No abstract available.
Retinoblastoma*

BACKGROUND: The FcgammaRII receptor, the only kind of Fc receptor in the platelet, plays important role for immune-complex mediated platelet activation, which occurs in Heparin induced thrombocytopenia(HIT) or antiphospholipid syndrome. The purpose of this research is to find out the role of gamma-subunit in FcgammaRII signal transduction of platelets. METHODS: After cross-linking the FcgammaRII receptors with IV.3 anti FcgammaRII specific antibody and Rabbit anti mouse antibody, we made the platelet lysate in the RIPA EDTA lysis buffer condition, and performed anti gamma-subunit immunoprecipitation. After polyacylamide gel electrophoresis and Western transfer, we probed the nitrocellulose membrane of gamma-subunit immunoprecipitate with anti gamma-subunit antibody. RESULTS: The mobility shift of gamma-subunit was observed upon FcgammaRII cross-linking. CONCLUSION: The gamma-subunit is activated upon FcgammaRII cross-linking, which means the gamma-subunit is involved in FcgammaRII signal transduction of platelet.
Animals ; Antiphospholipid Syndrome ; Blood Platelets ; Collodion ; Edetic Acid ; Electrophoresis ; Heparin ; Immunoprecipitation ; Membranes ; Mice ; Platelet Activation ; Receptors, Fc ; Signal Transduction*

BACKGROUND: Recently developed electrically stimulated gracilis neosphicter or artificial sphincter is quite a promising trial in fecal incontinence However, surgical technique is not simple, the devices are expensive and only specialists can perform the procedures successfully. The aim of this study is to evaluate the efficacy of a newly developed simple silicon device in incontinent dog model. METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured extemal balloon surrounding the internal balloon, a connecting tube disposed under the both infernal and external balloons and supply tube containing a pair of air passages and an enema fluid passage. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 22~26 kg of body weight were prepared. Anal incontinence was made by bilateral severing of the internal and external sphincters and puborectalis muscle under the general anesthesia. Marlex mesh ring was applied to the anal canal as Thiersch wire for the prevention of NCD expulsion in straining. After then, NCD with 2.5 cm of luminal diameter was inserted to the rectum proximal to the Malex mesh ring. Daily irrigation and evacuation was done with 800~1000 cc of tepid water in each dogs. Daily food contained 30 gm of Psyllium dextrose. RESULTS: Initially 6 dogs were observed for 7 days. Daily irrigation made evacuation of fecal matter well in each dogs. There was no prolapse of device through the anal orifice. Anoscopic examination after 7 days showed no rectal and anal mucosal injury. Two dogs were kept for 40 days as same manner. Sometimes spontaneous bowel movement without water irrigation was noted when the stool were loose. Weelky anoscopic examination revealed no evidence of mucosal injuries for 40 days also. There was no septic or other complication. CONCLUSION: NCD evacuated fecal matter well enough to empty the rectum in all incontinence dog model. Adequate sized NCD could be used for clinical trials in selected incontinence patients.
Anal Canal ; Anesthesia, General ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Fecal Incontinence ; Glucose ; Human Body ; Humans ; Phenobarbital ; Polypropylenes ; Prolapse ; Psyllium ; Rectum ; Silicones ; Specialization ; Water

No abstract available.
Hemorrhoids*

Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration int society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-does antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows: 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2) Extrapyramidal symptoms showed no significant difference between two groups. But EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.
Antipsychotic Agents* ; Chlorpromazine ; Haloperidol ; Humans ; Inpatients ; Psychopathology ; Quality of Life ; Rehabilitation

Concomitant with progressive rise in incidence of loosening of conventional total hip replacement arthroplasty which is mainly due to improper surgical technique and cement fixation, has been increased the incidence of revision. In addition to technical failure, there are many risk factors that effect the loosening, such as young active person, obesity, men, osteopomsis, those with bone stock deficiencies as congenital dysplasia of the hip, and those with previous hemiarthroplasties, etc.. Many experimental and clinical studies have been tried to decrease the incidence of loosening in conventional total hip replacement arthroplasty. One of these trials is the cementless total hip replacement arthroplasty with its simplicity of the surgical procedure. We have experienced 426 hips of the total hip replacement arthmplasty in 396 patients from January 1973 to December 1982, among whom 21 hips in 20 patients who had been undertaken revisional arthroplasty were followed up. The longest follow-up was 7 years and 3 months and the shortest was 2 years, the average being 2 years and 4 months. 1. Ankylosis of the hip and sequeale of the infected hip were most common in primary diseases of our revision cases. 2. Revision with cementless total hip replacement arthroplasty of a loosened conventional total hip replacement arthroplasty appears to be available as an effective alternative. 3. Initial attempt with cementlass total hip replacement arthroplasty to prevent loosening after conventional total hip replacement arthroplasty seems to be preferable for patients with ankylosis of the hip or sequeale of the infected hip, especially who are active and young.
Ankylosis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Dislocation, Congenital ; Humans ; Incidence ; Male ; Obesity ; Risk Factors

The blow-out fracture can be reconstructed by various autogeneous and alloplastic material. Particulate, nonresorbable hydroxyapatite is currently one of the choice of implant material available for reconstruction of blow-out fracture. Hydroxyapatite is radiopaque ceramic, physically and chemically similar to enamel and cortical bone. It is a biomaterial derived from natural corals to use as a bone graft substitute. And we looked into the clinical usefulness of 2 type of hydroxyapatite with their advantages and disadvantages in reconstruction of blow-out fracture. 183 patients with blow-out fracture who underwent surgical reconstruction with two types of hydroxyapatite from March 1933 to July 1977 have been analyzed the results of surgical reconstructions, and have been followed up for more than a year. And the condition of formerly inserted hydroxyapatite was observed in the patients who needed 2nd surgical reconstruction due to the enophthalmos. The disadvantages of hydroxyapatite are fragility, size and contour limitations. In spite of these demerits, hydroxyapatite can be one of the prospective materials to reconstruct orbital floor. Through the clinical experiences for 5 years, we have not found any of complications of exposure, infection, and foreign body reaction. Low rates of diplopia, limitation of ocular movement, and enophtalmos was observed. Hydroxyapatite was well adherent to adjacent orbital bone in most patients who needed secondary reconstruction for enopthalmos. In conclusion, our study shows that the availability of hydroxyapattite in reconstruction of blow-out fracture is recommendable, with low complication rates. Hydroxyapatite important appears to be well tolerated, and provides useful alloplastic prosthesis with few problems in reconstruction of blow-out fracture.
Anthozoa ; Ceramics ; Dental Enamel ; Diplopia ; Durapatite* ; Enophthalmos ; Foreign-Body Reaction ; Humans ; Orbit* ; Orbital Fractures* ; Prostheses and Implants ; Transplants

The basic technique for total reconstruction of the microtia was established by Tanzer, who utilized autologous rib cartilages for constructing the auricular framework. In order to decrease the number of surgical stages and to achieve maximal convolution, we employed a surgical procedure with simultaneous three layered costal cartilage grafting for the high profiled auricle, concha formation and lobule rotation. However, we performed ear elevation as an additional procedure for some patients who had decreased helical height due to absorption of cartilage framework or postoperative trauma and who had wanted to wear the spectacles or to have more natural appearance of auriculocephalic sulcus. From August 1988 to October 1997 we had performed surgeries for the ear elevation of 58 patients in 177 patients with total ear reconstruction, using various elevation methods; skin graft, local flap, and local with costal cartilage block. When the ear elevation was performed with skin graft, postoperative contraction of the grafted skin was inevitable. In cases with two skin flaps, it was difficult to stabilize and maintain the correct projection of the constructed ear. So we elevated the reconstructed ear by utilizing a costal cartilage block, two skin flaps to cover the posterior region and skin graft. We conclude that the local flap with costal cartilage block is one of the most favorable methods in ear elevation which can maintain the adequate projection and make natural looking auriculocephalic sulcus.
Absorption ; Cartilage ; Ear* ; Eyeglasses ; Humans ; Ribs ; Skin ; Transplants

Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.
Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Male ; Nasolabial Fold ; Nevus ; Prognosis ; Skin Neoplasms ; Skin* ; Surgery, Plastic

We report two cases of cleidocranial dysplasia, which was managed without significant craniofacial osteotomy. A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. In both patients, radiologic evaluation revealed the underdeveloped maxilla, persistent fontanelle opening, and cleidal aplasia. Clinical findings and radiologic studies were consistent with the diagnosis of cleidocranial dysplasia. Both patients underwent forehead plasty via bicoronal approach, augmentation rhinoplasty using tip plasty, and epicanthoplasty. In addition, the mother underwent malar augmentation using Medpor implantation and reduction genioplasty. The patients did not experience any postoperative complication and remained satisfied with the operation at 6-year follow-up.
Blepharoptosis ; Clavicle ; Cleidocranial Dysplasia* ; Depression ; Diagnosis ; Follow-Up Studies ; Forehead ; Genetic Diseases, Inborn ; Genioplasty ; Humans ; Intelligence ; Maxilla ; Mothers ; Nuclear Family ; Osteotomy ; Postoperative Complications ; Rhinoplasty