• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.150-154
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• 2009

In this paper, we described a case of mass mortality of doctor fish from a private fish hatchery farm in Korea with a history of abnormal swimming behavior, diffuse bleeding on the skin and fins and sudden death caused by fish pathogenic bacteria, Citrobacter freundii. Twelve moribund fish fingerling samples were submitted to College of Veterinary Medicine, Seoul National University in October 2008 for diagnostic examination. Diagnostic results showed that the morphological and biochemical properties of the bacteria isolated from the moribund fish were C. freundii. The remaining diseased fish from the hatchery farm were given treatment based on our recommendation and successfully recovered.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.101-106
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• 2006

Nipple reconstruction is an important step in breast reconstruction after mastectomy. The authors' preferred reconstructive technique is the local C-V flap in case that a small opposite nipple is not adequate for composite graft. This flap produces an excellent reconstruction, but it is not easy to produce an adequate projection and firmness of the nipple. This article describes the technique and experience in nine patients treated over two years with dermis(scar tissue) graft for nipple reconstruction. This is the first report of application of autologous dermis(scar tissue) grafting to reconstruct a nipple primarily after breast mound reconstruction, decreasing the absorption of the reconstructed nipple and increasing the hardness. The dermis(scar tissue) is taken from scar revision and/or dog-ear correction in the second stage operation after free TRAM flap breast reconstruction. And the dermis(scar tissue) graft is inserted vertically between the local flaps and horizontally under the reconstructed nipple base. Between September 2002 and February 2005, nine patients underwent C-V flap with dermis(scar tissue) graft as a part of their nipple reconstruction. The patient's ages ranged from 28 to 55 years old (mean, 41.1 years old). The follow-up period ranged from 5 to 35 months, with an average of 14.5 months. None of the nipples showed skin flap necrosis or local infection, and uneventful wound healing. Our result showed good nipple projection with less absorption and enough firmness. Our experiences shows that dermis(scar tissue) grafts in C-V flap is a very useful method for nipple reconstruction.

• Journal of fish pathology
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• v.25 no.2
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• pp.85-93
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• 2012

Many metacercariae in the musculature of southern top mouthed minnow (Pseudorasbora parva) cultured at a farm in Chonbuk Province. The excysted metacercariae looked yellowish white and were $4.02{\pm}1.80$ mm (1.66-5.81) in length and $1.27{\pm}0.27$ mm (1.01-1.64) in width for acetocarmin-stained specimens. The oral sucker measuring $0.18{\pm}0.05$ mm (0.11-0.24) in length and $0.23{\pm}0.07$ mm (0.15-0.33) in width, was located at the anterior end of the body. The ventral sucker situated at the fourth third of the body were measured $0.47{\pm}0.08$ mm (0.35-0.53) in length and $0.55{\pm}0.09$ mm (0.43-0.63) in width. The tongue-shaped metacercariae were identified as Clinostomum complanatum on the basis of morphological characteristics. The metacercaria was also confirmed to be C. complanatum using PCR reaction with C. complanatum-specific primer sets, Trem 18S F and Ccom670 R. No histopathological changes in the infected fish were observed except necrosis and exfoliation of epidermis in the skin and atrophy of muscle fibers.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.202-207
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• 2004

Group A streptococcus, also known as Streptococcus pyogenes, is a common bacterial pathogens of the upper respiratory tract and skin infections in children, but this organism is a less common cause of pneumonia, pericarditis. However, pneumonia that is caused by Streptococcus pyogenes, may be rapidly progressive course with developing severe consequences. It may be focal but often is bilateral and diffuse involvement of lung. Empyema is commonly developed, and pleurocentesis often yields thin, watery fluid that continues to flow out when a chest tube is inserted. Antimicrobial resistance to the ${\beta}$-lactam antibiotics has not been reported against group A streptococci, whereas increasing resistance to the macrolides seems to be directly related to the consumption of specific antimicrobial agent use in the community. Clindamycin resistance is uncommon but does occur. We experienced one case of group A streptoccoccal pneumonia with empyema and pericardial effusion, and treated successfully with amoxicillin-clavulanate, clindamycin and roxithromycin.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.720-726
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• 2009

Purpose: Fasciocutaneous flap with random pattern flap has limitation in mobility and length - width ratio. This characteristic is more pronounced in lower extremity which has relatively poor vascularity. Perforator based flap in lower extremity reconstruction has various advantages as a axial flap, allowing abundant blood supply and widening of mobility range. So if it is not a case of wide defect, free flap can be replaced by perforator based flap. Methods: From April 2007 to March 2009, 18 cases of perforator flap were performed. 8 had defect in upper 1/3 of calf, 6 in middle 1/3, and 4 in lower 1/3. In 10 cases island flap were used, 3 case had transposition flap, 2 cases used advancement flap, 2 case had propeller flap and 1 case had rotation flap. Results: 17 cases survived without flap necrosis. Partial flap necrosis occurred in 1 case, so secondary split thickness skin graft was done. Chronic wound with pseudomonas infection occurred in 1 case, but it was completely cured with conservative treatment. Conclusion: Perforator based flap is useful in lower extremity reconstruction because of relative freedom in changing the size and thickness of the flap depending on the recipient site, good mobility, and abundant vascularity. And donor site morbidity can be minimized. Lower extremity reconstruction using perforator based flap is a good method because it can minimize the complication and obtain effective result.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.773-778
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• 2009

Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.575-583
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• 2013

Background The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. Methods We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. Conclusions The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

• Korean Journal of Veterinary Research
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• v.33 no.2
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• pp.309-320
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• 1993

Guinea pigs were cutaneously inoculated with Trichophyton verrucosum var album, that is a common causative fungus of dermatophytosis in cattle. The developmental process of lesions, clinical and histopathological changes and reisolations of the fungi were studied to evaluate the pathogenicity of Trichophyton verrucosum var album in guinea pigs. Results obtained through the experiments were summarized as follows : 1. The incidence of infection of the clipping group was 13(86%) of 15 animals, and that of the plucking group was 14(93%) of 15 animals. In both of the clipping and plucking groups, visible cutaneoas lesions were developed between 4 and 7 days post inoculation(p.i.). The spreading and the climax stages persisted for 4 to 11 and 6 to 12 days, respectively. 2. In macroscopic observations, formation of various degree of erythemas and scales over the inoculated skin sites were observed in the spreading stage. In the climax stage, exudative changes and dark red crusts were formed as typical circular lesions. In the healing stage, the lesions revealed shedding of crust, alopecia and hair regrowth. 3. In histopathological observations, infiltration of inflammatory cells, hyperplasia, microabscesses and keratinous-hyaloid materials of epidermis were observed in the spreading stage. Hyphal invasion was primarily observed at the level of epidermis and pilosebaceous ducts. In the climax stage, the infected epidermis was thick with severe hyperplasia, hyperkeratosis and acanthosis. The microabscesses with fungal hyphae, folliculitis and hyperplasia of external root sheath were observed in the dermis. The fungal hyphae were observed only in the tissues of hair follicles, that were internal root sheath, cuticle, the keratinized portions of cortex and medulla 4. In reisolation of the inoculated fungus, all trials for ten animals showed positive cultures until 25 days p.i.. Afterward, the reisolation rates were gradually decreased, showing all negative after 40 days p.i..

• The Korean Journal of Pain
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• v.10 no.2
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• pp.225-230
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• 1997

Background: Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. Method: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23~25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The "pop" was well noted well. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. Result: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13($10.0{\pm}1.7$) cm. Tip of catheter was placed in infraclavicular space(66.7%), about the humeral head(17.9%) and in upper arm in 3 cases as U-shape(7.9%). Catheters were maintained for $6.7{\pm}2.6$(3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma. Conclusion: This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.93-99
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• 2007

Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint. Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)${\times}$4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously. Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes. Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.