• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.45-55
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• 1998

목 적: 우유 과민성 장병증(cow's milk-sensitive enteropathy, CMSE)은 우유를 식이 하였을 때 유해 반응과 함께 발생하는 상부 소장 점막의 손상이 병리적 특징으로 관찰되며, 이러한 점막의 손상은 우유를 제거하면 회복될 수 있고, 다시 유발시험을 하면 재발될 수 있다. CMSE 환자에서 소장 점막 손상의 정도를 형태학적 계측을 이용하여 정량적으로 분석하여 보고, 이를 이용한 CMSE의 진단적 가치 및 병리적 특성에 관하여 알아보고자 본 연구를 시행하였다. 대상 및 방법: 1994년 3월부터 1996년 6월까지 만성 설사와 성장 장애를 주소로 대구효성가톨릭 대학병원 소아과에 입원한 환자에서 우유에 대한 유발, 제거시험에 따른 임상적 반응 및 상부위장 관내시경을 시술하여 얻게 된 십이지장부의 생검조직 소견을 통하여 CMSE로 진단된 생후 $30.4{\pm}11.7$(14~56)일된 13명의 환아를 대상으로 하였다. 소장 생검조직의 형태학적 계측을 이용하여 융모 높이(villous height, VH), 음와 영역 깊이(crypt zone depth, CZD), 점막전체 두께(total mucosal thickness, TMT), 음와 영역에 대한 융모의 상대적 높이(VH/CD), 융모 1 mm당 상피세포간 림프구의 수(interepithelial lymphocytes, IEL), 0.5 mm의 점막근육판(muscularis mucosa)에 해당하는 상피 표면의 길이(length of surface epithelium, LSE), 상피층의 호산구 침윤(EOS-EP), 고유층(lamina propria)의 호산구 침윤(EOS-LP)을 측정하고, 대조군 및 회복기 생검 조직과 비교하였다. 결 과: 1) VH는 CMSE 환자군에서 $135{\pm}59\;{\mu}m$으로 대조군 $408{\pm}48\;{\mu}m$에 비하여 유의하게 낮았으며(p<0.001), 전례에서 융모 위축의 소견이 관찰되었다. 2) CZD는 CMSE 환자군에서 $311{\pm}65\;{\mu}m$으로 대조군 $188{\pm}24\;{\mu}m$에 비하여 유의하게 깊었다(p<0.05). 3) TMT는 CMSE 환자군에서 $449{\pm}56\;{\mu}m$으로 대조군 $596{\pm}71\;{\mu}m$에 비하여 유의하게 낮았다(p<0.001). 4) VH/CD는 CMSE 환자군에서 $0.46{\pm}0.28$로 대조군 $2.17{\pm}0.12$에 비하여 유의하게 낮았다(p<0.001). 5) LSE는 CMSE 환자군에서 $889{\pm}231\;{\mu}m$으로 대조군 $2547{\pm}378\;{\mu}m$에 비하여 유의하게 낮았다(p<0.001). 6) IEL은 CMSE 환자군에서 $34.1{\pm}10.5$개로 대조군 $13.6{\pm}3.6$개에 비하여 유의하게 높았다(p=0.001). 7) EOS-EP는 CMSE 환자군에서 $0.47{\pm}0.83$개로 의미 있는 침윤은 관찰되지 않았으며, 대조군 $0.80{\pm}0.84$개와 유의한 차이는 보이지 않았다. EOS-LP는 환자군에서 $2.67{\pm}3.72$개로 의미 있는 침윤은 관찰되지 않았으며, 대조군 $4.0{\pm}2.5$개와 유의한 차이를 보이지 않았다. 8) 회복기의 형태학적 변화는 VH $320{\pm}34\;{\mu}m$, CZD는 $194{\pm}19\;{\mu}m$, TMT $514{\pm}21\;{\mu}m$, VH/CD $1.41{\pm}0.25$, LSE $1840{\pm}210\;{\mu}m$, IEL $10.8{\pm}2.3$개로 관찰되었다. 결 론: 소장 조직의 생검은 상부위장관내시경을 이용하여도 그 임상적 유용성이 높으며, CMSE 환자에서 소장 점막의 손상은 형태학적 계측을 통하여 정량적으로 평가할 수 있으며 진단적 민감도가 높다. CMSE에서 점막의 손상은 빠른 융모 상피의 손상에 대한 음와 세포의 충분한 보상의 실패로 사료되며, 단백질 가수분해물의 수유후 빠른 회복이 관찰되었다.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.901-911
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• 2006

Maxillary palatal mucosa is the most frequently used donor site of the soft tissue for periodontal plastic surgery. In our study, thickness of the palatal mucosa between the mesial side of the maxillary first premolars and the distal side of the maxillary first molars was measured with a periodontal probe and an ultrasonic device in 30 young Korean adults. Using the data, the possibility of the clinical application of ultrasonic devices was evaluated. The results of this study were as follow; 1. The thickness of the palatal mucosa of the maxillary premolars is the thickest and that of the mid-palatal portion of the maxillary first molar is the thinnest. 2. The thickness of the palatal mucosal tissue increases from the gingival margin to the mid-palatal suture. 3. The measurements of the periodontal probe and the ultrasonic device revealed the strong positive correlations.

• Journal of Chest Surgery
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• 제42권5호
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• pp.657-661
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• 2009

점막하 식도 박리는 드문 질환으로 식도 천공 없이 점막하 출혈 및 혈종에 의해 점막하층과 근육층이 박리되는 상태를 의미하며, Mallory-Weiss, Boerhaave's syndrome과 함께 제3의 급성 식도 손상질환이다. 금식과 수액 요법 등의 보존적 치료만으로도 비교적 예후가 좋다. 하지만 출혈 소인이 있는 질환이나 정상적인 지혈에 영향을 미치는 약제(anticoagulants, anti-platelets, thrombolytic agents)를 복용중인 환자에서, 흉통 및 연하통 혹은 연하곤란 등을 호소하는 경우에 감별 진단으로 염두에 두어야 부적절한 치료를 피할 수 있다. 본 증례는 항혈소판 제재를 복용 중에 발생한 점막하 식도 박리를 보고하는 바이다.

• 대한한의학회지
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• 제30권3호
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• pp.51-60
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• 2009

Objectives : It has been known that immune reaction plays an important role in the pathogenesis of otitis media (OM). We investigated the change of middle ear mucosal inflammation induced by lipopolysaccharide (LPS) following administration of Taglisodog-eum (TSE) in experimental animals. Materials and Methods : Otitis media was induced by injecting 1 mg/kg of Pseudomonas aeruginosa LPS transtympanically in 60 rats. These rats were divided into two groups, the LPS group (n=30, remained naive after OM elicitation) and the TSE group (n=30, treated with TSE after OM elicitation) and 6 additional rats were kept as a normal control group (n=6, remained naive until tissue collection). The rats were killed at the 1st, 3rd, and 7th days after challenge. The temporal bones in each group were harvested and examined histopathologically by hematoxyline-eosin stain. Middle ear mucosa were taken at the 1st, 3rd, and 7th days after challenge. The levels of spicing variants of TNF-${\alpha}$ transcription were evaluated by Realtime-PCR. Results : TSE suppressed LPS-induced TNF-${\alpha}$ mRNA expression and thickness of the submucosal layer and infiltration of inflammatory cells in rat middle ear epithelium. Conclusion : The results suggest that TSE may be effective in decreasing inflammation with particular application to mucosal metaplasia in OM.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.296-302
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• 2021

Background: The reconstruction of large full-thickness alar defects requires complex surgical procedures that are usually performed in two stages, with concomitant disadvantages in terms of patient trauma, surgical risk, and cost. This study presents a functional folded nasolabial island flap (FNIF) that can be used to repair large-sized full-thickness alar defects in a straightforward manner. Methods: This retrospective study included seven patients who received a FNIF for a full-thickness alar defect between January 2007 and December 2020. The FNIF is different from the conventional nasolabial flap in that it is folded and twisted to achieve nostril reconstruction with a satisfactory three-dimensional mucosal lining in a single stage. The cosmetic and functional results of FNIF were evaluated by both patients and physicians. Results: The age ranged from 51 to 82 years (mean, 65.6 years). The causes of the defects were squamous cell carcinoma, basal cell carcinoma, and trigeminal trophic syndrome. The nostril lining did not collapse, there was no hypertrophic scarring, and air movement through the nostrils on the flap side was normal. Overall, FNIF produced excellent aesthetic and functional outcomes, with minimal patient discomfort. There were no postoperative complications. Conclusion: Compared with existing reconstruction methods for large full-thickness alar defects, FNIF can easily achieve aesthetic and functional success in a single-stage procedure. It provides satisfactory results for both the patient and the surgeon.

• Journal of Gastric Cancer
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• 제21권2호
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• pp.111-121
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• 2021

Laparoscopic endoscopic cooperative surgery (LECS) refers to the endoscopic dissection of the mucosal or submucosal layers with laparoscopic seromuscular resection. We recommend a treatment algorithm for the LECS procedure for gastric benign tumors according to the protruding type. In the exophytic type, endoscopic-assisted wedge resection can be performed. In the endophytic type, endoscopic-assisted wedge resection of the anterior wall is relatively easy to perform, and endoscopic-assisted transgastric resection, laparoscopic-assisted intragastric surgery, or single-incision intragastric resection in the posterior wall and esophagogastric junction (EG Jx) can be attempted. We propose an algorithm for the LECS procedure for early gastric cancer according to the tumor location. The endoscopic submucosal dissection (ESD) procedure can be adapted for all areas of the stomach, and single-incision ESD can be performed in the mid to high body and the EG Jx. In full-thickness gastric resection, laparoscopy-assisted endoscopic full-thickness resection can be adapted for the entire area of the stomach, but it cannot be applied to the pyloric and EG Jx. In conclusion, surgeons need to select the LECS procedure according to tumor type, tumor location, the surgeon's individual experience, and the situation of the institution while also considering the advantages and disadvantages of each procedure.

• Journal of Periodontal and Implant Science
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• 제37권1호
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• pp.103-113
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• 2007

The purpose of this study was to measure the thickness of masticatory mucosa in the hard palate as a donor site for mucogingival surgery by using computerized tomography(CT), Thickness measurements were performed in 84 adult patients who took CT on maxilla for implant surgery and 24 standard measurement points were defined in the hard palate according to the gingival margin and mid palatal suture. Radiographic measurements were utilized after calibration for standardization. Data were analyzed to determine the differences in mucosal thickness by gender, age, tooth positions and depth of palatal vault. The results of this study were as follows: 1. Mean thickness of palatal masticatory mucosa was $3.93{\pm}0.6mm$ and females had significantly thinner mean masticatory mucosa($3.76{\pm}0.56mm$) than males($4.04{\pm}0.6mm$)(p<0.05). 2. The thickness of palatal masticatory mucosa increased by aging. 3. Depending on position, masticatory mucosa thickness increased from canine to premeolar, but decreased at the first molar, and increased again in the second molar region(p<0.0001). 4. No significant difference in mean thickness of palatal masticatory mucosa were indentified between low palatal vault group and high palatal vault group(p>0.05). The results suggest that canine and premolar area appears to be the most appropriate donor site for soft tissue grafting procedure. The measurement of the thickness of palatal masticatory mucosa by using computerized tomography can offer useful information clinically but further studies in as-sessing the validity and reliability of the method using computerized tomography is needed.

• 대한두경부종양학회지
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• 제11권1호
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.117-123
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• 2005

The reconstructive modalities for vaginal reconstruction include simple dilatation, skin graft, use of intestinal segments and various methods using flaps. However, skin grafting procedure is the most commonly used technique and the McIndoe procedure is a representative technique among skin grafting procedures. McIndoe procedure is easier, faster and has a lower morbidity compared to other techniques. However the conventional McIndoe procedure has several problems such as incomplete vestibule formation, excessive bleeding during dissection, possibility of recto-vaginal or urethro-vaginal fistula formation, late vaginal contracture and discomfort in wearing hard plastic mold for a long time after operation. To solve these problems, the authors modified the conventional McIndoe procedure in several perspectives. The undeveloped vestibule was incised with X-shaped mucosal incision between the urethral opening and posterior margin of the vestibule and deepened by blunt finger dissection to provide a sufficient diameter & length of the neovagina and to minimize bleeding. A sizable medium thickness split skin graft was harvested and wrapped over a roll gauze-filled condom mold. Applying multiple stab incision on the skin grafted condom mold, it was inserted into the prepared neovaginal canal. Distal margin of the skin graft was secured with tips of the mucosal flaps created by X-shaped vestibular incision to prevent accidental extrusion of the skin grafted mold. During last 15 years, we applied this modification to 20 vaginal agenesis patients and investigated results of the 12 patients who could be followed up serially including hematoma formation and skin graft survival rate, size, depth, presence of late contracture, appearance, comfortness, and hygiene of the neovagina. And they were compared with 8 patients of 20 patients who underwent conventional McIndoe procedures. The modified McIndoe procedure revealed lower complication rate, higher patient satisfaction and better functional results.

• Food Science and Biotechnology
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• 제18권1호
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• pp.213-217
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• 2009

In this study, the effects of processed small black soybeans on the intestinal morphological characteristics of rats were examined. Adult male rats were fed diets containing raw, cooked, or acidified small black soybean powders for 4 weeks. The total short chain fatty acid (SCFA) level was significantly higher in the acidified small black soybean supplemented group than in the raw and cooked soybean diet groups. The major SCFAs found in the experimental groups were acetate, followed by propionate and butyrate. The duodenal villus height and colonic mucosal thickness were also significantly higher in the acidified small black soybean supplemented group than in the raw and cooked soybean diet groups. The acidified small black soybean supplemented group showed the densest colonic mucosa by staining with alcian blue (AB), as compared to the raw and cooked soybean diet groups. The acidified small black soybean supplemented group exhibited strongly stained $CD4^+$ in the mucosal lamina propria, while cooked and acidified diet groups were more strongly stained $CD8^+$ in the submucosal lamina propria than the raw diet group. These results suggest that acidified small black soybeans may help improve intestinal function.