In 1988, a new fascioutaneous flap, the Lateral supramalleolar flap, was introduced by Masquelet and Roman. The flap is designed on the lower third of the aspect of leg, and supplied by a cutaneous branch from the perforating branch of the peroneal artery. This perforating branch continues distally deep to the fascia along the anterior ankle and into the foot. This can be use as either proximally based rotation flap or distally based reversed pedicle island flap giving the flap an arc of rotation that allows coverage of the dorsal, lateral and plantar aspects of the foot, the posterior heel and the lower medial portion of the leg. The authors have recently used this flap for 13 cases of foot and ankle soft tissue defect reconstruction and all the cases, except two partial marginal necrosis, good postoperative course. In our opinion, this flap is useful for reconstruction of foot and ankle soft tissue defect which does not need nerve innervation. The main advantages of the flap are as follows 1. It may be a rather large flap(15× 9cm2 ). 2. The pedicle is long(8cm) and easy to dissect. 3. The pivot of the pedicle is distal(sinus tarsi) and allows great local possibilities of coverage. 4. It does not require the sacrifice of a main artery.
Ankle ; Arteries ; Fascia ; Foot ; Heel ; Leg ; Necrosis

No abstract available.
Cushing Syndrome*

OBJECTIVE: bjective: By identifying the unknown substance responsible for binding with nebulin SH3 domain within the sarcomeric Z-line, we tried to find out Z-line structure which plays an important role on muscle contraction and maintenance of muscle funtion. METHOD: First, the bait plasmid was made by binding the DNA binding domain of Gal4 protein of yeast and the SH3 domain. Second, library plasmid was made by binding activation domain and human skeletal cDNA library. Then, the base sequence of the clone, produced by combining the two proteins expressed by transgenically converted plasmid in yeast, was analyzed. RESULT: We screened out six true positive clones and analyzed the base sequence of the two of six clones. We identified them to be alpha-actinin2. CONCLUSION: We can theorize that Neublin SH3 domain and alpha-actinin2 plays a vital role for the integration of Z-line. Thus, this is an important data in further studying muscle functions, mechanisms, and muscular disease as well.
Base Sequence ; Clone Cells ; DNA ; Gene Library ; Humans* ; Muscle Contraction ; Muscular Diseases ; Plasmids ; src Homology Domains* ; Yeasts

BACKGROUND: The glomerulonephritis appears in various clinical presentations. Renal biopsy is important diagnostic tool for treatment decision and prognosis prediction of glomerulonephritis. We tried to study on the clinical presentations of glomerulonephritis through histopathological findings and treatment responses in elderly patients. METHODS: We made an retrospective analysis in elderly patients aged over 60 years performed renal biopsy in our medical center from January 1991 to February 2005. RESULTS: Of all the 42 patients, the mean age of the patients was 64.6+/-3.5 years, 24 male and 18 female patients were included(1.3:1). Patients aged 60-64 years (n=26, 62%) were majority. On clinical indications of renal biopsies, 17 patients had nephrotic syndrome, 10 had asymptomatic urinary abnormality, 5 had gross hematuria, and 5 had acute azotemia. The results of renal biopsies presented that 30 patients (71%) had primary glomerulonephritis, 9 patients (22%) had secondary glomerulonephritis. Among primary glomerulonephritis, membranous nephropathy (n=10) was most common, followed by IgA nephropathy (n=7),focal segmental glomerulos-clerosis (n=3), membranoproliferative glomerulonephritis (n=2), and mesangioproliferative glomerulonephritis (n=2). In secondary glomer-ulonephritis, there were diabetic nephropathy (n=2), lupus nephritis (n=2), cancer-related nephritis (n=2), poststreptococcal glomer-ulonephritis (n=1), Henoch-Schonlein nephritis (n=1), amyloidosis (n=1). In the cases of nephrotic syndrome, primary nephrotic syndrome (n=12, 71%) is more prevalent than secondary nephrotic syndrome (n=3, 18%). The most common cause of primary nephrotic syndrome was membranous nephropathy (n=8). The causes of asymptomatic urinary abnormality were IgA nephropathy (n=4), lupus nephritis (n=2), membranous nephropathy (n=1), mesangioproliferative glomerulonephritis (n=1). By the complications of renal biopsy, only a few patients presented new-onset hematuria, hematoma, aggravation of hypertension, but, severe complication including an infection or a death was none. 8 of 12 patients with primary nephrotic syndrome were treated, 5 patients of those were shown complete response (n=3) or partial response (n=2). CONCLUSION: Various clinical presentations of glomerulonephritis were shown to elderly patients. Number of complications after renal biopsies were relatively small, and good responsiveness to treatment could be expected in the elderly patients. Therefore it is reasonable to perform a renal biopsy if indicated.
Aged* ; Amyloidosis ; Azotemia ; Biopsy ; Diabetic Nephropathies ; Female ; Glomerulonephritis* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranoproliferative ; Glomerulonephritis, Membranous ; Hematoma ; Hematuria ; Humans ; Hypertension ; Lupus Nephritis ; Male ; Nephritis ; Nephrotic Syndrome ; Prognosis ; Retrospective Studies

Jessner's lymphocytic infiltration of the skin (JLIS) is a well-known but poorly understood disorder. Some doubt still exists about whether it is a distinct disease or a variant of lupus erythematosus or, less commonly, polymorphous light eruption, cutaneous lymphoid hyperplasia. An effective therapy is still unavailable for JLIS. We report a patient with JLIS which was successfully treated with dapsone and intermittent systemic glucocorticoid therapy.
Dapsone ; Humans ; Hyperplasia ; Light ; Skin

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.
Female ; Humans ; Microbial Sensitivity Tests ; Mycoplasma Infections/complications/microbiology ; Mycoplasma hominis/isolation & purification ; Obstetric Labor, Premature/*epidemiology/etiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/microbiology ; Premature Birth/*epidemiology/etiology ; Prevalence ; Risk Factors ; Streptococcal Infections/complications/microbiology ; Streptococcus agalactiae/isolation & purification ; Ureaplasma Infections/complications/microbiology ; Ureaplasma urealyticum/isolation & purification ; Vagina/*microbiology

Individual identification procedure is one of the most improtant part in medicolegal fields. Recently, radiolegal investigation methods have been widely applicated to the medicolegal field for the purpose of individual identification. So authors attempted to determine sex and calculate stature by using roentgenographic findings of long bones of 248 subjects the living materials. In orthoscanographic study for long bones, we measured total length, midshaft width, epiphyseal width, cortical width, head diameter of each bones The total length, midshaft width, cortical width, condylar breath, horizontal & vertical head diameter of femur show statistically significant differentiation between two sexes, in tibia, total length, midshaft, cortical width, proximal and distal epiphyseal width show statistically significant. In fibula, Humerus, radius and ulna, total length is only statistically significant. And other wresults are statistically insignificant. Using femoral and fibial lengths (mm) with "Regression Analysis method" in SAS program, we derived the following fomulae. Height (cm)=95.62±0.148×Total length of Femur. (mm) Height(cm)=82.07±0.22×Total length of Tibia. (mm). In conclusion, radiologic measurement of long bone might be one of the useful methods in individual identification of unknown subject in Korea.
Femur ; Fibula ; Head ; Humerus ; Korea ; Radius ; Tibia ; Ulna

BACKGROUND: All clinicians are aware of the difficulty of installing a dental implant in posterior maxilla because of proximate position of maxillary sinus, insufficient bone width, and lower bone density. This study is to examine which factors will make the implantation in the posterior maxilla more difficult, and which factors will affect the postoperative implant stability in this region. METHODS: Five hundred seventy-three fixtures on the maxilla posterior were included for this study from all the patients who underwent an installation of the dental implant fixture from January 2010 to December 2014 at the Department of Oral and Maxillofacial Surgery in Pusan National University Dental Hospital (Yangsan, Korea). The postoperative implant stability quotient (ISQ) value, fixture diameter and length, presence of either bone graft or sinus lift, and graft material were included in the reviewed factors. The width and height of the bone bed was assessed via preoperative cone beam CT image analysis. The postoperative ISQ value was taken just before loading by using the OsstellTM mentor® (Integration Diagnostics AB, Gothenburg, Sweden). The t test and ANOVA methods were used in the statistical analysis of the data. RESULTS: Mean ISQ of all the included data was 79.22. Higher initial bone height, larger fixture diameter, and longer fixture length were factors that influence the implant stability on the posterior edentulous maxilla. On the other hand, the initial bone width, bone graft and sinus elevation procedure, graft material, and approach method for sinus elevation showed no significant impact associated with the implant stability on the posterior edentulous maxilla. CONCLUSIONS: It is recommended to install the fixtures accurately in a larger diameter and longer length by performing bone graft and sinus elevation.
Bone Density ; Busan ; Cone-Beam Computed Tomography ; Dental Implants* ; Hand ; Humans ; Maxilla* ; Maxillary Sinus ; Methods ; Surgery, Oral ; Survival Rate ; Transplants

PURPOSE: Kawasaki disease-the most common cause of acquired heart disease in children-incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. METHODS: Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. RESULTS: Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2.3-fold, respectively. CONCLUSION: The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.
C-Reactive Protein ; Child ; Coronary Vessels ; Fever ; Forecasting ; Heart Diseases ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome

BACKGROUND AND OBJECTIVES: Percutaneous occlusion of patent ductus arteriosus (PDA) has become increasingly attractive with the evolution of devices and techniques. We reviewed results for percutaneous occlusion of PDA using various devices in a single center. SUBJECTS AND METHODS: A retrospective review was done for 118 consecutive procedures performed in 111 patients with PDA between January 1996 and December 2007. RESULTS: The median age of the patients was 4.5 years (0.9 to 60.3 years); body weight was 16.9 kg (6.8 to 74.7 kg). The median PDA diameter at the pulmonic end was 3.8 mm (0.7 to 10 mm); mean pulmonary artery pressure was 21.0 mmHg (7 to 60 mmHg). Complete occlusion occurred in 76/111 (68.4%) immediately after implantation and in 100/111 (90.0%) at one year of follow-up. Second procedures for residual shunts were done in 7 patients. After the year 2001, the complete closure rate was 95.2% compared to 71.4% before 2001. Complications associated with the procedure were left pulmonary artery narrowing (all <20 mmHg) in 14, arrhythmia in 2, and death in 1. CONCLUSION: Evolution of devices, cumulative experience, and health insurance covering the cost of devices have contributed to good outcomes in our center for percutaneous occlusion of PDA. Our results have improved over the years, particularly with the use of the Amplatzer duct occluder.
Arrhythmias, Cardiac ; Body Weight ; Ductus Arteriosus, Patent ; Follow-Up Studies ; Humans ; Insurance, Health ; Pulmonary Artery ; Retrospective Studies