The increased knowledge of the cutaneous circulation of the body and refinements in surgical technique have provided the basis for the successful microvascular transfer of various muscle, skin and myocutaneous free flap. We have found the tensor fascia lata(TFL) inyocutaneous flap to be reliable one and its transfer as a free flap. The TFL myocutaneous free flap was first introduced by Hill et al in 1978 and our two cases report were first introduced in Korea. Two cases of microvascular TFL myocutaneous free flap transfer were performed at the department of Orthopaedic Surgery of Hanyang University Hospital and satisfactory result was obtained from the one of those.
Fascia Lata ; Fascia ; Free Tissue Flaps ; Korea ; Skin

OBJECTIVE: This study was performed to assess agreements among screening tests, to estimate prevalence, and to identify related factors with postpartum depression. METHODS: For 323 women at 7 days postpartum, self-administered questionnaires were given including postpartum depression screening test such as EPDS, QIDS-SR16, BDI and questionnaires for their demographic and psycho-social information. Obstetric information were collected from medical records. Simultaneous positive cases in EPDS and BDI were defined as gold standard and used to estimate the prevalence of postpartum depression and agreements between 3 kind of screening test and gold standard. Related factors of postpartum depression were analysed by using SPSS. RESULTS: The prevalence of postpartum depression was 19.8% and the Kappa indices were 0.711 in BDI, 0.803 in EPDS, and 0.395 in QIDS-SR16. Feeding method, smoking history, antenatal anxiety/depression symptoms, residence status, marital satisfaction, relationship with husband's parents, and postpartum care method in univariate analysis and premature delivery (odds ratio: 2.9), formulated feeding (odds ratio: 3.8), marital dissatisfaction (odds ratio: 4.3), professional husband's occupation (odds ratio: 4.4), and antenatal anxiety/ depression symptoms (odds ratio: 4.4) in the logistic regression analysis were significantly related to postpartum depression (P<0.05). CONCLUSIONS: Simultaneous test of BDI and EPDS was effective to evaluate postpartum depression prevalence at 1-week postpartum and highly agree with EPDS. Significant related factors were defined and further prospective community-based studies are warranted.
Depression ; Depression, Postpartum ; Feeding Methods ; Female ; Humans ; Logistic Models ; Marital Status ; Mass Screening ; Medical Records ; Occupations ; Parents ; Postnatal Care ; Postpartum Period ; Prevalence ; Surveys and Questionnaire ; Smoke ; Smoking

Ectodermal dysplasia is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures. Characteristic manifestations include scanty hair and eyebrows, pigmented and hyperkeratinized skin around the eyes and mouth, frontal bossing with prominent supraorbital ridges, nasal bridge depression and dental anomalies. Hyperthermia or unexplained high fever as a result of the deficiency of sweat glands is common medical history. Findings of intraoral structures are anodontia or oligodontia with conical crowns. Consequently, generalized spacing and loss of vertical dimension of occlusion. Interdisciplinary approach has been performed to treat a 10-year old boy with ectodermal dysplasia. Orthodontists and a prosthodontist worked together on this case, and the result was satisfactory.
Anodontia ; Child ; Crowns ; Depression ; Ectoderm* ; Ectodermal Dysplasia* ; Eyebrows ; Fever ; Genetic Diseases, Inborn ; Hair ; Humans ; Male ; Mouth ; Skin ; Sweat Glands ; Vertical Dimension

PURPOSE: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta family and play an important role in cellular growth. Recent reports suggest that exogenous bone morphogenetic protein-2 (BMP-2) acts as an antiproliferative agent in a variety of cell lines. We will study whether BMP-2 is altered in human colorectal cancer. METHODS: We analyzed 40 colorectal cancer cases and 6 colorectal cancer cell lines by using reverse transcription-polymerase chain reaction (RT-PCR) to determine the expression of BMP-2. RESULTS: Thirteen of 40 colorectal cancers (33%) and 3 of 6 colorectal cancer cell lines (50%) revealed decreased expression of BMP-2. The rates of decreased expression were 0% (0/7), 42.1% (8/19), 28.6% (2/7), 33.3% (2/6), and 100% (1/1) in stages I, II, III, and IV, respectively. Histologically, the rates were 33.3% (2/6), 32.2% (10/21), 50% (1/2), and 0% (0/1) in well-differentiated, moderately-differentiated, poorly-differentiated and mucinous cancers, respectively. As for location, the rates for colon and rectal cancers were 27.8% (5/18) and 36.4% (8/22), respectively. We identified methylation in the CpG island of the BMP-2 gene in 60% of colorectal cancer cells and in 50% of colorectal cancer cell lines. The 13 cases without BMP-2 gene expression showed no significant correlation with clinicopathological factors. Epigenetic silencing through DNA methylation is one of the key steps during carcinogenesis. CONCLUSION: We found, through an analysis using the methylation-specific polymerase chain reaction technique, CpG island methylation of the BMP-2 promoter region in colorectal cancer. Thus, aberrant BMP-2 methylation and the resultant loss of BMP-2 expression may be related to colorectal carcinogenesis.
Bone Morphogenetic Proteins ; Cell Line ; Colon ; Colorectal Neoplasms ; CpG Islands ; DNA Methylation ; Epigenomics ; Gene Expression ; Humans ; Methylation ; Mucins ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Rectal Neoplasms

Cushing's syndrome that is caused by an adenoma of the corticotrape cells of the anterior pituitay or, rarely, by couticotrope hyperplasia is refered to as Cushing's disease. Cushings disease is usually characterized by chronic, moderate hypersecretion of ACTH and other POMC derived peptide. Most patients have ACTH-secreting anterior pituitary corticotrope microadenomas, but a small minority have a pituitary macroadenoma. We recently experenced two cases of Cushings disease due to pituitary macroadenoma. and report this cases with review of literatures.
Adenoma ; Adrenocorticotropic Hormone* ; Cushing Syndrome ; Humans ; Hyperplasia ; Pro-Opiomelanocortin

In spite of high-dose, hyperventilation, hyperosmolar agents, appropriate surgical evacuation, and cerebrospinal fluid when possible, uncontrolled intracranial hypertension, which was defined as occurring when intracranial pressure(ICP) exceeded 25 mmHg for 2 hours or more, occurred in 8 patients. Persistent elevated ICP occurred in 4 patient with acute subdural hematoma and brain contusion, in 2 patients with aneurysm and brain infarction, in 1 patient with hypertensive intracerebral hematoma, and in 1 patient with meningioma. All of these patients received intravenous barbiturate to control the ICP. The initial thiopental loading dose(10mg/kg) effectively reduced the ICP in 5 patients(62.5%). In those patients responding to the initial loading dose, four have survived, and one died due to pulmonary complication. None of three nonresponders to barbiturate survived. Two of the survivors have returned to a productive life, and two ramain moderately disabled. The favorable outcome in this series suggests that early aggresive treatment of intracranial hypertension with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, especially in postoperative state. A broader investigation of the clinical application of barbiturates in indicated.
Aneurysm ; Barbiturates ; Brain Infarction ; Brain Injuries ; Cerebrospinal Fluid ; Coma* ; Hematoma ; Hematoma, Subdural, Acute ; Humans ; Hyperventilation ; Intracranial Hypertension* ; Meningioma ; Survivors ; Thiopental

OBJECTIVEL: Anterior cervical discectomy and fusion has been successfully performed for many years using a variety of techniques. Recently, the concept of internal fixation has been applied to the lower cervical lesions. The need for postoperative immobilization, usually required to stabilize the patient while the fusion mass heals, is decreased or negated by internal fixation. In order to determine the effects of plate stabilization on maintenance of interspace height during postoperative period, we assessed the potential differences between anterior interbody fusion without plate and fusion with plate in patients with lower cervical lesions. PATIENTS AND METHODS: The authors analyzed the results of 76 patients with lower cervical lesions, who underwent anterior interbody fusion between May, 1991 and December, 1997. Of these, 36 underwent only anterior interbody bony fusion and 40 underwent bony fusion plus interbody fixation with plate system. RESULTS: In order to compare the difference of two groups, we investigated the pre- and postoperative interspace height, clinical outcomes, and radiographic fusion success rates. Anterior interbody fusion with plate was found to be superior to anterior interbody fusion without plate after anterior cervical decompression procedures with respect to maintenance of cervical interspace height(p<0.01), and radiographic and clinical fusion success rates. CONCLUSION: The authors concluded that the use of anterior plate fixation may provide added security to the nervous system before bony fusion occurs, may potentiate the maintenance of interspace height, may increase the probability of successful fusion, and may permit early ambulation.
Decompression ; Diskectomy ; Early Ambulation ; Humans ; Immobilization ; Nervous System ; Postoperative Period

Chikungunya infection is caused by an arbovirus transmitted by the Aedes mosquito. A 19-year-old man who had traveled to the Republic of Surinam to perform volunteer work complained of a fever, arthralgia, articular stiffness, and a skin rash on both the arm and trunk. Chikungunya fever was diagnosed using a Chikungunya virus specific IgM antibody in an enzyme-linked immunosorbent assay (ELISA) using blood samples obtained during follow-up visits. In this report, we describe a case of imported Chikungunya fever that presented with arthralgia and a skin rash, with islands of normal skin, that occurred following travel to Surinam, South America.
Aedes ; Arboviruses ; Arm ; Arthralgia ; Chikungunya virus* ; Culicidae ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Fever ; Follow-Up Studies ; Humans ; Immunoglobulin M ; Islands ; Skin ; South America* ; Suriname* ; Volunteers ; Young Adult

To evaluate the induction of preneoplastic hepatic foci in relation to natural killer cell (NK) activity, we sequentially analyzed glutathione S-transferase placental form positive (GST-P+) hepatocytes and NK activity during diethylnitrosamine (DEN) and phenobarbital (PB)-induced hepatocarcinogenesis in Sprague-Dawley rats. Previous studies have shown that NK activity can modulate the carcinogenic process induced by chemical carcinogens. Newborn females were initially given a single intraperitoneal injection of 15 mg DEN/kg and three weeks later, they were treated with 500 ppm phenobarbital (PB). From week 3, PB was administered in drinking water for 9 weeks. Interim and terminal sacrifices were performed at weeks 12, 15 and 30. GST-P+ hepatocytes increased with age in DEN-treated rats, especially in the population of more than two GST-P+ hepatocytes. The NK activity of DEN-treated rats did not significantly differ from that of control rats until week 12, but it progressively decreased from week 15 to 30. These results indicate that changes of NK activity inversely correlated with the induction of preneoplastic hepatic foci. This strong correlation of decreased NK activity with enhanced induction of GST-P+ foci suggests that NK activity is important in the early progression of hepatocarcinogenesis in rats.
Animal ; Body Weight ; Carcinogens/pharmacology* ; Diethylnitrosamine/pharmacology* ; Female ; Glutathione Transferase/metabolism* ; Killer Cells, Natural/immunology* ; Liver/enzymology* ; Liver/cytology ; Liver Neoplasms/physiopathology* ; Organ Weight ; Placenta ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Antiplatelet drugs play an important role in the prevention and treatment of coronary artery diseases. Triflusal, an antiplatelet drug structually related to acetylsalicylic acid, selectively inhibits the cyclooxygenase of platelet and thromboxane A2 formation. However there is a controversy about the clinical dosage and the quantitative evaluation of the platelet antiaggregatory effect of triflusal. In this study we have evaluated the platelet antiaggregatory effect and cost-effective dosage of triflusal in the whole blood of healthy volunteers. METHODS: Using the whole blood of 50 healthy people, we performed a baseline platelet aggregation function test induced by adenosine diphosphate (ADP) and collagen. The subjects were subdivided into 3 treated groups (300 mg, 600 mg, 900 mg). We compared the platelet aggregation effect between the baseline results and 2 weeks after triflusal administration. RESULTS: Triflusal inhibited the platelet aggregation induced by ADP and collagen in the 600 mg administration group most effectively. The platelet aggregation induced by collagen was inhibited dose-dependently. The definite inhibitory responders (% inhibition > or = 25) for platelet aggregation induced by collagen were more common than those induced by ADP (33% vs 27% in 300 mg, 71% vs 53% in 600 mg, 78% vs 39% in 900 mg). There were no serious clinical side-effects except gastrointestinal trouble. One volunteer in the 900 mg treated group discontinued the treatment due to epigastric pain. CONCLUSION: We conclude that triflusal has a dose-dependent inhibitory effect on platelet aggregation induced by collagen and that the most effective dosage for platelet antiaggregation effect is 600 mg per day.
Adenosine Diphosphate ; Aspirin ; Blood Platelets* ; Collagen ; Coronary Artery Disease ; Electric Impedance* ; Evaluation Studies as Topic ; Healthy Volunteers* ; Platelet Aggregation Inhibitors ; Platelet Aggregation* ; Prostaglandin-Endoperoxide Synthases ; Thromboxane A2 ; Volunteers