The old flexor tendon injury in the hand seen after 4 weeks from damage and associated with crushing injury, heavy scarring, fracture and infectious state has the difficulty to deliver the flexor tendon through fibro-osseous sheath and the pulleys. Treatment method depends on the circumstances of the injured flexor tendon and surgeons' judgement. We have treated twenty-three fingers of twenty-three cases, who had old flexor tendon injury, by advancement and tenolysis in 1 each, tendon graft in 5, and staged tendon graft in 16 from March 1989 through February 1994. The result was summarized as follows. 1. The old flexor tendon injury most commonly occurred in the fifth finger(11 cases, 47.8%)and in zone II (16 cases, 69.6%). 2. The most common cause was glass injury(15 cases, 69.6%). 3. 21 of 23 cases(2 thumbs excepted)were evaluated according to the original Strickland system. 14 cases of the staged tendon graft showed excellent(6 cases, 42.9%), good(5 cases, 35.7%)and fair(3 cases, 21.4%). 5 cases of the tendon graft showed excellent(2 cases, 40%), good(1 case, 20%), and fair(2 cases, 40%). 1 case of adhesiolysis and 1 case of advancement showed excellent and good results each. Little difference is observed in the method between the staged graft and tendon graft. 4. The degree of the associated soft tissue injury should be evaluated by the experienced hand surgeon before surgery and the delicate balance between protection and mobilization during the postoperative weeks is important as well as the surgical skill.
Cicatrix ; Fingers ; Glass ; Hand ; Methods ; Soft Tissue Injuries ; Tendon Injuries ; Tendons ; Thumb ; Transplants

A 33 years old house wife with accessory breast tissue is described and the literature is reviewed. The patient developed soft tumors in both axillae with axillary hair loss during the 8 th month of her 8 th pregnancy. This disorder is rather common in the literature but has been paied little attention dermatology.
Adult ; Axilla ; Breast* ; Dermatology ; Hair ; Humans ; Pregnancy ; Spouses

No abstract available.
Diazepam* ; Seizures, Febrile*

The authors experienced a case of gastroduodenojejunal trichobezoar detected by ultrasongraphic examination. We thought that tricholbezoar had relatively specific ultrasonographic findings such as a broad hyperechogenic superficial bandlike rim with a complete posteior sonic shadowing and multiple linear echogenic strands on its surface representing hairs, which were better seen after water ingestion. So we were able to get the correct diagnosis of trichobezoar prior to conventional barium studies in a patient who could not be suspected suspected clinically.
Barium ; Bezoars* ; Diagnosis ; Eating ; Hair ; Humans ; Shadowing (Histology) ; Ultrasonography* ; Water

This study was designed to determine if topical cardiac hypothermia is a necessary adjunct to intraoperative myocardial protection. In this study, 105 patients ranging in age from 22 to 74 years were included. Myocardial temperature was measured at the ventricular septum. All patients received cold blood cardioplegia without topical cooling. In most of the patients(90%) the myocardial temperature was dropped to 10-15degrees C without topical cooling. In Group A, myocardial temperature was dropped rapidly to 10-15degrees C with, 1,000ml or less cardioplegic solution. In Group B, the amount of cardioplegic solution required for lowering myocardial temperature to 10-15degrees C was 1,000-2,000ml. In Group C, myocardial temperature was not dropped below 18degrees C or cardioplegic solution over 2,000ml was required for lowering myocardial temperatur. Eight patients(8/61, 8%) in group A, 12 patients(12/35, 34%) in group B and 8 patients(8/9. 89%) in group C had Complete obstructive lesions in at least one of major branches of coronary artery(p=0.001). Myocardial perfusion score was different among the groups(8.27+/-2.27 in group A, 9.98+/-2.21 in group B, 10.30+/-2.49 in group C, p<0.002). These data suggest that routine topical hypothermia may be unnecessary if myocardial temperature of less than 15degrees C could be attained with cold blood cardioplegia, especially in case of myocardial perfusion score below 10.
Cardioplegic Solutions* ; Heart Arrest, Induced ; Humans ; Hypothermia ; Perfusion ; Ventricular Septum

No abstract available.
Cerebrospinal Fluid* ; Electroconvulsive Therapy* ; Hydroxyindoleacetic Acid* ; Schizophrenia* ; Serotonin*

Two cases with generalized G.A. were described. The first case was 42 years, old farmer representing slightly erythematous multiple papulonodular lesions on the face, neck, scapular areas, arms and dorsal hands. Coalescence of lesions in some areas of the dorsal hands and neck produced circinate or polycyclic pattern. The second case was 4 years old girl who developed purple to brown muliple papulonodular lesions and polygonal or round plague on the arms, dorsal hands, palms, neck, iliac crests, lower legs, dorsal feet and sole. The plague lesions mimick lichen planus.
Arm ; Child, Preschool ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Hand ; Humans ; Leg ; Lichen Planus ; Neck ; Plague

Cutis naarmorata telangiectatica congenita(CMTC) was first lesribed by Van Lohuizen in 1992. Cases of CMTC were reported later under various names, includir gan Lohuizens syndrome, congenital generalized phlebectasia. congential phlebectasia and reticulatever scular nevus. It is charaterized by persistent livedo reticularis, telangiectasia and phlectnsia from birch hand atrophy and superficial ulceration of the overlying skin are uncornmonly encountered. They have a steady improvement with time, however various congenital abnormalties, such as varicosities, hen ariomas, hypoplasia or hypertrophy of soft tissue and bones, rarely generalized congenital fibrornatos ectal and genital anomaliies may be associated in approxirnately 50 percent of patients. In case 1, the patient was 45-day-old female infant with reticulated mottling and atrophy of the skin on the right leg. In case 2, the patient was 30-day-old male infant who depressed, bluish, and reticulated patches on the both upprarms, right side trunk, buttock and loen leg. Decreased circumferences of the affected extremities vas observed in case 2. No other assotated anomalies were found in physical and X-ray examinatiorwlin both cases. The skin biiopsy of bothed similar findings, which revealed mild dilatation and proliferation of capillaries, mild inflammatoryel infiltration and extravasated red blood cells in the dermis. The clinical follow-up, alneast all of th lisions disappeared spont.anously in 1 year at case 1, and some of lesions also disappeared in 3 month, 11 case 2. In addition, we reviewed and summerized the reported cases in Korea.
Atrophy ; Betula ; Buttocks ; Capillaries ; Dermis ; Dilatation ; Erythrocytes ; Extremities ; Female ; Follow-Up Studies ; Hand ; Humans ; Hypertrophy ; Infant ; Korea ; Leg ; Livedo Reticularis ; Male ; Nevus ; Skin ; Telangiectasis ; Ulcer

Eccrine carcinoma does not have a characteristic clinical appreranc, but does have a high incidence of metastatic spread. It may arise anywhere in the skin. The microscopic patterns that of an adenocarcinoma, which may be confused with metastatic adenocarcinoma. In the classical type the histologic features varies from fairy well-differentiated tubular structures in some areaslo anaplastic carcinoma in other areas. The patient was a 51-year-old man who showed a painful, tender, right red-calored, 4 x 5crn-sized tumor mass on the right angle of the lower lip for ten years. In the diological examinations multiple metastatic foci were seen on both lung fields, Histopathologic findings of the skin and lung biopsy specimens revealed that of the classic type of eccrine carcinoma like the bove descriptions. Immunocytochemical studies showed a positive reactivity to anti-cytokeratin anti-ibody, anti-CEA antibody, and anti-S-100 protein on the skin and lung biopsy specimens and no he reactivity to anti-S-100 protein on the lung mass. Electronrnicroscopic findings revealed eccrine glaidlar structures such as nunierous mitochondria and dense core granules in the cytoplasm of neoplastic cells. We report a case of eccririe carcinoma with lung metastases baed on the clinical, radiological and histologic findings.
Adenocarcinoma ; Biopsy ; Carcinoma ; Cytoplasm ; Humans ; Incidence ; Lip ; Lung* ; Middle Aged ; Mitochondria ; Neoplasm Metastasis* ; Skin

No abstract available.
Nevus, Pigmented* ; Vitiligo*