Composite grafting remains a technique which is used reluctantly and without great hope of success. In the recent two years, unexpectedly good result of composite graft was gained from 30 cases. The purpose of our study is to identify factors influencing success and to overlook long-term problems from a cosmetic and a functional view point. A retrospective review and a questionnaire about 30 fingers of 29 patients which were operated for composite graft at Kyongju hospital of Dongguk university from March 1997 to February 1999 were carried out. In all cases of composite grafting, tie-over dressing and heat lamp were applied and left for five days. And following result and conclusion were obtained. 1. 24(80%) of 30 finger tips replaced as composite graft were survived completely or partially. 2. At children with an age range 1 to 14, the survival rate (100%) of composite grafted tips was higher than that (75%) at adults. So, patient's age was important factor for success. 3. The type of injury was more important factor than the level of amputation. The survival rate(100%) of tips to cutting injury was higher than that(75%) of tips to crushing injury. 4. The delay in time from amputation and replacement did not significantly correlate with the survival rate. But, all tips replaced within 3 hours were survived completely or partially. 5. Even if partial necrosis on grafted tips was present, a result of long-time conservative treatment with minimal debridrement was excellent. Especially in children, the tips with conservative treatment showed normal appearance, several months later. 6. Cosmetic and functional results were better in child group and in groups with higher survival rate. Most common problem in cosmetic aspect was a short digit and that in functional aspect was a tender tip. 7. As a heat lamp increased blood supply, we could obtain better outcome.
Adult ; Amputation ; Bandages ; Child ; Fingers ; Gyeongsangbuk-do ; Hope ; Hot Temperature ; Humans ; Necrosis ; Surveys and Questionnaires ; Retrospective Studies ; Survival Rate ; Transplants*

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.
Cicatrix ; Congenital Abnormalities ; Diplopia ; Enophthalmos ; Free Tissue Flaps ; Humans ; Orbit* ; Skin ; Tissue Donors ; Transplants

PURPOSE: Evidence exists that dysregulation of Bcl-2 family members is involved in the pathogenesis of cancer development. The aim of this study was to explore whether the somatic mutation of proapoptotic Bcl-2 member genes, one of the mechanisms that prolong the survival of cancer cells, is involved in gastric carcinogenesis. MATERIALS AND METHODS: In the current study, to detect somatic mutations of the DNA sequences encoding the Bcl-2 homology 3 (BH3) domain of the human BAD, BIM, BIK, and Bcl-G genes in 60 advanced gastric adenocarcinomas, we used the polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP), and DNA sequencing. RESULTS: The SSCP analysis revealed no mutations in the coding regions of the BH3 domain in the cancers. CONCLUSION: The data presented here indicate that proapoptotic Bcl-2 member genes, BAD, BIM, BIK, and Bcl-G, may not be mutated in human gastric carcinomas and suggest that these genes might be altered by mechanisms other mechanisms somatic mutation.
Adenocarcinoma ; Apoptosis ; Base Sequence ; Carcinogenesis ; Clinical Coding ; Humans ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA

The aim of this study was to investigate the relationships between the gadd genes expression and an apoptosis induction in two different growing cell types after treatments with cisplatin and methylmethan sulfonate (MMS). We have examined the kinetics and specificity of gadd45 and gadd153 expression following cisplatin and MMS treatments to HL-60 cells and primary cultured human kidney (HKN) cells. We have also determined an induction time of apoptosis by DNA fragmentation analysis and the presence of the cell cycle arrest by a flow cytometric measurement. The results were as follows. In non-adherent HL-60 cells, a typical ladder pattern was observed within 4 hours after treatments of 20 micrometer of cisplatin and 100 microgram/ml of MMS. At the same time while adherent HKN cells failed to exhibit a ladder pattern at even higher doses of genotoxic agents. Since HL-60 cells do not have p53 gene, these findings suggest the presence of a p53-independent apoptotic pathway. The increasing patterns of the mRNA levels of gadd45 and gadd153 varied with the type of genotoxic agents. In the case of MMS treatment, the induction was rapid and transient, regardless of the cell types. The mRNA level peaked at 4 hours after MMS treatment and markedly decreased after 12 hours. On the other hand, cisplatin-induced transcriptions of gadd45 and gadd153 continued to increase for at least 24 hours and reached a peak level at 48 hours after cisplatin treatment, regardless of the cell types. HL-60 cells revealed G2 arrest following 24 hours after cisplatin and MMS treatments. These findings suggest that the regulation mechanism of apoptosis between adherent and non-adherent cells, might be different and that gadd45 and gadd153 might have an important role in DNA repair rather than apoptosis. Also, the findings suggest that an expression pattern of gadd45 and gadd153 might be different according to the type of genotoxic agents.
Apoptosis* ; Cell Cycle Checkpoints ; Cell Cycle* ; Cisplatin ; DNA Damage ; DNA Fragmentation ; DNA Repair ; Genes, p53* ; Hand ; HL-60 Cells ; Humans ; Kidney ; Kinetics ; RNA, Messenger ; Sensitivity and Specificity

This study was conducted to examine nutrient intake status and iron food sources by dietary iron density of high school girls in Seoul. The subjects of 226 girls were divided into High group (> or = 6 mg/1,000 kcal, N = 115) and Low group (< 6 mg/1,000 kcal, N = 111) by dietary iron density. The nutrient intake data obtained by 24-hour recall method were analyzed by Can pro 3.0 software. Mean age of all subjects was 16.4 years old, heights and weights of High group and Low group were 164.5 cm, 53.4 kg and 161.7 cm, 51.7 kg, respectively. The body mass index (BMI) of High group and Low group was 20.5 kg/m2 and 19.8 kg/m2, respectively. Most nutrient intakes except energy and lipid intakes of High group were higher than those of Low group. High group showed significantly higher intakes of total iron, vegetable iron and animal iron than Low group. Ca and folate intakes of High group were under 75% of the recommended intake (RI) and Ca, iron, folate and vitamin C intakes of Low group were under 65% of RI. The percentage of subjects who consumed iron less than estimated average requirements (EAR) were 40.0% in High group and 77.5% in Low group. Total food intakes of High group showed higher than that of Low group. Total animal food intakes were significantly higher and total vegetable food intakes were significantly lower in Low group than those of High group. Iron intake from meats, fishes, shell fishes and seasonings were significantly higher in High group than Low group. Iron intake from milk and dairy products were significantly lower in High group than Low group. Major food sources of iron were rice, bean curd, pork, and egg in order among both groups.
Animals ; Ascorbic Acid ; Body Mass Index ; Dairy Products ; Female* ; Fishes ; Folic Acid ; Humans ; Iron* ; Iron, Dietary* ; Meat ; Milk ; Ovum ; Seasons ; Seoul* ; Vegetables ; Weights and Measures

PURPOSE: In the cases of a vascular compromised condition in an injured lower extremity, soft tissue coverage with free tissue transfer presents a challenging problem to the reconstructive surgeon. For this reason, cross-leg flaps are still used in unusual circumstances. Advances in surgical technique has made the cross-leg free flap possible although it may require long operation time along with significant donor site morbidity. Therefore, a pedicled cross-leg muscle flap may be an alternative treatment modality when local flap or free flap is not possible. METHODS: Twelve patients(9 males and 3 females) underwent the operation from October 2001 to December 2008. The patients' age ranged from 6 to 82 years. The unusual defects included the regions such as the knee, popliteal fossa, distal third of the tibia, dorsal foot, and the heel. Indications for the cross-leg gastrocnemius flap are inadequate recipient vessels for free flap(in eight cases), extensive soft tissue injuries(in three cases) and free flap failure(in one case). The muscle flap was elevated from contralateral leg and transferred to the soft tissue defect on the lower leg while both legs were immobilized with two connected external fixator systems. Delay procedure was performed in 2 weeks postoperatively, and detachment was done after the establishment of the adequate circulation. The average period from the initial flap surgery to detachment was 32 days(3 to 6 weeks). Mean follow-up period was 4 years. RESULTS: Stable coverage was achieved in all twelve patients without any flap complications. Donor site had minimal scarring without any functional or cosmetic problems. No severe complications such as deep vein thrombosis or flap necrosis were noted although mild to moderate contracture of the knee and ankle joint developed due to external fixation requiring 3 to 4 weeks of physical treatment. All patients were able to walk without crutches in 3 months postoperatively. CONCLUSION: Although pedicled cross-leg flaps may not substitute free flap surgery, it may be an alternative method of treatment when free flap is not feasible. Using this modification of the gastrocnemius flap we managed to close successfully soft tissue defects in twelve patients without using free tissue transfers.
Ankle Joint ; Cicatrix ; Contracture ; Cosmetics ; Crutches ; External Fixators ; Follow-Up Studies ; Foot ; Free Tissue Flaps ; Heel ; Humans ; Knee ; Leg ; Lower Extremity ; Male ; Muscle, Skeletal ; Muscles ; Necrosis ; Tibia ; Tissue Donors ; Venous Thrombosis

RNA fingerprinting using on arbitrary primed polymerase chain reaction (RAP-PCR) was carried out to identify differentially expressed genes in HL-60 cell after treatment of methylmethane sulfonate (MMS). Twenty differentially expressed PCR products were cloned and analyzed. We have successfully obtained eight partial cDNA sequences by TA cloning method. Among these, six cDNAs were up-regulated and two cDNAs were down-regulated after the MMS treatment. Of these six up-regulated cDNAs, 3 cDNAs were equivalent to known genes in the GenBank/EMBL databases with 98~100% homology searched by BLAST program: genomic DNA fragment containing CpGg island (clone 26h8), Human Rev interacting protein-1 (RIP-1), and human zinc finger protein-4 (HZF4). The sequences of the three remaining cDNA were entirely new genes, but we didn't try to identify a full cDNA sequence. Two clones called KIAA0060 and KIAA0065, were down-regulated in HL-60 cells after the MMS treatment. These findings suggest that the RNA fingerprinting method using RAP-PCR is an effective method which can identify and separate the differentially expressed cDNAs and that the isolated cDNAs might involve in regulation mechanism of apoptosis and/or cell cycle delay, especially a p53-independent pathway, in the cells after DNA damage. But the nature of cDNAs that we have isolated remains to be elucidated.
Apoptosis ; Cell Cycle ; Clone Cells ; Cloning, Organism ; Dermatoglyphics* ; DNA Damage* ; DNA* ; DNA, Complementary ; HL-60 Cells ; Humans ; Methyl Methanesulfonate ; Polymerase Chain Reaction ; RNA* ; Zinc Fingers

No abstract available.
Free Tissue Flaps*

PURPOSE: Clear cell hidradenoma, now regarded as an eccrine sweat gland tumor on the basis of its enzyme histochemical and electron microscopic features, occurs as a solitary tumor in most instances. METHODS: A 17 year old male presented with asymptomatic nodule, which had developed on nipple with a four years of history and total excision and purse-string suture was then performed. RESULTS: No recurrence was observed 2 months after excision. Histologically, it showed a well circumscribed tumor composed of characteristic clear epithelial cells which are focally arranged in glandular patterns. CONCLUSION: This case is unique in that the tumor developed on the young male nipple, unusual site and this report emphasizes the benefit of local excision to prevent recurrence of these tumor.
Acrospiroma* ; Adolescent ; Epithelial Cells ; Humans ; Male* ; Nipples* ; Recurrence ; Sutures ; Sweat Glands

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.
Arm/*blood supply ; Axillary Artery/anatomy & histology ; Brachial Artery/*anatomy & histology/*physiology ; Cadaver ; Female ; Humans ; Korea ; Male ; Median Nerve/blood supply ; Models, Anatomic ; Radial Artery/anatomy & histology ; Ulnar Artery/anatomy & histology