Reconstruction of extensive soft tissue defects of the lower extremity, especially when complicated by open fracture and bone loss, is usually a difficult problem for the plastic surgeon. Many methods have been devised to treat these conditions Musculocutaneous flaps add a valuable surgical alternative that bring vascularized cover to the defects, and the free microvascular transfer of these flaps gives the surgeon an added dimension of versatility. The latissimus dorsi is an extremly reliable musculocutaneous flap with a long, large-caliber vascular pedicle, so that dissection of the muscle can be performed with relative ease. The size of the latissimus dorsi muscle lends itself to coverage of large defects. While these characteristics appear to make the free latissimus dorsi musculocutaneous transfer ideal in many circumstances, it has some disadvantages. At the recipient site, the flap is ofter too bulky, and donor-site closure requires skin grafts if the flap is wider than 10cm. These skin grafts on the posterior thorax seriously detract from the final appearance of the donor site. The authors have experienced 12 cases of reconstruction of extensive lower extremity soft tissue defect in which the latissimus dorsi muscle alone was transferred and covered with a split-thickness skin graft. This method improves the recipient-site contour by decreasing the bulk of the flap and it also improves the donor-site appearance. We described technical considerations in each case and the advantages of free latissimus dorsi muscle flap and skin graft for the reconstruction of extensive soft tissue defect in the lower extremity.
Fractures, Open ; Humans ; Lower Extremity ; Myocutaneous Flap ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors ; Transplants

No abstract available.
Female ; Methotrexate* ; Pregnancy ; Pregnancy, Tubal*

No abstract available.
Replantation*

Excess hair growth in unwanted areas may result from heredity, endocrine disease, or drug therapy. Conventional methods of hair removal include shaving, wax epilation and chemical depilatories that frequently cause side effects such as contact dermatitis and that also have temporary effects. Electrolysis is a well-established medical method for permanent destruction of terminal hair follicles. However, this method is tedious and efficacy has been reported to range from 15-to-50% permanent hair loss. The evolution of the laser use for hair removal continues a year after Food and Drug Administration (FDA) approval of the first laser for these applications. The authors have experienced hair removal utilizing a long-pulsed alexandrite laser. This laser system employs the principle of thermokinetic selectivity, a revolutionary concept. The principle of thermokinetic selectivity involves the use of lasers with pulse durations below the thermal relaxation on a the large target such as the hair folllicle (40-100 msec), and significantly longer than the thermal relaxation time of smaller structures of the same chromophore (melanin) in epidermis (3-10 msec). The study was based on 76 patients treated with 20 msec pulse duration laser set to energy densities of 17-21 J/cm2. Treated areas included arms, legs, beard-chin, upper lips and bikini lines. Gross observation showed leaching of hair color, decresed size of the skin pores, easily broken hair shafts, and elimination of hair. Therefore, it can be assumed that the majority of hair follicles were destroyed by this procedure, Side effects included intermediary risk of hyperpigmentation and blister. Over 80% of treated patients were satisfied with the results. As the process of research and clinical application continues, we need the long-term results of this laser system to ensure its efficacy.
Arm ; Blister ; Dermatitis, Contact ; Drug Therapy ; Electrolysis ; Endocrine System Diseases ; Epidermis ; Hair Color ; Hair Follicle ; Hair Removal ; Hair* ; Heredity ; Humans ; Hyperpigmentation ; Lasers, Solid-State* ; Leg ; Lip ; Relaxation ; Skin ; United States Food and Drug Administration

Thirty five male Sprague-Dawley rats were treated with cadmium chloride solution ranging from 0.2 to 3.2mg CdCl2/kg by intravenous single injection. At 48 hours after administration of cadmium, total cadmium, MT bound cadmium and histopathologic finding in liver, kidney, lung, heart, testis, metallothionein in liver, kidney and total cadmium in blood were examined. Tissue cadmium concentration was highest in liver, followed by in kidney, heart, lung and testis. Cadmium bound to metallothionein(MT-Cd) and ratio of MT-Cd to total cadmium were increased in liver and kidney dependently of cadmium exposure dose, but not significantly changed in other organs. On histopathologic finding, the most susceptible organ was heart in considering cadmium exposed dose, but testis in considering cadmium concentration. Blood cadmium concentration was increased with dose-dependent pattern, and significantly correlated with tissue cadmium concentration, so that we may estimate tissue cadmium concentration by measurement of blood cadmium concentration. Metallothionein in liver and kidney was increased with dose-dependent pattern, higher in liver than in kidney, and was significantly correlated with tissue cadmium concentration. However, metallothionein induction efficiency of tissue cadmium(microgram MT/microgram Cd) was greater in liver than in kidney, and reverse to tissue concentration or exposed dose of cadmium.
Animals ; Cadmium Chloride ; Cadmium* ; Heart ; Humans ; Kidney ; Liver ; Lung ; Male ; Metallothionein* ; Rats* ; Rats, Sprague-Dawley ; Testis

With with use of Tono-pen, we investigated the degree of reduction in intraocular pressure of the Honan intraocular pressure reducer(HIPR) with preoperative use of dichlorphenamide and mannitol or without. Seventy five patients scheduled for cataract surgery were divided into 4 groups by preoperative medication. Intraocular pressure was measured before preoperative medication and in process of time after external compression with the Honan intraocular pressure reducer(HIPR) following retrobulbar injection. There was no additive effect on the reduction of intraocular pressure with the preoperative use of dichlorphenamide and mannitol. A rapid initial reduction in intraocular presure over the first 5 minutes of compression was followed by a more gradual reduction from 5 to 20 minutes. We concluded that the compression of up to 20 minutes duration without the preoperative use of dichlorphenamide and mannitol is adequate.
Cataract* ; Dichlorphenamide ; Humans ; Intraocular Pressure* ; Mannitol ; Premedication*

OBJECTIVES: The purpose of this study was to find the protective effects of garlic on the halogenated hydrocarbon induced hepatotoxicities, and the possible protection mechanisms involved. METHODS: Male Sprague-Dawley rats received garlic (0.5 %) or regular diet, for 4 weeks. This was followed by a single dose of corn oil (the controls), carbon tetrachloride (400mg/kg body weight) and trichloroethylene (2,000mg/kg body weight) being administered to each diet group. Blood samples were collected 24 hours following the administration, and the serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities measured. The liver samples were studied for their cytochrome P450 and CYP2E1 contents, lipid peroxidation and histopathology. RESULTS: The results for the group receiving the 0.5 % garlic diet showed a slight decrease of CYP2E1 expression compared with the regular diet group. Carbon tetrachloride was significantly decreased the CYP2E1 contents in both the regular and garlic diet groups, but the trichloroethylene remained unchanged. Garlic did not decrease the lipid peroxidation of the liver in the control group, but attenuated the increase of lipid peroxidation caused by carbon tetrachloride. Garlic attenuated the increase of both the serum AST and ALT activities caused by carbon tetrachloride. The histopathological observations also showed that garlic attenuated centrilobular necrosis and vacuolar degenerative changes significantly in the carbon tetrachloride treated group. Conclusions : The results indicate that garlic attenuates the carbon tetrachloride-induced hepatotoxicity, through the prevention of the metabolic activation and lipid peroxidation.
Alanine Transaminase ; Aspartate Aminotransferases ; Biotransformation ; Carbon Tetrachloride ; Carbon* ; Corn Oil ; Cytochrome P-450 CYP2E1 ; Cytochrome P-450 Enzyme System ; Diet ; Garlic* ; Humans ; Lipid Peroxidation ; Liver ; Male ; Necrosis ; Protective Agents ; Rats, Sprague-Dawley ; Trichloroethylene

OBJECTIVES: Cadmium (Cd), a toxic and non-essential metal, is recognized as a human carcinogen, which has a tendency to accumulate in the human body. The levels of Cd in renal cortex and liver are good indicators as an index of Cd exposure in the general population. In this study, we present an estimation of reference Cd levels in tissue (renal cortex and liver) and total body burden in the general population of Korea. MEDTHODS: Cd and zinc (Zn) were analyzed in renal cortex and liver from 254 autopsies (male : 188 cases, female : 66 cases) aged 0 to 87 years. RESULTS: Geometric mean concentration of Cd was 27.4 and 3.1 ua/g wet weight in renal cortex and liver, respectively. The level of Zn in renal cortex and liver was 35.4 and 42. 6 v/g wet weight, respectively. The result suggests that kidney is the target organ for Cd accumulation. The accumulation of Cd in renal cortex was age-dependent with a biphasic pattern. The level of Cd in renal cortex increased with age up to the fifties, and then leveled off thereafter. Based on the data, the regression model for Cd accumulation in renal cortex by age is predicted by : Log KCd = 0. 2325 + 0. 0553 Age 0. 0005 Age. The highest Cd accumulation in renal cortex of Koreans was estimated at 43. 3 ua/g wet weight at 50. 8 years old. In addition, the total Cd body burden by age was estimated by the following equation: Total Cd Body Burden = -4. 5948 + l. 2278 Age - 0. 0121 Age. The highest body burden of Cd was estimated at 26. 5 mg at age 50. 7 years in the Korean general population. The positive correlation between Zn and Cd was observed in renal cortex and liver. CONCLUSIONS: The level of Cd exposure in Korean was found to be lower than in Japanese, but same as or higher than in American and Europeans.
Asian Continental Ancestry Group ; Autopsy ; Body Burden ; Cadmium* ; Child ; Female ; Human Body ; Humans ; Kidney Cortex ; Kidney* ; Korea ; Liver* ; Reference Values* ; Zinc

No abstract available.
Tissue Expansion Devices*

A case of Fetus-in-fetu is reported. The patient was a 8 month-old-boy with a tumor in the left upper retroperitoneum. The characteristic feature of the specimen consisted of vertebral column including pelvis, both upper and lower extremities, neural canal and brain tissue, and well formed large intestine.