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방사선 조사를 받은 두경부 병소의 재건을 위한 유리피판술
채수욱,고경석,김주봉,박상훈,한상훈,이택종,남순열,김상윤 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.3
Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30∼75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.
착화제와 유기산이 Wistar rat체내의 Sr 분포에 미치는 영향
이기호,이제호,박상윤,이승훈,유용운,윤택구 대한방사선 방어학회 1990 방사선방어학회지 Vol.15 No.2
Wistar rat에 85SrCl2를 꼬리 정맥에 주사하여 체내 기관과 혈액 내 분포, 잔존율을 조사하였고 착화제와 유기산을 투여하여 혈장 단백질에 결합하는 Sr양의 변화를 측정하였다. 혈액내에서 Sr은 혈장에 60%, 세포에 40%부착되어 이동하였다. 혈장에 존재하는 Sr중 약 50%정도는 혈장 단백질과 결합한 상태였고, 세표에는 세포 표면에 가볍게 부착되어 있었다. Erythrocyte나 granulocyte보다 lymphocyte에 많은 양의 Sr이 부착되어 있었다. 투여후 초기 1시간 이내에 혈액 내에서 급격히 감소하여 뼈에 침착되었다. 이때 각 기관에서도 Sr의 잔존율은 24시간 이내에 크게 감소하였고, 뼈로 침착된 Sr은 24시간 이후에 서서히 감소하였다. 착화제 EDTA, EGTA 및 DTPA를 투여한 경우, 혈장 단백질에 결합하는 Sr의 양은 대조군의 57%에서 27-33%로 감소하였으며 citrate 및 oxalate의 투여시는 이값이 19%와 40%로 각각 감소하였다. 85SrCl2 was injected to the tail vein of Wistar rats and investigated its distribution and clearance in the tissues and blood. We also measured the changes in Sr binding to the blood plasma protein by administrating chelating agents and organic acids. For the blood, 60% of the Sr occurred in the plasma and 40% on the cell membrane. Fifty percent of Sr in the blood plasma was bound to plasma protein. Sr on the cell membrane seemed to be bound loosely. The binding in the lymphocyte was higher than in the erythrocyte and granulocyte. Within one hour Sr was quickly disappeared from the blood stream, to be accumulated in the bone. Twenty four hours after the injection, Sr decreased rapidly in the organs of soft tissue, but slowly in the bone. The binding of Sr to plasma protien decreased from 57% of the control to 27-33% in the group treated with chelating agents. EDTA. EGTA and DTPA and to 19% and 40% in the groups treated with organic acids, citrate and oxalate, respectively.