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

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

Typical programmed cell death requires de novo macromolecular synthesis and shares common morphological changes referred to as apoptosis. To elucidate the molecular mechanism of apoptosis, we isolated 13 cDNA clones of zinc finger genes that are differentially expressed in calcium ionophore-induced apoptosis of Ramos human B cell by 'targeted RNA fingerprinting' protocol (Stone & Wharton, 1993). According to DNA sequence analysis of the 13 cDNA clones, three clones are identical with ZNF7, ZNF143 and MTB-Zf, respectively, and 8 out of the other 10 clones showed partial homology to known zinc finger genes. Differential expression was confirmed in the three known zinc finger genes by ribonuclease protection assay. ZNF7 and ZNF143 are up-regulated after induction of apoptosis, and, in contrast, MTB-Zf is down-regulated. According to the previous reports on these three genes, all of the three genes have been suspected to be tumor suppressor genes, but their functions have not been identified yet. Taken together, our results suggest that many of the novel and known zinc finger genes might play important roles in regulation of apoptosis and that these findings also provide clues as to the functions of the three putative tumor suppressor genes, ZNF7, ZNF143 and MTB-Zf in terms of apoptosis. In addition, the isolation of zinc finger genes by targeted RNA fingerprinting could be a straightforward approach for the identification of novel candidate genes associated with apoptosis.
Apoptosis* ; B-Lymphocytes* ; Calcium ; Cell Death ; Clone Cells ; Dermatoglyphics ; DNA, Complementary ; Genes, Tumor Suppressor ; Humans ; Ribonucleases ; RNA ; Sequence Analysis, DNA ; Zinc Fingers* ; Zinc*

PURPOSE: Evidence exists that dysregulation of apoptosis is involved in the pathogenesis of cancer development. Fas- associated death domain (FADD) protein, an adaptor protein of death receptors, is a critical regulatory component of the extrinsic cell- death pathway that exerts its pro-apoptotic effect upon binding with death receptors. Expression of the FADD protein has not been reported in stomach cancer. The aim of this study was to explore the expression status of the FADD protein in stomach cancers. MATERIALS AND METHODS: In the current study, we analyzed the expression of the FADD protein in 60 advanced stomach cancer by using immunohistochemistry and a tissue microarray approach. RESULTS: Immunopositivity (defined as > or =30%) was observed for the FADD protein in 23 (38%) of the 60 cancers. Normal gastric mucosal cells showed expression of the FADD protein. CONCLUSION: Taken together, these results indicate that decreased expression of the FADD protein is a frequent event in stomach cancers and suggest that to avoid apoptosis, stomach cancer cells in vivo may need loss of FADD expression, which might contribute to tumor development.
Apoptosis ; Fas-Associated Death Domain Protein* ; Immunohistochemistry ; Receptors, Death Domain ; Stomach Neoplasms* ; Stomach*

PURPOSE: Evidence exists that dysregulation of apoptosis is involved in the pathogenesis of cancer development. The Bcl-XL/Bcl-2-associated death promoter (BAD), a member of the Bcl-2 family, is a critical regulatory component of the intrinsic cell-death pathway that exerts its pro-apoptotic effect upon heterodimerization with anti-apoptotic proteins Bcl-2 and Bcl-XL. Expression of the BAD protein has been reported in several cancer types, but not in stomach cancer. The aim of this study was to explore the expression status of the BAD protein in gastric carcinomas. MATERIALS AND METHODS: In the current study, we analyzed the expression of the BAD protein in 60 advanced gastric adenocarcinomas by using immunohistochemistry and a tissue microarray approach. RESULTS: Immunopositivity (defined as > or =30%) was observed for the BAD protein in 57 (95%) of the 60 cancers. Normal gastric mucosal cells showed weaker expressions of the BAD protein than gastric carcinomas. CONCLUSION: Taken together, these results suggest that stomach cancer cells in vivo may need BAD protein expression for apoptosis. Also, the higher expression of the BAD protein in stomach cancer cells than in normal gastric mucosal cells suggests that apoptosis might be easily triggered in susceptible stomach cancer cells, thereby producing selective pressure to make more apoptosis-resistant cells during tumor development.
Adenocarcinoma ; Apoptosis ; Apoptosis Regulatory Proteins ; bcl-Associated Death Protein* ; Humans ; Immunohistochemistry ; Stomach Neoplasms

Patient with compalints of swelling, pain in the maxillary region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal h yphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he w as diagnosed with nonspecific inflammation. But as yet, we do think this case is very similar to some kinds of mucomycos is. So we presented this case for more thorough discussion. Following are founded in the examination. 1. Patient had sufferd from Diabetes mellitus and complained of stuffness, headache, swelling in buccal cheeks and pare sthesia. And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examinati on. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal ca vities. CT and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in in volved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antibiotics were taken for 4 months. But now he was worse than in the past. 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa we re seen clearly in the CT and MRI.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Cavernous Sinus ; Cheek ; Cranial Fossa, Middle ; Cranial Fossa, Posterior ; Curettage ; Diabetes Mellitus ; Frontal Sinus ; Fungi ; Headache ; Humans ; Inflammation* ; Magnetic Resonance Imaging ; Maxilla ; Orbit ; Palate ; Seoul ; Ulcer