No abstract available.
Foot* ; Hand* ; Syndactyly*

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

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

BACKGROUND: The maximal removal rate of indocyanine green (ICG Rmax), which has been used as a useful indicator of quantitative assessment of the hepatic function, has some disadvantages such as high cost, requirement of multiple sampling, and long turn-around time. This study was designed to clarify that the measurement of the lidocaine metabolite, monoethylglycinekylidide (MEGX) test, can replace the ICG Rmax. And in healthy adults, MEGX forma pion was measured and compared according to methods of measurement and serf. METHOD: In 18 patients to whom ICG Rmax test was requested, ICG Rmax test was carried out at two doses of 0.5 mg/kg and 5 mg/kg and MEGX formation after 15 minute of 1 mg/kg lidocaine Injection was measured by fluorescence polarization immunoassay (FPIA) method. The correlation between them was analyzed, To 25 healthy volunteers included in this study as normal control, lidocaine was given intravenously at, a dose of 1 mg/kg and MEGX forma pion was measured IS and 30 minute later (MEGX15, MEGX30) using both high performance liquid chromatography (HPLC) and FPIA methods. RESULT: Patient group resealed significant correlation between ICG Rmax and MEGX15 (r=0.7674, p<0.001) and also between ICG Rl5 and MEGX15 (r=0.5612, p=0.008). There was significant difference between MEGX15 of 9 patients with chronic liver diseases and those of normal controls (22.24+/- 13.18 and 35.40+/- 14.43 ng/mL, respectively) (p=0.01). In normal controls, the correlation between methods was significant (p=0.001) and the values measured by FPIA method was significantly higher than that by HPLG (p(0.001). Of the normal controls, male group had higher MEGX15 values than female group in both methods (in HPLC method 33.89+/-15.95 and 22.53+/- 8.36, and in FPIA method 41.48+/-16.61 and 28.81+/-7.88 ng/mL, respectively), and in female group MEGX30 values was significantly elevated compared to MEGX15 (p<0.001). CONCLUSION: Inferred from the fact that the correlation between ICG Rmax and MEGX was good, MEGX test can be considered a replacement for ICG Rmax. In healthy adults, it is considered that there is serf-related difference In the rate of lidocaine metabolism so we should pay attention to it in interpreting the MEGX results.
Adult ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Female ; Fluorescence Polarization Immunoassay ; Healthy Volunteers ; Humans ; Indocyanine Green* ; Lidocaine ; Liver Diseases ; Male ; Mesons ; Metabolism

The purpose of this study is to evaluate the influence of the extent of involvement in the results of cementless THA in patients with idiopathic AVN of the femoral head. We reviewed 70 hips (52 patients) who had undergone cementless THA for idiopathic AVN of the femoral head. Anatomic femoral components were used in 43 hips and Harris Galante porous prosthesis were employed in 27 cases. The hips were classified according to International Classification (Association Research Circulation Osseous). The length of the follow-up period ranged from 3 to 5 years (average 53.5 months). Preoperative and postoperative clinical documentation and radiographs were evaluated. Statistical analysis was performed on the results of three analysis groups (Group A, comparison of results among Stage IIIA, IIIB, IIIC, and IV; Group B, between stage III and IV; Group C, between IIIA+IIIB and IIIC + IV). Of the 70 hips in the present study, there were 47 hips in stage III (IIIA, 15; IIIB, 19; IIIC, 13) and 23 hips in stage IV. The average postoperative Harris hip score at the time of study was 91.5 (Analysis Group C, p=.009). Femoral subsidence of more than 5 mm occurred in 5 hips (7.1%). Two hips were in Stage IIIC and three hips were in Stage IV (Group C, p=.024). The hips lower than -10 on Engh's index were present in one hip in Stage IIIC and three hips in Stage IV (Group C, p=.011). This study demonstrated that the clinical and radiological results of cementless THA were poor when the extent of involvement was greater or in the case of late stage subjects, particularly those above IIIC (p<05), with avascular necrosis of the femoral head.
Arthroplasty, Replacement, Hip* ; Classification ; Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Prostheses and Implants

Aneurysms of the superior mesenteric artery are rare, accounting for 8% of visceral artery aneurysms. About 60% of all superior mesenteric artery aneurysms have a mycotic origin. The only helpful clinical manifestations are episodes of previous abdominal pain and a history of valvular heart disease. In this case, a 66-year-old female patient with mitral regurgitation and aortic regurgitation presented with pain in the upper abdominal area. A superior mesenteric artery aneurysm was diagnosed at the time of impending rupture. Since excellent collateral circulation was present, an aneurysmectomy without revascularization was performed, and no ischemic symptom occurred. The patient presented no major complications during the postoperative course.
Abdominal Pain ; Aged ; Aneurysm ; Aneurysm, Infected* ; Aortic Valve Insufficiency ; Arteries ; Collateral Circulation ; Endocarditis* ; Female ; Heart Valve Diseases ; Humans ; Mesenteric Artery, Superior* ; Mitral Valve Insufficiency ; Rupture

This study was designed to investigate the effects of burn injury of the leg on the growth plate of proximal tibia in the immature rat. The procedure for burn injury of left leg was performed at the thigh, knee and lower leg under the general anesthesia with inhalation of ether. After the burn injury, follow up observations were made at second day, 1st, 4th, and 6th weeks with histological examination. The results were as follows. During postburn 4 weeks, height of the proximal tibial epiphyseal plates of the experimental group showed significant increment, comparing with control group. At postburn 6th weeks, it revealed no significant difference, comparing with control group (Wilcoxon rank sum test, p<0.05). During postburn 4 weeks, cell numbers in column of the proximal tibial epiphyseal plates of the experimental group showed significant increment, c omparing with control group. At postburn 6th weeks, it revealed no significant difference comparing with control group (Wilcoxon rank sum test, p<0.05).
Anesthesia, General ; Animals ; Burns* ; Cell Count ; Ether ; Follow-Up Studies ; Growth Plate ; Inhalation ; Knee ; Leg ; Rats* ; Thigh ; Tibia*

Although there has not yet been a clear determination of the structures responsible for nasal tip support, it is generally agreed that for Caucasians the components of nasal tip support include the attachment between the upper and lower lateral cartilage, the attachment between the lateral crus and the pyriform aperture, the attachment between the paired domes of the lower lateral cartilages, and the medial crural attachments of the caudal septum. To our knowledge, there has been no anatomical study of the nasal tip supporting structures for Asian patients. The purpose of this study is to determine these structures and how they differ from those of Caucasian patients. Ten noses of fresh cadavers were investigated. Dissection was performed and the above-mentioned nasal tip supporting structures were observed and excised. Histological examination was done with hematoxylin and eosin stains and Van Gieson elastin stains. Based on our results, we propose that the structures between upper and lower lateral cartilages, between lateral crus and pyriform aperture, between the paired domes of lower lateral cartilages should referred to as an intercartilaginous ligament, sesamoid fibromuscular tissure, and interdomal loose connective tissue, respectively. There is no identified specific tissue between medial crus and caudal septum. We consider that the loose connection between the domes of the middle crura and the lack of a specific structure between the medial crus and caudal septum might be the reasons why the nasal tips of Asian patients tend to be broad and unprojected with a wide base.
Asian Continental Ancestry Group ; Cadaver ; Cartilage ; Coloring Agents ; Connective Tissue ; Elastin ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Ligaments ; Nose

PURPOSE: The aim of the study was to determine the prognostic factors influencing the survival rate in patients with renal cell carcinomas treated by radical nephrectomy. MATERIALS AND METHODS: 90 patients, with a renal cell carcinoma, who underwent a radical nephrectomy between January 1992 and December 2001, were retrospectively reviewed. The survival rate according to the prognostic factors, such as the 1997 TNM stage, tumor size, cell type and nuclear grade of the tumor, age and gender, tumor location and erythrocyte sedimentation rate (ESR), were analyzed using the Kaplan-Meier method. A univariate analysis, using log rank tests, was performed to evaluate the prognostic factors. A multivariate analysis was performed to determine which factors had an independent impact on the survival of patients with a renal cell carcinoma. RESULTS: The overall 1- and 5-year cancer survival rates were 93.6 and 74.7%, respectively. The 1- and 5-year cancer survival rates by stage were 100 and 93.8% in stage I, 100 and 80.0% in stage II, 87.4 and 57.4% in stage III and 66.7 and 27.8% in stage IV (p<0.0001). The univariate analysis showed significant differences in the TNM stage and nuclear grade and the tumor size and the ESR. The multivariate analysis revealed that the TNM stage and nuclear grade of the tumor were the best prognostic indicators for a renal cell carcinoma. CONCLUSIONS: The TNM stage, nuclear grade, size of tumor and enhanced ESR are important prognostic factors in renal cell carcinomas. The TNM stage and nuclear grade of the tumor are independent prognostic factors.
Blood Sedimentation ; Carcinoma, Renal Cell* ; Cell Size ; Humans ; Multivariate Analysis ; Nephrectomy* ; Prognosis* ; Retrospective Studies ; Survival Rate

No abstract available.
Intestinal Volvulus* ; Pregnancy*