The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.
Free Tissue Flaps* ; Humans ; Incidence ; Myocutaneous Flap ; Pliability ; Ribs ; Superficial Back Muscles ; Tissue Donors

PURPOSE: The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role. MATERIALS AND METHODS: We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID; n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups. RESULTS: We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women; HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed. CONCLUSION: The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems.
Abdomen ; Abscess ; Adipose Tissue ; Diagnosis, Differential ; Fallopian Tubes ; Female ; Humans ; Pelvic Inflammatory Disease ; Pelvic Pain ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Rupture

PURPOSE: To compare the central corneal thickness (CCT) in eyes of Korean subjects with primary angle-closure glaucoma (PACG) to other patients with glaucoma and control subjects. METHODS: Medical records of patients who underwent examination for glaucoma and pre-operative examination for cataract surgery between March 2009 and August 2012 in our clinic were reviewed. CCT was compared in normal control eyes, primary open angle glaucoma (POAG) eyes and normal tension glaucoma (NTG) eyes. RESULTS: The mean CCT of POAG eyes was significantly larger than that of normal control eyes, NTG eyes and PACG eyes (p = 0.027, 0.009 and 0.008, respectively). There was no significant difference in mean CCT between normal control eyes, NTG eyes or PACG eyes. CONCLUSIONS: PACG eyes had a CCT similar to that of NTG or normal eyes in Korean subjects.
Cataract ; Glaucoma ; Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Medical Records

PURPOSE: To evaluate the efficacy of topical 0.1% hyaluronate (HA) and 0.05% cyclosporine A on tear film parameters in dry eye syndrome patients. METHODS: Patients who were diagnosed with dry eye syndrome were treated with mbined with cyclosporine A (Group 2, 54 eyes). Ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer's test, and tear osmolarity were evaluated before treatment and at 1, 2, 3, and 6 months after treatment. RESULTS: OSDI was significantly improved at 2 months after treatment and Schirmer's test results significantly improved at 1 month after treatment in both groups. The BUT was significantly improved 3 months after treatment in Group 1 and at 1 month after treatment in Group 2. Tear osmolarity significantly improved at 1 month after treatment in both groups, but continuously improved up to 6 months after treatment only in Group 2. The BUT and Schirmer's test showed greater improvements in Group 2 than in Group 1. CONCLUSIONS: Combined treatment of topical 0.1% HA and 0.05% cyclosporine A may be more effective for improving dry eye syndrome.
Cyclosporine ; Dry Eye Syndromes ; Humans ; Hyaluronic Acid ; Osmolar Concentration ; Sodium ; Tears

BACKGROUND: The aim of this study was to compare modified Barthel Index with manual muscle test, Brunnstrom stage or Berg balance scale related with lower extremity function and defined which methods was preferred method for evaluation of lower extremity functional status in patients with stroke. METHODS: Twenty patients with stroke were enrolled to assess manual muscle test, Brunnstrom stage, Berg balance scale and modified Barthel Index at admission and discharge following rehabilitation programs. We compared admission, discharge and gain (difference of admission and discharge) scores of lower manual muscle test, leg Brunnstrom stage or Berg balance scale with gait and stair climbing sub-scores of modified Barthel Index. RESULTS: Significant correlation was observed between admission (r=0.772, p<0.01), discharge (r=0.812, p<0.01) or gain of Berg balance scale (r=0.454, p<0.05) and gait and stair climbing sub-scores of modified Barthel Index respectively. Significant correlation was observed between leg Brunnstrom stage and gait and stair climbing sub-scores of modified Barthel Index at discharge (r=0.475, p<0.05). Significant correlation was observed between lower manual muscle test gain and gait and stair climbing sub-scores of modified Barthel Index (r=0.643, p<0.01). CONCLUSION: Berg balance scale was the preferred method for evaluation of functional status correlated with gait and stair climbing ability at admission, discharge and gain of rehabilitation period.
Gait ; Humans ; Leg ; Lower Extremity* ; Rehabilitation ; Stroke*

PURPOSE: To evaluate the central corneal thickness (CCT) and corneal endothelial cell density (ENDO) in pseudoexfoliation syndrome. METHODS: Medical records of patients who underwent a preoperative examination for cataract surgery and an examination for glaucoma were retrospectively reviewed. The present study included 44 patients (59 eyes) and age- and sex-matched controls. The total pseudoexfoliation patients divided into 2 groups, such as pseudoexfoliation syndrome (28 eyes) and pseudoexfoliative glaucoma (21 eyes) .The intraocular pressure (IOP), CCT, ENDO, corneal curvature (CC) and axial length (AL) were measured. RESULTS: The total pseudoexfoliation group showed significantly higher IOP (p = 0.001), thinner CCT (p = 0.003) and lower ENDO (p = 0.037). The pseudoexfoliation syndrome group showed significantly thinner CCT (p = 0.010) and lower EDNO (p = 0.041), but no significant difference in IOP (p = 0.941). There was no significant difference in CCT (p = 0.060) and ENDO (p = 0.171) between the pseudoexfoliative glaucoma group and controls, but the pseudoexfolliative glaucoma group showed significantly higher IOP (p < 0.001). CONCLUSIONS: The pseudoexfoliation group showed thinner CCT which should be taken into consideration when evaluating IOP with the applanation tonometer and diagnosing glaucoma, especially in pseudoexfoliation syndrome patients.
Cataract ; Endothelial Cells ; Exfoliation Syndrome ; Glaucoma ; Humans ; Intraocular Pressure ; Medical Records ; Retrospective Studies

PURPOSE: To explore the effect of recombinant human EGF on the proliferation and survival of human fibroblast cell lines following irradiation. MATERIALS AND METHODS: Fibroblast was originated human skin and primary cultured. The trypan blue stain assay and MTT assay were used to study the proliferative effects of EGF on human fibroblast cell lines in vitro. An incubation of fibroblasts with rhEGF for 24 hours immediately after irradiation was counted everyday. Cell cycle distributions were analyzed by FACS analysis. RESULTS: Number of fibroblast was significantly more increased rhEGF (1.0 nM, 10 nM, 100 nM, 1,000 nM) treated cell than control after 8 Gy irradiation. Most effective dose of rhEGF was at 160 nM. These survival differences were maintained at 1 week later. Proportion of S phase was significantly increased on rhEGF treated cells. CONCLUSION: rhEGF cause increased fibroblast proliferation following irradiation. We expect that rhEGF was effective for radiation induced wound healing.
Cell Cycle ; Cell Line* ; Epidermal Growth Factor* ; Fibroblasts* ; Humans* ; S Phase ; Skin ; Trypan Blue ; Wound Healing

PURPOSE: The purpose of this study is to evaluate the CT findings and clinical features of patients with pneumatosis intestinalis. MATERIALS AND METHODS: From January 2001 to October 2007, 15 patients with pneumatosis intestinalis were diagnosed by the use of CT. We analyzed the clinical features and CT findings to assess the involvement site, the presence of portal and mesenteric vein gas, and the existence of accompanied ischemic change. RESULTS: Of the 15 patients, five patients had end stage renal disease (33.3%), two patients underwent a gastrectomy, one patient underwent a laminectomy, one patient had tuberculous enteritis, one patient had lung cancer and one patient had pneumonia. Four patients presented with no specific disease. There was portal or mesenteric venous gas in six cases, and strangulation or an ischemic change of the bowel in five cases. Otherwise, pneumatosis intestinalis was associated with hydropneumoperitoneum in two cases, pneumoperitoneum in one case and a single case of perforated appendicitis. Nine patients underwent surgery for ischemic change of the bowel, hydropneumoperitoneum, appendicitis, and a clinical sign of panperitonitis. Among the remaining six patients, three patients recovered and were discharged, and three patients expired during progression of the disease. CONCLUSION: End stage renal disease is the most common condition associated with pneumatosis intestinalis. The presence of portomesenteric venous gas, ischemic change of the bowel, and linear pneumatosis intestinalis are indicative of a poor prognosis.
Appendicitis ; Enteritis ; Gastrectomy ; Humans ; Kidney Failure, Chronic ; Laminectomy ; Lung Neoplasms ; Mesenteric Veins ; Pneumatosis Cystoides Intestinalis ; Pneumonia ; Pneumoperitoneum ; Portal Vein ; Prognosis ; Renal Insufficiency

Eugenol (4-allyl-2-methoxyphenol), a major ingredient of herbs such as clove and Magnoliae Flos, is known to induce apoptosis in mast cells via p53 pathway. This study was undertaken to examine the in vivo effect of eugenol and the molecular mechanism underlying eugenol-induced apoptosis in several cancer cells with different p53 status. Effect of eugenol on mesenteric mast cells was tested using a rat anaphylaxis model. And TUNEL staining was conducted to observe the cells undergoing apoptosis. Several cancer cells were treated with eugenol, and Western blotting, immunocytochemistry, confocal microscopy and mitochondrial fractionation were conducted. Eugenol induced apoptosis in mast cells of mesentery in vivo, decreasing the density of mast cells. Although eugenol did not increase the expression level of p53, it caused the translocation of p53 into mitochondria and subsequent release of cytochrome c. Eugenol increased the level of phospho-ser 15-p53 in several cancer cells with wild type p53 but not in the cells with mutant p53 or p53 deficient cancer cell. In cancer cells with wild type p53, p53 translocated into mitochondria was phosphorylated on ser 15. In conclusion, eugenol induces apoptosis in cancer cells with wild type p53 via the translocation of phospho-ser 15- p53. Furthermore our data suggest that the anticancer effect on cancer cells with wild type p53 may be involved with the pharmacological effect of eugenol regulating apoptosis via a phospho-ser 15-p53 dependent fashion.
Anaphylaxis ; Animals ; Apoptosis* ; Blotting, Western ; Cytochromes c ; Syzygium ; Eugenol ; Immunohistochemistry ; In Situ Nick-End Labeling ; Magnolia ; Mast Cells ; Mesentery ; Microscopy, Confocal ; Mitochondria ; Rats

Mycobacterium marinum (M. marinum) is a nontuberculosis mycobacterium that is normally associated with cutaneous lesions. Most cases occur after an individual has suffered minor trauma in association with contaminated fresh or salt water. In immunocompromised patients, M. marinum can cause osteomyelitis, synovitis and/or disseminated infection, which can be mistaken for rheumatoid arthritis (RA) or remitting seronegative symmetrical synovitis with pitting edema (RS3PE). Therefore, precise history taking and specimen culture are very important for early diagnosis and appropriate treatment. We report an unusual case of septic polyarthritis due to M. marinum that was diagnosed by culture and improved with antibiotic therapy.
Arthritis ; Arthritis, Rheumatoid ; Early Diagnosis ; Edema ; Immunocompromised Host ; Mycobacterium ; Mycobacterium Infections, Nontuberculous ; Mycobacterium marinum ; Osteomyelitis ; Synovitis