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*

The allopurinol hypersensicivity syndrome is a rare, but life thereaning immunologic reaction of allopurinol therapy, characterized by multiple abnormalities such as fever, rash, decreased renal function, hepatocellular injury, leukocytosis, and eosinophila. It may require prolonged hospitalization and occasionally involves residual morbidity. Three patients developed erythematous skin eruption three to five weeks after beginning therapy with allopurinol. The clinical, laboratory, and histologic findings of these patients were compatible with a allopurinol hyperensitivity syndrome.
Abnormalities, Multiple ; Allopurinol* ; Exanthema ; Fever ; Hospitalization ; Humans ; Hypersensitivity* ; Leukocytosis ; Skin

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

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

Fourty cases of postpartum heart failure occuring in Korean women in the Dept. of Int. Med., Pusan University Hospital are reported, with and analysis of clinical data including frequency, age, time of onset, clinical features, hemoglobin, liver function, electrocardiographic and chest X-ray findings. The following results were obtained. 1. The cases were mostly found in 20-29 years age group, 50% of the total cases. 2. Eighteen cases of fourty patients experienced the symptoms during the 2nd week after delivery and 12 cases complained the symptoms during 4th week. 3. Only six cases noted onset of heart disease following the 4th pregnancy, whereas sixteen patients experienced this phenomenon after the first gestation, eight patients after the 2nd gestation and ten patients after the 3rd pregnancy. 4. At the admission the patients were suffering from paroxysmal nocturnal dyspnea, orthopnea, exertional dyspnea and generalized edema. Physical findings revealed cardiomegaly, gallop rhythm, edema, pulmonary fine rales and systolic murmur in frequency. 5. Electrocardiograms were available at the time of presentation in thirty patients. Twenty four patients had left ventricular hypertrophy, 18 patients sinus tachycardia, 3 patients lower voltage. 6. The chest X-ray film showed the cardiomegaly in 15 cases, 83.3% of the obtained 18 cases, 12 cases pulmonary edema, 3 cases pericardial effusion. 7. The venous pressure was measured in 15 patients. In 5 cases the venous pressure was normal and in 10 increased above 150mmH2O. 8. With prompt treatment by rest, salt restriction, diuretics and digoxin the clinical symptoms improved in 31 cases but 9 patients died at the admission.
Busan ; Cardiomegaly ; Digoxin ; Diuretics ; Dyspnea ; Edema ; Electrocardiography ; Female ; Heart Diseases ; Heart Failure* ; Heart* ; Humans ; Hypertrophy, Left Ventricular ; Liver ; Pericardial Effusion ; Postpartum Period* ; Pregnancy ; Pulmonary Edema ; Respiratory Sounds ; Systolic Murmurs ; Tachycardia, Sinus ; Thorax ; Venous Pressure ; X-Ray Film