BACKGROUND: Epidermis is directly exposed to various external stimuli and protects internal structures. Most studies about skin tension focused on the dermis, and epidermal tension has not been able to attract interest because dermis much thicker than epidermis and dermal collagen fibers play a predominant role in the skin tension. However, circumstances which involve only the epidermis are often shown, and thus it is necessary to study the mechanical property of the epidermis. OBJECTIVE: The purpose of this study is to quantify the role of the epidermis as a mechanical barrier. METHODS: Human epidermal sheets were obtained from suction blisters in 14 patients with vitiligo during epidermal grafting. Maximal tension, that is the power required to break the epidermal sheets, was measured by tensiometer. RESULTS: The maximal tension of the epidermis ranged from 40.0 g/cm² to 84.5g/cm² with a mean values of 56.1g/cm² and did not differ significantly according to the age or anatomical sites. CONCLUSION: The barrier function of epidermis is important and the results are expected to be used as the basic information for other studies about the mechanical property of the epidermis. In addition, this will be important data in developing an artificial skin whose mechanical property is similar to that of the human skin.
Blister* ; Collagen ; Dermis ; Epidermis* ; Humans* ; Skin ; Skin, Artificial ; Suction* ; Transplants ; Vitiligo

Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive, However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles. Reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.
Adhesives ; Ammonium Compounds* ; Ammonium Sulfate* ; Communicable Diseases ; Dust ; Ear Canal ; Ear, Middle ; Facial Nerve ; Fibrin Tissue Adhesive* ; Fibrin* ; Frontal Sinus ; Humans ; Mastoid ; Tympanoplasty

Regardless of the any cause leg ulcers are painful and inconvenient to patients and present clinical and economic problems due to their chronicity. Conventional skin grafts, cultured allogenic epidermis, and cultured autologous epidermis have been used for the treatment of leg ulcers. In a twenty-year-old woman with leg ulcers, autologous pure epidermal sheets were obtained from the lower chest by means of suction blisters and grafted to the leg ulcers. All lesions were healed completely in 20 days after grafting. The donor sites showed slight postinflammatory hyperpigmentations without scars. The autologous epidermal graft using suction blisters appears to be a useful method for the treatment of leg ulcers, with no immunologic rejection, no need for cultivation and anesthesia, no desiccation, and no scars on the donor sites.
Anesthesia ; Blister* ; Cicatrix ; Desiccation ; Epidermis ; Female ; Humans ; Leg Ulcer* ; Leg* ; Methods ; Skin ; Suction* ; Thorax ; Tissue Donors ; Transplants*

Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.
Adult ; Cesarean Section* ; Cicatrix ; Endometriosis* ; Female ; Humans ; Hysterectomy, Vaginal* ; Leiomyoma ; Metrorrhagia ; Pathology ; Pregnancy ; Rare Diseases

Apgar score is most widely used evaluating indicator of newborn health, but it is very subjective. Umbilical cord blood gas analysis is more objective and effective than Apgar score in evaluation of newborn status. Cord blood gas was changed slightly by processing of time after fetal birth. This study was undertaken to observe objectiveness and effectiveness of umbilical arterial blood gas analysis and effects of time interval of cord clamping to newborn health with 122 pregnant women and their babies. We observed following results: 1. There were poor correlation between Apgar score and umbilical cord arterial blood analysis in evaluating of newborn health (P>0.05). 2. There was no clinical significance of Apgar score or umbilical arterial blood gas analysis as single indicator in evaluating of newborn health (P>0.05). 3. Gas analysis and pH of umbilical arterial blood was more helpful in evaluating of newborn health than Apgar score. 4. There were no significant effects of time interval of umbilical cord clamping to newborn health. 5. If there were no indications of early umbilical cord clamping, cord blood sampling at immediately after birth without cord clamping was more effective to evaluate newborn status.
Apgar Score* ; Blood Gas Analysis ; Constriction ; Cordocentesis ; Female ; Fetal Blood ; Humans ; Hydrogen-Ion Concentration* ; Infant Health* ; Infant, Newborn* ; Parturition ; Pregnant Women ; Umbilical Cord

No abstract available.
Clone Cells* ; Cloning, Organism* ; Nucleopolyhedrovirus*

Bacterial endogenous endophthalmitis is a rare, but devastating complication of septicemia.It has occurred in the process of systemic infection and its underlying conditions are Diabetes Mellitus, advanced liver disease and immunosuppressive state or drug abuse. Klebsiella endogenous endophthalmitis is especially rapidly progressive and visual outcome is typically poor. To evaluate the clinical aspect of this disease, particularly predisposing factors, causative microorganism, outcome of therapeutic modality and initial time of therapy, we performed a retrospective study on 9 eyes of 9 patients who had been treated with this diagnosis from September 1988 to January 1999 at Kyung-Hee Medical Center. Mean time between the onset of disease and the initiation of therapy was 4.33 days. Underlying systemic diasease consist of Daibetes Mellitus, advanced liver disease and chronic renal failure [5 patients:DM with advanced liver disease, 3 patients:DM alone, 1 patient:DM with CRF].The visual outcome was poor but it turned out better in two patients compared with initial visual acuity, no change in one patient and worse in six patients. We found that Diabetes Mellitus and advanced liver disease were leading underlying predisposing factors of Klebsiella Pneumoniae and visual outcome was poor despite the various intensive treatments.High index of suspicion and aggressive diagnostic and therapeutic approach might improve visual outcome.
Causality ; Diabetes Mellitus ; Diagnosis ; Endophthalmitis* ; Humans ; Kidney Failure, Chronic ; Klebsiella ; Klebsiella pneumoniae ; Liver Diseases ; Retrospective Studies ; Substance-Related Disorders ; Visual Acuity

Lichen striatus is an uncommon unilateral inflammatory linear papular dermatosis of uncertain etiology. It most commonly affects the extremities and has a self-limiting course. Nail involvement in lichen striatus is a very rare reported finding and is a cause of a deformity of the nail plate. It tends to have a more prolonged course for cutaneous eruptions than disease limited only to the skin. Characteristic histopathological features are important to differentiate this condition from other linear lesions that may interfere with nail growth. Three cases of lichen striatus with onychodystrophy are presented herein.
Congenital Abnormalities ; Extremities ; Lichens* ; Skin ; Skin Diseases

Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate filaments(cytokeratin [CK1, CK7, CK8, CK18, CD19/, vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen(CEA), MHC class II antigen(HLA-DR), LeuM-1(CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin (ACHT), CD68(KP-1) and FcgammaRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients' transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative for CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes\histiocytes (CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothelial cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothelial cells should be further evaluated.
Actins ; Antibodies ; Cytoskeleton ; Desmin ; Exudates and Transudates ; Hot Temperature ; Humans ; Intermediate Filaments ; Keratins ; Liver Cirrhosis ; Mucin-1 ; Muramidase ; Pleural Effusion ; Vimentin

BACKGROUND: Nsocomial candidemia has increased during the last decade. We studied the clinical features, underlying illnesses, risk factors, and outcome of nosocomial candidemia patients. METHODS: We reviewed 137 admitted patients with nosocomial candidemia at Hangang Sacred Heart Hospital from Jan., 1990 to Dec., 1996. RESULTS: The annual occurrence of nosocomial candidemia from 1990 to 1996 was 2, 0, 4, 15, 45, 49, and 22, respectively. There were 99 males and 38 females, with a mean age of 37.9+/-15.6 years. Burn was the most common underlying illness(80.3%). Identified Candida species were C. albicans(68.0%), C. parapsilosis(25.0%), C. tropicalis, C. guilliermondii, and C. glabrata. The risk factors of candidemia were ICU care, broad-spectrum antibiotic therapy, central venous catheter insertion, and parenteral hyperalimentation. Concomitant focal candidal infections occurred in 71 patients and concomitant bacterial infections developed in 41 patients. Main clinical features were fever, leukocytosis, and tachypnea. Chorioretinitis developed in 6 patients by C. albicans and C. parapsilosis in five and one case, respectively. Overall mortality rate was 35.8% with lower mortality in cases with burn, antifungal treatment, and removal of central venous catheter. CONCLUSION: When fever persists despite the use of broad-spectrum antibiotics in burn patients or otherwise immunocompromised hosts, empirical antifungal treatment along with removal of central venous catheter and an ophthalmologic examination should be considered.
Anti-Bacterial Agents ; Bacterial Infections ; Burns ; Candida ; Candidemia* ; Central Venous Catheters ; Chorioretinitis ; Female ; Fever ; Heart ; Humans ; Immunocompromised Host ; Leukocytosis ; Male ; Mortality ; Parenteral Nutrition, Total ; Risk Factors ; Tachypnea