The area overlying the ischium is the most frequent site for the development and recurrence of pressure sores in the paraplegic patient. This report describes a newly-designed inferior gluteus maximus myocutaneous island flap that is useful for the repair of ischial pressure sores in paraplegic patients. Sacral sore develops a wide and flat ulcer crater. However, ischial sore seems to develop large and deep bursa with relatively small openings. We have used a newly-designed gluteus maximus myocutaneous island flap according to the specific characteristics of ischial sore. The flap is designed in the fashion of a small skin island with a large muscle flap. This flap with its abundant and constant blood supply had proved very reliable in the surgical management of ischial pressure sore. There is also the possible advantage of cushioning with the bulk of muscle for greater long-term durability. Incision could be extended for a complete bursetomy and partial ischiectomy. The reliability, versatility and low morbidity of the inferior gluteus maximus island flap has been demonstrated by its use in our consecutive series of 7 patients with 8 ischial pressure sores. We conclude that this newly-designed inferior gluteus maximus myocutaneous island flap can be applied in deep, infected ischial sore according to the specific characteristics of ischial sore, and it is a very useful method in comparison to other flaps.
Humans ; Ischium ; Pressure Ulcer ; Recurrence ; Skin ; Ulcer

No abstract available.
Carcinoma, Renal Cell*

No abstract available.

No abstract available.
Humans ; Prednisolone* ; Prostate* ; Prostatic Neoplasms*

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.
Uterus*

There are many established roentgen signs of ascites such as hepatic angle sign, generalized graying of the abdomen, frog belly appearance and Hellmer's sign. These signs are easily recognized in the standard flat abdomen film. It is however hardly possible to recognize such signs in small films of double contrasted upper GI series. By a retrospectroscopical observation we were able to find some interesting signs of massive ascites in small size films of double contrasted stomach and duodenum of upper GI series. The clinical materials consisted of 27patients with massive ascites and 30 normal subjects. The signs we observed were ;(1) Constriction deformity of the junction of the fundus and body of the stomach. We named this "waist" sign. This constriction was attended by convergence of mucosal folds. We called this "converging folds" sign. (2) The fundus assumed electric bulbappearance with its long axis directed vertically. We called this "electric bulb" sign. In normal subjects the fundus assumed beret-cap like appearance. These signs were only appreciated in the supine and RAO views and not in other views. Of these new signs of massive ascites where fundic view was obtained in supine or RAO position.
Abdomen ; Ascites ; Congenital Abnormalities ; Constriction ; Duodenum ; Stomach

Hemifacial microsomia is a common congenital craniofacial deformity involving bone and soft-tissue. Mandibular hypoplasia is the most obvious skeletal manifestation of hemifacial microsomia. In the past, complete realignment of the skeleton was preferred to soft-tissue correction, which was clearly second choice. However, in this study, simultaneous correction of bone and soft tissue deformities were equally important in treatment of hemifacial microsomia. One-stage and simultaneous bone and soft tissue reconstruction is possible and staged operations of the skeleton and soft tissue are no longer necessary, except in special cases. Even in children and adolescents, good results and normal growth potential can be achieved with simultaneous correction of bone and soft tissue.
Adolescent ; Child ; Congenital Abnormalities* ; Goldenhar Syndrome ; Humans ; Skeleton

No abstract available.
Chiroptera* ; Hemorrhagic Fever with Renal Syndrome* ; Korea*

Various treatments for trigeminal neuralgia (TN) are known to yield initial satisfactory results; however, the surgical treatment has excellent long-term outcomes and a low recurrence rate. Surgical treatment addresses the challenge of vascular compression, which accounts for 85% of the causes of TN. As for surgical treatment for TN, microvascular decompression (MVD) has become the surgical treatment of choice after Peter J. Jannetta reported the results of MVD surgery in 1996. Since then, many studies have reported a success rate of over 90% for the initial surgical treatment. Most MVDs aim to separate (decompress) the culprit vessel from the trigeminal nerve. To increase the success rate of surgery, accurate indications for MVD and management of the offender vessels without complications are critical. In addition, if there is no vascular compression, partial sensory rhizotomy or internal neurolysis can be performed to improve surgical outcomes.