The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

BACKGROUND: Although the wet earwax has been known to be related with the incidence of tinea versicolor, very little has been revealed on how they are correlated with each other. The incidence of Malassezia furfur, the etiological organism of tinea versicolor, and its population densities as yearst and mycelial form in the different types of earwax, the dry and the wet, have not been studied. METHODS: The type of earwax in 65 patients with tinea versicolor were classified into 2 types, dry and wet, by its appearence and the subjective complaints of the patients. The dry and wet cerumens were obtained from 142 and 49 individulas without tinea versicolor respectively. The cerumens were stained with 10% Parker ink-KOH solution. The incidence and its population densities of yeast and mycelial M. furfur in the wet cerumens were compared with those in the dry cerumens according to a new grading method using bacterial index(BI) of lepra bacilli. RESULTS: 1. Dry and wet earwax were observed in 58.5%(38 cases) and 41.5%(27 cases) of 65 patients respectively. 2. The incidence of yeast M. furfur in the dry and wet cerumens were 100% and 63.3%(31 of 49 cases) respectively, and that of mycelial M. furfur, 28.2%(40 of 142 cases) and 32.7%(16 of 49 cases) respectively. 3. The population densities(from 3+ to 6+) of yeast M. furfur in the dry and wet cerumens were ob served in 93.0%(132 of 142 cases) and 49.0%(24 of 40 cases), and those(3+) of mycelial M. furfur, 21.1%(30 of 142 cases) and 24.5%(12 of 49 cases) respectively. CONCLUSION: The incidence(41.5%) of wet earwax in tinea versicolor patients is significantly higher than that(0.8%) in The Korean control group. The ratio between the incidence of mycelial M. furfur and that of yeast M. furfur in the wet cerumens is higher than in the dry cerumens, and the ratio of population densities in the wet cerumens is also higher. These observations suggest that the skin surface conditions of the wet earwax group may be more suitable for yeast-mycelial transformation of M. furfur than those of the dry earwax group. The comparison of chemical compositions of the skin surface between dry and wet earwax groups is needed to elucidate the correlation between tinea versicolor and the types of earwax in the future.
Cerumen ; Humans ; Incidence* ; Malassezia* ; Population Density* ; Skin ; Tinea Versicolor* ; Tinea* ; Yeasts

Eczema herpeticum occurred in a patient with pemphigus foliaceus and esophageal cancer. The patient's initial skin lesions composed of large flaccid bullaes showed subcorneal bullae with typical acantholytic cells. Subsequent grouped small vesicles appeared widely on the erythematous base were diagnosed herpes simplex virus infection by Tzanck smear and histopathological findings. The patient died one week after the development of the widespread herpes virus infection.
Eczema* ; Esophageal Neoplasms ; Humans ; Kaposi Varicelliform Eruption* ; Pemphigus* ; Simplexvirus ; Skin

Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.
Arthroscopes ; Humans ; Magnetic Resonance Imaging ; Methods ; Rotator Cuff* ; Suture Anchors ; Sutures ; Tendons

The development of tophi in th absence of prior episodes of gauty arthritis is unusual. We report a case of extensive tophi in a 31 year-old man, whose initial skin lesion had started without arthritis.
Adult ; Arthritis ; Gout* ; Humans ; Skin

Capitellar fracture was first described by Hahn in 1853. It is rare, espically in children, and has been occurred 0.5% to 1% of incidence of all elbow injuries. Factures of the capitellum can involve a significant portion of the articular surfaces. It is desirable to reduce and internally fix the capitellar fragment, if possible, because this restores the artucular surface and augment joint stability. Three patients with displaced fractures of the capitellum(capitulum humeri) were treated by open reduction and internal fixation using Herbert screws, which stabilized the joint, allowed anatomical reduction, and gave rigid fixation. Postoperatively, early motion of the joint was allowed. All fractures were united without evidence of avascular necrosis and final follow-up was excellent.
Child ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Joints ; Necrosis

Thirty-five cerebello-pontine angle lesions were diagnosed with simple skull X-ray, CT, and angiography atSeoul National University Hospital from Sept. 1978 through Aug. 1982. The radiographic findings were analysed withemphasis on the differential points of CT among the major three cerebello-pontine angle tumors; acousticneurinoma, meningioma and epidermoid. The results are as follows; 1. Among the 35 cases of cerebello-pontine anglelesions, 19 cases were acoustic neurinoma. 4 cases miningioma, 4 cases epidermoid, 2 cases metastasis, 1 caseschoroid plexus papilloma, 1 case arteriovenous malformation, and 3 cases intra-axial posterior fossa tumors. 2.The characteristic radiographic findings of acoustic neurinoma were windening of internal auditory canal, petrousbone erosion, posterior extension of tumor at the level of internal autidory canal, hypo or isodense mass onpre-contrast CT with high enhancement after intravenous contrast infusion, and cystic change within the mass. 3.Meningioma shows anterior extenstion of the lesion at the level of internal auditory canal, broad base and obtuseangle sign of the lesion with petrous bone, hyperdense mass on precontrast CT. with highly homogeneous enhancementafter intravenous contrast infusion. 4. Epidermoid characteristically shows hypodense mass on precontrast CT withno change after intravenous contrast infusion. 5. The differential points of the major 3 cerebello-pontine tumorswere bone change, mass location, attenuation , degree of attachment to petrous bone, and cystic change.
Angiography ; Arteriovenous Malformations ; Infratentorial Neoplasms ; Meningioma ; Neoplasm Metastasis ; Neuroma, Acoustic ; Papilloma ; Petrous Bone ; Skull

To cover soft tissue defect, various types of flaps have been used. Although lateral supramalleolar flap has been used as rotation flaps or reversed island flaps to cover defects around the foot and ankle, there has been no report about its application as a free flap. The lateral supramalleolar island flap has proves to be supplied constantly by the terminal branch of the peroneal arterys perforating branch. The free lateral supramalleolar flap has the same skin territory. Its vascular pedicle can be extended to the main peroneal artery and vena comitans, which can be obtained by dissecting the peroneal vessels between the distal tibia and fibula through the interosseous membrane. We have successfully transferred this free flap in eight patients from April 1994 to February 1995. All of the patients had full thickness skin defects which were caused by contact thermal burn, electrical burn, flame burn or traffic accident. There were no complications. From our experience, we feel that this new free flap have some advantages, induding vascular anatomy and long pedicle with large diameter and a relatively thin flap with minimal morbidity of donor site.
Accidents, Traffic ; Ankle ; Arteries ; Burns ; Fibula ; Foot ; Free Tissue Flaps* ; Humans ; Membranes ; Skin ; Surgical Flaps ; Tibia ; Tissue Donors

Open long bone fracture is frequently difficult to reduce and maintain, especilly when there is extensive soft tissue damage. Infection, instability, malalignment and soft tissue complication often result in prolonged mobidity or failure. The Hoffmann's apparatus have merits, that can easily correct distracted, angular or rotational deformity of fracture site during early post-operative period, and stable fixation facilitates easily to the care of soft tissue injury. In addition, the affected limb can be elevated with balanced suspension, possible early exercise of neighboring joints. But we have exerienced some problems during treatment of fracture with Hoffmann's transfixation method. From February 1980 to December 1981, Hoffmann's transfixation method was employed in treatment of twenty-one patients that considered to have a poor prognosis with conversional forms of treatment. The results were obtained as follows; 1. For correction of distracted, angular, or rotational deformity, the fracture site should be reduced accurately. 2. Hoffmann pins should be transfixed as one plane and parrallel to each other. 3. Rigidity of fixation can be increased by increasing number of pins, actually three or more pins should be applied at each fragment of fracture. 4. Hoffmann's apparatus is more complex for management, more expensive and requires skillful technique compared with other external fixation apparatus. 5. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. 6. The main cause of injuries was due to traffic accidents in 17 cases (81%), involving tibia in 18 cases, femur in 2 cases and humerus in 1 case. 7. In the sixteen cases which could be assessed, the average times for external transfixation was 13.9 weeks and then followed by early weight bearing with P.T.B. cast or brace. The average time of bony union was 26.4 weeks. 8. The final result was excellent in 7 cases, good in 5 cases, acceptable in 3 cases, poor in 1 case.
Accidents, Traffic ; Braces ; Congenital Abnormalities ; Extremities ; Femur ; Fractures, Bone ; Fractures, Open ; Humans ; Humerus ; Joints ; Methods ; Prognosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing