No abstract available.
Hepatitis B* ; Hepatitis*

The purpose of this study is to introduce a new method for fingertip coverage for cases of soft tissue only defects and finger tip amputations including bone. 86 lingers in 67 patients haute undergone coverage with a large rotation flap based on digital artery and nerve and Z-plashy after fingertip amputation or finger pulp avulsion from October 1991 to December 1995. There were 53 thumbs, 12 index fingers, 5 long fingers, 3 ring fingers and 13 little fingers. All injured fingers had exposure of the distal phalanx bone. A large volar flap based on either the radial or ulnar aspect including both digital neurovascular bundles was elevated just abode the pulleys and flexor tendon sheath after longitudinal incision along the lateral border of the digit. Then a large Z-plasty was performed at the MP joint crease to release the tension. The volar flap was easily rotated to cover the fingertip and was sutured with slight flexion of the interphalangeal joints. All fingertip defects healed completely. These flaps successfully covered the fingertip, and up 2/3 of the distal phalanx on the volar or lateral aspect. Sensation returned to normal and fingers could be fully extended within 3 months of surgery. All patients only required a single operation for complete fingertip coverage and did not require bony shortening. We conclude that this large rotation, axial pattern, neurovascular flap and Z-plasty provided a durable, completely sensate, well vascularized coverage fort the fingertip with minimal discomfort for the patient.
Amputation ; Arteries ; Fingers ; Humans ; Joints ; Sensation ; Tendons ; Thumb

We describe five patiens with autoimmune bullous der matosis who presented cutaneous lesions localized on the face. In these patients iuumunopathologically confirmed diagnoses were penphigus erythematosus, bullous pemphigoid, cicatricial pernphigoid(Brunsting-Perry variant), epidemic lysis bullosa acquisita and bullous systemic lupus erythematosus in each. Except, for the case of pemphigus erythematosus, facelimited cutnious lesions can be seen rarely with these imrnunobullous diseases. We suggest that some external, in malfactors such as UV light and photosensitivity might be regarded as the precipitating factors fo the clinical rnanifestations of those skin lesions, and which should be included in the differential diingosis of vesiculobullous diseases involving the face.
Diagnosis ; Humans ; Lupus Erythematosus, Systemic ; Pemphigoid, Bullous ; Pemphigus ; Precipitating Factors ; Skin ; Ultraviolet Rays

No abstract available.
Bilirubin* ; Fetal Blood* ; Hyperbilirubinemia, Neonatal*

No abstract available.

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.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Nervous System Diseases*

BACKGROUND: In autoimmune bullous dermatoses, such as pemphigus and bullous pemphigoid, variations in the expression of the antigen in different body locations are recognized. OBJECTIVE: The degree of expession of epidermolysis bullosa acquisita (EBA) antigen in different sites on the body surface was estimated from the highest dilution factor of EBA sera that gave a positive reaction at a site by indirect immunofluorescence (IF). METHODS: Two sera, obtained from EBA patients with inflammatory and mechanobullous skin lesions, having antihody titers of 160 against the dermal component of the NaCl split skin, were used by indirect IF techniques with 20 specimens (2 from each of 10 locations) of normal human skin from different sites. These 20 skin samples were obtained from 10 healthy adults (1-3 from each individual). RESULTS: The greatest expression of the antigen was in the skin taken from the upper back with the titer of 160. EBA antigen was least recognized in skin specimens from the inner thigh and calf. Skin from the scalp, abdomen, and anterior chest and others demonstrated intermediate degrees of expression. CONCLUSION: There was some moderate degree of variation in the expression of EBA antigens in skin samples obtained from different locations on the body. It seems however that there is not any positive correlation between the degree of expression of EBA antigen in each location and predilection sites (possibly the trunk) of clinical lesions in EBA.
Abdomen ; Adult ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescent Antibody Technique, Indirect ; Humans ; Pemphigoid, Bullous ; Pemphigus ; Scalp ; Skin ; Skin Diseases, Vesiculobullous ; Thigh ; Thorax

A prenatal chromosomal microarray (CMA) is generally recommended when a major anomaly is suspected on prenatal ultrasonography. As it can overcome the limitations of conventional karyotyping, it is expected that the number of prenatal CMA test requests will gradually increase. However, given the specificity of prenatal diagnosis, there are practical considerations compared to postnatal testing, such as the validation of prenatal specimens, maternal cell contamination, precautions when reporting variants of uncertain significance, and the need for comprehensive genetic counseling considering secondary findings. The purpose of this article is to provide necessary information to health care providers in consideration of these issues and to provide appropriate genetic counseling to patients.