The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

Ureteral duplication is the most common developmental abnormality of the upper urinary tract. The upper pole ureter is often associated with a ureterocele and the lower pole ureter, the V-U reflux. A case of bilateral double collecting system associated with bilateral ureteroceles in a 6-month old Korean male is presented with review of literature.
Humans ; Infant ; Male ; Ureter ; Ureterocele* ; Urinary Tract

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.
Acellular Dermis ; Autografts ; Cicatrix ; Dermis* ; Extracellular Matrix ; Keratinocytes ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries*

In many cases the breast reconstruction surpasses the goal of a normal breast mound appearance in clothing and achieves a result that, in time, may look almost normal in the unclothe state. Breast reconstructions with autologous transverse rectus abdominis myocutaneous (TRAM) flaps are well known to produce the most aesthetically excellent results. the pedicled to TRAM flap cannot be used in high risk patient such as obese or smoking patients due to partial flap necrosis. But, the free TRAM flap have more robust blood supply and less donor site morbidity than the pedicled TRAM flap and is therefore the currently preferred technique in western. However, the free TRAM flaps has a problem related to the anastomotic failure which has been reported as high as 6% to 10%. Moreover many Korean women have smaller sized breast than western women and have no risk factors compromising flap circulation. So the single pedicled TRAM flap can be safely used for breast reconstruction without any flap necrosis. 60% of the elevated flap area has a sufficient volume to mold a new breast that matches with the contralateral breast and the unneccessary distal portion of the flap that has the marginal circulation can be resected. In this study we review our 20 consecutive cases of breast reconstruction using the pedicled TRAM flap and have a conclusion that the pedicled TRAM flap produce an aesthetically acceptable new breast in Korean mastecotmy patients without any flap necrosis or donor site morbidity.
Breast* ; Clothing ; Female ; Fungi ; Humans ; Mammaplasty* ; Necrosis ; Rectus Abdominis* ; Risk Factors ; Smoke ; Smoking ; Tissue Donors

One hundred and seventy-two cases of tuberculosis of the bones and joints were treated at the department of orthopedic surgery, Inchon Christian Hospital during the 3 years and 10 months from March, 1979, to December, 1982. The results obtained were as followings: 1. The incidence was decreased progressively 1.92% in 1980 to 1.18 in 1982. 2. Tuberculous lesions involved spine(50.58%), knee(16.28%), hip(13.37%), ankle(2.33%) and greater trochanter(2.33%) in order. 3. Age and sex distribution were not remarkable. 4. The main associated tuberculous lesions were pulmonary tuberculosis and tuberculous pleurisy (20.65%). Therefore, pulmonary problems should be always carefully investigated in every case of skeletal tuberculosis. 5. Average duration of disease was one year and 3.5 months, average hospital days was one month. 6. Initial miss diagnosis of lesions ultimately proved to be tuberculosis. Rheumatoid arthritis:13 cases, Osteoarthritis : 3 cases, Herniated lumbar disc: 3 cases, Cellulitis :2 cases, Neoplasm :2 cases. Early diagnosis is essential since proper therapy is available and far advanced destruction, long suffering and disability can be avoided. 7. Post operative complication was mainly due to failure of bone graft in tuberculous spondylitis and was draining sinus formation and wound disruption in other skeletal tuberculosis. 8. The result of treatment of skeletal tuberculosis from conservative methods were relatively poor. The corroboratory care of skeletal tuberculosis can be obtained by extensive surgery.
Cellulitis ; Diagnosis ; Early Diagnosis ; Incheon ; Incidence ; Joints ; Orthopedics ; Osteoarthritis ; Sex Distribution ; Spondylitis ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary ; Wounds and Injuries

OBJECTIVE: To analyze the interrelationship between homocysteine and methylenetetrahydrofolate reductase (MTHFR) mutation in patients with recurrent spontaneous abortion. MATERIAL AND METHOD: Homocysteine and MTHFR mutation were tested by fluorescent polarizing immunoassay and PCR-RFLP method, respectively. RESULTS: In patients with homocysteine level less than 5 mmol/L, there was no case of normal group but there were four cases of heterozygosity and one case of homozygosity. In patients with homocysteine level 5~10 mmol/L, the number of normal, heterozygosity and homozygosity group were eleven, eighteen and eight, respectively. In patients with homocysteine level 10~15 mmol/L, the number of normal, heterozygosity and homozygosity group were four, one and one, respectively. In patients with homocysteine level more than 15 mmol/L, there was no case of normal and heterozygosity group but there were two cases of homozygosity. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. And there was a significant relationship between homocysteine and MTHFR mutation.
Abortion, Spontaneous* ; Female ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

We had replaced 159 hips in 130 patients with cementless porous-coated AML porsthesis at Kwang Ju Christian Hospital between April 1987 and Feb. 1992. Among them, 100 cases(80 patients) could be analyzed clinically and radiologically with an average follow-up of 38.5 months(range 10 months to 74 months). The purpose of this study was to evaluate the relationships of initial fit, follow up stability and clinical results. The results were as follows. 1. The average postoperative Harris hip score was 90 points(preop. 42) at the follow-up of 1 year or more, the pain score 41 points(preop. 15). 2. When the surgical fit of stem was achieved properly, fixation by bone ingrowth could be expected. Simultaneously adequate fit of acetabular cup provided stable fixation. 3. The incidence of thigh pain was high in patients with an unstable implant of stem and the hip pain was more common in group of a definitely unstable cup. 4. Stress shielding was seen in 44 cases(44%). Of the 44 cases, 38 cases(86%) revealed in bone ingrowth. In conclusion, this study showed good clinical result of THR using AML prosthesis at the average follow-up of 38.5 months and it seemed to be influenced by initial fit significantly. But long-term follow-up is needed for accurate clinical and radiological evaluation.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Gwangju ; Hip ; Humans ; Incidence ; Prostheses and Implants ; Thigh

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

PURPOSE: The expression of matrix metalloproteinase-2 (MMP- 2) by cancer cells has been implicated in metastasis through cancer cell invasion of the basement membranes mediated by a degradation of collagen IV. However, the MMP-2 proenzyme requires proteolytic activation for its physiologic or pathologic role. We tried to 1) compare expression and activation of MMP-2 in breast cancers with benign tumors, 2) determine the correlation between the actviation of MMP-2 in breast cancer and established prognostic factors, 3) observe whether MMP-2 is expressed and activated in axillary lymph nodes as well, and 4) determine the degree of correlation between MMP-2 activity in lymph nodes and metastatic status, if MMP-2 is expressed in lymph node. METHODS: The specimens came from 11 fibroadenomas, 32 invasive ductal carcinoma and 129 axillary lymph nodes from cancer cases. Pro-MMP-2 cDNA transfected MDA-MB-231 cells were cultured and the conditioned media from them was used for a control. Zymography was used to monitor MMP-2 activation through the detection of the inactive proenzyme form (72 kDa) and the active form (62 kDa). Immunohistochemical staining was also performed for the localization of MMP-2 expression in tissues. RESULTS: 1) 72 kDa was expressed in all fibroadenomas and cancers, while 62 kDa was expressed in only 10 cases of fibroadenomas and all cancers. MMP-2 activity (62 kDa/72 kDa +62 kDa) was significantly higher in cancers than in fibroadenomas (P=0.014). 2) MMP-2 activity in cancers was significantly correlated with nodal metastasis (P=0.040). 3) The expression of MMP-2 in lymph nodes was very low and MMP-2 activity was not correlated with metastatic status. However, the immunohistochemical staining showed different staining patterns between the metastatic and non-metastatic nodes. CONCLUSION: We suggest that a measurement of the activation of MMP-2 could be useful as a prognostic marker representing metastatic potential in breast cancer. However, the low expression of MMP-2 in lymph nodes is an interesting subject for further study.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Collagen ; Culture Media, Conditioned ; DNA, Complementary ; Fibroadenoma ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis*