• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.46-48
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• 2013

Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권4호
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• pp.325-329
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• 2009

Objective : This is to report the effectiveness of intraoral distraction osteogenesis, iliac bone graft for alveolar augmentation in the extremely atrophied alveolar defects after infected allobone grafted area. Subjects and Methods : Anterior segmental osteotomy was performed and the trans-oral alveolar distractors (Martin, Germany) were applied in patient with the severe acquired anterior mandibular and mandibular defect after ameloblastoma enucleation. Iliac bone grafts were performed in defect sites and distraction osteogenesis were treated. After latent period for 1 week, the osteomized alveolar segments were distracted by 0.75 mm a day (0.25 mm/1 turn) for 10 days The consolidation period was about 12 weeks. Thereafter, 2 titanium threaded implants were simultaneously installed with removal of distractor. For oral rehabilitiation, The implants were installed in maxilla, mandible. It was tested with clinically and radiographically. Results : Amounts of acquired alveolar bone were 10 mm with the increased width of the ridge crests and soft tissue expansion. Dental implants installated on the augmented alveolar ridges in 12 weeks after distraction were confirmed as in good osseointegration and in good function without any complications. Conclusion : Intraoral distraction osteogenesis can be a good option for alveolar ridge augmentation of the severely atrophied ridges and soft-tissue defects.

• International Journal of Precision Engineering and Manufacturing
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• 제9권3호
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• pp.68-71
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• 2008

Transdermal and topical drug delivery with minimal tissue damage has been an area of vigorous research for a number of years. Our research team has initiated the development of an effective method for delivering drug particles across the skin (transdermal) for systemic circulation, and to localized (topical) areas. The device consists of a micro particle acceleration system based on laser ablation that can be integrated with endoscopic surgical techniques. A layer of micro particles is deposited on the surface of a thin metal foil. The rear side of the foil is irradiated with a laser beam, which generates a shockwave that travels through the foil. When the shockwave reaches the end of the foil, it is reflected as an expansion wave and causes instantaneous deformation of the foil in the opposite direction. Due to this sudden deformation, the microparticles are ejected from the foil at very high speeds, and therefore have sufficient momentum to penetrate soft body tissues. We have demonstrated this by successfully delivering cobalt particles $3\;{\mu}m$ in diameter into gelatin models that represent soft tissue with remarkable penetration depth.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.227-232
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• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.65-68
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• 2016

Acute bone shortening and delayed lengthening by Ilizarov surgery have been used to treat a wide range of soft tissue injuries including open fracture, osteomyelitis of the tibia and lower leg amputation. It has advantages such as bone lengthening as well as minimizing the loss of damaged tissues via tissue expansion. Here, we report a case of 52-year-old male with satisfactory results through acute bone shortening, replantation, and gradual bone lengthening after complete amputation of the ankle with related literature reviews.

• 한국동물위생학회지
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• 제29권4호
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• pp.507-511
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• 2006

Acanthomatous epulis is a malignant form of gingival tumor. This is a case of epulis affecting a four-year old, intact, female Maltese dog raised as indoor pet in Iksan city. Clinical examination showed an enlarged palpable mass along the rostral maxillary gingiva. Section of the excised mass showed epithelial overgrowth and expansion from the basal portions through the tissue stroma. Post-surgical radio-graph showed displacement of the first and second maxillary incisors. Histochemical staining showed strongly positive reaction to epithelial marker cytokeratin and moderately positive reaction to connective tissue marker vimentin. This case was diagnosed as a form of maxillary gingival acanthomatous epulis. Routine clinical oral examination is suggested.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.98-104
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• 2000

Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

• IMMUNE NETWORK
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• 제3권1호
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• pp.29-37
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• 2003

Background: CC chemokine receptor (CCR) 7 and cognate CCR7 ligands, CCL21 (formerly secondary lymphoid tissue chemokine [SLC]) and CCL19 (formerly Epstein-Barr virus-induced molecule 1 ligand chemokine [ELC]), were known to establish microenvironment for the initiation of immune responses in secondary lymphoid tissue. As described previously, coadministration of DNA vaccine with CCR7 ligand-encoding plasmid DNA elicited enhanced humoral and cellular immunity via increasing the number of dendritic cells (DC) in secondary lymphoid tissue. The author hypothesized here that CCR7 ligand DNA could effectively expand memory CD4+ T cells to protect from viral infection likely via increasing DC number. Methods: To evaluate the effect of CCR7 ligand DNA on the expansion of memory CD4+ T cells, DO11.10.BALB/c transgenic (Tg)-mice, which have highly frequent ovalbumin $(OVA)_{323-339}$ peptide-specific CD4+ T cells, were used. Tg-mice were previously injected with CCR7 ligand DNA, then immunized with $OVA_{323-339}$ peptide plus complete Freund's adjuvant. Subsequently, memory CD4+ T cells in peripheral blood lymphocytes (PBL) were analyzed by FACS analysis for memory phenotype ($CD44^{high}$ and CD62 $L^{low}$) at memory stage. Memory CD4+ T cells recruited into inflammatory site induced with OVA-expressing virus were also analyzed. Finally, the protective efficacy against viral infection was evaluated. Results: CCR7 ligand DNA-treated Tg-mice showed more expanded $CD44^{high}$ memory CD4+ T cells in PBL than control vector-treated animals. The increased number of memory CD4+ T cells recruited into inflammatory site was also observed in CCR7 ligand DNA-treated Tg-mice. Such effectively expanded memory CD4+ T cell population increased the protective immunity against virulent viral infection. Conclusion: These results document that CCR7 and its cognate ligands play an important role in intracellular infection through establishing optimal memory T cell. Moreover, CCR7 ligand could be useful as modulator in DNA vaccination against viral infection as well as cancer.

• Archives of Reconstructive Microsurgery
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• 제10권2호
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• pp.163-168
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• 2001

The defects of the abdominal wall could be brought about either congenitally, for instances in such cases as omphalocele or gastroschisis, or by various acquired causes-trauma, excision of tumors, excision of burn scar, tissue necrosis caused by infection, hematoma after abdominal surgery, tissue necrosis after radiation therapy and so on. As for the techniques of the reconstruction of the abdominal wall defects, many authors have developed and reported diverse methods. To summarize, primary closure, skin graft, local skin flaps, various myocutaneous flaps, free flap, fascia graft, artificial mesh, tissue expansion, etc could be used in the reconstruction of the abdominal wall defects. The periumbilical perforator-based island skin flap has a many advantages such as no significant sacrifice of the rectus abdominis muscle, wide rotation arc, reliable blood flow of the perforator, short elevation time for flap, and for middle-aged, obese patients, the donor site may be the best from the cosmetic point of view. We used perforator-based island skin flap in 5 cases with reasonable result from March 1999 to May 2001. There were no significant complications and donor sites could be repaired primarily.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.309-314
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• 2020

Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period.