No abstract available.
Dexamethasone* ; Psychotic Disorders*

Soft tissue related complications are quite frequent in limb lengthening. Muscle fibers may proliferate or regenerate after stretching injury over 10-20% of their original length. However, the cells which are engaged in this phenomenon are not confirmed yet. We chased the S-phase cells (phase for DNA replication) in the posterior leg muscle during limb lengthening by immunohistochemical technique. We lengthened the tibiae of fifteen New Zealand white rabbits. We divided them into three groups and each group is consisted of five rabbits. In group 1, we lengthened the left tibiae by 10% of their original length, in Group 2, 20%, and in group, 3, 25%, respectively, At the end of lengthening posterior muscles of lengthened left side and of controlled right side were fixed and processed for Immunohistochemical staining which could detect the incorporation of bromodeoxyuridine(BDU). Labelling index(LI:% of positively stained S-phase nuclei) of group 1 was zero. LI of groups for more than 20% lengthening (sum of group 2 and 3) was statistically significant. In conclusion, nuclei around or within the muscle tissue are in S-phase during limb lengthening which means proliferation of the muscle fivers or of the certain cells that abut muscle fibers.
Bromodeoxyuridine ; DNA ; Extremities ; Immunohistochemistry ; Leg ; Muscles ; Rabbits ; Tibia

Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized by hypogonadism or related other congenital anomalies in phenotypic females. In these patients, there are failure to develop normal secondary sex characteristics, amenorrhea, or short stature at puberty and the ovaries are reduced to atrophic fibrous strands devoid of ova and follicles(streak gonads). Individuals with this condition are particularly prone to the development of gonadoblastoma. For this reason, the gonads should be early removed and supplemental estrogen therapy given. We experienced a case of Turner's syndrome, 45, XO/46, XY karyotype in a 20-year-old phenotypic female complained an amenorrhea. On the exploratory laparotomy, the right gonadal mass is sevearly adhered to the adjacent organs and measures 8 x 5 x 5 cm in dimension and 75gm in weight and shows multiple foci of hemorrhage with necrosis. The left streak gonad measures 3.5 x 2 x 1.5 cm in dimension and shows multiple foci of calcification. Microscopically, the right gonadal mass reveals malignant mixed germ cell tumor, composed of endodermal sinus tumor, composed of endodermal sinus tumor with dysgerminoma and gonadoblastoma. The left streak gonad consists of mainly dense fibrous connective tissue and shows some foci of calcification associated with gonadoblastoma. On immunohistochemical and special stainings, the cytoplasm and hyalin droplets of the endodermal sinus tumor component reveal strong positivity to the a-fetoprotein and PAS. After removal of both gonads, the serum level of the a-fetoprotein is markedly down from 1742ng/ml to 2.6 ng/ml.
Female ; Humans

Pleomorphic xanthoastrocytoma is histologically characterized by marked cellular pleomorphism of lipid-laden neoplastic astrocytes and bizarre giant cells showing mitotic figures and high cellularity. Inspite of its ominous-looking microscopic features, howerver, the prognosis is usually favorable. This tumor develops mainly in the supratentorial area of young people and frequently involves the leptomeninges. We experienced a case of pleomorphic xanthoastrocytoma in 18 year-old-male. In addition to the cellular pleomophism, the prominent reticulin fibers surround the individual tumor cells or the tumor cells nests. Immunohistochemical staining and electron microscopy revealed glial fibrillary acidic protein(GFAP) expression and pericytoplasmic basal lamina in the tumor cells.

Distal radioulnar is a part which has a rotational movement through the function of distal radioulnar joint and extensor carpi ulnaris. The injury mechanism in this area is usually a trauma largely due to traffic accidents. In general these injuries to the distal radioulnar joint are treated by a closed reduction. However, the isolated distal ulnar fracture without radial fracture, which is often called the night stick fracture, is difficult to treat by a closed reduction and a cast immobilization alone, especially if there is a displacement or fracture segment impinging soft tissue or severe comminution. Nonunion has been the frequent outcome with this method of treatment and limitation of rotation of forearm and distal radioulnar joint have occurred due to long period of immobilization or malunion. Thus, a different treatment modality such as open reduction and internal fixation and early active joint motion has arisen as a better treatment modality. In this study, 8 cases of isolated distal ulnar fracture without radial fracture have recieved the operation and the early active joint movement, if a displacement was present either at the time of injury or after the initial closed reduction. As a result, this method has enabled the patients to reduce the rate of complication of nonunion and to recover limitation of joint motion in a shorter time period.
Accidents, Traffic ; Forearm ; Humans ; Immobilization ; Joints

Average anteversion of the femur is 15.3 degree. Ultrasound, computerized tomogram, and three dimensional reconstruction from CT or MRI have been used for more accurate measurement of the anteversion. There are two methods in measuing anteversion angle from CT scan:one is by drawing a mid line through long axis of the femoral neck (conventional method). Another is by drawing a line from the center of the head to that of the neck at the base of the trochanter using several cut slices (Murphy’s method). We compared these methods with fluoroscopic measurement of the Anteversion. We traced the change of the anteversion before and after closed femoral intramedullary (IMO) nailing to evaluate the origin of malrotation of the femur. 1. Normal anteversion angles were measured in 15 cases. Average anteversion angle was 6.9 degrees by conventional method, 12.3 degrees by Murphy’s method, and 12.2 degrees by fluoroscope. 2. Anteversion angles were measured after IM nailing in 18 cases. Average was 17 degrees by Murphy’s method and 15.2 degrees by fluoroscope. Mean of difference between these two methods sea 6.3 degrees. That was 1.7 degrees in normal side. 3. Change of the anteversion angle between before and after IM nailing was measured in 17 cases by fluoroscope. Average anteversion angle before the operation was 11.9 degrees and it was change to 15.8 degrees after operation. Mean of these change was 7.1 degrees. 4. Pereperative traction provides important information on change of anteversion. Reduction excessive flexion of proximal fragment was a origin of change of anteversion during nailing procedure. Conclusion : Malrotation of the femur after IM nailing must be keep in mind and it may be preventable by fluoroscopic control of the rotation in nailing procedure.
Femur ; Femur Neck ; Fracture Fixation, Intramedullary ; Head ; Magnetic Resonance Imaging ; Methods ; Neck ; Traction ; Ultrasonography

No abstract available.
Pulmonary Blastoma*

The reconstruction of soft tissue defects with open fracture around the knee joint is limited by its unique location. Free tissue transfer is hindered by the selection of the recipient vessel and problems of microsurgery. The arc of rotation, defect size, and location must be taken into consideration in the use of regional muscle transfer such as gastrocnemius. According to Mathes et al, the flap survival can be enhanced by selective division of the dominant segmental pedicles, only a part of which can normally be transposed safely on its minor segmental pedicle. Neovascularization, vascular proliferation, and dilatation have also been produced by the delay procedure using silicone sheets. The authors have used the delay procedures with wrapping of the gracilis or sartorius muscle which enabled distally-based transposition of these muscles. The method showed satisfactory outcome in resurfacing the wound around the knee joint. The indictions for this procedure were defects of moderate size and those difficult to reach with conventional muscle flaps. The flap could reach the upper one-third of the lower leg. Other merits are relative simplicity and reliability without significant extension of hospital stay. The drawbacks are the two operative procedures necessary and the risk of infection due to silicone sheets.
Dilatation ; Fractures, Open ; Knee Joint* ; Knee* ; Leg ; Length of Stay ; Microsurgery ; Muscles ; Silicones ; Surgical Procedures, Operative ; Wounds and Injuries*

BACKGROUND: Atopic dermatitis (AD) is primarily influenced by environmental factors including exposure to pollutants and indoor allergens (particularly, house dust mites). Al-though house dust mite antigens are the most prevalent components of indoor allergens in Korea, cockroaches also can be considered to act as an important allergen. OBJECT: This study was done to evaluate the differences in three different atopic patch test (APT) techniques, and the relationship between APT and skin prick test, total IgE, and specific serum IgE level using cockroach allergen. Methods: We performed patch test in 57 patients with AD and 30 normal controls on clinically lesional and normal appearing skin with German cockroach (GC) allergens (extract, as is) in three different techniques (standard, scratch, DMSO). Reactions were evaluated after 48hours, and compared with the results of skin prick test, total and specific IgE levels. Detailed atopy history and severity scoring were taken. RESULTS: In the GC (whole body) prick test positive group, there was 1263.02 IU/ml of total IgE, and this amount was significantly higher than GC (whole body) prick test negative group who had 549.46 IU/ml (P<0.05). The positive reaction rate to whole body of American cock-roach (AC) was significantly higher in the patient group than control group (p<0.05), but the positive rate to whole body of GC was high, but not significantly high in the patient group (p=0.053). There were significant differences in positive patch test reactions to either Ext or As is between patient group and control group (p<0.05). The positive rate to As is was significantly higher than to Ext in either lesional skin or non-lesional skin in patient group (p<0.05). But there were no considerable differences in positive reactions to either Ext or As is between 3 different methods (standard, scratch, DMSO mix) in both lesional and non-lesional areas (p>0.05). There was no significant relationship between the positive reactions to patch test and prick test to Ext and As is antigen. The APT results showed no significant concordances with skin prick test and RAST for cockroach antigens. CONCLUSIONS: APT seems to be a different dimension of atopic skin inflammation and may pro-vide further diagnostic information in addition to a patient's history, skin prick test, and RAST results.
Allergens ; Blattellidae ; Cockroaches* ; Dermatitis, Atopic* ; Dimethyl Sulfoxide ; Dust ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Inflammation ; Korea ; Patch Tests ; Pyroglyphidae ; Skin

This study was undertaken to know the extent of apoptosis, expression of bcl-2 and proliferating cell nuclear antigen (PCNA) in uterine cervical intraepithelial neoplasia (CIN; 15 cases) and invasive carcinoma (27 cases) and to evaluate them as a prognostic marker. Apoptosis was analysed by using the in situ apoptosis detection kit and bcl-2 and PCNA were detected by the immunohistochemical method. The results were as follows: Apoptotic indices (AI) in the invasive carcinoma (mean: 4.3) were 10-times higher than that in the CIN (mean: 0.43). Bcl-2 was expressed 60% of the cases in the dysplastic cells of the CIN II and CIN III, 33.3% of cases in the invasive carcinoma and not expressed in the CIN I except basal cells. The expression of the PCNA was increased by the grades of CIN and was strong in invasive carcinoma. The mean survival time of the patient with invasive carcinoma was significantly decreased in the higher AI index (above 4.3) than in the lower AI index (below 4.3). There was no significant correlation between the extent of apoptosis and the expression of bcl-2. According to the above results, AI are able to be used as an independent prognostic marker in the invasive cervical carcinoma, and bcl-2 and PCNA have an important role in the tumorigenesis of uterine cervical carcinoma.
Apoptosis* ; Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Humans ; Proliferating Cell Nuclear Antigen* ; Survival Rate