For treatment of the pressure sore, varieties of methods have been developed such as skin graftings, local flap, myocutaneous or fasciocutaneous flap, etc.. Except mild cases, myocutaneous flaps have been used commonly for the best coverage and padding of the wound. But the gluteus maximus muscle is not an expendable muscle, so the myocutaneous flaps using gluteus maximus muscle result in significant functional loss in ambulatory patients. Various methods as fasciocutaneous flap to reserve a function of the gluteus maximus muscle have been developed. We especially designed a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement in sacral sore when the defect is fusiform transversely in shape. With this design, we obtained reduced tension in the midline suture with less dissection in medial portion of the fasciocutaneous flap and made the flap more rleliable by including more parasacral perforators within the flap. We have experienced the eight cases of gluteal fasciocutaneous V-Y advancement flap and obtained the excellent results without flap necrosis. We conclude that a bilateral fasciocutaneous flap in the fashion of interdigitating extended V-Y advancement is useful in sacral sore when the defect is fusiform transversely in shape.
Humans ; Myocutaneous Flap ; Necrosis ; Pressure Ulcer ; Skin Transplantation ; Sutures ; Wounds and Injuries

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

BACKGROUND AND OBJECTIVES: Cholesteatoma is a disease of the temporal bone, affecting the squamous epithelium and invading into the middle ear cavity. Retinoic acid (RA) is known to inhibit or accelerate the proliferation of normal keratinocytes depending on its concentration. This study was aimed at investigating the effects of different concentrations of RA on the proliferation of cultured keratinocytes from the external ear and cholesteatoma and whether the effect is different according to the origin of tissue. MATERIALS AND METHODS: Patients undergoing tympanomastoid surgery for cholesteatoma were selected, and cholesteatoma matrix and skin were obtained from their middle ears and external ears, respectively. After culturing keratinocytes from the external ear and cholesteatoma, cells were cultured for 7 days in the medium 154 (Cascade, USA), and 10(-6)M RA or 10(-7)M RA was added twice every three days. The control group was cultured without the addition of RA. The absorbance was estimated at 490 using CellTiter 96(TM)AQ(ueous) Non-Radioactive Cell Proliferation Assay, nm and the survival fraction was calculated and compared with the control group. RESULTS: Proliferation of keratinocytes from the external ear and cholesteatoma was inhibited when the concentration of RA was 10-6 M and accelerated when the concentration of RA was 10(-7)M. The accelerated effect of retinoic acid on the proliferation of keratinocyte seems to be less prominent in the cholesteatoma tissue than in the skin of normal ear canal. CONCLUSION: Retinoic acid can inhibit or accelerate the proliferation of cholesteatoma keratinocytes dependining on its concentration.
Cell Proliferation ; Cholesteatoma* ; Ear Canal ; Ear, External* ; Ear, Middle ; Epithelium ; Humans ; Keratinocytes* ; Skin ; Temporal Bone ; Tretinoin*

The incidence of atherosclerosis in Korea seems to be much increased due to diet change after national development. The pathogenesis of atherosclerosis is not clarified and there are many hypothesis but the most recent and reliable hypothesis is the ratio of HDL-cholesterol per total cholesterol. Under the basis of this hypothesis there have been much trials to administer the agents which has effect on lipid metabolism, so we tried pantethine on 30 patients who visited Han-Yang University Hospital Internal medicine Department, and the result as follows; 1) The mean age of study population was 50.1 years of age, mean body weight was 62kg, and mean height was 160.8cm. male was 17, and female 10. 2) The associated disease of study population was <19 with> cardiovascular disease, in 19, gastrointestinal disease 3, obesity in 1 and others in 4. 3) The undesirable effect of the drug was found on 3 patients; that is, constipation on 1 patient, dizziness on 1 patient, and skin eruption on 1 patient. 4) The mean serum lipids before and after pantethine administration(levels) are as following table. In conclusion, it seems that the effect of the drug which decreases the serum lipids is mild at initial but more increasing as the time goes by and constant, and we experience little side reaction except mild dizziness, constipation and skin eruption.
Atherosclerosis ; Body Weight ; Cardiovascular Diseases ; Cholesterol* ; Constipation ; Diet ; Dizziness ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Internal Medicine ; Korea ; Lipid Metabolism ; Male ; Obesity ; Skin ; Triglycerides*

The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin

Bromidrosis is a disorder characterized by rancid body odor which influences a patient's social life and mental health. The therapeutic modalities and the mechanism of bromidrosis have been carefully studied, however, there have been few reports about the genetic inheritance of bromidrosis. We investigated the family history of 42 patients who were operated on for bromidrosis and followed up to the third generation in 10 cases. The results were as follows: Results of investigation which were followed up the second generation. The fathers of five patients and the mothers of 11 patients had bromidrosis in 18 male patients. The fathers of six patients and the mothers of 12 patients had bromidrosis in 24 female patients. Thirty-four patient (81.0%) among a total of 42 have a single parent with bromidrosis. Result of investigation which were followed up to the third generation Bromidrosis was occurred in 17 of 42 patients (40.5%) in the second generation, and 18 of 27 patients (66.7%) in the third generation. In one case, a father transmitted bromidrosis to his three sons, and as a result, X-linked inheritance could be ruled out Bromidrosis was not skipped in every generation of all families. We on conclude that bromidrosis is an autosomal dominant inherited disorder.
Fathers ; Female ; Genes, X-Linked ; Humans ; Male ; Mental Health ; Mothers ; Odors ; Single Parent ; Wills*

The use of mitomycin C as an adjunct improves the success rate of filtering surgery. Blebs after trabeculectomy with mitomycin C tend to be relatively transparent, thin-walled and cystic. Such a bleb is associated with low intraocular pressure but tends to leak and may predispose an eye to endophthalmitis. However, the incidence and risk factors associated with this complication are not known. To determine the incidence and possible risk factors for the development of thin-walled blebs, case records of 160 eyes of 112 patients who received mitomycin C during trabeculectomy were reviewed. Thin-walled, cystic blebs developed postoperatively in 38 (23.8%) of 160 eyes that underwent trabeculectomy with mitomycin C between 1992 and 1995. As the postoperative follow-up time became longer, a greater development of thinwalled cystic blebs was noted. Characteristics of patients after trabeculectomy with mitomycin C in whom thin-walled blebs developed were compared with those of patients in whom thin-walled blebs did not develop. Factors associated with increased risk were: thin conjunctiva and Tenon's capsule (odds ratio 12.7, 95% confidence interval 2.2 to 73.4, P=0.002), uncomplicated glaucoma (primary open-angle glaucoma >or=50 years, primary angle-closure glaucoma) (odds ratio 3.3, 95% confidence interval 1.5 to 7.0, P=0.002), and systemic hypertension (odds ratio 3.8, 95% confidence interval 1.7 to 8.6, P=0.001).
Blister* ; Conjunctiva ; Endophthalmitis ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hypertension ; Incidence ; Intraocular Pressure ; Mitomycin* ; Risk Factors* ; Tenon Capsule ; Trabeculectomy*

No abstract available.
Humans ; Somatoform Disorders*

Ultrasonography is a simple, noninvasive and relatively accurate method to differentiate carcinomas from stones in the extrahepatic biliary tree. We analysed ultrasonic findings in 18 stoen cases and 10 carcinoma cases of the extrahepatic biliary tree, which were confirmed by microscopic examination or percutaneous transhepatic cholangiography during the period of May 1980 through May 1982 in Kangnam St. Mary's Hospital. The results were as follows: 1. The number of incidences of multiple echogenecities was 11 out of the 18 stone cases (61.1%) but there were no incidences of multiple echogenecities among the carcinoma cases. Eight cases, four of stoens and carcinomas each , were not detected by sonography. 2. The average diameter of the stones was below 20mm in 13 of the 18 cases (72 .2%) and the number of the stoens over 20mm in diameter was only one of the 18(5.6%), while the number of carcinomas over 20mm was three of the 10 cases (30%). 3. In the 18 patients with stoens, the degree of echogenecity was uniformly high in seven (38.9%) and mixed-moderate in seven (38.9%) . All the carcinomas, however, presented mixed-slight echogenecity. The marginal sharpness was well defined in nine of the 18 stone cases (50%), but only one among the carclnomas. 4. The obstructive site in the biliary tree in the stone cases showed a typical meniscus in 10 (55 .6%), abrupt cutting in four (22_2%) and were indiscernible in four (22.2%). But of the 10 carcinoma cases four (40%) were of abrupt cutting, two (20%) funnel
Acoustics ; Bile Ducts, Extrahepatic ; Biliary Tract ; Cholangiography ; Diagnosis, Differential ; Dilatation ; Humans ; Incidence ; Methods ; Ultrasonics ; Ultrasonography

PURPOSE: We wanted to demonstrate the anti-cancer effect and interaction between belotecan and cisplatin on gastric cancer cell line and we evaluated the mechanisms of this synergistic effect in vitro. MATERIALS AND METHODS: The growth inhibitory effect of belotocan and cisplatin against several gastric cancer cell lines (SNU-5, SNU-16 and SNU-601) was estimated by tetrazolium dye assay. The effect of a combination treatment was evaluated by the isobologram method. The biochemical mechanisms for the interaction between the drugs were analyzed by measuring the formation of DNA interstrand cross-links (ICLs) and DNA topo-I activity. RESULTS: Belotecan showed synergism with cisplatin for growth inhibitory effect on the gastric cancer cell lines SNU-5, and SNU-16, but this was subadditive on the SNU-601 cell line. The formation of DNA ICLs in SNU-16 cells by cisplatin was increased by combination with belotecan, but this was not affected in SNU-601 cells. The topo-I inhibition by belotecan was enhanced at high concentrations of cisplatin in SNU-16, but not in SNU-601 cells. CONCLUSION: Belotecan and cisplatin show various combination effect against gastric cancer cells. The synergism between cisplatin and belotecan could be the result of one of the following mechanisms: the modulating effect of belotecan on the repair of cisplatin-induced DNA adducts and the enhancing effect of cisplatin on the belotecan-induced topo-I inhibitory effect.
Cell Line ; Cisplatin* ; DNA ; DNA Adducts ; Stomach Neoplasms*