No abstract available.
Drug Therapy* ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

No abstract available.

No abstract available.
Knee Joint* ; Knee*

Neuroarthropathy has infrequently been associated with diabetic patients. The initial presenting symptoms are in most cases the peripheral neuropathy involving chiefly the sensory components of peripheral nerves, leading to numbness, hyper-or paresthesia, and coldness of the extremity affected. The diabetic arthropathy, once occurred, is apt to show progressive deterioration of the function with destruction of both skeletal and supporting soft tissues Two cases of such arthropathy were presented here, the one was observed in a 29-year-old man with involvement of the left fourth and fifth tarsometatarsal joints and a large ulcer on the dorsal skin of the lesion, and the other in a 35-year-old man with destruction of the right ankle joint. Both of them showed remarkable remission of the symptoms with conservative measures such as arch support, cast immobilization and skin graft.
Adult ; Ankle Joint ; Extremities ; Humans ; Hypesthesia ; Immobilization ; Joints ; Paresthesia ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Skin ; Transplants ; Ulcer

We describe the clinical and pathologic observation of a 50-year-old man with superficial disseminated porokeratosis who developed a squamous cell carcinoma on the dorsum of his right thumb and Bowens disease on his right upper arm. The tumors were surrounded by lesions of superficial disseminated porokeratosis and were thought to develop from the dysplastic epidermal cells located under the comoid lamellae.
Arm ; Bowen's Disease* ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Middle Aged ; Porokeratosis* ; Thumb

Twelve cases of compression arthrodesis of the knee, which was performed during the period 1973 to 1978, were reviewed. All of the cases had tuberculous arthritis of the knee and included 3 children. Post-operative management was carried out with compression in a long leg cast with crutch walking for an average of 6 weeks and successive cylinder casts without compression and permitting full weight bearing were applied on an average of every 7 weeks. All cases eventually revealed bony fusion and the tuberculosis subsided without signiflcant complications even in the children.
Arthritis ; Arthrodesis ; Child ; Humans ; Knee ; Leg ; Tuberculosis ; Walking ; Weight-Bearing

There is debatable opinions as to the nature and clinical significance of the changes that may occur in the spine after posterior spine fusion performed in growing children. Clinical survey is known to be difficult because X-ray films in children are not easy to interpret and measure in the presence of disease and accuracy is uncertain due to magnification on X-ray films. Authors selected 8 cases of tuberculous spondylitis which were managed with posterior spine fusion under the criterias that cases had surgery under 10 years old, no evidence of pseudoarthrosis clinically and roentgenologically on serial examinations at least once 1 year, follow-up more than 2 years since 3 months after surgery, enough spines are included on lateral X-ray films, and accurate measurement and correction of magnification are possible. The cases were surveyed for changes occured in fused spines after posterior spine fusion and the results were as follows: 1. There was actual lengthening of grafted bone mass after solid fusion in all cases although the amounts were minimal. 2. The fused spines grew 46% on an average less than adjacent normal unfused spines. 3. The vertebral bodies of fused spines grew nearly same as the adjacent normal vertebral bodies. 4, The intervertebral disc spaces of the fused spines were narrowed in all cases. 5. The intervertebral angles had tendency to increase and kyphosis angles to decrease.
Child ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Kyphosis ; Pseudarthrosis ; Spine ; Spondylitis ; Transplants ; X-Ray Film

Laparoscopic cholecystectomy (LC) is considered as the gold standard operation for the removal of a nonmalignant, diseased gallbladder. With the increasing number of LCs, a number of gallbladder carcinomas have been unexpectedly found either during or following this procedure. The removal of unexpected gallbladder carcinomas by LC can cause also a new complication, port site metastasis (PSM), which is developed by the implantation of tumor cells into the abdominal wall at the port site. We report a rare case of PSM of gallbladder carcinoma which was unsuspected at the time of LC. A 65-year-old man underwent LC at another hospital for calculous cholecystitis. The histologic examination revealed an adenocarcinoma of the gallbladder infiltrating the muscle wall. Despite the surgeon's advice, the patient refused any additional treatment. Ten months after surgery, he visited our hospital because of a painful and palpable subcutaneous mass at the scar of the periumbilical trocar incision. The mass was biopsed and histological examination confirmed metastasis from the gallbladder carcinoma.
Abdominal Wall ; Adenocarcinoma ; Aged ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cicatrix ; Gallbladder* ; Humans ; Neoplasm Metastasis* ; Surgical Instruments

Staphylococcal scalded skin syndrome (4S) is an exfoliative skin disease caused by Staphylococcus aureus toxins. 4S usually has a benign course in young infants and children; however, it could be fatal in preterm infants, especially very low birth weight infants. We experienced two sequential 4S cases that occurred in the neonatal intensive care unit. One of the patients had complications such as bacteremia and acute kidney injury.
Acute Kidney Injury ; Bacteremia ; Child ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Skin Diseases ; Staphylococcal Scalded Skin Syndrome ; Staphylococcus aureus