No abstract available.
DNA* ; Herpesvirus 3, Human*

The TRAM flap provides the safe creation of a durable, soft, natural-appearing breast mound and has thus become the most popular method of breast reconstruction. On the other hand, the rectus muscle can be used as a good donor site for a flap reconstruction in trauma or osteomyelitis cases on the lower extremity. The abdominal sequelae, including abdominal wall dysfunction after free rectus muscle transfer, was evaluated. Thirty-seven patients underwent free TRAM (n=29) or rectus abdominis muscular free flap(n = 8) operations between 1994 and 1997. In harvesting of the TRAM flap, a muscle-splitting technique was used and thus one-quarter of the muscle was preserved. In rectus muscular free flap, the entire width of the rectus abdominis muscle was harvested. Among the 37 patients, 26 patients (20 free TRAM flap and 6 rectus muscular free flap) were studied, for they were followed up postoperatively for at least 6 months and had provided preoperative data of abdominal strength. Cosmetic results of the abdomem were appraised by four independent judges on photographs taken of 26 patients. The global appearance of the abdomen was rated as "natural" in 75%. The scar on the umbilicus and lower abdomen was rated as acceptable or not visible in 65%. The replies to questionnaires were analyzed Patient self-assessment showed general satisfaction. In 24 of 26 answers, they said they would recommend the operation to others, and 70% of the patients found their abdominal strength and sports ability the same or improved. Thirty percent of the patients complained that back pain developed or became aggravated after surgery. Abdominal muscular strength was tested both preoperatively and 6 months to 1 year period after surgery according to Lacote. The abdominal wall function was impaired, especially in the upper rectus and external oblique muscle. In conclusion even though the abdominal sequelae after free TRAM or rectus muscular free flap reconstruction should not be urderestimated, no problem of clinical significance was encountered, and patients showed a high degree of satisfaction with the operation
Abdomen ; Abdominal Wall ; Back Pain ; Breast ; Cicatrix ; Female ; Free Tissue Flaps* ; Hand ; Humans ; Lower Extremity ; Mammaplasty ; Osteomyelitis ; Surveys and Questionnaires ; Rectus Abdominis* ; Self-Assessment ; Sports ; Tissue Donors ; Umbilicus

PURPOSE: The most important step for patients who come to the emergency department with ureter stones is acute pain management. There have been insufficient studies on what factors affect acute pain management for ureteral colic the most. In this study, patients with ureteral colic were divided into two groups: one group, in which the pain was first managed with an analgesic, and another group with unmanaged pain, to find factors that most affect additive analgesics administration for ureter stones. METHODS: There were 121 patients, eventually confirmed for the presence of ureter stones through a computed tomography CT scan, included in this study. When ureter stones were suspected after the initial patient evaluation, initial pain was assessed through numerical rating scale (NRS) and the first analgesic was administered once. Pain was reassessed through NRS after 30 minutes. At that time, if the pain was managed, the patient was assigned to Group 1. If the pain persisted, another analgesic was administered for the second and third time, and the patient was assigned to Group 2. Finally, ureter stones were identified through CT scan. RESULTS: There were 58 patients (47.9%) in Group 1 and 63 patients (52.1%) in Group 2. There were no statistically significant differences in average age, serum creatinine, size of ureter stone, and severity of hematuria between the two groups. The differences in NRS measured initially and after 30 minutes were statistically significant (7.6+/-1.4 vs. 8.6+/-1.2, p<0.001; 1.4+/-1.3 vs. 6.6+/-1.9, p<0.001, respectively). The presence of hydronephrosis and perirenal edema were also statistically significant (p<0.001, p=0.007). The affecting factor for the administration of additive analgesics was hydronephrosis (odds ratio 7.213, p<0.001). CONCLUSION: Hydronephrosis is an important factor in the treatment of patients with additive analgesics. It can also be used as a predictive index to assess the severity of pain in patients with ureter stones.
Acute Pain ; Analgesics ; Creatinine ; Edema ; Emergencies ; Hematuria ; Humans ; Hydronephrosis ; Renal Colic ; Ureter ; Urolithiasis

Skin graft has been widely used for facial skin reconstruction. Inguinal area is the common donor site for full-thickness skin graft of various area. Especially for facial skin graft, retroauricular area or upper eyelid skin has been used as a donor site. But these donor sites have some limitations as perfect ones in terms of size, color and texture when applied onto facial area. Even retroauricular skin shows color and texture differences from normal facial skin after it is grafted. Authors performed expansion of the skin of preauricular area or forehead where minimal scars would come out after final operation. We harvested this expanded skin and performed skin graft following excision of nevus, poor scar, or hemangioma in face.We achieved satisfactory results in terms of color and texture by applying this method in 11 clinical cases; 4 cases of hemangioma, 4 nevus, and 3 cases of traumatic scar. Donor site scars were clinically inspicuous in all these 11 cases.
Cicatrix ; Eyelids ; Forehead* ; Hemangioma ; Humans ; Nevus ; Skin* ; Tissue Donors ; Transplants*

PURPOSE: Colonoscopy is a safe and commonly used method for the screening of colon cancer, but sometimes major complications, such as, colonic perforation or hemorrhage occur during the procedure. The aim of this study was to compare the surgical outcomes of laparoscopic and open surgery for colon perforation after colonoscopy. METHODS: A retrospective review of patient records was performed on 25 patients with iatrogenic colon perforation during colonoscopy during the 7-year period from January 2005 to June 2012. Demographic data, operative procedures, operation times, postoperative complications, hospital course, and morbidities in the laparoscopic surgery group (LG) and open surgery group (OG) were compared. RESULTS: Seventeen of the 25 patients underwent laparoscopic surgery (68%) and 8 patients open surgery (32%). The most common surgical methods were primary repair in the LG, and Hartmann's operation in the OG. Average time to first flatus was 2.9 days in the LG and 4.5 days in the OG, and average times to first meals were 4.5 days and 5 days, respectively. Mean hospital stays were 10.8 days in the LG and 17 days in the OG. After surgery, complications occurred in two patients in the LG, but no complication occurred in the OG. CONCLUSION: Laparoscopic repair for iatrogenic colonic perforation during colonoscopy seems to be useful and safe surgical method in early period after perforation. However, open surgery is also needed for the delayed cases after perforation.
Colon* ; Colonic Neoplasms ; Colonoscopy* ; Flatulence ; Hemorrhage ; Humans ; Intestinal Perforation ; Laparoscopy ; Length of Stay ; Mass Screening ; Meals ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: Oncogenes and EGF-Receptor(EGFR) may be involved n different stages of the multistep carcinogenesis process. A specific pattern of karyotypic abnormalities in solid tumors can be detected by cytogenetic methods. OBJECTIVE: This study is intnded to observe the cytomolecular kiologic chracterization of c-myc, erb B and EGFR genes in squasnous cell carcinoma(SCC) of the skin and cervix. METHODS: We have eytogenet,ically examined the short-term culturs from SCC. The rearrangement, amplification or expressi.on of erb B, c-myc, and EGFR genes were studied by Southern blot, analysis of genomic DNA and by slot blot analysis of tota! RNA extracted from biopsies of normal skin and SCC tissues. EGFR expression was examined immunohistochemially using monoclonal antibodies and the localizat,ion of the c-myc oncogene mRNA by in situ hybridization. RESULTS: A remarkably structural aberration was del 6(q21-qter) counted 20 metaphases among 28 metaphases ana1yzed. In nunierical aberration, all chromosomes were lost or gained randomly. Amenploid including triploid and tetraploid were observed in 8 metaphases, 6 tumor cells contained marker chromosome. In Southern blot analysis, rearrangement and amglificaton of EGFR in primary squamous cell carcinoma of cervix uteri and skin respectively. In slot blot analysis, the levels of c-myc, erb B and EGFR mRNA increaaed respectively 3.5, 2.5 and 2.8 times in SCC when compared to normal tissues. In immunoperoxidase stain, EGFR was present, in SCC where keratinocytes with strong cyto-plasmic staining but no membr, line labelling, where as in normal skin the were primarily present in t,he membrane and cytoplasm of basal cells. In situ hybridization with c-myc cDNAs allowed detection of grains representative of biotin labelled cDNA-mRNA hybrids in the frozden section of SCC tissues. CONCLUSION: These results suggest that specific patterns of karyotypir abnormalites, rearrangement, or amplification of EGFR gene, and overexpression of oncogenes and EGFR gene may be associated with the carcinogenesis of SCC.
Antibodies, Monoclonal ; Biopsy ; Biotin ; Blotting, Southern ; Carcinogenesis ; Carcinoma, Squamous Cell* ; Edible Grain ; Cervix Uteri ; Cytogenetics ; Cytoplasm ; DNA ; DNA, Complementary ; Epidermal Growth Factor* ; Female ; Genes, erbB-1 ; In Situ Hybridization ; Keratinocytes ; Membranes ; Metaphase ; Oncogenes ; RNA ; RNA, Messenger ; Skin ; Tetraploidy ; Triploidy

The goals of this study were 1) to present pre-surgical naso-alveolar molding(PNAM) appliance for bilateral cleft lip and palate treatment and 2) To evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and lateral segment was 8.09+/- 5.03mm and average duration of alveolar molding treatment was 8.8+/-3.1weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper. All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully. 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved posteriorly via alveolar molding. Conclusion : This appliance can be applied to bilateral cleft lip and palate infants with satisfactory result before cheiloplasty.
Cleft Lip* ; Female ; Fungi* ; Humans ; Infant* ; Male ; Orthodontics ; Palate* ; Photometry ; Seoul ; Vomer

Due to the increased frequency of interspecies transmission of avian influenza viruses, studies designed to identify the molecular determinants that could lead to an expansion of the host range have been increased. A variety of mouse-based mammalian-adaptation studies of avian influenza viruses have provided insight into the genetic alterations of various avian influenza subtypes that may contribute to the generation of a pandemic virus. To date, the studies have focused on avian influenza subtypes H5, H6, H7, H9, and H10 which have recently caused human infection. Although mice cannot fully reflect the course of human infection with avian influenza, these mouse studies can be a useful method for investigating potential mammalian adaptive markers against newly emerging avian influenza viruses. In addition, due to the lack of appropriate vaccines against the diverse emerging influenza viruses, the generation of mouse-adapted lethal variants could contribute to the development of effective vaccines or therapeutic agents. Within this review, we will summarize studies that have demonstrated adaptations of avian influenza viruses that result in an altered pathogenicity in mice which may suggest the potential application of mouse-lethal strains in the development of influenza vaccines and/or therapeutics in preclinical studies.
Animals ; Host Specificity ; Humans ; Influenza A virus ; Influenza in Birds* ; Influenza Vaccines ; Methods ; Mice ; Orthomyxoviridae ; Pandemics ; Serial Passage ; Vaccination ; Vaccines* ; Virulence

No abstract available.
Collagen Type I* ; Skin* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Primary liver tumors account for less than 2% of pediatric malignancies, and the best treatment is complete surgical excision. The aim of this study was to review the results of liver transplantation (LT) for primary hepatomas in children. METHODS: The medical records of patients who underwent LT for unresectable primary hepatoma between May 1996 and December 2009 were reviewed retrospectively. RESULTS: Seven of 130 patients (5.3%, M:F=4:3) underwent LT for unresectable hepatoma. The median age at transplantation was 9 years (range, 6 months-14 years). Two patients were transplanted for hepatitis B virus-associated hepatocellular carcinoma (HCC), 2 for hepatoblastoma, 1 for hemangioendothelioma, 1 for angiosarcoma, and 1 for intrahepatic cholangiocarcinoma after a Kasai operation for biliary atresia. There was no post-LT treatment except in patients with HCC who were taking immunoglobulin prophylaxis against hepatitis B. Four patients (2 HCC, 1 hepatoblastoma, 1 hemangioendothelioma) are now alive and well after 7.8, 7.2, 7.7, 6.3 years of follow-up, respectively. Three patients died after transplantation; 1 for the recurrent cholangiocarcinoma in the transplanted liver 1 year after the transplantation and 1 who underwent LT for the recurrent hepatoblastoma for the primary non-function 10 days after the transplantation. One patient died of metastatic angiosarcoma (bone) 2.5 years after LT. CONCLUSIONS: LT can be tried for unresectable primary hepatoma in children and, although limited, the outcome was successful in patients with HCC, hepatoblastoma, or hemangioendothelioma. Careful patient selection, based on the pre-transplant histological diagnosis, seems to be related to better outcome.
Biliary Atresia ; Carcinoma, Hepatocellular ; Child ; Cholangiocarcinoma ; Follow-Up Studies ; Hemangioendothelioma ; Hemangiosarcoma ; Hepatitis B ; Hepatoblastoma ; Humans ; Immunoglobulins ; Liver ; Liver Neoplasms ; Liver Transplantation ; Medical Records ; Patient Selection ; Transplants