• Title/Summary/Keyword: Skin transplantation

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POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer (갑상선암 환자에서 골전이로 오인된 POEMS 증후군)

  • Baek, Sang Ah;Ryoo, Hun Mo;Bae, Sung Hwa;Cho, Yoon Young;Kim, Seong gyu;Kim, Ga Young;Kim, Min Keun
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.122-126
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    • 2015
  • Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

Breast Reconstruction with Superior Gluteal Artery Perforator Flap in Asian (동양인에서 위볼기동맥 천공지판을 이용한 유방재건)

  • Jeong, Woo Shik;Lee, Taek Jong;Eom, Jin Sup
    • Archives of Reconstructive Microsurgery
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    • v.22 no.1
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    • pp.7-12
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    • 2013
  • Purpose: Breast reconstruction with lower abdominal tissue can produce the best outcome with acceptable rates of long-term complication. However, for cases in which sufficient abdominal tissue is not available, an superior gluteal artery perforator (SGAP) flap can be considered as the next option for autologous breast reconstruction. Materials and Methods: Among a total of 63 women who underwent breast reconstruction with free autologous tissue transfer from July 2010 to April 2011, SGAP flap was performed for four patients. In two cases, patients did not have enough abdominal tissue for sizable breast reconstruction. In another case, the patient had a long abdominal scar due to donor hepatectomy of liver transplantation. In the last case, which was a revisional case after radiation necrosis of a previous pedicled transverse rectus abdominis musculocutaneous (TRAM) flap, a large amount of healthy skin and soft tissue was needed. SGAP flap was elevated in lateral decubitus position. The internal mammary vessels were used for recipient vessels in all cases. Results: Breast reconstruction was performed successfully in all four cases without flap loss. Donor site complication was not observed, except for one case of seroma. The shape of the reconstructed breast was satisfactory in all patients. Conclusion: SGAP flap is an excellent alternative option for the TRAM or deep inferior epigastric artery perforator flap for breast reconstruction. In terms of narrower width, harder consistency of soft tissue, and shorter pedicle, it is clear that the SGAP flap is less competent than the TRAM flap. However, in cases where abdominal tissue is not available, SGAP flap is the only way of providing a large amount of healthy tissue.

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Reconstruction of post-burn anterior neck contractures using a butterfly design free anterolateral thigh perforator flap

  • Lellouch, Alexandre G.;Ng, Zhi Yang;Pozzo, Victor;Suffee, Tabrez;Lantieri, Laurent A.
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.194-197
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    • 2020
  • Anterior neck burns represent a major reconstructive challenge due to severe sequalae including restriction in movement and poor aesthetic outcomes. Common treatment options include skin grafting with/without dermal matrices, and loco-regional and distant free flap transfers with/without prior tissue expansion. Such variation in technique is largely influenced by the extent of burn injury requiring resurfacing. In order to optimize like-for-like reconstruction of the anterior neck, use of wide, thin and long flaps such as the anterolateral thigh (ALT) perforator flap have been reported with promising results. Of note, some patients have a tendency towards severe scar contractures, which may be contributed by the greater extent of inflammation during wound healing. We report our experience at 4 years' followup after secondary reconstruction of severe, anterior neck burn contractures in two patients by harvesting the ALT flap with a butterfly design. This technique provides adequate wound resurfacing of the burned neck and surrounding areas, and provides good neck extensibility by addressing both anterior and lateral aspects of the scar defect simultaneously. Such a flap design reduces tension on wound edges and thus, the risk of contracture recurrence in what remains a particularly challenging type of burn reconstruction.

Clinical Experience of Sturdy Elevation of the Reconstructed Auricle

  • Choi, Jeong-Hwan;Kim, Ju-Chan;Kim, Min-Su;Kim, Myung-Hoon;Lee, Keun-Cheol;Kim, Seok-Kwun
    • Archives of Craniofacial Surgery
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    • v.15 no.1
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    • pp.1-6
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    • 2014
  • Background: The ear is composed of elastic cartilage as its framework, and is covered with a thin layer of skin. Auricular reconstruction using autogenous cartilage in microtia patients requires delicacy. This paper reports clinical experiences related to elevation of reconstructed ear in the last 11 years. Methods: This study was based on 68 congenital microtia patients who underwent auricular elevation in our hospital. Among these 68 patients, 47 patients were recruited. We compared the differences in the ear size, auriculocephalic angle, and conchal depth with those in the opposite ear, and the patients' satisfaction levels were investigated using a survey. Results: The difference in the sizes of the two ears was less than or equal to 5 mm in 32 patients, 5 to 10 mm in 10 patients, and greater than or equal to 10 mm in 5 patients. The difference in the auriculocephalic angles of the two ears was less than or equal to 10 degrees in 14 patients, 10 to 20 degrees in 26 patients, and greater than or equal to 20 degrees in 7 patients. The difference in the conchal depths of the two ears was less than or equal to 5 mm in 24 patients, 5 to 10 mm in 19 patients, and greater than or equal to 10 mm in 4 patients. The average grade of 3.9 points out of 5 points was obtained by the patients with satisfactory surveys. Conclusion: We could make enough protrusion and maintain the three-dimensional shape for a long time to satisfy our patients.

Effect of Ratio of Demineralized Bone Powder with Alginate Microcapsules on Articular Cartilage Regeneration (탈미네랄 골분이 비율별로 포접된 알지네이트 미세캡슐을 이용한 조직공학적 연골재생)

  • Kim, A Ram;Kim, Hye Min;Lee, Jung Keun;Lee, Ji Hye;Song, Jeong Eun;Yoon, Kun Ho;Lee, Dongwon;Khang, Gilson
    • Polymer(Korea)
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    • v.36 no.6
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    • pp.768-775
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    • 2012
  • Alginate, obtained from the seaweeds, is a widely used biomaterial for cell transplantation, since its positive effect on viability of capsulized cells and its easier encapsulation capability of living cells. Demineralized bone powder (DBP), derived from the natural bone tissue, is widely applied for clinical trials for its low rate of reaction and antigenicity. A chondrocyte was seeded into an alginate with DBP of different contents, and a microcapsule was produced. The adhesion and proliferation of cells was observed through the MTT analysis, and the PCR was applied to estimate the content of the glycosaminoglycan (sGAG) and collagen, and confirm the specific genetic pattern of the chondrocytes. Also, the alginate microcapsule where the chondrocyte is seeded was extracted after transplantation under the skin of a nude mouse, and was immunochemically stained. The experimental result confirmed that the alginate microcapsule containing 1% of DBP not only showed the highest proliferation of cell but had a positive effect of chondrocytes by the interaction between the alginates and the growth factor in DBP. It can be expected that the microcapsule with application of the alginates and DBP might be an appropriate scaffold for tissue engineering.

WISKOTT-ALDRICH SYNDROME WITH DENTAL PROBLEMS : CASE REPORT (Wiskott-Aldrich 증후군 환아의 증례보고)

  • Lee, Yeon-Joo;Hyun, Hong-Keun;Jang, Chul-Ho;Kim, Yeong-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.468-472
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    • 2007
  • The Wiskott-Aldrich Syndrome (WAS) is an inherited immunodeficiency caused by a variety of mutations in the gene encoding the WAS protein (WASp). First described in 1937 by Wiskott, the incidence of WAS has so far been estimated at 4 in 106 live births. The Wiskott-Aldrich Syndrome is an X-linked condition characterized by 1) an increased tendency to bleed caused by a reduced number of platelets, 2) recurrent bacterial, viral and fungal infections, and 3) eczema of the skin. The purpose of this report is to present cases highlighting the clinical features of the syndrome and the required considerations in the treatment of patients. The report consists of two particular cases: a 2-year-11-month-old boy seen for a routine oral examination prior to his bone marrow transplantation and a 2-year-6-month-old boy with herpes gingivostomatitis and teeth discoloration.

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In vitro Biocompatibility Evaluation of Biomaterial-elution Using Inflammatory Cell Lines (염증세포주를 이용한 생체재료 용출물의 체외 생체적합성 평가)

  • Shin, Youn-Ho;Song, Kye-Yong;Seo, Min-Ji;Kim, Sung-Min;Park, Jung-Keug;Kim, Dong-Sup;Park, Ki-Jung;Hur, Chan-Hoi;Cha, Ji-Hun;Seo, Young-Kwon
    • KSBB Journal
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    • v.26 no.3
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    • pp.248-254
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    • 2011
  • Various biometerials have been researched and have been developed for treatment of some disease through transplantation to body. They have been evaluated by in vitro cytotoxicity test using some skin-derived cell lines for prediction of their biocompatibility in vivo. However, the results of experiments using mesenchymal or epithelial cells could not be considered in vivo immune reaction. In this study, we evaluated the biomaterial-elution (elute from high density polyethylene film) using some cell lines (L929, Jurkat, U937) in vitro, and then that results were compared with in vivo results from guinea pig sensitization test. In sensitization test, saline and elution of syringe could not induce erythema, but only DNCB (hypersensitive chemical) induce erythema at guinea pig sensitization test. In cell experiment, the cytotoxicity results of inflammatory cells (Jurkat; T lymphocyte, U937; monocyte) was no difference with L929 (fibroblast) in the overall trend. However, inflammatory cell lines were only secreted inflammatory cytokine (TNF-${\alpha}$, INF-${\gamma}$) in some materials (biomateriallution, FAC, DNCB). And the biomaterial-elution did not have toxicity to the cells, but it induced the inflammatory cytokines in inflammatory cell lines only. So, we were predicted inflammatory reaction through the cytokine resultes of inflammatory cell lines, and it was more correlated with in vivo results than cytotoxicity test. Therefore, we suggested that the inflammatory cytokine assay using inflammatory cell lines are more effective method in vitro for evaluation of biocompatibility of biomaterials or chemicals.

The Analysis of Free Flap (유리 조직 이식의 분석)

  • Choi, Sang-Mook;Hong, Sung-Bum;Chung, Chan-Min;Suh, In-Seock
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.35-45
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    • 1996
  • After transplantation of groin free flap was sucessed by the Daniel and Taylor in 1973, the reconstruction of plastic surgery was extensive and universal due to rapidly developement of anatomic study of the donor site and technique of microvascular surgery. The free tissue transfers is possible to be early activity and rehabilitation by one stage operation. It currently available allow transfer of specific tissue quality as bone, muscle, nerve to achieve a functional and cosmetic result as well as the most favorable secondary defect. But free flaps require critical, skillful technique and lengthy operating time. Also it has disadvantage of donor site morbity at the large tissue transfer. Authors were transferred with 107 cases in 103 patients from May 1987 to June 1996, and then we analysed free tissue transfer to acquire more increased sucess rate, satisfactory functional and cosmetic results. The sexual distribution was male prominent in 79 cases(76.7%), female in 24(23.3%) and age was variable distribution from 3 to 76 years old. The cause of defects was most prevalent in trauma of traffic and industrial accident in 51 cases(49%). The common recipient site were lower extremities in 47 cases(43.9%), upper extremities in 28 cases(26.5%), head and neck in 25 cases(23.4%), and trunk in 7 cases(6.5%). The type of transfer were free skin flaps in 46 cases(43%), free muscle or musculocutaneous flaps in 31 cases(29%), free vasculized or osteocutaneous flaps in 10 cases(9.3%), and specilized free flaps in 20 cases(18.7%). The anastomosis of artery was end to end anastomosis in 94 cases(87.9%), end to side anastomosis in 13 cases(12.1%) and all vein was end to end anastomosis. The number of anastomosed vessels were one artery one vein in 62 cases(57.9%), one artery two vein in 45 cases(42.1%) and vein graft was performed only one case. The postoperative mornitoring were used with temperature, color of flap, capillary refilling time, ultrasonogram, bone scan, doppler, and endoscopy. The reexploration was performed in 9 cases(8.4%), and then flap was loss in 3 cases(2.8%). Accordingly overall success rate was 97.2%. The postoperative complication was early vascular occlusion, hematoma, partial necrosis and late bulkiness, scarring, color dismatch etc. Therefore, free tissue transfer is the preferred method of treatment, even through conventional local and distant flaps are available.

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In Vitro Efficacies of Complex of Cedrol and Three Peptides, and Wrinkle Improvements and Lips Volumization effects of Applied Formulations (Cedrol 및 펩타이드 3 종 Complex 의 In Vitro 효능 및 적용 제형의 입술 주름 개선 및 Volumization 효과에 대한 연구)

  • Seongsu Kang;Seung-Hyun Jun;Jinyong Lee;Myoung Jin An;Nae Gyu Kang
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.49 no.4
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    • pp.365-373
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    • 2023
  • Since the lips are a representative facial part that can express human attraction, aesthetic interest in them has always existed in human history. However, as lips age, they tend to form wrinkles, become thinner, and lose their volume. To counteract this phenomenon, medical procedures such as fillers or fat transplantation have been suggested. In this study, we verified that the one of main effective material complex of L G H&H L IPCERIN®, combination of cedrol, a sesquiterpene found in cedarwood, and three peptides (acetyl hexapeptide-8, acetyl tetrapeptide-9, and desamidocollagen) could ameliorate the photo-aging and reduce the wrinkles through in vitro experiments. The possibility of improving collagen and elastin expression in skin fibroblasts and reducing MMP expression under photoaging conditions was verified. In addition, it was confirmed that the amount of fat tissue in the lips can be increased by promoting adipose stem cell differentiation and increasing the amount of fat produced in the in vitro adipose stem cell differentiation experiment. Two weeks of human application tests confirmed that a combination of cedrol and peptides can improve the wrinkles, texture, elasticity, and volume of the lips. This study verified that the combination of cedrol and three peptides can be used as effective cosmetic materials to decrease the various signs of aging in the lips.

Evaluation of Manufacturing and Biological Properties of Y Zone Care Hydrogel Solution (Y존 케어 하이드로젤솔루션의 제조 및 생물학적 특성 평가)

  • Eun-Ji Kim;In-Kyoung Kim
    • Journal of Advanced Technology Convergence
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    • v.3 no.2
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    • pp.25-31
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    • 2024
  • In recent industrialization and development due to information and communication technology, modern women in modern society are exposed to physical and mental health due to numerous stresses. Popular inflammations are attributable to a decrease in lactic acid bacteria, frequent antibiotic use, and a decrease in immunity. It is necessary to develop products that are helpful and reflected. The inner care gel currently introduced on the market can increase beneficial bacteria and maintain a healthy y-zone. The inner gel contains a hydrogel component. 90% is made up of water, and other components act as support for supporting water and are formed through crosslinking between polymer chains. Hydroxyethyl cellulose (HEC) is a hydroxyethyl ethylenetel of cellulose. The purpose of use is to act as a binder, an emulsion stabilizer, a viscosity enhancer (water-soluble), and a film forming agent. CA (crosslinker) is a crosslinking agent and serves to bind. Hydrogel in the beauty field acts as a film forming agent that gently wraps around the skin by forming a thin film and serves as an emulsion stabilizer that helps to prevent separation of other raw materials. It also acts as a thickener by increasing viscosity in cosmetics. In addition, it is used for glucose monitoring, nursing care, cell transplantation, and wound treatment in the bio field. Currently, it is understood that no products using functional hydrogel have been released, so in this study, a Y zone care hydrogel solution was manufactured to find out the antibacterial properties of the functional hydrogel, and a new solution was developed. As a result, it was confirmed that the appropriate Ph was applied to the Y zone, and after culturing Candida albicans in PDB medium, all three products of the Y zone care hydrogel solution showed an antibacterial effect of 0.5-1.0mm