The ability of photochemotherapy(PUVA) or UVA phototherapy to stimulate melangenesis is well known. It is now recognized that the PUVA lentigines, irregular in outline and often more darkly and unevenly pigmented than solar lentigines, are related to the additional pigmentary effects of the PUVA therapy. We present herein four cases of unusual pigmentation after one month of UVB irradiation. Raticulated dark brown pigmentation appeared on the lower extremities of the patients. Histopathologicially, an increase in melanin in the basal layer was found, but no dysplasia or malignant change. We suggest UVB as the cause of this unusual hyperpigmentation.
Humans ; Hyperpigmentation ; Lentigo ; Lower Extremity ; Melanins ; Phototherapy* ; Pigmentation* ; Psoriasis* ; PUVA Therapy

Seventy consecutive ipsilateral fracture of the femur and tibia in sixty-eight patients from December 1974 through December 1984 treated at Severance Hospital were analysed in clinical and radiological aspect. 1. Fifty-nine patients were male and nine patients were female. The male patients were more injured in the ratio of 6: 1. The avarage age was 34. 2. The main cause of injuries were traffic accidents; 59 patients. (86.8%). 3. The majority of the fractures were shaft fracture; for example, femur shaft 57% and tibia shaft 47%, The open fracture of the tibia was 34% and the femur was 17%. 4. There were 24 cases of concomitant fracture and dislocation of other sites. A fat embolism was disgnosed in 4% of the patients. Four patients had died one month after sustaining injuries. 5. Over-all, a good or excellent functional result was achieved in 76% of the patients treated with internal fixation of both fracture, 65% of the patients with intexnal fixation for the femur fracture only and 35% of the patients managed conservatively.
Accidents, Traffic ; Dislocations ; Embolism, Fat ; Female ; Femur ; Fractures, Open ; Humans ; Male ; Tibia

We experienced 12 cases of 8 patients Duputren's contracture, which is a rare disease entity and characterized by proliferative fibroplasia of the subcutaneous palmar aponeurosis and contracture of the palmar fascia and result in the deformity of the hand and fingers. Among 12 cases, we operated 11 cases and the result was excellent in 2 cases and good in 6 cases, and there were no evidence of recurrence over the follow-up period, average 4.1 years.
Congenital Abnormalities ; Contracture ; Dupuytren Contracture ; Fascia ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Rare Diseases ; Recurrence

The head patient with musculoskeletal trauma is a challenge to the orthopedic surgeon and its incidence is increasing markedly with the development of modern culture and a high velocity motor vehicle. So, for the purpose of studying the difference between lower extremity fracture concomitant with head injury and only lower extremity fractured patients, we studied the radiologic bone union time, serologic test and heterotopic ossification. For the control group we analysed each 10 patients of only femur and tibia fractures. The following clinical results were obtained by analysis of 46 patients of lower extremity fracture concomitant with head injury, experienced in the Department of Orthopedic Surgery, Yonsei University College of Medicine in past 5 years from Jan. 1980 to Dec. 1984. 1. The mean age was 24.5 yrs old (2~6 yrs old) and the prevalent age was 1st and 3rd decade, and the sex ratio between males and females was 2.8: l. 2. The most common mode of injury was auto-pedestrian injury (84.8%) and the other was falling down injury(15.2%) . 3. The common brain injuries were cetebral contusion with skull fracture (37.0%) and cerebral contusion only(34.8%) . Among 26 patients whos mental states were not alert, 23 patients recovered mental states completely. 4. Serum Calcium, Phosphate, and Alkaline Phosphatase level were no difference between the head injury with lower extremity fractured patients and only lower extremity fractured patients. 5. There were no evidence of early bony union in the patients with head injury. 6. The formation of callus were abundant in the patients of lower extremity fracture with head injury rather than the only lower extremity fractured patients. 7. The incidence of heterotopic ossification was 10.9% and all patients with heterotopic ossification were treated with physiotherapy and all patients recovered fully. 8. The incidence of complication was 17.3% and there was no fat embolic patients. In conclusion, there was no evidence of early bony union, but the callus formation was abundant in the patients of lower extremity fracture concomitant with head injury.
Accidental Falls ; Alkaline Phosphatase ; Bony Callus ; Brain Injuries ; Calcium ; Clinical Study ; Contusions ; Craniocerebral Trauma ; Female ; Femur ; Head ; Humans ; Incidence ; Lower Extremity ; Male ; Motor Vehicles ; Orthopedics ; Ossification, Heterotopic ; Serologic Tests ; Sex Ratio ; Skull Fractures ; Tibia

The treatment of extensive soft tissue injury is a chsllenge to Orthopedidic Surgeon especially in young children and at present reconstructive surgery with free flap is being employed under microscopy actively. The author present 27 cases of free flaps in young children below 6 years old, which were performed from March 1983 to December 1986. The results are as followes ; 1. The mean age was 4.9 years old. 2. The mechanism of injuries were all pedestrian injury. 3. We performed 27 cases of free flaps, among them 24 cases of flap were survived(88.9 %) with good functional and cosmetic result. 4. The vessels were larger in these young children than we expected. It is apparent that in a healthy child even though below 6 years old, the careful application of microsurgical principle is an excellent method for salvaging devascularized parts that are vital for function or appearance.
Child ; Clinical Study ; Free Tissue Flaps ; Humans ; Methods ; Microscopy ; Soft Tissue Injuries

No abstract available.
Animals ; Electroshock* ; Glutamate Decarboxylase* ; Glutamate-Ammonia Ligase* ; Glutamic Acid* ; Glutamine* ; Hippocampus* ; Rats*

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

No anstract available.
Magnetic Resonance Imaging* ; Spine*

We observed a 51-year-old male, who developed depigmented patches on the lower abdomen after photochemotherapy(PUVA) of psoriasis without evidence of phototoxic reaction. The depigmented patches did not orginate from the sites of previous psoriatic lesions. Fontana-Masson stain of the biopsy specimen revealed nearly absent melanin pigments in the epidrmis of the hypopigmented patch, while lots of pigments were obsereved on the surrounding hyperpigmented area. Electron micrograph showed no melanocytes in the hypopigmented patch. Thus we report this case as having vitiliginous patches induced by photochemotherapy of psoriasis.
Abdomen ; Biopsy ; Humans ; Male ; Melanins ; Melanocytes ; Middle Aged ; Photochemotherapy* ; Psoriasis* ; Vitiligo

No abstract available.
Hyperlipidemias* ; Obesity* ; Risk Factors* ; Urolithiasis*