• Journal of Chest Surgery
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• 제30권3호
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• pp.248-252
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• 1997

48세 남자 환자의 전종격동을 깊게 침범하며 흉골에서 발생한 거대한 연골육종을 치료하였다. 환자는 흉골의 연골육종과 주변의 정상변연 4cm을 포함하여 광범 위 절제술을 받았으며 그 종양 자체 는 양측의 쇄골과제 1,2,3늑연골을 포함하는 15$\times$ 16X10cm크기였다. 종양의 광범위 절제술후 남은 결손 부위는 매우 컸으며 흉벽 재건술을 Marled mesh와 methylmethacrylate와 wire steels로 겹싸는 sandwich식의 방법으로 시행하였고 연부조직의 재건술 또한 대흉근을 이용한 근피 판 치환술을 시행하 였다. 그러나 환자는 수술후 결핵성 종격동염이 발생되었고 다량의 농이 배출되었다. 재수술은 흉벽 재건술시의 사용되었던 이물질 모두를 제거하고 괴사성 조직의 소파술과 배농술을 시행하였다. 환자는 1 년간 항결핵제요법을 시행하였으며 완치되었기에 문헌고찰과 보고하는 바이다.

• 대한두경부종양학회지
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• 제36권2호
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• pp.41-44
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• 2020

Clear cell hidradenoma is a skin adnexal tumor originating from eccrine glands. The risk of local recurrence after surgical resection exceeds 50%, and 6-19% of cases are malignant. The rarity of clear cell hidradenoma and its diverse histological findings make this type of tumor a diagnostic challenge. We present a case of recurrent clear cell hidradenoma of the posterior neck in a 70-year-old woman. The tumor recurred once after complete excision, and did not recur again after 1-cm wide excision and reconstruction with a local bilobed flap. Recurrent clear cell hidradenomas are activated by surgical stimulation, increasing the risk for metastasis. Therefore, we suggest that wide excision with confirmation of a tumor-free margin by frozen-section biopsy should be the first-line treatment for recurrent benign clear cell hidradenoma.

• Archives of Plastic Surgery
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• 제43권5호
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• pp.461-465
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• 2016

Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.702-704
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• 2010

Purpose: Chordoma is a rare primary osseous tumor arising from the remnants of the primitive notochord. It occurs once in 2,000,000. It is characterized by its slow growth, high frequency to invade destroy bone by direct extension. We experienced giant sacral chordoma and reconstructed with gluteal advancement flap. Methods: A 52-year-old woman presented with a 2-years history of gluteal pain. In the biopsy study revealed sacral chordoma. MRI study showed $13{\times}12{\times}10\;cm$ sized m0cs. We approached anterior and posterior resection and reconstructed with bilateral gluteus maximus advancement flap. Results: After the operation, blader and anal function were slightly decreased. But, 4 months later those were almost fully recovered. There was no significant complication and recurrence after 2-years follow-up. Conclusion: Chordoma is characterized by its slow growth, high frequency to invade and destroy bone by direct extension. Wide surgical resection is the only curative procedure. We report a ase of giant sacral chordoma which was successfully treated by anterior and posterior approach and reconstructed with bilateral gluteal advancement flap.

• 대한골관절종양학회지
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• 제2권1호
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• pp.111-115
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• 1996

Benign osteoblastoma, a rare tumor which forms osteoid and woven bone, represents 3% of benign and 1% of all primary bone tumors. It can involve anywhere in the axial skeleton, which is most common in the spine (34%). But the lesion of the calcaneus is extremely rare. The ratio of males to females is 2:1, with 80 percent of the patients being under thirty years of age. Pain is the most common symptom and rarely pathologic fracture. Osteoblastoma is a benign tumor but has a high recurrence rate after intracapsular malignant change. Therefore, choice of surgical procedure is the 'enbloc' resection. Authors have experienced a case of osteoblastoma developed in calcaneus. The treatment was wide resection and triple arthrodesis. We have reported here the case in which osteoblastoma occured in calcaneus of the right foot.

• 대한두경부종양학회지
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• 제27권1호
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• pp.92-95
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• 2011

The anterior mediastinal tracheotomy(AMT) facilitates resection of stomal recurrence after total laryngectomy and tumors involving the cervicothoracic trachea and esophagus. An 81-year-old-man came to our clinic due to the progressive dyspnea during three months. He received the total laryngectomy five years ago. We diagnosed as Sisson type I stomal recurrence and then performed the wide excision, both selective neck dissection, sternal manubrium resection and AMT. Before surgery, we planned the pectoralis major myocutaneous flap. Unluckily we could not fulfill this procedure because of patient's medical status during anesthesia. The tracheocutaneous fistula was observed in the second postoperative day. He expired due to the huge bleeding from the wound. When AMT is performed, exact manipulation of major vessels and adequate flap are mandatory these elevate the feasibility of AMT.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.225-230
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• 1999

The labiomandibulotomy approch to the oral cavity and oropharygeal region was first described by Roux in 1836 and become popular for oral and oropharyngeal tumors in cases where there are no clinical and radiological signs of mandible invasion. Anterior labiomandibulotomy and swing procedure provides excellent access and facilitate a mandibular resection and subsequent repair. In last two years, 8 cases of oral and oropharyngeal tumors were treated by this approach at the Dept. of Oral & Maxillofacial Surgery, Holy Family Hospital, Catholic University of Korea. And we analyzed postoperative complications as well as functional evaluations, and the results were as follows; In 4 cases, marginal mandibulectomy were combined with labiomandibulotomy and in case of malignancies, neck dissection was performed simultaneously. In almost case, plate and miniscrew fixation was used for osteotomy sites. Histologic evaluation of the resection margins of the specimens revealed tumor free in all cases. The postoperative complications were occured in 3 cases, one case of nonunion, one case of orocutaneous fistula, and one case of wound dehisence. Occlusal stability, jaw movement and swallowing function were acceptable postoperatively in 3 months. From above results, we concluded that, this approach not only provides wide exposure, permitting radical removal of benign and malignant lesions but also preserves function with minimal complications.

• 대한두개안면성형외과학회지
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• 제22권2호
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• pp.105-109
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• 2021

The use of a fibula osteocutaneous flap is currently the mainstay of segmental mandibular reconstruction. This type of flap is used to treat tumors, trauma, or osteoradionecrosis of the mandible. However, a fibula osteocutaneous flap may also be a good option for reconstructing the mandible to preserve oropharyngeal function and facial appearance in cases of pathological fracture requiring extensive segmental bone resection. Chronic osteomyelitis is one of the various causes of subsequent pathologic mandibular fractures; however, it is rare, and there have been few reports using free flaps in osteomyelitis of the mandible. We share our experience with a 76-year-old patient who presented with a pathologic fracture following osteomyelitis of the mandible that was reconstructed using a fibula osteocutaneous flap after wide segmental resection.

• 대한두경부종양학회지
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• 제12권2호
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• pp.188-192
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• 1996

점막형 악성흑색종 10례에 대한 임상분석 결과 비강에서 가장 호발하였고 증상은 비폐색이 가장 많았다. 치료 성적은 수술을 우선적으로 선택한 후 방사선요법을 시행한 경우군에서 평균생존기간이 20.8개월이었고 방사선치료를 우선적으로 선택한 경우군에서는 14.7개월로, 접막형 악성흑색종의 경우 광범위 절제술 후 방사선요법을 시행하는 것이 도움이 될 것으로 생각되나 윈격전이 6례를 포함한 8례의 환자에서 재발이 있어 예후가 극히 불량한 암종으로 생각된다.