Flap survival is critical to the success in reconstructive surgery, there have been many investigations to increase the blood supply to the flaps such as surgical delay and pharmacologic delay. Prostaglandin(PG) is released from various tissues including blood vessel in response to physical stimulus. Among the Prostaglandins, PGE1 has been proven to be a vasodilatation property and many authors have demonstrated its effect to increase blood supply after random cutaneous flap surgery. Clinically, however, muscle flap or musculocutaneous flap is more significantly used in reconstructive surgery and hemodynamic effects of PGE1 of this type of flap are still not documented. The authors designed the random muscle flap to study the hemodynamic effects of PGE1 of the muscle flap. Superior based rectus muscle flap was elevated from rats and the superior epigastric artery, its major vascular pedicle, was ligated to create the random-type muscle flap. Twenty two rats were divided into two experimental groups and each group had 11 rats; Group I: No drugs Group II: PGE1 injection group for 7 postoperative days intraperitoneally The average muscle flap survival rate of group I was 46+/-3.0 precent and it had a higher survival rate than the control group(23+/-4.3%). The muscle flap survival rates showed significant differences between the two groups (p< 0.005) This study shows that the administration of the PGE1, in clinical usage of the rare random muscle flap with a pedicle injury or musculocutaneous flap with the risk of distal cutaneous flap necrosis, such as TRAM flap, which might be much safer and popular.
Alprostadil ; Animals ; Blood Vessels ; Epigastric Arteries ; Hemodynamics ; Myocutaneous Flap ; Necrosis ; Prostaglandins ; Rats* ; Rectus Abdominis* ; Survival Rate ; Vasodilation

We examined the factors which may serve as predictors of success or failure of amputation in lower extremity for vascular obstructive diseases in 52 consecutive patients who were treated at the Department of Orthopaedic Surgery and Yonsei Cardiovascular Center from January 1st, 1990 to December 31st, 1994. The minimum follow up period was 10 months. The population was divided into two groups, group of success of primary amputation and group of failure. The results were as follows, male and female ratio was 42:10 and the average age was 57.5 years old. Among total 52 cases, there were 22 cases of arteriosclerosis obliterans, 15 cases of Buerger's diseases, 12 cases of vasculitis, 3 cases of acute arterial embolism. Complications after primary amputation included 9 cases of superficial wound infections, 7 cases of marginal wound necroses. Sixteen cases belonged to the group in which reamputation were performed because of intractable poor wound healing. Preoperative value of hemoglobin, hematocrit, serum albumin and serum creatinine which had been generally known as prognostic factors in wound healing were not related to the necessity of reamputation (Multivariate Regression Test, P>0.05). And also age, blood pressure and smoking history and level of amputation didn't show any difference between two groups but existence of lower extremity infection and uncontrolled diabetes mellitus were related to the prognosis of reamputation (Multivariate Regression Test, P<0.05).
Amputation* ; Arteriosclerosis Obliterans ; Blood Pressure ; Creatinine ; Diabetes Mellitus ; Embolism ; Female ; Follow-Up Studies ; Hematocrit ; Humans ; Lower Extremity* ; Male ; Necrosis ; Prognosis ; Risk Factors* ; Serum Albumin ; Smoke ; Smoking ; Vasculitis ; Wound Healing ; Wound Infection ; Wounds and Injuries

We report two cases of supratentorial gangliocytomas mimicking an extra-axial tumor. MR imaging indicated that the tumors were extra-axial, and meningiomas were thus initially diagnosed. Relative to gray matter, the tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On contrast-enhanced T1-weighted images, homogeneous enhancement was observed, while CT scanning revealed calcification in one of the two cases.
Adult ; Brain Neoplasms/*diagnosis/pathology ; Case Report ; Female ; Ganglioneuroma/*diagnosis/pathology ; Human ; *Magnetic Resonance Imaging ; Middle Age

Purpose: This study examined the acute effects of static and dynamic stretching on the flexibility of the hamstring, dynamic balance ability, and function of the lower extremities in healthy adults. Methods: Thirty participants were assigned randomly to three groups: static stretching group (SSG), basic dynamic stretching group (BDSG), and 5 sec dynamic stretching group (5DSG). SSG performed three sets of 30 seconds of static stretching. BDSG performed a single-leg deadlift (SLD) at the same time as SSG, and 5DSG performed SLD held for five seconds. Hamstring flexibility, dynamic balance ability, and lower extremity function were evaluated before and after intervention. Results: The hamstring flexibility significantly improved in all groups (p<0.05). The dynamic balance ability improved significantly after intervention in all groups except BDSG in the anterior direction (p<0.05). There were significant differences in the posterolateral and posteromedial direction in all groups. The function of the lower extremity showed significant improvement over time only in BDSG (p<0.05). Conclusion This study suggested that basic dynamic stretching and 5 sec dynamic stretching positively affect the hamstring flexibility, dynamic balance ability, and lower extremity function. Therefore, it is recommended to include dynamic stretching in a program for improving the hamstring flexibility, dynamic balance ability, and the lower extremity function. In addition, it is recommended to apply it at different times depending on the purpose.

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

No abstract available.
Cervix Uteri* ; Female ; Lymph Nodes* ; Neoplasm Metastasis*

The determination of proliferative activity in the colorectal mucosa has been used for different purposes as the estimation of cancer risk and the assessment of disease activity in ulcerative colitis. But the prognostic significance of proliferative activity in colorectal carcinomas remains controversial. To investigate the prognostic significance of proliferative activity in colorectal carcinomas, the author estimated the proliferative activity immunohisto chemically using the monoclonal antibody PCNA and compared with clinicopathological data in 62 colorectal carcinomas. The results were as follows: 1) The reactivity of PCNA was more pronounced at the infiltrative margins of the tumors and tumor cells within the vascular or lymphatic channels. 2) The mean PCNA index of colorectal carcinomas was 40.5?0.4%. PCNA indices had positive correlations with lymph node invasion(p<0.05), liver, metastasis(p<0.05), Dukes' stage(p<0.01) and TNM classification(p<0.01), and didn't correlated with location of tumor, size of tumor, histological type and lymphtic or vascular invasion. 3) The patients with high PCNA index(more than 45%) represented higher recurrence or metastasis rate(37.5%) than those with low PCNA index (less than 45%)(19.3%) in Dukes B or C colorectal carcinomas during the follow-up periods, but not significant statistically. These results suggested that the reactivity of PCNA may be a useful prognostic factors in colorectal carcinomas.
Neoplasm Metastasis

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence