Heterotopic Salivary Glands Simulating Bronchial Cleft Fistular in the Lower Neck

A heterotopic salivary gland (HSG) in the lower neck is an unusual developmental anomaly rarely encountered by the dermatologist. Klimko and Horanyi (1) reported the first histologically documented case of HSG in the lower neck in 1958. To our knowledge, fewer than 100 such cases have been reported in the literature to date. The origin of HSG in the lower neck seems to be closely associated with the branchial apparatus. Because this condition is rarely encountered, dermatologists should be well informed about the clinical manifestations, development of various malignancies, and the differential diagnosis of HSG.     

Congenital Giant Pigmented Nevus Associated with Angiolipoma

We report a 20-year-old-Korean woman with a congenital giant pigmented nevus and angiolipoma. She was admitted our department with a large, dark, pigmented lesion on the right flank and abdomen and a slowly growing mass on the right flank area since birth. On biopsy, the specimen taken from the giant pigmented patch showed typical findings of compound nevus. The right flank mass was surgically removed. The specimen was composed of mature fat cells with an increased vascular component. These findings are compatible with angiolipoma.     

Loads in the spinal structures during lifting: development of a three-dimensional comprehensive biomechanical model

Summary Epidemiological studies have shown that loads imposed on the human spine during daily living play a significant role in the onset of low back pain. The loads applied to the lumbar spine are shared by a number of structures: muscles; posterior elements, including facets and ligaments; and the disc of a ligamentous motion segment. In vivo, it is not practical to determine forces in these structures using experimental techniques. Biomechanical models, based on an optimization technique or electromyographic activities of the trunk muscles, have been proposed to predict forces in the load transmitting structures. The mathematical models reported in the literature are based on information collected from a wide variety of sources, of which the subject that takes part in the experiment is only one. The present study describes techniques developed in our laboratory to collect from the subjects themselves all the data needed for the formulation of a biomechanical model. The results demonstrated that back lifting with 0 N (no load), 90 N, and 180 N in the hands created maximum external flexion moments respectively of 109.6 Nm, 137.9 Nm, and 161,7 Nm, at the L3–4 disc level. The corresponding external axial compression forces on the disc were 469.5 N, 511.8 N, and 601.5 N. The predicted disc compression varied from 3.4 to 5.0 times the body weight. In comparison to the static lifting mode, the dynamic lifting task caused an increase in the disc compression force ranging from 15.8% to 39.4% depending on the load being lifted (e.g., 3256 N for the dynamic mode vs. 2516 N for the static mode when the subject lifted 90 N). The salient features of the entire protocol developed by the authors and the need for further improvements are also presented.     

Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea

Objective: The present study was initiated to investigate the validity of cadmium (Cd) and lead (Pb) in urine in comparison with the metals in blood as a biological marker of nonoccupational exposure of general populations to these metals as environmental pollutants. Design: Peripheral blood samples, morning spot-urine samples, and 24-h total food duplicate samples were collected from 107 nonsmoking women (aged 30–59 years) in four urban and rural survey sites in Korea. Methods: Portions of the samples were digested by heating in the presence of mineral acids, and the digests were analyzed for Cd and Pb by graphite furnace atomic absorption spectrophotometry. The metal concentrations in urine were adjusted for creatinine concentration and a specific gravity of 1.016. The analyte levels were evaluated on an individual basis (n = 107) and also on a group basis, i.e., in terms of geometric means for the survey sites (n = 4). Results: Cd in urine correlated with Cd in blood on an individual as well as survey-site basis and tended to correlate with Cd in food duplicates on a group basis. The correlation of Pb in urine with Pb in blood was weaker than that of Cd in urine with Cd in blood when evaluated on an individual and survey-site basis. Pb in urine correlated with Pb in food duplicates either weakly or even negatively when examined on a survey-site basis. Conclusions: Cd in urine proved to be valid as a biological marker of environmental exposure of general populations, whereas less support was obtained for Pb in urine as an exposure marker. Received: 5 May 1997 / Accepted: 28 August 1997     

Endovascular stent placement for interposed middle hepatic vein graft occlusion after living-donor liver transplantation using right-lobe graft.

Middle hepatic vein (MHV) reconstruction is performed to drain the right paramedian sector to prevent hepatic venous congestion (HVC). The aim of the present study was to evaluate endovascular stent placement in patients with stenosed and/or occluded interposition vein graft (IVG) to segment V hepatic vein (V5) and segment VIII hepatic vein (V8) after living-donor liver transplantation (LDLT). The procedure was performed in 11 recipients; 7 underwent it within 24 hours of LDLT. The following parameters, including technical success, clinical success, complications, patient survival data, and serial computed tomography (CT) findings during follow-up, were documented retrospectively. Technical success was defined as both successful stent placement and resolution of stenosis or occlusion with copious flow of contrast medium through the stent, while clinical success was defined as both improvement of liver function tests (LFTs) and reduction or disappearance of hepatic low-attenuation areas on follow-up CT scans taken within 1 week of stent placement. Technical success was achieved in 10 of 11 patients (91%), and clinical success was achieved in 9 of 11 patients (82%). Acute thrombotic occlusion of the stent-inserted hepatic vein occurred in 1 patient 1 day following stent placement. During the mean follow-up period of 468 days (range, 13-891 days), 9 patients survived and 2 patients died. No death was directly related to stent placement or its related complications. The low-attenuation area in the involved hepatic segment V (S5) and/or VIII (S8) area prior to stent placement disappeared completely on follow-up CT scans performed at 3-12 days (mean, 5.4 days) after stent placement in all 9 patients with clinical success. No attenuation change occurred even in cases with chronic occlusion of the stent-inserted hepatic veins. In conclusion, though IVG to V5 and V8 remains controversial, the treatment of their stenosis or occlusion is safe and effective, even during their immediate postoperative period.     

‘Swiss Cheese’ Lymphangiectasia in a Case of Solitary Morphea Profunda

Reports of lymphangiectases that occur in lesions of morphea are rare. We describe a 24-year-old woman with a solitary morphea profunda associated with lymphangiectasia. Unlike previously reported cases, our case showed lymphatic dilatation resembling Swiss cheese and developed around a milium.     

Antitumor activity ofTrichosanthes kirilowii

The activity-directed fractionation upon the MeOH extract of the root ofTrichosanthes kirilowii led to the isolation of eight cucurbitane triterpenes namely cucurbitacin B (I), isocucurbitacin B (II), cucurbitacin D (III), isocucurbitacin D (IV), 3-epi-isocucurbitacin B (V), dihydrocucurbitacin B (VI), dihydroisocucurbitacin B (VII) and dihydrocucurbitacin E (VIII), as active principles. All isolates were shown to exhibit significant cytotoxicity against cultured human tumor cells, including A-549, SK-OV-3, SK-MEL-2, XF-498 and HCT 15, with an exceptionally high potency.     

Simultaneous bilateral breast reconstruction with the transverse rectus abdominus musculocutaneous free flap.

OBJECTIVE: The purpose of the study was to assess the results and morbidity associated with simultaneous bilateral TRAM free flap breast reconstruction and describe refinements in its surgical technique. SUMMARY BACKGROUND DATA: Bilateral prophylactic total mastectomies might be an agreeable option for those patients at highest risk for breast cancer if autogenous tissue breast reconstruction could be performed with reasonable technical ease and acceptable morbidity. However, some surgeons harbor reservations regarding the extensiveness of the surgery, the associated morbidity, and the aesthetic quality of the resulting outcome. METHODS: A multicenter retrospective review of clinical experience with 120 consecutive patients who underwent 240 simultaneous bilateral TRAM free flap breast reconstructions was developed. RESULTS: The average operating time, including the time required for the breast ablative portion of the procedures, was 8.6 hours. The average length of hospitalization was 7.6 days. However, for the last 40 patients, these figures were reduced to 7.1 hours and 6.1 days, respectively. Nonautologous blood transfusions were needed in 33 cases (28%), but only 1 was required in the last 40 patients. Thromboses developed in six of 240 flaps (2.5%): 4 were arterial and 2 were venous. Re-exploration allowed us to restore circulation in five flaps, whereas one flap was unsalvageable and was replaced successfully with an alternate flap. An uncomplicated deep vein thromboses developed in one patient with a history of recurrent deep vein thromboses that had no adverse effect on her outcome. Minor complications developed in 18 patients (15%) (e.g., hematoma, partial wound necrosis, wound infection, or prolonged postoperative ileus) that did not affect the long-term outcome. Fourteen patients (11.6%) had abdominal wall weakness or hernias. Follow-up time averaged 37.2 months (range, 14-62 months). On last follow-up, patients' self-reported overall satisfaction with the procedure was 56% excellent, 40% good, and 4% fair.CONCLUSIONS: Simultaneous bilateral free flap reconstruction is technically feasible with a high rate of success and an acceptable morbidity. When performed by experienced surgeons, bilateral prophylactic total mastectomies combined with simultaneous bilateral TRAM free flap reconstruction may provide an adequate surgical option with aesthetically acceptable results for patients at high risk for breast cancer.     

Polyoxygenated flavones; Synthesis,cytotoxicities and antitumor activity against ICR mice carrying S-180 cells

Fifty two flavones were synthesized from polyoxygenated dibenzoylmethanes which were obtained by a modified Baker-Venkataraman rearrangement, of 2-benzoyl oxyacetophenones. The following flavones among then showed good cytotoxic activities against L1210 and HL-60 cells; 2′-benzyloxy-5-methoxyflavone [ED₅₀(L1210)=4.9 μg/ml) ED₅₀(HL-60)=3.1 μg/ml] 2′-benzyloxy-5,7-dimethoxyflavone (8.2 μg/ml, 5.0 μg/ml), 2′-benzyloxy-5,7,8-trimethoxyflavone (5.9 μg/ml, 11.0 μg/ml), 2′-hydroxy-5,7-dimethoxyflavone (8.3 μg/ml 4.9 μg/ml) 2′-hydroxy-5-methoxyflavone (4.2 μg/ml, 2.7 μg/ml), 2′-hydroxy-5,7,8-trimethoxyflavone (9.8 μg/ml, 6.2 μg/ml), 2′-benzyloxy-5-hydroxyflavone (5.2 μg/ml, 3.6 μg/ml), and 5,2′-dihydroxyflavone (5.1 μg/ml, 4.0 μg/ml). Presence of 5-methoxy group potentiated the cytotoxic activity, while the existence of 7-methoxy group decreased the activity. 5-Hydroxy or methoxy, activates 4-carbonyl group, while 7-methoxy group deactivates the carbonyl group. From these observation it was concluded that the activation of carbonyl group at C-4 of a flavone is important for the enhancement of the cytotoxic activity. The presence of both 5-hydroxy and 2′-benzyloxy- or 2′-hydroxy group enhanced the antitumor activity; 2′-benzyloxy-5-hydroxy-7-methoxyflavone (T/C=144%), 5,2′-dihydroxy-7-methoxyflavone (T/C=132%), and 5,2′-dihydroxy-6,7,8,6′ tetramethoxyflavone (T/C=172%). 2′-Hexanoylation of 5,2′-dihydroxy-flavones did not improve the antitumor activity; 2′-hexanoyloxy-5-hydroxy-7-methoxyflavone showed T/C=132%, about the same as that of 5,2′-dihydroxy-7-methoxyflavone (T/C=130%)     

Characterization of acetylcholinesterase from Korean electric ray and comparison withTorpedo californica

This study has been undertaken to examine the acetylcholinesterase (AChE) of electric organ from korean electric ray (Narke japonica). Korean electric ray was caughted at Chungmu sea and transported to the laboratory, where electric organs were removed and stored at −70°C until used. Acetylcholinesterase(AChE) of electric organ was purified by affinity column that was prepared with dicaproyl-methylpyridinium linked to Sepharose 4B. Upon purification, the specific activities in Ellman unit were increased by 52 and 39 times for high salt soluble AChE (HSSE, 870.86 ΔOD/min/gram of tissue) and detergent soluble AChE(DSE, 105.42 ΔOD/min/gram of tissue), respectively. Each subunit of AChE separated by SDS polyacrylamide gel electrophoresis(SDS-PAGE) was transferred to immobilon P by western blotting and detected by mAbs raised against each subunit of AChE from electric organ ofTorpedo californica. Collagenic tail of AChE fromNarke japonica were identified by monoclonal antibody specific to collagenic tail of AChE fromTorpedo californica, likewise 103Kd protein of AChE fromNarke japonica was detected by monoclonal antibody specific to 103Kd of AChE fromTorpedo californica. However, molar ratio of three subunits of AChE fromNarke japonica is different from that ofTorpedo californica. Furthermore, catalytic subniit of AChE fromNarke japonica was not identified by monoclnal antibody specific to catalytic subunit of AChE fromTorpedo californica. These results showed differences in molecular structure of AChE fromNarke japonica and AChE fromTorpedo californica eventhough they showed same enzymatic activities.