The development of a safe method of transfer of the greater toe for thumb reconstruction, using dorsalis pedis artery and the great saphenous vein, suggested the possibility of one stage microvascular transfer of the second toe for reconstruction of surgery. Based upon our part experience with microsurgical experiments, limb transplantation and toe-to-thumb transplantation since 1975, we accomplished the second toe-to-index transplantation done in Korea on October 24, 1979, and succeeded in one stage second toe-to-index transplantation in two cases. Following results were obtained. I. Free second toe-to index transplantation on making a index is the most excellent method of index reconstruction with results in minimum functional and cosmetic impairment. 2. Technically, skin incision, isolation of blood vessels and flexor tendon in preparation for transplantation of second toe is more difficult than that of greater toe. 3. The specialized microsurgical training with skillful technique is essential for success.
Arteries ; Blood Vessels ; Extremities ; Korea ; Methods ; Microsurgery ; Saphenous Vein ; Skin ; Tendons ; Thumb ; Toes

No abstract available.
Adult* ; Femur* ; Humans

The effects of hind-limb immobilization by skeletal fixation of bilateral ankle and knee joints. for sither one or five weeks on glycogen concentrations, glycogen resynthetic activities and insulin responses to glucose uptake of hind-limb muscles were studied on male Splague-Dawley rats. There were significant drops in muscle wet weight to body weight ratio of immobilized soleus and plataris. In the group immobilized for one week, the ratios of sleous and plantaris were decreased by 11% and 38% respectively; and in the group immobilized for five weeks, the ratios were decreased by 42% in both muscles equally. The glycogen concentration and glycogen resynthetic activities of soleus and plantaris muscles in immobilized rats were decreased significantly in the one week group. However, in the five week group, these values were increased significantly compared to the values of those muscles of the one week group. The increased values of the five week group did not exceed those of the control group. The glucose uptake rate of the soleus muscle of the hind-limbs immobilized for one week and for five weeks were studied in vitro. The basal glucose uptake rate of the muscle of the control group was 8.4 ± 0.77Mol/gm/20min. The values of basal rate and insulin responses to the glucose uptake rates in the doses of physiological and supramaximal on the soleus muscles immobilized for one week was significantly decreased, but after immobilization for five weeks, these values were not significantly different statistically those from of the control group statistically.
Animals ; Ankle ; Body Weight ; Extremities ; Fracture Fixation ; Glucose ; Glycogen ; Humans ; Immobilization ; In Vitro Techniques ; Insulin ; Knee Joint ; Male ; Metabolism ; Muscle, Skeletal ; Muscles ; Rats

BACKGROUND: Chronic obstructive pulmonary disease(COPD) is one of the major contributors to morbidity and mortality amont the adult population. Cigarette smoking(CS) is undoubtedly the single most important factor in the pathogenesis of COPD. However, its mechanism is unclear. The current hyopthesis regarding the pathogenesis of COPD postulates that an imbalance between proteases and antiproteases leads to the destructive changes in the lung parenchyma. This study had two aims. First, to evaluate the effect of CS exposure on histologic changes of the lung parenchyme, and second, to evaluate the effect of CS exposure on the expression of the gelatinolytic enzymes in BAL fluid cells in guinea pigs. METHODS: Two groups of five guinea pigs were exposed to the whole smoke of 20 commerical cigarettes per day, 5 hours/day, 5 days/week, for 6 weeks, and 12 weeks, respectively, using a smoking apparatus. Five agematched guinea pigs exposed to room air were used as controls. Five or more sections were microscopically examined(×400) and the number of cellular infiltration of the alveolar wall was measured in order to evaluate the effect of CS exposure on the histologic changes of lung parenchyme. The statistical significance was analyzed by a linear regression method. To evaluate the expression of the gelatinolytic enzymes in intraalveolar cells, BAL fluid was obtained and the intraalveolar cells were separated by centrifugation (500 g for 10 min at 4℃). Two sets of culture plates were loaded with 1×106 intraalveolar cells. One plate, contained 0.1mM EDTA, a inhibitor of matrix metalloproteases(MMPs), and the other plate had no EDTA. Both plates were incubated for 48 hours at 37℃. After incubation, gelatinolytic protease expression in the supernatants was analyzed by gelatin zymography. RESULTS: At the end of CS exposure, the level of blood carboxy Hb had increased significantly(4.1g/dl in control group, 24g/dl immediately after CS exposure, 18g/dl 30 min after CS exposure). Alveolar inflammatory cells were identified in the CS exposed guinea pigs. The number of alveolar cellular cells observed in a microscopic field (400×) was 121.4±7.2, 158.0±20.2, 196.8±32.8, in the control, the 6 weeks, and the 12 weeks group, respectively. The increased extent of inflammatory cellular infiltration of the lung parenchema showed a statistically significant linear relationship with the duration of CS exposure(p=0.001, r2=0.675). Several types of gelatinolytic enzymes in the intraalveolar cells of CS exposed guinea pigs were expressed, of which some were inhibited by EDTA. However, the gelatinolytic enzymes were not expressed in the control groups. CONCLUSION: CS exposure increases inflammatory cellular infiltration of the alveolar wall and the expression of gelatinolytic preoteases in guinea pigs. EDTA inhibits some of the gelatinolytic proteases. These findings suggest a possibility that CS exposure may increase MMP expression in the lungs of gunea pigs.
Adult ; Animals ; Centrifugation ; Edetic Acid ; Gelatin ; Guinea Pigs* ; Guinea* ; Humans ; Linear Models ; Lung* ; Mortality ; Peptide Hydrolases* ; Protease Inhibitors ; Pulmonary Disease, Chronic Obstructive ; Smoke* ; Smoking* ; Swine ; Tobacco Products

Metastatic pulmonary calcification refers to calcium deposition in the normal pulmonary parenchyma and this deposition is secondary to abnormal calcium metabolism. The most common radiologic manifestation consists of poorly-defined nodular opacities that are mainly seen in the upper lung zone. We present here a case of metastatic pulmonary calcification that manifested as atypical, dense, calcium deposition in airspaces within the previously existing consolidation in the bilateral lower lobes, and this process was accelerated by pneumonia-complicated sepsis in a patient with hypercalcemia that was due to hyperparathyroidism.
Calcinosis/*radiography ; Female ; Humans ; Hypercalcemia/etiology ; Hyperparathyroidism/complications/surgery ; Lung Diseases/*radiography ; Middle Aged ; Parathyroidectomy ; Pneumonia/complications ; Shock, Septic/microbiology ; Tomography, X-Ray Computed/methods

OBJECTIVES: Using two stimuli, this study was designed to evaluate variations of P300 in relations to reaction time of pressing the button for target tones in patients with schizophrenia. METHODS: The auditory oddball paradigm was used for the patients (N=22) and normal controls (N=23). The two stimuli were composed of target (20%, 2000 Hz, 75 dB) tone and standard (80%, 1000 Hz, 75 dB) tone, with 2 sec inter-stimulus interval, 50 msec duration and 10 msec rise or fall time. In each subject, P300s were acquired for both fast reaction time (FRT) and slow reaction time (SRT) to target response. RESULTS: P300 amplitude in patients with schizophrenia was lower than controls across FRT and SRT (p<0.001), but P300 latency was not delayed (p>0.8). In this study, even though the reaction time for the button pressing task might be faster in patients with schizophrenia (p<0.1), the P300 to FRT in patients with schizophrenia was lower than the P300 to SRT in controls (p<0.01). CONCLUSION: These results suggest that the lower P300 in patients with schizophrenia might be due to cognitive dysfunction and the patient's performance in reaction time for pressing buttons, both independently. Thus, P300 as well as reaction time may be used to further explore a variety of domains of cognitive function.
Evoked Potentials* ; Humans ; Reaction Time* ; Schizophrenia*

The authors report a case of oligodendroglioma in the septum pellucidum. A 22-year-old male presented with symptoms of headache and decreased visual acuity. Simple skull series showed calcified density near the midline. Brain C-T scan revealed huge calcified mass involving right lateral ventricle, 3rd ventricle and obstructive hydrocephalus. The authors diagnosed oligodendroglioma in operative findings and pathologic examination.
Brain ; Headache ; Humans ; Hydrocephalus ; Lateral Ventricles ; Male ; Oligodendroglioma* ; Septum Pellucidum* ; Skull ; Visual Acuity ; Young Adult

We experienced a case of cavernous hemangioma suspected to cerebral cysticecosis. The 23-year-old male patient was admitted to our hospital due to sudden severe headache and generalized tonic-clonic seizure. The computerized tomography showed multiple calcification of bilateral cerebral hemisphere, especially right, and cystic mass on right frontal area with mass effect. The mass was diagnosed cavernous hemangioma under the microscopic examination.
Cerebrum ; Cysticercosis ; Headache ; Hemangioma, Cavernous* ; Humans ; Male ; Seizures ; Young Adult

BACKGROUND: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. MATERIAL AND METHOD: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. RESULT: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, lymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6%). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). CONCLUSION: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer. Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.
Carcinoma, Squamous Cell* ; Cyclin D1* ; Cyclins* ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Genes, p53 ; Humans ; Lymph Nodes ; Mitotic Index* ; Polymerase Chain Reaction ; Prognosis* ; Survival Rate

The finite element method was utilized to find the rigidity of the device in changing the parameters, such as geometrical configuration, material property, and loading condition in an external fixation. In the experimental analysis, a universal testing machine(UTM) was used to evaluate the rigidity of EBI, Monofixator and Hoffmann under the different type of lodings, such as axial compression, bending and torsion in changing the parameters. The result was compared with those of the experimental work. The results were as follows: 1) In standard condition, the yielding loads in axial compression were 85Kg in the EBI, 55Kg in the Hoffmann, and 100Kg in the Monofixator, The rigidity figures were 2930N/cm in the EBI, 764N/cm in the Hoffmann, and 2391M/cm in the Monofixator. Z) The experimental method was adapted to figure out the effect of parametric change on the stiffness of 3 different external fixation apparatus(Monofixator,EBI, Hoffmann). A Monofixator with a parametric change of pin diameter from 6mm to 5mm indicated 40% reduction of stiffness in axial compression and 60% reduction of stiffness in torsion. Also, in the case of the change of pin group separation from 20cm to 15cm it showed 64% increase of stiffness in, AP bending. EBI with the increase of the distance between pin and aluminum bar to 8cm showed 32% decrement of stiffness in axial compression and 38% decrement of stiffness in AP bending. The stiffness of the Hoffmann device was remarkable according to the number of the pin used and the distance between the pin and the aluminum bar. 3) Concerning the difference between the experimental analysis and finite element method in a Monofixator, the results of the experimental analysis were 10% to 37% lower than those of the finite element method. The reason is thought to be caused by complete binding. The obtained data shed light on the future guide-lines and future alterations of the design factors in external fixation device. Approprate use of the obtained information is desirable for the optimal,treatment of the fractured long bone.
Aluminum ; External Fixators ; Methods