No abstract available.
Child* ; Humans ; Humerus*

No abstract available.
Birth Certificates* ; Parturition*

The idiopathic retroperitoneal fibrosis means that proliferation of fibrous tissue in the retroperitoneal cavity influences the aorta, inferior vena cava, psoas muscle and ureter, and its etiology is not found. Especially, when both ureters are compressed, hydronephrosis resulted in uremia are developed progressively, and it may be treated by urinary diversion. We report a case of idiopathic retroperitoneal fibrosis that treated by bilateral pyelo-ileo-neocystostomy and postoperative metabolic derangement that managed successfully with brief review of literature.
Aorta ; Hydronephrosis ; Psoas Muscles ; Retroperitoneal Fibrosis* ; Uremia ; Ureter ; Urinary Diversion ; Vena Cava, Inferior

This paper concerns professional socialization of medical students. Professional socialization, in the context of this paper, means the process through which a layperson becomes a doctor equipped with professional identity and values. While medical education does not include such process in the curriculum, medical students obtain certain values and identity informally. The dependent variables were professional values and professionalism. The former means the desirable attributes required to conducting professional works such as humane attitudes, science-oriented mind, capability for organizational management. The latter means socio-political reasoning with which doctors can rationalize their privileges such as autonomy. A specially designed questionnaire was developed. The data were collected from five medical schools for 1,318 students in 1994. A total of 1,070 cases were finally included in the statistical analysis. The students emphasized the human factor in the professional values. Their attitude did not change with the grade. Other independent variables such as motives for entering a medical school, socioeconomic status, satisfaction with medical education, etc. also did not influence professional values. It implies that professional values were not consolidated among the students. However, the factors of professionalism change significantly with the grade. It implies that the students paid more attention to socio-political issues related to doctor`s interests as the grade went up. And the factor scores for professionalism were higher for those students who had more positive attitude towards doing medical practice for profit, expected higher income, and were more conservative about social reform. Other independent variables did not influence professionalism. It seems that the students also give emphasis on professionalism, like current medical doctors, mainly because of their concern with recent unfavorable changes in economic conditions of medical care providers.
Curriculum ; Education, Medical ; Humans ; Surveys and Questionnaires ; Schools, Medical ; Social Class ; Socialization* ; Students, Medical*

Biological skin substitutes can be used in human skin defects. However, with the exception of autograft, they are not permanent due to incompatible tissue antigenicity. In our study, we planned to determine the fate of porcine skin, preliminarily processed, in order to eliminate tissue antigenicity after implantation onto nude athymic mice. Harvested porcine skin was meshed and put through epidermal separation, decellular, lyophilization and antiseptic processes. After rehydration, the processed skin is grafted to the skin defect made on the back of a nude mouse. Then thin autologous skin is overlaid and secured with suture(Experimental group). The control group is recovered by autologous skin graft only. Evaluation for wound contraction area(1st, 2nd, 4th, 8th week) and histological analysis(2nd, 4th, 8th week)were performed.The porcine dermis became completely incorporated into the wound without evidence of rejection. The reduction in wound contraction in the experimental group was significant in comparison with that of the control group. In conclusions, the decellularization and lyophilization process was found to have destroyed cells regulating immune re sponse while preserving the structural organization of extracellular matrices. We are trying to focus on establishment and management of the skin bank for the preparation, storage of the porcine xenograft in the future.
Animals ; Autografts ; Dermis ; Extracellular Matrix ; Fluid Therapy ; Freeze Drying ; Heterografts* ; Humans ; Mice ; Mice, Nude ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries

Biological skin substitutes can be used in human skin defects. However, with the exception of autograft, they are not permanent due to incompatible tissue antigenicity. In our study, we planned to determine the fate of porcine skin, preliminarily processed, in order to eliminate tissue antigenicity after implantation onto nude athymic mice. Harvested porcine skin was meshed and put through epidermal separation, decellular, lyophilization and antiseptic processes. After rehydration, the processed skin is grafted to the skin defect made on the back of a nude mouse. Then thin autologous skin is overlaid and secured with suture(Experimental group). The control group is recovered by autologous skin graft only. Evaluation for wound contraction area(1st, 2nd, 4th, 8th week) and histological analysis(2nd, 4th, 8th week)were performed.The porcine dermis became completely incorporated into the wound without evidence of rejection. The reduction in wound contraction in the experimental group was significant in comparison with that of the control group. In conclusions, the decellularization and lyophilization process was found to have destroyed cells regulating immune re sponse while preserving the structural organization of extracellular matrices. We are trying to focus on establishment and management of the skin bank for the preparation, storage of the porcine xenograft in the future.
Animals ; Autografts ; Dermis ; Extracellular Matrix ; Fluid Therapy ; Freeze Drying ; Heterografts* ; Humans ; Mice ; Mice, Nude ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries

The aim of the present study is to get anatomical information of internal mammary vessels(IMV), which is usually used for recipient vessels in the breast reconstruction. The past anatomical studies of these vessels had been done primarily with cadavers in the Occidentals. Because there is no report for the anatomical study of these vessels and also the cadaver study is pretty limited in this country, we studied the anatomical pattern of IMV in Koreans by using two dimensional reconstructive computed tomography (2DCT) and Doppler ultrasound (US). The branching patterns, level of bifurcation, size of IMV and the distance from the sternal edge to the IMV were measured. This study was performed in 30 breast cancer patients from May 1999 to May 2000. One artery and one vein on both sides(type I) was the most common type that were observed in 22 of 30 patients(73%). The diameter of the internal mammary artery(average 2.1 mm) was constant but that of the internal mammary vein had a wide variation(ranged 0.8 to 4.8 mm). The distance from sternum to IMV gradually got narrower as it went caudally. In three cases the size of vein was not enough for anastomosis, but the bifurcation point may be used for anastomosis due to the wider point. Compared with the result of Caucasian, the incidence of bifurcation of internal mammary vein was lower and the level of bifurcation was higher. The result showed that the most successful level of anastomosis was the 3rd intercostal space in Korean due to shorter chest. The combination of 2DCT and US provided us with useful preoperative information as well as general anatomical data in Korean.
Arteries ; Breast Neoplasms ; Cadaver ; Female ; Humans ; Incidence ; Mammaplasty ; Sternum ; Thorax ; Ultrasonography ; Veins

The aim of the present study is to get anatomical information of internal mammary vessels(IMV), which is usually used for recipient vessels in the breast reconstruction. The past anatomical studies of these vessels had been done primarily with cadavers in the Occidentals. Because there is no report for the anatomical study of these vessels and also the cadaver study is pretty limited in this country, we studied the anatomical pattern of IMV in Koreans by using two dimensional reconstructive computed tomography (2DCT) and Doppler ultrasound (US). The branching patterns, level of bifurcation, size of IMV and the distance from the sternal edge to the IMV were measured. This study was performed in 30 breast cancer patients from May 1999 to May 2000. One artery and one vein on both sides(type I) was the most common type that were observed in 22 of 30 patients(73%). The diameter of the internal mammary artery(average 2.1 mm) was constant but that of the internal mammary vein had a wide variation(ranged 0.8 to 4.8 mm). The distance from sternum to IMV gradually got narrower as it went caudally. In three cases the size of vein was not enough for anastomosis, but the bifurcation point may be used for anastomosis due to the wider point. Compared with the result of Caucasian, the incidence of bifurcation of internal mammary vein was lower and the level of bifurcation was higher. The result showed that the most successful level of anastomosis was the 3rd intercostal space in Korean due to shorter chest. The combination of 2DCT and US provided us with useful preoperative information as well as general anatomical data in Korean.
Arteries ; Breast Neoplasms ; Cadaver ; Female ; Humans ; Incidence ; Mammaplasty ; Sternum ; Thorax ; Ultrasonography ; Veins

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the diagnosis of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Conventional modalities including simple radiographs, bone mineral density (BMD) tests, and bone scans are sufficient for diagnosis of OSFs. However, other clinical and radiographic clues should be considered for prediction of the prognosis and differential diagnosis. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: Clinical clues including morphometric changes in the vertebral body are sufficient for diagnosis of OSFs. BMD testing is helpful for diagnosis of osteoporosis. However, simple radiographs and BMD tests do not present sufficient information on the prognosis of OSFs. The location of the involved segments, morphological characteristics, and other co-morbidities should be taken into consideration in the initial management of OSFs. Moreover, pathologic conditions leading to spinal fractures should be taken into account in some clinical situations. CONCLUSIONS: With increasing reports of complicated OSFs or other pathologic fractures, other diagnostic modalities and clinical factors should be considered in predicting the prognosis of OSFs and differentiating OSFs from other pathologic conditions.
Bone Density ; Diagnosis* ; Diagnosis, Differential ; Fractures, Spontaneous ; Osteoporosis ; Prognosis ; Spinal Fractures*

BACKGROUND: Although development of DM nephropathy in NIDDM patients is associated with poorly controlled blood sugar level and hypertension, relationship of genetic factor is also emphasized. Recent studies showed that an insertion or deletion (I/D) polymorphism in the ACE gene and a 4/5- guanine tract polymorphism in the promotor region of the PAI-1 gene are associated with the myocardial infarction. The aim of this study were to determine the relationships of these polymorphism and substance activities to DM nephropathy and macroangiopathy. METHODS: 72 NIDDM patients who suffered from DM more than 6 years and 62 non-diabetic healthy control were evaluated. After extraction of DNA from peripheral blood, ACE and PAI-1 gene polymorphisms were determined by polymerase chain reac tion, SSCP electrophoresis and silver stain. Serum PAI-1 level was dctected by Immulyse PAI-1 ELISA kit(Bipool Sweden). RESULTS: Total 134 samples were evaluated and ACE genotype were DD 27(20%), ID 88(66%), and II 19(14%). PAI-1 genotype were 4G4G 26(19%), 4G5G 73(55%), and 5G5G 35(26%). The distribution of ACE and PAI-1 polymorphism according to presence or absence of nephropathy were DD 10, ID 32, II 8, 4G4G 9, 4G5G 31, and 5G5G 10 in DM nephropathy group and DD 3, ID 17, II 2, 4G4G 5, 4G5G 12, and 5G5G 5 in non-nephropathy group. There were no significant differences in the distribution of ACE and PAI-1 gene between the two groups. The distribution of ACE and PAI-1 polymorphism according to macroangiopathy were DD 6, ID 16, II 3, 4G4G 5, 4G5G 15, and 5G5G 5 in macroangiopathy group and DD 7, ID 33, II 7, 4G4G 9, 4G5G 28, and 5G5G 10 in non-macroangiopathy group. There were no significant differences in the distribution of ACE and PAI- 1 gene between macroangiopathy and non-macroangiopathy groups. Serum PAI-1 level according to PAI-1 gene and ACE gene polymorphism were 4G4G 47.99+/-19.73, 4G5G 40.19+/-18.49, 5G5G 40.37+/-20.99 ng/mL, DD 37.99+/-16.64, ID 44.80+/-20.35, and II 31.92+/-12.98 and had a tendency that is higher in 4G4G genotype. CONCLUSION: From the above results, we cannot define the relationships of ACE and PAI-1 gene polymorphism and PAI-1 activities to DM nephropathy and macrovascular complications of NIDDM patients, but prospective studies including more patients population will be required.
Angiotensin II ; Angiotensins* ; Blood Glucose ; Diabetes Mellitus, Type 2* ; Diabetic Nephropathies* ; DNA ; Electrophoresis ; Enzyme-Linked Immunosorbent Assay ; Fibrinogen ; Genotype ; Guanine ; Humans ; Hypertension ; Myocardial Infarction ; Peptidyl-Dipeptidase A* ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators* ; Plasminogen* ; Polymorphism, Single-Stranded Conformational ; Promoter Regions, Genetic ; Silver