Eleven cases of the free vascularized bone graft have been performed in the Department of Orthopaedic Surgery, Yonsei University Hospital during the period of 30.9 months from February 1981 to December 1985. Follow up ranges from 8 to 62 months. The indication for the procedure was reconstruction of extensive bony defect after acute trauma in 3 cases, osteomyelitis in 3 cases, chronic nonunion 3 cases, bone tumor in one case and congenital pseudoarthrosis in one case. The results were obtained as follows; 1. To reconstruct the lower extremity the vascularzed bone graft has much more advantages than the other conventional method and the technique may be very useful in the management of certain difficult reconstructive problem of the lower extremity. 2. In the defects of bone and skin, even infected, composite bone and soft tissue transfer can be filled by one stage operation and made the infection heal more rapidly. 3. In children the vacularized fibular graft was hypertrophied and similar to thickness of tibia.
Child ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Osteomyelitis ; Pseudarthrosis ; Skin ; Tibia ; Transplants

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

No abstract available.
Acinar Cells* ; Arthritis* ; Carcinoma, Acinar Cell* ; Humans ; Panniculitis*

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

Tuberculosis is a systemic disease with a world-wide distribution, and its occurance in the oral cavity is well documented in the literature. Disease of oral cavity and jaw caused by Mycobacterium tuberculosis is very rare, so it is often difficult to diagnose tuberculosis in the oral cavity. When granulomatous and ulcerative lesion persists in the oral cavity for a long time, it may be considered a tuberculosis. When differential diagnosis is needed, the most reliable indicators of mycobacterial infection are careful clinical evaluation, skin test, acid-fast staining, biopsy and culture. We report a case of tuberculous osteomyelitis which simultaneously occurred on the maxilla and mandible in a 85 years old man that proved diagnosis difficult, but which responded very well to surgical treatment and chemotherapy.
Aged, 80 and over ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Humans ; Jaw ; Mandible* ; Maxilla* ; Mouth ; Mycobacterium tuberculosis ; Osteomyelitis* ; Skin Tests ; Tuberculosis ; Ulcer

PURPOSE: Tumor necrosis factor-alpha(TNF-alpha) is a pro-inflammatory cytokine that has been implicated in the pathogenesis of cardiovascular disease. Serum levels of TNF-alpha are elevated in many human cardiac related pathogenic conditions, including heart failure. It is well known that TNF-alpha inhibits myocardial contractility and induces apoptosis of adult rat cardiomyocytes via stimulation of TNF receptor 1. But pathophysiologically relevant low levels of TNF-alpha can not induce apoptosis of neonatal cardiomyocytes. So, we evaluated the effects of different concentrations of TNF-alpha in cultured rat neonatal cardiomyocytes : apoptosis or necrosis. METHODS: Neonatal ventricular myocytes were isolated from 3-day-old rats by stepwise collagenase dissociation, and the cells were cultured for 3 days. After that, cardiomyocytes were treated with low(25 ng/mL) and high(250 ng/mL) concentration of TNF-alpha for 48 hours. Apoptosis was determined by terminal deoxynucleotidyl transfer-mediated end labelling(TUNEL) staining, and cell viability was evaluated by lactate dehydrogenase(LDH) measurements using cell culture supernatants. RESULTS: Low dose TNF-alpha did not induce apoptosis compared with controls(10.5 +/- 3.5% : 10.4 +/- 4.3%). And high dose TNF-alpha also did not induce significant apoptosis(10.2 +/- 3.6% : 10.4 +/- 4.3%). There was no detectable morphological changes of cardiomyocytes after low and high concentration of TNF-alpha treatment. LDH levels after TNF-alpha treatment was not significant compared with control(control : low : high, 3.2 +/- 0.1% : 3.1 +/- 0.2% : 3.3 +/- 0.3%). CONCLUSIONS: Our results suggest that high concentration of TNF-alpha alone can not induce apoptosis and significant cytotoxicity in neonatal rat cardiomyocytes.
Adult ; Animals ; Apoptosis ; Cardiovascular Diseases ; Cell Culture Techniques ; Cell Survival ; Collagenases ; Heart Failure ; Humans ; Lactic Acid ; Muscle Cells ; Myocytes, Cardiac* ; Necrosis ; Rats* ; Receptors, Tumor Necrosis Factor ; Tumor Necrosis Factor-alpha*

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*