There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

Sparganum infestation in human body was reported over 20 cases in Korea. Infestation of sparganosis in spermatic cord was reported a case in Korea. Three cases of sparganosis at Keu Je island in Korea was reported by Dr. Weinstein, Krawczyc and Peers 1954. We experienced a case of the sparganum infestation in scrotum. The patient, 41 year-old male who was suffering with pulmonary tuberculosis moderate advanced, visited 3rd Army Hospital urologic clinic complained with acute swelling of the scrotum in baby head size abruptly without any specific causes. severe tenderness and walking disturbance. The laboratory findings revealed no specific findings except ascaris ova in stool. Operation revealed massive hematoma formation and proliferated connective tissue where noted several infested parasites in length of 120cm, 75cm, 70cm around the tunica vaginalis in scrotum Extracted parasites revealed milkish-whitish color, flat, fragile, and tendon like glistening appearance. There is not any specific sign and symptoms by parasite infestation on the other organs. Patient had an episode of intake of raw snake as a tonic 9 years ago at Keu Je island in Korea.
Adult ; Ascaris ; Connective Tissue ; Head ; Hematoma* ; Hospitals, Military ; Human Body ; Humans ; Korea ; Male ; Ovum ; Parasites ; Scrotum* ; Snakes ; Sparganosis* ; Sparganum ; Spermatic Cord ; Tendons ; Tuberculosis, Pulmonary ; Walking

A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.

Accessory breast is an ectopic breast tissue from developemental remnants. It sometimes begins to make symptoms, pain and swelling, during premenstrual period or pregnancy. For it has been known as a rere condition, it has occasionally misdiagnosed as a abnormal mass, such as lymphadenitis or hidradenitis. We have analyzed 52 accessory breast tissues prospectively, to document the characteristic findings of accessory breast. In summary, the characteristic sonographic findings of accessory breast were the presence of breast tissue superficial to the axillary fascia or underlying fascia if not in axilla, resembling the patient's own breast pattern, the presence of converging appearance of dilated ducts, presence of nipple and/or areola, the obliteration of inner wall of dermis, the obliteration of sucutaneous fat layer, and the downward displacement of axillary fascia or underlying fascia if not in axilla wighout interruption.
Axilla ; Breast* ; Dermis ; Fascia ; Hidradenitis ; Lymphadenitis ; Nipples ; Pregnancy ; Prospective Studies ; Ultrasonography

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

BACKGROUND: Langerhans cells (LC), keratinocytes and Thy-1+ dendritic epidermal cells(DEC) are epidermal cells which are known to have important roles in inflammatory or immunologic skin disorders. Allergic contact dermatitis(ACD) is a prototype of a delayed hypersensitive reaction in which LC, keratinocytes and T lymphocytes play an important role. The role of LC in ACD is well known, but the role of Thy-1+ DEC is not yet fully revealed. Futhermore, the mechanism of irritant contact dermatitis(ICD) is not known and more study is required on the interaction between these epidermal cells in ICD. OBJECTIVE: The aim of this study is to observe the changes of these cells in ACD and ICD and to discuss their possible roles in the disease precess. MEHTODS: We evoked ACD with DNFB and ICD with croton oil in BALB/c mice and observed the morphologic changes of LC, Ia+ keratinocytes, and Thy-1+ DEC by immunoperoxidase staining when the inflammation was at its peak and at the resolution state. RESULTS: 1. In the control group, LC were evenly distributed and their average number was 1147+/-132/mm*. Thy-1+ DEC were slightly bigger than LC and showed uneven distribution. The average number of Thy-1+ DEC was 57+/-69/mm* Ia+ keratinocytes did not appeared. 2. On the 1st day of DNFB challenge, the number of LC was significantly decreased and their size and dendritic processes were increased when compared to those of the control group. Most of the keratinocytes showed Ia antigen expression on their surfaces. 3. On the 12th day of DNFB challenge, no significant changes in the number and morphologyof LC were noted when compared to the cotrol group, Ia+ keratinocytes were not observed. 4. there were no significant changes in the number and morphology of Thy-1+ DEC in ACD on the 1st and 12th day after DNFB challenge. 5. On the 2nd day after croton oil application, the number of LC was significantly decreased but the morphology not significantly changed. Ia+ keratinocytes were not observed. 6. On the 20th day after croton oil application, the number of LC was significantly increased but the morphology was not significantly changed. Ia+ keratinocytes were not observed. 7. There were no significant changes in th number and morphology of Thy-1+ DEC in ICD on the 2nd and 20th day after application of croton oil. Ia+ keratinocytes were not observed. CONCLUSION: In can be deduced that the LC have important roles in the mechanisms of both ACD and ICD reactions. Ia+ keratinocytes have an important role mainlyin the inflammatory precess of ACD. In addition, since the changes of the number of Langerhans cells in ACD and ICD showed different time courses and Ia+ keratinocytes appeared only in ACD, we hypothesized that different pathways of inflammation exist in ACD and ICD, and different cytokines may be responsible. It is probable that Thy-1+ DEC does not have any significant role in the inflammatory process of both ACD and ICD.
Animals ; Croton Oil ; Cytokines ; Dermatitis, Allergic Contact* ; Dermatitis, Contact* ; Dinitrofluorobenzene ; Histocompatibility Antigens Class II ; Inflammation ; Keratinocytes ; Langerhans Cells ; Mice ; Skin ; T-Lymphocytes

The authors studied the lung injury induced by endotoxemia and the effects of proteolytic agent on the lung changed by endotoxemia. Sprague-Dawley rats were intraperitoneally administrated with a single dose of endotoxin (4 mg/kg, E. coli 025 : B6 lipopolysaccharide) or with endotoxin and gabexate mesilate (200 mg/kg), a proteolytic agent, concomitantly. Rats of each group were scarificed at 9, 18, and 27 hours after injection. Light and electron microscopic examination were done. The results obtained were summarized as follows: Light microscopic exmination revealed congested capillaries and neutrophilic infiltration in both groups. Electron microscopic findings were interstitial and alveolar neutrophilic infiltration, endothelial swelling with increased pinocytotic vesicles and cytoplasmic process formation, and interstitial edema. Decrease of osmiophilic bodies in the type II pneumocytes had appeared at 9 hours after endotoxin injection. These changes were increased in severity at 18 hours and 27 hours after endotoxin injection. In the group of concomitant treatment of gabexate mesilated and endotoxin, there was no edema at 9 hours after injection. After 18 hours welling of endothelial cell and interstitial edema had appeared. However, the severity of the edema was markedly decreased. Type II pneumocytes showed well preserved osmiophilic bodies. According to these results, it is considered that administration of gabexate mesilate can significantly redeced the lung injury induced by endotoxemia.
Rats ; Animals

No abstract available.

Borderline malignant ovarian tumor are characterized as neoplasrns exhibiting cellular priliferative changes greater than those seen in the benign form, but not showing destnictive invasion of the ovarian strama. We reviewed 14 cases of borderline ovarian tumor who had been diagnosed and treated at Kyung Pook university hospital from 1987 to 1992. We nnalysed the clinical features, treatment and prognosis which were compared to 24 cases of the epithelial ovarian cancer at the same period The most common histological thpe of boderline tumnr was mucinous type (1 l cases, 79%), the next one was serous type (3 cases, 21%). In FIGO stage of Borderline tumor, 11 caseS weve stage I a, 1 with stage II c, 1 with stage gb and 1 with stage lV, and the FIGO stage of 24 cases of ovarian cancer was 8 cases with stage I a, 1 with stage I b, 2 with stage I c, 1 with II c, 2 with stage III a, 1 with stage III b, 7 with stage III c and 2 with stage 1V. The mean age of borderline and malignant tumor was 37.1 and 47.6 years.. 3 cases were being pregnant on the operatian. In the 14 cases of borderline turnor, 7 cases were managed by conservative operation, but 1 case recurred 4 years later so extirpative operation and pastoperative chemotherapy were given. The other 4 cases were managed by extirpative operation but postoperative chemotherapy was given in only 1 patient. Follow up ranged from 7 to 72 months. 12 cases were alive. 2 cases died, one was stage III b, the other was atage IV. This atudy suggeat, that it is neceasary to follow up carefully even the early stage of botderline tumor and manage as oyarian carcinama in the advanced stage.
Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Mucins ; Ovarian Neoplasms ; Ovary* ; Prognosis

Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Skin