Long-Term Effect of Rigid Foot Orthosis in Children Older Than Six Years With Flexible Flat Foot

OBJECTIVE: To evaluate the long-term effect of a custom-made rigid foot orthosis (RFO) in children older than 6 years with pes planus (flat foot). METHODS: Medical records of 42 children diagnosed with flexible pes planus who were fitted with RFOs based on the inverted technique and underwent more than four consecutive radiological studies were reviewed. Resting calcaneal stance position (RCSP), anteroposterior talocalcaneal angle, lateral talocalcaneal angle, lateral talometatarsal angle, and calcaneal pitch were initially measured in both feet to evaluate alignment. Followup clinical and radiological evaluations were then performed at 12–18, 24–30, 36–42, and ≥48 months after RFO application. Repeated measures analysis of variance was used to evaluate significant differences. RESULTS: Significant improvements in all radiological indicators and significant progression of RCSP toward the corrective direction were observed after RFO application relative to baseline measurements. CONCLUSION: According to our findings, RFO can induce significant improvements in calcaneus-related radiographic indices and subsequently improve talus-related radiologic indices.

Anti-neuroinflammatory effects of ethanolic extract of black chokeberry (Aronia melanocapa L.) in lipopolysaccharide-stimulated BV2 cells and ICR mice

BACKGROUND/OBJECTIVES: One of the mechanisms considered to be prevalent in the development of Alzheimer's disease (AD) is hyper-stimulation of microglia. Black chokeberry (Aronia melanocapa L.) is widely used to treat diabetes and atherosclerosis, and is known to exert anti-oxidant and anti-inflammatory effects; however, its neuroprotective effects have not been elucidated thus far. MATERIALS/METHODS: We undertook to assess the anti-inflammatory effect of the ethanolic extract of black chokeberry friut (BCE) in BV2 cells, and evaluate its neuroprotective effect in the lipopolysaccharide (LPS)-induced mouse model of AD. RESULTS: Following stimulation of BV2 cells by LPS, exposure to BCE significantly reduced the generation of nitric oxide as well as mRNA levels of numerous inflammatory factors such as inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2), interleukin 1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α). In addition, AD was induced in a mouse model by intraperitoneal injection of LPS (250 µg/kg), subsequent to which we investigated the neuroprotective effects of BCE (50 mg/kg) on brain damage. We observed that BCE significantly reduced tissue damage in the hippocampus by downregulating iNOS, COX-2, and TNF-α levels. We further identified the quinic acids in BCE using liquid chromatography-mass spectrometry (LCMS). Furthermore, we confirmed the neuroprotective effect of BCE and quinic acid on amyloid beta-induced cell death in rat hippocampal primary neurons. CONCLUSIONS: Our findings suggest that black chokeberry has protective effects against the development of AD.

The effect of yacon (Samallanthus sonchifolius) ethanol extract on cell proliferation and migration of C6 glioma cells stimulated with fetal bovine serum

BACKGROUND/OBJECTIVES: Yacon (Samallanthus sonchifolius), a common edible plant grown throughout the world, is well known for its antidiabetic properties. It is also known to have several other pharmacological properties including anti-inflammatory, anti-oxidant, anti-allergic, and anti-cancer effects. To date, the effect of yacon on gliomas has not been studied. In this study, we investigated the effects of yacon on the migration and proliferation of C6 glioma cells stimulated by fetal bovine serum (FBS). MATERIALS/METHODS: Cell growth and proliferation were determined by evaluating cell viability using an EZ-Cytox Cell Viability Assay Kit. FBS-induced migration of C6 glioma cells was evaluated by performing the scratch wound healing assay and the Boyden chamber assay. We also used western blot analysis to determine the expression levels of extracellular signal-regulated kinase 1/2 (ERK1/2), a major regulator of migration and proliferation of glioma cells. Matrix metallopeptidase (MMP) 9 and TIMP-1 levels were measured by performing reverse transcription PCR. RESULTS: Yacon (300 microg/mL) reduced both the FBS-induced proliferation of C6 glioma cells and the dose-dependent migration of the FBS-stimulated C6 cells. FBS-stimulated C6 glioma cells treated with yacon (200 and 300 microg/mL) showed reduced phosphorylation of ERK1/2 and inhibition of MMP 9 expression compared to those shown by the untreated FBS-stimulated C6 cells. In contrast, yacon (200 and 300 microg/mL) induced TIMP-1 expression. CONCLUSIONS: On the basis of these results, we suggest that yacon may exert an anti-cancer effect on FBS-stimulated C6 glioma cells by inhibiting their proliferation and migration. The most likely mechanism for this is down-regulation of ERK1/2 and MMP9 and up-regulation of TIMP-1 expression levels.

Short-Term Effect of Botulinum Toxin A Injection on Spastic Equinovarus Foot in Cerebral Palsy Patients: A Study Using the Foot Pressure Measurement System

OBJECTIVE: To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS). METHODS: Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6-12 units/kg and TPo at a dose of 4-9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group. RESULTS: A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. CONCLUSION: The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.

The Therapeutic Effect of Tibia Counter Rotator With Toe-Out Gait Plate in the Treatment of Tibial Internal Torsion in Children

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.

The Therapeutic Effect of Tibia Counter Rotator With Toe-Out Gait Plate in the Treatment of Tibial Internal Torsion in Children

OBJECTIVE: To evaluate the therapeutic effect of a Tibia Counter Rotator (TCR) with toe-out gait plate (GP) upon tibial internal torsion by a comparative analysis of transmalleolar angle (TMA) and gait analysis with GP alone. METHODS: Twenty participants with tibial internal torsion were recruited for this study. Each 10 participants were included in group A with TCR and GP application and in group B with GP application only. The TMA and the kinematic results were used for the evaluation of the therapeutic effects of orthoses. RESULTS: Within each group, TMA showed a significant increase after treatment. Group A showed a continuous improvement up to six months, however, group B showed an improvement up to five months only. Group A showed a significantly higher correction effect than group B after treatment. Regarding kinematic data, both groups showed a significantly decreased mean ankle adduction angle after treatment. However, group A showed a significantly lower mean ankle adduction angle than group B after six months. CONCLUSION: The group with TCR and GP showed a significantly better outcome and continued correction force compared to the group with GP only. Our results suggest that TCR with GP may be useful therapeutic orthoses for children with tibial internal torsion.

Artemisinin attenuates platelet-derived growth factor BB-induced migration of vascular smooth muscle cells

BACKGROUND/OBJECTIVES: Artemisinin (AT), an active compound in Arternisia annua, is well known as an anti-malaria drug. It is also known to have several effects including anti-oxidant, anti-inflammation, and anti-cancer activities. To date, the effect of AT on vascular disorders has not been studied. In this study, we investigated the effects of AT on the migration and proliferation of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor BB (PDGF-BB). MATERIALS/METHODS: Aortic smooth muscle cells were isolated from Sprague-Dawley rats. PDGF-BB stimulated VSMC migration was measured by the scratch wound healing assay and the Boyden chamber assay. Cell viability was determined by using an EZ-Cytox Cell Viability Assay Kit. The production of reactive oxygen species (ROS) in PDGF-BB stimulated VSMC was measured through H2DCF-DA staining. We also determined the expression levels of signal proteins relevant to ROS, including measures of extracellular signal-regulated kinase (ERK) 1/2 measured by western blot analysis and matrix metalloproteinase (MMP) 9 measured by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: AT (10 microM and 30 microM) significantly reduced the proliferation and migration of PDGF-BB stimulated VSMC in a dose-dependent manner. The production of ROS, normally induced by PDGF-BB, is reduced by treatment with AT at both concentrations. PDGF-BB stimulated VSMC treated with AT (10 microM and 30 microM) have reduced phosphorylation of ERK1/2 and inhibited MMP9 expression compared to untreated PDGF-BB stimulated VSMC. CONCLUSIONS: We suggest, based on these results, that AT may exert an anti-atherosclerotic effect on PDGF-BB stimulated VSMCs by inhibiting their proliferation and migration through down-regulation of ERK1/2 and MMP9 phosphorylation.

A Case of Advanced Gastric Cancer and the First Symptom was a Skin Lesion / 대한소화기내시경학회지

Cutaneous metastasis of internal malignancies is rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% for patients with all types of malignancies. Furthermore, cutaneous metastasis from advanced gastric cancer is exceedingly rare. A 43-year-old man presented with a single, symptomatic, erythematous nodule on the chest wall. A biopsy taken from the nodule showed an adenocarcinoma of the poorly differentiated type. An endoscopic examination and biopsy was done and these showed the same histologic findings. We reported here on this unusual case of advanced gastric cancer and the patient's first symptom was a skin lesion.

A Case of Polypoid Angiolipoma of the Distal Descending Colon as Cause of Hematochezia / 대한소화기내시경학회지

Angiolipoma is a benign tumor that is mainly observed in the subcutaneous tissue and is composed of mature adipose tissue and proliferative blood vessels. However, the condition is rare in the gastrointestinal tract including the colon. There was a case report of angiolipoma of the proximal ileum but there are no reports of angiolipoma of the colon in Korea. A 47-year-old man, who presented with intermittent left lower quadrant pain and hematochezia, underwent contrast enhancement CT, which revealed a huge mass with inhomogeneous density in the distal descending colon. The colonoscopy viewed a large polypoid mass with vascular engorgement, and a laparotomy was performed urgently due to the persistent abdominal pain, intussusception and hematochezia. The histology examination disclosed a benign angiolipoma. We report this case of symptomatic angiolipoma of the distal descending colon.

Morphological Changes of Anterior Horn Cells of Lumbar Spinal Cord after Anterior Root Avulsion in Adult Rat / 대한해부학회지

The morphological changes in the anterior horn of the L4 and L5 spinal segments were observed following anterior root avulsion in the adult male Sprague-Dawley rat (300~350 gm) at 5 days, 1 week, 2 weeks and 3 weeks postlesion. The animals were perfused with 4% paraformaldehyde, 0.15% picric acid in 0.1 M phosphate buffer solution and cryostat sections were prepared. Immunohistochemistry was used to identify changes of the phenotype in the anterior horn cells. Primary antibodies, goat anti-choline acetyltransferase (ChaT, 1 : 500, Chemicon), mouse antirat ED-1 (1 : 200, Serotec), rabbit anti-glial fibrillary acidic protein (GFAP, 1 : 200, DAKO) and rabbit anti-vascular endothelial growth factor (VEGF, 1 : 500, Santa Cruz Biotechnology) were used. Avidin-Biotin complex method was performed for immunohistochemical reaction and color reaction was developed with DAB-H2O2. Following results were observed in the anterior horn of lumbar spinal cord; 1. The number of ChaT-immunoreactive (ir) cells were reduced 20% level of control animals at 3 weeks after avulsion. 2. ED-1-ir microglia were significantly increased at 1 week and processes of ED-1-ir microglia surrounded around the axotomized neuronal cell bodies. 3. Gliosis defined by extensive GFAP immunoreactivity was observed both ipsilateral and contralateral side of lesion but the VEGF-ir cells were significantly increased in the ipsilateral side of lesion. Therefore, this study suggested that the majority of axotomized motor neurons were degenerated and the cellular proliferation and phenotype changes including glial cell activation were observed in the lumbar spinal cord after anterior root avulsion of adult rats.

Comparison of the Effects of NOS Inhibitor or HS-1580 on Nigrostriatal Dopaminergic System in MPTP-induced Parkinson's Disease Animal Model / 대한해부학회지

The antioxidant effects of HS-1580 derived from Brown seaweeds in comparison with NOS inhibitor, L-NAME, were tested in the Parkinson's disease animal model. C57BL/6 mice were implanted with osmotic pump containing vehicle, HS-1580 or L-NAME intraperitoneally 2 days before MPTP injection. The Parkinson's animal model were prepared by intraperitonal injection of MPTP (20 mg/kg, 4 times with 2 hours intervals in a ay).The mice were perfused with Zamboni fixative 2 days or 7days after MPTP injection. The 30 micrometer cryostat section were immunostained with free-floating method. Rabbit anti-tyrosine hydroxylase (TH)and rat anti-mouse MAC-1 were used as the primary antibodies. The following results were obtained. The number of TH-immunoreactive (ir)neurons in substantia nigra (SN)and the relative density of TH-ir axon terminals in striatum were decreased by MPTP injection. But the ecrease was significantly attenuated with 10%HS-1580 or L-NAME (50 mg/kg)pretreatment before MPTP injection. MAC-1-ir activated microglia were observed in substantia nigra 2 days after MPTP injection. Activated microglia were showed as thickened processes with round cell bodies. The morphological changes of MAC-1-ir activated microglia were inhibited by HS-15980 or L-NAME pretreatment before MPTP injction. Above results mean that the damage of nigrostriatal dopaminergic system was rescued by pretreatment of HS-1580 or L-NAME in MPTP-induced Parkinson's disease animal model.

Effects of Intermittent Sequential Pneumatic Compression on Coagulation and Fibrinolysis in Multiple Trauma

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed by overproduction of plasminogen activator inhibitor-1 (PAI-1). Intermittent sequential pneumatic compression (ISPC) is an effective method to prevent deep vein thrombosis. Its action is explained by the mechanical effect on blood flow, as well as by the enhancement of fibrinolysis by the reduction of PAI-1. The aim of this study was to determine the effects of ISPC on coagulation and fibrinolysis after multiple trauma. METHODS: Thirty-nine trauma patients were either treated with ISPC (ISPC group, 20 patients) or without ISPC (control group, 19 patients). We measured the plasma levels of the thrombin antithrombin III complex (TAT), the plasmin alpha 2 plasmin inhibitor complex (PIC), the tissue plasminogen activator (t-PA), and the plasminogen activator inhibitor-1 (PAI-1) on admission and at 1, 2, 3, 6, 12, and 24 hours after admission. RESULTS: The TAT was higher than normal in both groups, with no significant difference between the two groups throughout the study period. The PIC level of ISPC group was significantly higher than that of the control group. In the ISPC group, the PIC level increased gradually, reaching a peak at 3 hours and decreasing thereafter. In the control group, the PIC level increased to a peak level at 2 hours. The TAT/PIC ratio dropped in the first two hours and increased at 3 hours, dropping again thereafter. In the ISPC group, the ratio dropped gradually without an intermittent fluctuation. At 3 and 6 hours, the control group showed a significantly greater ratio compared to the ISPC group. PAI-1 was higher than normal in bothgroups, with a significantly lower level in the ISPC group from 2 hours to 24 hours. For the t-PA level, no difference was noted between the two groups, with the peak level occurring at 1 hour. The PAI-1/t-PA ratio was significantly greater in the control group from 2 hours to 12 hours than in the ISPC group, but the difference was not significant at 24 hours. CONCLUSIONS: In multiple trauma patients, ISPC does not seem to affect coagulation, but enhances fibrinolysis through suppressed PAI-1 production. This effect of ISPC may be maintained for 12 hours.

Alteration of Coagulation and Fibrinolysis in Multiple Trauma

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed. Due to high tissue thromboplastin concentration in cerebral tissue, more serious coagulation and fibrinolytic abnormalities may occur when concomitant head trauma is present. The aim of this study was to determine the changes in coagulation and fibrinolysis after trauma and the effects of head trauma on coagulation and fibrinolysis. METHODS: This study includes 35 trauma patients: 16 patients with head trauma (group A) and 19 patients without head trauma (group B). We measured the plasma levels of functional protein C, antithrombin III (AT III), thrombin antithrombin III complex (TAT), plasmin alpha 2 plasmin inhibitor complex (PIC), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor-1 antigen (PAI-1) on admission and on days 1, 2, 4, and 6 after the trauma. RESULTS: The TAT and the TAT/PIC were significantly higher in group A than in group B on all days. PIC was significantly lower in group A than in group B on all days except the day of admission. Over the course of time, the TAT and the TAT/PIC decreased in both groups and PIC increased. On admission, the PAI-1 of both groups was increased, but it decreased over the course of time. The t-PA was increased on admission, was suppressed on the 1st day, and then increased again. The PAI-1 and the t-PA showed no significant difference between the two groups. CONCLUSIONS: After multiple trauma, coagulation was enhanced and fibrinolysis was suppressed. Enhanced coagulation and suppressed fibrinolysis were significantly greater in group A than in group B.

Strategy of Early Diagnosis in Blunt Diaphragm Rupture

Diaphragm rupture often challenges the surgeon by it's subtle presentation in the face of more obvious injuries, equivocal chest roentgenography, and no obvious indication of celiotomy or thoracotomy. Delayed diagnosis is one variable implicated in increased morbidity and mortality. This retrospective study was performed to determine the diagnostic value of diaphragm rupture on initial evaluation and to present an algorithm for initial evaluation. We reviewed the hospital records and the radiographs of 37 patients with a blunt diaphragmatic rupture who were treated at Yongdong Severance Hospital during a period of 5 years. The blunt diaphragmatic ruptures in 14 (38.9%) of the thirty-seven patients were missed on initial admission. At admission, initial physical findings were diagnostic in 3 cases (8.1%), suspicious in 24 cases (64.9%) and normal in 10 cases (27%). On chest roentgenogram, findings were diagnostic in 6 cases (16.2%), suspicious in 28 cases (75.7%) and normal in 3 cases (8.1%). Chest CT scans were performed on 20 patients. Findings were diagnostic in 6 (30%) of these, suspicious in 11 (55%) and normal in 3 (15%). On the chest roentgenograms of the 15 cases with suspicious physical findings, which were diagnosed early, the findings were diagnostic in 4 cases (26.7%) and suspicious in 11 cases (73.3%). Chest CT scans were performed in 10 out of 15 cases with suspicious physical findings which were diagnosed early, and the findings were diagnostic in 3 cases (30%), suspicious in 6 cases (60%), normal in 1 case (10%). In 23 patients (61.1%), diagnosis was established within 48 hours. In 4 (17.4%) of these patients, the diaphragm rupture was detected at the time of the celiotomy performed for other injuries. In conclusion, a blunt diaphragm rupture can easily be missed in the absence of obvious indications for a celiotomy or a thoracotomy, because radiologic abnormalities are often interpreted as other injuries. In such cases, a high index of suspicion coupled with selective use of a CT scan, fluoroscopy, thoracoscopy, or laparoscopy may be necessary for early detection of the diaphragm rupture.

Penetrating Injury by an Iron Reinforcing Bar Associated with a Fall or Slip Injury

INTRODUCTION: There was increase in a fall injury at the field of construction work, nowadays. There was also increase in penetrating injury by an iron reinforcing bar associated with a fall or slip injury. But this is not widely discussed in the surgical literature. The purpose of this study was to define the characteristics of injury, diagnosis, treatment and prognosis of the penetrating injury by an iron reinforcing bar associated with a fall or slip injury. METHODS AND MATERIALS: We reviewed retrospectively medical records of 17 patients who admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating injury by an iron reinforcing bar associated with a fall or slip injury from Nov. 1987 to Dec. 1996. RESULTS: The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury were 5 cases of a slip injury and 12 cases of a fall injury. The insertion site of an iron reinforcing bar was perineum in all of a slip injury. In a fall injury, insertion site was flank and back in 5 cases, perineum 4 cases, chest 2 cases and abdomen 1 case. In a fall injury, 9 patients had two or more organ injuries. CT scan was taken in 3 cases, sigmoidoscopy 3 cases and fistulogram 1 case in a slip injury. CT scan was done in 5 cases, sigmoidoscopy 1 case, cystogram 2 cases and intravenous pyelogram 1 case in a fall injury. 2 cases was cured conservatively, and operation was done in 3 cases in a slip injury in contrast to 2 cases of conservative management and operation 10 cases in a fall injury. There was no negative celiotomy. Complication was only one wound infection in a slip injury. There were wound infection 6 cases, pulmonary complication 4 cases, sepsis 1 case, necrotizing fascitis 1 case, anal sphincter injury 1 case, intraabdominal abscess 1 case and neurogenic bladder 1 case in a fall injury. There was no mortality. CONCLUSION: The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury had characteristics of both penetrating and blunt injury. The chest and abdominal penetrating injuries lead to multiple organ injury. In perineal penetrating injury, we should evaluate the injury of urinary bladder, rectum and genital organ.

Penetrating Zone II Neck Injuries

The management of penetrating injuries of zone II of the neck presents a difficult problem. The difficulties are due to the close anatomical relationships between the many vital structures in the neck and to the insidious nature in which some of the injuries may present themselves, for example, esophageal lacerations. If a significant injury is overlooked, the consequences may be dire with severe complication and mortality. Two management strategies have been developed for coping with these difficult injuries : (1) mandatory exploration of all injuries penetrating the platysma, and (2) a selective approach with neck exploration being performed based on clinical and investigative findings. The aim of this study was to review the clinical characteristics of and the various treatment protocols for II penetrating injuries of the neck. We reviewed retrospectively the medical records of 38 patients who were admitted to and treated at Yongdong Severance Hospital, College of Medicine, Yonsei University, due to penetraing injuries of the neck from Jan. 1990 to Dec. 1996. Twenty-three of the 38 patients (60.5%) underwent immediate operative exploration. In 13 of these patients, the exploration produced positive findings (56.5%), and in 10, the exploration produced negative findings (43.5%). Following neck exploration, 13 patients presenting acutely were found to have 21 injuries. The predominant injuries were vascular followed by neurologic and then respiratory. Eight of the 11 patients (73%) with positive clinical findings were found to have injuries at exploration, and 5 of the 12 patients (42%) with no clinical signs were found to have injuries (p=0.0432). Three of 4 patients (75%) with positive CT scan findings were found to have injuries at exploration and 4 of the 8 patients (50%) with no CT scan findings were found to have injuries (p=0.0455). The complication rate and the performance rate of CT scan were not statistically different between patients with a negative neck exploration and patients with conservative management. The duration of hospitalization was an average of 6.2 days for those patients with a negative neck exploration and 4.1 days for those patients with conservative management (p=0.0022). There was no mortality. In conclusion, it is possible, by careful physical examination and CT scan, it will be possible to reduce the rate of negative neck exploration without risk to those patients who need immediate surgery.

Management of Penetrating Neck Injuries

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.

The Effects of Gonadectomy and Prenatal Testosterone Injection on Galanin Immunoreactive Cells in the Medial Preoptic Area of Rats / 대한해부학회지

Within the medial preoptic area[MPOA], several cytoarchitectonically defined cell groups are sexually dimorphic in their morphology. Specially, the sexual dimorphic nucleus of the preoptic area[SDN-POA] is reported an example of a morphological sex difference in the rat hypothalamus which is influenced by gonadal steroid hormones. Thus, we detemined the distribution of Galanin-immunoreactive[Gal-I] cells and fibers within MPOA and their morphological response to gonadal steroids which is influenced by gonadectomy or prenatal restosterone treatments were observed. The Gal-I cells were appeared within the medial preoptic area. In the males, the volume and number of Gal-I nerve cell bodies were greater than that of females. But the female which treated prenatal testosterone injection had many Gal-I neurons than infact female. And the males that decreased the volume of gonadal hormone by gonadectomy were decreased the volume and number of Gal-I neurons than that of normal males. These results suggest that galaninergic cells within the medial preoptic area are influenced by gonadal steroid hormone[testosterone] in the regulation of sexually dimorphic function.

A Clinical Study of 500 Cases of Breast Cancer / 대한암학회지

PURPOSE: We investigated the clinical characteristics of breast cancers and its significance. MATERIAL AND METHOD: We evaluated the clinical characteristics of 500 women with breast cancer who were diagnosed and treated by one surgeon between March 1991 and August 1996. RESULTS: The median age was 46.7 years and the most common age group was 40's. The presenting symptoms for most patients were palpable mass (75.2%) followed by abnormal mammographic findings (8.4%), pain (6.3%) and nipple discharges (4.7%), and the duration of symptoms was less than 1 month in 41.4%. Fifty three percent of the 500 cases had T2 lesion (size; 2 to 5 cm). With the increase of tumor size, overall and disease free survival rates (OS, DFS) were decreased. Surgical treatment consisted of modified radical mastectomy (52.8%) and partial mastectomy (33.6%) The most common stage was II (42.3%) and the early breast cancer (stage 0, I, II) was 388cases (78.1%) and the stage were inversely correlated with DFS and OS. The positivity of axillary lymph node was 39.3% and the number of the metastatic lymph nodes was inversely correlated with DFS and OS. The pathologic types were infiltrating ductal carcinoma (83.0%), ductal carcinoma in situ (12.8%), infiltrating lobular carcinoma (1.2%), lobular carcinoma in situ (0.4%) and Paget's disease (2.0%). ER positivity was 48.9% and PR 46.9%. ER positive patients showed survival benefit compared to ER negative patients. The common sites of distant metastases were lung, bone and liver. CONCLUSIONS: Our patients with breast cancer were younger than those of western and showed the impacts on survival according to the lymph node status,tumor size.

Detection of herpesviruses in renal allograft rejection by in situ hybridization / 감염

No abstract available.