Malformation of the anus and rectum, frequently refered to as imperforate anus are the most common of congenital anomalies among the congenital anomalies of gastrointestinal tract, occuring about once in every 5,000births. They consist of variety of lesions ranging from mild congenital stenosis of the anus which requires simple dilation for cure to complex deformities which present some of the most vexing and discouraging problem in management. This is the report of clinical analysis and evaluation of 67 patients with congenital anorectal malformation, experienced at Severance Hospital, during past 15 years form Jan. 1963 to Dec. 1978. The results of observation were as follows: 1. Incidence of observation were as follows: 2. There were 47 males and 18 females and 2 cases of unknown sex, than male/female ratio was 2.6 : 1. 3. First and second born were more commonly observed than the others. 4. High anomalies were 37.3%, intermediate anomales were 11.9% and low anomalies were 46.3%. 5. Associated anomalies were noted in 12 out of 67 cases, which consist of congenital heart diseases, skeletal anomalies, single umbillical artery, congenital megacolon etc. 6. In general, perineal anoplasty with or without preliminary colostomy were performed in low anomalies and some cases of intermediate anomalies. And abdominoperineal pull-through operation with or without preliminary colostomy were done in high anomales. 7. Complication after surgery were main wound infection ad disruption, intestinal obstruction, fecal incontinence, urinary incontinence, vaginal perforation, and urethral injury etc. 8. Overall mortality was 19.4% and operative mortality was 9.4%. 9. Factors influencing on mortality were congenital heart diseases, sepsis, prematurity, multiple congenital anomalies, respiratory insufficiency, meningomyelocele and tracheoesophageal fistula.
Anal Canal ; Anus, Imperforate ; Arteries ; Colostomy ; Congenital Abnormalities ; Constriction, Pathologic ; Fecal Incontinence ; Female ; Gastrointestinal Tract ; Heart Diseases ; Hirschsprung Disease ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Meningomyelocele ; Mortality ; Rectum ; Respiratory Insufficiency ; Sepsis ; Tracheoesophageal Fistula ; Urinary Incontinence ; Wound Infection

Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561−10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087−5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981−0.999), ulcer size (HR, 1.247; 95% CI, 1.107−1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224−0.73) were associated with risk of amputation. Conclusion Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.
Anterior Cruciate Ligament ; Artifacts ; Cartilage ; Knee Joint ; Knee* ; Pathology ; Protons ; Relaxation ; Water

The purpose of this study was to compare the clinical results of guided tissue regeneration(GTR) using a resorbable barrier manufactured from an copolymer of polylactic acid (PLA) and polylactic-glycolic acid(PLGA) with those of nonresorbable ePTFE bdmer. Thirty two patients(25 to 59 years old) with one radiographically evident intrabony lesion of probing depth > or =6mm participated in a Gmonth controlled clinical trial. The subjects were randomly divided into three independent groups. The fist group(n=8) received a ePTFE barrier. The second group (n=12) received a resorbable PLA/PLGA barrier. The third group (n=12) received a resorbable PLA/PLGA barrier combined with an alloplastic bone graft. Plaque index (PI), gingival index(GI), probing depth(PD) , gingival recession, clinical attachment level(CAL), and tooth mobility were recorded prior to surgery and at 3,6 months postsurgery. Statistical tests used to analyze these data included independent t-test, paired t-test, one-way ANOVA. The results were as follows : 1. Probing depth was significantly reduced in all groups at 3,6 months postsurgery and there were not significant differences between groups. 2. Clinical attachment level was significantly increased in all groups at 3, 6 months postsurgery and there were not significant differences between groups. 3. There were not signifiicant differences in probing depth, clinical attachment level, gingival recession, tooth mobility between second group (PLA/PLGA barrier) and third group (PLA/RLGA barrier combined with alloplastic bone graft) 4. Tooth mobility was not significantly increased in all groups at 3,6 months postsurgery and there were not significant differences between groups. In conclusion, PLA/PLGA resorbable barrier has similar clinical potential to ePTFE barrier in GTR procedure of intrabony pockets under the present protocol.
Gingival Recession ; Guided Tissue Regeneration* ; Humans* ; Methods ; Tooth Mobility ; Transplants

Lectins are glycoproteins that bind specifically to carbohydrates. Considerable interests in the lectins were encouraged by several reports that certain members of the family bind to the extracellular matrix proteins (ECM), such as fibronectin and laminin. However, the relations between lectin and ECM protein remain unclear. To elucidate the relations of lectin-matrix-cell, we treated three cancer cell lines, HeLa, L929, and EATC with ConA and PHA-P at low dose (4 microgram/ml) and high dose (20 microgram/ml) for 1, 3, 5 days. 1. Whether or not lectins significantly regulate the cell proliferation was evaluated by MTT assays. 2. Whether the amount of fibronectin and laminin which of cancer cells can be influenced by lectins was confirmed by immunocytochemical staining. 3. Whether, in turn, the lectins which can change the morphology were observed under inverted and electron microscopes. ConA and PHA-P inhibited cell proliferation rate of all cell lines in a dose- and time- dependent manner. The amount of fibronectin and laminin considerably reduced in the three cell lines after the lectins treatment in a dose- and time-dependent manner. The cancer cell lines showed various morphological changes such as cell aggregation, irregular-shaped cellular processes, rounded cells, cytoplasmic vacuolation, swollen RERs, dilation of mitochondria, margination of chromatin and cell death. In conclusion, our results showed ConA and PHA-P caused damages of the three cancer cell lines, but the effect of PHA-P was much stronger than ConA. Taken together, the present data strongly indicate that ConA and PHA-P influence the cell proliferation rate, reduce the amount of fibronectin and laminin and induce cell injuries of HeLa, L929, and EATC cell lines. Our results also suggest that the cancer cell proliferation and the morphological changes might be modulated by the specific interaction between lectins and ECM proteins associated with the cell surface.
Carbohydrates ; Cell Aggregation ; Cell Death ; Cell Line* ; Cell Proliferation ; Chromatin ; Cytoplasm ; Extracellular Matrix Proteins ; Extracellular Matrix* ; Fibronectins ; Glycoproteins ; Humans ; Laminin ; Lectins ; Mitochondria

The aim of this investigation was to elucidate the changes in the cytoplasmic distribution of beta-actin, fibronectin, and laminin through mainly the morphological changes occurring in HeLa and L929 cancer cell treated with paclitaxel. Whether or not paclitaxel regulates cell proliferation was assessed with MTT assay. Possible influence on the distribution of beta-actin, fibronectin, and laminin in these cells was confirmed with immunocytochemistry and analySIS Auto software program. The changes in cell morphology were observed under inverted and electron microscope. The MTT assay showed that 1 micrometer and 10 micrometer concentrations of paclitaxel inhibited HeLa cell growth approximately by 20% to 80% and L929 cell by 27% to 44% in a dose- and time-dependent manner. The distribution of these proteins was changed from the condensed around nucleus and strong reaction to the weak throughout cytoplasm. The morphological changes indicated that paclitaxel changes the location or number of protein synthesis apparatus: damages of RERs, Golgi complex, and increase of heterochromatin. These data suggest that the growth inhibition and morphological changes of tumor cells induced by paclitaxel might be modulated by the rearrangement and decreased production of beta-actin, fibronectin, and laminin in cytoplasm.
Actins* ; Cell Proliferation ; Cytoplasm ; Fibronectins* ; Golgi Apparatus ; HeLa Cells ; Heterochromatin ; Humans ; Immunohistochemistry ; Laminin* ; Paclitaxel*

In this research, the author investigated antitumor effects of green tea catechin on cancer cell lines in various concentrations and durations. Additionally, antitumor mechanism of catechin associated with apoptosis and necrosis, especially their onset and duration were invesigated. Cancer cell lines, L1210 (lymphocytic leukemia), L929 (fibrosarcoma), HepG2 (hepatoblastoma) were used. In each group, intensity of morphological changes and cell damage was observed under inverted, light, confocal and electron microscopes, and MTT and flowcytometric analysis, gel electrophoresis were used to elucidate the effects of catechin after exposure to 1, 10, 100 and 500 microgram/ml catechin until 72 hours. In all cancer cell lines, catechin induced cellular injury and inhibition of proliferation in concentration- and duration-dependent manner. The effects of catechin were the strongestt in L1210 cells and L929 and HepG2 cells in order. Dual phenomena, of apoptosis and necrosis, were shown after catechin treatment. In necrotic cells, cellular swelling, cell organelles destruction, nuclear disintegration and random DNA fragmentation were observed. In apoptotic cells, apoptotic bodies, nuclear and cytoplasmic condensations, periodic DNA fragmentation were seen. In L1210 cells, necrotic and apoptotic cells were co-existed earlier, after exposure to catechin 100 microgram/ml and then apoptosis predom-inated later. In the same concentration, catechin induced apoptosis of L929 cells. but after exposure to 500 microgram/ml catechin, They were involved with apoptosis and necrosis simultaneously. On the other hand, HepG2 cells were damaged less than other cell lines but were involved with necrosis and inhibition of G2/M phase after treatment with 500 microgram/ml catechin. These results suggested that anti-tumor mechanism of catechin, associated with apoptosis, necrosis and cell cycle arrest, were quite different according to cancer type, concentration and duration of catechin treatment. Therefore, much more research would be essential for clinical application of catechin and this study would be the basic source for further study of green tea.
Apoptosis ; Catechin* ; Cell Cycle Checkpoints ; Cell Line* ; Cytoplasm ; DNA Fragmentation ; Electrophoresis ; Hand ; Hep G2 Cells ; Necrosis ; Organelles ; Tea*

The keratinocyte culture has been used for the reconstruction of artificial skin or as in vitro skin model. For these purpose, keratinocytes should be cultured for long time (usually 10 cumulative population doublings) and it is important to evaluate the state of replicative senescence or cell senescence during this time. This study was undertaken to investigate senescence associated beta-galactosidase (SA-beta-gal) activity for the senescent cell and keratin 19 immunohistochemistry for the skin stem cell in keratinocytes on ten times serial subculture (referred to 10 cumulative population doublings). Keratinocytes were isolated from foreskin of a 2 day old child, and cultured in KSFM and then in DMEM/F-12. In both keratinocytes cultured in KSFM and DMEM/F-12, lysosomal beta-galactosidase activity, which is detected at pH 4.0, was present in all cells regardless of their replicative age. In contrast, SA-beta-gal activity, which is detected at pH 6.0, was present in a few cells (from 0.1% to 3%) during whole subcultures. These data suggest that most of keratinocytes did not undergo replicative senescence in this culture. Furthermore, in keratin 19 skin stem cell staining, a lot of keratinocytes (13.8%) showed strong positive reaction on the 10th subculture. Together with the results of beta-galactosidase activity, the persistence of high proportion of keratin 19 positive skin stem cells implies further increment of keratinocyte populations by continued subcultures.
Aging ; beta-Galactosidase ; Cell Aging* ; Child ; Foreskin ; Humans* ; Hydrogen-Ion Concentration ; Immunohistochemistry ; Keratin-19 ; Keratinocytes* ; Skin ; Skin, Artificial ; Stem Cells

PURPOSE: Hepato-pancreatico-biliary (HPB) surgeons often must make decisions regarding hepatic artery (HA) resection while performing major HPB surgery. The purpose of this report was to review and summarize HA resection experience with a focus on vascular preservation during major HPB surgery and to develop a useful algorithm in dealing with these needs. METHODS: We reviewed 1,324 cases that had available computed tomographic and angiographic findings and summarized the problematic HA variations encountered in major HPB surgery. In reviewing our series and previous studies, we have created a set of guidelines that enables a pragmatic approach to the unique variations in HA and the risks of cancer invasion. RESULTS: Challenging HA variations during major HPB surgery were found in 25.7% of the cases and included variations of common HA from superior mesenteric artery (SMA), gastroduodenal artery (GDA), aorta, celiaco-mesenteric (CM) trunk or left gastric artery (LGA) (3.70%), the variations of the right HA from SMA, GDA, aorta, celiac axis (CA) including CM trunk or LGA (12.76%), the variations of the left HA from LGA, CA or GDA (4.46%), and the mixed types of the aberrant left medial HA and/or left lateral HA and/or right anterior HA and/or right posterior HA (2.11%). CONCLUSION: Surgeons should have knowledge of the anatomically variable vasculature of the HA when planning for major HPB surgery. Preoperative imaging studies can aid and should be performed in anticipation of potential HA variations during major HPB surgery.
Aorta ; Arteries ; Axis, Cervical Vertebra ; Hepatic Artery ; Mesenteric Artery, Superior

PURPOSE: Percutaneous removal of benign breast tumors using ultrasound-guided vacuum-assisted breast biopsy (VABB) has been recently regarded as a feasible and safe method without serious complications. The aim of this study was to evaluate the efficacy and safety of the VABB in the treatment of benign phyllodes tumors, and to identify whether or not surgical re-excision is necessary for benign phyllodes tumors diagnosed and excised by VABB. METHODS: From January 2003 to December 2011, a total of 6,923 VABB were performed in 5,434 patients. Out of 6,923 lesions, 53 were benign phyllodes tumors. Among these, 31 lesions, with a follow-up period of longer than 24 months, were enrolled in this study. Ultrasonography follow-up was performed at 3 to 6 month intervals in order to assess recurrence. The mean follow-up period was 75.9+/-13.5 months (range, 24-94 months). RESULTS: The mean patient age at presentation was 31.6+/-9.4 years. The mean size of the lesion was 1.60+/-0.88 cm. The majority of lesions, 74.2% (23 cases), were palpable, and 25.8% (8 cases) were non-palpable. Twenty-two lesions (71.0%) were classified as Breast Imaging Reporting and Data System category 3, and nine lesions (29.0%) were classified as category 4a, by ultrasonography. During the follow-up period, local recurrence developed in one lesion, making the local recurrence rate 3.2%. CONCLUSION: If a benign phyllodes tumor is diagnosed, and sufficiently excised by VABB, observing the clinical course may be considered as an alternative to performing immediate wide local excision; this is the case despite the fact that it would need to be observed for a prolonged period of time.
Biopsy ; Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Information Systems ; Phyllodes Tumor ; Recurrence