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원위기저 표재성 비복동맥 피판을 이용한 하지 연부조직 결손의 재건 치험례
배형운,박병화,양경무 의과학연구소 1997 全北醫大論文集 Vol.21 No.1
A soft tissue defect of the lower third of the leg caused industrially or by traffic accidents presents a troublesome problem because of the tightness and poor circulation of the skin. Soft tissue reconstruction in this region should provide tissue components similar to the original lost tissue, provide durable yet sensitive tissue, be reliable, result in a donor site that is well tolerated, and entail one operative procedure with minimal morbidity. In general, a soft tissue defect of the lower third of the leg was reconstructed by various free flaps for many years. But, free flaps have some disadvantages - long operation time, equipment for microanastomosis, increased risk of flap failure in the lower third of the leg etc. The distally based superficial sural artery flap is a skin island flap supplied by the vascular axis of the sural nerve. The advantages of the flap are the followings : the blood supply is reliable, flap elevation is easy and quick, and major artery is not sacrificed. We have treated ;7 patients selected with distally based superficial sural artery flaps. All flaps were survived without serious complications. The distally based superficial sural artery flap appears to be an easy and useful alternative for reconstruction of the lower third of the leg in selected patients. Key Words : Superficial sural artery flap, Reconstruction, Lower leg.
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양경무,배형운,Yang, Kyung-Moo,Bae, Hyung-Woon 대한미세수술학회 1998 Archives of reconstructive microsurgery Vol.7 No.1
Despite of technical advances in surgery & other therapeutic modalities five-year survival rates in patients with carcinoma of hypopharynx have remained low. Many techniques have been used to create a structure capable of allowing the passage of food and fluids in an attempt to maintain the anatomy and physiology of the upper digestive system. The development of microsurgical techniques and the concept of mucocutaneous unit has brought about important changes in the reconstruction of cervical esophagus following tumor resection. The one-stage procedure using microvascular anastomosis of free jejunal graft provides physiologic reconstruction of cervical esophagus and has a low morbidity rate as well as a short recuperation time. With free jejunal graft, there is marked improvement in the quality of life and numerous advantages over the previous methods of reconstruction. Reconstruction of esophageal defect after resection of carcinomas of the hypopharynx, and cervical esophagus has traditionally been carried out with deltopectoral, or musculocutaneous skin-lined flaps. A second approach is to reconstruct the defect with the colon or stomach. A more ideal mettled is to repair these defects with mucosa-lined flaps. The authors experienced 35 cases of reconstruction of cervical esophagus after resection of carcinoma of the hypopharynx with free jejunal autograft and one case of secondary repair with radial forearm free flap after failure of initial free Jejunal autograft. Postoperative results were satisfactory in most patients and two patients expired in 8 days postoperatively because of carotid blow out by chronic inflammation.
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상백피가 사람정장에 의한 흰쥐 복강 비반세포의 활성화에 미치는 영향
이종인,이무삼,채옥희,배형운,송창호 대한알레르기학회 1999 천식 및 알레르기 Vol.19 No.5
Background : It has been reported that Cortex mori(Morus alba L, Sangbaikpi ; CM ), the root bark of mulberry tree, plays a role in inhibiting mast cell activation. Human seminal plasma (HSP) modulates immune systems and activates rat peritoneal mast cells (RPMC). However, the inhibitory agents of HSP-induced mast cell activation have not been disclosed yet. Objective and method: This study was undertaken to determine the effects of CM on HSP-induced mast cell activation by morphologic and functional methods. Morphological changes of RPMC by HSP alone or CM plus HSP were observed with the inverted light microscope. And the amounts of histamine and calcium were measured by radioisotopic enzymatic histamine and radioisotopic calcium assays. Results : By inverted microscopy, HSP-induced RPMC degranulation occurred in a dose-dependent fashion. After pretreatment of RPMC with CM, there was no HSP-induced degranulation. Degranulation index (DI) of RPMC treated with Hanks balanced salt solution (HBSS), CM or HSP was 7.0±4.3, 9.0±6.2, 56.5±16.9, respectively. After pretreatment of RPMC with CM, HSP-induced DI was 11.0 ±7.1. These results indicate that CM inhibited HSP-induced degranula- tion of RPMC. HSP-induced RPMC histamine release (HR) was dose-dependent. HR of RPMC treated with HBSS, CM or HSP was 0.18±0.10, 0.30±0.19, 4.48±0.86 ug/ml, respectively. After pretreatment of RPMC with CM, HSP-induced HR was 0.52±0.21 ug/ml. These results indicate that CM inhibited HSP-induced HR from RPMC. Intracellular calcium level (ICL) of RPMC was also increased according to the concentration of HSP. ICL of RPMC treated with HBSS, CM or HSP was 6.1±1.0, 9.0±2.1, 30.2±6.5 pmole, respectively. After pretreatment of RPMC with CM, HSP-induced ICL of RPMC was 11.6 ± 3.3 pmole. These results indicate that CM inhibited HSP-induced calcium uptake of RPMC. Conclusion : From these results, it is suggested that CM contains some substances which inhibit HSP-induced RPMC activation by suppressing the calcium influx into RPMC.
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