One of the most difficult problems confronting the orthopedic surgeon today is what to do when faced with a large defect in a peripheral nerve. Recent advances in engineering and neurophysiology have improved our technical ability to understand the consequences of severing a nerve. We have treated a large traumatic ulnar nerve defect with microsurgical nerve graft technique. In a follow-up study of twehre monthes post surgery, the results were satisfactory.
Follow-Up Studies ; Neurophysiology ; Orthopedics ; Peripheral Nerves ; Transplants ; Ulnar Nerve

BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

Various immunologic investigations of 159 patients with Behqets syndrome undertaken included; the DNCB sensitization test, total T-cells and T-cell subsets and the lymphocyte transformation test using PHA. The percentage of positive esponsiveness to DNCB decreased in the order of possible (65%), suspected (60%), incomplete (37%) and complete type (37%), The number of patients with impaired LTT was larger in the group of patients with DNCB( + ) responsiveness (seventeen of 32) than in DNCB(+) group (six of 25), There was significant impairment of cell mediated immunity in Behcets syndrome compared to normal subjects, when analyzed by the impaired LTT and decreased proportions of helper T-cells.
Behcet Syndrome* ; Dinitrochlorobenzene* ; Humans ; Immunity, Cellular* ; Lymphocyte Activation ; T-Lymphocyte Subsets ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

Staphylococcus aureus is one of many causative agents of the fu uncles. As the S. aureus strains resistant to penicillinase-repsistant penicillins (methicillin-resistant S. aureus, MRSA) are more frequently isolated, their accuiate identification became a very important step in selection of an appropriate therapeutic regimen. We report herein a case of multiple furunculosis caused by metkicillin-resistant S. aureus in a 11-year-old male patient, who was successfully treated with sulbactam/ampicillin and amikacin.
Amikacin ; Child ; Furunculosis* ; Humans ; Male ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Staphylococcus aureus

Infantile cortical hyperostosis is a disease of infants which is characterized by formation of cortical subperiosteal new bone of the the body. Pain and soft tissue swelling over the affected parts, associated with fever and irritability, are found frequently with the disease. Usually self-limiting, it is not as a rule followed by any residual skeletal deformity. A case of Infantile cortical hyperostosis in three months-old baby was diagnosed and followed up to ten months.
Congenital Abnormalities ; Fever ; Humans ; Hyperostosis, Cortical, Congenital ; Infant

No abstract available.
Arthritis*

Under certain pathophysiological conditions, such as inflammation and ischemia, the concentration of H+ ion in the tissue surrounding neurons is changed. Variations in H+ concentration are known to alter the conduction and/of the gating properties of several types of ion channels. Several types of K+ channels are modulated by pH. In this study, the whole cell configuration of the patch clamp technique has been applied to the recording of the responses of change of external pH on the delayed rectifier K+ current of cultured DRG neurons of rat. Outward K+ currents were examined in DRG cells, and the Charybdotoxin and Mn2+ could eliminate Ca2+-dependent K+ currents from outward K+ currents. This outward K+ current was activated around -60 mV by step depolarizing pulses from holding potential -70 mV. Outward K+ currents were decreased by low external pH. Activation and steady-state inactivation curve were shifted to the right by acidification, while there was small change by alkalization. These results suggest that H+ could be alter the sensory modality by changing and modifying voltage-dependent K+ currents, which participated in repolarization.
Animals ; Charybdotoxin ; Diagnosis-Related Groups ; Ganglia, Spinal* ; Hydrogen-Ion Concentration* ; Inflammation ; Ion Channels ; Ischemia ; Neurons ; Rats* ; Spinal Nerve Roots*

PURPOSE: Radical cystectomy with pelvic lymphadenectomy is an effective therapeutic modality in invasive bladder cancer. The development of another technique for a radical cystectomy for the early recovery and reduction of complications was attempted. MATERIALS AND METHODS: Between March 1997 and June 2003, an extraperitoneal radical cystectomy was attempted in 18 patients with invasive bladder cancer (pT1-pT4). Not only standard or extended pelvic lymphadenectomy, but also re-positioning of the ureter to the opposite side, could be performed extraperitoneally. An intestinal segment could be taken out through a small window within the peritoneum and manipulated as desired. The clinical safety and complications of other surgical approaches for radical cystectomy were also investigated. RESULTS: The procedure was successful in 15 of the 18 patients (4 studer pouches, 3 ileal conduits and 8 ureterocutaneostomies). Failure to peel out the peritoneum occurred in 3 cases, 1 each due to technical difficulties, tumor invasion at the bladder dome and adhesion due to a previous radical prostatectomy. Complications occurred in 8 cases (53.1%). The intestinal obstruction progressed in 1 case (12.5%) due to a high positioned mesentery of the Studer pouch. There were no significant gastrointestinal complications in any of the 8 patients that underwent the extraperitoneal radical cystectomy with ureterocutaneostomy. CONCLUSIONS: An extraperitoneal radical cystectomy seems to reduce the gastrointestinal complications and be worthwhile in certain cases with advanced bladder cancer. Despite the visual limitation, it is an acceptable surgical technique compared to the conventional transperitoneal methods.
Cystectomy* ; Humans ; Intestinal Obstruction ; Lymph Node Excision ; Mesentery ; Peritoneum ; Prostatectomy ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion

Rabies is a uniformly fatal encephalitis and cannot be treated, therefore efforts must be focused on preventing the disease. The incidence of rabies in humans and animals has decreased with the introduction of rabies vaccination for animals since the early 1950s in Korea. There was no rabies occurrence either in human or animal for 8 years from 1985 to 1992. However, a case of animal rabies recurred in 1993. Since then, rabies endemic areas were expanded into 17 counties near the demilitarized zone, and 6 human cases were reported from the endemic areas of animal rabies. According to epidemic studies, wild raccoon dogs were suspected to be the transmission source of rabies in dogs, domestic animals, and other wild animals, which resulted in human rabies. Rabies prevention strategies were aimed at the animals capable of transmitting rabies or vaccination for the high risk group and postexposure prophylaxis for the bitten patients. Unfortunately, these activities were not conducted appropriately and substantially. All rabies victims were either not treated or did not receive timely and appropriate postexposure treatment. Prevention of rabies can only be achieved by securing political and financial support for an effective rabies program. Key activities for rabies prevention should include changing current public perception regarding rabies, strengthening surveillance for the exposed person to suspected rabid animals, and laboratory-based rabies surveillance.
Animals ; Animals, Domestic ; Animals, Wild ; Dogs ; Encephalitis ; Epidemiology* ; Financial Support ; Humans ; Immunoglobulins ; Incidence ; Korea* ; Rabies* ; Raccoon Dogs ; Vaccination

A 38-year old male patient underwent tracheal reconstruction because of a tracheal tumor. A CT scan showed that the mass was located 5 cm above the carina, the size was 2x1.5cm, and there was a 50% narrowing of the stenotic segment. After endotracheal intubation (1.D. 8mm), a pediatric suction catheter (lenght:40cm, diameter: 2mm) was inserted with a stylet at the side of the tube to pass the stenotic segment with fiberoptic bronchoscopic guidance. Conventional ventilation with an inhalation agent was performed and HFJV was started just prior to the tracheal incision. A driving gas pressure of 1 kg/cm, respiratory rate of 120/min., I:E ratio fo 1:1, and Fio2 of 1.0 were applied through the suction catheter. Ten minutes after HFJV, PaCO2showed 50mmHg. Hypercabia was relieved by increasing the driving gas pressure from 1kg/cm(2) to 1.5 kg/cm(2). HFJV was performed for one and a half hours. During the procedure, blood gas analyses were perfomed frequently and all results revealed an adequate ventilatory status. After completing the end to end anastomosis, conventional ventilation was started until surgery was ended. The patient's course proceeded uneventfully and he was discharged 13 days after surgery.
Adult ; Blood Gas Analysis ; Catheters ; High-Frequency Jet Ventilation* ; Humans ; Inhalation ; Intubation, Intratracheal ; Male ; Respiratory Rate ; Suction ; Tomography, X-Ray Computed ; Ventilation