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

PURPOSE: The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. MATERIALS AND METHODS: A. uthors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast s0nography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. RESULTS: Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. CONCLUSION: In breast cancer patients under 30 years of age who have palpable breast mass as a initiaJ, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Mammography ; Medical Records ; Physical Examination ; Ultrasonography* ; Ultrasonography, Mammary

PURPOSE: The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest reasonable guideline of breast imaging in breast cancer patients under 30 years of age in whom breast cancer shows different clinicopathologic characteristics compared with breast cancer in older women. MATERIALS AND METHODS: A. uthors reviewed medical records of 27 patients under 30 years of age with pathologically-proven breast cancer. Age, family history, physical examination findings, indications for breast s0nography were reviewed. Cases in whom breast cancer lesion is detectable and cases in whom not detectable using mammography or breast sonography were reviewed. And then, authors evaluated the usefulness of each method and reasons for nonvisualization of lesion on mammography. RESULTS: Among 27 patients, 25 patients had palpable breast mass as indication of mammography and breast sonography. Cancer lesions were detectable in 16 of 25 patients (64%) on mammography and 24 of 25 patients (96%) on breast ultrasonography. Reasons for nonvisualization of cancer lesions on mammography were dense breast with nodular parenchyma pattern and minimal breast change of ductal carcinoma in situ. CONCLUSION: In breast cancer patients under 30 years of age who have palpable breast mass as a initiaJ, and main clinical problem, breast ultrasonography is superior to mammography in detecting and diagnosing breast cancer. We suggest that guidelines can avoid unnecessary mammography in these patients.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Female ; Humans ; Mammography ; Medical Records ; Physical Examination ; Ultrasonography* ; Ultrasonography, Mammary

This study was carried out to investigate the heavy metal contents and their correlations between paddy soil and brown rice near the Kum-River area. In this study, eighty soil samples and forty brown rice samples were taken from the paddy soil. The contents of heavy metals were measured by flame atomic absorption spectrophotometry. The results were as follows: 1. The average contents of soluble heavy metals in surface soil were Cd 0.19, Cu 15.31, Zn 18.10 and Pb 9.08 ppm. The average contents of soluble heavy metals in subsurface soil were Cd 0.19, Cu 14.52, Zn 17.75 and Pb8.11 ppm. There wan no statistically significant difference between the two layers. 2. The contents of Cu, Zn and Pb of Taejeon(S6) and Cd of Sinbyung(S5) in surface soil were higher than those of other areas. The contents of Cd and Cu of Taejeon(S6) and Zn and Pb of Kumnam(S3) in brown rice were higher than those of other areas and four heavy metals in soil and brown rice of Simchon(S7) were lower than those of other areas. 3. The ratio of soluble contents(Cd : Cu : Zn : Pb) in surface soil was 1 : 79 : 93 : 47, that of soluble contents in subsurface soil was 1 : 79 : 94 : 43, and that of total contents in brown rice was 1 : 84 : 294 : 12. 4. The correlations of the content between soluble heavy metals in surface(0-15 cm depth) soil total heavy metals in brown rice was found to be order of Cd>Cu>Zn>Pb. The correlations of the content between soluble heavy metals in subsurface(20-30 cm depth) soil and total heavy metals in brown rice was found to be order of Cu>Cd>Zn>Pb.
Metals, Heavy ; Rivers* ; Soil* ; Spectrophotometry, Atomic

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

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

We reported herein a rare case of a 65-year-old female who lead intestinal tuberculosis of about 2 months duration, with little late development of metastatit berculosis abscess of the skin. The lesions were egg tow wolnut-sized abscesses or nodules occu in, on the back, right flank and lower abdomen with no pain or mild tenderness. Physical exami saion was unremarkable on dissemination of other sites. The tuberculin test was negative. The skin esions were diagnosed by clinical, histopathologic features, and positive results for Mycobactc iuntuberculosis in smear.; and cultures in the pus discharge: as well as polymerase chain reaction nethod on the nodular lesion. A barium enema showed the findings of intestinal tuberculosis, with positive culture in the stool. A combined treatment was intituted. During the initial 4 month, utaneous lesions did not respond and in some cases worsened with the multidrug of isoniazicr fampin, pyrazinamide and streptomycin, all of which were surgically excised. Thereafter, the drugs of isoniazid and rifampin were further administered for ahout 14 months, with the complete resecution of both lesions and the systemic symptomatolo. There was no relapse at follow-up after 6 months.
Abdomen ; Abscess* ; Aged ; Barium ; Enema ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Ovum ; Polymerase Chain Reaction ; Pyrazinamide ; Recurrence ; Rifampin ; Skin* ; Streptomycin ; Suppuration ; Tuberculin Test ; Tuberculosis*

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

We report a case of giant cell tumor of the tendon sheath in a 36-year-old male, who presented an asymptomatic, firm, 1.0 × 0.8 × 0.4cm-sized nodule, involving the volar aspect of the distal phalanx of the right index finger about 1 year ago. Histopathologically, the enucleated lesion showed four lobules surrounded by thin connective tissue, each of which demonstrated the variable cellularity and the polymorphic cell population consisting of foam cells, spindle-shaped fibroblasts, histiocyte-like cells and multinucleated giant cells with heavy hemosiderin deposits near the periphery, in the collagenous stroma. He has done well with no recurrence during one year of follow-up since the operation.
Adult ; Collagen ; Connective Tissue ; Fibroblasts ; Fingers ; Foam Cells ; Follow-Up Studies ; Giant Cell Tumors* ; Giant Cells* ; Hemosiderin ; Humans ; Male ; Recurrence ; Tendons*

No abstract available.
Pyelonephritis, Xanthogranulomatous*