One case of congenital cutis aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regeneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal artery was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of congenital cutis aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.
Bone Regeneration ; Debridement ; Dura Mater ; Estrogens, Conjugated (USP) ; Humans ; Scalp ; Skin ; Skull ; Temporal Arteries ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

No abstract available.
Thumb*

No abstract available.
Thumb*

No abstract available.
Lung*

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy

MRI findings of extramedullary hematopoiesis of the spleen have not been described in the literature. Wereport the MRI features of this condition, as seen in two patients and confirmed by fine needle biopsy. Threesmall masses(< or =3cm) were isointense on T1WI, hyperintense on T2WI, and enhanced after the injection of gadolinium.Two 6cm-sized masses were hypointense on both T1WI and T2WI, and showed no contrast enhancement.
Biopsy, Fine-Needle ; Hematopoiesis, Extramedullary* ; Humans ; Magnetic Resonance Imaging* ; Primary Myelofibrosis* ; Spleen*

BACKGROUND: The most common complication of latissimus dorsi myocutaneous flap in breast reconstruction is seroma formation in the back. Many clinical studies have shown that fibrin sealant reduces seroma formation. We investigated any statistically significant differences in postoperative drainage and seroma formation when utilizing the fibrin sealant on the site of the latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction after skin-sparing partial mastectomy. METHODS: A total of 46 patients underwent immediate breast reconstruction utilizing a latissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedure without fibrin sealant and the other 23 were administered the fibrin sealant. All flaps were elevated with manual dissection by the same surgeon and were analyzed to evaluate the potential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U test were used for analyzing the drainage volume according to age, weight of the breast specimen, and body mass index. RESULTS: Although not statistically significant, the cumulative drainage fluid volume was higher in the control group until postoperative day 2 (530.1 mL compared to 502.3 mL), but the fibrin sealant group showed more drainage beginning on postoperative day 3. The donor site comparisons showed the fibrin sealant group had more drainage beginning on postoperative day 3 and the drain was removed 1 day earlier in the control group. CONCLUSIONS: The use of fibrin sealant resulted in no reduction of seroma formation. Because the benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussed with patients before its use as a part of informed consent.
Breast ; Drainage ; Female ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Informed Consent ; Mammaplasty ; Mastectomy ; Seroma ; Tissue Donors

We describe here a 57-year-old woman with a chronic-contained rupture of an internal iliac arterial aneurysm, and this was eroding the sacral neural foramen. Although an isolated internal iliac arterial aneurysm is known to be rare, the ruptured internal iliac arterial aneurysm was diagnosed based on the characteristic radiolgic findings with performing color Doppler ultrasound, MRI and multi-slice computed tomography. The ruptured aneurysm was successfully treated by coil embolization. Color Doppler US, MRI and multi-slice CT are useful for evaluating a mass of a vascular origin that involves the neural foramen.
Aneurysm ; Aneurysm, Ruptured ; Cytochrome P-450 CYP1A1 ; Embolization, Therapeutic ; Female ; Humans ; Middle Aged ; Rupture ; Spine