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Melanoma surgery and NPWT as a reconstruction option
정기양 ( Kee Yang Chung ) 대한피부과학회 2013 대한피부과학회 학술발표대회집 Vol.65 No.2
Melanoma in dark-skinned individuals often develops in an acral lentiginous fashion on the foot and wide excision usually results in a substantial defect. Various repair methods including distant flap, full-thickness skin graft and secondary intention healing (SIH) are used to repair these defects. Recently, use of negative pressure wound treatment (NPWT) has been shown to accelerate wound healing in different types of wounds. We have retrospectively compared the functional and cosmetic results of NPWT and SIH in 22 patients who underwent wide excision of melanomas on the foot. The defects of 13 patients were healed by secondary intention (SIH group) and 9 using negative pressure wound treatment (NPWT group). There was no significant difference in time to complete wound healing between the two groups. However, evaluation using Vancouver Burn Scar Assessment Scale of Scars at time of complete healing showed that the mean value of NPWT group was significantly lower than that of the SIH group. The NPWT group also had significantly better results than the SIH group for total score, vascularity, and height of the scars. As for complications, no wound infection was encountered in NPWT group, whereas 8 of 13 patients in SIH group were found to be affected by wound infection in the course of treatment despite frequent and meticulous aseptic dressing changes. These results show that, despite the drawback of rather prolonged healing time, NPWT is an excellent therapeutic option for post-wide excision wounds on feet with acceptable functional and cosmetic outcomes.
Update in surgical treatments for skin cancers: understand new surgical methods
정기양 ( Kee Yang Chung ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2
Background: Dermatologic surgery is widely becoming an important subspecialty of dermatology and new developments are being reported on surgical management of skin cancers. Objectives: To summarize recent new developments in the surgical aspects of cutaneous oncology. Methods: Literatures were searched and pertinent articles on surgical treatment of skin cancers during the last 2 years were summarized. Results: Mohs micrographic surgery is usually used for the most common nonmelanoma skin cancers, i.e., squamous cell carcinomas and basal cell carcinomas. However, it can be applied to to treat rarer and more aggressive types of cancer, such as Merkel cell carcinoma and also can be utilized for skin cancers in areas where preservation of function and cosmesis is very important. Squamous cell carcinomas occurring on penis can be cleared with Mohs to conserve penis of its function and benign condition such as erosive adenomatosis of the nipple can be safely removed to maintain the cosmesis of the nipple. Among the many methods of wound reconstruction, secondary intention wound healing is very effective but has a drawback of taking longer time to heal than direct closures. However, using porcine xenograft over the second intention wounds can protect the wound and promote healing. Conclusion: Surgical innovations in dermatologic surgery is ongoing and they can surely benefit patients who have to undergo surgery of the skin for various causes.
항보체 간접 면역형광법을 이용한 조직내의 Treponema pallidum 검출에 관한 연구
정기양(Kee Yang Chung),이민걸(Min Geol Lee),이정복(Jung Bock Lee) 대한피부과학회 1987 대한피부과학회지 Vol.25 No.4
Using the FTA-ABS complernent test, 32 skin speciruens from 27 patients with primary and secondary syphilis and a stomach specimen from a patient with suspected gastric syphilis which were confirmed by clinical history, physical examination, VDRL, FTA-ABS, and 19S(IgM)-FTA test, were tested. The following results were obtained. 1. In the darkfield examination, 7 of the 9 specimens(78%) were positive and in the FTA-ABS complernent test, 20 of the 33 specimens(61%) were positive. 2. The ratio of agreement between the darkfield examination and the FTA- ABS complement test was 89%. 3. In the chancres, macular syphilids, and condyloma lata, T. pallida were diffusely scattered in the epidermis, dermoepidermal junction, connective tiasue, and vascular walls, whereas in the papular syphilid T. pallida were mainly aggregated in the the epidermis, dermoepidermal junction, papillary dermis as well as the blood vessel walls in the papillary dermis. From these results, the FTA-ABS complement test can be considered to be a useful method for both the diagnosis and research of syphilis. It is especially helpful in cases where serological or histopathological study can not confirrn the diagnosis as when internal organs are involved.