The survival of skin flap has vital importance in plastic surgery. Many clinical and experimental researches have been carried out to increase the survival of skin flap. As a result of these researches, many drugs have been used clinically and experimentally for increasing the survival of skin flap, and prostaglandin E1 is known to be used for improving peripheral circulatory disturbance. The pharmacophysiologic mechanisms of the effect of prostaglandin E1 are 1) increasing blood flow by dilatation of smooth muscle of small sized vessels, 2) inhibition of aggregation of platelets, 3) increasing arteriolar blood flow by improving fluidity of erythrocytes, 4) preclusion of free-radical formation, 5) decreasing the endothelial cell damage by down- regulation of sensitivity for eosinophils, 6) making the endothelial cell be refractory to adrenergic stimulation, and 7) promotion of secretion of erythropoietin in the kidney. In this terms, in order to validate effectiveness of preoperative administration of prostaglandin E1 as a pharmacological flap delay, following experimental study was performed. Forty male Sprague-Dawley rats were divided into 4 groups and caudally based 2x8 cmsized flap was elevated on dorsal surface. In group 1, normal saline (0.25 ml/kg) was injected intraperitoneally as control, in group 2, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for preoperative seven days, in group 3, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven preoperative days, and in group 4, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven days preoperatively and for seven postoperative days. On the seventh postoperative day, the animals were sacrificed and the flap survival area was measured. The following results were obtained. 1. On the seventh postoperative day, the flap survival rates of group 2, 3, 4 were higher than that of group 1 with a statistical significance. 2. On the seventh postoperative day, the flap survival rate of group 3 was higher than group 2, but there was no statistical significance. 3. On the seventh postoperative day, the flap survival rate of group 4 was higher than that of group 2 and 3 with a statistical significance.In conclusion, preoperative administrations of prostaglandin E1 increase flap survival equally as when it is administrated postoperatively, and the improvement in flap survival can be enhanced by continuous administration of prostaglandin E1 in preoperative and postoperative period. So it is expected that surgical flap delay procedure is replaced by pharmacological flap delay by the use of prostaglandin E1 preoperatively.
Alprostadil* ; Animals ; Dilatation ; Endothelial Cells ; Eosinophils ; Erythrocytes ; Erythropoietin ; Humans ; Kidney ; Male ; Muscle, Smooth ; Postoperative Period ; Rats* ; Rats, Sprague-Dawley ; Skin ; Surgery, Plastic ; Surgical Flaps ; Survival Rate

The most common malignant renal neoplasm is renal cell carcinoma. It is estimated that renal cell carcinoma accounts for 1% of all primary malignancies in Korea. Rell cell carcinoma presents diverse clinical courses with gross, histopathologic features. It has been known to be very difficult tumor to predict its clinical prognosis. In Korea, many studies have been reported concerning the clinical aspects of renal cell carcinoma. However, pathological studies of renal cell carcinoma are very few even though studies of nuclear grade have been attempted recently. We reviewed 93 cases of renal cell carcinoma examined in the period from 1978 to 1987 in the department of pathology, Yonsei university college of medicine, Yongdong Severance hospital, Wonju college of medicine and analyzed the histopathologic classification, including nuclear grade according to the Fuhrman's method. We abtained the following results by studying the relationship of the factors which had been known as correlated with the prognosis. 1) The ages of patients ranged from 9 to 74 years with a peak in the 6th decade. 2) The most common symptoms of the patients were hematuria, mass and pain, in that oder, and 7 patients complained to specific symptoms. The incidentally found cases characterized stage I, nuclear grade 2 small tumor size (not more than 4 cm) and clear cell type. 3) The renal cell carcinoma was more frequently located in the left kidney than the right by a ratio of 1.25 : 1. The incidence of intrarenal location was divided to the upper pole, 40% : mid portion, 29% : lower pole, 23% : diffuse involvement, 8%. The tumor shoing diffuse growth pattern had a large size, high nuclear grade and mixed cells. 4) The tumor size averaged 8 cm and there was no significant relationship between the size and stage. Seven cases of neoplasms not more than 3 cm were seen, of which 2 cases revealed an outcome of distant metastasis. 5) The histological pattern showed major solid, 53% : tubular, 11% : mixed, 18% : papillary, 9% and sarcomatoid type 9%. The sarcomatoid type was characterized by grade 4, a larger size(more than 10 cm), advanced stage. 6) There was no special relationship between the stage and grade but mostly grade 2 occupied the stage I. 7) The clear cell type was predominantly noted at grade 2 (65%), at the stage I (63%), granular or mixed cell type at grade 3 (87%), 4 (70%). According to these results, the tumors showing a sarcomatoid histologic pattern, diffuse growth pattern had unfavorable prognostic factors, and are thus estimated to have a poor prognosis. But the case which were incidentally found have favorable prognostic factors and probably a better prognosis. The tumor size alone can not exactly predict the metastasis and is not correlated with the stage. Small renal cell neoplasm (not more than 3 cm) generally has unfavorable prognostic factors and should be considered potentially malignant. The high grade frequently has granular cytoplasm. This represents the relationship between grade and cytoplasm, poor prognosis in the granular cell than the clear. The renal cell carcinoma shows variable prognosis and thus the prognosis should be estimated by all the factors. Nuclear grade can be used as one of the useful prognostic factors.
Incidence ; Neoplasm Metastasis

The immunoreactivities of surgically removed 16 cardiac myxomas were studies for factor VIII-related Ag (F VIII-RA), Ulex europaeus agglutinin I (UEA-I) and desmin alpha1-antichymotrypsin, and this study was accompained by a clinicopathologic review. More than 50% of the patients with cardiac myxomas were in their fourth and fifth decades, and cardiac myxomas were much more common in women than in men. All but on occurred in the left atrium, and the majority were attached to the atrial septum, usually in the region corresponding to the fossa ovalis. In one case, an atrial myxoma recurred 37 months after the initial excision. Microscopically, the myxomas contained a myxoid matrix composed of acid mucopolysaccharides within which were embedded polygonal cells. The cells forming both the surface and complicated vascular like channels throuhout the myxoid stroma tested positive for F VIII-RA and UEA-I. The outer cell layers of the complex vascular structures demonstrated variable staining for F VIII-RA, while isolated bundles of smooth muscle cells were present and stained for desmin. A small number of the so-called myxoma cells, immunoreactive for alpha1-antichymotrypsin which were not laden with hemosiderin pigment but were similar to histiocytes, were present particularly around the areas of hemorrhage. These findings support the current view that cellular and histologic heterogeneity arose from the divergent differentiation of multipotential mesenchymal cells. In particular, it remains to be confirmed by further study whether or not true histiocytic differentiation occurs.
Female ; Male ; Humans

No abstract available.
Leukemia*

OBJECTIVE: The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency (RF) neurotomies for pain arising from sacroiliac joint dysfunction(SIJD) METHODS: Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac joints and deep interosseous ligaments. After confirming the positive response (more than 50% of pain relief), sensory stimulation was applied to detect the `pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. RESULTS: Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus (88%) and S2-upper division (88%). Ten patients (63%) reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients (31%) reported complete relief (100%). Five patients (31%) showed moderate improvements. One patient reported failure. CONCLUSION: RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.
Chronic Pain ; Follow-Up Studies ; Humans ; Ligaments ; Sacroiliac Joint*

No abstract available.
Child* ; Humans ; Neurilemmoma* ; Neurofibromatosis 1

No abstract available.
Female ; Follicle Stimulating Hormone* ; Injections, Subcutaneous* ; Ovulation* ; Polycystic Ovary Syndrome*

No abstract available.
Trichosporon*

The p53 protein was discovered in 1979 as cellular 53-kD nuclear phosphoprotein bound to the large transforming antigen of SV40 virus. P21WAF1/CIP1, which has been described as the critical downstream mediator of p53, is known to suppress DNA replication and arrest the G1 cell cycle by quaternary complex with cyclin D, cyclin-dependent kinase(CDK) and proliferating cell nuclear antigen(PCNA). In these days, some studies shows that the p21 can be induced by independent pathways. There are various reports about the expression of p21 (67%.82.4%) in oral squamous cell carcinoma. But these studies are mostly done in malignant tumor not in benign tumor. So we decided to study the expression of p21 in ameloblastoma and the relationship between p53 and p21 as a downstream mediator of p53 in ameloblastoma. We investigated the expression of p21 and p53 with the method of immunohistochemistry. We selected 30 cases of ameloblastoma tissue blocks (acanthomatous type: 5 cases, follicular type: 8 cases, plexiform type: 17 cases) imbedded in paraffin. We used 30 cases of normal gingival tissues and 30 cases of squamous cell carcinoma tissues (SCC) respectively and compared their results with those of ameloblastoma. We made slides with the streptavidin-biotin methods and used monoclonal antibody DO-7 (Novocastra, Newcastle, United Kingdom) as p53 antibody and monoclonal antibody M7202 (DAKO, California, U.S.A.) as p21 antibody. We used Pearson's correlation coefficient to analyse the relationship. The results were as follows: 1. p21 was expressed in ameloblastoma about 30% and this is lower than that of normal gingiva and SCC. 2. In normal gingiva and ameloblastoma, p21 expression was correlated with p53 expression. 3. In SCC, p21 were expressed about 83.3% and this is more than that of p53. But there was no correlation between p21 and p53 expression. We confirmed p21 expression and relation with p53 in ameloblastoma. But, to confirm the function of p21, more studies about p21 expression in malignant ameloblastoma and ameloblastic carcinoma are needed.
Ameloblastoma* ; Ameloblasts ; California ; Carcinoma, Squamous Cell ; Cell Cycle ; Cyclin D ; DNA Replication ; Gingiva ; Immunohistochemistry ; Paraffin ; Simian virus 40

An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.
Adenocarcinoma ; Biopsy ; Neoplasm Metastasis