No abstract available.
Coronary Vessels* ; Mammary Arteries* ; Transplants*

No abstract available.
Arthroplasty* ; Knee*

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Humans* ; Sarcoma, Kaposi*

Cutis verticis gyrata(CVG) is an unusual conformation of the scap characterized by the presence of folds and furrows due to thickening of the corium and the subutlneous tissue. In sccordance with etiological factor and associated findings, CVG occurs as primarary disease or secondary to a variety of local or systemic diseases. Cerebriform intradermal nevus(CIN) is a cause of CVG that can usually be recognized clinically and for a certainty histologically. We report two cases of CVG due to CIN. Not only did they have CVG due to CIN on the scalp, but also they had associated congenital nevi on the face and whole boispy, respectively.
Dermis ; Nevus ; Nevus, Intradermal* ; Scalp

CT findings of seventy seven cases in sixty six patients were compared with the conventional radiographicfindings to evaluate the utility and the merits of the high resolusin CT in trauma, The resuls were as follows: 1.CT was helpful in the management in 50 cases(64%) of total 77 cases. 2. CT was useful in detection and evaluationof traumatic lesion in shoulder, wrist and ankle as well as spine, pelvis, hip and knee. 3. In difficultdiagnostic dilemas in trauma of the bones and the joints with the complex anatomy, CT should be consideredroutinely when appropriate.
Ankle ; Hip ; Humans ; Joints ; Knee ; Pelvis ; Shoulder ; Spine ; Wrist

Cryoglobulinernia occurs in about 5% of the cases of multiple myeloma. The most common finding in patient with cryoglobulinemia is ulceraticn that oceurs about ankle, hands, and occasionally the ears, upon prolonged exposue to cold. A 59-year old male had had 5 years of pain in his ears. There were black or dark brown colored ischemic ulcerations on his both helix. He also had mottled purpuric patches on his both ankles. A test for cryoglobulinema was positive. X-ray examination of the skull showed multiple punched but lesions. The bone marrow study revealed myeloma cell infiltration.
Ankle ; Bone Marrow ; Cryoglobulinemia* ; Ear ; Hand ; Humans ; Male ; Middle Aged ; Multiple Myeloma* ; Skull ; Ulcer

In a consecutive series of 15 patients with unstable C1,2 cervical spine injuries treated with halo vest, 1992-1996, a total 7 patients (comprising 46%) among the patients with C1,2 cervical spine injuries, had odontoid fractures, no patient had neurologic injury. In all cases, initial treatment was Halter or skull traction for 1-2weeks. In the vitally stable state, they were stabilized with halo vest for 12-16 weeks. In 2 cases of C1,2 instability, initial treatment was internal fixation and halo vest for the same time. 2 cases of the patients, who were treated with halo vest, had additional posterior wiring and fusion due to instability checked after removal of halo vest. There was no other serious complications during the treatment. One case (25%) of 4 Anderson-d' Alonzo type II fractures was failed to unite. The halo vest was well tolerated in all patients and assured a high percentage of healing. Flexion-extension motion was measured with dynamic lateral cervical tomography. The age range was 17-67 (mean 41.3) years and male/female ratio was 3/2. Complications during the treatment were pin loosing (1 case) and halo vest frame breakage due to falling down. Pain on motion and stiffness of neck were the most frequently remained symptoms. But the symptoms were mild and did not usually have any major impact on return to work or leisure activities.
Humans ; Leisure Activities ; Neck ; Return to Work ; Skull ; Spine* ; Traction

In spite of the many improvements in arthroscopic surgical techniques for the treatment of mild to moderate degree degenerative joint diseases which were resistant to conservative treatment, the results are variable, showing a tendency to decline in therapeutically following the passage of time. Using a 2.1 un holmium: YAG laser we operated on patients with mild to moderate degenerative joint diseases which had not improved through conservative treatment. We evaluated the results of arthroscopic laser surgery for degenerative joint disease and investigated the proper indication and complications of laser surgery. We operated on 28 knees of 28 patients between July 1995 and June 1996. There were 16 females and 12 males. The average follow-up period was 16.3 months and the average age was 54.5 years. Under epidural or general anesthesia, we used arthroscopic tools, including laser, and the laser power was modified according to the type of operation (chondroplasty: 1.0Jx20pulse/sec, meniscectomy: 2.0Jx15pulse/sec, bone drilling: 2.5Jx10 pulse/sec). We used Bauer & Jackson's classification of articular cartilage change, and performed 12 laser chondroplasties in grade II, III, V lesions, 16 chondroplasties and laser bone drilling in grade IV, VI lesions, 16 laser meniscectomies, 6 laser synovectomies and 2 lateral retinacular releases. Medial femorotibial arthritis was the most common site. Postoperative results by Orgilvis-Harris & Fitsialos's methods indicated that 82% of treated patients were satisfied and only two patients (7%) did not improve. As a postoperative complication, eight patients complained of postoperative effusion which was subsided by medication and physical therapy. We performed second-look arthroscopic examinations in four knees that had been treated with laser chondroplasy and drilling. Regenerated tissues at the operated site were observed in three cases, but denuded articular cartilage and naked subchondral bone at the operated site were found in one case as a sign of osteonecrosis. Concluding this short-term study, 2.1 holmium: YAG laser in arthroscopic surgery seems to be effective in mild to moderate degenerative joint disease but care should be taken to avoid thermal injuries to the adjacent normal cartilages.
Anesthesia, General ; Arthritis ; Arthroscopy ; Cartilage ; Cartilage, Articular ; Classification ; Female ; Follow-Up Studies ; Holmium* ; Humans ; Joint Diseases ; Knee Joint* ; Knee* ; Laser Therapy ; Lasers, Solid-State* ; Male ; Osteoarthritis* ; Osteonecrosis ; Postoperative Complications ; United Nations

It is well known that fractures around the knee joint are usually combined with ligament injuries but it is easy to miss the ligament injuries during the treatment of fractures. The invention of the MRI and the development of arthroscopic techniques has made it easy to diagnose and care for ligament injuries. Authors reviewed the patients who had fractures around the knee joint to evaluate the frequencies, types, treatments and the results of combined ligaments injuries. There were 57 cases with the fracture of the proximal tibia and fibula which could be follwed up at least one year: from January 1992 to June 1995. There were 19 cases (33%) which had combined ligament injuries. The ligament injuries were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Single lateral rim avulsion fracture of proximal tibia was the most common type of fractures (7 cases, 37%). There were 11 cases (57%) of combined injuries of anterior cruciate ligament and medial collateral ligament. It was the most common combined ligament injury. Except for one, eleven cases that were combined with lateral rim avulsion of proximal tibia had anterior cruciate ligament injury. There were ten cases (53%) of fibula head and neck fractures which were combined with ligament injuries. The total number of the injured ligament was 35 and the common rupture sites of the injured ligaments was the attachment site of femur (13 cases) and tibia (16 cases). There were seven meniscal injury cases (37%). The interval from injury to operation averaged 14.1 days because many cases were acute injuries. Primary repairs for ruptured ligament were done in 31 cases (88%) because of their attachment site injuries. There were no instabilities except one case which was treated with posterior cruciate ligament reconstruction using semitendinosus ligament. It had a grade I posterior instability at the last follow-up. Early diagnosis and proper treatment on the ruptured ligaments and the torn meniscus combined with proximal tibia and fibular fractures seem to be important for a good prognosis.
Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Femur ; Fibula* ; Follow-Up Studies ; Head ; Humans ; Inventions ; Knee ; Knee Joint ; Ligaments* ; Magnetic Resonance Imaging ; Neck ; Posterior Cruciate Ligament ; Prognosis ; Rupture ; Tibia*