The autogenous fascia graft has been used for various surgical purposes because it has good durability, a gliding capacity, elasticity and a high survival rate. However, few studies have reported histological changes of the graft in various situations. This study attempted to determine histomorphologic changes after autogenous fascia graft in various surgical conditions. The results revealed were as follows: 1. The tension applied to grafts plays the key role in the survival rate of autogenous fascia grafts. 2. Rolling the fascia reduced the volume and weight after autogenous graft due to fibrosis and central fatty degeneration. 3. Autogenous fascia graft covering silicone blocks showed its fascial structure and reduction of the formation of fibrous capsule around the silicone.
Elasticity ; Fascia ; Fibrosis ; Silicones ; Survival Rate ; Transplants*

No abstract available.
Knee Joint* ; Knee*

Botulium toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. Some wrinkle and unsightly facial expressions are due to hyperkinetic muscle. For the past year, the author has injected it for variant purpose, so we describe the our experience with the variant extended use of the toxin including correction for just dynamic wrinkle, used with subperiosteal face lifting or peeling, post-traumatic twitching, and facial paralysis and relevant anatomy are discussed. Also we have another concept about muscle anatomy which have superficial and deep portion. The superficial portion is for harmonious action with SMAS during facial expression, which is also related to fine wrinkle, and the deep portion play role gross movement. Botulium toxin is safe and effective in varient field without complication. Its use is associated with a high degree of patient and physician satisfaction.
Exotoxins* ; Facial Expression ; Facial Paralysis ; Humans ; Rhytidoplasty

Neuroarthropathy has infrequently been associated with diabetic patients. The initial presenting symptoms are in most cases the peripheral neuropathy involving chiefly the sensory components of peripheral nerves, leading to numbness, hyper-or paresthesia, and coldness of the extremity affected. The diabetic arthropathy, once occurred, is apt to show progressive deterioration of the function with destruction of both skeletal and supporting soft tissues Two cases of such arthropathy were presented here, the one was observed in a 29-year-old man with involvement of the left fourth and fifth tarsometatarsal joints and a large ulcer on the dorsal skin of the lesion, and the other in a 35-year-old man with destruction of the right ankle joint. Both of them showed remarkable remission of the symptoms with conservative measures such as arch support, cast immobilization and skin graft.
Adult ; Ankle Joint ; Extremities ; Humans ; Hypesthesia ; Immobilization ; Joints ; Paresthesia ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Skin ; Transplants ; Ulcer

No abstract available.
Anal Canal* ; Carcinoma, Squamous Cell*

Among 334 thoracolumbar spinal injury patients who were admitted to this hospital from June 1972 to June, 1982, 66 patients with fracture and fracture dislocation of thoraco-lumbar spine which were defined as unstable clinically and radiologically were treated with surgical measures. The ratio between male and female was 7.3:1, the majority was found in third and fourth decade (46 cases, 69%), and the most common cause of injury was falling from a height (38 cases, 58%). The most common site of the injury was lumbar spine (29 cases, 44%) and the most common mechanism of injury was flexion-rotation (29 cases, 44%). Our surgical measures were Harrington rod instrumentation with either anterior or posterior fusion (25 cases, 38%), posterior wiring and fusion (14 cases, 21%), anterior decompression and anterior fusion (14 cases, 21%), posterior fusion (4 cases, 6%), anterior fusion and posterior fusion (3 cases, 5%) and etc. The average correction of displacement was 65% and the average correction of kyphotic deformity was 50%. The most remarkable correction was found at the cases of Harrington rod instrumentation (71%, 74%). Neurological deficit had already developed in 43 cases(65%) prior to operation, and the recovery was observed in 18 cases(42%). Most excellent recovery of neural deficit was found also at the cases of Harrington rod instrumentation (11 cases, 52%). We have analysed the results of these treatment and obtained following conclusions. 1. For the unstable fracture and fracture-dislocation of thoraco-lumbar spine with or without neural involvement, immediate surgical treatments were valuable to expect restoration of anatomical reduction and promotion of every possible recovery of neural function with spinal stability and fewest complication. 2. Fixation with Harrington rod instrumentation appears to provide better reduction and stability with neural improvement than other methods, and therefore early undertaking of rehabilitation activities is possible. 3. For the patients who are seriously compromised or require anterior decompression, immediate posterior reduction and fixation with Harrington rod instrumentation followed anterior decompression and anterior fusion of the involved segments at the eariest feasible time, we feel, is the treatment of choice.
Accidental Falls ; Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Female ; Humans ; Male ; Mortuary Practice ; Rehabilitation ; Spinal Injuries ; Spine

There was increasing tendency to stabilize unstable cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and therefore early rehabilitation. A clinical study was performed on 47 patients with fractures and dislocations of the cervical spine treated at the department of orthopedic surgery, Inje Medical College, Paik Hospital from Jan. 1975 to Dec. 1981. Following is the summery of the our findings. 1. The prevalent age distribution was between 3rd and 6th decade and the ratio between males and females was 10:1. The most common cause of injuries was automobile accident (70%). 2. The most common site of the injuries was C5-6 (34%) and the most frequent mechanism of injury was flexion-rotation type (47%). 3. In overall patients, neurologic damage was found at first examination in 73% and among these, complete paralysis below the injured level in 26%, incomplete paralysis in 11% and nerve root injury in 35%. 4. Among 47 patients, conervative treatment was performed on 9 patients, anterior spinal fusion on 8 patients, anterior spinal fusion with Halo application on 4 patients, posterior wiring with posterior spinal fusion on 16 patients and posterior wiring with anterior spinal fusion on 8 patients. 5. In the several methods of treatment, the posterior wiring with anterior spinal fusion revealed the best results, the correction rate of displacement was 92%, the correction rate of angular deformity 98% and neural recovery rate 72%. 6. The posterior wiring with posterior spinal fusion revealed good results in correction of displacement and angular deformity but required rigid external support for a long time. The anterior spinal fusion revealed poor results in correction of displacement(67%) and angular deformity(38%) and required rigid external support for a long time and had increasing tendency of kyphotic angle after operation. 7. In the treatment of unstable cervical spine injury, we thoughy that early posterior reduction with posterior wiring and followed anterior spinal fusion was ideal for accurate reduction, rigid stability and early mobilization with simple external support.
Age Distribution ; Automobiles ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Early Ambulation ; Female ; Humans ; Male ; Nursing Care ; Orthopedics ; Paralysis ; Rehabilitation ; Spinal Fusion ; Spine

Staphylococcal scalded skin syndrome (4S) is an exfoliative skin disease caused by Staphylococcus aureus toxins. 4S usually has a benign course in young infants and children; however, it could be fatal in preterm infants, especially very low birth weight infants. We experienced two sequential 4S cases that occurred in the neonatal intensive care unit. One of the patients had complications such as bacteremia and acute kidney injury.
Acute Kidney Injury ; Bacteremia ; Child ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Skin Diseases ; Staphylococcal Scalded Skin Syndrome ; Staphylococcus aureus

The importance of vegetables as a allergen for the development of hand eczema has been a matter of debate. The aim of this study was to evaluate the clinical manifestations of hand eczema and to investigate the role of vegetables in the hand eczema of Korean housewives. In this study, clinical evaluatons and patch tests with Hollister-Stier standard allergens and 22 vegetable allergens wer performed in 32 patients with housewife's hand eczema. The results are summarized as follows : 1. The prevalence was highest in fourth(59.4%) and third(25.0%) decades of life and the peak age of onset was third(53.1%) and fourth(31.3%) decades. 2. Only 3 of 32 patients(9.4%) had past histories of atopic dermatitis ; however, childrens of 12 patients(37.5%) had atopic dermatitis. 3. The common skin signs were fissuring(90.6%), scaling(78.1%), erythema(75.0%), hyperkeratosis(71.9%), lichenification(62.5%), and vesicle(43.8%) in descending order. 4. The common aggravating factors were soap or detergent(93.8%), water(90.6%) and rubber glove(25.0%). 5. The most common involved areas of hand eczema were fingers including fingertips and fingertips only. 6. The results of patch test using vegetable allergens with 10 normal controls were all negative. Of the 32 patients with hand eczema, 13(37.5%) showed positive patch test with standard allergens and 5(15.6%) showed positive with vegetable allergens. 7. Among 30 standard allergens, cinnamic alcohol(9.4%). potassium dichromate(9.4%), nickel sulfate(6.3%), and wool wax alcohol(6.3%) were the common allergens which showed positive reactions. Of the 22 vegetable allergens, garlic, Chinese cabbage juice, Chinese cabbage extract, cucumber juice, spinach extract, potato juice showed weak positive reactions in only one patient(3.1%) respectively. From the above results contact sensitivity to vegetables is not significant in Korean housewives with hand eczema.
Age of Onset ; Allergens ; Asian Continental Ancestry Group ; Brassica ; Child ; Dermatitis, Atopic ; Dermatitis, Contact ; Eczema* ; Fingers ; Garlic ; Hand ; Humans ; Nickel ; Patch Tests* ; Potassium ; Prevalence ; Rubber ; Skin ; Soaps ; Solanum tuberosum ; Spinacia oleracea ; Vegetables* ; Wool

Penetrating neck trauma involving tracheobronchial tree is potentially fatal, especially in cases of gunshot injury, which are rare in Korea. A 28-year-old male presenting with an air-leaking gunshot wound in the left supraclavicular area and a 39-year-old female with a full depth penetrating laceration in her chest wall and a pin-point sized cervical wound on the midline below the cricoid cartilage presented with common symptoms of dyspnea and subcutaneous emphysema, and radiologic findings of pneumomediastinum, bilateral pneumothorax and hemothorax, which are key findings suggesting potential major airway injury. Urgent bronchosopic evalution was performed to confirm the suspected diagnosis of tracheobronchial injury, as well as the extent and the level of injury. To exclude associated injury of esophagus and major vascular structures prior to surgical exploration, esophagography and angiography had been carefully planned based on the principles, but were only performed for the second case. Through a low collar incision extending to an mid-thoracotomy incision, the damaged segment of tracheal rings of cervical trachea was resected out and an end-to-end anastomosis was performed for both cases. Extubation was done on the first postoperative day and the chin-to-chest sutures done to minimize the tension at the suture line were maintained until postoperative day 7. Both cases with penetrating injury of cervical trachea regardless of the mechanism of injury were successfully treated by early diagnosis and prompt surgical exploration.
Adult ; Angiography ; Cricoid Cartilage ; Dyspnea ; Early Diagnosis ; Esophagus ; Female ; Hemothorax ; Humans ; Korea ; Lacerations ; Male ; Mediastinal Emphysema ; Neck ; Pneumothorax ; Subcutaneous Emphysema ; Sutures ; Thoracic Wall ; Trachea ; Wounds, Gunshot