• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.5
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• pp.315-317
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• 2022

Osseous metaplasia is defined as the formation of lamellar bone inside soft tissue structures where bone normally does not exist. It results from the transformation of non-osseous connective tissue into mature bone. This condition is rare in the oral and maxillofacial region. We report a case of osseous metaplasia of the maxilla, a rare benign tumor in an uncommon region. A 60-year-old male patient visited our clinic complaining of foreign body sensation and asymptomatic swelling on the right palatal side. However, he did not experience pain and reported no local trauma that he could remember. Intra-oral examination revealed an exophytic lesion on the right palatal portion. On computed tomography, there was a round hard-tissue mass approximately 2 cm in diameter on the right palate area. The mass was biopsied and diagnosed as an osseous metaplasia. We review the clinical, radiographic, and histologic features and common causes of osseous metaplasia and report a rare case of osseous metaplasia of the palate.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.357-369
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• 2001

In this present study, the healing process and the recurrence of pigmentation were evaluated clinically and histologically in accordance with the extent and the range of pigmentation after phenol was applied to remove melanin pigmentation in gingiva. Six mongrel dogs were used. The melanin pigmentation in canine gingiva were classified into slight, moderate and severe according to the extent of pigmentation and divided into local and diffuse types according to the range. Following general and local anesthesia, 90% phenol was applied to the pigmented gingiva of the subjects with small cotton balls until the surface was etched to be whitish and was neutralized with small cotton balls soaked by 95% alcohol. The contralateral pigmented gingiva to the one treated with phenol, was treated by surgical deepithelialization. At 1, 3 and 8 weeks, the treated gingiva was examined clinically and evaluated histologically following H-E stain, and HMB 45 stain for melanocyte after biopsy. In the phenol treated sites, epithelium and connective tissue healed normally and there was no pigmentation at 1 week. At 3 weeks of healing, melanin repigmentation was observed in the severe local type and moderate to severe diffuse type. In the surgically deepithelialized sites, healing was delayed, compared to phenol treated sites and the infiltration of the inflammatory cells and congestion in connective tissue was shown at 1 week. At 3 weeks, healing was completed and there was a partial melanin repigmentation. At 8 weeks of healing, the extent and the range of repigmentation were increased in both group according to the extent or range priot to depigmentation procedure. These results suggpriorest that the removal of melanin pigmentation with 90% phenol application result in normal healing process of gingiva. However, in the severe local type and moderate to severe diffuse type, sites treated with phenol showed repigmentation at 3 week, which was earlier than surgical deepithelialized sites. Therefore it is required to select appropriate method according to initial condition of pigmentation.

• Journal of Veterinary Clinics
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• v.33 no.5
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• pp.300-303
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• 2016

An age-unknown, 4.8 kg, male, wild, domestic short-hair cat was presented for left hindlimb lameness. A physical examination revealed a draining tract which was suspected of bite on left calcaneal bone. The left tarsal joint was markedly swollen and exudates were observed around the draining tract. Sequestrum at left calcaneus bone, and osteolysis were identified by radiography. The sequestrum and its surrounding exudative tissue were debrided during surgery and the tissue was submitted for bacterial culture and sensitivity test. The debridement caused a bone defect ($1.5cm{\times}0.5cm{\times}0.5cm$) on the medial left calcaneal bone. Plate and screw fixation was performed to the calcaneus bone as buttress plate. Recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded hydroxyapatite was implanted in the bone defect. Furthermore, Amikacin-impregnated collagen sponges were also placed around bone plate to deliver local antibiotics. A systemic antibiotic treatment regimen based on bacterial culture and sensitivity test results was administered for 4 weeks. The wound properly healed without any signs of infection, and the bone healing was confirmed by radiography. The patient showed normal weight bearing ambulation at 18 weeks after surgery. The use of rhBMP-2 and local antibiotic delivery system is a good surgical option for the one-stage treatment of chronic osteomyelitis.

• Archives of Reconstructive Microsurgery
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• v.8 no.1
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• pp.15-21
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• 1999

Soft tissue defect on heel area of the foot present difficult problems particularly because of anatomic property of plantar surface of the foot. There is a paucity of available local tissue in the foot for coverage. In addition to having little expandable tissue, the foot's plantar surface has a unique structure, making its replacement especially challenging. Plantar skin is attached to the underlying bone by fibrous septa, preventing shear of the soft-tissue surfaces from the underlying skeleton. Plantar surface of foot is in constant contact with the environment. Protective sensibility also would be maintained or restored in the ideal reconstruction. So the ideal flap for reconstruction of the heel should include thin, durable hairless skin with potential for reinnervation. The aim of this article is to present a clinical experience of free lateral arm neurosensory flap for reconstruction of the heel. From March 1995 to December 1997, a total 16 lateral arm free flaps were performed to soft tissue defects on the weight-bearing area of the hindfoot. we used tibial nerve as recepient nerve in 11 and calcaneal branch of tibial nerve in 5 for restoration of sensibility of flap. All cases survived completely. A static two-point discrimination of 14 to 34mm was detected in the flap. Radial nerve palsy which was caused by hematoma in donor site occured in one case, but recorverd in 3 weeks later completely. In conclusion, the lateral arm free flaps are versatile, reliable and sensible cutaneous flap and especially indicated for soft tissue defect on plantar surface of the hindfoot which are not good indications for other better-known flaps.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.759-764
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• 2007

Purpose: Various types of flaps, with their own advantages and disadvantages, have been described for reconstruction of soft tissue defect with exposure of tendons, bones, or joints in the hand or foot. Local flaps with random vascularity have a limitation by their length. Free flaps are time-consuming procedure that may require the sacrifice of some major vessels. The ideal flap for covering soft tissue defects of the hand or foot must provide subcutaneous tissue that tendons can glide through which, supply enough subcutaneous tissue for cover of vital neural, bony, vascular and joint structures, and it has to be aesthetically pleasing. The adipofascial flap fulfills these criteria. It allows immediate or early closure of difficult wound of hand and foot in an easy way, and is especially indicated for small to medium-sized defects. Methods: From October 2005 to December 2006, seven cases underwent this procedure to reconstruct soft tissue defect on hand or foot. Results: All flaps survived completely, and no complications were observed. Conclusion: The adipofascial flap is a convenient flap for coverage of soft tissue with exposure of vital structure in the hand or foot, and provide several advantages, as following; easy and safe, short operating time, one stage procedure, thinness and good pliability of the flap, preservation of the major vascular pedicles, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.536-540
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• 2006

Purpose: The soft tissue injuries of the patellar area are difficult problems because of insufficient arterial blood supply and lack of muscle layer. There have been many methods for reconstructing the soft tissue injuries of the patellar area such as primary closure, skin graft, local flap and free tissue transfer. However, each method has some limitations in their application. After the first introduction, the fasciocutaneous flaps are widely used to reconstruct the soft tissue injuries. The saphenous nerve, one of the superficial sensory nerves in the lower leg, is supplied by the saphenous artery and its vascular network. We used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. Methods: From March 2002 to May 2005, we used the saphenous fasciocutaneous island flap to reconstruct the soft tissue injuries of the patellar area. The flap was elevated with saphenous nerve, saphenous vein and saphenous artery and its vascular network. The flap donor site was reconstructed with primary closure or split-thickness skin graft. Results: Five cases survived completely but 1 case developed partial necrosis of the skin on the upper margin of the flap. However, the necrosis was localized on skin layer, and we reconstructed with debridement and split-thickness skin graft only. After the operation, there was no contracture or gait disturbance in any patient. Conclusion: In conclusion, the saphenous fasciocutaneous island flap is safe, comfortable and effective method to reconstruct the soft tissue injuries of the patellar area.

• Archives of Reconstructive Microsurgery
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• v.23 no.2
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• pp.76-81
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• 2014

Purpose: Anteromedial surface of the leg is susceptible to trauma, which frequently induces soft tissue defect. When the size of a soft tissue defect is small to moderate, a local muscle flap is an easy and reliable alternative to a free flap. The authors performed medial hemisoleus flaps for reconstruction of soft tissue defects on the anteromedial surface of legs. The aim of this study was to evaluate clinical outcomes and effectiveness of the medial hemisoleus flap. Materials and Methods: Twelve patients underwent the medial hemisoleus flap for reconstruction of a soft tissue defect on the anteromedial surface of the leg from February 2009 to December 2013. There were eight males and four females with a mean age of 47.8 years (15 to 69 years). The mean size of defects was $4.7{\times}4.2cm$ ($2{\times}2$ to $9{\times}6cm$). Flap survival and postoperative complications were evaluated. Results: Mean follow-up period was 39.6 months (7 to 64 months) and all flaps survived. There were two cases of negligible necrosis of distal margin of the flap, which were healed after debridement. All patients were capable of full weight bearing ambulation at the last follow-up. Conclusion: The medial hemisoleus flap is a simple, reliable procedure for treatment of a small to moderate sized soft tissue defect on the anteromedial surface of the leg.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.1
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• pp.13-19
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• 2016

Objectives: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. Materials and Methods: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. Results: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. Conclusion: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.

• Journal of the Optical Society of Korea
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• v.17 no.4
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• pp.289-295
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• 2013

Although low-level laser therapy (LLLT) has been a valuable therapeutic technology in the clinic, its efficacy may be reduced in deep tissue layers due to strong light scattering which limits the photon density. In order to enhance the photon density in deep tissue layers, this study developed an optical tissue clearing (OTC) laser probe (OTCLP) system which can utilize four different OTC methods: 1) tissue temperature control from 40 to $10^{\circ}C$; 2) laser pulse frequency from 5 to 30 Hz; 3) glycerol injection at a local region; and 4) a combination of the aforementioned three methods. The efficacy of the OTC methods was evaluated and compared by investigating laser beam profiles in ex-vivo porcine skin samples. Results demonstrated that total (peak) intensity at full width at half maximum of laser beam profile when compared to control data was increased: 1) 1.21(1.39)-fold at $10^{\circ}C$; 2) 1.22 (1.49)-fold at a laser pulse frequency of 5 Hz; 3) 1.64 (2.41)-fold with 95% glycerol injection; 4) 1.86 (3.4)-fold with the combination method. In conclusion, the OTCLP system successfully improved the laser photon density in deep tissue layers and may be utilized as a useful tool in LLLT by increasing laser photon density.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.181-186
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• 2023

Objectives : The purpose of this study is to report case of hypergranulation tissue that occurred after laparotomy and dissected by CO₂ laser. Methods : A 72-year-old female had hypergranulation tissue on the epigastrium. Local anesthesia was achieved with bufonis venenum pharmacopuncture. The CO₂ laser was used for dissection. After removal of granulation, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were performed. Yeonkyopaedok-san were administered for 7 days and the suture was removed after 14 days. At last, saengkigo was applied. Results : Hypergranulation tissue sized 1.0×1.0×1.0cm was clearly removed. Including excessive growing of granulation tissue, adverse effects were not reported until the clear skin adhesion. Conclusions : Hypergranulation tissue was surgically removed and sutured completely without any complications by using pharmacopuncture, oral herbal medicine and ointment that have anti-inflammatory effects and wound healing. Through this study, it is hoped that surgery including suture will be actively performed in more diverse diseases in the Korean medicine community.