Explosive burns following inhalation of butane gas rarely occurred in the past, but recently it has brought about a social problem among groups of teenagers. This constitutes 1.6% of admissions due to flame burn in the burn unit of Hallym Medical Center. A retrospective review during a five-year period identified 48 patients. The male to female ratio was 3:1. The mean age was 16 years and 8 months. The place of accidents were commonly bedrooms or motel rooms. There were nine group settings of 27 patients at the time of the accident. The pneumothorax(n=3) and respiratory difficulty(n=12) were noted on admission. The average burn area was 28.5% of the total body surface area. All patients sustained burn injury on the face, arms and hands, and 24 patients among them had extended burn areas on the trunk and/or lower extremity. Twenty-two patients(mean hospital stay; 51.6%) required skin grafting, and 12 patients (mean hospital stay; 22.3 days) were treated with conservative management. The mortality rate was 10.4 percent. Explosive burns following inhalation of butane gas can result in mortality as well as major burn injuries.
Adolescent ; Arm ; Body Surface Area ; Burn Units ; Burns* ; Female ; Hand ; Humans ; Inhalation* ; Length of Stay ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Skin Transplantation ; Social Problems

No abstract available.
Burns* ; Congenital Abnormalities* ; Free Tissue Flaps*

A prospective study was done to evaulate the dfficacy of Silon-STS application on problemed scars. Silon-STS is one of various methods for the treatment of problemed scar. It is supplied in flat sheets composed of inner silicone layer and outer acrylic plate. It was pre-heated with an gas lighter and shaped over a mold of the anatomical region to be splinted. Silon-STS had been applied to 45 patients with hypertrophic scar, trapdoor, scar, irregular elevated scar, and keloid for 2 to 6 months. Color changes and thickness of the scars were evaluated by serial photography. Customory forming techniques to shape Sion-STS followed by trimming and strap attachment can also be used. The results have been successful in 43 cases(96%). Skin rash, pruritis were complained by two patients. Silon-STS application has been an effective method for the treatment of problemed scars in our experience.
Cicatrix* ; Cicatrix, Hypertrophic ; Exanthema ; Fungi ; Humans ; Keloid ; Photography ; Prospective Studies ; Pruritus ; Silicones* ; Splints

The free flaps have been used for reconstruction of the head and neck because of their superior results comparing with other types of flaps. Among them, radial forearm free flap has many advantages, its thinness, pliablilty, long vascular pedicle, large sensory flap, and compound flap including tendons and bone. We report 28 cases of head and neck reconstruction with radial forearm free flap between March 1991 and March 1997. Patient's age ranged from 21 to 76 years(mean 50.5 years). There were 23 men and 5 women. Mean follow-up period was 14 months. The most common cause was malignant tumor of the head and neck, especially squamous cell carcinomas(18 cases). We used this flap to reconstruct the oral cavity in 13 cases, the hypopharyngoesophagus in 6 cases, external surface of the head and neck in 7 cases, and the orbit in 2 cases. All of these flaps survived without complication. Two cases of fistula developed, in which forearm flaps were used for tongue and hypopharyngoesophageal reconstruction, and they were treated with conservative manners. Partial losses of skin graft at donor site of the forearm developed in 3 cases. They healed with split-thickness skin graft or local flap. The function of reconstructed upper aerodigestive tract and eye socket was good. The cosmetic result was not good in cases of reconstruction for external surface of the face with this flap, but it was better than other free flaps. So, we concluded the radial forearm free flap is available for reconstruction of the head and neck.
Female ; Fistula ; Follow-Up Studies ; Forearm* ; Free Tissue Flaps* ; Head* ; Humans ; Male ; Mouth ; Neck* ; Orbit ; Skin ; Tendons ; Thinness ; Tissue Donors ; Tongue ; Transplants

Herniation of the kidney through a traumatic diaphragmatic rupture in itself is rare. However, complete avulsion of the renal pedicle implies not only a more rare event, but also a surgical emergency. We report a case of a patient with complete avulsion of renal vessels and ureter of an intrathoracic kidney herniated through a diaphragmatic rupture caused by blunt trauma. Prompt diagnosis with a computer tomographic scan and immediate surgery saved the patient's life.
Diagnosis ; Diaphragm ; Emergencies ; Humans ; Kidney ; Pleural Cavity* ; Rupture ; Ureter

No abstract available.
Ischemia* ; Skin*

We report a case of a 46-year-old man with end-stage renal failure who developed a giant aneurysm after a brachiocephalic arteriovenous shunt. The patient had complaints of pulsating pain and swelling of his left upper extremity. The patient had abandoned use of the arteriovenous shunt and had a second arteriovenous shunt procedure over his right extremity. The giant venous aneurysm was removed just distal to his anastomosis. The patient's postoperative course was uneventful.
Aneurysm* ; Extremities ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Upper Extremity

Melatonin was derived from pineal gland, act as hormone and is known to be extremely active in certain biological systems. To observe the depigmentation effet of melatonin, author induced activation of melanocytes and melanin by UVB irradiation for seven days and then melatonin ointment or ointment base was applied topically on the ear skin of C57 B1 mouse. Tissue samples were obtained from 4 mice in each group before and after UVB irradiation for given days(1,3,5 and 7 week). The morphological, numerical, and ultrastructural changes of epidermal melanocytes were observed with light microscope and electron miroscope after DOPA stain. The results were as follows: 1) In all groups, the number of DOPA positive melanocytes began to decrease from 1 week. 2) The number of DOPA-positive melanocytes in melatonin ointment applied group was significantly lower than in control group. 3) In the electron microscopic findings, the number of melanosomes markedly decreased from 1 week to 7 weeks and a small amount of destructed melanosomes(vacuoles) and destroyed or swollen mitochondria in cytoplasm of th melanocyte appeared more significant in 3% melatonin ointment applied group compared to ointment base applied group from 5 weeks.
Animals ; Cytoplasm ; Dihydroxyphenylalanine ; Ear ; Melanins ; Melanocytes* ; Melanosomes ; Melatonin* ; Mice* ; Mitochondria ; Pineal Gland ; Skin

Split-thickness skin grafting is commonly used to cover donor site defect of radial forearm free flap. One of disadvantages in this method is contour reflection of underlying structures (tendons and muscles) with irregularity which was caused by incomplete soft tissue replacement, and we called it 'silhouette phenomenon'. To promote soft tissue replacement, we have used Terudermis(R) (atelocollagen). In 10 cases of radial forearm free flap surgery of 10 patients, Terudermis(R) was applied on flap donor site just after flap surgery, followed by split-thickness skin grafting for resurfacing after 2 weeks. In all cases, Terudermis(R) and skin graft were taken well with no complications such as skin necrosis and loss. We successfully overcame silhouette phenomenon in all cases in the follow-up period of mean 8 months. Terudermis(R) , as a tissue-restoring biomaterial, is expected to be easily used for coverage of donor site defect of radial forearm free flap.
Follow-Up Studies ; Forearm* ; Free Tissue Flaps* ; Humans ; Necrosis ; Skin ; Skin Transplantation ; Tissue Donors* ; Transplants

PURPOSE: This study aimed to characterize the autonomic and chaotic control of heart rate and circadian rhythm in asymptomatic patients with postoperative tetralogy of Fallot (pTOF). METHODS: Twenty-four-hour electrocardiogram recordings were obtained in 30 asymptomatic pTOF patients and in 30 age-and sex-matched controls, aged between 6 and 11 years. The data was digitized and partitioned into sections of 30- minute'durations. For each section, time-domain and frequency-domain measures (low- and high- frequency component) of heart rate variability and three measures based on chaotic dynamics- approximate entropy, correlation dimension and Lyapunov exponent-were calculated. RESULTS: In pTOF patients, 24-hour mean values of the time domain measures, high-frequency component, and all chaotic measures were significantly lower, while 24-hour mean value and all 6-hour mean values of the low-frequency component were significantly higher; all 6- hour mean values of high-frequency component, except from 6am to midday, were significantly lower. In pTOF patients, all 6-hour mean values of all three chaotic measures were significantly lower. In pTOF patients, the day- night circadian variation seen in controls was diminished (time- domain measures) or absent (low- and high- frequency component). CONCLUSION: Even in asymptomatic patients with pTOF, who are thought to be at minimal risk of fatal arrhythmia, a sustained increase in sympathetic activity and decrease in vagal activity, abnormal circadian rhythm of the autonomic activity, and decreased cardiac chaos were found. When other arrhythminogenic risk factors are superimposed, these abnormalities may contribute to the development of fatal arrhythmia and sudden death.
Arrhythmias, Cardiac ; Child* ; Circadian Rhythm* ; Death, Sudden ; Electrocardiography ; Entropy ; Heart Rate ; Humans ; Risk Factors ; Tetralogy of Fallot*