PURPOSE: Electrical burn of scalp is uncommon. Much more, chronically exposed dura in unstable burn scar is quite exceptional. Hence, we report a case of chronically exposed dura following electrical burn. METHODS: A 63-year-old man presented with an about 40 years history of an ulcerative lesion arising from electrical burn scar with 'squeeze like sensation' around wound. Wound was about 6 x 8cm. Area in the center was 3 x 3 cm nonviable dura without sequestrum. Tangential excision with an intraoperative neurosurgical consultation and transposition flap under general anesthesia was done. Intraoperative biopsy was done. The wound was diagnosed as chronic osteomyelitis, not Marjolin ulcer. Flap was taken successfully. But after 5 days, infectious discharge had been appeared during 2 weeks, despite irrigation and drainage. As flap was re-evaluated, we could see remnant necrotic dura. After that, latissimus dorsi muscle free flap with meshed split thickness skin graft was transferred without excision of necrotic dura. RESULTS: Flap was taken successfully. Follow-up at 10 weeks has been uneventful, with good and stable coverage of the wound. CONCLUSION: It is true that complete excision of devitalized tissue with sagittal sinus obliteration is prerequisite to flap taken. But necrotic dura was tangentially excised instead of total dura excision, because, posterior two-thirds of the sagittal sinus was involved underneath. Muscle is rich in blood vessels and decrease the recipient-site bacterial count effectively. In this case, muscle flap with skin graft without total dura excision is an alternative treatment.
Anesthesia, General ; Bacterial Load ; Biopsy ; Blood Vessels ; Burns ; Burns, Electric ; Cicatrix ; Drainage ; Dura Mater ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Middle Aged ; Muscles ; Osteomyelitis ; Scalp ; Skin ; Transplants ; Ulcer

PURPOSE: This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies. METHODS: This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area. RESULTS: Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors. CONCLUSION: Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.
Aged ; Breast ; Breast Neoplasms ; Compliance ; Counseling ; Diet ; Female ; Humans ; Primary Prevention ; Program Development ; Surveys and Questionnaires ; Secondary Prevention

Nesidioblastosis is a term that describes the prolonged differentiation of islets of Langerhan's cells from the epithelium of the pancreatic duct. Nesidioblastosis is a primarily childhood disease, which is often associated with hyperinsulinemic hypoglycemia, but rarely found in adults. A 62-year-old man with hyperinsulinemic hypoglycemia complained of general weakness and mental change while fasting. Abdominopelvic CT, celiac angiography, intra-arterial calcium stimulation test and endoscopic ultrasonography did not reveal any tumor in the pancreas. A subtotal pancreatectomy (nearly 80% of pancreas was removed) was then carried out. He was diagnosed with nesidioblastosis inform the pathology after the operation. Herein, our experience of a 62-year-old Nesidioblastosis patient is reported.
Adult* ; Angiography ; Calcium ; Endosonography ; Epithelium ; Fasting ; Humans ; Hypoglycemia* ; Middle Aged ; Nesidioblastosis* ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pathology

It has been demonstrated that an unidentified cytosolic factor (s) reduces K (ACh) channel function. Therefore, this study attempted to elucidate the cytosolic factor. Fresh cytosol isolated from normal heart (FC) depressed the K (ACh) channel activity, but cytosol isolated from the ischemic hearts (IC) did not modulate the channel function. Electrophorectic analysis revealed that a protein of ~80 kDa was markedly reduced or even lost in IC. By using peptide sequencing analysis and Western blot, this 80 kDa protein was identified as transferrin (receptor-mediated Fe3+ transporter, 76 kDa). Direct application of transferrin (100 nM) to the cytoplasmic side of inside-out patches decreased the open probability (Po, 12.7+/-6.4%, n=4) without change in mean open time (tau o, 98.5+/-1.3%, n=4). However, the equimolar apotransferrin, which is free of Fe3+, had no effect on the channel activity (N*Po, 129.1+/-13.5%, n=3). Directly applied Fe3+ (100 nM) showed results similar to those of transferrin (N*Po: 21.1+/-3.9%, n=5). However Fe2+ failed to reduce the channel function (N*Po, 106.3+/-26.8%, n=5). Interestingly, trivalent cation La (3+) inhibited N*Po of the channel (6.1+/-3.0%, n=3). Taken together, these results suggest that Fe3+ bound to transferrin can modulate the KACh channel function by its electrical property as a polyvalent cation.
Animals ; Blotting, Western ; Cytoplasm ; Cytosol ; Heart ; Muscle Cells* ; Rats* ; Transferrin*

PURPOSE: We compared the anteroposterior translation and the internal-external rotation of the tibia in stable knees without an anterior cruciate ligament (ACL) injury with those of ACL injured knees by using a navigation system and we report the objective data. MATERIALS AND METHODS: Forty-four patients who were treated for a meniscal tear without ACL injury were allocated to the stable group, and 41 patients were allocated to the ACL injury group. The anteroposterior displacement and the rotation of the knees were measured in 0, 30, 60 and 90 degrees of flexion with using the Orthopilot(R) navigation system. RESULTS: The mean total rotation values were 18.8degrees+/-4.5degrees, 31.4degrees+/-4.2degrees, 30.1degrees+/-5.1degrees and 29.2degrees+/-5.9degrees at 0, 30, 60 and 90 degrees of flexion, respectively, in the stable group and 22.7degrees+/-6.9degrees, 37.6degrees+/-5.8degrees, 34.0degrees+/-9.4degrees and 31.8degrees+/-8.8degrees at 0, 30, 60 and 90 degrees of flexion, respectively, in the ACL injury group. CONCLUSION: The quantitative values for anteroposterior translation and rotations of stable and ACL injured knee were obtained using a navigation system.
Anterior Cruciate Ligament ; Displacement (Psychology) ; Humans ; Knee ; Tibia

PURPOSE: The genes involved on the suppression of radiation-induced apoptosis by genistein in K562 leukemia cell line was investigated. MATERIALS AND METHODS: K562 cells in exponential growth phase were irradiated with a linear accelerator at room temperature. Forx-ray irradiation and drug treatment, cultures were prepared at 2x105 cells/mL. The cells were irradiated with 10 Gy (Clinac 1800C, Varian, USA). Stock solutions of herbimycin A (HMA, Calbiochem, UK) and genistein (Calbiochem, UK) were prepared in dimethylsulfoxide (DMSO, Sigma, UK). After incubation at 37degreesC for 24 h, PCR-select cDNA subtractive hybridization, dot hybridization, DNA sequencing and Northern hybridization were examined. RESULTS: Smad6 gene was identified from the differentially expressed genes in K562 cells incubated with genistein which had been selected by PCR-select cDNA subtractive hybridization. The mRNA expression of Smad6 in K562 cells incubated with genistein was also higher than control group by Northern hybridization analysis. CONCLUSION: We have shown that Smad6 involved on the suppression of radiation-induced apoptosis by genistein in K562 leukemia cell line. It is plausible that the relationship between Smad6 and the suppression of radiation-induced apoptosis is essential for treatment development based on molecular targeting designed to modify radiation-induced apoptosis.
Apoptosis* ; Cell Line ; Dimethyl Sulfoxide ; DNA, Complementary ; Genistein* ; K562 Cells* ; Leukemia ; Particle Accelerators ; RNA, Messenger ; Sequence Analysis, DNA

PURPOSE: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. MATERIALS AND METHODS: During 1998~1999, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. RESULTS: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered 3~4 times. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). CONCLUSION: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.
Brachytherapy ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Endoscopy ; Esophageal Neoplasms* ; Esophagitis ; Female ; Fluorouracil ; Humans ; Korea* ; Male ; Photons ; Radiotherapy ; Republic of Korea ; Tomography, X-Ray Computed