Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

We report 2 cases of pediatric DNTs which presented with intractable seizures and no other associated neurologic abnormalities. They showed typical appearance of DNTs on neuroimaging and histopathology. Most patients with DNT can be cured by surgical treatment with exellent outcome and do not need ratio- or chemotheraphy. This study indicates that it is quite important to consider DNTs as one of differential diagnoses in patients with intractable seizures especially when they present only with seizures without other neurologic symptoms.
Child* ; Diagnosis, Differential ; Humans ; Neoplasms, Neuroepithelial* ; Neuroimaging ; Neurologic Manifestations ; Seizures*

No abstract available.
Chlorpromazine* ; Nicotine* ; Skin*

No abstract available.
Fascia* ; Nasolabial Fold*

Image-guided localized, water-suppressed in vivo 1H MR spectroscopic studies were performed on the brain tumors in 3 patients. In all 3 patients, in vivo 1H MR spectra in brain neoplastic tissues revealed that the signal intensities of N-acetylaspartate (NAA) choline (Cho) resonances were decreased and increased, respectively, comparing with healthy normal tissue. A distinct lactate signal was identified in all three patients. A ratio that the observed metabolite alterations from localized, water-suppressed in vivo 1H MR spectroscopy can be useful as an index of brain tumors, and that the technique is clinically to highlight as one promising modalities in brain tumors for more accurate diagnosis.
Brain Neoplasms* ; Brain* ; Choline ; Diagnosis ; Humans* ; Lactic Acid ; Magnetic Resonance Spectroscopy*

In vivo 1H MR spectroscopic studies were performed on the human brain in six normal volunteers. Some distinct proton metabolites, such as N-acetylaspartate (NAA), creatine/phosphoccreatine (Cr), choline/phosphocholine (Cho), myo-inostitol (Ins) and lipid (fat) were clearly identified in normal brain tissues. The signal intensity of NAA resonance is strongest. The standard ratios of metabolites from the normal brain tissues in specific regions were obtained for the references of further in vivo 1H MR spectroscopic studies. Our initial results suggest the in vivo 1H MR spectroscopy may provide more precise diagnosis on the basis of the metabolic informations on brain tissues. The unique ability of in vivo 1H MR spectroscopy to offer noninvasive information about tissue biochemistry in patients will stimulate its impact on clinical research and disease diagnosis.
Biochemistry ; Brain* ; Diagnosis ; Healthy Volunteers* ; Humans* ; Magnetic Resonance Spectroscopy* ; Protons

PURPOSE: To evaluate the various phosphorus metabolism' of breast tumors with use of in vivo phosphorus-31 (31P) M R spectroscopy (MRS) MATERIALS AND METHODS: Five patients with breast tumor (benign in two, malignant in three) and three normal healthy volunteers participated in this study. All in vivo31P MRS examinations were performed on 1.5 Twhole-body MRI/MRS system by using a Free Induction Decay (FID) pulse sequence. Tl-weighted MR images were used for localization of tumors. Peak areas for each phosphorus metabolite were measured using a Marquart algorithm. RESULTS: Breast carcinoma had a substantially larger phosphomonoester (PME) and a smaller phosphocreatine (PCr) peak intensity than normal breast tissue. This was reflected in the relatively higher PME/PCr ratio of breast carcinomas as well as phosphodiester (PDE)/PCr, inorganic phosphate (Pi)/PCr, and adenosine triphosphate (ATP)/PCr ratios, compared with normal controls. The mean pH value of breast tumor demonstrating the alkaline nature was higher than that of normal controls. Spectral patterns between benign breast disease and normal breast tissue were quite similar, and differentiation was not established. CONCLUSION: Our preliminary study suggests that in vivo 31P MRS is a noninvasive examination which may be useful in the early differentiation of malignant breast tumors from normal and benign conditions. However, normal control and benign conditions could not be characterized on the basis of the phosphorus metabolite ratios.
Adenosine Triphosphate ; Breast Diseases ; Breast Neoplasms* ; Breast* ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Magnetic Resonance Spectroscopy* ; Phosphocreatine ; Phosphorus ; Spectrum Analysis

PURPOSE: To evaluate the spatial distribution of various proton metabolites in the human brain with use of water-suppressed in vivo 1H MR spectroscopic imaging (MRSI) technique MATERIALS AND METHODS: All of water-suppressed in vivo 1H MRSI were performed on 1.5 T whole-body MRI/MRS system using Stimulated Echo Acquisition Method (STEAM) Chemical shift Imaging (CSI) pulse sequence. T1 -weighted MR images were used for CSl Field Of View (FOV; 24 cm). Voxel size of 1.S cm3 was designated from the periphery of the brain which was divided by 1024 x 16 x 16data points. RESULTS: Metabolite images of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) + choline/phosphocholine (Cho), and complex of gamma-aminobutyric acid (GABA) -I- glutamate (Glu) were obtained on the human brain. CONCLUSION: Our preliminary study suggests that in vivo 1H MRSl could provide the metabolite imaging to compensate for hypermetabolism on Positron Emission Tomography (PET) scans on the basis of the metabolic informations on brain tissues. The unique ability of in vivo 1H MRSI to offer noninvasive informations about tissue biochemistry in disease states will stimulate on clinical research and disease diagnosis.
Biochemistry ; Brain* ; Diagnosis ; gamma-Aminobutyric Acid ; Glutamic Acid ; Humans* ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Protons

BACKGROUND/AIMS: Glucosamine is widely taken as a functional food, and some studies reported its anti-inflammatory effects. K+ channels and intracellular signal play important roles in the activation of immune cells such as T lymphocytes. Therefore we aimed to examine the effects of glucosamine on the cell physiological parameters. METHODS: In Jurkat-T lymphocytes, intracellular [Ca2+] ([Ca2+]i) was measured using fura-2 fluorimetry, and voltage-gated K+ current (I(Kv)) was measured using whole-cell clamp technique. Ca2+-activated K+ current (I(Kca)) was measured in HEK293 cells over expressing SK4 using inside-out patch clamp technique. RESULTS: An acute application of glucosamine (0.5 mM) affected neither the increase in [Ca2+]i induced by CD3 stimulation (anti-CD3 Ab, 5 microgram/mL) nor the I(Kv) in Jurkat-T cells. A chronic stimulation of with anti-CD3 Ab (5 microgram/mL, 24~36 hr) largely increased the amplitude of IKv. However, the combined treatment with glucosamine (0.1 mM) did not block the increase of I(Kv). The I(KCa) in SK4-overexpressing cells was slightly decreased by glucosamine (0.5 mM). CONCLUSIONS: While glucosamine had a minor inhibitory effect on SK4 K+ channels, the anti-inflammatory effects of glucosamine could not be explained by the effects on the Ca2+ signaling in T lymphocytes.
Calcium ; Fluorometry ; Functional Food ; Fura-2 ; Glucosamine ; HEK293 Cells ; Ion Channels ; Lymphocytes ; T-Lymphocytes

PURPOSE: Thrombus formation enhances both neointima formation and clinical restenosis after vascular injury or angioplasty. Thrombotic occlusions and intimal hyperplasia limit the success of vascular reconstructive procedures. Thrombolysis is expected to improve the outcome for both restenosis and acute arterial occlusion after injury. Tissue-type plasminogen activator (tPA) is commonly used clinically, and it is thought to play a critical role in vascular remodeling by mediating intravascular clot lysis and modulating cell migration within the vessel wall. However, there is controversy about the late effects of tPA on the vascular lumen either for preventing or enhancing intima hyperplasia in vivo. Thus, this study was done to evaluate the impact of a clinical infusion of tPA on the neointima formation after a balloon injury. METHOD: Forty male Sprague- Dawley rats weighting of 250~300 gm each were underwent aortic intimal denuation with a 2F balloon catheter. The rats were divided into two groups: the control group (n=20: normal saline infusion), and the*ean IMAR on the 21st day was 1.14+/-0.16 in the control group and 1.10+/-0.11 in the experiment group. The mean IMAR was lower in the experiment group, but the result was not statistically significant. In comparison to the gelatinolytic activity of MMP-9 and, activated MMP-2, there was no significant difference between the two groups. CONCLUSION: These results suggest that the effect of tPA on intimal hyperplasia after balloon injury to rat aorta showed minimal significance.
Angioplasty ; Animals ; Aorta* ; Catheters ; Cell Movement ; Humans ; Hyperplasia* ; Male ; Negotiating ; Neointima ; Rats* ; Thrombosis ; Tissue Plasminogen Activator* ; Vascular System Injuries