Soft tissue reconstruction of the hand remains a challenge for the hand surgeon, who must choose whether to use a local flap, a distant flap or a free flap. Local flaps, derived from tissue immediately adjacent to the primary defect, are the first choice. But there is a shortage of skin in the hand and there are regions of the hand that should not be used as donor sites since cover of the resultant secondary defect with a skin graft would be inappropriate. We used island flaps for the small soft tissue defects in the hand which were difficult to cover with a conventional skin graft or local flap. The results were as follows; 1. The causes of the soft tissue defects were traumatic amputation in 4 cases, camptodactyly in 4 cases, replantation in 3 cases, infection in 3 cases and tumor in 1 case. 2. The sites of the soft tissue defects were thumb tip in 6 cases, fifth finger PIP joint volar aspect in 3 cases, index tip in 2 cases, thumb volar and dorsal surface in 2 cases, third and fourth MP joint dorsal surface in 1 case, fourth finger PIP joint volar aspect in 1 case and first interdigital web space in 1 case. 3. The donor flaps were fourth finger neurovascular island flap in 8 cases, reverse dorsal matacarpal flap in 5 cases and first dorsal metacarpal artery flap in 4 cases. 4. The sizes of the flap were from 1. 0×1. 5cm to 2.0×4.0cm and and average of 1.5×2.0cm. 5. The flaps were survive completely with a touch sensat,ion except 2 cases which were covered by reverse 5th dorsal metacarpal flap.
Amputation, Traumatic ; Arteries ; Fingers ; Free Tissue Flaps ; Hand ; Humans ; Joints ; Replantation ; Skin ; Surgical Flaps ; Thumb ; Tissue Donors ; Transplants

The sequential use of ⁹⁹mTc-methylene diphosphonate(⁹⁹mTc-MDP) and ⁶⁷Ga imaging is thought to be useful to diagnose acute hematogenous osteomyelitis, and to determine whether it is active or inactive in chronic osteomyelitis. We compared the results obtained by the sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging with those obtained by the surgical culture and biopsy in 31 patients who were supposed to have the osteomyelitis and admitted to Pusan National University Hospital from July 1987 to July 1989. The results were as follows:l. According to the diagnosis at discharge, 4 cases were normal, 20 cases active osteomyelitis, and 7 cases inactive osteomyelitis. 2. Four normal cases were negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. Twenty cases of active osteomyelitis showed positive results both with 99mTc-MDP and with ⁶⁷Ga. And of 7 cases of inactive osteomyelitis, 6 cases showed positive ⁹⁹mTc-MDP and negative ⁶⁷Ga, 1 cases was negative both with ⁹⁹mTc-MDP and with ⁶⁷Ga. 3. It is suggested that in active osteomyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga were positive, in inactive osteomyelitis ⁹⁹mTc-MDP positive and ⁶⁷Ga negative and in normal or wastive ostemyelitis both ⁹⁹mTc-MDP and ⁶⁷Ga negative. 4. The sequential use of ⁹⁹mTc-MDP and ⁶⁷Ga imaging was particularly useful to diagnose acute hematogenous osteomyelitis in the case of the obscure diagnosis and supposedly normal radiological finding and to determine whether chronic osteomyelitis is active or complicated by an acute flare-up.
Biopsy ; Busan ; Diagnosis ; Humans ; Osteomyelitis ; Technetium Tc 99m Medronate

No abstract available.
Hip Joint* ; Hip*

No abstract available.
Hyperostosis, Sternocostoclavicular*

We, at Department of Orthopedic Surgery, College of Medicine, Pusan National University, applied epiphyseal distraction as a method of limb lengthening, using unilateral one-plane pin fixator(ORTHOFIX) and bilateral multi-plane ring fixator(SEQUOIA) to three children with limb length discrepancies and angulation deformity due to injury of epiphyseal plate, and obtained following results. l. At first case, on whose distal femoral physis, bone bridge occupied about 20% of total epiphyseal plate and distributed mainly on the lateral side. At 10 days of distraction, epiphysiolysis occurred from the lateral side at first and angulation deformity was corrected. Epiphysiolysis on the medial side of physis appeared apparently after 60mm distraction. Bone lengthening of 4.2cm and correction of 25 valgus deformity were achieved after 72mm distraction for about 10 weeks. The percentage of increase in the initial length achieved was 11.67% and healing index was 27.86. 7 months later, loss of lengthening of 2.7cm was observed and it was considered that this was due to relatively short corticalization phase. 2. At second case, on whose distal tibial physis, bone bridge occupied about 40% of total epiphyseal plate and distributed on the medial side. At 10 days of distraction, epiphysiolysis occurred on the medial side of the epiphyseal plate, but not on the lateral side and instead of further lengthening, valgus deformity of the ankle appeared. It was thought that asymmetric distraction was attributed to the difference between the force applied on the medial side and that applied on the lateral side of the epiphyseal plate by unilateral one-plane pin fixation. 3. At third case, on whose distal tibial physis, bone bridge occupied about 75% of total epiphyseal plate. No epiphysiolysis occurred. there was a difficulty in observation of epiphysiolysis because ring fixator was overlapped with the epiphyseal plate on radiographs.
Ankle ; Bone Lengthening ; Busan ; Child ; Congenital Abnormalities ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Methods ; Orthopedics

The authors studied organic brain syndrome, using organic brain syndrome scale of the Diagnostic Interview Schedule for DSM-Ⅲ, in the subjects of 65 males and 231 females at the homes for the aged in the Taegu and Kyong-buk areas. The authors collected the data during the period from June to August, 1986, and applied ANOVA and x²-test in order to compare various psychologic factors in relation to the organic brain syndrome. The results could be summarized as follows: The elderly males (15%) showed high OBS scores of 12 and over, while ninety elderly females (39%) showed the same scores. Among those psychosocial factors, age, education, birth place, occupation, religion, history before institutionalization are significantly related to the OBS scores.
Aged* ; Appointments and Schedules ; Brain* ; Daegu ; Education ; Female ; Homes for the Aged ; Humans ; Institutionalization ; Male ; Occupations ; Psychology ; Residence Characteristics

After bone damage of the fetal rat femurs induced by administrating cyclophosphamide(CP),(1/8 LD50) to the pregnant rat on 13th day of gestation, the effects of serum and ascorbic acid on the repair process of the bone during organ culture were studied, histologically and scanning electron microscopically. CP-damaged fetal femurs harvested at 20 days of gestation were cultured fro 2, 5 and 7 days in the waymouth media(WM) with or without fetal bovine serum(FBS) and ascorbic acid, and were observed with light microscope and JSM-35C scanning electron microscope. The results were as follows:1. CP-damaged bone tissue cultured in WM with 10% FBS showed relatively enhanced activities in the differentiation of chondrocytes and ossificstion as compared to that cultured in WM. 2. CP-damaged bone tissue cultured in WM with 10% FBS and 100µg/ml ascorbic acid, showed increase in the length of the bone marrow cavity, and active formation of new osteoid and collagen bundles. 3. The bone tissues cultured in WM with 10% FBS and 400µg/ml ascorbic acid revealed active deposition of bone matrix, thickening of periosteum and marked elongation of the bone marrow cavity. 4. Bone trabeculae of CP-damaged femurs cultured for 2 days in WM showed poor cell proliferation and insignificant bone matix formation. 5. The number of new cells and the amount of the collagen fibrils increased on the bone trabeculae of the bone cultured in WM with 10% FBS as compared to that cultured in WM and this increase was enhanced as the culture time progressed. 6. A remarkable increase was noted in the number of cells and collagen fibrils in the bone tissues cultured in WM with 10% FBS and ascorbic acid than in those cultured in WM with 10% FBS. 7. The number of the spherules formed by cellular component with collagen fibrils is more numerous than that formed by calcospherites associated with collagen fibrils.
Animals ; Ascorbic Acid ; Bone and Bones ; Bone Marrow ; Bone Matrix ; Cell Proliferation ; Chondrocytes ; Collagen ; Cyclophosphamide ; Femur ; In Vitro Techniques ; Organ Culture Techniques ; Periosteum ; Pregnancy ; Rats

No abstract available.
Child* ; Humans ; Humerus*

Hemolytic disease of newborn due to Rhesus incompatibility occurs mostly by anti-Rh(D) antibodies. But recently, because of Rh(D) immune globuin prophylaxis, Rh(D) incompatibility is decreased and importance of minor group incompatibility is increasing. The majority of minor blood group incompatibilities are anti-c, anti-E or anti-Kell, but hemolytic diseases caused by combination of these antibodies are relatively rare. The 21 day-old male neonate was admitted because of pallor and poor feeding for 2 days. Laboratory data showed severe normochromic and normocytic anemia with increased reticulocyte and bilirubin. Patient's and his mothers blood type was B, Rh(D) positive. Minor blood groups of mother's and sons were different and anti-c and anti-E antibody were detected in mother's serum. After transfusions of two times with anti-c and anti-E free B, Rh(D) positive blood, the baby was discharged at 11th hospital day with good general condition.
Anemia ; Antibodies ; Bilirubin ; Blood Group Antigens ; Blood Group Incompatibility ; Erythroblastosis, Fetal ; Humans ; Infant, Newborn* ; Male ; Mothers ; Pallor ; Reticulocytes

A case of crotamiton resistant scabies is described in a 21-year-old male patient The scrapings using mineral oil from lesions on the wrist and finger webs showed mites and eggs, typical of scabies. Ten percent crotamitn cream was applied 10 times in one month without any effect. We could not find any source of reinfection in the patient. After above treatment the scrapings still showed mites. and eggs. Retreatment with 1% gamma benzene hexachloride cream was effective in clearing of the skin rashes and itching sensation.
Eggs ; Exanthema ; Fingers ; Humans ; Lindane ; Male ; Mineral Oil ; Mites ; Ovum ; Pruritus ; Retreatment ; Scabies* ; Sensation ; Wrist ; Young Adult