No abstract available.
Rectal Neoplasms*

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*

No abstract available.
Snake Bites* ; Snakes*

PURPOSE: In order to assess the incidence and radiologic findings of herniation pit of the femur neck in Korean. IVlaterials and Methods:In 152 macerated femurs of 88 cadavers, and randomly selected 115 hips of 70 patients, the presence of herniation pit was determi ned by using fluoroscopy and radiography. It was then examined by CT for inspection of overlying surface and its opening was confirmed by inserting thin steal wire under the fluoroscopic guidance. RESULTS: Seventeen herniation pits in 15 macerated femurs of 13 cadavers were noted. (14.8%, 13/88). Two of 13 individuals showed bilaterality. All lesions were found only in males. Six herniation pit in 6 femurs of 6 patients (8.6%, 6/70) were also noted. All lesions were on anterosuperior aspect of. femur neck. Plain radiographs of macerated femurs revealed well marginated and thin sclerosis in 15 lesions. Of all 23 lesions, CTshowed cortical breakdown in 3, and overlying cortical thickening in 8. In 15 macerated femurs, roughed area of cortex was found in anterosuperior aspect of femur in all cases, and tiny openings(diameter less than 1 mm) related to cystic lesions were confirmed in 9 lesions. CONCLUSION: The incidence of herniation pits was 14.8% in 88 cadaver, and 8.6% in 70 patients. All were males.
Cadaver ; Femur Neck* ; Femur* ; Fluoroscopy ; Hip ; Humans ; Incidence* ; Male ; Radiography ; Sclerosis

PURPOSE: To evaluate the optimal pulse sequences in the detection of erosions and for the discrimination of theeffusion from pannus. MATERIALS AND METHODS: MR studies were performed in thirteen patients with clinical diagnosis of rheumatoid arthritis. We used a 1.5T MR unit with single or dual 3 inch coil. We compared coronal images at the same location, obtained with pulse sequences of T2, T2 with fat saturation, and postcontrast T1 with fat suppression. Erosions were assessed by comparing the count of the numbers of erosions depending on each imaging method. A four point scoring systems was used for the comparison of conspicuitof lesion. RESULTS: T2WI with fat suppression and postcontreat T1WI with fat suppresison were better than conventional T2WI in the detection of erosions. The pannus had a heterogeneous signal on T2WI, some of which were enhanced after the intravenous injection of MR contrast a gents. CONCLUSION: We suggest that the fat suppression TIWI with enhacnement or the fat suppression T2WI were better than conventional T2WI for detecting both bone erosion and pannus. The postcontrast MR imaging may often be helpul in distinguishing pannus from the effusion.
Arthritis, Rheumatoid* ; Diagnosis ; Discrimination (Psychology) ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Wrist*

We report a case of morphea profunda in a 21-year-old male who had diffuse brown sclerotic plaques on his extremities. Laboratory findings showed peripheral eosinophilia and an increased titers for anti-DNA and anti-nuclear antibodies. Histopathologic findings showed diffuse fibrosis and a thickening of the lower dermis and subcutaneous tissue. He has been treated with hydroxychloroquine 400mg per day and the sclerosis of the skin improved.
Antibodies ; Dermis ; Eosinophilia ; Extremities ; Fibrosis ; Humans ; Hydroxychloroquine ; Male ; Scleroderma, Localized* ; Sclerosis ; Skin ; Subcutaneous Tissue ; Young Adult

Adenoma of the nipple is a benign tumor of the lactiferous ducts of the nipple which frequently causes erosion of the surface. It can clinically mmic Paget's disease and histologically be misdiagnosed as a well-differentiated adenocarcinoma. A 20-year-old woman developed an erythematous oozing patch on the right nipple two years ago, which subsequently developed iiito verrucous surfaccd papules. A biopsy specimen of the lesion showed focal acanthosis of the epidermis. The tumor was composed of fairly well-circumscribed, glandlike structures within the nipple stroma. Ductlike struciures, papillary areas, solid nests of cells and cysts lined by squarnous epithelium, could be seen, Two cell types lining the ducts were recognized; inner columnar cells and peripherally located cuboidal cells. Although simple excision of the adenoma is the treatment of choice, our case was treated successfully by electrucoagulation.
Adenocarcinoma ; Adenoma* ; Biopsy ; Epidermis ; Epithelium ; Female ; Humans ; Nipples* ; Young Adult

Dynamic cardiomyoplasty is a recently introduced surgical method to improve myocardial performance. It consists of a placement of a skeletal muscle flap around the heart and stimulation of the flap in synchrony with ventricular contraction. We experienced a case of cardiomyoplasty in a 25 year old male patient with congestive heart failure. Anesthesia was induced and maintained with fentanyl, midazolam and isoflurane. The operation was performed for 8hrs without cardiopulmonary bypass and the patient was transferred to the intensive care unit. He was mechanically ventilated electively overnight and extubation was done 18hrs postoperatively. The patient was discharged home on the 40days after operation and improved in exercise tolerance. We report the anesthetic management and hemodynamic changes in a patient who underwent dynamic cardiomyoplasty.
Adult ; Anesthesia ; Cardiomyoplasty* ; Cardiopulmonary Bypass ; Exercise Tolerance ; Fentanyl ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Intensive Care Units ; Isoflurane ; Male ; Midazolam ; Muscle, Skeletal

No abstract available.
Duodenal Ulcer* ; Vagotomy*

No abstract available.
Humans ; Stomach Neoplasms* ; Young Adult*