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

Primary carcinoid tumor of the kidney is extremely rare ; only 29 previous reports have been described in the world literature, 3 cases of which were known to arise in horseshoe kidneys. Because of the scarcity of primary renal carcinoid tumor, its clinicopathologic features and prognosis are not well characterized, and its histogenesis is unknown. We present a case of primary carcinoid tumor arising in the horseshoe kidney of a 43-year-old man. The lesion is morphologically identical to those of gastrointestinal or respiratory tracts. In addition, this tumor contains clusters of intestinal epithelium with goblet cells and mature bony trabeculae. The cytoplasm of the tumor cells are immunoreactive for keratin, NSE, and synaptophysin, but are negative with Grimelius and Fontana-Masson stains. Membrane-bound cytoplasmic neurosecretory granules are observed by electron microscopic examination. This is the first case of primary renal carcinoid tumor arising in a horseshoe kidney documented in Korea. We describe the gross features, light and electron microscopic, and immunohistochemical findings of renal carcinoid and review the literature, with speculations on the possible histogenesis of this unusual neoplasm.

No abstract available.
Folliculitis* ; Hair*

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

Hemangioma are not rare tumor, they are found in almost all the vascular structures of the body. They are fairly common in the akeletal muscles. There Is no unanimity of opinion concerning the etlology and pathogenesis of hemangioma. It Is most llkely, however, that hemangioma are congenital in origin. The authors have experienced unusual huge skeletal hemangioma occurred in forearm and hand in infant. These huge hemangioma in infant ls very difficult to excise completely with the conventional methods. But we have obtained the excellent result by using recently advanced meticulous microsurgical technique.
Forearm ; Hand ; Hemangioma ; Humans ; Infant ; Muscles

The authors have studied 60 cases of back pain with respect to diagnostic accuracy of myelography with metrizamide from January, 1983 to Decembar, 1984 at the Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University. The results were as followes; 1. Of the 60 cases, 57 cases (95%) showed excellent and good findings of myelography. 2. In case of the marginal clearance of the nerve-sleeve in myelography, the excellent finding was 93.3%.3. The side effect of myelography was slight and 44% of all patients complained of headache, which disappeared within 24 hours after onset in 92% of them. 4. The accuracy rate of myelography with metrizamide was 89. 2%.
Back Pain ; Clinical Study ; Headache ; Humans ; Metrizamide ; Myelography ; Spinal Canal

The injury of the epiphysis or epiphyseal plate produces undesirable effects on the normal growth of the bone, such as bone bridge, growth arrest and angular deformity. Authors performed vascularized fibular epiphysis and epiphyseal plate transplantation in 7 years old girl, who received the excision of the exostosis on distal ulna, followed by progressive varus deformity of right forearm and growth arrest of distal ulna. With follow
Congenital Abnormalities ; Epiphyses ; Exostoses ; Female ; Forearm ; Growth Plate ; Humans ; Methods ; Transplantation ; Ulna

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: Smoking increases the risk of respiratory, cardiac diseases and cancer. This study is to ascertain the relationship between passive smoking, the modes of residence, its location and the immunoglobulin values as well as the eosinophil counts in relation to child patients suffering from bronchial or cardiac asthma. METHODS: The research was conducted at a general hospital with cooperation of 242 patients who had been hospitalized 1991 through 1995. We compared the average values of immunoglobulin between the groups of exposed and non-exposed to smoking by T-test. A same work for residential modes was done by T-tests, while the data regarding the residing locality were processed by ANOVA. RESULTS: Each values of TEC, IgE, IgA, and IgM in both groups has been analysed but spelling no significant differences. The group residing in apartments showed lower value of IgM than those of flats. CONCLUSIONS: The reason the IgM value of apartments is lower than that of flats is due to the difference of living quarters. This signifies the modes of residence may as well affect the IgE value.
Asthma ; Child* ; Eosinophils ; Heart Diseases ; Hospitals, General ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin M ; Immunoglobulins* ; Smoke ; Smoking ; Tobacco Smoke Pollution*