 초어와 백련을 사용 채란과 부화실험을 하였는 바, 그 결과는 좋지 못하였지만, 다음과 같은 점을 지적한다. 1. 부산지방의 못에서 양식한 초어가 백련의 성숙 채란 적기는 6월 말부터 8원 초까지의 사이에 있다고 인정된다. 2. 산란 촉진용 뇌하수체는 동종 또는 근연종의 친어로부터 그들의 산란기이 진에 적출 보관하였다가 사용하는 것이 좋다고 인정된다. 3. 백련은 체장 40cm(전장 48cm) 가량의 작은 개체도 6년생은 모두 채란 가능하였으며, 포란수는 체장 $40\~44.5cm$ 되는 것에서 $23\~26$ 만개로 추산되었다. 4. 부화 시설로서는 원추형 망부화기를 급수 파이프에 병렬하고, 각 부화기에는 수량 조절용 발브를 달아서 수중에 설치하는 것이 좋은 동작을 하였다. 5. 알의 발생 중, 분할된 할구(세포)가 배체 밖으로 방출되는 것이 생기면, 그 알은 예외없이 괴사하였다. 6. 친어의 사전 관리를 보다 철저히 하는 것이 긴요함을 느꼈으며, 좋은 먹이와 적절한 수심 및 수온을 유지시키도록 해야 할 것이다.

• Clinical and Experimental Reproductive Medicine
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• 제50권3호
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• pp.177-184
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• 2023

Objective: Reconstructed oocytes after polar body genome transfer constitute a potential therapeutic option for patients with a history of embryo fragmentation and advanced maternal age. However, the rescue of genetic material from the first polar body (PB1) through introduction into the donor cytoplasm is not yet ready for clinical application. Methods: Eighty-five oocytes were obtained following in vitro maturation (IVM) and divided into two groups: PB1 nuclear transfer (PB1NT; n=54) and control (n=31). Following enucleation and PB1 genomic transfer, PB1 fusion was assessed. Subsequently, all fused oocytes underwent intracytoplasmic sperm injection (ICSI) and were cultured in an incubator under a time-lapse monitoring system to evaluate fertilization, embryonic morphokinetic parameters, and cleavage patterns. Results: Following enucleation and fusion, 77.14% of oocytes survived, and 92.59% of polar bodies (PBs) fused. However, the normal fertilization rate was lower in the PB1NT group than in the control group (56.41% vs. 92%, p=0.002). No significant differences were observed in embryo kinetics between the groups, but a significant difference was detected in embryo developmental arrest after the four-cell stage, along with abnormal cleavage division in the PB1NT group. This was followed by significant between-group differences in the implantation potential rate and euploidy status. Most embryos in the PB1NT group had at least one abnormal cleavage division (93.3%, p=0.001). Conclusion: Fresh PB1NT oocytes successfully produced normal zygotes following PB fusion and ICSI in IVM oocytes. However, this was accompanied by low efficiency in developing into cleavage embryos, along with an increase in abnormal cleavage patterns.

• 한국발생생물학회지:발생과생식
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• 제14권4호
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• pp.233-241
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• 2010

사람의지방줄기세포는지방조직내에존재하는 줄기세포로 얻기 쉽고, 골수줄기세포와 유사한 특징을 가지고 있다. 그러나 지방을 추출하는 과정, 공여자의 나이, 체질량, 추출 부위에 따라 세포의 특성이 달라지며, 이질적인 세포군을 얻게 된다. 따라서 본 연구에서는 허벅지 지방에서 유래한 줄기세포 특성 분석 및 중배엽, 내배엽성 세포로의 분화능을 알아보았다. 허벅지 유래 줄기세포는 골수줄기세포와 유사한 섬유아세포와 유사한 모양을 보였으며, 체외에서 56.5번의 분열을 하였고, 약 $5{\times}10^{22}$개의 세포를 얻을 수 있었다. 이들은 SCF, Oct4, nanog, vimentin, CK18, FGF5, NCAM, Pax6, BMP4, HNF4a, nestin, GATA4, HLA-ABC, HLA-DR과 같은 유전자를 발현하였으며, Oct4, Thy-1, FSP, vWF, vimentin, desmin, CK18, CD54, CD4, CD106, CD31, a-SMA, HLA-ABC 등과 같은 단백질을 발현하였다. 또한 이들은 지방, 골, 연골 세포와 같은 중배엽성 세포로 분화하였고, 더욱이 인슐린 분비세포와 같은 내배엽성 세포로도 분화하였다. 결론적으로, 사람의 허벅지 유래 줄기세포는 골수 줄기세포와 유사하게 체외에서 증식이 가능하였으며, 유전자 및 단백질 발현 패턴을 가지고 있었으며, 다양한 세포로 분화 가능하였다. 이러한 결과로 미루어 보아 허벅지 지방유래 줄기세포는 골수 줄기세포를 대체할 수 있는 세포치료제의 재료가 될 수 있을 것으로 사료된다.

• 한국양식학회지
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• 제19권4호
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• pp.281-287
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• 2006

우리나라 주요 담수어종인 미꾸라지(Misgurnus mizolepis)를 어류 염색체 조작 모델로 개발하기 위한 연구의 일환으로 동일 종내 웅성발생성 이배체 유도 조건을 개발하고 유도된 웅성발생성 이배체의 생존능력을 평가하였다. 자외선(UV; $10,800\;ergs/mm^2$)을 이용하여 난자의 유전물질을 불활성화시키고 인공수정 28분 후(제1난할 중기)에 온도처리(고온 자극 $40.5\;^{\circ}C$ 120초 후 저온 자극 $1\;^{\circ}C$ 45분)를 통해 제1난할을 억제하였다. 본 온도처리를 통해 생존력 있는 웅성발생성 이배체들이 유도되었고(평균 부화율, 26.9%), 부화 후 1주일째를 기준으로 평균 웅성발생성 이배체 수율은 최초 처리난의 7%내외로 나타났다. 그러나 웅성발생성 이배체 유도 효율은 cytoplasmic donor의 질에 크게 영향을 받음이 관찰되어 사용한 암컷 친어별로 큰 편차가 관찰되었다. Flow cytometry 분석에 의해 생존력 있는 웅성발생성 개체들의 이배체 복원이 확인되었으며 아울러 형질전환 표지를 이용하여 동형접합성 개체 유도의 가능성이 확인되었다. 웅성발생성 이배체들은 일반대조군 이배체에 비해 낮은 생존능력을 보였으며 특히 부화 후 1개월까지 유의적으로 낮은 생존율을 나타내었다. 그러나 후기 생존능력은 일반 이배체군과 유사하였다.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.