A variety of malignant neoplasms have been shown to induce neovascularization, and in some cases the degree of vascularization appears to correlate with an aggressive behavior and risk of metastasis. We compared the degree of vascularization in 11 benign and 33 cancerous lesions of the cervix. The microvessels were identified by immunohistochemistry using antibody to Factor VIII-related antigen in 44 hystrectomy specimens. Three highly vascularized microscopic fields were selected and counted the number of microvessels in 400 magnification. The proportion of the endothelial cell area was also quantified by using the CAS 200 image analysis system. All 33 cases of carcinomas demonstrated a significantly higher microvessel count and an endothelial cell area than those of the benign lesions (p<0.01). There were no significant difference in microvessel count and endothelial cell area among carcinoma in situ, microinvasive carcinoma and invasive carcinoma (p>0.05). Microvessel count and an endothelial cell area in invasive cancers were not correlated with tumor size, depth of invasion, or histologic type (p>0.05).This study showed cervical cancer induces neovascularization in an early stage but it is difficult to predict prognosis and metastasis with microvessel count and an endothelial cell area.
Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Endothelial Cells ; Female ; Immunohistochemistry ; Microvessels ; Neoplasm Metastasis ; Prognosis ; Uterine Cervical Neoplasms ; von Willebrand Factor

Stercoraceous ulcerations of the colon are produced by hard fecaloma that collect in the coton. Bleeding and more seriously perforation are complications of these ulcerations. These are generally thought to be rare, but this may reflect the difficulty of establishing the diagnosis, both before and during operation. This disease is relatively neglected as well. This is reflected by the small number of case reported in the literature. Authors report a case of stercoraceous ulcer of cecum which confirmed under the colonofiberscopy and managed in the Department of General Surgery, College of Medicine, Ewha Womans University,
Cecum* ; Colon ; Diagnosis ; Female ; Hemorrhage ; Humans ; Ulcer*

Pseudomyxoma peritonei often have synchronous appendiceal and ovarian mucinous tumors. There has been considerable debate as to whether the ovarian tumors are secondary to the appendiceal tumor or they are independent primary ovarian tumors. It is important to reveal the primary site for treatment and prognosis of a patient. Five cases of synchronous mucinous tumors of the ovary and appendix were studied. Four cases had pseudomyxoma peritonei and pseudomyxoma ovarii. The ovarian tumors were bilateral in two cases, right in two, and left in one. The ovarian tumors were four mucinous cystadenoma of borderine malignancy and one mucinous cystadenocarcinoma, and the appendiceal tumors consisted of four mucinous tumors of borderline malignancy and one mucinous adenocarcinoma. The histology of the ovarian and appendiceal tumors was similar. Rupture of the tumor was seen in all appendiceal tumors and two ovarian tumors. It has been reported that cytokeratin 7 is a useful marker for distinguishing primary ovarian neoplasms from metastases of intestinal origin. All ovarian and appendiceal tumors showed positive reaction for broad-spectrum cytokeratin, but negative for cytokeratin 7. Based on the clinicopathologic and immunohistochemical features, it should be considered that the appendiceal tumors are primary and ovarian tumors are secondary in the synchronous presentation of the ovarian and appendiceal mucinous tumors.
Adenocarcinoma, Mucinous ; Appendix* ; Cystadenocarcinoma, Mucinous ; Cystadenoma, Mucinous ; Female ; Humans ; Keratin-7 ; Keratins ; Mucins* ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Pseudomyxoma Peritonei* ; Rupture

No abstract available.
Hip*

No abstract available.
Humerus*

Cytokeratin 7 has been known to be present in various types of human epithelial cells including the ovarian neoplasms, but not in colon cancers. The antibody to colon ovarian tumor antigen (COTA) has been introduced as a marker of colon and ovarian tumors. The aim of this study was to evaluate the usefulness of cytokeratin 7 and COTA in the differential diagnosis between ovarian primary and metastatic tumors. Nineteen primary ovarian epithelial tumors, seven metastatic carcinomas of the ovary from the stomach, three metastatic carcinomas of the ovary from the colon, one mucinous tumor of the ovary associated with a mucinous tumor of the appendix and pseudomyxoma peritonei, and nineteen colonic and twenty gastric adenocarcinomas were stained with monoclonal antibodies to cytokeratin 7 and COTA. The results are summerized as follows; In the primary ovarian tumors, 94.4% were positive for cytokeratin 7 and 50% were positive for COTA. In the primary colonic adenocarcinomas, 94.7% were negative for cytokeratin 7 and 68% were positive for COTA. In the metastatic ovarian tumor from the colonic adenocarcinomas, 100% were negative for cytokeratin 7 and positive for COTA. In the primary gastric adenocarcinomas, 40% were negative for cytokeratin 7 and 85% were negative for COTA. In the metastatic ovarian tumor from the gastric adenocarcinomas, 43% were negative for cytokeratin 7 and 14% were negative for COTA. From the results of this study, it could be concluded that in the differential diagnosis of primary ovarian tumors from metastatic colonic carcinomas, positive reaction for cytokeratin 7 suggests a primary ovarian tumor but a negative reaction for cytokeratin 7 and positive reaction for COTA suggest metastatic colonic carcinomas. The results of this study also reveal that cytokeratin 7 and COTA are not useful in the differential diagnosis of primary ovarian tumors from metastatic gastric carcinomas.
Adenocarcinoma ; Antibodies, Monoclonal ; Appendix ; Colon* ; Colonic Neoplasms ; Diagnosis, Differential* ; Epithelial Cells ; Female ; Humans ; Keratin-7* ; Keratins* ; Mucins ; Ovarian Neoplasms ; Ovary ; Pseudomyxoma Peritonei ; Stomach

The skin defects or sensory impairment of the fingers, especially at the critical area for prehension(tips of thumb, index and middle fingers) should be reconstructed for the better function of hand. In our department, we performed neurovascular island pedicle flap transfer for the purpose of reconstruction of sensibility and skin defect simultaneousely to the critical area. 1. Since 1978, we had performed neurovascular island pedicle flap transfer in 14cases, among which 9 cases were followed for more than one year. 2. The operation was performed for the reconstruction of thumb in 8 cases, and index in 4 cases. The most common cause of injury was crushing by machine(8 cases). 3. The island flap was transferred from middle finger(9 cases) and from ring finger(4 cases). 4. Recovery of the protective sensation at the recipient sites was good or fair after one year, but reorientation and two point discrimination were poor. 5. Cold intolerance was developed in 3 cases and callosity was formed in 2 cases. 6. In all cases, the transferred flaps were good in circulation status and durability. 7. It is considered that the neurovascular island pedicle flap is an accepted method of restoring skin coverage as well as sensation to a localized tactile area in the hand.
Callosities ; Discrimination (Psychology) ; Fingers ; Hand ; Methods ; Sensation ; Skin ; Thumb

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.
Activities of Daily Living ; Apgar Score ; Daejeon ; Humans ; Inpatients* ; Jeollabuk-do ; Rehabilitation* ; Solar System

STUDY DESIGN: Prospective study. OBJECTIVES: Analyzing the clinical outcome of operative treatment in lumbar degenerative kyphosis (LDK) by means of anterior and posterior operation using Wedged cage (SynCage(R)) and pedicle screws. SUMMARY OF LITERATURE REVIEW : LDK is common in old farmers who have worked in a stooping posture for decades and is a quite rigid form of kyphosis accompanied by adjacent instability, dystrophic changes of vertebral bodies and weakness of back and hip extensors. For surgical treatment, restoration and maintenance of lumbar lordosis is mandatory for global balance. Anterior release and restoration of disc space with the same morphologic cage seems to be a quite anatomic and harmonious approach. MATERIALS AND METHODS: Ten LDK patients, who underwent anterior interbody fusion using Wedged cage (SynCage(R)) and posterior fusion with pedicle screws between 2000 to 2001, were followed up for more than 2 years. The operation was done in one or two stages. We performed anterior release, gradual widening of the intervertebral space with wedge trials of increasing size, insertion of wedged cages filled with auto-, allo- or synthetic bone and posterior pedicle fixation and fusion. We measured the lumbar lordotic angle, sacral inclination, fusion segmental angle, thoracic kyphotic angle and vertical axis line in preoperative, immediate postoperative and follow-up standing X-ray. RESULTS: Mean fusion segments using Wedged cage were 2.8 segments for anterior interbody fusion and 3.4 segments for posterior fusion. Mean sagittal correction angle was 40.3 degrees with mean correction loss of 2.6 degrees. Whole lordosis was 6.9 degrees kyphosis preoperatively, which was corrected to 33.4 degrees lordosis postoperatively and 30.8 degrees lordosis at last follow-up. Mean sacral inclination was corrected from 18.2 degrees preoperatively to 37.8 degrees postoperatively and 30.7 degrees at follow-up. Vertical axis line was corrected from 11.4 cm preoperatively to 0.4 cm postoperatively and 1.3cm at follow-up. Thoracic lordosis was corrected spontaneously without any surgical extension to the thoracic spine by mean 19.9 degrees(0.2 degrees lordosis preoperatively to 19.7 degrees kyphosis at follow-up). Loss of cardinal signs occurred in 70-80 % of patients and satisfactory clinical results were shown in 90% of patients. CONCLUSIONS: Anterior and posterior fusion using Wedged cage (SynCage(R)) and pedicle screws showed high efficiency in the correction and maintenance of LDK. It is a good modality in the surgical treatment of lumbar degenerative kyphosis.
Animals ; Axis, Cervical Vertebra ; Follow-Up Studies ; Hip ; Humans ; Kyphosis* ; Lordosis ; Posture ; Prospective Studies ; Spine

External fixation was improved in its devices and techniques as a specific method of fracture treatment. It was possible to immobilize the fractures firmly with the use of Vidal modified Hoffmann external fixation and could be used effectively in difficult fractures with severe soft tissue injury. From October 1981 to December 1983, 28 patients of tibial fracture who had been treated with Hoffman external fixation at Severence Hospital, Yonsei University College of Medicine were studied. The results are summerized as follows: 1. The age of patients varied from 14 to 66 years old, the majority (53.6%) being between 20 to 39 years old and males comprized 89.3%. 2. Traffic accidents and machinary injuries comprized 96.4%. 3. Average duration with Hoffmann frame was 16.6 weeks and average time of bone union was30.1 weeks. 4. Many complications were noticed but majority were related to personalities of the fractures, not due to Hoffmann external fixation itself. 5. Hoffmann device was relatively easy and quick to apply: sufficient stability was obtained: reasonable anatomic reduction of major fragments was possible: facilitated treatment and care of polytr- aumatized patients. 6. Secondary operations, e,g., bone grafting and even plastic surgery, had been possible without necessitating removal of the device. 7. It was useful in open fractures with severe soft tissue tissue injury and also in taking care of further necessary managements.
Accidents, Traffic ; Bone Transplantation ; Fractures, Open ; Humans ; Male ; Methods ; Soft Tissue Injuries ; Surgery, Plastic ; Tibia ; Tibial Fractures