It has been generally believed that the continuous flow of blood characterised by arterial inflow and venous outflow is essential for the survival of flaps. Since Baek et al.(1985) demonstrated the survival of a flap based on only a single vein without arterial inflow, there have been a lot of reports of successful skin flaps that depend on only venous blood flow. The location of pedicle is one of the important factors on the survival of flaps, but there have not been an effective study on the survival rates of venous island flaps according to their location of pedicles. In this study, we compared the survival rates of proximally based venous island flaps with those of distally based ones and attempted to decrease the difference, if any, in the survival rates between them. Distally or proximally based 4x3 cmvenous island flap, whose pedicle was a marginal branch of central vein, was elevated from the auricular cartilage of New Zealand white rabbit. IN the half of 20 rabbits, superoxide dismutase (SOD, 20,000 U/kg) was injected intravenously 30 minutes and 60 minutes after the flap elevation. On the 7th postoperative day, survival areas of the flaps were measured by image analysis system and the vascular network with the flaps were examined by micro fil cast. 40 flaps were divided as follows: proximally based venous flaps, distally based venous flaps, SOD treated proximally based venous flaps, SOD ttreated distally based venous flaps. The results were as follow: 1. The survival rate(79.39+/-9.24%) of the proximally based venous flaps were significantly higher than those(60.79+/-14.10%) of the distally based ones (p< 0.01). 2. SOD improved survival of the flap significantly (p< 0.05), and there was no statistical difference in the survival rates between proximally based venous flaps and SOD treated distally based venous flaps (p = 0.1785). 3. Revascularization was actively developed in the proximally based venous flaps and those flaps treated with SOD, but was minimal in the distally based venous flaps. These results suggested that the vascular pedicle would rather be located proximally than distally in designing the venous island flaps and that SOD treatment may be effective for the enhancement of survival of venous island flaps, especially in distally based ones.
Ear Cartilage ; New Zealand ; Rabbits ; Skin ; Superoxide Dismutase* ; Superoxides* ; Surgical Flaps ; Survival Rate ; Veins

No abstract available.

Recently, cell cycle regulators have been suggested as new prognostic factors of the lung cancer. In this study, we evaluated the expression of cyclin D1, p21, and p53 using the X2-test, with regard to the stage of the patients, histologic type, and histologic differentiation in the 135 cases of non-small cell lung carcinomas (NSCLC). To evaluate the confounding effects among cyclin D1, p21, and p53 on X2-test analysis, we used the Mantel-Haenzel test. The NSCLC in this study included 82 cases of squamous cell carcinoma and 53 cases of adenocarcinoma. Each nuclear staining of cyclin D1, p21, and p53 was observed in 65 cases (48.1%), in 54 cases (40.0%), and in 81 cases (60.0%) of NSCLCs, respectively. Only p53 expression was significantly associated with the stage (stage I, II, IIIa) (p<0.05) and squamous cell carcinoma (p<0.05). On the other hand, cyclin D1 expression was significantly associated with the histologic differentiation. The confounding effects among cyclin D1, p21, and p53 revealed that only p21 expression changed the relationship between p53 and stage. In this regard, further study is needed.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cyclin D1* ; Cyclins* ; Hand ; Humans ; Lung Neoplasms ; Lung* ; Prognosis*

No abstract available.
Forearm*

No abstract available.
Aneurysm*

No abstract available.
Echocardiography* ; Heart*

No abstract available.
Liposarcoma, Myxoid*

As the incidence of acute myocardial infarction been increasing with prolongation of life spans, improvement in foods and life styles in Korea, rapid diagnosis and treatment is critical in survival of acute myocardial infarction patient. Most of the acute myocardial infarction result from atherosclerotic plaque forming thrombus and occlusion of coronary artery. Because early thrombolytic therapy is important to maintain the left ventricular function and survival rate, there have been many trials to reperfuse the occluded coronary artery. We have studied the many aspects of acute myocardial infarction such as sex, age, infarction site, chief complaints, change of ECG, change of serum enzyme, time delay on emergency room arrival, and compared the effectiveness of thrombolytic therapy. Total number of patient was 212, and males were 141(66.5%) and females were 71(33.5%). The most common infarction site was ant, fuel wall(102 cases,48%)of the heart and the most common chief complaint was chest pain(204 cases,97%). Among the 106 patients who received thrombolytic therapy, 101 patients(95%) had survived and 5 patients(5%) had died. Among the 64 patients who didn't receive thrombolytic therapy, 56 patients (87.5%) were alived and 8 patients(12.5%) were dead.
Ants ; Coronary Vessels ; Diagnosis* ; Electrocardiography ; Emergency Service, Hospital ; Female ; Heart ; Humans ; Incidence ; Infarction ; Korea ; Life Style ; Life Support Care ; Male ; Myocardial Infarction* ; Plaque, Atherosclerotic ; Survival Rate ; Thorax ; Thrombolytic Therapy ; Thrombosis ; Ventricular Function, Left

In modem medical industries as in others, it has been emphasized by many experts such as Dr. Mayer and Dr. Donabedean that there should be quality assurance activities applying statistical knowledges in the processes of medical management and medical staff themselves for the better medical care and customer satisfaction. Three of our quality assurance programs for the purpose of shortening the treatment time In the department of emergency medicine in Keimyung University, Dong-San Medical Center had been carried out during the period of June 94 through December 95. Our methodology was mainly the process emphasized ; finding the causes of delaying factors in various processes related to the works of nurses, doctors, laboratory services, radiology services etc. in the emergency room, holding various meetings among the related groups with genuine discussions, notifying the new results in each step, encouraging the positive ones and also applying the new leadership technics. During the period of June 94 through December 95(for 1.5 years), the average E.R. patient treatment time from registrations to dispositions had been reduced by about 2 hours (from 5 hours 3 minutes to 2 hours 5 minutes) and its variations among the different specialities had been narrowed down to significant degree (p<0.05) revealing the preprogram base line standard deviation of 2.43 to 1.28 in post program through continuous quality assurance programs. It was also noted that the successful results of Q/A program have been closely related to the fact that the process should be designed and redesigned repeatly as needed and that all the participants related were actively involved in the planning and redesigning processes.
Emergency Medicine ; Emergency Service, Hospital ; Humans ; Leadership ; Medical Staff ; Modems

The experimental study for peripheral nerve reconstruction was performed using degenerated skeletal muscle and omentum. At the sciatic nerves of 26 rabbits, about 10mm gaps were made under ketamine anesthesia. Degenerated skeletal muscles were made through the procedure of freezing with liquid nitrogen and thawing in distilled water. And omenta were taken through midline abdominal incisions. On 14 rabbits of experimental group, the nerves were connected with the degenerated skeletal muscles and surrounded with the omenta. On 6 rabbits of control group, the nerve gaps were connected with the degenerated skeletal muscles without surrounding with the omenta. And the other 6 rabbits of control group, the gaps were lets without further treatment. After 3, 6, 9 and 12 weeks, the results were compared using light microscope and transmission electron microscope. There were contractions and fragmentations at the skeletal muscles during the freezing and thawing. There were nerve regenerations through the degenerated skeletal muscles. The nerve tissues of the experimental group were more abundant than the control group using the degenerated skeletal muscles only.
Anesthesia ; Freezing ; Ketamine ; Linear Energy Transfer ; Muscle, Skeletal ; Nerve Regeneration ; Nerve Tissue ; Nitrogen ; Omentum ; Peripheral Nerves ; Rabbits ; Sciatic Nerve ; Water