The authors performed microsurgical reconstruction by free cutaneous or myocutaneous flaps transfer in 104 cases, who were sustained of extensive soft tissue injuries on their extremities by accident. These 104 cases were operated in 6 years from 1980 to 1986 and were consisted of 47 cases of latissimus dorsimyocutaneous free flaps, 36 cases of scapular free flaps, 18 cases of dorsalis pedis sensible free flaps, and 3 cases of groin flaps. Most of them were males(80 cases) and were in third decade(28 cases). The youngest case was 2-year-old baby and the oldest one was 76-year-old woman. The traffic accident was the most frequent cause of injuries(55 cases), and the others were burn, industrial injuries, and cultivator accidents. Most of the microsurgical reconstruction were performed in lower extremity injuries(81 cases), especially below the ankle joints(65 cases). The average dimension(width and length) of free flaps were 7.3×14.3cm in latissimus dorsi free flaps, 5.6×8.2cm in scapular free flaps, and 4.5×5.9cm in dorsalis pedis free flaps. The dorsalis pedis free flaps were successful in 100%, the scapular free flaps were in 83.3%, the latissimus dorsi myocutaneous free flaps were in 89.4%, and the groin free flaps were in 33.3%, And the overall viability of 104 free flaps was 87.5%.
Accidents, Traffic ; Aged ; Ankle ; Burns ; Child, Preschool ; Extremities ; Female ; Free Tissue Flaps ; Groin ; Humans ; Lower Extremity ; Myocutaneous Flap ; Soft Tissue Injuries ; Superficial Back Muscles

Endometrial papillary serous carcinoma (EPSC) is a distinct variant of endometrial adenocarcinoma that histologically resembles ovarian serous papillary adenocarcinoma and has an aggressive clinical course. Usually, the tumor is diagnosed at the advanced stage. The tumor has well confused with metastatic ovarian tumor of identical histology. Dignosis of EPSC should be considered when the cervico-vaginal smear reveals numerous papillary clusters of tumor cells with macronucleoli and psammoma bodies. Recently, we have experienced two cases of EPSC diagnosed on cervico-vaginal smears, which revealed characteristic cytologic features including numerous papillary clusters of tumor cells with macronucleoli. The cytologic diagnoses were confirmed on histologic sections.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Diagnosis ; Polycystic Kidney, Autosomal Recessive*

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

No abstract available.

The Mayer-Rokitansky-K ster-Hauser syndrome represents a spectrum of m llerian anomalies, including vaginal agenesis with or without renal anomalies, in genotypically and phenotypically normal female subjects with normal endocrine status. We experienced a case of this anomaly which combined with unilateral renal agenesis and pelvic cystic mass in child.
Child* ; Female ; Humans

BACKGROUND: Blowout fracture is one of the most common facial fractures, and patients usually present with accompanying ocular complications. Many studies have looked into the frequency of persistent ocular symptoms, but there is no study on assault patients and related ocular symptoms. We evaluated the incidence of residual ocular symptoms in blow-out fractures between assaulted and non-assaulted patients, and sought to identify any connection among the degree of enophthalmos, defect size, and assault-related injury. METHODS: A retrospective review was performed for any patient who sustained a unilateral blowout fracture between January 2010 to December 2014. The collected data included information such as age, gender, etiology, and clinical ocular symptoms as examined by an ophthalmologist. This data was analyzed between patients who were injured through physical altercation and patients who were injured through other means. RESULTS: The review identified a total of 182 patients. Out of these, 74 patients (40.7%) have been struck by a fist, whereas 108 patients (59.3%) have sustained non-assault related injuries. The average age was 36.1 years, and there was a male predominance in both groups (70 patients [94.6%] in the assaulted group and 87 patients [80.6%] in the non-assault group). Diplopia and enophthalmos were more frequent in patients with assault history than in non-assaulted patients (p <0.05). Preoperatively, 25 patients (33.8%) with assault history showed diplopia, whereas 20 patients (18.5%) showed diplopia in the non-assaulted group (p <0.05). Preoperative enophthalmos was present in 34 patients (45.9%) with assault history, whereas 31 patients (28.7%) showed enophthalmos in the non-assaulted group (p <0.05). CONCLUSION: Patients with an assault history due to a fist blow experienced preoperative symptoms more frequently than did patients with non-assault-related trauma history. Preoperative diplopia and enophthalmos occurred at a higher rate for patients who were assaulted. Surgeons should take into account such characteristics in the management of assaulted patients.
Diplopia ; Enophthalmos ; Humans ; Incidence ; Male ; Orbital Fractures ; Retrospective Studies ; Surgeons ; Violence

Nonpalpable breast abnormalities which require excision and biopsy usually require marker localization. Many of these abnormalities are visible on ultrasound and this imaging technique can be used to guide fine needle aspiration and the placement of a wire marker prior to surgical excision. A non-invasive technique which does not require placement of a wire marker would offer significant advantages, being more pleasant for the patient and less demanding on resources. We attempted to localize 36 nonpalpable breast masses with non-invasive ultrasound marker technique at the department of general surgery, Soon Chun Hyang University Hospital, between January 1994 and February 1995. Cases clearly visible on ultrasound, whether on mammography(15 patients) or not(17 patients), underwent non-invasive ultrasound localization. In all cases the abnormality was easily identified and removed during surgery. The surgical biopsies contained fibroadenoma(19 cases), fibrocystic disease(12 cases), epithelial hyperplasia(1 case), intraductal papilloma(1 case), parasitic disease(1 case) and infiltrating ductal carcinoma(2 cases). The average age was 43 years old.. This non-invasive technique is a simple and accurate method for localizing small ultrasonically visible nonpalpable breast abnormalities, especially in younger female patient with dense breast, though further trials and studies will be attempted.
Adult ; Biopsy* ; Biopsy, Fine-Needle ; Breast* ; Female ; Humans ; Ultrasonography*

In order to investigate the efficacy and safety of oral cilazapril, a new angiotensin converting enzyme inhibitor, on essential hypertension, a single daily dose of 2.5 to 5.0mg cilazapril was administered in 30 hypertensive patients with diastolic blood pressure in the range of 95??15mmHg while off all other anti-hypertensive agents for 10 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete blood count with platelet count, blood chemistry by SMA-12 including lactic dehydrogenase and serum electrolytes, and urinalysis were performed at 4th and 10th week of therapy. The electrocardiography was performed at the beginning and the end of treatment period. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) The mean age was 49.2 years, and the ratio of male-to-female was 1 : 1.3. 2) Blood pressure started to fall significantly within 2 weeks of treatment with cliazpril 2.5mg(M+/-S.E., 15.4+/-17.4mmHg vs 138.5+/-23.3, 100.3+/-6.2 vs 89.4+/-6.6, p<0.05), and after 6 weeks of treatment with a mean dosage of 2.84mg. diastolic blood pressure of all subjects was maintained below 90mmHg throughout the rest of trial. 3) Pulse rate or body weight were not significantly changed during the entire treatment period(69.3+/-6.0/min vs 10th week : 69.0+/-7.7, 64.7+/-7.4kg vs 63.6+/-6.7, p>0.05). 4) There were no significant changes in blood chemistry including blood sugar, cholesterol and electrolytes, except mild changes of serum creativine and alkaline phosphatase values. 5) Hematologic findings, urinalysis and electrocardiographic findings remained unchanged. 6)Side effects were mostly mild in nature without potentially serious episodes(dry cough : 20%, indigestion, headache, dizziness, in order), but there was 1 cases in whom the dosage was redyced due to postural hypotension. From the above results, cilazapril with the dosage of 2.5 to 5.0mg was effectvie and well tolerated in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg, and cilazapril seems to be appropriate for monotherapy of mild to moderate hypertensive patients.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Cell Count ; Blood Glucose ; Blood Pressure ; Body Weight ; Chemistry ; Cholesterol ; Cilazapril* ; Cough ; Dizziness ; Dyspepsia ; Electrocardiography ; Electrolytes ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypotension, Orthostatic ; Oxidoreductases ; Peptidyl-Dipeptidase A ; Platelet Count ; Urinalysis

No abstract available.
Carcinoma, Transitional Cell* ; Tuberculosis, Renal* ; Ureter*

We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.
Humans ; Incidence ; Mandible ; Mouth Neoplasms* ; Osteoradionecrosis ; Osteotomy