A new balloon dissector, a modification of a Foley catheter, was devised and it can be used either as a dissector or a tissue expander. Since most operating time was spent in balloon manipulation (inflation/deflation), the duct for saline injection was made to be wider than the Foley catheter. As a result, the balloon could be inflated faster than before. In order to reduce the scar at the donor site, harvest of the sural nerve using endoscopic technique is currently applied, but utilization of this method is technically difficult and requires a long operating time. For these reasons, new our method of using a balloon dissector was devised. The balloon dissector can also be used for immediate intraoperative tissue expansion for the reconstruction of small skin defects without distortion. We have found that the advantages of using the new balloon dissector include a reduction in operating time, preservation of the perforating vessels, and primary closure with less tension. In addition, this simple and inexpensive instrument is cost-beneficial to patients.
Catheters ; Cicatrix ; Humans ; Skin ; Sural Nerve ; Tissue Donors ; Tissue Expansion ; Tissue Expansion Devices

The question of infectivity and prevalence of Clonorchis sinensis in Cheju province (Quelpart Island) was arisen to authors since the several surveys on the endemic diseases were performed in this island. Therefore, authors decided to solute this question. Then the survey on the possible second intermediate host of Clonorchis sinensis was performed and reported already with negative finding. At present time, authors carried out the collection of all kinds of fresh-water snails through all areas of this island, to confirm the presence or not of Parafossarulus manchouricus, the only first intermediate host of Clonorchis sinensis in Korea . And the following results were obtained. The fresh-water snails collected in the survey were Semisulcospira libertina Gould and Lymnaea ollula Gould. Parafossarulus manchouricus Bourguigant was not collected in this island. It is confirmed that the Clonorchis sinensis can not be prevalent in this island.
parasitology-helminth-trematoda-Clonorchis sinensis ; life cycle ; epidemology ; Parafossarulus manchouricus ; Semisulcospira libertina Gould ; Lymnaea ollula Gould

Suction-assisted lipoplasty is now flrequently-performed pre cedure in plastic surgery, but it has several drawback including bleeding contour irregularity due to its traumatic nature. The recently introduced ultrasound-assisted lipoplasty (UAL) technique uses ultrasonic energy which has specificity in lower density tissue like fat tissue. Therefore, UAL can minimize these compli cations. We performed UAL in 21 patients from OCt. 1988 to Jun 1999. There were 17 females and 4 males, and patient age ranged from 18 to 52 years(average 40 years). A total of 58 areas were operated on for an averge of 28 areas per patient. We used a fivestage technique consisting of tumescent infiltration, ultrasonund treatment, emulsion suction, endermology, and postperative pressuregarment application. Total volume (fluid and fat) removed ranged from 200 to 4,050 cc(averge 1,750 cc) per patient and the lipocrit within the aspirate was 4-8%, which was significantly lower compared with traditional liposuction Residual emulsion was evacuated by endermology and pressuregarment was applied to all patients for postoperative 2-3 months. Pestoperative complications were seroma, induration, and paresthesia, but all these problems resolved spontaneously within a month. One patient required secondary UAL for correction of excess fat at the medial knee. We believe that UAL is a safe and excellent technology in liposuction because of reduced surgical bleeding and good contral of body contour.
Bezafibrate ; Cations ; Female ; Hemorrhage ; Humans ; Knee ; Lipectomy ; Male ; Paresthesia ; Sensitivity and Specificity ; Seroma ; Suction ; Surgery, Plastic ; Ultrasonics

Prostatic adenocarcinoma is a common genitourinary malignancy which frequently is assiciated with bony metastasis at initial diagnosis. The detection of bony metastasis is important because it often alters the therapeutic strategy. The radionuclide one scintigraphy is known to be the most sensitive diagnostic method in detecting bony metastasis from prostatic adenocarcinoma. In the histologic grading of prostatic adenocarcinoma, the Gleason's grading system is the most widely employed one which is based on the degree of glandular differentiation and the growth patterns of tumor in relation to the prostatic stroma. The purpose of this study is to know the correlation of Gleason's grade and bone scintigraphic findings in prostatic carcinoma. We analyzed 99mTc-diphosphonate bone scintigraphies of 19 cases with prostatic adenocarcinoma confirmed by transurethral prostatic biopsy. Ten of the 19 cases showed asymmetrical multiple radioisotope uptake suggesting bony metastases and their Gleason's grade were 4 or 5 in seven cases. The remaining three cases were Gleason's grade 2 or 3. Another nine cases showed symmetrical radioisotope uptake with normal renal imaging suggesting no bony metastases and their Gleason's grade were 1,2 or 3 in seven cases. The remaining two cases of these nine cases were Gleason's grade 4 and 5. As the results, there was a correlation between the Gleason's grade and bone scintigraphic findings. The asymmetrical multiple skeletal uptake of radioisotope may suggest that the Gleason's grade is likely to be higher.
Adenocarcinoma ; Biopsy ; Diagnosis ; Methods ; Neoplasm Metastasis ; Radionuclide Imaging

Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30-75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.
Fistula ; Head* ; Humans ; Neck* ; Postoperative Complications ; Radiation Injuries ; Wounds and Injuries

BACKGROUND: PTCA is often unsuccessful in a patient with chronic total occlusion of coronary arteries with success rates varying from 60 to 70%. Success rates are related to the duration of total occlusion, longer occlusions being associated with lower success rates. Chronic total occlusion may be associated with thrombi superimposed on the stenotic lesion. We used an intra-coronary bolus of urokinase followed by a prolonged urokinase infusion in an attempt to lyse the lesion and allow for passage of the PTCA wire during subsequent angioplasty. The purpose of prolonged durokinase infusion was to reduce the clot sufficiently to recanalize the coronary artery and make it more amenable to PTCA. METHODS: Study patients: We were included six patients who developed total occlusion for more than 3 weeks and good collateral channels of Grade 2 or more and previous attempts at angioplaty had failed. Procedures: All patients underwent dual catheter system and incremental dose protocol of intracoronary urokinase infusion. RESULTS: The mean duration of occlusion was calculated to be 65.3+/-2.7 weeks and urokinase dose ranged from 130,000 to 200,000U/hr and treatment lasted 21.7+/-1.4 hours in our study. The prolonged urokinase infusion resulted in reperfusion of the occluded dvessel in 5 of the 6 patients(83%), with or without the complementary balloon inflation. One patient failed to recanalize the occluded vessel because cardiac tamponade was developed during the prolonged urokinase infusion. CONCLUSION: We concluded that the prolonged urokinase infusion in occluded coronary artery appeared to increase the likelihood of successful PTCA in patients with chronic total occlusion of coronary arteries.Also, in carefully selected patients, prolonged urokinase infusion in occluded coronary artery was relatively safe and well tolerated.
Angioplasty ; Cardiac Tamponade ; Catheters ; Coronary Vessels* ; Humans ; Inflation, Economic ; Reperfusion ; Urokinase-Type Plasminogen Activator*

PURPOSE: Estrogens control the development and cell proliferation of various tissues including the normal mammary epithelial cells, where they induce the expression of the immediate and delayed hormone-responsive genes. The proliferative effects of estrogen have been attributed to its ability to increase the expression of the key cell cycle regulatory genes responsible for cell cycle progression. However, the regulation of cell proliferation is only one aspect of estrogen function. It has also been well documented that estrogen plays a critical role in the etiology and progression of human breast and gynecological cancers. This tumorigenic effect of estrogen might be associated with its anti- apoptotic activities such as of Bcl-2 induction. The aim of this study was to clarify the role of E2IG5, which is an estrogen-induced downstream effector molecule, in breast cancer cell lines. RESULTS: This study shows that E2IG5 is a pro-apoptotic protein that is localized to the mitochondrial membrane via two distinct transmembrane domains. When over-expressed, it induces a mitochondrial permeability transition with the resultant of release cytochrome c and caspase activation. However, three out of four breast cancer cell lines lost their estrogen dependence of E2IG5 expression, which suggests the possible involvement of E2IG5 in the development of breast cancer. CONCLUSION: These results suggest that breast cancer cells may loose their pro-apoptotic signals and selectively use the proliferative mechanism of estrogen, which drives the normal mammary epithelial cells to transform into cancer cells. Further studies using breast cancer tissues will be needed.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Line* ; Cell Proliferation ; Cytochromes c ; Epithelial Cells ; Estradiol ; Estrogens ; Genes, Regulator ; Humans ; Mitochondrial Membranes ; Permeability

No abstract availble.
Carcinoma, Renal Cell/*diagnosis/pathology/*secondary ; Female ; Gallbladder Neoplasms/*diagnosis/pathology/*secondary ; Humans ; Immunohistochemistry ; Kidney Neoplasms/*pathology ; Middle Aged ; Tomography, X-Ray Computed

PNP is a rare autoimmune mucocutaneous blistering disease associated with neoplasms, most frequently of the lymphoproliferative type. As PNP is clinically characterized by polymorphous mucosal lesions and cutaneous eruptions, it is important to differentiate it from erythema multiforme, Stevens-Johnson syndrome, lichen planus, and other bullous diseases. A diagnosis of PNP can be confirmed by immunologic studies such as direct and indirect immunofluorescence, immunoblotting, immunoprecipitation. Rare PNP cases related to nonhematological solid tumors have been reported. A 54-year-old male visited us with generalized pruritic scaly lichenoid lesions on the whole body from 5 weeks prior to his first visit. He also presented with extensive painful ulcers and erosions on the oral mucosa and lips for 2 months. Histopathologic findings showed lichenoid infiltration with vacuolar interface change, lichenoid interface dermatitis, keratinocyte apoptosis, and suprabasal acantholysis with cleft. Indirect immunofluorescence using normal human skin showed IgG deposition at the intercellular space. Immunoblotting using normal epidermal extracts in the serum of patient detected antibody to the 190 kDa (envoplakin), 210 kDa (periplakin) molecules polypeptides. He also had a hepatocellular carcinoma and chemoradiotherapy done before. The diagnosis of paraneoplastic pemphigus (PNP) was made. To our knowledge, there are only two reports of PNP associated with hepatocellular carcinoma worldwide, yet no report in Korean literature. Herein, we report the first case of PNP associated with hepatocellular carcinoma in Korea.
Acantholysis ; Apoptosis ; Blister ; Carcinoma, Hepatocellular* ; Chemoradiotherapy ; Dermatitis ; Diagnosis ; Erythema Multiforme ; Extracellular Space ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoblotting ; Immunoglobulin G ; Immunoprecipitation ; Keratinocytes ; Korea ; Lichen Planus ; Lip ; Male ; Middle Aged ; Mouth Mucosa ; Pemphigus* ; Peptides ; Skin ; Stevens-Johnson Syndrome ; Ulcer

The authors reviewed angiographic findings of 96 cases of ruptured anterior communicating artery aneurysms that were operated at the Department of Neurosurgery of Hanyang University Hospital from Jan. 1986 to June 1990. The results were summarized as follows ; 1) Asymmetricity of caliber of A1 was observed in 71.9%(69/96) and which was 3 times more frequent than that of reported incidence of control group(2~23%). 2) The incidence of predominance of left A1 was 54.2%(53/96) and that of right A1 was 17.7%(17/96). Among them, predominant A1 was operated as afferent artery of aneurysm in 94.2%(65/69). 3) Of 69 cases in which a unilateral A1 showed predominance, the direction of aneurysm was opposite to the side of predominant A1 in 66.7%(46/69) and ipsilateral to the predominant A1 in only 2.9%(2/69). 4) Above findings suggest that it is desirable to approach the anterior communicating artery aneurysm via the side of predominant A1 when the direction of aneurysm is uncertain on cerebral angiogram.
Aneurysm ; Arteries ; Cerebral Angiography ; Incidence ; Intracranial Aneurysm* ; Neurosurgery