Since the introduction of surgical microscope in microvesael surgery by Jacobson and Suarez in 1960, many surgeons have succeeded replantation, transplantation of composite segment of tissues so called free fiap-free bone graft and toe to hand transfer. McCraw & Furlow reported successfully transfered dorsal foot flap using dorsalis pedis artery in 1975 and Cobett transfered great toe to band for reconstruction of the amputated thunb. The authors experienced six cases of microsurgery using dorsalis pedis artery durig the recent two years in the department of Orthopaedic surgery of Soon Chun Hyang College and results in this paper. 1. Four cases out of six were dorsalis pedis free flap, one case was second toe to thumb and tbe other one was reconstruction of an amputated thumb in one stage using iliac bone graft and dorsalis pedis flap. 2. One case out of four cases of dorsalis pedis free flap was performed for reconstruction of contracted first web and the other cases were performed for foot. 3. Five cases out of six were successfully transfeed, one case which was toe to thumb was failed. The cause. of fail was probably due to post-operative hematoma. 4. Composite tissue using dorsalis pedis artery is one of the good donor site for composite tissue transfer for not only skin defect and scar contracture of the hand and foot but also reconstruction of the amputated fingers because it has several advantages; an acceptable thickness, a constant arterial supply, venous drainage through the saphenous system, and constant innervation through the terminal branches of the superficial and deep peroneal nerve.
Arteries ; Cicatrix ; Contracture ; Drainage ; Fingers ; Foot ; Free Tissue Flaps ; Hand ; Hematoma ; Humans ; Microsurgery ; Peroneal Nerve ; Replantation ; Skin ; Surgeons ; Thumb ; Tissue Donors ; Toes ; Transplants

No abstract available.
Holoprosencephaly*

PURPOSE: This study was undertaken to obtain basic data about the megakaryocyte colony formation of fetal liver cells by using immunocytochemical staining and ex vivo culture with growth factors. METHODS: The mononuclear cells were isolated from fetal liver and bone marrow with idiopathic thrombocytopenic purpura(ITP) and pancytopenia. These mononuclear cells were cultured in MegaCultTM-C(Stem Cell Tech, Canada) media in the presence of growth factors and CFU-Megakaryocyte(CFU-Mk) colonies were counted on day 12. The expansion of CD34+ and CD41+ cell was analyzed by flow cytometry after 5 days incubation using flask culture. RESULTS: The numbers of CFU-Mk colonies of mononuclear cells obtained from fetal liver in the 11th week gestational age were more than those in the 19th week specimens; growth factors could not enhance the colony expansion in all cases. Total numbers of CFU-Mk colony of fetal liver cells were higher than bone marrow from ITP or pancytopenia groups. The numbers of pure or large CFU-Mk colonies of fetal liver cells were also higher than bone marrow specimens. The rate of CD34+ cell expression of fetal liver was increased after flask culture and the enhancement effect of epression was seen only in cases which added thrombopoietin. The rate of CD41+ cell expression of fetal liver was increased after incubation, but the enhancement effect of growth factors was unclear. CONCLUSION: This study revealed good results about the megakaryocyte colony assay of fetal liver mononuclear cells using MegaCultTM-C media. This study suggests that the fetal liver could be a good source of megakaryocytic progenitor cells for clinical application in hematopoietic stem cell transplantation.
Bone Marrow ; Flow Cytometry ; Gestational Age ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Intercellular Signaling Peptides and Proteins ; Liver* ; Megakaryocytes* ; Pancytopenia ; Stem Cells ; Thrombopoietin

The authors report a case of posterior fossa dural arteriovenous malformation with increased intracranial pressure. It was fed left occipital artery, posterior auricular artery, posterior meningeal branch of vertebral artery, and meningohypophyseal artery of left internal carotid artery. Treatment has been tried with transcatheter embolization using gelfoam and ivalon, intracranial clipping of feeders, ligation of external carotid artery, and radiation therapy. The unusual clinical manifestations such as visual disturbance and hearing impairment are discussed.
Arteries ; Arteriovenous Malformations* ; Carotid Artery, External ; Carotid Artery, Internal ; Gelatin Sponge, Absorbable ; Hearing Loss ; Intracranial Pressure ; Ligation ; Vertebral Artery

The authors ahve analyzed various chemical components of intracerebral hematoma in 20 cerebrovascular accident patients who were operated at the Department of Neurosurgery, Kosin Medical Center, from October, 1984 to April, 1986. The results showed that there are no differences between the levels of sodium and chloride in serum and hematoma, while potassium and phosphorus significantly higher in hematoma, and calcium lower in hematoma. The changes of various chemical components seem not to be correlated with the timing of operation. We are going to discuss the possible explanations of the changes.
Calcium ; Hematoma* ; Humans ; Neurosurgery ; Phosphorus ; Potassium ; Sodium ; Stroke

We report a rare case of tension pneumocephalus after eyebrow surgery for the treatment of a saccular aneurysm at posterior communicating artery. The patient's consciousness was suddenly aggravated due to the tension pneumocephalus on fifth postoperative day, which was treated by repairing the frontal sinus. The patient was recovered completely and uneventfully after this revision surgery.
Aneurysm* ; Arteries ; Consciousness ; Eyebrows* ; Frontal Sinus ; Humans ; Pneumocephalus*

This study was conducted to estimate the prevalence rate of cervical cancer and to investigate its risk factors. 5,417 asymptomatic married women were screened from March, 1984 to December, 1990 in Taegu city. Of 5,417 examinees, 3,817 (70.46%) were normal, 1,542 (28.7%) showed inflammatory change, 51 (0.94%) were dysplasia and 7 (0.13%) were carcinoma in situ or invasive carcinomas. The prevalence of abnormal finding (dysplasia, carcinoma in situ or invasive carcinoma) was 1,070 per 100,000 population. The prevalence of dysplasia was 940 per 100,000 and that of carcinoma in situ or invasive carcinoma was 130 per 100,000. Age-adjusted prevalence rate for abnormal finding adjusted with standard population of Taegu city was estimated to be 850 per 100,000. The prevalence of cervical cancer was significantly increased with age (P<0.05). The prevalence of cervical cancer was significantly decreased with age at marriage and educaitonal level (P<0.05). The history of induced abortion and the number of pregnancies were significantly associated with the prevalence of cervical cancer (P<0.05), whereas, the number of parity was not. Age at marriage was significantly associated with the prevalence of cervical cancer after stratification by age (P<0.05). However, the level of education, parity, induced abortion, number of pregnancies were not significant. Inflammation and human papiloma virus infection were associated with cervical cancer with odds ratio of 13.48(95% confidence interval 7.80~23.40) and 474.29 (95% confidence interval 196.80~1143.10), respectively. In conclusion, for early detection of cervical cancer it should be recommended to perform mass cytological screening. In particular, regular and periodic cytologic screening, starting at age 25, for cervical cancer should be recommended for those women who have frequent cervical inflammation and for those women married before age of 20.
Abortion, Induced ; Carcinoma in Situ ; Daegu ; Education ; Female ; Humans ; Inflammation ; Marriage ; Mass Screening* ; Odds Ratio ; Parity ; Pregnancy ; Prevalence ; Risk Factors ; Uterine Cervical Neoplasms*

Vancomycin-resistant enterococci(VRE) are rare cause of meningitis, occurring in immunocompromised patients, severely ill, hospitalized patient, and patients who have undergone neurosurgical procedures. Resistance to vancomycin has increased in frequency during the past few years. Limited therapeutic options are available for VRE infections and the optimum therapy has not been established. We report a case of VRE meningitis that was successfully treated with administration of quinupristindalfopristin (Synercid) by both intravenous and intraventricular routes. A brief review of the literature is provided, which indicates that optimal management with Synercid should include daily intraventricular doses of at least 2 mg and intravenous 0.5 mg/kg every 8 hours. We also review the previously reported cases of VRE meningitis.
Enterococcus* ; Humans ; Immunocompromised Host ; Meningitis* ; Neurosurgical Procedures ; Vancomycin

OBJECTIVE: This study is aimed to assess the clinical outcome in early and minimally invasive surgery using an eyebrow incision for the patients with poor grade aneurysm. METHODS: The authors retrospectively reviewed all 46 poor grade patients of Hunt and Hess(H-H) grade IV and V who suffered aneurysmal subarachnoid hemorrhage(SAH) between 1999 and 2004. All 35 patients harboring 43 aneurysms who underwent early surgery within 72 hours were included in this study. Clinical outcome was assessed by Glasgow outcome scale(GOS) and compared with that of conventional pterional approach. RESULTS: Twenty four patients were operated with conventional pterional approach and 11 with eyebrow approach within 72 hours after SAH. Seven multiple aneurysm patients harbor 15 aneurysms. Forty one aneurysms were treated with clippings. All 11 patients of eyebrow surgery group(ESG) were in H-H grade IV, 3 in Fisher grade III and 8 in Fisher grade IV. Among 24 patients of pterional approach group(PAG), 20 were in H-H grade IV and 4 in H-H grade V, 3 were in Fisher grade III and 21 in Fisher grade IV. Overall favorable outcome was achieved in 41.7% and 54.5% in PAG and ESG, respectively. Favorable outcome of H-H grade IV in PAG showed 45.0%. Overall mortality rate was 14.3%. CONCLUSION: It is concluded that the clinical outcome of early and minimally invasive aneurysmal surgery using eyebrow incision in the selected poor grade aneurysm patients can be compatible with that of conventional pterional surgery.
Aneurysm* ; Eyebrows* ; Humans ; Mortality ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

A 41-yr-old man was admitted with acute headache, neck stiffness, and febrile sensation. Cerebrospinal fluid examination showed pleocytosis, an increased protein level and, a decreased glucose concentration. No organisms were observed on a culture study. An imaging study revealed pituitary macroadenoma with hemorrhage. On the 7th day of the attack, confusion, dysarthria, and right-sided facial paralysis and hemiparesis were noted. Cerebral infarction on the left basal ganglia was confirmed. Neurologic deficits gradually improved after removal of the tumor by endoscopic transnasal transsphenoidal approach. It is likely that the pituitary apoplexy, aseptic chemical meningitis, and cerebral infarction are associated with each other. This rare case can serve as a prime example to clarify the chemical characteristics of pituitary apoplexy.
Adenoma/*complications ; Adult ; Cerebral Infarction/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis/*etiology ; Pituitary Apoplexy/*complications/etiology ; Pituitary Neoplasms/*complications ; Tomography, X-Ray Computed