Free flaps have been widely used in lower leg reconstruction. However, in cases with extensive injury to the vessels as well as to the bone and soft tissues, and having only one intact major vessel in the lower leg(single vessel leg), careful selection of recipient vessels for the free flap transfer is mandatory for preventing further vascular compromise of the distal lower leg. The sural artery and its vena comitantes are frequently protected form externally harmful forces by the bulky surrounding gastrocnemius muscle and can be used as recipient vessles for free flaps without any detrimental influence on the vascularity of the distal lower leg. In our department, three latissimus dorsi muscle free flap were transferred with sural vessels as recipient vessels in the reconstruction of the single vessel legs. Except for one case of flap failure due to serious infection at the microvascular anastomoses site, all the other cases were successfully reconstructed without any necrosis of the gastrocnemius muscle or the distal leg. In addition, the sural vessels were easily accessed in any patient position and their caliber was similar to that of the vascular pedicles of the donor muscle flaps. In conclusion, the sural vessels can be another useful option in selecting recipient vessels for free flap transfer in the reconstruction of the single vessel leg.
Arteries ; Free Tissue Flaps* ; Humans ; Leg* ; Muscle, Skeletal ; Necrosis ; Superficial Back Muscles ; Tissue Donors

No abstract available.
Pregnancy*

A clinical observation was made on 239 cases of benign prostatic hypertrophy, admitted to the Department of Urology, Korea University College of Medicine during the period of 9 years and 8 months from Jan. 1972 to Aug. 1981. Following results were obtained. 1. Amount of residual urine from 10 ml to 1,500 ml with average 304 ml. 2. Hypertension in 35 cases (14.8%)and pulmonary diseases in 29 cases (12.1%)were frequently associated with B.P.H. 3. E.K.G. was performed in 171 cases. Abnormal findings included L.V.H. in 38 cases (22.2%), arrhythmia in 11 cases (6.4%), but normal in 118 cases (69%). 4. In blood chemistry, blood urea nitrogen was elevated in 75 cases (31.4%)and creatinine was elevated in 69 cases (28.9%). 5. The most common endoscopic findings were trabeculation in 214 cases (89.5%), inflammation in 192 cases (80.3%), kissing of lateral lobes in 138 cases (58.7%)and elevated interureteric ridge in 71 cases (29.7%). 6. Methods of operative treatment were T.U.R. in 184 cases, retropubic prostatectomy in 7 cases and suprapubic prostatectomy in 3 cases.
Arrhythmias, Cardiac ; Blood Urea Nitrogen ; Chemistry ; Creatinine ; Hypertension ; Inflammation ; Korea ; Lung Diseases ; Prostatectomy ; Prostatic Hyperplasia* ; Urology

Pertutaueous transluminal angioplasty is the treatment of choice for renovascular hypertension in cases due to the renal vascular occlusion which is not severe enough to pass dilatation catheter. The advantages of percutaneous transluminal angioplasty are the use of local anesthesia, its noninvasiveness without surgical risk, feasibility of repetition and shorter hospital days compared with surgical methods. We are presenting a case of renovascular hypertension due to atherosclerosis cured by percutaneous transluminal angioplasty with the review of literatures.
Anesthesia, Local ; Angioplasty* ; Atherosclerosis ; Catheters ; Dilatation ; Hypertension, Renovascular*

No abstract available.
Cisplatin* ; Hearing Loss* ; Hearing*

The claw-foot deformity is only a symptom of some primary lesion, not an entity in itself. The treatment of claw-foot usually depends on the type and severity of the deformity. In the past two years, authors have treated 7 cases of claw-foot, 3 of which were treated by Cole's anterior tarsal wedge osteotomy and 4 cases by Japas “V”-osteotomy of tarsus. In all 7 cases, Steindler's plantar fasciotomy for cavus deformity were combined and 1 case was combined with Achilles tendon lengthening. The followings were noted. 1. AlI patients were military personals and the ages were between 21 to 27 years old male. 2. Two patients were bilateral claw-foot deformity and both sides were operated. 3. The causes were secondary to poliomyelitis in one case and the others were idiopathic. 4. Postoperative complications were skin necrosis in one case and sensory disturbance on the dorsum of the first web space of the foot in 3 cases. 5. All patients can walk and run without pain after average 1 year follow-up period.
Achilles Tendon ; Ankle ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Foot Deformities ; Humans ; Male ; Military Personnel ; Necrosis ; Osteotomy ; Poliomyelitis ; Postoperative Complications ; Skin

PURPOSE: Metastatic carcinoma of the eye is a common sequela of widespread dissemination of malignancy. Metastasis to the iris is less frequent than that of the cilliary body and choroid. We report a case of iris metastasis in a patient with non-small cell lung cancer. METHODS: 57-Year-Old man was seen in the department of ophthalmology because of blurred vision in his right eye for seven days. The patient had a metastasis of non-small cell lung cancer in the brain. Trabeculectomy and iridectomy were performed due to secondary glaucoma. RESULTS: The case was diagnosed as iris metastasis of non-small cell lung cancer by the clinical and histopathologic findings.
Brain ; Carcinoma, Non-Small-Cell Lung* ; Choroid ; Glaucoma ; Humans ; Iridectomy ; Iris* ; Middle Aged ; Neoplasm Metastasis* ; Ophthalmology ; Trabeculectomy

PURPOSE: It was noted some changes of clinical manifestations of mycoplasma pneumonia. we reviewed and compared these changes and saught any clues causes for proper dignosis and treatment. METHODS: We divided patients with mycoplasma pneumonia into two groups, Group 1 (from Jan. to Dec. 1996) and Group 2 (from Jan. to Dec. 1994), and analyzed clinical, radiologic, and serologic differences. RESULTS: Mean age of onset lowered markedly from was 8.34 +/- 2.56 years to 6.91 +/- 3.28 years (P<0.05). In clinical symptoms, high fever lasted longer and gastrointestinal symptoms were more frequent noted group 1. Serologically, high titers of mycoplasma-specific antibody (>1 : 1280) were more frequently observed in group 1 and correlated with severity of clinical manifestations. In radiologic findings, alveolar consolidation were significantly prominent findings in Group (P<0.05). The mean period of response to Roxithromycin was not difference between two groups but longer lasting fever (> or = 3 days) in spite of medication were more prevalent in Group 1 (P<0.05), suggesting increased cases of diminished responsiveness to treatment. CONCLUSIONS: Recently, there was some clinical changes of mycoplasma pneumonia, lowering of onset age, severe clinical symptoms, and more decreased responsiveness to antibiotic treatment. We suggest that it is to neccessary to make some efforts to prevent antibiotics abuse and to decrease the occurrence of resistant strains by introducing of new method for early diagnosis, selective identification of micro-organism and minute sensitivity test for antibiotics.
Age of Onset ; Anti-Bacterial Agents ; Early Diagnosis ; Fever ; Humans ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Roxithromycin

PURPOSE: To evaluate the correlation between foveal thickness, as measured with optical coherence tomographic evaluation, and the visual acuity in patients who suffered from unilateral resolved central serous chorioretinopathy. METHODS: Twenty-eight consecutive patients who were diagnosed with unilateral resolved central serous chorioretinopathy were studied. High-resolution optical coherence tomography was performed on all of the patients. The foveal thickness of the involved eye was normalized by dividing its thickness with that of the uninvolved eye. The best-corrected visual acuity of the involved eye was normalized as well. The subjects were divided into two groups according to the minimum value of the normalized foveal thickness in the 22 healthy subjects. RESULTS: The mean foveal thickness was 128.68+/-22.06 micrometer in the involved eyes and 148.18+/-13.88 micrometer in the uninvolved eyes. There was a statistically significant correlation between the normalized foveal thickness and the normalized visual acuity. There were statistically significant differences in the normalized visual acuity and the duration of the symptoms between the group with foveal thickness above the minimum value and the group with foveal thickness below the minimum value. CONCLUSIONS: There was a statistically significant correlation between foveal thickness and visual acuity. The patient group with a foveal thickness value above the minimum value of the normalized foveal thickness showed a statistically significant improvement in visual acuity and a shorter duration of symptoms. It seems that the foveal thickness is associated with visual acuity and the duration of symptoms.
Central Serous Chorioretinopathy* ; Humans ; Tomography, Optical Coherence ; Visual Acuity*

DNase I footprinting assay using liver nuclear extracts revealed six protected regions between nucleotide -600 and +110 and hence named Box I-VI. Upstream promoter element (UPE), a DNA element playing crucial role in transcriptional control of the tissue specific expression of pancreatic beta-cell, has been detected within the proximal region of rat GLUT2 promoter. This region is included in Box VI. The protein-DNA interaction in this region (Box VI) was confirmed by mobility shift assay using liver nuclear extracts. Deletion of the region between -585 bp and -146 bp resulted in dramatic changes in promoter activity when they were expressed in liver and beta-cell derived cell line. When -585/-146 construct was expressed in liver, the activity was decreased to 46%, whereas the activity in beta-cell line, HIT-T15 cell, was increased by 84% when compared to -146/+190 construct. These opposing phenomena can be explained by the fact that beta-cell specifically expresses the UPE binding protein. Assuming that there may be Box VI-binding protein playing negative roles both in hepatocyte and beta-cell, and that the protein acts as a negative regulator of GLUT2 gene, the UPE binding protein in the beta-cell may overcome the inhibition by binding to the protein.
Animal ; Binding Sites ; Cell Line ; Comparative Study ; DNA Footprinting ; Deoxyribonuclease I ; Gene Expression Regulation ; Islets of Langerhans/metabolism* ; Islets of Langerhans/cytology ; Liver/metabolism* ; Liver/cytology ; Monosaccharide Transport Proteins/genetics ; Monosaccharide Transport Proteins/biosynthesis* ; Promoter Regions (Genetics)* ; Protein Binding ; Rats ; Transcription Factor AP-1