The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

No abstract available.
Nasal Bone*

BACKGROUND AND OBJECTIVES: Cholesteatoma is a disease of the temporal bone, affecting the squamous epithelium and invading into the middle ear cavity. Retinoic acid (RA) is known to inhibit or accelerate the proliferation of normal keratinocytes depending on its concentration. This study was aimed at investigating the effects of different concentrations of RA on the proliferation of cultured keratinocytes from the external ear and cholesteatoma and whether the effect is different according to the origin of tissue. MATERIALS AND METHODS: Patients undergoing tympanomastoid surgery for cholesteatoma were selected, and cholesteatoma matrix and skin were obtained from their middle ears and external ears, respectively. After culturing keratinocytes from the external ear and cholesteatoma, cells were cultured for 7 days in the medium 154 (Cascade, USA), and 10(-6)M RA or 10(-7)M RA was added twice every three days. The control group was cultured without the addition of RA. The absorbance was estimated at 490 using CellTiter 96(TM)AQ(ueous) Non-Radioactive Cell Proliferation Assay, nm and the survival fraction was calculated and compared with the control group. RESULTS: Proliferation of keratinocytes from the external ear and cholesteatoma was inhibited when the concentration of RA was 10-6 M and accelerated when the concentration of RA was 10(-7)M. The accelerated effect of retinoic acid on the proliferation of keratinocyte seems to be less prominent in the cholesteatoma tissue than in the skin of normal ear canal. CONCLUSION: Retinoic acid can inhibit or accelerate the proliferation of cholesteatoma keratinocytes dependining on its concentration.
Cell Proliferation ; Cholesteatoma* ; Ear Canal ; Ear, External* ; Ear, Middle ; Epithelium ; Humans ; Keratinocytes* ; Skin ; Temporal Bone ; Tretinoin*

Fingertip injuries represent the most common type of injuries were seen in the upper extrimity. Reconstruction of a injured digit needs good aesthetic result as well as functional recovery. From August 1994 to August 1996, sixty two digits in the fifty four patients were treated by using the reverse digital island flaps. The age of the patients ranged from 13 to 64 years. We reviewed the medical records of our cases and analyzed them in several aspects. Majority of the cases (79%) were covered primarily. Neurorrhaphy was performed in 26 digits (42%). The survival of these flaps was successful in all cases except one case. The mean values of the static two point discrimination in sensate and nonsensate flaps were 6.5 mm and 10.3 mm retrospectively. In this study, venous congestion was the most common early complication (9.6%). Arterial insufficiency and flap loss (6.4%) were the troublesome early complications. Bulky mushroom shaped flap (24.6%), scar contracture (6.4%), paronychia (8.2%), cold intolerance (9.6%), hyperesthesia (3.2%) and flap atrophy (4.8%) were the late complications. In conclusion, despites of its complications, reverse digital island flap provide durable skin cover, superior aesthetic result and excellent sensory restoration.
Agaricales ; Atrophy ; Cicatrix ; Contracture ; Discrimination (Psychology) ; Humans ; Hyperemia ; Hyperesthesia ; Medical Records ; Paronychia ; Retrospective Studies ; Skin ; Surgical Flaps

A clinical observation was made on 38 patients with the suspicion of prostatic cancer in the department of urology, St. Mary's Hospital during the period from January, 1969 to December, 1978. The results are as follows. 1. The most prevalent age was from 60 to 69 (44.7%) 2. Among 38 cases of the transrectal needle biopsy, the adequate tissues for the histologic diagnosis were obtained in 34 cases. 3. Of 34 cases whose tissue were obtained adequately by the needle biopsy, 22 cases were diagnosed the malignancy of prostate. 4. Among 38 cases of the transrectal needle biopsy, the fever were developed in 4 cases and the rectal bleeding in one case.
Biopsy, Needle* ; Diagnosis ; Fever ; Hemorrhage ; Humans ; Needles* ; Prostate ; Prostatic Neoplasms ; Urology

Allopurinol is a xanthine oxidase inhibitor widely used to control plasma uric acid levels. Serious and life threatening adverse effects such as the allopurinol hypersensitivity syndrome(AHS) are rare. We describe a 32-year-old female patient who was treated with allopurinol and developed fever, rash, and renal and liver dysfunction.
Adult ; Allopurinol* ; Exanthema ; Female ; Fever ; Humans ; Hypersensitivity* ; Liver Diseases ; Plasma ; Uric Acid ; Xanthine Oxidase

In order to assess the efficiency of Percoll gradient centrifugation(PGC) as a method of sperm selection, we have examined morphological characteristics of spermatozoa from 40 teratozoospermic patients attending the Infertility Clinic of Inchon Gil Gerneral Hospital. Patients were divided into three groups according to percentage normal morphology in the fresh sample : group A(n=5), < 5% normal morphology : group B(n=21), 5~14% normal morphology : and group C(n=14), > 14% normal morphology. Morphology slides were perpared using Diff-Quik staining techniques and evaulated by Kruger strict criteria, under oil immersion at a magnification of X 1000, specific defects, head, neck and tail were assesed individualy. The results were as follows. 1. Following PGC, sperm samples with enhanced morphology were recovered for all groups. 2. For group A, PGC did not select a sample with significantly improved morphological characteristics. 3. Usually, sperm defects affected by PGC was head and neck. No significant difference was found for tail abnormality. In conclusion, Percoll gradient centrifugation is an efficient sperm preparation technique when the semen sample exhibits teratozoospermia, especially head or neck abnormality. However, in sample with < 5% normal form or tail abnormality, There is not significant improvement following PGC.
Centrifugation* ; Equidae ; Head ; Humans* ; Immersion ; Incheon ; Infertility ; Neck ; Semen ; Spermatozoa*

Inflammatory polyposis of the colon is rare portion of the colon polyp entity. We experienced three patieats who suffered from colitis of unknown'etiology and discovered membranous retkular with/ without filiform polyp in the distal sigmoid colon of the them. Case 1, 56-year-old female, combined with basaloid cercinoma of the rectal canal that confirmed by pathology after abdominoperineal resection. So we obtained specimen of inflammtory polyp end tried to evaluate the mechanism of it. We found healed ulcer under the mucosal bridge. Case 2. 55-year-old male, had been suffered from irritable bowel syndrome. Prior to visit outpatient clinic, he complained tenesmus with diarrhea for a week. Inflammatory polyp was discovered by colonoacopy but his symptoms relieved by tranqulizers only. Case 3. 57-year-old male, has been a good health. He undertook colonoscopy for routine check thst revealed membranous reticular with filiform inflammatory polyp from distal sigmoid colon to hepatic flexure. Such shape of inflammatory polyp was not documented in Korea, so we reported three cases of it with review of the literature.
Ambulatory Care Facilities ; Colitis ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Female ; Humans ; Irritable Bowel Syndrome ; Korea ; Male ; Middle Aged ; Pathology ; Polyps* ; Ulcer

The allopurinol hypersensicivity syndrome is a rare, but life thereaning immunologic reaction of allopurinol therapy, characterized by multiple abnormalities such as fever, rash, decreased renal function, hepatocellular injury, leukocytosis, and eosinophila. It may require prolonged hospitalization and occasionally involves residual morbidity. Three patients developed erythematous skin eruption three to five weeks after beginning therapy with allopurinol. The clinical, laboratory, and histologic findings of these patients were compatible with a allopurinol hyperensitivity syndrome.
Abnormalities, Multiple ; Allopurinol* ; Exanthema ; Fever ; Hospitalization ; Humans ; Hypersensitivity* ; Leukocytosis ; Skin