No abstract available.

No abstract available.
Child* ; Humans ; Humerus*

Distal foot defect is frequently encountered as an output site in high-tension electrical burn injuries, and proper treatment methods should be applied in order to achieve a properly-functioning foot. However, in distal foot defects around the metatarsal heads or metatarsophalangeal joints, conventional methods have not been ideal, replaced by such methods as secondary healing, amputation or skin graft because there was insufficient tissue in the distal foot and the general condition of the patient was unsuitable for distant or free flap surgeries. So, in order to establish convenient, promising methods for the reconstruction of distal foot defects in severe electrical burns, we classified the distal foot into four zones according to their blood supply and we defined or created ideal reverse flaps in each zone. From April 1996 to March 1999, we reconstructed 43 cases of distal foot defects in fourth-degree high voltage electrical burn wounds. In 19 cases of MP(medial plantar) zone injuries, we used reverse medial plantar island flap and in 5 cases of DP(dorsalis pedis) zone, we created a reverse dorsalis pedis island fascia flap, In 11 cases of P(peroneal) zone, we created reverse peroneal fascia flap and in 8 cases of I (intermediate) zone, we modified a reverse posterior tibial island flap, There was partial flap necrosis or grafted skin loss in five cases, but those were extremely minor problems and we successfully reconstructed distal foot defects in all 43 cases. In conclusion, proper reverse flaps according to the zone of the distal foot are ideal reconstructive methods because they provide good vascularization, sufficient tissue from the proximal parts and they require short operative time with relatively easy procedures.
Amputation ; Burns* ; Fascia ; Foot* ; Free Tissue Flaps ; Head ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Necrosis ; Operative Time ; Skin ; Transplants ; Wounds and Injuries

There is considerable experimental evidence to indicate that tumor growth is dependent on angiogenesis. However, we do not understand how the angiogenic activity is initiated by a given tumor. There is a clear distinction between a stage without neovascularization, which correlates with a paucity of metastases, and a stage in which increasing neovascularization correlates with a rising rate of metastasis. The authors therefore asked whether the extent of angiogenesis in human prostatic carcinoma is correlated with the tumor grades or some growth factors. To investigate how tumor angiogenesis correlates with tumor aggressiveness, the authors counted microvessels within the various grades of invasive prostatic carcinomas of 44 patients and the nodular hyperplasias of 10 patients. Highlighting of the vessels by immunohistochemical staining for factor VIII-related antigen and assessment of the tumor aggressiveness by the degree of expression of some growth factors(transforming growth factor-alpha, and beta, epidermal growth factor), tumor necrosis factor-alpha and tumor grading(Gleason's score) were done. As a result, both microvessel counts and the expression of growth factors and tumor necrosis factor correlated with tumor grades. In conclusion, the number of microvessels per 200 X fields in the areas of most intense neovascularization in a prostatic carcinoma may be a predictor of the patient's prognosis. Therefore, assessment of tumor angiogenesis may prove valuable in selecting patients with prostatic carcinoma, especially small needle biopsy, for aggressive therapy.
Humans ; Tumor Necrosis Factor-alpha

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.
Breathing Exercises ; Cough ; Dyspnea ; Heart Rate ; Humans ; Incidence ; Motivation* ; Organization and Administration ; Prospective Studies ; Respiration* ; Spirometry* ; Sputum ; Thorax

Cholelithiasis is defined as the presence of stones within the lumen of the gallbladder or in the extrahepatic biliary tree. Cholecystitis, secondary to gallstones, is a common surgical disorder in Korea. Detailed microscopic descriptions, particularly the ultrastructural changes, of these diseases were not available. The goal of this study was to identify the ultrastructural alterations of gallbladder epithelium in cholecystitis with and without a stone, according to the degree of severity of inflammation, and the nature of the stone. The gallbladders of the control group, and cholecystitis cases without stone and with stone were fixed and examined with routine stain, special stain, immunohistochemical stain and trans-mission electron microscopy. The number and the volume density of the mucin containing secretary granules were not significantly increased in the calculous cholecystitis cases compared with those of the acalculous cholecystitis cases. Major findings were that the calculous cholecystitis cases showed a markedly reduced total lysosome area and volume density of the lysosome compared with those of the acalculous chole-cystitis cases. The differences between the mucin secretary granules and lysosomes, according to the degree of severity of cholecystitis and the natures of gallstones, were statistically not significant.
Humans

BACKGROUND: Oxygen concentrators are convenient to operate and economical for patients with chronic obstructive pulmonary disease (COPD). However, oxygen concentrators are not manufactured domestically and the COPD patients are currently treated with imported oxygen concentrators. To evaluate the efficacy and safety of domestically developed prototype oxygen concentrator before clinical application, the efficacy and safety of the domestic oxygen concentrator were evaluate by comparing with the imported one. Meterial and METHODS: The clinical tests were performed on 36 hyperhydrosis patients from April 1999 to August 1999. Domestic and imported oxygen concentrators were in turn applied to the same patient, who inspired oxygen for 60 minutes at a rate of 3 liters per minute through nasal prong. The oxygen concentrator, which was applied first, was randomly allocated. The arterial partial oxygen pressure (PaO2) was estimated to compare the efficacy; and the carboxy hemoglobin(COHb), pH, arterial CO2 partial pressure, pulse rate, blood pressure, and respiration rate to compare the safety before and after applying each oxygen concentrator. A student t-test was used to analyze the results. RESULTS: In respect to efficacy, the difference in the change of PaO2 before and after the application between two concentrators was not statistically significant. In respect to safety, the differences in the changes of COHb, pH, partial pressure of arterial CO2, pulse rate, blood pressure, respiration rate between two concentrators were also not statistically significant. CONCLUSION: The domestically developed oxygen concentrator, showed satisfactory efficacy and safety when compared with the imported one.
Blood Pressure ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Oxygen* ; Partial Pressure ; Pulmonary Disease, Chronic Obstructive ; Respiratory Rate

Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

PURPOSE: The purpose of this study was to determine whether Fas-L expression is associated with increased apoptotic induction of tumor-infiltrating lymphocytes (TIL) in human gastric carcinomas. MATERIALS AND METHODS: The author analysed 38 cases of early gastric carcinoma (EGC) and 61 cases of advanced gastric carcinoma (AGC) who received gastric resection, in whom the number of diffuse type was 38 cases and the number of intestinal type was 61 cases. The author used immunohistochemical staining for Fas, Fas-L and CD45, and TUNEL in situ apoptosis detection kit. TIL were detected by CD45 and apoptosis of TIL were detected by CD45 expression and TUNEL positivity on serial histologic sections. RESULTS: Fas-L was localized to neoplastic cells in 61% (23/38) of EGC group and 66% (40/61) of AGC group. The extent of Fas-L expression was variable, with both Fas-L positive and negative neoplastic region occuring within tumors. TIL adjacent to Fas-L expressing tumor region were decreased in number and TIL adjacent to FasL-negative tumor region were increased in number; apoptotic induction of TIL showed just the opposite pattern (p<0.05). Fas expression was found essentially homogeneously throughout the tumor mass independent of tumor stage. Fas expression showed 64% (39/61) of intestinal type and 68% (26/38) of diffuse type. Labeling indices for tumoral apoptosis in EGC and AGC were 6.72% and 7.13%, respectively and this difference was statistically insignificant. Co-expression of Fas-L and Fas, which occurred over large areas of the tumors, did not result in an enhanced rate of tumor cell apoptosis. In addition, factors such as tumor stage and other prognostic factors were not concerned in Fas and Fas-L expression, number of TIL and apoptotic induction. CONCLUSION: These findings suggest Fas-mediated apoptotic depletion of TIL in response to Fas-L expression by stomach cancers, and provide the evidence to support the Fas counterattack as a mechanism of immune escape in gastric cancer. In addition, gastric carcinoma cells of the intestinal and diffuse type did not differ in their expression of the apoptotic receptor Fas.
Apoptosis* ; Humans ; In Situ Nick-End Labeling ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms ; United Nations

Osteogenesis imperfecta has been categorized as a heritable disorder of connective tissue affecting both bone and soft tissues and is characterized by fragility of bone, blue sclera, and deafness, less frequently by dentinogenesis imperfect and laxity of ligament. The goals of orthopedic management with osteogenesis imperfecta are the treatment of acute factures and long term rehabilitation in an effort to maintain ambulation. We report a case of osteogenesis imperfecta with anterior bowing of tibia which was successfully corrected by multiple osteotomies and intramedullary fixation by Sofield method and reviewed literatures.
Connective Tissue ; Deafness ; Dentinogenesis ; Ligaments ; Methods ; Orthopedics ; Osteogenesis Imperfecta* ; Osteogenesis* ; Osteotomy ; Rehabilitation ; Sclera ; Tibia ; Walking