• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.56-62
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• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.

• 한국미생물·생명공학회지
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• 제30권1호
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• pp.51-56
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• 2002

국내 토양에서 분리한 식물성 병원균인 Alternaria brassicicola SW-3리 항암활성 물질 생산능을 조사하고, 활성물질을 분리 정제하여 구조를 확인하였다. A. brassicicola SW-3는potato dextrose broth를 이용하여 15$^{\circ}C$에서 2주간 진탕 배양한 다음, MTT assay를 실시하여 항암활성을 확인하였으며, 배양여액 중의 항암물질은 ethyl acetate로 추출하고, silica gel column chromatography로 정제하여 무색의 oily product를 얻었다(수율 22mg/m1). 분리된 물질은 물이나 hexane에는 녹지 않고, chloroform, ethyl acetate, ethanol 등에는 잘 녹는 특징을 보였으며, , $IR^{1}$H-NMR, $^{13}$C-NMR 등을 통해 구조를 분석한 결과, 최근에 일본에서 분리되어 항암효과가 있는 것으로 알려진 depudecin과 동일한 물질로 추정되었다. 본 실험에서 분리된 depudecin은 인체간암세포와 mouse 피부암세포에 대한 세포독성을 나타내었으며, 각각의$ IC_50$ 는 $57\mu$g/ml, $69\mu$g/ml로 나타났다. Alternaria brassicicola SW-3에 의해 생산된 물질이 기지의 물질이지만, depudecin은 아직 작용 기작이나 적용범위 등이 밝혀지지 않은 초기 연구 단계에 있는 물질로서, 새로운 항암제로서의 가능성이 매우 높아 이의 유도체를 합성하거나, 다른 항암제와의 혼용에 의해 부작용이 적은 강력한 항암제를 개발하기 위한 선도물질로 활용될 수 있을 것이다.