BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

Many pictures must be taken for the presumption of the stereorelation of the cerebral artery, which obtained with ordinary cerebral angiography. And it is very difficult to understand the stereoimage and required many experiences. But it is able to presume the stereorelationship in only brief eye's training without the aid of the stereoscope using the prism. For the stereoview, we need the paired angiograms obtained only straight and tilting the X-ray tube. In practice, with this stereoview in cerebral angiogram, we could know the directions of the aneurysmal neck and fundus with the stereorelationship of the cerebral artery and indeed helps us greatly in operation field. In addition, we might guess the location and stereorelationships of the feeding artery and draining vein in arteriovenous malformation and other vascular tumors and it was great aid in diagnosis and operation. Now we present the methods of the pictures for the stereoview in cerebral angiogram and the methods for eye's training.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Cerebral Angiography ; Cerebral Arteries ; Diagnosis ; Neck ; Veins

No abstract available.
Subarachnoid Hemorrhage*

No abstract available.
Lower Extremity

We investigated the distribution of S-100 protein positive dendritic cells in the skin lesions with tuberculoid sturcture. For this study, we selected the paraffin blocks of biopsied specimens with the characteristic histopathology of lupus vulgaris (5cases), tubereulosis verrucosa cutis (1 case), lupus milaris disseminatus faciei (4 cases), and erythema induratum (7 cases). The cells were identified by immunohistochemical demonstration in paraffin sections. The results were as follows: 1. S-100 protein positive dendritic cells were regularly visualized in all lesions examined. 2. S-100 protein positive dendritic cells appeared usually between the lymphohistiocytic infiltrates around the tuberculoid granulomas in contrast to the cells of monocyte-macrophage system which were within the granulomas. And they appeared occasionally (e.g. in a case of lupus vulgaris) between epitheloid cells in the granulomas. 3. S-100 protein positive dendritic cells were more numerous in the granulomatous lesions which showed the well-formed tuberculoid sturcture. From these results, we suggested the S-100 protein positive dendritic cells act as accessory cells in the pathogenesis of the granulomatous lesions by the delayed type hypersensitivity.
Dendritic Cells* ; Erythema Induratum ; Granuloma ; Hypersensitivity ; Lupus Vulgaris ; Paraffin ; S100 Proteins ; Skin*

A case of situs inversus totalis was observed in the cadaver of a 35 year old Korean female and the anatomical structures were investigated. The fact that she had received intestinal resection due to tuberculosis of intestines was confirmed. The results are summarized as follows : 1. All thoracic and abdominal viscera were completely transposed and in the left lower quadrant of abdomen, it was observed that the distal portion of the small intestine, cecum, appendix and part of the ascending colon had been resected. 2. Classic mirror-image dextrocardia with patent foramen ovale (large diameter, 7mm), sinusitis in the left maxillary sinus, bilateral thoracic duct, variation of the opennig site of the common bile duct and the main pancreatic duct, and maldvelopment of the left adrenal gland were observed together with the sinus inversus totalis.
Abdomen ; Adrenal Glands ; Appendix ; Cadaver ; Cecum ; Colon, Ascending ; Common Bile Duct ; Dextrocardia ; Female ; Foramen Ovale, Patent ; Humans ; Intestine, Small ; Intestines ; Maxillary Sinus ; Pancreatic Ducts ; Sinusitis ; Situs Inversus* ; Thoracic Duct ; Tuberculosis ; Viscera

No abstract available.
Syndactyly*

BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

Several measurements were performed about 105 cases of normal stress A-P arthrographic findings in adult knee including discoid without tearing or osteoarthritis, those were selected from 166 cases examined arthrographicaliy under same technical condition due to suspicious internal derangement of the knee from October 1976 to March 1980. After stastistical analysis and comparative study about chondrai thickness, chondral index, meniscal size, meniscal index, intermeniscal distance, type of meniscus, communication between knee and proximal tibiofibular joint, following results were obtained. 1. Chondral thickness of normal articular cartilage was not related to joint size, but almost same value individually. Mean chondral thickness In P and P points was 2.90±0.63mm, 2.90±0.62mm, 2.93±0.64mm, 2.92±0.65mm in lateral, medial femoral condyle and lateral, medial tibial condyle in order. Age change was not seen statistically. 2. The size of meniscus was correlated nearly proportional with that of the joint. Mean lateral meniscus size (transverse meniscal length × meniscal thickness) was 12.55±2.50mm × 6.53±0.7mm in male and 10.13±2.25mm × 6.02±0.52mm in female. That of medial meniscus was 9.79+1.54mm × 5.85+ 0.45mm in male, and 7.72±1.64mm × 5.36±0.92mm in female. Age change was not seen statistically either. 3. Mean intermeniscal distance was 60.21x2.74mm in male, 53.34±3.31mm in female and occupied 83% in male, 82% in female of joint size each other. 4. In types of meniscus, normal type was 8.10%, infantile type dlscoid 12.4%, intermediate type 2.9%, primitive type 3.7% each other. 5. Communications between knee joint and proximal tibiofibular joint were seen in 24%.
Adult ; Cartilage, Articular ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Menisci, Tibial ; Osteoarthritis ; Tears