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.

No abstract available.
Orbit*

No abstract available.
Adenoma*

We describe the clinical and pathologic observation of a 50-year-old man with superficial disseminated porokeratosis who developed a squamous cell carcinoma on the dorsum of his right thumb and Bowens disease on his right upper arm. The tumors were surrounded by lesions of superficial disseminated porokeratosis and were thought to develop from the dysplastic epidermal cells located under the comoid lamellae.
Arm ; Bowen's Disease* ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Middle Aged ; Porokeratosis* ; Thumb

No abstract available.
Fibronectins* ; Granulation Tissue* ; Wound Healing* ; Wounds and Injuries*

The purpose of this study was to investigate the difference of body composition, eating habits and dietary intake in three Sasang constitutions. This survey was carried out using anthropometry, a questionnaire about eating habits, and 24-hour recall of dietary intake on 45 male and 29 female students of the fifth grade at C elementary school. The results are summarized as follows: A total of 44.6% of the subjects were Taeumin, 35.1% were Soyangin, and 20.3% were Soeumin. The average weight, WHR, Triceps, Rhrer index and BMI in the Taeumin group were significantly higher than those of the Soeumin and Soyangin groups. The body fat mass (kg) and abdominal fat (%) in the Taeumin group were significantly higher than those of the Soeumin and Soyangin groups. The soft body mass (%) in the Soeumin group was significantly higher than that of the Soeumi and Soyangin groups. The Taeumin's energy expenditure in physical activities was little high than that of the Soyangin and Soeumin groups, but the Soyangin's energy expenditure in physical activities per weight was a little higher than that of the Taeumin and Soeumin groups. The calorie and most of the nutrient intake were lower than those of Korean RDA. In the case of males, most nutrient intake, except for fiber, carotene and vitamin C were high in the Taeumin. For females, most nutrient intake, except for calcium and retinol were significantly higher in the Taeumin group. Conclusively, anthropometry characteristics, body composition, energy expenditure in physical activities, eating habits and dietary intake are different among the three Sasang constitutions. This study suggests the possibility of using Sasang consitutions as a basis for providing nutritional education and health guidelines.
Abdominal Fat ; Adipose Tissue ; Anthropometry ; Ascorbic Acid ; Body Composition* ; Calcium ; Carotenoids ; Child* ; Constitution and Bylaws* ; Eating* ; Education ; Energy Metabolism ; Female ; Humans ; Male ; Motor Activity ; Vitamin A ; Surveys and Questionnaires

In the multiply traumatized patients, the distinguising feature is the hypermetabolic response to the insult. These response includes an alteration in energy needs and productions, preferential catabolism of body glucose, fat and protein stores,. limitation of intake by anorexia,. decreased intestinal absorption if the gut is poorly perfused,. production of immune cells and acute phase proteins,. fever,. sodium and fluid retention due to the influence of hormones and oxidative stress. The degree of hypermetaboism is proportional to the severity of the injury, and is influenced by the type of injury. The hypermetabolic response is thought to maximize a healing reponse to injury. This cataboism is partly mediated by the counter-regulatory hormones, ACTH, GH, catecholamines and glucagon. These hormones maintain the supply of glucose and result in hyperglycemia to provide energy and precursors to maintain the metabolic and immunological response. In addition to the hormonal response, the invasion of pathogens and the injury itself will activate the immune system to elicit widespread metabolic changes. This activation of immune response leads to the production of the immunoglobulin, complement proteins and cytokines. The pro-inflammatory cytokines, the key mediators of inflammation, are IL-1, IL-6 and TNF, which not only mediate and modulate immune system activity but also cause widespread metabolic changes. These widespread metabolic changes are.control the other cytokine production, .protect healthy tissues from the effects of free radicals and other oxidant molecules,.remove from the blood stream nutrients that may assist pathogen multiplication. However, excessive or inappropriate production of cytokines has been associated with morbidity and mortality. Since in these hypermetabolic patients, nutritional support should therefore always commence as early as possible in order to provide sufficient energy and avoid further complications.
Acute-Phase Proteins ; Adrenocorticotropic Hormone ; Anorexia ; Catecholamines ; Complement System Proteins ; Cytokines ; Fever ; Free Radicals ; Glucagon ; Glucose ; Humans ; Hyperglycemia ; Immune System ; Immunoglobulins ; Inflammation Mediators ; Interleukin-1 ; Interleukin-6 ; Intestinal Absorption ; Metabolism ; Mortality ; Nutritional Support ; Oxidative Stress ; Rivers ; Sodium

MR images of seven patients with histologically documented synovial sarcoma were reviewed to find the suggestive or pathognomonic findings of the disease. MR appearance of the tumor was inhomogeneous, multiseptated mass with various degree of internal septation and infiltrative tumor margin. The signal intensity of the mass was slightly hyperintense relative to muscle on T1-weighted image and hyperintense relative to subcutaneous fatty tissue on T2-weighted image.
Adipose Tissue ; Humans ; Magnetic Resonance Imaging* ; Sarcoma, Synovial*

No abstract available.