No abstract available.
Urodynamics*

A randomized, prospective study was conducted between October, 1994 and April, 1996 to compare the efficacy and safety of warfarin (group I) with dextran (group II) for the prevention of DVT after hip arthroplasty. 109 cases in 106 patients were included in the study. There were 60 cases in group I and 49 cases in group IL Risk factor for DVT were analysed before surgery and prophylactic modalities were performed. Color doppler was performed to all patients by one muskuloskeletal radiologist on 5th 8th post operative day and on 6 weeks after operation. DVT occurred in ten ( 16.6% ) of the 60 patients in group I, six ( 12.2% ) of the 49 patients in group II. but, this difference was not significant ( p= 0.582 ). Statistical analysis for the risk factors of age, sex, operation time, anesthetic method and operation method were performed and there were no statistical difference. Only statistical significance was a higher rates of DVT in cemented hip arthroplasty (p=0.028). There were seven proximal thigh DVT and nine calf DVT. We confirmed with sequential color doppler image that all cases of DVT except two complicated cases were resolved within 8 weeks after treatment: one case was expired for the reason of PE, and the other case had thigh hematoma during the treatment with warfarin. We could detect only one case of late onset DVT.
Arthroplasty* ; Dextrans ; Hematoma ; Hip* ; Humans ; Prospective Studies ; Risk Factors ; Thigh ; Venous Thrombosis* ; Warfarin

OBJECTIVE: 6-Gingerol, one component of ginger (Zingiber officinale) compound, has been known to possess anti-inflammatory, analgesic, anti-emetic, and anti-cancer effects. In this study, the apoptotic ability of 6-gingerol was investigated in human prostate cancer cells. METHODS: 3-(4,5-Dimethylthiazol-2-yl)- 2,5-diphenyl-tetrazolium bromide (MTT) assay, flow cytometry, and western blot analysis were done in LNCaP human prostate cancer cell lines treated with the various doses of 6-gingerol for the different durations of drug exposure. RESULTS: 6-Gingerol in doses ranging from 100 to 300 microM induced dose- and time-dependent inhibition of cell viability in prostate cancer cells by using MTT assay. Maximal inhibition of cell viability was observed at 300 microM of 6-gingerol for 48 hours treatment in LNCaP cells. 6-Gingerol at the dose of 100 microM did not produce any significant change in apoptotic cells in flow cytometry analysis. However, significant increase in sub-G0/G1 phase was observed in cells treated with 200 and 300 microM of 6-gingerol. Any significant cell cycle arrest was not induced by 6-gingerol. In western blotting analysis, expression of caspase-3 was not evident in cells treated with 6-gingerol for 24 hours. However, 48 hours treatment with 6-gingerol altered the expression of caspase-3 in LNCaP cells. Expression of cleaved poly showed the dose-dependent fashion in both 24 hours and 48 hours treatment of 6-gingerol. CONCLUSION: These observations suggest that 6-gingerol may induce apoptosis in LNCaP human prostate cancer cells.
Apoptosis ; Blotting, Western ; Caspase 3 ; Catechols ; Cell Cycle Checkpoints ; Cell Line ; Cell Survival ; Fatty Alcohols ; Flow Cytometry ; Ginger ; Humans ; Poly(ADP-ribose) Polymerases ; Prostate ; Prostatic Neoplasms

PURPOSE: The therapeutic approach to patients with emphysematous pyelonephritis long has been a debatable issue. So we evaluated the efficacy of percutaneous drainage in patients with emphysematous pyelonephritis. MATERIALS AND METHODS: 7 patients with emphysematous pyelonephritis underwent percutaneous drainage. The result was classified as cure, partial success, recurrence, or failure. The mean drainage period and complication were analyzed. RESULTS: There were 2 men and 5 women with 49 to 72 years old(mean age 60) suffering from diabets mellitus. Six patients(87.5%) were cured with percutaneous drainage and antibiotics, but one patient who had diffuse renal parenchymal destruction without perirenal fluid collection was failed. The mean catheterization Period was 26.3 days(range 10 to 45). Bacteremia after percutaneous drainage in one patient was cured with antibiotic therapy. CONCLUSIONS: Percutaneous drainage can be a lifesaving alternative method in critically ill, high risk patient with emphysematous pyelonephritis.
Anti-Bacterial Agents ; Bacteremia ; Catheterization ; Catheters ; Critical Illness ; Drainage* ; Female ; Humans ; Male ; Pyelonephritis* ; Recurrence

PURPOSE: Although muscle hernia has been well described in the lower-extremity, muscle hernias in the upper extremity are extremely rare. As with lower extremity muscle hernias, the forearm muscle hernia may result from forced exertion of strenuous activity or following blunt trauma. The objective of this paper is to report an extraordinary case of forearm muscle hernia after radial forearm sensory tendocutaneous free flap with references. METHODS: A 58-year-old male patient received wide excision and radical neck dissection and lower lip reconstruction with radial forearm sensory tendocutaneous free flap for squamous cell cancer on the lower lip. 16 weeks after the operation, he complained of protruding mass on the forearm and the size was increasing. In postoperative 18 weeks, MRI showed herniation of flexor digitorum superficialis. For unaesthetic cause and preventing progress, the authors performed direct fascial closure and Mesh graft. RESULTS: In 12 months after the surgery there was no recurrence and the patient remained symptom-free. CONCLUSION: Pain on extremity exertion and unaesthetic buldge of forearm due to forearm muscle hernia were the primary indications for surgery which consist of direct closure, fasciotomy, fascia lata onlay graft, fascia lata inlay graft, etc. The authors experienced uncommon forearm muscle hernia after radial forearm free flap and satisfying result of treatment.
Extremities ; Fascia Lata ; Forearm ; Free Tissue Flaps ; Hernia ; Humans ; Inlays ; Lip ; Lower Extremity ; Male ; Middle Aged ; Muscles ; Neck Dissection ; Neoplasms, Squamous Cell ; Recurrence ; Transplants ; Upper Extremity

PURPOSE: As a rare congenital anomaly, Poland's syndrome has been known to show hypoplasia in breast and nipple, absence of pectoralis major muscle, and aplasia or deformity of rib or costal cartilage which has been reported to be more common in male. However, most patients who are seeking operation are female patients having one-side deformity. In the field of plastic surgery, the major surgical indications could be asymmetric chest wall depression in man or breast hypoplasia in woman. There are many reconstruction options according to the degree of patient's deformity: a prosthetic implant, breast implant with or without tissue expander, latissimus dorsi musculocutaneous pedicled flap with or without implant and/or tissue expander, and free tissue transfer with or without tissue expander. METHODS: The authors have treated 4 patients(2 male, 2 female) who had a diagnosis of Poland's syndrome. According to the degree of patient's deformity, all patients underwent correction of breast asymmetry and unilateral anterior thoracic hypoplasia with one-staged or two-staged reconstruction. RESULTS: All patents were satisfied with the results and there occurred no specific complications. CONCLUSION: The authors propose the treatment plan for patient with Poland's syndrome, according to the degree of patient's deformity. In case of male patient with mild deformity, the prosthetic implant or latissimus dorsi musculocutaneous pedicled flap will simulate the missing pectoralis and improve the contour deformity. In case of female patient with moderate to severe breast asymmetry and upward displaced nipple areolar complex (NAC), NAC can be lowered with tissue expander, breast can be enlarged with autologous free flaps or latissimus dorsi musculocutaneous pedicled flap with implant.
Breast Implants ; Breast* ; Cartilage ; Congenital Abnormalities ; Depression ; Diagnosis ; Female ; Free Tissue Flaps ; Humans ; Male ; Mammaplasty* ; Nipples ; Ribs ; Superficial Back Muscles ; Surgery, Plastic ; Surgical Flaps ; Thoracic Wall* ; Thorax* ; Tissue Expansion Devices

PURPOSE: The significance of constitutive apoptosis in the development and progression of transitional ceil carcinoma of the bladder has yet to be investigated. The wild type p53 gene is known to play a significant role in apoptosis. Therefore, mutation of p53 gene, which correlates closely with p53 protein overexpression, would be predicted to limit apoptosis. We evlauated the prognostic significance of apoptosis and the relationship between apoptosis and mutant p53 overexpression in transitional cell carcinoma of bladder. MATERIALS AND METHODS: The extent of apoptosis was determined by TUNEL(terminal deoxynucleotidyl transferase mediated biotinylated deoxyuridine-triphosphate nick end labeling) stain in 64 paraffin embedded tissue of primacy transitional cell carcinoma specimens. Also, the level of p53 overexpression was determined immunohistochemically on the same tissue. RESULTS: Although the incidence of apoptosis increased with increasing tumor grade, the difference in indices between grade II and grade III failed to reach statistical significance. The mean apoptotic index(AI) of grade I tumors was significantly lower than that of grade III tumors(p=0.0023). The apoptotic index was not related to p53 overexpression, T(tumor)-category, growth type of tumors and also there was no significant difference in disease-free survival between the bladder tumors with high as opposed to low apoptotic index. CONCLUSIONS: The results show that AI is related to histological grade in transitional cell bladder tumor, while AI hardly has any independent prognostic significance.
Apoptosis* ; Carcinoma, Transitional Cell* ; Disease-Free Survival ; DNA Nucleotidylexotransferase ; Genes, p53 ; Incidence ; Paraffin ; Urinary Bladder Neoplasms ; Urinary Bladder*

In the microsurgical era, replantation with microvascular anastomosis is considered as the most superior method in aspects of texture, color, shape in case of nose amputation. There are some reported cases of replantation in nose amputation historically, but most of them are composite graft cases rather than microvascular anastomosis. Only a few cases of successful nasal replantation with microvascular anastomosis have been reported due to the reason that the size of vessels is usually very small and identifying suitable vessels for anastomosis is difficult. Microanastomosis of artery and microanastomosis of vein are ideal in replantation, but identifying suitable veins is often difficult. Without venous anastomosis, resolving the venous congestion remains to be a problem. We can carry out arteriovenous shunt if we can find two arteries in amputee. However, the smaller the size of amputee is, the more difficult it is to find two arteries. Instead of arteriovenous shunt, we can try external venous drainage(frequently swab, pin-prick, stab incision, IV or local heparin injection, dropping, apply of heparin-soaked gauze, use of medical leech). Here, we present three cases of replantation with microscopical arterial anastomosis (one angular artery, two dorsal nasal arteries) and external venous drainage (stab incision, application of medical leech and heparin-soaked gauze) even though the size of amputee may be as small as 1.5x1.0 cm. In all cases, surgical outcomes were excellent in cosmetic and functional aspects. This report describes successful replantation by microvasular anastomosis in case that suitable veins are not found.
Amputation* ; Amputees ; Arteries ; Drainage ; Heparin ; Humans ; Hyperemia ; Nose* ; Replantation* ; Transplants ; Veins

PURPOSE: Finger injury by green onion cutting machine is one of the common hand injuries in the kitchen. It has a unique feature: there are multiple parellel laceration 3 -5mm wide. There are two directions of injuries(vertical, oblique). It may involve bone, tendon, nerve, and vessel injuries. We discuss its management and the long -term progress. METHODS: We have treated six patients from 2003 to 2007. We carried out low tension approximation with thin suture materials to avoid ischemia and performed the additional operation as nail bed repair, tenorrhaphy, open reduction, vessel anastomosis, and composite graft. We reviewed the record of initial injury and collected the follow-up record. RESULTS: They were all middle aged - women who had worked in the kitchen. Right hand was dominent over left hand. The ratio of the directions was 3:3 (vertical:oblique). They were all competely healed although there were three atrophy, four hyperesthesia, and one nail deformity. CONCLUSION: Finger injury by green onion cutting machine is a unique pattern of laceration with various accompanied injuries. It may look like a severe form of injury, but in most cases have relatively favorable progress. We have to perform careful examination of accompanied injuries and carry out the proper management. First and foremost, the user especially in the middle aged women should be warned to be careful in handling this risky machine.
Atrophy ; Female ; Finger Injuries ; Fingers ; Follow-Up Studies ; Glycosaminoglycans ; Hand ; Hand Injuries ; Handling (Psychology) ; Humans ; Hyperesthesia ; Ischemia ; Lacerations ; Middle Aged ; Nails ; Onions ; Sutures ; Tendons ; Transplants

No abstract available.
Chin* ; Humans ; Membranes* ; Prostate* ; Prostatic Neoplasms* ; RNA, Messenger* ; RNA-Directed DNA Polymerase*