14 research outputs found
้ๅ ็ฐๅขๆฟ็ญ์ ๆฑบๅฎ ้็จ์ ๊ดํ ็คพๆๅญธ็ ์ฐ๊ตฌ : ๋ฌผ ็ฎก็้ซ็ณป์ ่ฎๅ ้็จ์ ไธญๅฟ์ผ๋ก
ํ์๋
ผ๋ฌธ(์์ฌ)--์์ธๅคงๅญธๆ ก ๅคงๅญธ้ข :็คพๆๅญธ็ง,1995.Maste
Epigallocatechin gallate๊ฐ ํผ๋ถ ํผํ ์์กด์ ๋ฏธ์น๋ ์ํฅ
์ํ๊ณผ/์์ฌSurgical skin flaps are often used in plastic and reconstructive surgery to repair defects resulting from trauma, congenital defects, tumor excision, or other causes. Partial or complete skin flap necrosis is a common problem encountered postoperatively. Epigallocatechin gallate (EGCG), the major polyphenol of green tea has been investigated as a vasodilator and antioxidant. The authorโs hypothesis is that EGCG could improve viability of random pattern skin flaps through its vasodilatory effect, vasoprotective effect and neovascularization effect. The rat dorsal skin flap model was applied. Forty rats were randomly divided into four groups, with 10 rats in each group. Group A is the experimental group for local injection of EGCG to the flap. Group B is the experimental group for topical application. Group C is the control group for local injection. Group D is the control group for topical application. At 1, 5, and 10 days after the operation, the surviving area of the flap, regional blood flow, capillary density and VEGF expression were evaluated. We could observe increment of survival area in group A and B compared to group C and D (ANOVA, p < 0.05). However, no difference was observed between the two experimental groups. Doppler measurement showed greater blood flow in groups A and B compared to groups C and D in distal, middle and proximal portions of the flap. (ANOVA, p < 0.05) Between groups A and B, group B showed greater blood flow than group A only in the proximal portion. Quantitative analyses revealed that the capillary density and VEGF expression in groups A and B were significantly higher than those of groups C and D (ANOVA, p < 0.05). To summarize, the EGCG treatment could enhance neovascularization and enhance regional blood flow, and as a result, improve the skin flap survival. The topical application of EGCG seems to be more effective in increasing blood flow, however, the overall survival of the flaps showed no difference between local injection and topical applicationrestrictio
์ฅ ํผํ ๋ชจ๋ธ์์ ํ์ํ ๋์ถ ํ์ฅ์ด ํํ-์ฌ๊ด๋ฅ ์์์ ๋ฏธ์น๋ ์ํฅ
์ํ๊ณผ/๋ฐ์ฌํํ-์ฌ๊ด๋ฅ ์์์ ํผํ์ ์คํจ์ ์ฅ๊ธฐ ๊ธฐ๋ฅ ๋ถ์ ์ ์ฃผ์ ์์ธ์ผ๋ก ์ด๋ฅผ ์ค์ด๊ธฐ ์ํ ๋ง์ ์ฐ๊ตฌ๊ฐ ์งํ๋์ด ์๋ค. ํ์ฑํ๋ ํ์ํ์ ํํ ์ฌ๊ด๋ฅ ์์์์ ํ์ ๊ณผ ํจ๊ป ๋ดํผ์ธํฌ์ ์์์ ์ผ์ผํค์ง๋ง ์ฒด์ธ์์ ํฌ์ฌ๋ ๋ค๋์ ํ์ํ์ ์คํ๋ ค ํ์ํ์ ๋ชจ์์ ์ ํํจ์ด ์ฌ๊ทผ ๊ฒฝ์ ๋ชจ๋ธ์์ ๊ท๋ช
๋์๋ค. ๋ณธ ์ฐ๊ตฌ์ ๋ชฉ์ ์ ์ฅ์ ํผํ ๋ชจ๋ธ์์ ํํ-์ฌ๊ด๋ฅ ์์์ ๋ํด์ ํ์ํ ๋์ถ ํ์ฅ์ ์ํฅ์ ๊ท๋ช
ํ๊ณ ๊ทธ ๊ธฐ์ ์ ๋ฐํ๋๋ฐ ์๋ค. 4๊ฐ์ ๊ตฐ์ ๋ฌด์์๋ก ๋๋์์ผ๋ฉฐ ๊ตฐ๋ณ๋ก 30๋ง๋ฆฌ์ ๋ง์ฐ์ค๋ฅผ ์ฌ์ฉํ์๋ค. A๊ตฐ์ ํผํ์ ๊ฑฐ์ ํ ์๋ฌด ์ฒ์น ์์ด ์ ์๋ฆฌ์ ๋ดํฉํ์์ผ๋ฉฐ B๊ตฐ์ ํ์ํ ๋์ถ ํ์ฅ์ ํผํ ๋ดํฉ์ ์ฃผ์
ํ์๋ค. C๊ตฐ์ ํผํ ๊ฑฐ์ ํ ๋ฏธ์ธํด๋จํ๋ฅผ ์ด์ฉํ์ฌ 4์๊ฐ์ ํํ ํ ์ฌ๊ด๋ฅ ์์์ ์ฃผ์์ผ๋ฉฐ D๊ตฐ์ ํํ-์ฌ๊ด๋ฅ ์์ ํ ํ์ํ ๋์ถ ํ์ฅ์ ํผํ์ ์ฃผ์
ํ์๋ค. ํผํ ๊ฑฐ์ 1,3,7,10์ผ ํ ์์กด ๋ฉด์ ๊ณผ ํ๋ฅ๋์ ์ธก์ ํ์๋ค. ํ์ํ ๋์ถ ํ์ฅ์ด ํผํ์ ์์กด ๋ฉด์ ๊ณผ ํ๋ฅ๋์ ์ ์ํ๊ฒ ์ฆ๊ฐ ์์ผฐ์ผ๋ฉฐ ํนํ ํํ-์ฌ๊ด๋ฅ ์์์ด ์์ ๋ ๊ทธ ํจ๊ณผ๊ฐ ์ฆ๋๋์๋ค. ํผํ์ ์์กด๋ถ๋ถ์ ์ฑ์ทจํ์ฌ ์กฐ์ง ์ํ์ ๊ดํ ํ๋ฏธ๊ฒฝ์ผ๋ก ๊ด์ฐฐํ ๊ฒฐ๊ณผ ํ์ํ ๋์ถ ํ์ฅ์ด ํ๊ด ์ ์์ ์ด์ง์ํค๋ฉฐ ๋ํ ํธ์ค๊ตฌ์ ๋ชจ์๊ณผ ํ์ ์ ๊ฐ์์์ผ ํํ-์ฌ๊ด๋ฅ ์์์ผ๋ก๋ถํฐ ์กฐ์ง์ ๋ณดํธํ์๋ค. ํํ ์ฌ๊ด๋ฅ ์์์ ์ ๋๋ฅผ ์ธก์ ํ๊ธฐ ์ํ์ฌ ์ฌ๊ด๋ฅ 12์๊ฐ ํ ์กฐ์ง์์ ์ผ์ฐํ ์ง์, ๋ง์ด์๋กํผ์ฅ์๋ค์์ (Myeloperoxidase), ๋ง๋ก ๋์๋ฐํ์ด๋ (Malondialdehyde), ๊ณผ์ฐํ๋ฌผ์ ๊ฑฐํจ์ (Superoxide dismutase)๋ฅผ ์ธก์ ํ์๋ค. ํํ-์ฌ๊ด๋ฅ ์์์ ์
์ ๊ตฐ๊ณผ ๋น๊ตํ์์ ๋ ํ์ํ ๋์ถ ํ์ฅ์ ์ผ์ฐํ ์ง์, ๋ง์ด์๋กํผ์ฅ์๋ค์์ , ๋ง๋ก ๋์๋ฐํ์ด๋ (Malondialdehyde)๋ฅผ ๊ฐ์์ํค๋ ์์ฉ์ ๋ณด์์ผ๋ฉฐ ๊ณผ์ฐํ๋ฌผ์ ๊ฑฐํจ์๋ ์ฆ๊ฐ๊ฐ ํ์ธ๋์๋ค. ๋ํ ์ ์ผ์ฆ ์ฌ์ดํ ์นด์ธ(proinflammatory cytokines)์ ๋ณํ๋ฅผ ์๊ธฐ ์ํ์ฌ ์ค์๊ฐ ์คํฉํจ์ ์ฐ์๋ฐ์ (RT-PCR)์ ์ด์ฉํ์ฌ ๋จํต์ธํฌ ํํ์ฃผ์ฑ ๋จ๋ฐฑ์ง(monocyte chemotactic protein-1), ์ข
์๊ดด์ฌ์ธ์ (tumor necrosis factor-ฮฑ), ์ธํฐ๋ฃจํจ (IL-1ฮฒ, IL-6)๋ฅผ ์ธก์ ํ์๋ค. ํ์ํ ๋์ถ ํ์ฅ์ ํํ-์ฌ๊ด๋ฅ ์์์ ์์ด์ ์ ์ผ์ฆ์ฌ์ดํ ์นด์ธ์ ๋ชจ๋ ๊ฐ์์์ผ์ ์กฐ์ง์ ๋ณดํธํ๋ ํจ๊ณผ๋ฅผ ๋ณด์๋ค. ์ด๋ฌํ ํ์ํ ๋์ถ ํ์ฅ์ ์์ฉ์ ์ธํฌ์ฌ๋ฉธ์ ํธ์กฐ์ ์นด์ด๋ค์ด์ฆ(Apoptosis signaling regulating kinase 1)์ ํํ ์ ํ์ ์ฐ๊ด์ด ์์ ๊ฒ์ผ๋ก ์ฌ๋ฃ๋๋ค.
๋ณธ ์ฐ๊ตฌ์์ ํ์ํ ๋์ถ ํ์ฅ์ ์ฅ์ ํผํ ๋ชจ๋ธ ํํ-์ฌ๊ด๋ฅ ์์์ ๊ฐ์์ํค๋ฉฐ ์กฐ์ง์ ๋ณดํธํ๋ ๊ฒ์ผ๋ก ํ๋ช
๋์๋ค. ์ด๋ฅผ ์ด์ฉํ์ฌ ์์์ ์ ์ฉํจ์ผ๋ก ๋ณด๋ค ์ป๊ธฐ ์ฝ๊ณ ์ ๋ ดํ ๋ณดํธ์ ๋ก ์ด์ฉ๋ ์ ์์ ๊ฒ์ด๋ค.ope
Gluteal artery perforator flap: a viable alternative for sacral radiation ulcer and osteoradionecrosis
Radiotherapy is a crucial part in the treatment of cancer; however, it may cause adverse effects to normal tissue such as radiation-induced ulcer and osteoradionecrosis. The few cases of conservative management that were reported had a limited value and unsatisfactory results. The most reliable method to treat sacral radiation ulcer and osteoradionecrosis is a wide excision of the affected tissue, followed by coverage with well-vascularised tissue. Musculocutaneous free flaps and local gluteus maximus musculocutaneous flaps have been used; however, there were many drawbacks such as dissection of recipient vessel in the previously radiated area and donor-site morbidity. During a 4-year time period at our institute, we found favourable clinical results using gluteal artery perforator procedure for radiation-induced ulcers and osteoradionecrosis of the sacral area. The 10 patients, who were treated with gluteal artery perforator flaps, had chronic non-healing radiation ulcers or bone exposure of the sacrum. Intra-operatively, massive debridement of bone and soft tissue was performed, while the well-vascularised skin with only a colour change was preserved. The flap was designed to include two or more perforators using Doppler flowmetry and the perforators were preserved with surrounding subcutaneous tissue during the flap elevation. The mean post-operative follow-up period was 25.7 months. As regards the surgery, there was one major complication (of partial flap loss) and three minor complications (of wound dehiscence). In the patient with partial flap loss due to infection and a floating flap, the contralateral superior gluteal artery perforator flap was used to treat complications. Other complications were conservatively treated and well healed. Gluteal perforator flaps are a valuable alternative in treating sacral radiation ulcers and osteoradionecrosis. Sufficient excision of devitalised tissue is a crucial procedure to achieve optimal resultsope
Multiple Symmetric Lipomatosis: Characteristics and Treatment in Korean Patients
Purpose: Multiple symmetric lipomatosis (MSL) is a relatively rare disorder characterized by presence of multiple, symmetric, nonencapsulated fat masses in face, neck, shoulder and other areas. There has been only a few cases reported in Korea. The main purpose of this research is to examine the Korean patients to see what kinds of special characteristics occurred due to this disease and to decide the proper treatment.Methods: A total of 16 patients were evaluated retrospectively. 5 patients were treated at our hospital. The other patients were reviewed from literature. We analyzed the biological characters of patients, location of fat deposit, morphologic characters of patients, clinical evidence of neuropathy, associated metabolic disorders and treatment modality.Results: All cases were male patient. The mean age of onset was 47.43 years. All patients were moderate to heavy alcoholics. The most common location of fat deposition was posterior neck and abdomen. In neurologic exam of 9 patients, 5 patients showed muscle weakness, tremor, pain and autonomic nerve dysfunction. In metabolic studies of 9 patients, total cholesterol values were higher in 1 patient. A glucose tolerance test was abnormal in 1 patient. In treatment modality, 14 patients were treated with surgical resection, 1 patient was treated with liposuction and surgical excision, 1 patient was treated only with liposuction. Conclusion: To treat MSL patients successfully, we should concentrate not only on the removal of the fatty tissue but also on neurologic abnormities, metabolic disorders and associated diseases.ope