The purpose of this study is to evaluate the short-term results of the reconstruction of acetabular bone defect radiographically. Twenty three reconstruction with bone graft and non-cemented porous hemispherical cup and one reconstruction with bone graft and cemented polyethylene cup that had been performed in 24 patients from 1991 at Wonkwang University Hospital and had followed more than one year were included in this study. Osseous union, resorption of the graft, the amount of the migration and angle change of the acetabular components and radiolucency were checked on plain X-ray. 9 morselized grafts for contained defect showed 100% union within 6 months, without severe resorption and loosening. Of the 15 structural grafts, 11 minor column or shelf grafts showed 100% union and remodeling, and one case of radiolucency around the cup. There were two collapses of the structural graft and one migration of the cup which suggest the failure among the 4 major column grafts. For the above 3 failed cases, non-cemented porous hemispherical cups were used. In conclusion, bone graft for reconstruction of the deficient acetabular bone stock seems to be suc- cessful, but the use of cement and the delay of weight bearing should be considered for the major column graft.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Humans ; Polyethylene ; Transplants* ; Weight-Bearing

Forty eight female Sprague-Dawley rats received a subcutaneous implant containing 12.5 mg estradiol ant the age of 3 weeks. Three rats were killed in 1, 2, 3, 4, 6 weeks and in every month during 2~12 months after implantation, and the breasts were examined by light microscope. In all rats, enlargement of terminal end buds was obseved in 1~2 weeks, maximum development of hyperplastic alveolar nodules in 3 weeks, and marked dilatation and secretion of alveoli or ducts in 1~12 months after implantation. Ductal epithelial hyperplasia was observed in 27 rats and carcinomas developed in 23 rats in 2~12 months after implantation. It was thought that the changes induced by estradiol are more similar to the human breast lesions, compared with changes induced by chemical carcinogens such as dimethylbenzanthracene(DMBA), because breast carcinomas developed in close relationship with ductal epithelial hyperplasia in both estradiol-treated rats and humans, but not in DMBA-treated rats.
Female ; Humans ; Rats ; Animals ; Carcinogens

The use of a tissue expander and implant is the simplest option for breast reconstruction after mastectomy. Use of a round dome-shaped prosthesis and the commonly used one-stage technique with a Becker type prosthesis, however, often produces an undesirable upper pole fullness. To overcome this and to achieve improved aesthetic results, we started using an anatomically-shaped expander and implant, as described by Maxwell, as a two-stage breast reconstruction. We reviewed the results of our 21 reconstructed breasts in 22 patients who were deemed suitable for reconstruction using this technique since January 1995. The most commonly used expander was 350cc (range 350-550cc) and an average of 4.2 inflations were required before replacing the expander with a permanent implant. All the expanders were placed in submuscular pockets and implant volume. The longest follow-up was 36 months. Few complications developed and most patients were satisfied with the results. We found that the anatomically-shaped expander and implant produced better aesthetic results compared to a done-shaped prosthesis.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy ; Prostheses and Implants ; Tissue Expansion Devices

BACKGROUND: The objective of this study was to measure malondialdehyde (MDA) and isoprostane which has been used as an index of lipid injury, 8-hydroxy-2′-deoxyguanosine (8-OHdG), which has been used as an index of DNA damage, and dialkyl-phosphate (DAP), which has been used to quantify pesticide exposure, and to investigate the relationship between pesticide exposure and oxidative stress. METHODS: This study was a cross-sectional study that evaluated 84 male farmers exposure to pesticide. In this study, 8-OHdG, isoprostane, and MDA were measured as oxidative stress indices, and dialkyl-phosphate (dimethylphosphate(DMP), diethylphosphate(DEP), dimethylthiophosphate(DMTP), and diethylthiophosphate (DETP)) excreted in the urine was also measured to evaluate pesticide exposure. A linear regression analysis was performed to investigate the relationship between pesticide metabolites, and oxidative stress biomarkers. RESULTS: A Correlation analysis was performed for pesticide exposure month (PEI), cumulative exposure index (CEI), and DAP as well as the concentration of the oxidative stress biomarkers. The PEM significantly and positively correlated to the levels of 8-OHdG, isoprostane, CEI, and DMP. CEI showed a correlation to 8-OHdG and PEM. DMP, DEP, and DETP showed a positive correlation to 8-OHdG, isoprostane, and MDA. A correlation analysis was adjusted some demographic characteristics, such as age, smoking, drinking, and exercise to determine the relationship between pesticide exposure and oxidative stress. The 8-OHdG, isoprostane, and MDA levels were significantly related to the DMP (ß = 0.320), DEP (ß = 0.390), and DETP (ß = 0.082); DMP (ß = 0.396), DEP (ß = 0.508), and DETP (ß = 0.504); and DMP (ß = 0.432), DEP (ß = 0.508), and DETP (ß = 0.329) levels, respectively. CONCLUSIONS: The concentration between oxidative stress biomarkers and the pesticide metabolite were a positive correlation. Indicators of oxidative stress was associated with a pesticide metabolite DMP, DEP, and DETP. Therefore, Pesticide exposure and oxidative stress were relevant.
Biomarkers ; Cross-Sectional Studies ; DNA Damage ; Drinking ; Farmers* ; Humans ; Isoprostanes ; Linear Models ; Male* ; Malondialdehyde ; Oxidative Stress* ; Smoke ; Smoking

It has been well documented that dysfunction of the Eustachian tube if the main cause of middle ear disease in most cleft palate patients. The middle ear disease is refractory to medical treatment and has frequent recurrences; the final results may end up with chronic otitis media and/or hearing loss. Currently, myringotomy with placement of ventilation tube in early infant stage have been widely accepted for treatment of otitis media in cleft palate patients. We calculated the frequency of the occurrence of otitis media in cleft palate patients who have received palatoplasty in our clinic. Preoperative otoscopic examination and tympanometric test were taken in all patients. We performed tympanostomy and ventilation tube insertion at the time of palatal repair on every patients who had evidence of otitis media in the preoperative otologic examinations. Since November 1996, 79 patients received palatoplasty and among these 63 patients(79.7%) received bilateral ventilation tube insertion simultaneously. We confirmed the previously documented high prevalence of otitis media in cleft palate patients and understood the importance of preoperative otologic examinations in the managements of cleft palate.
Cleft Palate* ; Ear, Middle* ; Eustachian Tube ; Hearing Loss ; Humans ; Infant ; Middle Ear Ventilation ; Otitis Media ; Prevalence ; Recurrence ; Ventilation

PURPOSE: The purpose of this study was to conceptualize and clarify a concept of "preparatory grief" in terminal cancer patients. METHOD: A hybrid model of concept development was applied to develop a concept of preparatory grief, which included a field study carried out in Busan, Korea. Participants of this study were 8 cancer patients. RESULTS: On the basis of our literature, research and clinical experience, the concept of preparatory grief emerged as a complex phenomenon playing an important role in five areas; physical, emotional, interpersonal, religious, and transcendental dimensions. Two new attributes were defined through a field phase; trust of the post-mortal world and a serene state of mind. Indicators reflected attitudes of sadness, worry, regret, capability to adapt and hope. The results of preparatory grief were loss of energy and interest, emotional chaos, contemplation, taciturnity and restoration. CONCLUSIONS: Differentiating among preparatory grief and other symptoms in cancer patients is essential because of therapeutic implications. Understanding preparatory grief is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patient's life.
Adaptation, Psychological ; Aged ; *Concept Formation ; Counseling/*methods ; Female ; *Grief ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms/nursing/*psychology ; Quality of Life ; *Terminal Care

Although both medical and surgical approaches have been investigated, recurrent symblepharon due to chronic ocular surface inflammation is a difficult disease to manage.This condition can also result in many complications such as cosmetic and visual deteriorations.In this condition, we can use the amniotic membrane transplantation that has a biological contact inhibition effect for the prevention of recurrent symblepharon. We treated successfully a case of a progressive symblepharon involving central cornea from 2-year old. The 14 year-old male patient had suffered from serious cosmetic problem and undergone multiple dissection, argon laser photocoagulation, using cyclosporin eyedrops. He was treated using allograft amniotic membrane, autograft limbal-conjunctiva, and buccal mucosa transplantation. we think that amniotic membrane transplantation was very effective method for the prevention of recurrent symblepharon.
Adolescent ; Allografts ; Amnion* ; Argon ; Autografts* ; Child, Preschool ; Contact Inhibition ; Cornea ; Cyclosporine ; Humans ; Inflammation ; Light Coagulation ; Male ; Mouth Mucosa ; Ophthalmic Solutions

OBJECTIVE: To investigate the correlation between the motor evoked potentials (MEPs) amplitude of 1st dorsal interosseus in affected limbs and affected hand function after stroke. METHOD: We enrolled 109 patients with acute and subacute 1st attack stroke. Transcranial magnetic stimulation (TMS) was applied to the motor cortex and MEP was recorded at the 1st dorsal interossei (DI) muscle. MEP parameters were latency of the affected side, latency ratio (latency of affected side/latency of unaffected side), amplitude of affected side and amplitude ratio (amplitude of affected side/latency of unaffected side). Hand function tests (HFT) including hand power measures and a nine hole peg test (NHPT) were conducted and the ratios of the value of the affected hand to unaffected hand were used for the analysis. The Korean version of the modified Barthel index (K-MBI) and the manual muscle test (MMT) of finger flexion were also evaluated. Correlation between MEP parameters and the clinical variables such as HFT, K-MBI and MMT grades were analyzed. RESULTS: While MEPs in the affected 1st DI were recorded in fifty six patients, MEPs were not recorded in forty nine patients. The responsiveness of MEPs was significantly correlated with the HFT, K-MBI and MMT grades. The amplitude ratio had the most significant correlation with the HFT and MMT grade in this MEP study. Also, the amplitude ratio had more significant correlations with the K-MBI score compared with other MEP parameters. CONCLUSION: We concluded that the amplitude ratio may be a useful MEPs parameter for indicating hand function.
Evoked Potentials, Motor ; Extremities ; Fingers ; Hand ; Humans ; Motor Cortex ; Muscles ; Organometallic Compounds ; Stroke ; Transcranial Magnetic Stimulation

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency. Adrenal crisis in isolated ACTH deficiency is less common compared to primary adrenal insufficiency, but isolated ACTH deficiency is an important cause of hypoglycemia. Recently we experienced a 41-year-old man admitted because of mental confusion. On admission, plasma glucose and sodium concentration were 1.7, 132 mmol/L, respectively. Basal plasma ACTH and cortisol levels were low and other pituitary hormone showed normal response to combined pituitary stimulation test except growth hormone. Plasma ACTH concentration remained low even after intravenous injection of ovine corticotropin releasing factor. It suggest that the defect of ACTH secretion was apparently due to intrinsic pituitary rather than hypothalamic disease. The sellar CT showed the fossa to be filled by cerebrospinal fluid. After treatment with glucocorticoid, he had no further evidence of hypoglycemia and hyponatremia. In conclusion, we report a case of isolated ACTH deficiency with empty sella.
Addison Disease ; Adrenocorticotropic Hormone ; Adult ; Blood Glucose ; Cerebrospinal Fluid ; Corticotropin-Releasing Hormone ; Growth Hormone ; Humans ; Hydrocortisone ; Hypoglycemia ; Hyponatremia ; Hypothalamic Diseases ; Injections, Intravenous ; Plasma ; Sodium

Purpose: To compare the prognosis of patients with axillary adenocarcinoma from an unknown primary (ACUPax) origin with negative MRI results and those with MRI-detected primary breast cancers. Materials and Methods: The breast MRI images of 32 patients with ACUPax without signs of primary breast cancer on mammography and ultrasound (US) were analyzed. Spot compression-magnification mammography and second-look US were performed for the area of MRI abnormality in patients with positive results; any positive findings corresponding to the MRI abnormality were confirmed by biopsy. If suspicious MRI lesions could not be localized on mammography or US, MR-guided biopsy or excision biopsy after MR-guided localization was performed. We compared the prognosis of patients with negative breast MRI with that for patients with MRI-detected primary breast cancers. Results: Primary breast cancers were confirmed in 8 (25%) patients after breast MRI. Primary breast cancers were not detected on MRI in 24 (75%) patients, including five cases of false-positive MRI results. Twenty-three patients underwent axillary lymph node dissection (ALND) followed by whole breast radiation therapy (WBRT) and chemotherapy (n=17) or subsequent chemotherapy only (n=2). Recurrence or distant metastasis did not occur during follow up in 7/8 patients with MRI-detected primary breast cancers and 22/24 patients with negative MRI results. Regional recurrence or distant metastasis did not occur in any MR-negative patient who received adjuvant chemotherapy after ALND and WBRT. Conclusion The prognoses of MR-negative patients with ACUPax who received ALND and WBRT followed by chemotherapy were as good as those of patients with MRI-detected primary breast cancers.