The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

No abstract available.
Osteoma*

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effeciveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3 weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and Followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 2(70.5%). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refreactoriness and drug induced side effect.
Amenorrhea ; Antipsychotic Agents ; Brief Psychiatric Rating Scale ; Clozapine* ; Female ; Follow-Up Studies* ; Humans ; Movement Disorders ; Psychomotor Agitation ; Psychotic Disorders ; Risperidone* ; Schizophrenia

No abstract available.
Nasal Bone*

Kimura's disease is a chronic inflammatory condition of unknown cause. It usually appears as a painless nodule in the head and neck region often associated with regional lymphadenopathy, but there have rarely been reports of penile involvement or clinical presentation as an ulcerative plaque. We present a case of Kimura's disease occurring on the penile shaft as an ulcerative plaque in a 44-year-old man. A vesicular eruption had occurred on his penile shaft followed by an ulcerative plaque for 2 months. He had suffered from recurrent regional lymphadenopathy for 15 years and he had also exhibited intermittent eosinophilia. Histopathologic findings revealed diffuse eosinophilic infiltration in the dermis of the skin and eosmophilic abscesses in the lymphoid follicles of the mguinal lymph node. After short-term systemic steroid therapy and local injection of triamcinolone acetonide, the ulcerative plaque was healed.
Abscess ; Adult ; Dermis ; Eosinophilia ; Eosinophils ; Head ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Skin ; Triamcinolone Acetonide ; Ulcer

BACKGROUND: Erythema induratum was first described by Bazin in association with tuberculosis. However, the tuberculous cause of this entity has been questioned by several authors and gradually, the concept of nontiiberculous nodular vasculitis has been accepted OBJECTIVE: The purpose of this study is to document the clinicopathologic features of erythema induratum. METHODS: We investigated clinical and histopathological findings of 31 patient with erythema induratum who showed positive tuberculin hypersensitivity reaction or had active associated tuberculosis. RESULTS: The ages of the 31 patients(M7: F24) ranged from 13 to 66 years(mean 37.1 years). All patients displayed recurrent crops of tender, painful, violaceous noudules or plaques. Most lesions were present on the legs, but they also occurred on the thighs, feet, buttocks, and forearms. The skin lesions evolved for several weeks and healed with scarring and residual pigmentation. Histological examination revealed lobular or septolobular panniculitis with varying cornbinations of granulomatous inflammaticn, primary vasculitis and necrosis in most biopsies. Twenty two patients were treated with isoniazid alone and the remaining 9 patients received combination anti tuberculous treatment. Relapses were encountered in 4 patients who received isoniazid alone or stopped the medicationrgainst medical advice. CONCLUSION: A diagncisis of erythema induratum should be rendered in the presence of relevant clinicopathologic features, strong positive Mantoux test reaction, and good therapeutic response to antituberculous treatme,it. A full course of combination antituberculous therapy is indicated to achieve a cure of the skin lesions of erythema induratum.
Biopsy ; Buttocks ; Cicatrix ; Erythema Induratum* ; Erythema* ; Foot ; Forearm ; Humans ; Hypersensitivity ; Isoniazid ; Leg ; Necrosis ; Panniculitis ; Pigmentation ; Recurrence ; Skin ; Thigh ; Tuberculin ; Tuberculosis ; Vasculitis

No abstract available.
Follow-Up Studies* ; Prostheses and Implants*

Fingertip injuries represent the most common type of injuries were seen in the upper extrimity. Reconstruction of a injured digit needs good aesthetic result as well as functional recovery. From August 1994 to August 1996, sixty two digits in the fifty four patients were treated by using the reverse digital island flaps. The age of the patients ranged from 13 to 64 years. We reviewed the medical records of our cases and analyzed them in several aspects. Majority of the cases (79%) were covered primarily. Neurorrhaphy was performed in 26 digits (42%). The survival of these flaps was successful in all cases except one case. The mean values of the static two point discrimination in sensate and nonsensate flaps were 6.5 mm and 10.3 mm retrospectively. In this study, venous congestion was the most common early complication (9.6%). Arterial insufficiency and flap loss (6.4%) were the troublesome early complications. Bulky mushroom shaped flap (24.6%), scar contracture (6.4%), paronychia (8.2%), cold intolerance (9.6%), hyperesthesia (3.2%) and flap atrophy (4.8%) were the late complications. In conclusion, despites of its complications, reverse digital island flap provide durable skin cover, superior aesthetic result and excellent sensory restoration.
Agaricales ; Atrophy ; Cicatrix ; Contracture ; Discrimination (Psychology) ; Humans ; Hyperemia ; Hyperesthesia ; Medical Records ; Paronychia ; Retrospective Studies ; Skin ; Surgical Flaps

This study was designed to investigate the role of onion as a natural antioxidant. Onion was distinguished as yellow onion peel and onion flesh. Onion samples were extracted with 5 different kinds of solvents such as water, 70% ethanol, 99.9%ethanol, 99.9% methanol, and 96% butanol in order to select optimal extraction solvents, In this part of study linoleic acid was used s an model system for the purpose of determining the antioxidant activities. The optimal extraction rate of various solvents containing onion samples was determined by measuring extraction yield, electron donating ability(EDA), thiobarbituric acid(TBA), and thiocyanate, which are common methods for measuring activity. As a result 70% ethanol was shown as the most effective solvent.
Antioxidants* ; Ethanol ; Linoleic Acid ; Methanol ; Onions* ; Solvents ; Water