No abstract available.
Thyroidectomy*

An immunoperoxdase technique in electron microscopy was used to investigate the ultrastructural site of keratinolytic proteinase (KPase) of M crosporum cans in sections of skin from guinea pigs infected with the same organism. Ultrastructurally, the KPase was present only in the cell walls of the invading dermatophytes as a continuous deposition of the electron-dense reaction product on the inner and outer aspects of the cell wall of the fungal hyphae without deposition in the keratin surrounding the invading hyphae. Our results suggest that the KPase may not play an absolute role in the invasion of dermatophytes into keratinized tissue in vivo.
Animals ; Arthrodermataceae ; Cell Wall ; Guinea Pigs* ; Guinea* ; Hyphae ; Immunoenzyme Techniques* ; Microscopy, Electron* ; Microsporum* ; Skin* ; Tinea

Background: Gastric juice volume and acidity are influenced by food, drugs, and patient factors such as age, sex, weight, and fasting time. But almost studies were performed without controlling of these confounding variables. This study was designed to determine the change of gastric juice volume and acidity in relation to the fasting time within a constant food intake. Methods: Fifty-seven healthy patient randomly allocated to one of two groups. Group I was instructed to ingest 200 ml of milk up to 8 hours before anesthesia and Group II was instructed to drink 200 ml of water up to 1~2 hours before anesthesia. After the endotracheal intubation the volume and acidity of gastric juice were measured. Relationships between gastric volume or acidity and fasting time were analysed using correlation analysis. The data were analyzed using Wilcoxon rank sum test, comparing Group I with Group II. Results: There is no significant relationship between gastric juice volume or acidity and the fasting time within the same food intake. Gastric juice volume and acidity of the patients who ingested milk at 8~9 hours before anesthesia were similar to that of those patients who drank water at 1~2 hours before anesthesia. Conclusion: It is necessary to individualize the fasting time of the patients and it seems that water ingestion up to 1~2 hours before anesthesia may be safe.
Anesthesia ; Confounding Factors (Epidemiology) ; Eating ; Fasting* ; Gastric Juice* ; Humans ; Intubation, Intratracheal ; Milk ; Water

The main goals of treatment of malignant bone tumor are the prolongation of life survival and the improvement of quality of life. In growing children, however, leg length discrepancy (LLD) is one of major problem in the treatment of malignant bone tumors. Therefore, the precise understanding of growth in children is essential, and the prediction of LLD is critical in deciding the time and options of surgery. In addition, to use the adequate method of growth expectation, periodic follow-up and collaboration with patient's parents are needed.
Child ; Cooperative Behavior ; Humans ; Leg ; Life Support Care ; Parents ; Quality of Life

We analyzed 41 cases of burst fractures on the thoracolumbar junction which were operated with Kaneda and Cotrel-Dubousset implant at Chosun University Hospital between 1989 and 1993. The purpose of this study was to evaluate the radiologic sign, the amount of reduction, complications, and functional results. The results were as follows: 1. According to McGrorys Criteria to evaluate the posterior superior vertebral body angle of burst fractures, 33 out of 41 cases(80.5%) were positive and the average angle degree was 107.6°. 2. The average postoperative kyphotic correction was 15.4° in the Kaneda group and 13.8° in the C-D group. The average loss of correction at follow-up examination was 5° in the Kaneda group and 4.8° in the C-D group. 3. Indirect reduction was achieved in 10 cases(50%) and we obtained a good indirect reduction even though canal compromise was over 50%. 4. The pain at operative site was much more severe in the Kaneda group(6 cases) than in the C-D group(2 cases) and both groups experienced 2 cases each of implant failure. 5. According to Denis' pain and work scale, 28 cases(63.8%) had good and excellent, 8 cases had fair and 5 cases had poor results. In summary we recommend doing 1) a posterior instrumentation first for stability and indirect reduction, if it is not a severe neurologic symptom and 2) anterior decompression if it is a severe or progressive neurologic symptom.
Decompression ; Follow-Up Studies ; Neurologic Manifestations

Since Klemm introduced the concept of antibiotic-containing bone cement for the treatment of chronic osteomyelitis, a number of studies have demonstrated the positive results of this therapy. It has been proved that antibiotic-containing bone cement continuously releases high levels of atibiotics locally into the infected and avascular wound environment. Antibiotic-containing bone cement provides several distinct advantages over irrigation-suction drainage. The major objective of this study is to analyze the results of therapy using antibiotic-containing bone cement beads for chronic osteomyelitis. The authors analyzed 21 cases of chronic osteomyelitis in patients who had been treated by saucerization and antibiotic-containing bone cement beads at Chosun University Hospital, between February 1990 and January 1993. Each patient's case was followed for at least thirteen months after operation. The results are as follows: 1. The causes of osteomyelitis were postoperative complications(10 patients), open fracture(8 patients), and hematogenous osteomyelitis(3 patients). 2. Staphylococcus aureus was the most common organism causing osteomyelitis, followed by Pseudomonas. 3. The femur was the most common location of lesion(11 patients) followed by the tibia(7 patients), the humerus(2 patients) and the ulna (1 patients). 4. Pus drainage was stopped in 13 cases with one insertion of the beads, in 2 cases with two insertions and in 2 cases with three insertions. 5. Therapy using antibiotic-containing bone cement beads can be regraded as an effective method of increasing local antibacterial activity by releasing the antibiotic into surrounding tissue over a continuous period in the treatment of chronic osteomyelitis. Antibiotic-containing bone cement beads are useful in the treatment of chronic osteomyelitis.
Drainage ; Femur ; Humans ; Methods ; Osteomyelitis ; Pseudomonas ; Staphylococcus aureus ; Suppuration ; Ulna ; Wounds and Injuries

A retrospective analysis of eighty-six consecutive patients who underwent stabilization with AO internal fixator for thoracolumbar spine fractures was performed at Wonju Christian hospital between 1988 and 1994. The purpose of this study was to determine the quality of reduction and stabilization with the fixateur interne(F-I) and the effects of limited posterior segmental fixation on neurologic recovery and rehabilitation. The mean wedge angle of the fractured vertebra was changed from 19.2° preoperatively to 8.4° preoperatively, and remained almost unchanged at last follow up(10.2°). Also, the wedge index showed nearly no bony loss of correction within the reduced fracture vertebra(corrected from 0.63 to 0.83 and 0.81 at follow up). The mean kyphosis angle was corrected from 22.3° to 8.3° and 16.9° at last follow up. Most of the change of kyphosis was due to the disc space collapse above the fractured vertebra. Transpedicular cancellous bone grafting for the vertebral body fractures effected a significant improvement in results of fixation. All cases of translational displacement were anatomically reduced. No neurologic or vascular complication occurred. Fixateur interne is capable of achieving three-demensional reduction in unstable thoracolumbar spinal fractures and maintaining sufficient stability until bony healing is achieved.
Bone Transplantation ; Follow-Up Studies ; Gangwon-do ; Humans ; Internal Fixators ; Kyphosis ; Rehabilitation ; Retrospective Studies ; Spinal Fractures ; Spine

Dermatofibroma with granular cells is composed mainly of spindle shaped cells mixed with in-conspicuous foamy cells that contain granular cytoplasm. We present a case of dermatofibroma with granular cells in a 36-year-old male who visited our clinic to evaluate a slow-growing nodule on the medial side of the left lawer leg. He have had the nodule for five years and sometimes felt an itching sensation. Biopsy of the nodule identified a dermal nodular tumor showing cellular spindle cell proliferation admixed with peripheral foamy histiocytes. With the immunohistochemical staining, the granular cell was positive for alpha-1-antitrypsin and CD68, and negative for S-100. A few electron-dense granules were seen in the cytoplasm on the electronmicroscopic study. These results suggested that the granular cells originated from histiocytes.
Adult ; Biopsy ; Cell Proliferation ; Cytoplasm ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Male ; Pruritus ; Sensation

E-cadherin is a calcium-dependent epithelial adhesion molecule which plays a role in the initial step of invasion of cancer cells. The step that follows the migration of separated tumor cells is a proteolytic lysis of basement membrane and extracellular matrix by protease of epithelial and endothelial cells such as matrix metalloproteinase (MMP). Vascular endothelial growth factor (VEGF) is known to be an endothelial cell-specific powerful mitogen as well as a vascular permeability factor. This study is aimed to evaluate the correlation between expression of these factors and pathologic or clinical variables and the roles and prognostic significance of those factors in squmous cell carcinoma and adenocarcinoma of the lung. Immunohistochemical stains were performed for E-cadherin, MMP-2, and VEGF in surgically resected specimens from 90 patients with squmous cell carcinoma and adenocarcinoma of the lung. Mean age of the patients was 59.7 years. Histologic type was categorized into 56 cases of squamous cell carcinoma and 34 cases of adenocarcinoma. Mean survival period of the 35 patients was 54 months. The immunohistochemical stains for E-cadherin, MMP-2, and VEGF revealed positive reaction in 67 cases (74.4%), 43 cases (47.8%), and 34 cases (37.8%), respectively. The expression of E-cadherin was higher in adenocarcinoma (82.4%) than in squamous cell carcinoma (69.6%). MMP-2 was expressed in the tumor cells, especially those invading into the surrounding stroma. The expression of MMP-2 was significantly correlated with the survival rate (p<0.05). The expression of VEGF in the tumor cells was significantly higher in cases with lymph node metastasis (p<0.05). In conclusion, these findings suggest that the expression of MMP-2 and VEGF predict poor prognosis of patients with squmous cell carcinoma and adenocarcinoma of the lung and that VEGF may play a role in tumor metastasis.
Adenocarcinoma* ; Basement Membrane ; Cadherins* ; Carcinoma, Squamous Cell* ; Coloring Agents ; Endothelial Cells ; Extracellular Matrix ; Humans ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A*

Scaphoid fractures are the most common fracture and early diagnoses are very important because of preventing from serious complications such as nonunion, avascular necrosis, and disability of wrist joint. There are a few reports of clinical survey of scaphoid fractures, but not to be reported the evaluation for the close relation among mechanism, modes of treatment, especially operation and late complications. This paper reports more clear corelationships among them as mentioned as above through clinical study of scaphoid fractures. The authors have surveyed the clinical study of 26 cases of scaphoid fractures from July, 1983 to November, 1989 at Department of Orthopedic Surgery, Haewha hospital of Korea University. The following conclusions were obtained through clinical survey. 1. Among 26 cases, they were 25 males and one female between 20 and 50 years of age, and ocalization was 16 in right and 10 in left. They were 21 fresh fractures and five nonunions. 2. Mechanism of injuries had revealed fall down or slip down in 13 cases, roller injury in five cases, fisting injury in four cases, direct trauma in two cases, and traffic accident in two cases. Fracture loeation was four cases in proximal 1/3, 17 cases in middle 1/3, and five cases in distal 1/3. 3. Operations using volar approachs in 12 cases and dorsal approachs in three cases had been done for ten cases of displaced fresh fractures and five cases of neglected nonunions. 4. Eleven undisplaced fresh fractures were treated with short arm thumb spica cast but one with. long arm cast. Of ten displaced fresh fractures treated by open reduction, seven cases were treated with Herbert screw, two cases with K-wire, and one case with treated by open reduction and bone graft with Herbert screw fixation in three cases, K-wire fixation in one case, and open reduction with bone graft in one case. 5. Unions were obtained at average 11.5 weeks in eight of 11 cases treated with conservative treatment for fresh fractures, 12 weeks in eight of 10 open reduction cases of fresh fractures, and 20 weeks in three of five neglected nonunion cases. 6. Of eleven conservatively treated cases, two cases resulted in nonunion and other one case in avascular necrosis. Of ten treated with open reduction, one complicated in delayed union, other one nonunion. Of five neglected nonunion cases treated by open reduction added with bone graft, one remained in nonunion and other one case complicated with arthritis and nonunion.
Accidents, Traffic ; Arm ; Arthritis ; Clinical Study ; Diagnosis ; Female ; Humans ; Korea ; Male ; Necrosis ; Orthopedics ; Thumb ; Transplants ; Wrist Joint