BACKGROUND: Trisomy 16 in mice is considered to be an animal model for Down's syndrome in human. We studied the morphologic characteristics of the heart and the edema, and their significance to the teratogenesis in this animal model. METHODS: A total of 30 dams were sacrificed to bear 125 (61.9%) normal fetuses 35 (17.3%) abnormal fetuses and 42 (20.8%) resorptions. Cytogenetic study and morphological examination were performed using microdissection agar-mount sectioning histologic examination and scanning electron microscope. RESULTS: The crown-rump length was significantly shorter in abnormal (trisomic fetuses) than the normal (eusomic) fetuses. Trisomic fetuses showed massive edema at the back from the vertex to the lumbar area. Four-chamber view section of the agar-mount and histologic section showed a common atrioventricular valve bridging the left and the right atrioventricular junction. Scanning electron microscopic examination on atrioventricular valves showed three types of atrioventricular valves:five cases with common atrioventricular orifice, three cases with partitioned atrioventricular orifice and two cases with atresia of the right atrioventricular orifice. CONCLUSION: This study confirmed the presence of massive edema and cardiac anomalies in the mouse with trisomy 16. But there was morphologic diversity of cardiac anomaly in this model.
Animals ; Crown-Rump Length ; Cytogenetics ; Down Syndrome ; Edema* ; Endocardial Cushion Defects ; Fetus* ; Heart ; Humans ; Hydrops Fetalis ; Mice ; Microdissection ; Models, Animal ; Pathology* ; Teratogenesis ; Trisomy*

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

No abstract available.

BACKGROUND: Xerosis is a relatively common disorder, especially in the elderly. The condition is characterized by fine scaling and is associated with generalized pruritus. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy, safety and tolerability of Zalsming cream in patients with xerosis and pruritus. METHODS: Thirty patients were treated with Zalsming cream. Clinical efficacy, as measured by the score of subjective symptom and objective signs, transepidermal water loss(TEWL) and electron microscopic finding, were asessed at 2, 4, and 6 weeks after topical application of the cream. RESULTS: The scores of clinical signs and TEWL showed statistically significant improvements. No one developed any local or systemic side effects. CONCLUSION: Topical application of Zalsming cream was found to be effective and safe for patients suffering from xerosis and pruritus.
Aged ; Humans ; Pruritus*

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

OBJECTIVE: We analyzed the clinical features of amniotic fluid embolism confirmed by autopsy or clinical dicision for making a plan of rapid diagnosis and intensive emergency care. STUDY DESIGN: We experienced 2 clincal cases in Ewha Mokdong Hospital and Severance Hospital at 1995, and reviewed the medical record & autopsy report of 15 cases in National Institute of Scientific Investigation from Jan, 1991 to Dec, 1995. RESULTS: The mean maternal age was 31+/-3 years. The mean gestational age was 40+/-1 weeks. The number of delivery were 1.4+/-0.8. The number of abortion history. were 2.6+/-2. The sexuality of fetus were six males (35 %), five females (29%), and unknown six cases (35 %) and the fetal mortality rate was 29 % (5 cases). The initial clinical symptoms and signs were hypotension (12 patients, 71%), vaginal bleeding(ll patients, 65%), cardiac arrest (6 patients, 35 %), dyspnea (5 patients, 29 %), and seizure (2 patients, 12%). In the case of normal spontaneous vaginal delivary (NSVD), the symptoms occurred during induction in 3 (18%), during delivery in 1 (6%), and after delivery in 9 (53%). In the case of Cesarean section, the symptoms occurred during section in 2 (12%), and after section in 1 (6%). There are one case whose symptoms occurred during 3rd gestational period. CONCLUSIONS: We should alert for the amniotic fluid embolism in the clinical findings of acute collapse and vaginal bleeding, respiratory symptoms, and seizure at any peripartum. With eary suspicion of this disease and aggressive intensive care we can reduce amniotic fluid embolism mortality rate and it's legal problem.
Abortion, Induced ; Amniotic Fluid* ; Autopsy ; Cesarean Section ; Diagnosis ; Dyspnea ; Embolism, Amniotic Fluid* ; Emergency Medical Services ; Female ; Fetal Mortality ; Fetus ; Gestational Age ; Heart Arrest ; Humans ; Hypotension ; Critical Care ; Male ; Maternal Age ; Medical Records ; Mortality ; Peripartum Period ; Pregnancy ; Seizures ; Sexuality ; Uterine Hemorrhage

PURPOSE: The purpose of this study was to identify the nursing images appearing in elementary school textbooks. METHOD: This study targeted 130 textbooks of 13 subjects under the 7th national curriculum for elementary schools as of December 2005. Nursing-related texts, photographs, and illustrations in the textbooks were analyzed by using a content analysis method. As for the textbook analysis, two coders thoroughly read the textbooks to record nursing-related content per coding paper, respectively. RESULT: The total number of nursing-related content appearing in 130 textbooks of 13 subjects was 70. More nursing-related content was exhibited in the photograph and illustration domain(N=57, 81.4%) than in the text domain(N=13, 18.6%). Nursing-related content(N=70) appeared in the order of nursing activities with 56(80.0%), nursing as a job with 10(14.3%), and others with 4(5.7%). As for the nursing image of nursing-related content, positive images weremost with 30(42.9%), followed by negative images with 21(30.0%), and neutral images with 19(27.1%). CONCLUSION: Nursing-related content was dealt with too little, and dependent nursing activities such as medication, and assisting roles for doctor's examinations and treatments mainly appeared. Also, the main activity place was a hospital. To introduce proper and adequate nursing activities to the students, various types of nursing-related data and material should be distributed to front line schools, teachers, main authors, and publishing companies.
Child ; *Curriculum ; Humans ; *Nursing ; Prejudice ; *Schools ; *Textbooks as Topic

To evaluate usefulness of MR in assessment of tumor response to the chemotheraphy, we prospectively studied cases of cervical carcinoma with more then 2.5cm in diameter or stage IIb or more. Three courses of chemotherapy were performed with cisplatin and 5 F-U. MR images were obtained both before and after chemotherapy. Nine of 13 patients were undertaken radical hysterectomy after chemotherapy and MR examination. MR volumetry, stage and depth of stromal invasion were compared before and after chemotherapy. And in 9 patients who underwent radical hysterectomy, comparison of pathologic and MR imaging findings were also done. @ES The results were following. @EN 1) All tumors dectrased in volume (m=80.5%). 2) Five tumors (38.5%) reduced in stage, IB→CIS(1); IIA→CIS(1), IIA→IB(2), IIB→IB(1). 3) Depth of stromal invasion in MRI correlated well with that of histo-pathologic specimen in 7 of the 9 patients. Conclusively MR imaging is useful in assessement of tumor response to chemotherapy.
Cisplatin ; Drug Therapy* ; Humans ; Hysterectomy ; Magnetic Resonance Imaging* ; Prospective Studies

We describe an unusual case of cysticercosis in soft tissue. On US, a well-defined oval shaped cystic lesionwith an inner central hyperechoic portion was noted. This portion showed high signal intensity on T1-weightedimages and equivocal enhancement. On MRI, other portions of the lesion showed their cystic nature. Pathologicexamination confirmed the presence of cysticercosis and, in particular, the central portion was found to be amural nodule with scolex. Cysticercosis in the soft tissue and musculature of patients from endemic areas shouldthus be considered in the differential diagnosis of an incidental mass, especially when this is cystic and has aninner central nodule.
Cysticercosis* ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Parasites

Periprosthetic fractures after total hip arthroplasty or hemiarthroplasty are an uncommon complication. These fractures have problems of fixation of fracture and stability of the femoral component. Ipsilateral femoral fractures after hip arthroplasty occurred in 14 cases (11 patients) out of 510 hip arthroplasties performed between January 1985 and May 1996. These fractures occurred at an average of 3 years and 6 months after primary hip arthroplasty. These fractures were classified by Johansson classification. Nine fractures were treated with plate and cerclage wires. Four fractures were treated with skeletal traction. Bone graft was applied to the fracture site in 9 fractures which were treated by open reduction and internal fixation with plate and cerclage wires. Average follow up period was 21 months. The results were as follows. 1. All but three of the fractures had been developed by low energy trauma. Seven patients had osteolytic lesion around femoral component. Of the seven patients who had osteolytic lesions, six patients had periprosthetic fractures which connected with osteolytic lesions. We think that osteolysis is one of the important factors of the periprosthetic fractures after hip arthroplasty. 2. Four cases were treated by skeletal traction. One case had malunion. Progressive subsidence of femoral component was noted after union of fracture in 3 cases. Therefore these periprosthetic fractures which had an osteolysis and subsidence preoperatively should be managed with operative methods. 3. Nine fractures which had treated with plates and autogenous bone graft showed good hip joint function with stable femoral component. We think that stabilization of periprosthetic fractures with plates and cerclage seemed to be a good method for femoral fractures after hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Classification ; Femoral Fractures* ; Follow-Up Studies ; Hemiarthroplasty ; Hip Joint ; Hip* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Traction ; Transplants