this study was first initiated to compare the effectiveness of the KOH mount versus actual culturing from 1928 skin scrapings obtained frorn December, 1975 to August, 1976 in Daegu area. Second, changes in both clicical patterns and fungal flora isilated among the causative organisms were observed and following results were obtained . The KOH mount reparte;d a higher number of positive cases, when compared with the culture method. Covered areas of the body reported higher KOH positive rates than exposed areas, while cultures from the finger and toe-nails r."ported unusually low positive rates. In 51. 3% of the cases, both culture and KOH rnount were pasitive. The positive coincidence rate was found to be highest with the lesions frorn the scalp, buttock and groin, and lowest with lesions from the hands and feet. The positive KOH scrapings when cultured, showed a 10. 3% negative rate while the negative KOH scrapings reported a 7. 3%. positive culture rate. The rate of culture contamination was highest in KOH negative cases and also highest among finger and toe-nail lesions. Weather was also thought to be a factor: the higher the temperature, the lower the frequency of contamination. The 1138 strains isolated in 1976 were compared to a similar study done between 1957---1959, the following result., were observed: Trubrum has markedly increased while T. ferrugineum has significantly decreased with M. gypseum reported for the first time in Korea. Although most of these species were fairly equally distributed thrcughout the urban and rural areas, M. canis and M. gypseum were lirnited to the urban areas. Compared to 1959 changes in the causative organisms rate of the following dermatophytosis were observed In T. pedis, T. corporis, T. manus and T. Unguiurn, T. rubrum was reported as the predorninant causative agent and t.he second most prominent causative agent was T. mentaprophytes. In. T. cruris, T, rubum. was also repoted as the predoniinant causative agent with E. floccosurn the second whiile in T. capitis, T. ferrugineum remained the predominant causative agent, The frequeny of dernatophytosis was reported as follows: Tinea nf the nands and feet reported the highest incidence, T. pedis alone accounted for 38. 8% of all dermatophytosis while T, cruris was second 21.0% Compared to the previously study T. capitis decreased significantly. The majority of cases were found to be in the ag group(20~39 years) 68.4%. T. capitis and T. cruris were reported predominatly in males while similar results were reported with T. pedis. T. rnanus and T. unguium in females. The monthly distribution of T. capitis, T. corporis and T, cruris remained fairly consiant while T. pedis and I manus greatly increased during the liottcr months KIay to August. Coexistence of dermatophytosis preferred females to males and T.cruris infected from T. pedis was also common in males. On second experiment we extended the length of application to 15 days and the number of sujects to 15 persons. There developed erytherna in 1 case after 13 days of application and the others never showed erythema after 15 days of application, whereas with 2% soap solution erythema developed in 2 cases in 24 hours, 9 cases by 48 hours and 13 cases by 72 hours of application. The other 2 cases never showed erythema after 15 days of application. With above result there is no need to calculata IT as Kligman already mentioned. It is apparent that topically applied Ginseng saponin is essentially non-irritant material to the skin.
Buttocks ; Daegu ; Erythema ; Female ; Fingers ; Foot ; Groin ; Hand ; Humans ; Incidence ; Korea ; Male ; Panax ; Saponins ; Scalp ; Skin ; Soaps ; Tinea* ; Weather

The purpose of this paper is to describe a new apparatus which utilizes the principle of Van Tieghems hanging drop culture method. After using various methods of culturing fungi authors have found van Tieghems method to yield the most satifsymg result. Until now, this method has been slightly more tedious due to durability, storage, and quantity of culture necessary for each species. The new apparatus consists of 20mm plexiglass tubing cut in 16mm lengths and attache to a 16cm x12cm x2mm plexiglass plate with paraffin or manicure. These tubes a.re ranged in rows approximately 6cm apart with at least 8mm between tubes. Plates of varying sizes can be made to accornodate specific experimente. The authors developed thse inexpensive unbreakable plexiglass plates to allow for aimultaneous growth of various fungi and therefore more accurate comparison. Since these plates can be stored and handled easily, most af the disadvantages of using van Tieghems hanging drop culture rnethod have been eliminated.
Fungi ; Paraffin ; Polymethyl Methacrylate*

No abstract available.
Vascular System Injuries*

This article introduces a new method of thumb reconstruction with the use of an iliac bone graft and a free neurovascular wrap-around flap from the big toe, previously reported by Morrison et al. in 1980. Using this method it is possible to reconstruct a thumb similar to the missing part without total sacrifice of the toe. There is no mobile portion in the reconstructed thumb and motion is provided only by intact joint of traumatized thumb. In thumb reconstruction, it is possible to preserve the nail and its pulp, thus preventing swivelling of the nail and loss of pulp sensation as well as ensuring continued nail growth. This is achieved by free tissue transfer from the 1st web space of the foot, innervated by the deep peroneal nerve and supplied by the dorsalis pedis artery with relatively large diameter. Three cases of thumb reconstruction were performed with this method. Follow up was done for an average of 11.3 months; the rate of viability was 100% with excellent appearance; the 2-point discrimination averaged 8.3 mm.
Arteries ; Discrimination (Psychology) ; Follow-Up Studies ; Foot ; Hallux ; Joints ; Methods ; Peroneal Nerve ; Sensation ; Thumb ; Toes ; Transplants

The simple cutaneous flap and myocutaneous flap are presently being employed in skin defects since Daniel and Taylor first tried the free flap in 1973. But the simple cutaneous flap which is being employed at present has problem in the flap size, the variation and complexity of the anatomical structure and postoperative complication of the donor site. On the other hand, the myocutaneous flap has partially solved the problem of a simple cutaneous flap, but the myocutaneous flap remains inadequate when thin flap reconstruction only is required. The scapular flap was first suggested by Saijo in 1978 and Santos described the anatomical aspects of the scapular flap in 1980. Since Gilbert first clinically utilized the scapular flap, it was seen to be much more suitable for relatively thin cutaneous flaps, The authors present 10 cases of free scapular flap performed at the Department of Orthopedic Surgery of Severance Hospital during the period of one year and 2 months from April, 1983 until June, 1984. The results of the study are as follows: 1. The scapular flap was of medium size in 9 cases and large in one case. 2. The pedicles of the scapular flaps were constant in length and diameter. 3. The flap was uniform and relatively thin in thickness. 4. The reconstruction of a large soft tissue defect was possible with a combination of scapular flap and latissimus dorsi myocutaneous flap done in one stage. 5. The donor site of a scapular flap can be primarily closed. 6. The free scapular flap is an excellent choice when intermediate-sized or large-sized uninnervated flap coverage is necessary for soft tissue damage.
Clothing ; Free Tissue Flaps ; Hand ; Humans ; Myocutaneous Flap ; Orthopedics ; Postoperative Complications ; Skin ; Superficial Back Muscles ; Tissue Donors

Degloving injuries of the fingers result in avulsion of skin and subcutaneous tissue from the underlying deep fascia, the arterial supply is embarrassed and necrosis may result. Theoretically primary microvascular replantation may be a complete solution, however, the prognosis in terms of both immediate and long term function following avulsed digits is poor. The ideal reconstruction aims at retension of mobility and restoration of a skin cover that is adherent, has a sensibility approaching the norm, and is free from pain. A method of finger reconstruction for an avulsion injury using a free neurovascular wrap-around flap from the big toe may be a choice of treatment for both esthetic and functional aspects.
Fascia ; Fingers ; Hallux ; Methods ; Necrosis ; Prognosis ; Replantation ; Skin ; Subcutaneous Tissue

The treatment of extensive soft tissue injury is a chsllenge to Orthopedidic Surgeon especially in young children and at present reconstructive surgery with free flap is being employed under microscopy actively. The author present 27 cases of free flaps in young children below 6 years old, which were performed from March 1983 to December 1986. The results are as followes ; 1. The mean age was 4.9 years old. 2. The mechanism of injuries were all pedestrian injury. 3. We performed 27 cases of free flaps, among them 24 cases of flap were survived(88.9 %) with good functional and cosmetic result. 4. The vessels were larger in these young children than we expected. It is apparent that in a healthy child even though below 6 years old, the careful application of microsurgical principle is an excellent method for salvaging devascularized parts that are vital for function or appearance.
Child ; Clinical Study ; Free Tissue Flaps ; Humans ; Methods ; Microscopy ; Soft Tissue Injuries

The Marjolin's ulcer is the malignant lesion developed in a burn scar or chronic fistula. Due to the low prevlalence of this lesion, there has been disagreement in its clinical features, methods of treatment, and prognosis. We evaluated 19 cases of patients who had been admitted to Severence Hospital from Jan. 1970 to Dec. 1958. The results were as follows : 1. The previous lesion was burn scar in 52% of the cases and fistula of chronic osteomyel-itis in 32%. 2. The mean latent period was 31.5 years. 3. The initial symptoms were increased pain(74%), discharge with foul odor(68%) and bleeding(58%). 4. Upon histological examination, all of the cases were squamous cell carcinoma. 5. The rate of recurrence of metastasis at time of diagnosis was 32%. 6. Of the 16 patients treated by surgery, local recurrence was noted in 4 cases. Three of these cases were patients who had been treated by excision and split thickness skin graft. 7. The time interval for local recurrence ranged from 6 months to 11 months(average 8. 8 months). In conclusion, the squauious cell carcinoma of the Marjolin's ulcer seems to have a worse prognosis than other squamous cell carcinoma and it requres aggressive treatment. The burn scar or chronic fistula that occured in elderly patients especially required more adequste treatment and close observation.
Aged ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Clinical Study ; Diagnosis ; Fistula ; Humans ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Skin ; Transplants ; Ulcer

In 1973, Daniel and Taylor reported the first successful microsurgical transplantation of the groin flap as a one-stage reconstrutive procedure. The free vascularized groin flap has several advantages, such as its potenitally large size, comfortable position of the patient during operation, minimal donor site morbidity, possible coverage of the donor site scar with a bikini, its multiple arterial and venous system, and the potential for incorporating bone with the overlying skin. The authors perfomed free groin flaps in 36 patients at Severance Hospital, Yonsei University College of Medicine from January 1985 to August 1988. The results were as follows : 1. Good results were obtained in 26 of 36 cases with a 72.2% success rate. The results were better in the upper extremity than the lower extremity. 2. The anatomical classification of the superficial circumflex iliac artery was as follows : a common origin of the superficial circumflex iliac artery and the superficial inferior epigastric artery in 39.5% of cases, an absent superficial inferior epigastric artery with a large compensatory superficial circumflex iliac artery in 36.8%, separate origins of the two vessels in 7.9%, and an origin from a profunda femoral artery in 15.8%. This result was similar to that of Daniel and Taylor. 3. The average diameter of the artery was 1.0mm and the average length of the vascular pedicle was 9.0mm. 4. The results were better in the end to side anastomosis than the end to end anastomosis, but there was no statistical significance. 5. In the 10 failed cases, free scapular flaps were performed in 4 cases, skin grafts in 5 cases, and the cross leg flap in one case. 6. The donor sites healed well by primary closure without functional disturbance except in one cases in which secondary closure was done. In conclusion, the free vascularized groin flap can be used without restriction as a onestage reconstruction of an extensive soft tissue injury of the extremity.
Arteries ; Cicatrix ; Classification ; Epigastric Arteries ; Extremities ; Femoral Artery ; Groin ; Humans ; Iliac Artery ; Leg ; Lower Extremity ; Skin ; Soft Tissue Injuries ; Tissue Donors ; Transplants ; Upper Extremity

No abstract available.
Adult* ; Child* ; Humans ; Tuberculosis, Spinal*