Animal Skin Pigmentation Model Using Full Thickness Skin Graft in C57BL/6 Mouse

PURPOSE: Skin grafting is one of the most commonly used methods in reconstructive plastic surgery field, but complications such as color change, contracture or hypertrophy are common problems. However, pathophysiology of the color change after skin graft is not yet determined and no animal model is established. METHODS: Full thickness skin grafts were performed on the dorsum of C57BL/6 mice. Serial chronological gross inspection for color change and pigmentation were examined. Melanin pigments were traced by Fontana-Masson staining and semi-quantitative analysis was performed. In addition, immunohistochemical staining of S-100, Micropthalmia related Transcription Factor(MITF) and Melan-A antibodies were also performed to observe melanocytes and their changes. RESULTS: After skin graft, color change and pigment spots were observed in the graft. Fontana-Masson staining showed melanin pigments in the epidermal and dermal layers in all mice. Immunohistochemistry staining to S-100, MITF, Melan-A antibodies showed melanocytes at the basal layer of epidermis and dermis. CONCLUSION: In conclusion, we have established an animal model for skin pigmentation after skin graft. We believe this study may be useful in understanding of the behavior of melanocytes after skin graft.

The Application of Impulse Oscillometry (IOS) in the Workers Who had been Exposed to Inorganic Dust Induced Early Airway Obstruction / 결핵및호흡기질환

BACKGROUND: We tried to examine the small airway diseases which can be found early, in workers exposed to inorganic dusts. This is measured in normal breath by using the impulse oscillometry (IOS). METHODS: The Pulmonary function test (forced vital capacit [FVC], forced expiratory volume in one second [FEV1], forced expiratory flow between 25% and 75% of vital capacity [FEF25-75]), IOS resistance (Rrs at 5, 10, 15, 20, 25, 35 Hz) and reactance (Xrs at 5, 10, 15, 20, 25, 35 Hz) were measured for 454 workers. The subjects were classified into 173 workers of normal (38.1%) and 281 patients with pneumoconiosis (61.9%). RESULTS: There were significant differences between normal and patients with FVC (3.82+/-0.61 vs. 3.53+/-0.56 L), FEV1 (2.67+/-0.63 vs. 2.35+/-0.48 L), and FEF25-75 (1.88+/-0.95 vs. 1.47+/-0.80 L/sec) between groups (p0.05), and there were significant differences between normal and patients with reactance (Xrs) 15 Hz (0.003+/-0.05 vs. -0.006+/-0.04 kPa/L/s), 20 Hz (0.043+/-0.05 vs. 0.031+/-0.04 kPa/L/s), and 35 Hz (0.141+/-0.05 vs. 0.131+/-0.05 kPa/L/s) between groups (p<0.05). CONCLUSION: We could find out that 15 Hz, 20 Hz, and 35 Hz values of reactance were significantly influenced by pneumoconiosis. When usefulness and reproducibility to carry out the IOS are considered, it is thought that in future work will be required to draw the reference values for normal Korean persons.

Annual Changes of Lung Function in Retired Workers Exposed to Inorganic Dusts / 결핵및호흡기질환

BACKGROUND: The aim of this study was to investigate annual changes in pulmonary function in workers who were exposed to inorganic dust. METHODS: The subjects were 2,922 male patients who had been diagnosed with pneumoconiosis more than twice during 6 years from 2005 to 2010. RESULTS: Of the 2,922 cases, forced vital capacity (FVC) decreased by 54 mL in 1 year. In contrast, the annual change of forced expiratory volume in one second (FEV1) decreased by 56 mL. CONCLUSION: This is the first study that has investigated the annual change in pulmonary function in workers exposed to inorganic dust. The results will help estimate the pulmonary condition of patients who are unable to perform a pulmonary function test due to age or a disorder.

Inframammary Approach for Breast Augmentation

Recently, most people think that the ample breast is the symbol of a glamorous woman. This concept made many women knock the door of the plastic surgery clinic for the consultation about their breast and the breast augmentation became rare operation no longer in Korea. For beautiful breast, plastic surgeons should take into consideration of incision placement, optimal implants, dissection plane and so on. Among those considerations, incision placement is largely dependent on the surgeon and patient's preferences. Surgeons can choose inframammary, axillary, periareolar or umbilical incision. Inframammary approach has been abandoned by the surgeons and patients in Korea for a long time because of the visible scar and hyperpigmentation on the incision site. But Inframammary approach has the advantages of direct vision of surgical field, short operation time and early recovery. If surgeons can overcome the scar and pigmentation problem of incision site, inframammary approach can be a great option for both. In this article, we examined the advantages and disadvantages of many approaches for breast augmentation and reviewed the usefulness of the inframammary approach for breast augmentation.

Endoscopic Forehead Lift Using Endotine(R)

Brow lift is the most effective method of brow ptosis correction. For brow lifting, suprabrow incisions have not been widely used yet because they lead to prominent scars above the eyebrow especially in orientals. Although classic brow lift using coronal scalp incisions has so far been performed as an alternative to brow lift using suprabrow incisions, it is being increasingly replaced with endoscopic brow lift due to more less postoperative complications such as scalp scars and paresthesia, However, many facial plastic surgeons may abandon this operation after initially unsatisfactory surgical outcome because the learning curve of endoscopic operation is relatively painful. Endoscopic brow lift is an effective surgical treatment that can achieve a good surgical outcome if we fully understand basic anatomical structures and the surgical principles of the operation. Release and fixation are of utmost importance in this operation. We can obtain successful postoperative results if we adequately release the retaining ligamentous attachments which anchor the facial soft tissue to the facial skeleton and the depressor muscles which retract the soft tissue inferiorly and, fix the soft tissue firmly to the facial skeleton in the elevated position. Many techniques and principles for releasing the ligaments and the muscles have been described based on anatomical knowledge. In addition to them, various fixation techniques have been developed for the past decade including using fibrin glue, internal screws or plates, external screws, absorbable screws, and cortical tunnels, but some drawbacks have been reported in these fixation techniques. The Endotine forehead device, an absorbable fixation device, was developed in order to solve the drawbacks several years ago and has since been widely used in clinical practice. Brow lift using the Endotine forehead device has several advantages over other surgical procedures. First of all, the surgical time is short because this operative procedure is simple. This operative procedure can minimize patient discomfort postoperatively. And then this device can prevent relapse of brow ptosis after surgery. We describe herein our 2-year experience with endoscopic brow lift.

Change of Body Composition in Obese Women with Short-term Low Calory Diets

BACKGROUND: A reasonable weight reduction method is to reduce fat-body mass while preserving fat-free mass. Recently, many people in Korea have been trying reckless diet therapy for weight reduction by means of low calory and protein diets, which gave rise to many side effects consequently. For reasonable weight reduction, this study was undertaken to investigate the significant dietary factors that change body composition during short-term low calory diet. METHODS: Twenty six healthy obese women aged 23~37 years, whose BMI was greater than 24, volunteered for the 6 week diet therapy from January to April in 2003. All subjects were instructed to eat approximately 1,200 kcal/day and keep a dietary diary. In the beginning the 3rd week and the 6th week of the study, subjects' body weight were measured and fat body weight were measured by BIA. In the 6th week, the analysis of the dietary diary was conducted. RESULTS: There was a significant positive correlation between the protein intake per ideal body weight in the first 3 weeks and the fat-free mass increase in the latter 3 weeks (P<0.05). At the same time, the fat intake in the first 3 weeks had positive correlation with the fat-free mass in the latter 3 weeks, also (P<0.05). But, we could not find any significant values that had effect on the fat-free mass increase in multiple regression analysis. CONCLUSION: The protein intake in the first 3 weeks helped to preserve the fat-free mass in the latter 3 weeks, and had positive effects.

Cold Agglutinin Disease due to Anti-Pr Cold Autoantibody in a Patient with Bone Marrow Transplantation / 대한수혈학회지

Cold agglutinin disease (CAD) is a most common autoimmune hemolytic anemia (AIHA) induced by cold antibody. CAD represents approximately 16-32% of AIHA cases and causative cold autoantibodies commonly show specificity against the I antigen. We report a case of cold agglutinin disease with anti-Pr cold autohemolysin. A 20 year old woman with a history of bone marrow transplantation was admitted with nausea, vomiting, and pallor. Direct antiglobulin tests were positive with IgG and C3d specific AHG reagents. Cold agglutinin titer was as high as 1:1024 at 4degrees C, 1:16 at room temperature, negative at 37degrees C. The agglutinin titer was diminished after treatment with protease, ficin and immunohematologic results of cold agglutinin was compatible with anti-Pr specificity. In unexpected antibody identification test, anti-M which showed reactivity at anti-human globulin phase was identified. Washed and prewarmed 16 units of A+, M antigen negative red blood cells were transfused. After two weeks, patient was improved with steroid therapy and experienced relief of fever and hemolysis, and she was discharged.

Correction of Pixy Ear Deformity with Triangular Flap

No abstract available.

Correlation between Progenitor Cell Dose and the Rate of Engraftment in Autologous Peripheral Blood Stem Cell Transplantation and Allogeneic Bone Marrow Transplantation / 대한수혈학회지

BACKGROUND: Bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) following high dose chemotherapy has been an important therapeutic option for patients with hematologic malignancies or some solid tumors. The number of progenitor cells in the collection products has been used to determine the optimum time to stop the collections and to predict the hematopoietic engraftment after transplantation. In this study, we investigated the relationship between end-product cell counts measured by different methods and the influence of the infused cell dose on the engraftment rate. METHODS: Twenty five patients receiving autologous PBSCT and 25 patients receiving allogeneic BMT were studied. The number of total nucleated cells (TNC), of mononuclear cells (MNC), of CD34+ cells, and of CFU-GM (colony-forming unit-granulocyte monocyte) colonies were measured in each collection product. The number of days required to achieve an absolute neutrophil count (ANC) of 0.5x109/L with TNC count of 1.0x109/L and platelet count of 20x109/L without transfusions was taken as an arbitrary measure of the engraftment rate. RESLUTS: A close correlation between CD34+ cells/kg and CFU-GM/kg was observed in both collection products (p<0.05). However, MNC/kg also showed significant correlations with CD34+ cells/kg and CFU-GM/kg in allogeneic bone marrow collection products (p<0.05). The CFU-GM amount in the PBSC products was greater than that in the bone marrow collection products (p<0.05). Time to engraftment was a median of 14 (range 9-50) days in autologous PBSCT group, but 29 (range 17-57) days in allogeneic BMT group. In autologous PBSCT, infused CD34+ cells/kg and CFU-GM/kg correlated significantly with ANC recovery (p<0.05). CONCLUSIONS: The number of CD34+ cells was correlated with that of CFU-GM in the collection products, and the infused cell doses showed positive relation to the engraftment rate in autologous PBSCT. These findings suggest that measurement of CD34+ cell counts alone would be a sufficient parameter to predict the engraftment rate in autologous PBSCT.

Two cases of pheochromocytoma associated with acute myocardial infarction / 대한내과학회지

Pheochromocytoma was usually derived from adrenal medulla or chromaffin cells in or about sympathetic ganglia, and manifested several symptoms and signs by producing, storing, secreting catecholamine. This tumor frequently presented various symptoms such as paroxysmal or persistent hypertension, headache, sweating, palpitation. EKG abnormalities, myocarditis, cardiomyopathy, angina pectoris and myocardial infarction have been reported in cardiovascular systems. We experienced two cases of pheochromocytoma associated with myocardial infarction Two patients presented typical cardiac enzyme patterns and regional wall motion abnormalities on ehcocardiography which was compatible with acute myocardial infarction. However, these patients showed normal coronary artery on coronary angiograpy. Urinary excretion of catecholamine metabolites were elevated and pheochromocytoma was found on right adrenal gland. After the removal of pheochromocytoma, urinary excretion of catecholamine metabolities, regional wall motion abnormalities on echocardiography and blood pressure were normalized.

Evaluation of ABO Isoagglutinin Titers in Korean Adults / 대한수혈학회지

BACKGROUND: Isoagglutinin titers may be useful markers in the assessment of ABO-incompatible transfusion, bone marrow transplantation, and solid organ transplantation as well as determination of ABO subtypes, and screening of B cell defect. ABO isoagglutinin titers can be differed according to age, gender, race, and environmental factors. We determined isoagglutinin titers of IgM anti-A, anti-B in Korean healthy adults. METHODS: Sera from 215 adults of blood group A, B, and O were tested. IgM isoagglutinin titers were determined by mixing the two fold serum dilutions from 1:2 to 1:512 with pooled 3% red blood cells. Tests were read after spinnig the tubes at 3400 rpm for 15 seconds. RESULTS: The results were analyzed according to the ABO types, ages, and sex. From 77 sera from group A (44 male, 33 female), the geometric mean of IgM anti-B titers in group A was 73.5 (male 84.4, female 61.4), and the median was 64 (male 64, female 64). From 68 sera from group B (36 male, 32 female), the geometric mean of IgM anti-A titers in group B was 64.0 (male 64.0, female 65.3), and the median was 64 (male 64, female 64). From 70 sera from group O (64 male, 28 female), the geometric means of IgM anti-B and anti-A titers in group O were 52.3 (male 42.2, female 72.5) and 64.4 (male 63.1, female 70.5), respectively. And the median were 64 (male 32, female 64) and 64 (male 64, female 64), respectively. There were no linearity of isoagglutinin titers with the increase of age in Korean adults from 20 to 69 years old. CONCLUSION: The titers of IgM anti-B and anti-A isoagglutinin in Korean adults were estimated to be equally 1:64. No decrease of ABO isoagglutinin titers were observed with the increase of age from 20 to 69 years old.

3D-reconstruction of right portal vein / 한국간담췌외과학회지

BACKGROUND/PURPOSE: Thorough knowledge of hepatic anatomy is essential in liver surgery. Recent development of computer technology has allowed three-dimensional (3D) reconstruction of radiological images. We evaluated the right portal veins by 3D-reconstruction and determined the numbers and directions of the segmental branches to provide a readily understandable portal branching pattern. METHODS: CT arterial portography(CTAP) data from 11 hepatoma patients were reconstructed threedimensionally in a computer workstation. The images were rotated from top(U90) to bottom(D90) and from right lateral(R90) to left lateral (L90), and the 3rd portal branches were matched and their course was determined. RESULTS: The direction of right portal trunk was right(R) 105(5/7 patients) - R 90(2/7 patients) and 0 - up(U) 15 in 5/7 patients(pt). The most common directions of R anterior trunk, VIII, V, R posterior trunk, VII, VI segmental portal branches were R60(6/10 pt) & U15(5/10), R 135(5/10) & U60(5/10), R30-75 & down(D)15-60(9/10), R105-120(6/10) & D15-30(8/10), R165(6/11) & U15(6/11), R105(6/11) & D30-45(8/11). The numbers of VIII & V branches visualized were 1(4),2(6),3(1) & 1(5),2(5),3(1). The numbers of VI branches were 1(5),2(4),4(1). The VII branch always branched into lateral and medial branches. Simple branching patterns were obtained on posterior segmental branches. The anterior segmental branches were somewhat variable. CONCLUSION: 3D-reconstruction of portal veins allowed accurate assessment of segmental branches and their spatial relationship was readily understandable. It would be helpful in planning and simulation of surgery.

Carpal Tunnel Syndrome among workers in a condom industry / 예방의학회지

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

Geographic variations in tonsillectomy and adnoidectomy (T & A) and appendectomy in Korea / 예방의학회지

The objectives of this study are two-fold : to identify geographic variations in the rate of tonsillectomy and adenoidectomy(T and A) and appendectomy and analyze the socioeconomic variables and health resources which affect geographic variation in the rate. The nationwide three month's cases of the two surgical procedures in 1991 are obtained from the record of the National Federation of Medical Insurance. The analysis shows two to ten-fold variations in the regional rates for the performance of two common procedures such as T and A and appendectomy. T and A shows a bigger regional variations than appendectomy. As a result of multiple regression, the factor of bed supply has been found significant for the dependent variable of the rate of T and A. The findings of large variations in the rate of surgical procedures throughout the country would have important implications for allocating scarce resources and managing quality of care. Further analysis is needed for the elaboration of the above implications.

Flow Cytometric DNA Analysis of Prostate Adenocarcinoma :Correlation with histologic grade and DNA ploidy

Nuclear DNA content of 32 cases of prostate adenocarcinoma diagnosed 1986-1991 was determined by flow cytometry, with the use of paraffin-embedded archival tissue. The present study was done to define the relationship between clinical stage, histopathological grade, and DNA ploidy. Aneuploidy was found in 10(31.3%) cases including 7 cases of near-tetraploidy. Among diploid tumors, 36.4% were localized disease(stage A and B), 13.6% were characterized by invasion outside the prostate(stage C), and 50.0% showed distant metastasis(stage D). Among aneuploid tumors, 10.0% were stage B, 50.0% stage C, and 40.0% stage D. The degree of glandular differentiation was characterized by the Gleason score and the percentage of sampled tissue involved by carcinoma was graded by Dhom's method. Apparent correlation was found between Gleason grade and Dhom grade(P<0.05). All 13 tumors with a Gleason grade I(score of 2 to 5) were diploid. Four of 9 tumors with a Gleason grade II(score of 6 to 7) were aneuploid(near-tetraploidy 33.3%, aneuploidy 11.1%) and 60.0%, of tumors with a Gleason grade III(score of 8 to 10) were aneuploid(near-tetraploidy 40.0%, aneuploidy 20%). The percentage of aneuploid cases increased with advanced clinical stage, but the relationship between aneuploidy versus clinical stage was not significant. However, it can be concluded that DNA ploidy correlates well with Gleason grade(p<0.05), which may have predictive prognostic value for prostate adeno-carcinomas.

Intrathecal Hyaluronidase in the Management of Spinal Block due to Tuberculous Spinal Arachnoiditis

Despite the appropriate chemotherapy and the use of steroids, spinal arachnoiditis, as a complication of tuberculous meningitis, is not uncommon in developing countries. The various methods of treatment previously undertaken have been unsatisfac.ory due to their serious side effects and/or doubtful therapeutic value. The proteolytic enzyme, hyaluronidase, by virtue of its action of hydrolysing the glucosaminidic bonds of hyaluronic acid and other mucopolysaccharides of the ground substance, offers a promising mode of treatment. This report describes the effectiveness of intrathecal injections of hyaluronidase in a patient with spinal block due to spinal tuberculous arachnoiditis. Despite the antituberculous regimen combined with steroid therapy, paraparesis and sensory changes developed in a 25-year-old female patient diagnosed with tuberculous meningitis. At that time, the CSF protein level was 6500mg%, and the myelogram and MRI showed a definite block of the CSF flow in the subarachnoid space from the second to the ninth thoracic level. After the 5 intrathecal hyaluronidase injections with the interval of two weeks(total 7500 unit), the neurological deficits were markedly improved to a nearly normal state and the CSF protein converted from 6500mg% to 128mg%. The thoracic myelogram showed improvement of passage of the contrast media through the right lateral column. Thus this case may provide the therapeutic role of hyalironidase as an adjunvant in the management of spinal arachnoiditis complicating Tb meningitis for which no satisfactory treatment exist.