The provision of adequate soft tissue cover for a complex hand and forearm wound-dirty, infected and exposed bone can be a challenging problem. Conventionally, a distant flap or free flap have been used, but these have been associated with several problems such as joint stiffness, risk of microsurgical procedures, negligible donor site morbidity, prolonged operation time and economic restriction. As well, fasciocutaneous flap has been the limitation of infection control. In these situations, the ipsilateral muscle flap provides the ideal cover with its rich blood supply and single operative field. Previously described by Lendrum(1980), by Lae et al.(1981), and later by McGeorge(1991), the brachioradilis muscle is the most superficial muscle on the radial side of the forearm. Its flap is based on the radial artery and venae comitantes. From August 1996 to October 1997, we performed branchioradialis muscle flap in seven patients. Despite the sacrifice of the major hand artery, brachioradialis muscle flap has many advantages including the reliability of flap survival, easy dissection, early mobilization and absence of functional and aesthetic problems at the donor site. It is a relatively simple and rapid method for resurfacing soft tissue defect in the hand and forearm. We obtained satisfactory and reliable results.
Arteries ; Early Ambulation ; Forearm* ; Free Tissue Flaps ; Hand* ; Humans ; Infection Control ; Joints ; Radial Artery ; Tissue Donors

The Epstein-Barr virus(EBV) is known to play a causal role in oncogenesis and to be associated with endemic Burkitt's lymphomas, B cell lymphomas in immunocompromised patients, and nasopharyngeal carcinomas. More recently, EBV has also associated with Hodgkin's disease, B cell lymphomas in non-immunocompromised patients, and T-cell lymphomas. Twenty eight cases of a non-Hodgkin's lymphoma of gastrointestinal tract were investigated to determine both the immunophenotype by using immunohistochemical staining and the incidence of the EBV nuclear antigen by using the polymerase chain reaction. Twenty-four of the 28 cases(85.7%) were B-cell type, and 4 of the 28 cases(14.3%) are of T-cell type. The EBV nuclear antigen was detected in three of the 28 cases(10.7%), including two cases of B-cell lymphoma of the stomach and one case of T-cell lymphoma of the small bowel. The EBV nuclear antigen was more frequently found in malignant lymphomas arising in the intestine(1/4) than in stomach(2/16). EBV positivity (25%) in T-cell NHLs was rather higher than EBV positivity (8.3%) in B-cell NHLs. Further expanded evaluations on the role of EBV in the tumorigenesis of a gastrointestinal malignant lymphomas are necessary because the cases of gastrointestinal lymphomas examined were very limited.
B-Lymphocytes ; Burkitt Lymphoma ; Carcinogenesis ; Gastrointestinal Tract* ; Herpesvirus 4, Human* ; Hodgkin Disease ; Humans ; Immunocompromised Host ; Incidence* ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Lymphoma, T-Cell ; Polymerase Chain Reaction ; Stomach ; T-Lymphocytes

No abstract available.
Carcinoma, Squamous Cell* ; Cisplatin* ; Drug Therapy, Combination* ; Female ; Ovary* ; Paclitaxel*

Nasal vestibular stenosis is an uncommon cause of nasal obstruction. There are various causes of the narrowing of vestibule, including previous trauma, surgery, infection, and iatrogenic injury. The disease is characterized by circumferential scar retraction in inlet of nasal cavities which are caused by secondary proliferation of granulation and fibrous tissue. A number of studies were reported on the surgical correction of vestibular stenosis, but no single technique had been widely accepted due to a wide spectrum treatment methods owing to the various causes of disease and deformities of the related anatomy. Here we suggest a new surgical technique for correcting a case of vestibular stenosis caused by trauma.

No abstract available.
Enophthalmos* ; Orbit*

Osteochondroma, the most frequent benign bone tumor, is composed of trabecular bone covered with a hyaline cartilage cap. It is well known that multiple osteochondromatosis may undergo malignant change. Such sarcomatous change usually present with the form of chondrosarcoma, and transformation to other malignancy is extremely rare. This report describes one case of osteosarcoma arising in patients who had multiple osteochondromatosis, and includes brief review of the literatures.
Chondrosarcoma ; Exostoses, Multiple Hereditary* ; Humans ; Hyaline Cartilage ; Osteochondroma ; Osteosarcoma*

Although the reconstruction with tumor prosthesis is a routine procedure for extremity sarcomas, this option has some technical limitation in children under 10 years old. Customized expandable tumor prosthesis is too expensive in most cases and arthrodesis of any kind is not functional. This report presents one case of osteosarcoma of distal femur in eight years old child which was reconstructed with adult type total elbow endoprosthesis as a reconstructive option, and includes brief review of the literature.
Adult ; Arthrodesis ; Child ; Elbow* ; Extremities ; Femur* ; Humans ; Knee Joint* ; Knee* ; Osteosarcoma* ; Prostheses and Implants ; Sarcoma

Nasal septal perforation is a defect of cartilage, bone, or mucosa of the nasal septum. Nasal septal perforation has several potential causes such as previous septal surgeries, trauma, malignancy, inflammation, or drugs. According to previous studies, successful surgical outcome is affected by the size and location of the perforation. Although many surgical techniques have been reported, there is no standardized nor consistent surgical method for repairing nasal septal perforation. This report suggests a new surgical technique of repairing septal perforation using a posterior perforation-margin-based hinge flap.
Cartilage ; Inflammation ; Methods ; Mucous Membrane ; Nasal Septal Perforation ; Nasal Septum ; Surgical Flaps

Background: Orbital complications arising from acute rhinosinusitis (ARS) are a major concern for clinicians and serve as important warning indicators of ARS. Prompt recognition and appropriate management are crucial for preventing potential vision-threatening sequelae. Orbital complications of rhinosinusitis are markedly more common in children than in adults. The aim of this study was to investigate the clinical characteristics and treatment outcomes of orbital complications of ARS in adult patients. Methods: This retrospective observational cohort study analyzed the medical records of 176 patients admitted for orbital cellulitis/abscess (ICD code: H050) who underwent orbit or paranasal computed tomography from January 2001 to February 2022 at a tertiary hospital. Results: Eighteen adults with a mean age of 53.2±18.9 years were diagnosed with orbital complications due to ARS: five (27.8%) had preseptal cellulitis, eight (44.4%) had orbital cellulitis, and five (27.8%) had subperiosteal orbital abscess. None of the patients had an orbital abscess or cavernous sinus thrombosis. All patients had unilateral orbital complications (7 right and 11 left) and were managed with intravenous antibiotics for an average of 10.3±6.6 days. Five patients with subperiosteal orbital abscesses underwent intranasal endoscopic drainage at an average of 1.4±1.9 days after admission, while two patients required additional external drainage. Complete recovery was observed in all patients. Conclusions Conservative antimicrobial therapy can be effective for treating orbital complications from ARS, and not all adult patients require immediate surgical intervention for subperiosteal abscesses. Nonetheless, careful monitoring is essential, and an ophthalmologist must check patients’ visual acuity to prevent irreversible blindness.

BACKGROUND: Airwayscope (AWS), which has been used successfully for difficult airway in general anesthesia, has been anticipated that hemodynamic response to tracheal intubation in the difficult airway may be attenuated. Also, there is a series of reports demonstrating the successful use of lightwand to open the difficult airway. Thus, we decided to conduct a survey to compare AWS to lightwand and to direct laryngoscopy of cardiovascular response to tracheal intubation. METHODS: Of 64 healthy patients without cardiovascular disease, 22, 21, 21 patients were randomly assigned to AWS group, lightwand group and direct laryngoscope group. After induction of general anesthesia, intubation was performed with manual in-line neck stabilization. During laryngoscopy, a modified Cormack-Lehane grade was assessed and time to intubation was measured. Systolic arterial pressure (SAP) and heart rate (HR) were recorded at the following timepoints: baseline, just before intubation, 1 min, 2 min, 3 min, 4 min and 5 min after intubation. RESULTS: There were no significant differences between the 3 groups in SAP, HR (P > 0.05). However modified Cormack-Lehane grade of all patients in the AWS group was I, while that in direct laryngoscope group was IIB or III. In addition, the mean time to intubation of the direct laryngoscope group was significantly longer than that of the AWS and lightwand (P < 0.05). CONCLUSIONS: In the difficult airway, AWS was very effective in improving laryngeal view and decreasing time to intubation compared to direct laryngoscopey. In addition, lightwand reduced the time to intubation. However we could not find any significant difference in hemodynamic response to tracheal intubation among the 3 groups.
Anesthesia, General ; Arterial Pressure ; Cardiovascular Diseases ; Heart Rate ; Hemodynamics ; Humans ; Intubation ; Laryngoscopes ; Laryngoscopy ; Neck