The ectomycorrhizal roots were collected from the soils around the bases of basidiocarps of the four edible mushrooms in the stands of Pinus densiflora or Querus acutissima communities (Mt. Wol-Ak in Eastern Chung-Puk): The basidiocarps of Tricholoma matsutake (TM), Sarcodon asparatus (SA), S. imbricatum (SI), and Polyozellus multiplex (PM) are usually collected. The ectomycorrhizal roots of TM, PM and SI were related to the roots of P. densiflora, but the other to the roots of Q. acutissima in Korea. Particularly, the basidiocarps of PM were collected in the mixed stand of both P. densiflora and Q. acutissima. The morphologies of the ectomycorrhizal roots were observed to be the yellowish brown coral (dichromatous) or pyramid types in the roots of the pine, but dark brown un-branched sticks (roots) in the ends of ectomycorrhizal roots of Querus plants. The un-branched roots were covered with the dark mycelia (rhizomorph) around them. Therefore, the ectomyorrhizal roots of PM were observed to have two kinds of types; The single blackish un-branched roots were observed to be attached to the yellowish coral type roots. The bundles of TM mycelia were filled with cortical cells (in the roots of P. densiflora), but the mycelia of the other fungi (Aphylloporales) were massed between the cortical cells of P. densiflora or Q. acutissima. Their anatomical and gross features were considered to be simailar but very important in the ectomycorrhizal roots for these edible mushrooms.
Agaricales ; Anthozoa ; Fruiting Bodies, Fungal* ; Fungi ; Korea ; Mycorrhizae ; Pinus ; Soil ; Tricholoma

BACKGROUND: Recently, partial pancreatectomy has been performed for treatment of benign pancreatic lesion with special attention to functional preservation of adjacent organs. In contrast to traditional pancreaticoduodenectomy( Whipple's procedure) and pylorus-preserving pancreaticoduodenectomy(PPPD), the duodenum-preserving pancreatic head resection(DPPHR) preserves stomach, duodenum, jejunum, extrahepatic bile duct, and this procedure is reported to preserve function of adjacent organs, to reduce morbidity and mortality rates. The indications of DPPHR are benign lesion of the head of the pancreas as well as complications of chronic pancreatitis, including distal common bile duct obstruction, duodenal obstruction, colonic stenosis, pseudocyst of the head of the pancreas, internal pancreatic fistula, portal or splenic vein stenosis. Also this procedure is indicated for the management of the pancreatic head injury. Reconstructive methods following resection of the pancreatic head are modified variously, this methods are end-to-end anastomosis of the pancreatic duct, Roux-en-Y pancreaticojejunostomy, pancreaticogastrostomy, pancreaticoduodenostomy. MATERIALS AND METHODS: The authors performed DPPHR in 4 patients; pseudocyst of the pancreatic head 1, pancreatic head injury 2, chronic pancreatitis 1. Two patients with pseudocyst of the pancreatic head and pancreatic head injury underwent end-to-end anastomosis of the pancreatic duct after resection of the head of the pancreas. This procedure involved insertion of feeding tube into the pancreatic duct and then end-to-end anastomosis of the pancreatic duct. Other two patients with pancreatic head injury and chronic pancreatitis underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. RESULTS: Two patients with end-to-end anastomosis of the pancreatic duct developed leakage of the anastomotic site of the pancreatic duct at 3rd and 8th postoperative days, respectively. So this patients were performed reoperation, Roux-en-Y pancreaticojejunostomy. But the peripancreatic abscess developed after reoperation and then performed drainage of the abscess. This patients were improved and discharged. Total hospital stay was 35days and 34days, respectively. Other two patients underwent Roux-en-Y pancreaticojejunostomy after resection of the head of the pancreas. This patients were improved without complications and discharged within 1 month. CONCLUSIONS: In our experiences, DPPHR can be appropriated in the treatment of complications of chronic pancreatitis, benign lesion of the head of the pancreas, pancreatic head injury. And we consider that the Roux-en-Y pancreaticojejunostomy is more safe reconstructive method, compare with the end-to-end anastomosis of the pancreatic duct.
Abscess ; Bile Ducts, Extrahepatic ; Colon ; Common Bile Duct ; Constriction, Pathologic ; Craniocerebral Trauma ; Drainage ; Duodenal Obstruction ; Duodenum ; Head* ; Humans ; Jejunum ; Length of Stay ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatic Fistula ; Pancreaticojejunostomy ; Pancreatitis, Chronic ; Reoperation ; Splenic Vein ; Stomach

The causes of subclavian artery obstruction are arteriosclerosis, chest trauma, extrinsic compressive lesion of tumor or fibrosis, ateritis and coractation of aorta. Symptoms associated with subclavian artery obstruction can manifest dizziness, vertigo, ataxia, bilateral visual change because of vertebral-basilar artery insufficiency, or manifest fatigue, claudication, rest pain, digital necrosis because of arm ischemia. Treatment of subclavian artery occlusive lesion can be only medical treatment if patients was asymptomatic and a variety of surgical procedures-endarterectomy, carotid-subclavian bypass, subclavian- subclavian bypass, axillo-axillary bypass-can be recommended according to the state of surrounding vessel and general condition of patients. We experienced a case of subclavian artery obstruction in a 65 years-old male with severe claudication in left upper extremity and who had suffered from ischemic symptoms of left lower extremity. Patient was surgically treated by femoro-femoral bypass on occlusive lesion of the left lower extremity and carotid-subclavian transposition on left subclavian lesion. Postoperative result was excellent and claudication of left upper and lower extremities were completely relieved.
Aged ; Aorta ; Arm ; Arteries ; Arteriosclerosis ; Ataxia ; Dizziness ; Fatigue ; Fibrosis ; Humans ; Ischemia ; Lower Extremity ; Male ; Necrosis ; Subclavian Artery ; Thorax ; Upper Extremity ; Vertigo

Reconstruction of soft tissue defect with exposure of the tendons and bone in the lower third of the leg and the heel represents a challenge to plastic surgeons. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of soft tissue defects, we operated on 10 patients using a distally-based sural artery flap. The sites of the soft tissue defect were the lower third of the leg in 7 cases and the heel in 3 cases. The size of flap varied from 3.5x4cm to 12x18cm. Nine of 10 flaps survived completely. One flap in which the sural nerve was preserved showed partial necrosis but healed spontaneously. Two flaps showed slightly venous congestion which disappeared after a few days. The advantages of the sural flap are a reliable blood supply, easy and quick elevation of the flap, preservation of the major artery and minimal donor site morbidity. The disadvantage of the flap is hypoesthesia at the lateral part of the foot. In conclusion, the distally-based sural artery flap can be used safely for soft tissues coverage in the lower third of the leg and the heel.
Arteries* ; Foot ; Heel ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Necrosis ; Sural Nerve ; Tendons ; Tissue Donors

Bone graft is an important procedure in craniomaxillofacial reconstruction and the success of reconstruction depends on the survival of the grafted bone. In this study, the survival of the membranous inlay bone graft on the mandibles of dogs was investigated with bone scan and histologic examination. The inlay bone graft, 1x2cm critical-sized bone, was completely separated from the lower border of the mandible of dogs and then refixed to the original site. Bone scan and histologic examination were done at 1,2,3 and 4 weeks postoperatively. The bone scan after 1 week showed radioisotope uptake on the margin of the grafted bone and the isotope count was 21% compared to the uptake of the normal bone. After 2 weeks, the radioisotope uptake in the grafted bone increased to 52% of normal bone uptake. After 3 and 4 weeks, the degree of isotope uptake was 111% and 124% respectively. Histological findings after 1 week showed the absence of osteoblastic activity and 6 viable blood vessels in one 200X magnified field, which was 25% compared to the vessels of the normal bone. After 2 weeks, osteoblastic activities were noted and the number of viable blood vessels totalled 15, which was 63% of the vessels of the normal bone. After 3 weeks, osteoblastic activities increased and the number of viable blood vessels totalled 21, which was 88% of the vessels of the normal bone. After 4 weeks, there were markedly increased osteoblastic activities with a total number of 23 vessels, which was 96% of the normal bone. In summary, the revascularization of the membranous inlay bone graft began from the first week after bone graft, and then it gradually increased. After 3 weeks, the revascularization had returned to a nearly normal value compared with the value of the near-by normal mandibular bone.
Animals ; Blood Vessels ; Dogs ; Inlays* ; Mandible* ; Osteoblasts ; Reference Values ; Transplants*

It has been suspected that the cannula of the ultrasonic generator became heated during liposuction, and that the heated cannula might possibly damage the soft tissues such as vessels, nerves and muscles. To confirm these suspicions, the actual temperature of the cannula was measured after being switched on, and the influence of the heated cannula on the soft tissues of 30 rabbits was studied macroscopically and microscopically. When the cooling system of ultrasonic generator was not operated, the temperature of a cannula tip increased to 100degrees C in 10 seconds, and the temperature of a cannula shaft did not increase over 40 degrees C. When the cooling system of the ultrasonic generator was operated, the temperature of the cannula tip increased to 70 degrees C in 20 seconds and to 100 degrees C in 1 minute. The stronger ultrasonic power was, the higher the temperature of the cannula tip was. When the heated cannnula tip touched the muscles, vesseles and nerves directly, the arterial and venous walls were perforated in about 20 seconds and 10 seconds, respectively. Gross changes of the muscles, such as color change and depression of the contacted area, were seen in about 30 seconds, and histological changes occurred in about 3 seconds. When adding the Klein solution, an infiltration solution for increasing the destructive effects of the ultrasound, the onset time of tissue damage was significantly shortened in vessels and nerves, but there was no significant difference in muscles. Although there was no finding of damage by the ultrasonic wave itself on the vessels, nerves, and muscles during ultrasonic liposuction, this study confirmed that the heated cannula could damage vessels, nerves, and muscles. Thus we must try to avoid placing the cannula at certain areas for more than 10 seconds douring the ultrasonic liposuction.
Catheters* ; Depression ; Hot Temperature ; Lipectomy* ; Muscles* ; Rabbits ; Ultrasonics* ; Ultrasonography

The purpose of this study was to investigate the possibility of distraction osteogenesis in membranous onlay bone graft on the mandible and to clarify the histology of bone repair during distraction osteogenesis in the membranous onlay bone in a dog model. Four dogs, 5 months of age at the beginning of the experiment, were used for this study. The zygomatic arch was exposed in the subperiosteal plane and the full-thickness zygomatic arch was harvested to 3 centimeters in length. The lateral surface of the mandibular body was exposed in the subperiosteal plane and the membranous onlay bone graft was performed with firm contact using screws. The osteotomy on the membranous onlay bone graft and underlying mandibular body was carried down week 1 in dog 1, week 2 in dog 2, week 3 in dog 3, and week 4 in dog 4 after membranous onlay bone graft. The external distraction device was applied to the mandibular body. Mandibular distraction was started 7 days after the operation at a rate of 1mm per day for a total of 10 mm distraction over 10 days. After completion of distraction, the distraction device was left in place for 6 weeks bony consolidation of the distracted area. Radiographs were carried out at 2 weeks, 4 weeks and 6 weeks after distraction. New bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between the native underlying mandibular segments was generated in the distracted zone in all dogs. The new bone between segments of membranous onlay bone graft was not generated in dog 1, but it was generated in dogs 2, 3 and 4. However, in dog 2 and 3, the new bone between segments of the distracted membranous onlay bone graft presented less firmness with fibrous tissue than that of the native underlying mandibular segment. Histologically, the distracted gap between segments of the membranous onlay bone graft was composed of much fibrous tissue in the central zone while activated osteoblastic cells formed new bone in the margins of the distracted gap in dogs 2 and 3. In dog 4, there were abundant osteoblastic activities in the distracted gap and the new bone appeared as nearly-normal cortical bone. In conclusion, these findings suggested that membranous onlay bone graft had an osteogenic capacity and that distraction osteogenesis was possible in membranous onlay bone graft.
Animals ; Dogs* ; Inlays* ; Mandible ; Osteoblasts ; Osteogenesis, Distraction* ; Osteotomy ; Transplants* ; Zygoma

Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

Perioperative surgical stress makes various metabolic and endocrinologic changes that may influence the postoperative outcome. These changes, so-called, "surgical stress responses" ar hyperglycemia, lipolysis, negative nitrogen balance due to proteolysis, and changes in the hormonal secretion, e.g. increased release of ACTH, prolactin, cortisol, catecholamine, and so on. To prevent these stress responses, many studies reported some kinds of effective methods. In these study we used general anesthesia combined with epidural blockade with local anesthetic(bupivacaine) and narcotic(fentanyl) mixture via epidural catheter for the total abdominal hysterectomy and the postoperative pain control(group II). We measured serum prolactin and cortisol concentrations by time-resolved fluoroimmunoassay and glucose concentrations by routine glucose oxidase method and scored the degree of postoperative pain and compared the results with those of group I, given general anesthesia during surgery and nalbuphine intramuscular injection for postoperative pain control. The results were as follows. 1) Serum prolactin concentrations were increased during the operation in both groups. 2) Serum cortisol concentrations were increased during and after the operation in both groups but were normalized sooner in group II. 3) Serum glucose concentrations were increased during and after the operation but were normalized sooner in group IL 4) The three measurements showed significant differences between the two groups during and on the first postoperative day. 5) The pain scores were significantly lower in group II untill the third postoperative day. According to the results, we concluded that serum prolactin concentration could be as much valuable index to surgical stress response as serum cortisol concentration and that the method of epidural blockade combined with general anesthesia for the surgery and postoperative pain control via epidural route could prevent or alleviate the stress response more effectively.
Adrenocorticotropic Hormone ; Anesthesia, Epidural* ; Anesthesia, General* ; Blood Glucose* ; Catheters ; Fentanyl* ; Fluoroimmunoassay ; Glucose ; Glucose Oxidase ; Hydrocortisone* ; Hyperglycemia ; Hysterectomy ; Injections, Intramuscular ; Lipolysis ; Nalbuphine ; Nitrogen ; Pain, Postoperative ; Prolactin* ; Proteolysis

PURPOSE: This study aimed to provide preliminary data for a nursing intervention plan for puerperal women to reduce postpartum depression by investigating factors that affect depressive disorder during the puerperal period. METHODS: A total of 153 pregnant women were recruited from a university hospital in Gimhae city in Korea. Data were collected using self-report questionnaires. RESULTS: Mothers' quality of sleep, breast-feeding confidence, discomfort with breastfeeding, depressive feeling during pregnancy, and baby's feeding capability and growth were significant predictors of postpartum depression. These variables explained 36.1% of the variance in postpartum depression in puerperal women. CONCLUSION: The aforementioned results indicate that puerperal women are less likely to experience postpartum depression when their quality of sleep is higher, breast-feeding confidence is higher, discomfort with breast-feeding is lower, when they did not feel depressed during pregnancy, and when baby's feeding capability and growth is better. Therefore, to decrease puerperal women's depression, a nursing intervention program and a research study to verify the effects of the program are necessary to increase mother's sleep quality and breast-feeding adaptation and prevent depression during pregnancy.
Breast Feeding ; Depression ; Depression, Postpartum ; Depressive Disorder ; Female ; Gyeongsangnam-do ; Humans ; Korea ; Nursing ; Postpartum Period ; Pregnancy ; Pregnant Women