The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
Amyloid ; Blister ; Dermis ; Epidermis ; Follow-Up Studies ; Free Tissue Flaps ; Friction ; Glycosaminoglycans ; Heel ; Myocutaneous Flap ; Superficial Back Muscles ; Weight-Bearing

No abstract available.
Cervix Uteri* ; Chlamydia trachomatis* ; Chlamydia* ; Female

From May, 1985 to July, 1986, 500 cases of intraocular lenses were implanted, and all 500 cases had been followed up for more than 2 months. The results were as follows: 1. In the 500 cases of intraocular lens implantation, the number of patients were 318 men and 115 women. Patient's age was largely distributed to fifth decade in men and fourth decade in women. 2. IOL power ranged from +13.5D to +23.0D in PCL and ranged from +12.5D to +20.0D in ACL. The most frequently used IOL poeer was +19.5D in PCL and +18.0D in ACL. 3. Postoperative corrective vision with IOL was improved up to 0.8 or better in 446 cases(89.2%). 4. During operation, some complications were developed and those were posterior capsular rupture in 19 cases(3.8%), hyphema in 15 cases(3.0%), Descemet's membrane stripping in 2 cases(0.4%), and corneal edema in 1 case(0.2%). More frequently developed postoperative complications were clinical cystoid macular edema in 26 cases(5.2%), secondary glaucoma in 18 cases(3.6%), and distorted pupil in 13 cases(2.6%). 5. Postoperative corrective vision lower than 0.4 was observed in 22 cases(4.4 %), and the causes were diabetic retinopathy, cystoid macular edema, vitreous opacity, congenital cataract, phacoanaphylactic uveitis, endophthalmitis, amblyopia, optic nerve atrophy, corneal opacity, glaucoma, hypertensive retinopathy, and others.
Amblyopia ; Atrophy ; Cataract ; Corneal Edema ; Corneal Opacity ; Descemet Membrane ; Diabetic Retinopathy ; Endophthalmitis ; Female ; Glaucoma ; Humans ; Hypertensive Retinopathy ; Hyphema ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Macular Edema ; Male ; Optic Nerve ; Postoperative Complications ; Pupil ; Rupture ; Uveitis

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

No abstract available.
Humans ; Hypertension* ; Quality of Life*

This study was designed to evaluate the personality characteristics of orthognathic surgery patients preoperatively and postoperatively through the MMPI. Comparison was made between the personality characteritics of preoperative and postoperative groups. Motivation for undergoing orthognathic surgery and postoperative satisfaction were examined through the questionnaire. Subjects used in this study consisted of 50 patients under presurgical orthodontic treatment and 22 patients who had received orthognathic surgery. From this study, the results were followings. 1. In preoperative patients group, all T-scores were within the normal range except for K-scale. The T-score of K-scale is 57.7, this showed that these patients underwent some or less stress. 2. In postoperative patients group, all T-scores were within the normal range. 3. Only in K-scale, there was statistically significant increase after surgery (P<0.05). 4. In male patients group, all T-scores were within the normal range except for that of preoperative K-scale. Postoperatively, there were statistically significant increase in K and Hs scales(P<0.05) 5. In female patients group, all T-scores were within the normal range. 6. Motivation for undergoing orthognathic surgery could be divided into 4 categories: esthetic goal(28.2%), functional goal(32.1%), TMJ problem(9.0%), and psychosocial reason(30.7%). 7. The degree of postoperative satisfaction was quite high(85.7%). 14.3% of all patients were very satisfied, 71.49/o were satisfied, 9.5% were neither satisfied or dissatisfied, and 4.8% were very dissatisfied.
Female ; Humans ; Male ; MMPI* ; Motivation ; Orthognathic Surgery* ; Surveys and Questionnaires ; Reference Values ; Temporomandibular Joint

BACKGROUND: The efficacy of palonosetron in preventing postoperative nausea and vomiting (PONV), as well as chemotherapy-induced nausea and vomiting, has already been demonstrated in multiple clinical studies. The purpose of this study was to determine whether continuous infusion of palonosetron following single injection could reduce PONV to a greater extent than single injection only of palonosetron. METHODS: In total, 132 women were enrolled in the study. All subjects were over the age of 20 years and were scheduled to undergo gynecologic laparoscopic surgery. Patients were randomly allocated into two groups. In both groups, patients received 0.075 mg of palonosetron intravenously, immediately before induction of anesthesia. In the continuous palonosetron infusion group, 0.075 mg (1.5 ml) of palonosetron was added to the patient-controlled analgesia device. In the single-injection palonosetron group, 1.5 ml of normal saline was added. RESULTS: The incidence of PONV 24 hours postoperatively was significantly lower in the continuous palonosetron infusion group than the single-injection palonosetron group (31.8 vs. 56.1%, P = 0.009). CONCLUSIONS: Continuous palonosetron infusion, following single injection, reduces the incidence of PONV compared with single injection only.
Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Humans ; Incidence ; Laparoscopy ; Nausea ; Postoperative Nausea and Vomiting* ; Vomiting

The purpose of this study was to examine the frequency of eutaneous disorders in patients with chronie renal failure presently on hemodialysis(HD). The results were as follows. 1. Cutaneous lesions were present in all 78(100% ) patients with chronic renal failure. 2. The frequency of msjor cutaneous problems associated with chronic renal failure was as follows: xerosis(82.1%), pruritus(74.4%), nail changes(74.4%), hyperpigmentation(70.5 % ), xerostomia(42.3'Yo), poor wound healing(37.2%), easy bruisability(30,8%), hypotrichosis(21.896), and purpura(14.1 % ). 3. Cutaneous problems which appeared after the initiation of HD were. appearance of new pigmented nevi or lentigines(9 patients), appearance or aggravation of acne(6), contact dermatitis at AV fistula site(2), gynecomastia(1), extensive flat warts(1), extensive tinea versicolor(1), and extensive vitiligo(1). 4. Among 55 patients with hyperpigmentation, 11 patients reported decreased pigmentation following HD. In 15 patients, hyperpigmentation worsened following HD, and in 9 patients hyperpigmentation first appeared after HD was initiated. 5. Cutaneous disorders favorably affected by HD were as follows: easy bruisability(3/ 24), xerostomia(3/33), gingival friability(2/7), and hypotrichosis(5/17). 6. Poor wound healing and xerosis were not improved by HD. 7. Among 58 pruritic patients, 7 patients were improved after HD, 7 patients became worse during each HD, and 3 patients were not pruritic only for 2 to 3 days after each HD. Four patients experinced pruritus only during each HD. 8. There was no significant statistical difference between the frequency of pruritus and xerosis and the levels of blood urea nitrogen, calcium, phosphorus, and parathyroid hormone.
Blood Urea Nitrogen ; Calcium ; Dermatitis, Contact ; Fistula ; Humans ; Hyperpigmentation ; Kidney Failure, Chronic* ; Nevus, Pigmented ; Parathyroid Hormone ; Phosphorus ; Pigmentation ; Pruritus ; Renal Dialysis* ; Renal Insufficiency ; Tinea ; Wound Healing ; Wounds and Injuries

No abstract available.
Diagnosis* ; DNA* ; Ichthyosis* ; Xeroderma Pigmentosum*

In the present study, we investigated the differences in the levels of expression of virulence factors between blood isolates of Candida albicans and commensal strain isolated from the oral cavities of health volunteers, and correlations between virulence factors. Blood isolates of 33 and commenal isolates of 71 were characterized by putative virulence factors such as proteinase production (PROT), an ability to adhere to epithelial cells (ADH), cell surface hydrophobicity (CSH), phospholipase production (PLASE), and hyphal transition (GERM). In PROT, ADH, CSH, and PLASE, the means of expression of blood isolates were higher compared with those of commensal isolates, however statistical significance was only shown in CSH (p=0.036). On the contrary, mean expression of GERM of blood isolates was lower than that of commensal isolates. Of relationships between virulence factors, although a negative correlation of PROT with CSH was obtained, the correlation was relatively low (r=-0.316, p=0.001). These results suggest that higher expression of CSH is a more distinguishing character in virulent blood isolates of C. albicans and that the expression of virulence factors are independent.
Candida albicans* ; Candida* ; Epithelial Cells ; Healthy Volunteers* ; Hydrophobic and Hydrophilic Interactions ; Phospholipases ; Virulence Factors ; Virulence* ; Volunteers