BACKGROUND: Apoptosis is a highly selective form of cell suicide with characteristic morphologieal and biochemical features, including chromatin condensation, formation of apoptotic bodies, and DNA fragmentation by the activation of endonucleases. Various cytokines and physical or chemical factors can provoke apoptotic changes in the skin. OBJECTIVE: We investigated the cytotoxic effects with epidermal cytokines and their combinations, K+ ionophores, protein synthesis inhibitor(emetine), inhibitor of endogenous endonuclease(aurintricarboxylic acid, ATA), sodium azide, and retinoic acid witp human epithelial tumor cell lines(A431 cells) to examine the degree of induction of apoptosis in the epidermal keratinocytes. METHODS: Induction of apoptosis was measured in cultured human keratinocytes, keratinocyte cell lines(A-431, HaCat, KB cells), cultured human melanocytes and malignant melanoma cell lines(SK-28, SK-30) using a mixture of ethidium bromide and acridine orange, DNA agarose gel electrophoresis and TUNEL staining. RESULTS: l. In the A-431 cells, (1 to a certain degree, the combination of IFN-gamma and TNF-alpha could only induce apoptosis. Q2 most of K+ ionophores were observed to induce necrosis rather than apoptosis. Q3 emetine, a protein synthesis blocker, was found to induce apoptosis in a dose-dependent pattern. Q4 sodium azide at a concentration of 1% .induced apoptosis rather than necrosis. Q5 retinoic acid inhibit the beuvericin induced apoptosis. 2. In human keratinocytes, Ql more resistant in the induction of apoptosis than any cultured keratinocyte cell lines p aurintricarboxylic acid(ATA)-an endonuclease inhibitor, could inhibit UV induced apoptosis 3. In human keratinocytes and cultured keratinocyte cell lines, c-PAF inhibit the beauvericin induced apoptosis. 4. Human melanocytes is very resistant for the induction of apoptosis by beauvericin. 5. In the melanocytes and melanoma cell lines, sodium azide and beauvericin induced necrosis rather than apoptosis. CONCLUSIONS: The epidermis is continuously exposed to toxic factors which might induce cell death. With the above results, the induction of appeared to be rather resistant, epidermal cell apoptosis which may reflect the existence of some endogenous protective mechanisms in the epidermis to survive at certain toxic environments; melanocytes showed high expression of bcl-2 protein which could play a role in endogenous defense against toxic environments of the epidermis.
Acridine Orange ; Apoptosis* ; Cell Death ; Cell Line ; Chromatin ; Cytokines ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Emetine ; Endonucleases ; Epidermis ; Ethidium ; Humans ; In Situ Nick-End Labeling ; Ionophores ; Keratinocytes ; Melanocytes ; Melanoma ; Necrosis ; Skin ; Sodium Azide ; Suicide ; Tretinoin ; Tumor Necrosis Factor-alpha

The accessory ovary can be defined as an extraovarian tissue that is located near the normal ovaries and is connected to the broad ligament, infundibulopelvic ligament or utero-ovarian ligament. It has very rarely been reported. The majority was found during abdominopelvic surgeries for any other purposes, because they were usually small and less than 1 cm in diameter adn gave no particular symptoms related simply to their presence. We reported a case of accessory ovary in which developed a simple cyst of a largest diameter of 12 cm, and discussed the significance of the accessory ovary in clinical and pathological aspects.
Cysts

There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

No abstract available.
Flail Chest*

The thoracolumbar fracture and fracture-dislocations are ever increasing today as the traffic accidents and industrial accidents frequently occur. But the controversy as to the relative values of early surgical instrumentation and conservative means has continued for well over a decade. The duration of this dispute without final resolution suggests an absence of significant differences in the results of surgical and non-surgical method. The purpose of this study is to review the results of conservative treament for 132 patients with thoracolumbar fracture and fracture-dislocations, who were admitted and treated at Yonsei University Severance Hospital from January, 1980 to December, 1984. And we obtained following results. l. In cases of stable fracture without neurologic deficit, especially when the wedging deformity of vertebral body is below 50%, it seems to be better to treat conservatively; that is, immediate postural reduction and after 2 or 3 weeks of bed rest, to start ambulation with back brace or cast. 2. In cases of stable fracture with neurologic deficit, operative treament is necessary when the frac-fragment is protruded into the spinal canal and neural compression sign is evident. But if not so, attempt to treat by conservative means may be done. 3. In cases of unstable fracture without neurologic deficit, it is more retional to treat conservatively by bed rest for a suffient time and then wearing back brace or cast. If the spinal deformity is so severe that it needs spinal fusion, the operation can be performed later on. 4. In cases of unstable fracture with neurologic deficit, spinal instrumentation and fusion do nothing to enhance neural recovery but are done to provide anatomic spinal alignment and stability to allow early the patient mobilization and rehabilitation.
Accidents, Occupational ; Accidents, Traffic ; Bed Rest ; Braces ; Congenital Abnormalities ; Dissent and Disputes ; Humans ; Methods ; Neurologic Manifestations ; Rehabilitation ; Spinal Canal ; Spinal Fusion ; Spine ; Surgical Instruments ; Walking

The Enchondroma is a benign cartilage forming harmartoma arising chiefly from short tubular bones on hands and feet. If on a long tubular bone or flat bone such as femur or ilium, it is most likely to be a true neoplasm such as chondrosarcoma, not a harmartoma. A case of enchondroma was reported. It occurred over right ischium of 19 years old male and was found incidentally by roentgenogram. The lesion was biopsied and diagnos's was confirmed by histologic examination. It was treated by curretage with filling of cavity with bone chips. Post operative-course was uneventful.
Cartilage ; Chondroma ; Chondrosarcoma ; Femur ; Foot ; Hand ; Humans ; Ilium ; Ischium ; Male

Complications after surgical treatment of trochanteric fracture such as varus deformity or delayed union are frequent and there are many difficulties to maintain the stability of fragments because of the cortical deficit or comminution on medial aspect of the neck and posterior trochanteric fragment. Evans, Dimon, Sarmiento and others suggested several methods of internal fixation, furthermore it is attempted recently to reduce the fragments anatomically with sliding compression hip screw and plate. 31 cases of interal fixation on trochanteric fracture were carried out from March, 1972 to February 1979 at the Orthopaedic Department of Seoul Adventist Hospital and their comparable results were as follows. 1. Acceptable placement of metals was noted 2 cases of 6 cases in Smith-Petersen nail with Thornton plate fixation, 2 cases out of 8 cases in Smith-Petersen nail with McLaughlin plate fixation and 9 cases out of 14 cases in sliding compression hip screw and plate fixation. 2. Complications after internal fixation such as varus deformity and delayed union were noted 1 case out of 3 cases in multiple pinning, 3 cases out of 6 cases in Smith-Petersen nail with Thornton plate fixation, 4 cases out of 8 cases in Smith-Petersen nail with McLaughlin plate fixation, 4 cases out of 14 cases in sliding compression hip screw and plate fixation. 3. Required weeks in union were 18 weeks in Multiple pinning, 20 weeks in Smith-Petersen nail with Thornton plate fixation, 25 weeks in Smith-Petersen nail with McLaughlin plate fixation and 16 weeks in sliding compression hip screw and plate fixation. 4. There are few complications in treatment of trochanteric fracture with surgical procedure using Sliding compression hip screw and plate.
Adult ; Clinical Study ; Congenital Abnormalities ; Femur ; Hip ; Humans ; Metals ; Neck ; Seoul

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered
Adult ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Paresthesia ; Tissue Donors ; Transplants

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second*

BACKGROUND: The Fas antigen is a cell surface molecule that mediates apoptosis in many cell types. Matsues group indicated that keratinocytes constitutively express the Fas antigen and apoptosis was induced only on pretreatment with interferon-r (IFN-y) in cultured normal human keratinocytes (NHK). OBJECTIVE: We undertook this study to determine the induction of apoptosis by Fas antibody alone and/or in combination with IFN y, IL-1a in normal human keratinocytes (NHK) and transitional epithelioma cell lines (KB cell) which had lower levels of intracellular IL-1 receptor antago- nists (IL-1ra ). METHODS: We used cultured NHK and KB cells. Each cell was treated with IFN-r, IL-la and Fas antibody for induction of apoptosis. For quantifying the apoptosis, index fluorescent DNA- binding dyes were used. Result: Fas antibody alone could induce apoptosis not only in KB cells but also in NHK cells. The combination of Fas antibody and IFN-r enhanced the induction of apoptosis in NHK and KB cells. The IL-la alone could induce apoptosis only in KB cells which had relatively small amounts of IL-1ra compared to NHK. CONCLUSION: Our result may indicate that Fas antigen in human keratinocytes can regulate normal epidermal cellular differentiation and proliferation.
Antigens, CD95 ; Apoptosis* ; Carcinoma ; Cell Line ; Coloring Agents ; Humans* ; Interleukin 1 Receptor Antagonist Protein ; Interleukin-1 ; Interleukin-1alpha ; KB Cells* ; Keratinocytes*