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

No abstract available.
Child* ; Humans

Ganglion cysts of the cruciate ligament are quite rare. Ganglion cysts on the anterior cruciate ligament(ACL) should be suspected in any patient having pain and clicking sensation during terminal knee extension. A few cases have been reported concerning ganglion cysts present on the surface of the anterior cruciate ligament. We report three cases of a ganglion cysts on the ACL that was treated with arthroscopic excision.
Anterior Cruciate Ligament ; Ganglion Cysts ; Humans ; Knee ; Ligaments ; Sensation

This is a case of synovial chondromatosis involving the left knee joint of a forty one year old man. Chief complaints were gradual development of pain and limitation of knee joint motion of about 10 years duration. K-ray study revealed a single radio-opaque loose body filling the joint cavity. This body, measuring about 3×2×2cm, was removed surgically and found to have a pedicle from the synovial membrane, consisting of fat and fibrous tissue. The diagnosis of synovial chondromatosis was confirmed by pathological study. The postoperative course was uneventful and three months after the operation, the range of motion of the affected knee joint was good.
Chondromatosis, Synovial ; Diagnosis ; Joints ; Knee Joint ; Knee ; Range of Motion, Articular ; Synovial Membrane

The bilirubin formed in utero by the fetus can cross the placena and be excreted by the maternal liver. After birth, however, the infant must excrete its own bilirubin and hepatic clearance is not sufficient to prevent its accumulation during first week of life This transition has been physiologic jaundice and defined as an elevation of serum bilirubin that does not exceed 12mg% that occurs in first week of life in the absence of hemolytic disease. It is becoming increasingly apparent that several factors act in concert and that no single mechanism is soly responsible for producing physiologic jaundice in the new born. A simple micromethod technique for the analysis of small samples has made it possible to record the changes in the level of bilirubin in the serum by means of daily observation a large number of infants. So, serial observations for serum bilirubin concentrations on 40 healty fullterm infants from birth to 7 day. The study revealed that 14 infants(38%) exhibited the bilirubin levels of 12mg% or higher. The means of the peak bilirubin concentrations were obtained and revealed most higher on the forth dey. Positive correlations were found between the intensity and the duration of physiologic icterus, between the degree of hyperbilirubinemia and the age at which the process attains its maximum intensity and between the maximum height of the bilirubin level and the total duration of elevated levels of bilirubin in the serum. The mean total bilirubin level of the physiologic jaundice in the Korean new born infants was remarkably higher than those observed in the white iufants. So, the definition of physiologic jaundice by zeuzer is not of use in the Korean full term in fants.
Bilirubin* ; Fetus ; Humans ; Hyperbilirubinemia ; Infant* ; Jaundice* ; Liver ; Parturition

BACKGROUND: As the incidence of coloanal diseases has been steadily increasing during the past few decades in Korea, we illustrate the necessity of a specialized colorectal clinic for the efficient management of such diseases. METHOD: Outpatients at our colorectal clinic were studied epidemiologically and clinically by retrospective studies between November 1986 to December 1996. RESULTS: During this period, the total number of outpatients were 30,590 of which 24% were new patients. The patient pool consisted of anal diseases (62%), colon diseases (28%) and other diseases (10%). In this study, we found that condyloma, perianal abscesses, anal fistulas were predominant in males compared to females while rectovaginal fistulas, functional bowel diseases, and perianal fissures were predominant in females. There was no sexual bias for rectal cancer. Colorectal diseases occurred in all age groups; however, the peak age was in the fourth or fifth decade where social activity was maximum. There was a variation in age incidence among different disease entities. The range of age for benign conditions such as hemorroids, perianal abscessess and functional bowel diseases were from the third to the fifth decades; however, malignant lesions such as colon cancer were frequently seen in older patients (> 40 years). Condyloma was frequently seen in younger patients (< 20 years). There were no monthly variations in the incidences of colorectal diseases. Yearly variations were not found for colorectal disease, but were found for cancer. Of the cancers, the incidence of rectal cancer was higher than s-colon cancer or colon cancer in year variations. The diagnostic time has been reduced significantly over the past decade. The mean time required for a diagnosis work up in the period from 1984 to 1986 was 9.4 days; the diagnostic time in the period from 1993 to 1996 was 4.7 days. CONCLUSIONS: The incidences of coloanal disease have increased recently in Korea; thus, the demand for an efficient outpatient colorectal clinic has inevitably increased. We concluding that a specialized clinic, such as our colorectal clinic, has become essential for properly managing the exploding number of coloanal patients in Korea.
Abscess ; Bias (Epidemiology) ; Colon ; Colonic Neoplasms ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Male ; Outpatients* ; Rectal Fistula ; Rectal Neoplasms ; Rectovaginal Fistula ; Retrospective Studies

No abstract available.
Antibodies, Monoclonal* ; Herpesvirus 3, Human*

This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.
Catheters ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Fistula ; Humans ; Male ; Pelvic Bones ; Rupture ; Urethral Stricture ; Urinary Tract Infections

This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.
Catheters ; Constriction, Pathologic ; Cystostomy ; Erectile Dysfunction ; Fistula ; Humans ; Male ; Pelvic Bones ; Rupture ; Urethral Stricture ; Urinary Tract Infections

In 1971, for purpose of reduction of peak stress occuring in cement and trabecular bone of the acetabulum, Harris reported a series of metal-backed acetabular components with removable polyethylene liners that could be replaced if excessive wear occured. Modular designs of hip prostheses have become popular recently, but they introduce the risk of disassembly of the components postoperatively. And introduce of loosening and infection of femoral or acetabular components by debris of polyethylene liner. We report a case of mechanical disassembly of polyethylene liner in cementless metal backed cup, and review previously reported articles.
Acetabulum ; Hip Prosthesis ; Polyethylene