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

We reported a case of Norwegian scabies in 14-year-old male with sepsis, pneumonia, pyopneumothorax and auto immune hemolytic anemia which subsequently became a source of ward epidemic of classical scabies, totalling 25 cases including physicians, nurses, other patients in the same ward and their families. The organisms of scabies on the KOH examination began to decrease 3-5 days after treatment, but they were detccted on the nail, elbow and fingerweb 19 days after treatment.
Adolescent ; Anemia, Hemolytic ; Elbow ; Humans ; Male ; Pneumonia ; Scabies* ; Sepsis

Epiderniologic description of the tinea capitis of adults was made for the cases detected in Taegu city for 11 years from January 1978 to December 1988. 1. Totalnumber of adult patients(20 years or older) were 41(2.0%) out of 2,029 cases of all tiena capitis. Among 41 patients, 34 cases were detected between 1983 and 1988. 2. Clinically 24 patients were superficial tinea capitis and 17 patients were kerion celsi. 3. Age of the patients ranged from 21 to 85 years with an average of 58.5 years and mode interval of 61-70 years. Patients over 50 years of age accounted for 70.7% of all csses. 4. Sex distribution of the cases was 39 females(95.1%) and 2 males(4.9%). 5. Causative agents isolated from the patients were Microsporum canis in 36 cases, Trichophyton verrucosum in 2 cases, T. mentagrophytes, T. ferrugineum and T. rubrum in 1 case, respectively. 6. Solitary lesion was most common and alopecia was not prominent in most of the cases. The most frequent site of involvement was frontal and posterior scalp. At initial exarnination, 5 cases were misdiagnosed as seborreic dermatitis and 1 case as multiple folliculitis. 7. Sources of infection were presurned to be cat in ll cases, cattle in 2 cases and the rests were unidentified. Interfarnilial infection was observed in 5 cases.
Adult* ; Alopecia ; Animals ; Cats ; Cattle ; Daegu* ; Dermatitis ; Folliculitis ; Humans ; Microsporum ; Scalp ; Sex Distribution ; Tinea Capitis* ; Tinea* ; Trichophyton

Isolation of Microsporum canis from home environment was carried out for 30 tinea capitis patients infected by M, canis. M. canis was isolated in 84.2-100% of patients caps, mattresses, clothes and pillows and families' clothes. The greatest mean number of M. canis colonies per petri dish was found in the patients pillows and followed by caps, mattresses, outerwear, and underwear. Mean number of M. canis colonies in the clothes of mothers, grandmothers, brothers, sisters and roommates of patients was smaller than that of the M. canis colonies in the clothes of patients but greater than that isolated from the clothes of other family members. Frequency of isolation and mean number of colonies decreased drarnatically after 2 weeks therapy and rarely isolated after 6 weeks therapy. M. canis was isolated in 100% of the house dust of patients. Isolation index was greater in the house dust of patients with concomittant infection of other family members and with lesions of scaly and inflammatory type. M. canis was isolated from cats and goat of patients by the hair brush technique.
Animals ; Beds ; Cats ; Dust ; Fungi* ; Goats ; Hair ; Humans ; Microsporum* ; Mothers ; Siblings ; Tinea Capitis* ; Tinea*

Inverted Papilloma arising from mucous membrane of the nasal cavity and paranasal sinuses is rare benign neoplasm, and usually unilateral arise from lateral wall of nasal cavity. This tumor is histologically benign neoplasm but clinically malignant, because of frequent recurrence and extensive bone destruction. And occasionally, this tumor can be transformed to squamous cell carcinoma or verrucous carcinoma. Recently, we have experienced a case of the inverted papilloma with verrucous carcinoma of the nose and paranasal sinuses and patient expired due to extension of intracranial cavity. We report out case with review of current literatures.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Humans ; Mucous Membrane ; Nasal Cavity ; Nose* ; Papilloma, Inverted* ; Paranasal Sinuses* ; Recurrence

An epidemiological investigation of 878 workers(male 812, female 66) who suffered from low back injury(LBI) in some workplace of Pusan city from January 1 to December 31 in 1992 was carried out to obtain the various informations of the prevention and management in the occupational low back pain(LBP). The results were summarized as follows: 1. The mean age of LBP workers was 39.3±10.4(18-67) in male 48.5±12.6(21-69) in female workers. And the most common age groups were the 4th decade in male and the 6th decade in female workers. 2. In the frequency distribution of LBI according to the kind of industry, manufacturing industry was most frequent, and industry of construction, transport-storage-communication were the next in order. Among manufacturing industry, LBI of metallic products and machinery was the most frequent. 3. The occupational frequency of LBP was technical worker, monotonous worker, driver of automobile, driver of heavy equipment and office worker in order. 4. The cumulative percentage of LBI was 6.9% at the first day of employment and 90.8% until 10 years after employment. 5. The mean working duration from employment to onset of injury was 1081 days(about 2.9 years) and the working duration according to occupation was the shortest in driver of heavy equipment(502 days) and longest in office worker(1982 days). 6. The careless handling of object was the most common cause of LBI, and fall down, slip down, collision and traffic accidents were the next in order. 7. The most common cause of LBI according to occupation was traffic accident in driver of automobile, fall down in driver of heavy equipment and careless handling of object in office worker respectively. 8. The case of localized LBI were 517(58.9%) and the cases of LBI combined with other injuries, such as head, neck, trunk, arm or leg, were 361(41.1%) 9. Lumbar sprain was the most frequent diagnosis of LBI, and Herniated Nucleus Pulposus(HNP) and lumbar fracture were the next in order. 10. In multiple injuries, LBI combined with multiple body injury was the most frequent, and the next was LBI combined with arm and leg, with trunk, with head and with neck in order. 11. LBI combined with multiple body injury was the main injury in fall down, slip down and traffic accident, and lumbar sprain was the main injury in careless handling of object.
Accidents, Traffic ; Arm ; Automobiles ; Back Injuries ; Busan ; Diagnosis ; Employment ; Epidemiologic Studies ; Female ; Head ; Humans ; Leg ; Male ; Multiple Trauma ; Neck ; Occupations ; Spine ; Sprains and Strains

OBJECTIVES: The K-ARS(Korean ADHD Rating Scale) is one of the most important assessment tool of attentiondeficit hyperactivity disorder(ADHD) in Korea. In this study, we presented detailed normative data on the K-ARS for school-aged children in Seoul metropolitan area to put it to practical use. METHODS: The subjects were 2,397 students(1,223 boys and 1,174 girls, aged 6-12) from 4 elementary schools in Seoul, and one caretaker of each child completed the K-ARS for parents. Children who showed high scores of the KARS for parents were screened, and 2 child psychiatrists interviewed them to make a clinical diagnosis. We compared the mean scores of the K-ARS for parents between ADHD and normal group, and examined the percentage of correct classification. RESULTS: There were some differences in score of the K-ARS for parents according to sex and age, so we presented continuous normative data with T score and subdivided cut-off points for ADHD screening. Interviews with child psychiatrists using DSM-IV criteria were performed to test diagnostic validity, and the difference in every the K-ARS for parents index between ADHD and normal group was significant(p<.001). Using 3 different cut-off points(80th, 90th, 93rd percentage), the accuracies of ADHD correct classification were 67.9, 72.2, 71.1% and all 3 canonical discriminants were significant(p<.05) between ADHD and normal group. CONCLUSION: The normative data and cut-off points on the K-ARS for parents are useful in screening ADHD children in Seoul metropolitan area.
Child ; Classification ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea ; Mass Screening ; Parents* ; Psychiatry ; Seoul

Authors evaluated the accuracy of preoperative pelvic CT scan staging and its effects on management in 12 biopsy proved rectal cancer patients. Authors also studied postoperative CT in 5 patients to detect disease recurrence and metastasis. Preoperative CT staging was identical to surgical and/or pathological staging in 9 patients (75%), but it was underestimated in two cases and overestimated in one instance than in surgical stagings. In 7 cases, CT scan did not alter original choice of procedures. However, preoperative CT staging gave definitive informations to change management plans in 5 cases otherwise the treatment would be difficult and inadequate. Postoperative CT showed local recurrence in one and liver metastases in 2 cases. One of them was not detected at exploratory laparotomy.
Biopsy ; Humans ; Laparotomy ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Tomography, X-Ray Computed*

Ketotifen, a benzocycloheptathiophene, has an orally effective antiallergic as well as antihistaminic properties. In pervious studies, Ketotifen has shown encouraging results on patient with allergic rhinitis, either perennial or seasonal. 39 patients with allergic rhinitis had been treated with Ketotifen 1 mg twice daily for 8 weeks. And we obtained following results. 1) The efficacy rate in sneezing attack was 73.5%, in nasal discharge 71%, in nasal obstruction 58%. 2) Some improvements in at least one of three-major symptoms were noted within 1 week in 30.7%, within 2 weeks in 55.8%, within 3 weeks in 66.7%, within 8 weeks in 87.2%. 3) Physical findings such as colour, swelling of turbinate, character of rhinorrhea were not improved significantly. 4) Side effect was observed only in one patient with abdominal pain and diarrhea, which was subsided after interruption of administration. These results suggested that Ketotifen was effective in treatment of allergic rhinitis.
Abdominal Pain ; Diarrhea ; Humans ; Ketotifen* ; Nasal Obstruction ; Rhinitis, Allergic* ; Seasons ; Sneezing ; Turbinates

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic* ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing* ; Toes