• Archives of Plastic Surgery
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• 제38권4호
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• pp.451-457
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• 2011

Purpose: As a central feature of the face, the nose has considerable significance in appearance and expression. Reconstruction of full thickness defects of the nasal ala has always been a challenge because of the 3-dimensional structure. For reconstruction of post burn defects of ala, skin graft, local or pedicled flap and composite graft are optionally available. We have reconstructed the ala defects using adiposocutaneous graft and observed the outcome. Methods: From March 2003 to December 2010, 19 cases in 11 patients with scar contracture and defect on ala portion were performed operation using adiposocutaneous graft. As a donor site, we used the inguinal crease and posterior auricular area and the donor site was primarily closed. We made incision through the superior rim of ala and released fully. A graft is applied to recipient site with larger size than recipient volume. Results: The mean age of the patient was 38.6 years (16~51), males are seven patients and females are four patients. The operation was performed bilaterally in 5 patients and unilaterally in 6 patients. Composite grafts were harvested from inguinal area in 13 cases and posterior auricular area in 6 cases. In one case, we did 4 times of operation to get enough volume. All the grafts were well taken. The mean size of the graft was 3.63 $cm^2$. Conclusion: For reconstruction of post burn defects of ala, it's not easy to use local flap or pedicled flap because of hardness and fibrosis of surrounding tissue. So, we choose adiposocutaneous graft for ala deformity reconstruction, got satisfactory outcome in color matching and texture.

• 대한한방내과학회지
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• 제26권4호
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• pp.853-863
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• 2005

Object : This study was performed to investigate the anti-fibrogenic effect of Artemisiae Capillaris Herba(ACH) on cultured rat hepatic stellate cells. Methods : Hepatic Stellate Cells were obtained from a 350gm Sprague-Dawley rat by tissue perfusion system, and the cells for the study were selected after 3 passages of culture on non-coated plastic culture dishes which enable the cells to activate, thus producing collagens in the cell media. Cells were treated with various concentrations of Artemisia Capillaris Herba(ACH) extract powder for 24 or 48 hours. After the treatment, Soluble collagen, procollagen levels and the mRNA of the procollagen type I C were measured by using assay kit and RT-PCR method. Results : Procollagen production by the hepatic stellate cells decreased after the treatment in a time-dependent dose-dependent manner. The mRNA expression decreased consistently with the volume of the secreted procollagen which indicates the herb hat inhibitory effect on fibrogenesis of the liver by regulating one of the fibrosis associated genes in transcription. Conclusion : These results suggest that ACH is beneficial in the treatment of cirrhotic patients as well as for the patients with chronic hepatitis.

• Clinical and Experimental Pediatrics
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• 제58권12호
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• pp.459-465
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• 2015

Postinfectious bronchiolitis obliterans (PIBO) is an irreversible obstructive lung disease characterized by subepithelial inflammation and fibrotic narrowing of the bronchioles after lower respiratory tract infection during childhood, especially early childhood. Although diagnosis of PIBO should be confirmed by histopathology, it is generally based on history and clinical findings. Irreversible airway obstruction is demonstrated by decreased forced expiratory volume in 1 second with an absent bronchodilator response, and by mosaic perfusion, air trapping, and/or bronchiectasis on computed tomography images. However, lung function tests using spirometry are not feasible in young children, and most cases of PIBO develop during early childhood. Further studies focused on obtaining serial measurements of lung function in infants and toddlers with a risk of bronchiolitis obliterans (BO) after lower respiratory tract infection are therefore needed. Although an optimal treatment for PIBO has not been established, corticosteroids have been used to target the inflammatory component. Other treatment modalities for BO after lung transplantation or hematopoietic stem cell transplantation have been studied in clinical trials, and the results can be extrapolated for the treatment of PIBO. Lung transplantation remains the final option for children with PIBO who have progressed to end-stage lung disease.

• 대한한의학방제학회지
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• 제6권1호
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• pp.119-139
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• 1998

간경변(肝硬變)은 각종(各種) 만성미만성간염(慢性彌滿性肝炎)이나 광범위(廣範圍)한 간장실질(肝臟實質)의 손상(損傷)이 계속적(繼續的)으로 발전(發展)하여 이루어진 결과(結果)이다. 주(主)된 병리적(病理的) 특징(特徵)은 간세포(肝細胞)의 변성(變成), 괴사(壞死) 후(後)에 나타나는 섬유조직(纖維組織)의 증식(增殖), 간세포(肝細胞)의 결절상(結節狀) 재생(再生), 가소엽(假小葉)의 형성(形成) 등(等)으로서, 이들 세가지의 변화(變化)가 뒤섞여 진행(進行) 되는 가운데, 간내(肝內) 혈관망(血管網)이 감소(減少)하거나 혈관망(血管網)에 이상(異狀) 함몰(陷沒)이 발생(發生)하는 것이다. 주(主)된 임상표현(臨床表現)은 간기능감퇴(肝機能減退)와 문맥압(門脈壓) 상승(上升)으로 인(因)한 비종대(脾腫大), 복수(腹水), 복벽정맥(腹壁靜脈)의 노장(怒張), 식도(食道)와 위저정맥(胃底靜脈)의 노장파열(怒張破裂), 간성혼수(肝性昏睡) 등(等)이 나타난다. 한의학(韓醫學)의 범주(範疇)로는 '적취(積聚), 징가, 황달(黃疸), 고창(鼓脹), 협통(脇痛), 단복창(單腹脹), 비괴' 등(等)에 해당(該當)되는 것으로 습열(濕熱)이 구울(久鬱)함에 따라 간(肝), 비(脾)가 손상(損傷)되고 이것이 더욱 오래되어 기체혈어(氣滯血瘀)로 발전(發展)하게 되는 병리변화(病理變化)를 갖는다. 이에 담도결찰(膽道結紮) 및 dimethylnitrosamine의 복강투여(腹腔投與)로 간경화(肝硬化)를 유발(誘發)하고, 울증(鬱證)에 다용하는 익국환과 익국보화환이 이러한 병증(病症)에 간기능보호작용(肝機能保護作用)이 있는가를 관찰(觀察)하고, 한의학적(韓醫學的) 병증(病症)의 분류(分類)에 따라 간질환(肝疾患)에 대(對)한 치료(治療)의 가능성(可能性)을 알아보고자 본(本) 실험(實驗)을 실시(實施)한 결과(結果), 유의성(有意性) 있는 결과(結果)를 얻었기에 보고(報告)하는 바이다.

• 한국임상수의학회지
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• 제24권4호
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• pp.647-652
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• 2007

In the present study, we address systemically a case of renal disease developed in a 1 year-old male cocker spaniel dog in terms of clinical signs, clinical pathology and pathological examinations. The animal has been suffered from renal dysfunction signs such as polyuria, anorexia, vomiting, diarrhea and weight loss. The dog was very weak and emaciated and had foamy contents with foul-smell in oral cavity. The animals showed notable decrease in the number of red blood cells and severe decreases of hemoglobin and hematocrit with or without changes of mean corpuscular volume and mean corpuscular hemoglobin concentration values, indicating microcytic or normocytic hypochromatic anemia. In serum chemistry, blood urea nitrogen, creatinine, phosphorous, Na and Cl, which are associated with renal function, were dramatically increased. In addition, alanine aminotransferase, aspartate transferase, alkaline phosphatase, cholesterol, lipase and amylase were also significantly elevated, while K concentration was notably decreased. Urinalysis indicated prominent proteinuria with increase of bilirubin. Despite of symptomatic treatments, the dog was getting worse in healthy condition and dead in the end. At necropsy, both kidneys were brownish, pale, slightly small, and have diffuse, firm and subcapsular pits. Histologically, the kidneys indicated prominent segmental or diffuse interstitial fibrosis in cortex and medulla as well as glomerulonephritis. The clinical signs, clinical pathology and histopathological abnormalities of the young dog presented were consistent with chronic glomerulonephropathy, which was suspected to be a case of familial renal disease in the juvenile cocker spaniel dog.

• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.28-33
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• 2001

The numbers of breast cancer are increasing in Korea and the needs for breast reconstruction are also parallel with cancer frequency. The purpose of the study is to define the different state and condition between the delayed reconstruction and the immediate reconstruction of breasts and to suggest how to get more satisfactory outcome. The study included 22 patients who underwent delayed breast reconstruction using transverse rectus abdominis myocutaneous(TRAM) free flap from December, 1990 to January, 2001. Their ages ranged from 28 years to 58 years. We have used internal mammary artery and vein as a recipient vessel in 13 patients because of fibrosis and severe scarring in the axillary region and thoracodorsal artery and vein in 9 patients. When we used internal mammary artery with recipient vessel, we would use contralateral deep inferior epigastric artery with donor vessel. We obtained satisfactory result without any flap loss, and most patients satisfied with shape and volume of reconstructed breast. We found that delayed breast reconstruction have some differences compared with immediate breast reconstruction. First, we remove fibrotic and scar tissue as much as possible to achieve satisfactory shape of breast. Second, we plan preoperative design in standing position to obtain symmetrical recreation of inframammary fold. Third, we use internal mammary vessel in many cases with recipient vessel for microvascular anastomosis. Fourth, patients with delayed breast reconstruction feel more satisfaction than patients with immediate breast reconstruction do. Finally, economic burden is much higher in the delayed case than in the immediate case because of no coverage with insurance.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.225-231
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• 2013

Objective : Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods : Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results : The overall median skin lesion area was 36.2 $cm^2$ (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of $64.4{\pm}32.5cm^2$ versus $27.7{\pm}27.8cm^2$, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 $cm^2$ or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion : Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.

• 대한핵의학회지
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• 제4권1호
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• pp.37-42
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• 1970

In an endeavor to help understand some typical scan findings and portal hemodynamics in liver cirrhosis, several commonly occurring scan changes and esophageal varices as demonstrated by esophagram were correlated one another from quantitative and qualitative stand points. Clinical materials consisted of 34 patients with proven diagnosis of liver cirrhosis and esophageal varices. Liver scan was performed with colloidal 198-Au and the changes in the size and internal architecture of the liver, splenic uptake and splenomegaly were graded and scored by repeated double-blind readings. The variceal changes on esophagrams were also graded according to the classification of Shanks and Kerley following modification. Of 34 patients, 91% showed definite reduction in liver volume (shrinkage) constituting the most frequent scan change. The splenic uptake and splenomegaly were noted in 73.5 and 79.4%, respectively. The present study revealed no positive correlation between the graded scan findings including shrinkage of the liver, splenic uptake or splenomegaly and severity of variceal changes of the esophagus. Exceptionally, however, apparently paradoxical correlation was noted between the severity of mottlings and varices. Thus, in the majority (73.5%) of patients mottlings were either absent or mild. This interesting observation is in favor of the view held by Christie et al. who consider the mottlings to be not faithful expression of actual scarring of the cirrhotic liver. This also would indicate that variceal changes are to be the results of intrahepatic arteriovenous shunting of blood with hypervolemic load to the portal system rather than simple hypertension secondary to fibrosis and shrinkage.

• 대한영상의학회지
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• 제81권2호
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• pp.302-309
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• 2020

파브리병(Fabry disease)은 매우 드문 X-연관 유전 대사 질환으로 알파 갈락토시다아제(alpha galactosidase A)의 결핍으로 인하여 다양한 세포 및 기관에 글리코스핑고지질(glycosphingolipid)의 축적을 초래하는 질환이다. 심장 침범이 비교적 흔하며 비정상적인 지질침착으로 인한 심근 염증, 좌심실 비대 및 심근 섬유증을 일으킨다. 심장 침범은 환자 예후를 결정하는 중요한 요인이므로 이를 진단하는 것은 매우 중요하다. 심장 자기공명영상은 심실의 기능, 부피 측정을 위한 표준기법으로 알려져 있으며 심근의 조직 변화를 볼 수 있는 유용한 기법이다. 특히 최근 많이 쓰이는 T1 지도화 기법을 통한 심근 조영 전 T1 수치를 이용하여 파브리병의 심장 침범을 조기 진단할 수 있으며 자기공명영상을 이용한 심근 질량 측정으로 치료 모니터링을 할 수 있다. 심장 자기공명영상은 파브리병 환자에서 다양한 역할을 할 수 있을 것으로 생각되며 이에 대해 정리해보고자 한다.

• 대한한의학회지
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• 제18권1호
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• pp.480-498
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• 1997

간경변(肝硬變)은 간장손상(肝腸損傷)을 주로 나타내는 만성(慢性) 전신성(全身性) 질환(疾患)이다. 이것은 각종 병인(病因)이 지속적(持續的) 또는 반복적(反復的)으로 간조직(肝組織)에 작용하여 간세포(肝細胞)의 변성(變成) 괴사(壞死) 섬유성(纖維性) 조직(組織) 증식(增殖) 등의 병리변화(病理變化)를 일으켜 결국 간조직(肝組織)의 정상구조(正常構造)가 변하여 간(肝)의 형태이상(形態異常)과 경화(硬化)를 유발하는 것이다. 한의학(韓醫學)에서는 간경변(肝硬變)의 단계에 따라 표현이 다른데 협통(脇痛), 복창(腹脹), 황달(黃疸), 적취(積聚), 창(脹), 단복창(單腹脹), 수(水), 석수(石水), 간수(肝水)의 범주(範疇)에 해당된다. 울증(鬱症)은 정지부서(情志不舒), 기기울결(氣機鬱結)로 울체(鬱滯)하고 발월(發越)하지 못하여 발생하는 병증(病症)으로, 기울(氣鬱)은 기체혈어성(氣滯血瘀性) 병변(病變)인 적취(積聚)의 전단계(前段階)로 설명되고, 간경변(肝硬變)의 초기상태(初期狀態)에서 나타나는 증상(症狀)들과 유사하다고 볼 수 있으므로, 본(本) 연구(硏究)에 사용된 목향조기산(木香調氣散)과 해울조위탕(解鬱調胃湯)은 기울(氣鬱)에 적용되는 처방(處方)으로서 초기(初期) 간경변(肝硬變)의 섬유화(纖維化) 진행억제(進行抑制)에도 유효할 것으로 사료(思料)된다. 이에 본 연구에서는 담도결찰술(膽道結紮術) 및 Dimethylnitrosamine으로 만성간염(慢性肝炎) 및 간경변증(肝硬變症)을 유발한 후 목향조기산(木香調氣散)과 해울조위탕(解鬱調胃湯)을 투여한 결과 다음과 같은 결론을 얻었다. 1. 담도결찰(膽道結紮)로 인한 혈청(血淸) total bilirubin과 direct bilirubin의 상승은 목향조기산(木香調氣散)과 해울조위탕(解鬱調胃湯)의 투여로 모두 억제되는 효과를 보였으며 두 처방(處方)간의 차이는 보이지 않았다. 2. 담도결찰(膽道結紮)로 인한 혈청(血淸) AST의 상승은 목향조기산(木香調氣散)과 해울조위탕(解鬱調胃湯)을 투여한 두 실험군(實驗群) 모두에서 억제되는 양상을 보였으며, 목향조기산(木香調氣散)을 투여한 실험군(實驗群)에서 억제되는 보다 나았으나 그 차이는 크지 않았다. 3. 담도결찰(膽道結紮)로 인한 血淸 ALT의 상승은 목향조기산(木香調氣散)과 해울조위탕(解鬱調胃湯)을 투여한 두 실험군(實驗群) 모두에서 억제되는 양상을 보였으며, 목향조기산(木香調氣散)의 억제효과가 해울조위탕(解鬱調胃湯)보다는 유의성이 인정되었다.