No abstract available.
Dermatitis, Atopic* ; Killer Cells, Natural*

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

Cutaneous horn is the clinical term for a circumscribed, conical, markedly hyperkeratotic lesion. We report a case of cutaneous horn occuring on the face in a 81 year old women. An about 1.2 X1.3 cm sized dark brownish conical horn was developed on her face 1 year before. Histopathologic findings showed marked hyperkeratosis, parakeratosis, and papillornatosis of the epidermis, and some cells of straturn mslpighii showed pleornorphism and nuclesr atypis. This case was considered to be cutaneous horn arising from actinic keratosis, and we performed minimal local excision.
Actins* ; Aged, 80 and over ; Animals ; Epidermis ; Female ; Horns* ; Humans ; Keratosis, Actinic* ; Parakeratosis

The authors investigsted the effects of azelaic acid on human melanoma cells (G 361 melanoma cell line) and cultured normal melanocytes obtained from the prepuce of newborn. The results were as follows : 1. The proliferation of melanoma cells was decreased, but not in a dose-and time- ependent fashion. The cell population of melanoma cells after 2, 4, and 6 days of culture was decreased to 3.80 x 10(5)cells/well, 4.55 x 10(5)cells/well, and 4.30 X 10(5)cells/ well, respectively, in the presence of 10(-2)M azelaic acid. The proliferation of mormal elanocytes of normal melanocytes was decreased in a dose-dependent, but not in a time-dependent fashion. The cell population of normal melanocytes after 2, 4, and 6 days of culture was significantly decreased to 6.38 x 10(5)+/-1.37 x 10(5) cells/well, 5.33 x 10(5)+/-0.73x10(5) cells/well, and 7.20x10(5)+/-1,11 x10(5)cells/well, respectively, in the presence of 10(-2) M azelaic acid(p<0,05, p<0.01). 2. A dose-and time-dependent inhibition of DNA synthesis was not found in either group. However, DNA synthesis in melanoma cells was decreased to 92710+5188 CPM, 16268+/-15S5 CPM, 8518+/-996 CPM, respectively, after 2, 4, and 6 days of culture, and in normal melanocytes was decreased to 9398+/-2279 CPM(p>0.05) and 6953+/-1217 CPM (p<0.05) after 4 and 6 days of culture in the prensence of 10(-2) Mazelaic acid, 3. There was no difference in melanin content per well at various concentrations in either group, but the melanin content per individual melanocyte of the melanoma cells was increased to 0.0303 ng/cell, 0.0253 ng/cell, and 0.0377 ng/cell, respectively, and that of normal melanocytes was signifieantly increased to 0.0754+/-0.0215 ng/cell, 0.0719+/-0.0144 ng/cell(p<0.05), and 0.1089+/-0.0185 ng/cell(p<0.05), respectively, after 2, 4, and 6 days of culture in the presence of 10(-2) M azelaic acid.
DNA ; Humans ; Infant, Newborn ; Melanins ; Melanocytes* ; Melanoma

We studied sputum eosinophil count of patients with chronic cough. Differential count of sputum cells(simple direct smear with Wright stain) were successfully examined in 44(73%) among 60 patients with chronic cough. The patients were divided according to PC2O value; 20(45%) patients had increased airway hyper responsiveness(AHR) (PC2O < 24mg/ml), remained 24 Patients did not have any evidence of airway AHR. Age, sex, duration and severity of symptoms, serum total IgE and positive skin test reaction were not different between two groups. In patients with increased AHR, increased sputum eosinophil ratio(10%) was found in 11 patients (55%) and increased peripheral blood eosinophil ratio(>5%) was found in 66% of patients with increased AHR. In patients without increased AHR, increased sputum eosinophil ratio was found in three patients(12%) and increased peripheral blood eosinophil ratio was found in 24%. This discrepancy between two groups was statisticalla significant(p<0.01). In regarding to sputum eosinophilia, increased sputum eosinophil ratio was in 14(32%) of 44 patients with chronic cough. Eleven patients(78%) of them had increased AHR. Only nine(30%) among 30 patients without sputum eosinophilia had increased AHR. These discrepancies between two groups were statistically significant(p<0.01). To predict AHR, sputum eosinophilia has 55% of sensitivity and 88% of specificity. Significant positive correlation between peripheral blood eosinophil ratio and sputum eosinophil ratio was found in patients with cough-variant asthma (r=0.76, p<0.01), We suggest that simple direct smear for sputum eosinophil count could be an useful test to diagnose the patients with chronic cough.
Asthma ; Cough* ; Eosinophilia ; Eosinophils* ; Humans ; Immunoglobulin E ; Sensitivity and Specificity ; Skin Tests ; Sputum*

We report a case of multiple xanthogranuloma occurring ori the scalp in a 33 years old wornan. Multiple yellowish papules were developed on her scalp 3 months ago. Histopathologic findings showed massive granulomatous infiltrations of foamy histiocytes Touton giant cells in the dermis, and these cells were positive for lipid stain. This case was considered to be multiple xanthogranuloma in an adult, and treated by sur- gical excision.
Adult* ; Dermis ; Giant Cells ; Histiocytes ; Humans ; Scalp

INTRODUCTION: The fixation strength of transpedicular screw system in the vertebral hody relied on bone quality and anatomical characteristics of vertebral pedicle, designs of screw and types of connection(rod or plate) with screw. The purpose of this study is to verify the biomechanical nature of the transpedicular fixation in spine under various conditions with porcine vertebrae. MATERIAL AND METHOD: Fresh porcine vertebrae and the custom-made screws were used in this experiment. To reduce the errors caused by vertebral bodies of different size and quality, vertebral bodies having regular range of pedicular width(10.0 to 11.5mm) and hone density(more than 1.0 gm/cm2) were used. The pedicle screws were inserted in the same procedure and axial pull out test was performed with using the Material Testing System(lntron8511, Canton, USA). The experiments were performed in four types to assess the difference of strength accroding to designs of the screw hy using two group of screws. The first group of screw was designed according to the outer and inner diameter and the second group was designed according to the shape, pitch, and thread profile of screw. Experiment I was perfomed to evaluate the effect of screw diameters on the biomechanical pull-out strength hy using the first group of custom-made pedicle screw which fixed all other factors except the diameter of screw. Experiment I was to verify the effect of screw shape, experiment III to verify the effect of pitch and experiment IV to verify the effect of thread profile. RESULTS: The results of experiments were summarized as follows: Experiment I showed that the screw of larger outer diameter had greater holding strength. Experiment II showed that the holding strength of cylindrical shaped screw is superior to that of conical shaped screw. Experiment III showed that there is no statistical significance between different modes of pitch. Experiment IV showed that the holding strength of buttress shape of thread profile is superior to that of V-shape. CONCLUSION: It seemed that the fixation strength of the screw was more powerful with 1 mm increment of outer diameter in 4-7mm of outer diameter, 3mm of pitch and buttress shape of thread of the screw with the same operation technique.
Spine

No abstract available in English.
Methods ; Reference Values

The ankle is a complex, weight bearing joint and its injury result in a severe functional disturbance of complex anatomical characteristics. It is very important to understand the mechanism of trauma in order to make definite diagnosis and proper treatment. The authors analysed 52 cases(52 patients) of the ankle fractures which were admitted and treated in Orthopaedic department, Korea University Hospital from Sept. 1980 to Dec. 1986. The results obtained were as follows : l. Of the 52 cases, male was 32 cases(61.5%), female was 20 cases(38.5%) and average age of the patients was 32.9 years. 2. The causes of the injury were slipping down, traffie accident, falling down and sports injuries, in orders. 3. Open fractures were 8 cases(15.4%) and closed fractures were 44 cases(84.6%). The most common type of the ankle fracture was supination-extenal rotation type(18 cases, 34.1%) and next was pronation-external rotation type(15 cases, 30%), according to the classification of Lauge-Hansen. 4. 38 cases(73.1%) were treated by open reduction and 14 cases(26.9%) by closed reduction, and average duration of immobilization was 7.7 weeks in open reduction and 10.4 weeks in closed reduction. 5. The associated fractures other than ankle was 15 cases(28.8%). 6. The better results were obtained from open reduction and the worst results obtained from pronation-dorsiflexion type, according to the criteria of Meyer. 7. The complication was 7 cases(13.5%), traumatic arthritis 4 cases, malunion 2 cases and nonunion 1 case. 8. Accurate reduction and rigid internal fixation of the fractured lateral malleolus, distal fibular and distal tibiofibular diastasis was important in treatment of the ankle fracture.
Accidental Falls ; Ankle Fractures ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Diagnosis ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Joints ; Korea ; Male ; Weight-Bearing

General anesthesia is the most common method used for operations and volatile anesthetics are commonly used for general anesthesia. Moreover, it is known that the newly developed volatile anesthetics are safe in liver and kidney. However, inorganic fluoride levels increase with anesthetic time and increase the possibility of renal toxicity and repeat a anesthesia in short term period increase the possibility of hepatic failure. We experienced 2 cases who received general anesthesia with volatile anesthetics more than 50 times without any organ failure. Here, we review the anesthetic records and preoperative laboratory findings of each operation.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Fluorides ; Kidney ; Liver ; Liver Failure