Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type III peptide levels of proliferative scar tissue before and after explanting. The procollagen type III peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.
Animals* ; Biology ; Catheters ; Cell Proliferation ; Cicatrix* ; Cicatrix, Hypertrophic ; Collagen Type III ; Fibroblasts ; Humans ; Keloid ; Models, Animal* ; Rats ; Rats, Nude

BACKGROUND: The appropriate procedures and equipment for the pretransfusion test are fundamental to a safe blood transfusion. The present study aimed to assess the current status of procedures and equipment for pretransfusion tests at small- and medium-sized medical institutions, as well as to use this basic raw data to better manage blood transfusions at these institutions. METHODS: Offline and online questionnaire surveys were performed at institutions that used between 24 and 1,000 units of blood products in 2014. A total of 338 institutions participated, and the survey results were subsequently analyzed. RESULTS: Among 307 institutions where on-site ABO blood typing was performed, 15.0%, 2.1%, and 43.5% did not conduct ABO serum typing, RhD typing, and irregular antibody screening tests, respectively, and 12.8% only conducted the saline phase for crossmatching. Moreover, among 338 institutions, only 66.7% of blood banks had centrifuges, 84.5% had 37℃ incubators, 41.1% had slide view boxes; in addition, 66.1% and 18.6% had refrigerators and deep freezers, respectively, for blood storage. CONCLUSION: Certain small- and medium-sized institutions did not have the essential equipment required to operate as blood banks. Moreover, they also needed to improve their testing procedures. To address these issues, the initiation of systematic training programs and the employment of institutional strategies are necessary to enhance testing procedures and equipment, respectively.
Blood Banks ; Blood Grouping and Crossmatching ; Blood Transfusion ; Education ; Employment ; Incubators ; Korea* ; Mass Screening

PURPOSE: To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA). MATERIALS AND METHODS: 15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria. RESULTS: The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection. CONCLUSION: Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.
Cicatrix ; Follow-Up Studies ; Forearm ; Humans ; Nails ; Pronation ; Radius ; Range of Motion, Articular ; Supination ; Ulna

It has been emphasized that continuous monitorings of arterial pressure, central venous pressure, electrocardiogram, blood gas analysis, serum electrolytes, body temperature, hematacrit and urinary output are mandatory for the anesthetic management of pheochromocytoma. In addition, it is necessary for the anesthetists to understand pharmacologic effects of drugs which influence the peripheral vascular tone and cardiac excitability. We experienced recently anesthetic management of two cases of pheochromocytoma; one raised problems of ventricular arrhythmias and hypertension that aggravated nature of arrhythrmias by increasing blood pressure and responded favorably to treatment with propranolol and trimetaphan. Tumor of this case originated from abdominal aortic wall. The other was managed by injection of d-tubocurarine which induced narrowing of pulse pressure by depletion of increasing systolic pressure and accompanied tachycardia without cardiac decompensation. We have reported proper anesthetic managements of two cases of pheochromocytoma with N2O O2-halothane anesthesia and reviewed literatures in discussion.
Anesthesia ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Gas Analysis ; Blood Pressure ; Body Temperature ; Central Venous Pressure ; Electrocardiography ; Electrolytes ; Hypertension ; Pheochromocytoma* ; Propranolol ; Tachycardia ; Trimethaphan ; Tubocurarine

Transient symptomatic zinc deficiency (TSZD) is clinically similar to acrodermatitis enteropathica. The patients are experienced dermatitis on periorifice and extremities, alopecia, diarrhea, growth retardation, anemia, delayed wound healing and infection. They showed a characteristically rapid response to zinc supplement without recurrence. We report 3 cases of TSZD infants, 2 premature infants with inadequate zinc supply and 1 mature infant with chronic diarrhea.
Acrodermatitis ; Alopecia ; Anemia ; Dermatitis ; Diarrhea ; Extremities ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Recurrence ; Wound Healing ; Zinc*

OBJECTIVE: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. METHODS: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery). RESULTS: Among all the 2617 THI patients, total number of pediatric patients was 256. The average age of the subjects was 9.07 (standard deviation±6.3) years old. The male-to female ratio was 1.87 to 1 and male dominance increases with age. The most common cause for trauma were falls and traffic accidents. Age (p=0.007), surgery (p<0.001), mechanism of trauma (p=0.016), subdural hemorrhage (SDH) (p<0.001), diffuse axonal injury (DAI) (p<0.001) were statistically significant associated with severe brain injury. CONCLUSION: Falls were the most common cause of trauma, and age, surgery, mechanism of trauma, SDH, DAI increased with injury severity. There is a critical need for effective fall and traffic accidents prevention strategies for children, and we should give attention to these predicting factors for more effective care.
Accidental Falls ; Accidents, Traffic ; Brain Injuries* ; Cause of Death ; Child ; Craniocerebral Trauma ; Developed Countries ; Diffuse Axonal Injury ; Epidemiology* ; Female ; Glasgow Coma Scale ; Hematoma, Subdural ; Hospitals, University ; Humans ; Korea ; Male ; Mortality* ; Pediatrics ; Republic of Korea ; Trauma Centers

Hemobilia is defined as hemorrhage into the biliary tract, and the patients with hemobilia present with abdominal pain, jaundice and gastrointestinal bleeding. The causes of hemobilia are traumatic or operative injury to the liver or bile ducts, intraductal rupture of the hepatic abscess or aneurysm of the hepatic artery. Cholecystitis can also develop in patients with hemobilia. Polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of the small and medium-sized muscular arteries and patients with this illness may present with fever, sweats, weight loss, severe arthralgia and myalgia. Mesentery artery involvement that can result in gastrointestinal hemorrhage, bowel infarction and perforation is rare, yet very serious in patients with PAN. We report here on a rare case of PAN that presented as hemobilia due to rupture of a hepatic arterial aneurysm.
Abdominal Pain ; Aneurysm ; Arteries ; Arthralgia ; Bile Ducts ; Biliary Tract ; Cholecystitis ; Fever ; Gastrointestinal Hemorrhage ; Hemobilia ; Hemorrhage ; Hepatic Artery ; Humans ; Infarction ; Jaundice ; Liver ; Liver Abscess ; Mesentery ; Polyarteritis Nodosa ; Rupture ; Sweat ; Vasculitis ; Weight Loss

PURPOSE: The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. In order to satisfy that goal, variable reduction mammaplasty methods are performed, however, two methods such as vertical reduction method and inverted T-scar method are currently most used. We compared indications and advantages of the two methods and set up useful guidlines. METHODS: For 15 years from 1995 to 2010, we experienced 84 patients(162 breasts). We performed vertical reduction method as Lejour's superior pedicle technique(45 patients) and inverted T-scar method as Goldwyn's inferior dermal flap technique(39 patients). We evaluated the result of the operation comparing patient's age, amount of resected tissue, complications and post-operative scars of the two methods. RESULTS: The mean age was 36 years and the vertical reduction group was 3 years younger than inverted T-scar group. The mean breast tissue resection amount per one breast, inverted T-scar group(712 gm) was lagger than vertical reduction group(395 gm). CONCLUSION: There is no ideal method for reduction mammaplasty until now. However, we suggest that guide line, the vertical reduction method is effective for minimal and moderate macromastia in young and middle aged women and inverted T-scar method is appropriate for severe macromastia with ptosis in elderly women. Recently, all procedures tried shorter and smaller scar on the vertical line as small I, J or L shape scar, and inframammary fold as short inverted T-scar.
Aged ; Breast ; Cicatrix ; Female ; Humans ; Hypertrophy ; Mammaplasty ; Middle Aged

ENoG is the objective electrophysiologic measurement of the muscle compound action potential(CAP) to assess the rate of degenerated nerve fibers. However, occasional discorrelation with clinical findings may diminish the utility of the ENoG. So, we studied the significance of recording electrode placement, which is considered to affect the result of the ENoG. We performed the interside variance in 20 healthy adults(20 males) volunteers and retest was performed in 6 adults of 20 volunteers. The recording electrode was placed at 3 positions.(whole nasolabial fold(A), 2 / 3 of the nasolabial fold(B), 1 / 2 of the nasolabial fold(C)) And then we compared the results: 1) In the first measurement, the mean CAP was 3.02+/-0.98mV(A), 2.80+/-0.75mV(B), 2.56+/-0.57mV(C) on the right side, 2.70+/-1.02mV(A), 2.50+/-0.90mV(B), 2.33+/-0.86mV(C) on the left side, and there was no significant difference between right and left inter-side amplitude(p>or=0.05). 2) In the first measurement, the mean interside variance(ISV) was 32.7%(37.55+/-16.32%(A), 29.88+/-17.15%(B), and 30.67+/-18.56(C)) and there was no significant difference among them(A, B, C)(p>or=0.05). The minimal individual ISV was 20.35+/-12.44%. There was significant difference between it and the other individual 3 positions(p<0.05). 3) In the second measurement, the mean test-retest variability was 17.78%(A: 18.62+/-3.70%, B: 18.50+/-3.10%, C: 16.22+/-4.95%). There was no significant difference among them(p>or=0.05). The minimal individual ISV was varied in each testing at 3 positions. And the value was 14.32+/-2.69%. There was no significant difference between it and other 3 postions(p>or=0.05). So we recommand that the recording electrode may be fixed at the bilateral same position of the nasolabial fold. But if there is any indication of facial nerve decompression, you must find the best recording electrode position to get the minimal ISV before operation.
Adult ; Decompression ; Electrodes* ; Facial Nerve ; Humans ; Nasolabial Fold ; Nerve Fibers ; Volunteers

Thoracic outlet syndrome is a relatively well known disease. Other than trauma, this disease is mostly caused by anatomical structures that cause vascular or neural compression. The cause of thoracic outlet syndrome is diverse; however, there are only few reports of thoracic outlet syndrome caused by lipoma in the pectoralis minor space. We report a case of compression of the lower trunk of brachial plexus in which a large lipoma that developed in the pectoral minor space grew into the subclavicular space, along with a review of literature.
Brachial Plexus ; Lipoma ; Nerve Compression Syndromes ; Thoracic Outlet Syndrome