The trestment of extensive soft tissue injury of the extremities is known to be one difficulty in the field of Orthopedic Surgery. The authors present a study of 55 free vascularized scapular flaps, 12 free vascularized parascapular flaps and 9 combined scapular and latissimus dorsi flaps for extensive soft tissue injury of the extremities at the Department of Orthopedic Surgery, Severance Hospital from March 1983 to December 1988. The results of the study are as follows:1. The pedicles of the flap were consistent in length and diameter. 2. The flap was uniform and relatively thin in thickness in free scapular and psrascapular flaps 3. There was no limitation to motion of the shoulder despite excision of the scapular and parascapular flap. 4. Primary closure of the donor flap was feasible in almost all cases. 5. Reconstruction of a 1arge soft tissue defect was possible with scapular and parascapular flap in one stage. 6. The free vaseularized scapular flap and parascapular flap would be recommended of one-stage reconstructional surgery for extensive soft tissue defects.
Clothing ; Extremities ; Humans ; Orthopedics ; Shoulder ; Soft Tissue Injuries ; Superficial Back Muscles ; Tissue Donors

BACKGROUND: The concentration of the blood including ACTH, catecholamine, serum prolactine, cortisol is increased due to responding on stress by carrying out endotracheal intubation upon the mutiple trauma patients who were taken to the emergency room. Diazepam is a kind of benzodiazepine pharmacon and common pharmacon used for stability of the patients, relief and pretreatment as a booster for the relaxation of skeletal muscle. This research aims to know how effectively medication of diazepam before endotracheal intubation helps to constrain the reaction on the part of cardiovascular system due to laryngoscopy and endotracheal intubation, and makes concentration of catecholamine in blood changed. METHODS: The subjects are consisted of the patient asked for endotracheal intubation instantly, suffering from caput trauma (GCS 8.0) among the multiple trauma patient, more than 20-year-old who were taken to the emergency room in Chosun university hospital from October 1, 1995 to September 30, 1996. They were decided into 2 classes, 30 people each class, and one (group I ) was carried out endotracheal intubation without injecting diazepam,0.3 mg/kg, and the other (group II) was done with the endotracheal intubation by injecting diazepam, 0.3mg/kg. Group I and group II were measured blood pressure and heart rate before intubation and at 1, 3, 5, 7 minute after endotracheal intubation, sampled arterial blood from femoral artery, and then compared and analyzed. All of the data were recorded by mean, standard deviation, and percentage and repeated measures ANOVA test was used for the statistical test and the data was regarded as statistically significant when p value is below 0.05. RESULTS: 1) They were no significant differences statistically between 2 groups in the distribution of the age, weight, sex of the patients. 2) The changes in the systolic blood pressure had no statistical significance in the comparison between group I and group II, but diastolic blood pressure and the change of heart rate had statistical significance because p value was shown below 0.05. 3) Norepinephrine of blood was significantly lower in group II than group I. 4) Epinephrine of blood was significantly lower in group II than group I. CONCLUSION: It was shown that medication of diazepam before endotracheal intubation made stability of the patients and it changed significantly the reaction on the part of cardiovascular system from stress caused by laryngoscopy and endotracheal intubation. So it will be a good thing to inject diazepam for pretreatment to bring relief of the patients and cardiovascular stability before endotracheal intubation.
Adrenocorticotropic Hormone ; Benzodiazepines ; Blood Pressure ; Cardiovascular System ; Diazepam* ; Emergency Service, Hospital ; Epinephrine ; Femoral Artery ; Heart Rate ; Humans ; Hydrocortisone ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Multiple Trauma* ; Muscle, Skeletal ; Norepinephrine ; Prolactin ; Relaxation ; Young Adult

The Tikhoff-Linberg procedure is a limb-sparing surgical option to be considered for bony and soft tissue tumors in and around the proximal humerus and shoulder girdle. The authors reported 6 cases of the Tikhoff-Linberg procedure for tumors around the shoulder Joint at the Department of Orthopedic Surgery of Severance Hospital from March 1988 to August 1989. 1. The 6 cases were composed of 2 osteogenic sarcoma, 2 chondrosarcoma, 1 chondroblastoma, and 1 giant cell tumor cases. 2. The tumors were completely removed by the Tikhoff-Linberg procedure without amputation or disarticulation of the upper extremity. 3. The distal clavicle, upper humerus and or parts or all of the scapula were resected. 4. The Tihkoff-Linberg procedure was performed for patients whose tumors did not involve the neurovascular bundle in the axilIa. 5. The function of the hand and forearm after the Tihkoff-Linberg procedure are near normal in all cases. 6. The Tikhoff-Linberg procedure would be recommended as a limb-sparing operation for tumors around the shoulder joint that were required wide resection without disarticularion or forequarter of the upper extremities.
Amputation ; Chondroblastoma ; Chondrosarcoma ; Clavicle ; Disarticulation ; Forearm ; Giant Cell Tumors ; Hand ; Humans ; Humerus ; Orthopedics ; Osteosarcoma ; Scapula ; Shoulder Joint ; Shoulder ; Upper Extremity

Human lymphoblastoid B-cell lines immortalized by Epstein-Barr virus (EBV) were established from peripheral blood of patients with acute myeloblastic and chronic lymphocytic leukemia and chronic fatigue syndrome. The sera of patients with acute myeloblastic and chronic lymphocytic leukemia did not show antibodies to Epstein-Barr viral capsid antigen (VCA), but serum of a patient with chronic fatigue syndrome disclosed antibodies to VCA (IgG, IgM), and EBNA was demonstrated in peripheral blood mononuclear cells by polymerase chain reaction. The established cell lines were mature B-cell phenotypes with polyclonal proliferation in early passage and no evidence for commitment to other lineages. The immortalized cells by EBV were designated as CSUP-1 and CSUP-2 (from acute myeloblastic leukemia, FAB classification M2 and M1), CSUP-3 (from chronic lymphocytic leukemia) and CSUP-4 (from a patient with chronic fatigue syndrome). The CSUP-1, 2, 3, and 4 grew in suspension forming clumps with a doubling time of 38 to 49 hours. Colony formation was not recognized in plate. By light and electron microscopic examination, the immortalized cells showed features of lymphoblastoid to plasmacytoid lymphocytes, and multinucleated giant cells. The lymphoblastoid cells showed scanty cytoplasm with poorly developed organelles. Immunophenotypic analyses of CUSP-1, 2, 3, and 4 with monoclonal antibodies by flow cytometry showed B-cell phenotype with polyclonal proliferation in early passage. Epstein-Barr virus nuclear antigen was confirmed in the extracted DNAs from immortalized cells by polymerase chain reaction. DNA analysis showed a normodiploid stemline with a DNA index of 1.12. The established cells were strongly reactive for CD10, CD30 (Ki-1) in early passage, and bcl-2 and c-myc onco-protein in early and late passage. Karyotypic analysis of CSUP-1, 2, 3 and 4 showed 46, XY or 46, XX. No tumorigenesis in heterotransplanted SCID mouse was recognized. This immortalized cells by EBV should be a valuable cell lines to study the pathogenesis of EBV-related malignant lymphoma.
Animals ; Antibodies ; Antibodies, Monoclonal ; B-Lymphocytes* ; Capsid ; Carcinogenesis ; Cell Line ; Classification ; Cytoplasm ; DNA ; Fatigue ; Fatigue Syndrome, Chronic ; Flow Cytometry ; Giant Cells ; Granulocyte Precursor Cells ; Herpesvirus 4, Human* ; Humans* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Leukemia, Myeloid, Acute ; Lymphocytes ; Lymphoma ; Mice ; Mice, SCID ; Organelles ; Phenotype ; Polymerase Chain Reaction

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therefore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving joint motion, maintaining the health of muscle supplying motor power about the joint, and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. For the period of 15 years from January 1973 to December 1987, 55 cases of rheumatoid arthritis who received surgical treatment were reviewed and the results of clinical observation were as follows : 1. Among 977 patients of rheumatoid arthritis, 76 sites in 55 patients were operated on. 2. Sites of operation were the knee in 33 cases, hip in 20 cases, wrist and finger in 12 cases, ankle in 5 cases, elbow in 5 cases, and cervial spine in 1 case. 3. Operative methods were 40 cases of joint replacement, 27 cases of synovectomy, 4 cases of fusion, and 2 cases of tenotomy and capsulectomy. 4. Postoperative results were good in 19 patients, satisfactory in 16 patients, unsatisfactory in 5 patients, and poor in 2 patients. 5. The clinical stage at the time of joint replacement was not related to the end results of the operations. 6. Causes of unsatisfactory and poor results were preoperative flexion contracture and Felty's syndrome.
Adult ; Ankle ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Contracture ; Elbow ; Felty Syndrome ; Fingers ; Hip ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Range of Motion, Articular ; Spine ; Synovial Membrane ; Tenotomy ; Wrist

No abstract available.
Immunohistochemistry* ; Sciuridae*

No abstract available.
Endocrine Cells* ; Immunohistochemistry* ; Sciuridae*

The effects of ether and halothane anesthesia, and surgery on blood sugar level in children were studied in twelve patients, Six patients were anesthetized with ether and other six patients with halothane. Blood samples were taken two times through a catheter in the external jugular vein after intravenous injection of pentothal 6 mg/kg and succinylcholine 1mg/kg during the anesthesia and. surgical procedure. Blood sugar was measured with the orthotoluidine method. The mean value of blood sugar in the ether group was elevated significantly from 68 mg/100 inl to 92. 2 mg/100 ml and also in the halothane group it was elevated' from 68. 8 mg/l00 ml to 81 mg/100 ml, with a significant difference that the blood sugar level was higher in the ether group than in the halothane group. Results were also compared with the hyperglycemic response to different types of surgery. The value of blood sugar under general anesthesia during intra-abdominal, body surface and other surgery was measured. The hyperglycemic response to intra-abdominal surgery was the largest and the next was in other surgery, and in body surface surgery it was smallest, so it was shown there is a relationship between the degree of trauma and the rise in blood sugar.
Anesthesia* ; Anesthesia, General ; Blood Glucose* ; Catheters ; Child* ; Ether ; Halothane ; Humans ; Injections, Intravenous ; Jugular Veins ; Methods ; Succinylcholine ; Thiopental

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

No abstract available.
Temporal Bone*