In 1988, a new fascioutaneous flap, the Lateral supramalleolar flap, was introduced by Masquelet and Roman. The flap is designed on the lower third of the aspect of leg, and supplied by a cutaneous branch from the perforating branch of the peroneal artery. This perforating branch continues distally deep to the fascia along the anterior ankle and into the foot. This can be use as either proximally based rotation flap or distally based reversed pedicle island flap giving the flap an arc of rotation that allows coverage of the dorsal, lateral and plantar aspects of the foot, the posterior heel and the lower medial portion of the leg. The authors have recently used this flap for 13 cases of foot and ankle soft tissue defect reconstruction and all the cases, except two partial marginal necrosis, good postoperative course. In our opinion, this flap is useful for reconstruction of foot and ankle soft tissue defect which does not need nerve innervation. The main advantages of the flap are as follows 1. It may be a rather large flap(15×9cm2 ). 2. The pedicle is long(8cm) and easy to dissect. 3. The pivot of the pedicle is distal(sinus tarsi) and allows great local possibilities of coverage. 4. It does not require the sacrifice of a main artery.
Ankle ; Arteries ; Fascia ; Foot ; Heel ; Leg ; Necrosis ; Osteotomy ; Tibia

Ovarian cancer has the highest mortality rate among gynecologic malignancies in developed countries. Most women present with advanced disease and require a combination of surgery and chemotherapy. One patient presented with recurrent ovarian cancer was initially treated with taxol and platinum-based compounds. Although response to these agents occurred, tumor progression was evident by elevated CA 125 levels and CT findings after a period of 4 months. This patient was then treated with topotecan and exhibited a response and stopped therapy. Topotecan exhibited activity in this patient with ovarian cancer resistent to both platinum and paclitaxel. We report a case of advanced ovarian cancer which was treated with topotecan after taxol-cisplatin treatment failed.
Developed Countries ; Drug Therapy ; Female ; Humans ; Mortality ; Ovarian Neoplasms* ; Paclitaxel ; Platinum ; Topotecan*

No abstract available.
Biopsy* ; Child* ; Humans

Osteoarthritic changes in experimental animals has been induced by several different methods. In order to study the changes of the articular cartilage induced by injuries of ligaments and/or meniscus of the knee joints, the author performed the experimental study that section of the medial collateral and anterior cruciate ligaments (group I) and section of the medial collateral and anterior cruciate ligaments combined with excision of the medial meniscus (group II) in twenty adult rabbit's knees caused instability. Histological changes of the articular cartilage were observed up to four months. The results were as follows: 1. The changes of the articular cartilage were gradually advanced depend on the time lapse after experimental procedures, in group I and ll. 2. The changes of the articular cartilage could be noticed from eighth week after experimental procedures in group I and from fourth week in group II, and more severe at sixteenth in group I and at twelfth week in group II. 3. The changes of the articular cartilage in group ll were appeared earlier and more severe than in group l. 4. The changes of the articular cartilage in the medial side of the knee joint were noticed more severe than in the lateral side.
Adult ; Animals ; Anterior Cruciate Ligament ; Cartilage, Articular ; Humans ; Knee Joint ; Knee ; Ligaments ; Menisci, Tibial ; Rabbits

Detection and evaluation of early soft tissue changes are important in rheumatoid arthritis or other jointdiseases. The most important factors for radiologic demonstration of soft tissue changes are resolving power andthe optimization of contrast differences between structures representing skin and subcutaneous tissue densities.Phantom study was done by using combination of immersion technique and mammography to get the most reliable methodfor improvement of soft tissue contrast without deterioration of resolution. Clinical application was also done in5 normal volunteers and 5 rheumatoid patients. The results indicate that soft tissue contrast, especially betwenskin and subcutaneous tissues can be significantly imporved with combination of immersion technique andmammography with 50% ethanol in both phantom and clinical study.
Arthritis, Rheumatoid ; Clinical Study ; Ethanol ; Healthy Volunteers ; Humans ; Immersion ; Mammography ; Radiography ; Skin ; Subcutaneous Tissue

No abstract available.
Animals ; Macrophages, Peritoneal* ; Mice* ; Mycobacterium bovis*

No abstract available.

The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

Hexafluorenium was used to potentiat succinylcholine in 36 patients undergoing major surgery, mainly abdominal, of from 1/2 to 7 hours duration. Anesthesia consisted of thiopental-nitrous oxide-oxygen-ether or haIothane and ventilation was controlled. In a first group, succinylcholine was administered for intubaticn and repeated intermittently as required with a single dose of hexafluorenium after the intubating dose of succinylcholine had worn off. In a second group, succinylcholine was administered similary but hexafluorenium was also given intermittenly. In a third group, a single initial dose of hexafluorenium was given followed by succinylcholine intermittently. In a fourth group, both drugs were given intermittently throughout, 1) The apnea time of succinylcholine was prolonged about 8times after a single dose of hexafluorenium in the first and third groups but the prolongation was gradually lessened with successive doses of succinylchohne. Rut in second and fourth groups, the apnea times were significantly prolonged following successive dose of both drugs. 2) In third and fourth groups, fasieulation following succinylcholine was not observed and nausea, vomiting and muscle pains were not noted. 3) In recovery room, about 80% of patients could raise their heads by themselves but ether required longer recovery than halthane. 4) No bronchospasm or cardiovascular side effects were noted. It is considered that this drug combinations provides excellent relatation for surgery. The technique with a single dose of hexafluorenium seems particularlly suitable in cases which last from 30 minutes up to 2 or 3 hours and repeated doses of hexafluorenium and succinylchloin are advisable for longer major cases.
Anesthesia* ; Apnea ; Bronchial Spasm ; Drug Combinations ; Ether ; Head ; Humans ; Myalgia ; Nausea ; Recovery Room ; Relaxation* ; Succinylcholine ; Ventilation ; Vomiting

Peripelvic lymphatic cyst or the kidney is a rare case in Korean Urological literature. We have experienced a case of it in 30 years old woman who had a palpable fluctuant mass in the upper right quadrant of the abdomen. The operated cyst was dark-red colored appearance and filled with amber colored fluid about 800cc. We have removed it together with kidney. The cyst measured 200gm. in weight, 10 x 5 x 4.5 cm in size and 0.5cm thickness of the cystic wall. Histological finding of the cystic wall showed a consisting of endometrial cell underlying tissue was collagen fiber and fibrotic change. The fluid of cyst contained 98 % of lymphatic cell.
Abdomen ; Adult ; Amber ; Collagen ; Female ; Humans ; Kidney ; Lymphocele*