Breast cancer is the second leading cause of cancer death in women. Unfortunately, the frequency of breast cancer and mastectomy are increasing in Korea. The purpose of the study is to analyze the results of breast reconstruction using free transverse rectus abdominis myocutaneous(TRAM) flap and to suggest the operative technique for more satisfactory results. 19 patients underwent immediate breast reconstruction from 1990 to 1998, and we experienced 2 cases of bilateral immediate reconstruction of breasts following mastectomy. We have performed the free TRAM flaps based on the deep inferior epigastric vessels using microvascular technique. TRAM flap included very small portion of rectus sheath and muscle-so called muscle sparing technique. So it reduced markedly donor site morbidity. The postoperative course of these cases was uneventful with minor complication. The free TRAM flap was an excellent method of immediate breast reconstruction using autogenous tissue and provided satisfactory outcome. The goals of the immediate breast reconstruction after mastectomy are to restore body image, to achieve near normal shape of breast, and to reduce the complications. This paper represents our experience of immediate breast reconstruction using free TRAM flap, and technical options to get more satisfactory result and reduce the complications. We think this method could be regarded as the first choice for immediate breast reconstruction.
Body Image ; Breast Neoplasms ; Breast* ; Female ; Humans ; Korea ; Mammaplasty* ; Mastectomy ; Rectus Abdominis* ; Tissue Donors

No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

A neglected Monteggia fracture can pose a significant clinical problem because of decreased range of motion of the elbow, increased cubitus valgus, progressive damage and elbow instability. Factors leading to misdiagnosis include swelling of soft tissue, overlying of bones on radiographs and lack of inclusion of the elbow on the radiograph at the ulnsr fracture. Therefore, a radiograph that includes the elbow at the ulnar fracture should be taken. A line drawn through the shaft and head of the radius into the elbow should align with the capitulum in any projection, thereby assisting in the correct diagnosis. Three cases of neglected Monteggia fracture were treated by open reduction of the radial head with repair or reconstruction of the annular ligament and osteotomy of the ulna, and satisfactory results were obtained.
Child ; Diagnosis ; Diagnostic Errors ; Elbow ; Head ; Humans ; Ligaments ; Monteggia's Fracture ; Osteotomy ; Radius ; Range of Motion, Articular ; Ulna

In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
Anxiety* ; Appetite ; Asian Continental Ancestry Group ; China* ; Depression* ; Divorce ; Dyspepsia ; Education ; Ethnopsychology ; Family Relations ; Female ; Flushing ; Hospitalization ; Humans ; Libido ; Literacy ; Marital Status ; Mouth ; Paresthesia ; United Nations ; Weight Loss

No abstract available.
Takayasu Arteritis*

No abstract available.
Hydranencephaly*

Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary

No abstract available.
Esophageal Neoplasms*

Suprapubic cystostomy by trocar is a simple, safe and useful method for urinary diversion in acute urinary retention. But rarely, severe complications occur during or after suprapubic cystostomy such as bowel perforation, through and through perforation of the bladder, rectal injury and severe hematuria. We studied the complications of suprapubic cystostomy retrospectively and compared 19 patients who performed ultrasonographic examination with 30 patients without ultrasonographic examination. The complications in 30 patients without preliminary ultrasonographic examination were initial failure in 4 cases (13.3%), extravesical Foley indwelling in 2 cases (6.7%), puncture site closed to the pubic bone in 2 cases (6.7%), spontaneous bladder rupture in 1 case (3.3%) and bowel injury in 1 case (3.3%). But, the complication in 19 patients with preliminary ultrasonographic examination was only 1 retried case (5.3%) because of extravesical Foley indwelling. As above results, the brief preliminary ultrasonographic examination of the bladder is a very useful method with minimal risk during suprapubic cystostomy by trocar.
Cystostomy* ; Hematuria ; Humans ; Pubic Bone ; Punctures ; Retrospective Studies ; Rupture ; Surgical Instruments* ; Ultrasonography ; Urinary Bladder ; Urinary Diversion ; Urinary Retention

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*