Intralesional belomycin injection has been an effective treatment of recalcitrant warts since 1970. A 1 U/ml solution of bleomycin sulfate in normal saline or lidocaine solution was injected intralesionally in 72 warts of 33 patients on the hands, forearm, feet, and face. Dosage of bleomycin was dependent on the size of warts, usually 0.1 to 0.15 cc of solution. All patients was permitted to wash the treated area without care. 59 (81.9%) of 72 warts were cured after one injection, 12 (16.7%) warts after two or three bleomycin injections. One large wart was not cured. Most patients experienced minimal painful discomfort for two to three days after one to two days of injection, but did not take the analgesics. There was no evidence of systemic and local toxicities. The most responsive warts shoed hemorrhagic black eschars that separated after 2 to 3 weeks and healed with very little or no scar tissue. Intralesional bleomycin injection is a reliable and useful alternative for the treatment of warts.
Analgesics ; Bleomycin* ; Cicatrix ; Foot ; Forearm ; Hand ; Humans ; Injections, Intralesional ; Lidocaine ; Warts*

No abstract available.
Burns* ; Congenital Abnormalities* ; Free Tissue Flaps*

Neomorphogenesis of cartilage using chondrocyte-polymer constructs is a potential source for development of cartilage reconstruction. Current tissue engineering techniques of neocartilage rely on in vivo implantation of polymer-chondrocyte constructs. The purpose of this study was to find a way to bioengineer cartilage in vitro by entrapping chondrocytes in a molded autologous fibrin glue. Chondrocytes isolated from the cartilage of rabbit joints were combined with fibrinogen extracted by a single cryoprecipitation of autologous plasma, and they were then polymerized with thrombin to create a fibrin glue with a final cell density of 2.5x10(6) cells/ml. The collagen for a control study was used as a polymer. The polymer-chondrocyte constructs were cultured for 4 weeks and the fibrin-chondrocyte constructs molded in the shape of a human ear were cultured for 6 weeks in vitro. Morphometric, histochemical, and histomorphometric analysis including glycosaminoglycan quantitation confirmed the following results: 1) Highly-concentrated autologous fibrinogen was easily extracted by a single cryoprecipition of autologous olasma. 2) The fibrin-chondrocyte constructs demonstrated the presence of actively proliferating chondrocytes with the production of cartilaginous matrix(collagen and glycosaminoglycan) at 1 week after culture, as well as gross and histologic evidence similar to those of normal cartilage at 3-4 weeks after culture. 3) The collagen-chondrocyte constructs demonstrated lower degrees of hardness and transparency, as well as a lower density of cells and glycosaminoglycan during the culture period. 4) Neocartilage generated from fibrin-chondrocyte constructs in the shape of a human ear nearly retained their original configuration and size without degeneration for 6 weeks of culture in vitro. This study demonstrated a novel method for bioengineering the molded cartilage in vitro using autologous fibrin glue as a matrix scaffold. The generated cartilage showed gross and histologic evidence similar to those of normal cartilage, retaining the original gross dimension. With further refinement, this may be a new application of tissue engineering for the reconstruction of cartilage.
Bioengineering ; Cartilage* ; Cell Count ; Chondrocytes* ; Collagen ; Ear ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Fungi ; Hardness ; Humans ; Joints ; Plasma ; Polymers ; Thrombin ; Tissue Engineering*

Raynaud's phenomenon manifests as triphasic color change episodes of blanching, cyanosis, and reddening of the digits, induced by exposure to low temperature or emotional stress. It is a relatively common disorder, estimated to affect 5-10% of the general population and 20-30% of otherwise healthy women. Most cases of primary Raynaud's phenomenon also called Raynaud's disease, are mild and self-limited. Secondary Raynaud's phenomenon presents as a secondary manifestation of an underlying disease and are complicated by ulcerations and tissue necrosis. From March 1996 to August 1998, we experienced 4 patients with Raynaud's phenomenon. Two patients were diagnosed Raynaud's disease and the other two were secondary. Raynaud's disease responded to drug therapy and sympatetic ganglion block. Secondary Raynaud's syndrome was treated with vein graft and free tissue transfer. During postoperative follow-up of 33-49 months, both severity and symptomatic intervals were improved.
Cyanosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Necrosis ; Raynaud Disease ; Stress, Psychological ; Transplants ; Ulcer ; Veins

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

Explosive burns following inhalation of butane gas rarely occurred in the past, but recently it has brought about a social problem among groups of teenagers. This constitutes 1.6% of admissions due to flame burn in the burn unit of Hallym Medical Center. A retrospective review during a five-year period identified 48 patients. The male to female ratio was 3:1. The mean age was 16 years and 8 months. The place of accidents were commonly bedrooms or motel rooms. There were nine group settings of 27 patients at the time of the accident. The pneumothorax(n=3) and respiratory difficulty(n=12) were noted on admission. The average burn area was 28.5% of the total body surface area. All patients sustained burn injury on the face, arms and hands, and 24 patients among them had extended burn areas on the trunk and/or lower extremity. Twenty-two patients(mean hospital stay; 51.6%) required skin grafting, and 12 patients (mean hospital stay; 22.3 days) were treated with conservative management. The mortality rate was 10.4 percent. Explosive burns following inhalation of butane gas can result in mortality as well as major burn injuries.
Adolescent ; Arm ; Body Surface Area ; Burn Units ; Burns* ; Female ; Hand ; Humans ; Inhalation* ; Length of Stay ; Lower Extremity ; Male ; Mortality ; Retrospective Studies ; Skin Transplantation ; Social Problems

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic change after scar revision is not uncommon. It has been done intramarginal excision to diminish the chances of recurrent hypertrophic scarring. Core scars in the auricle are easily separated from auricular cartilage and overlying soft tissue because there is loose areolar tissue between them. We therefore reviewed our experience with core extirpation of post-burn hypertrophic scars in the auricle. Between June 14, 1991, and August 6, 1994, we excised 10 hypertrophic scars in the auricle in 5 burn patients. Core extirpations of hypertrophic scars were performed under local anesthesia with longitudinal incision along long axis of scars. The wounds were closed directly in one layer after marginal trimming. We observed that core extirpation yielded good results in post-burn hypertrophic scars in the auricles.
Anesthesia, Local ; Axis, Cervical Vertebra ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Ear Cartilage ; Humans ; Recurrence ; Wounds and Injuries

Diabetic and nondiabetic vascular diseases cause significant foot problems and it frequently progress to osteomyelitis and amputation. Advances in vascular surgical techniques, including distal arterial bypass via synthetic grafts or autogenous vein grafting have opened the way for higher rate of limb salvage. We have experienced patients with ischemic vascular foot disease and combined skin ulceration and varing degree of soft tissue defect. In three patient with major vessel obstruction, we could preserve limb and avoid major amputation using greater saphenous vein graft with or without microvascular free tissue transfer.
Amputation ; Extremities ; Foot Diseases ; Foot* ; Humans ; Limb Salvage ; Osteomyelitis ; Saphenous Vein ; Skin Ulcer ; Transplants ; Vascular Diseases ; Veins

The operative treatment of orbital blowout fracture involves restoration of intra-orbital soft tissue and bony structural integrity. In extensive blowout fracture, postoperative edema and subsequent increase of intraoribital pressure may sometimes lead to displace the implant. To prevent postperative displacement of the implant, we tried reinforcing the implant using a buttress consisting of micro-titanium mesh and titanium mesh in 13 cases of extensive orbital blowout fracture, including medical wall fracture (6), inferior wall fracture (5) and inferomedial wall fracture (2). A small thin titanium buttress was inserted beneath the implant at the point where intraorbital pressure was involved maximally. It was usually placed superoinferiorly in a medial wall fracture wall fracture, mediplaterally along th posterior ridge of bony defect in an inferior wall fracture, and anteroposteriorly in an inferomedial wall fracture. No evidence of implant displacement after operation was noted in any cases and this was confirmed by postoperative computed tomographic scan. Also, any complication by a titanium buttress did not occur. Orbital implant reinforcement using a titanium buttress may be an available technique for preventing implant displacement in reconstruction of extensive orbital blowout frature.
Edema ; Orbit* ; Orbital Implants ; Titanium*

A prospective study was done to evaulate the dfficacy of Silon-STS application on problemed scars. Silon-STS is one of various methods for the treatment of problemed scar. It is supplied in flat sheets composed of inner silicone layer and outer acrylic plate. It was pre-heated with an gas lighter and shaped over a mold of the anatomical region to be splinted. Silon-STS had been applied to 45 patients with hypertrophic scar, trapdoor, scar, irregular elevated scar, and keloid for 2 to 6 months. Color changes and thickness of the scars were evaluated by serial photography. Customory forming techniques to shape Sion-STS followed by trimming and strap attachment can also be used. The results have been successful in 43 cases(96%). Skin rash, pruritis were complained by two patients. Silon-STS application has been an effective method for the treatment of problemed scars in our experience.
Cicatrix* ; Cicatrix, Hypertrophic ; Exanthema ; Fungi ; Humans ; Keloid ; Photography ; Prospective Studies ; Pruritus ; Silicones* ; Splints