－S 249 －
￭ S-373 ￭
췌장 신경내분비 종양으로 나타난 von Hippel-Lindau (VHL) 질환 1예
서울대학교 의과대학 내과학교실
*온정헌, 김정희, 이현정, 서원우, 황보율, 홍은실, 김성연
The von Hippel-Lindau (VHL) disease is an autosomal dominant disorder that results from a germline mutation of the VHL gene. Affected individuals might develop several benign or malignant tumors such as central nervous system or retinal haemangioblastomas, endolymphatic sac tumors, renal cell carcinomas, pheochromocytomas or pancreatic cysts and neuroendocrine tumours. We report a case of 21 year old female with von Hippel-Lindau disease that presents with only pancreatic neuroendocrine tumor and no evidence of haemangioblastomas or other visceral complications. Further, direct sequencing of the VHL gene reveals a novel germline frameshift mutation of codon 198 from deletion of nucleotide 592 (cytosine), leading to truncation of the VHL protein.
￭ S-374 ￭
Experience of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure in Diabetic Foot Ulcers
Departments of 1Internal Medicine, 2Orthopedics, Maryknoll Medical Center
*Bong Jae Kim1, Ji Hye Suk1, A Ra Jo1, Jong Kun Ha1, Mi Kyung Kim1, Jeong Min Ha2, Hyeong Taek Park2
Diabetic foot ulcers (DFUs) are one of the most common and serious complication associated with diabetes mellitus. Even for the most superficial wounds, treatment is often difficult with poor healing, which potentially lead to amputations of the lower extremity. Several techniques have been developed to induce healing in chronic DFU, and among them, negative-pressure wound therapy (NPWT) using vacuum-assisted closure (VAC) is noteworthy. We experienced 4 patients with DFU, treated with VAC therapy in concurrence with surgical debridement. All 4 wounds were grade 3 (Wagner’s scale) DFU with exposed tendon, fascia and bone. In one case, VAC therapy was done after repeated skin graft due to failure of the initial graft. All 4 patients had multiple diabetic complications and poor glycemic control. An electronic vacuum pump was used to apply controlled negative pressure evenly across the wound surface. The length of treatment with VAC was 43, 48, 60 and 52 days, respectively. All wounds were satisfactorily granulated and cleared of bacterial infection at the end of VAC therapy. In our cases, change of VAC dressing was performed every 7 days. This was longer than the changing interval of standard VAC dressing, which was every 48-72 hours. This reduced cost of VAC therapy without increased adverse events associated with infection. VAC therapy was useful in the treatment of infected DFU.
