Severe injuries of hands frequently expose the bone and joint due to the defect of crushing of soft tissues. Although the several methods are introduced, the treatment of bone and joint exposure of finger and hand is very difficult to control satisfactorily. From October 1986 to February 1988, we performed the pedicled skin flap in 11 cases; 9 abdominal skin flaps and 2 pectoral skin flaps. Follow up stuides showed good results. The successful surviving of flaps was accomplished in all cases and the dead bones were regenerated by the creeping substitution. Therefore this pedicled skin flap operation can be considered to be a simple and effective method in treating the bone and joint exposure of fingers.
Fingers ; Follow-Up Studies ; Hand ; Joints ; Methods ; Skin

The examination of small bowel in Crohn's disease (CD) is very important. Capsule endoscopy (CE) has been recognized as a good tool for evaluation of small bowel. The capsule placement is achieved endoscopically for Children not to swallow capsule. CE is superior to any other modalities for examination of small-bowel. The large portion of pediatric patients with known CD were found with CE to have more extensive and newly diagnostic small-bowel disease. All of them had therapeutic changes. The most side effect of CE is capsule retention. The capsule retention rate in pediatric CD is about 7.3%. The patency capsule helps to predict the possibility of capsule retention. For the improving of the diagnostic accuracy, the experience of more than 20 readings of CE is needed.
Capsule Endoscopy ; Child ; Crohn Disease ; Humans ; Intestine, Small ; Reading ; Retention (Psychology)

As a series of systematic classification of paramphistomes, in the first step, paramphistomes in the rumen and reticulum were collected on 170 Korean cattles (2-3 years age, male) slaughtered at Jeonju abattoir from July 1984 to September 1985 and were classified by means of morphology of the worms. Afterwards, the karyotype of Paramphistomum explanatum (Creplin, 1849) which is the common in Korean cattle was detected by means of modified air-drying method from testis cells of the worm. The following is a brief summary of the leading facts gained through the experiment. Most of the cattle slaughtered at the abattoir were infected with paramphistomes. The 5 species of the worms were detected on 170 Korean cattle and the worm burden per head was from 2 to 784 (on the average 170) worms, 120(70.59 percent) heads out of them involving 2-100 worms. In 28,900 individuals of paramphistomes obtained on 170 Korean cattle, appearance rates of various worms were as follows : 49.74 percent in P. explanatum, 48.08 percent in P. cervi, 0.98 percent in Orthocoelium orthocoelium, 0.89 percent in Fischoederius cobboldi and 0.14 percent in Cotylophoron cotylophorum. The chromosome number of 620 P. explanatum in the haploid and diploid cells was n=9 and 2n=18, and abundant cells in meiotic division were observed; 1,420 haploid and 38 diploid cells were reliable. Nine pairs of mitotic chromosomes were homologous and the chromosomes were composed of five medium-sized metacentrics (m), subtelocentrics (st) or submetacentrics (sm)and four small-sized subtelocentrics (st) or submetacentrics (sm), while meiotic metaphase chromosomes were composed of five medium and four small-sized. The haploid of the testis cells showed C-band in the centromeric region from 8 of them, whereas the remaining chromosome No. 5 included heterochromatin on the tip region, and chromosomes No. 3 and No. 7 showed a remarkable C-band distinguished from other chromosomes.
parasitology-helminth-trematoda ; karyotype ; chromosome ; Paramphistomum explanatum ; Paramphistomum cervi ; Orthocoelium orthocoelium ; Fischoederius cobboldi ; Cotylophoron cotylophorum

We have experienced a reexpansion pulmonary edema(RPE) during general anesthesia. This patient has undertaken the decortication operation due to right sided massive pleural effusion and fibrothorax. Generally reexpansion pulmonary edema is believed to oceur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid in pneumothorax and pleural effusion. The pathogenesis of RPE is unknown and is probably multifactorial. The implicated etiologies are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant and pulmonaty artery pressure changes. The outcome of RPE may be fatal, so physician treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complieation.
Airway Obstruction ; Anesthesia, General* ; Arteries ; Capillary Permeability ; Humans ; Lung ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema*

We report a case of chronic bullous dermatosis of childhood occurring in a 8-year-old girl, who has multiple, pruritic, tense, vesicobullous eruptions on the both extremities and pelvic region without mucous membrane inuolvement. A skin biopsy revealed subepidermal vesicles infiltrated with many neutrophiles and a few eosinophiles. Direct immunofluorescent study of the perilesional skin demonstrated moderate intensity of linear IgA and to a lesser degree of IgG deposition at the dermoepidermal junction. The skin lesions responded dramatically to oral dapsone therapy, initially 4mg/kg, and taporing to 2mg/kg for 27 days.
Biopsy ; Child ; Dapsone ; Eosinophils ; Extremities ; Female ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Mucous Membrane ; Neutrophils ; Pelvis ; Skin ; Skin Diseases* ; Transcutaneous Electric Nerve Stimulation

No abstract available.
Antifungal Agents* ; Chemotaxis* ; Humans* ; Neutrophils* ; Phagocytosis*

PURPOSE: Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme regulating folate level, which affects DNA synthesis and methylation. MTHFR is highly polymorphic, and its variant genotypes result in decreased MTHFR enzyme activity and lower plasma folate level. Generally, a low folate level is known to be associated with a gastrointestinal neoplasm. Three common single nucleotide polymorphisms (SNPs) resulting in amino-acid changes (C677T, A1298C and G1793A) have been reported in MTHFR. We studied the relationship of MTHFR C677T, A1298C and G1793A polymorphisms between from colon cancer group and control group of Korean people. METHODS: We performed a case- control study to examine the relationship between MTHFR C677, A1298C, and G1793A polymorphisms and the risk of colon cancer. Two hundred seven (207) individuals with colon cancer and 288 healthy persons were analyzed. Blood sampling of each group was performed, and (PCR-RFLP) was analyzed; as a result, MTHFR polymorphism genotypes were obtained. RESULTS: The genotype frequencies of MTHFR C677T polymorphisms were 27.1% (CC), 48.3% (CT), 24.6% (TT), and 72.9% (CT+TT) in the patient group and 39.2% (CC), 36.8% (CT), 24.0% (TT), and 60.8% (CT+TT) in the control group. The genotype frequencies of MTHFR A1298C polymorphisms were 58% (AA), 35.7% (AC), 6.3% (CC), and 42% (AC+CC) in the patient group and 55.6% (AA), 40.3% (AC), 4.2% (CC), and 44.4% (AC+CC) in control group. The genotype frequencies of MTHFR G1793A polymorphisms were 83% (GG), 15.9% (GA), 1% (AA), and 16.9% (GA+AA) in the patient group and 85.8% (GG), 11.8% (GA), 2.4% (AA), and 14.2% (GA+AA) in the control group. The 677CT genotype was associated with a significantly increased risk for colon cancer (adjusted OR=1.90, 95% confidence interval: 1.25~2.90 in CT) than the 677CC genotype. The 1298CC, 1298AC, 1793AA, and 1793GA genotypes were not associated with a significantly increased risk for colon cancer. CONCLUSIONS: The MTHFR C677T polymorphism may influence colon cancer, but the MTHFR A1298C and G1793A polymorphisms need to be studied further for careful interpretation and confirmation in larger studies.
Colon ; Colonic Neoplasms ; DNA ; Folic Acid ; Gastrointestinal Neoplasms ; Genotype ; Humans ; Methylation ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma ; Polymorphism, Single Nucleotide

PURPOSE: To assess the accuracy of MR cholangiography(MRC) in the diagnosis of cholelithiasis, and to determine interobserver agreement. MATERIALS AND METHODS: Between March and September 1999, 43 consecutive patients with biliary obstruction [24 men and 19 women aged 25 -85 (mean, 58) years] underwent MRC using the single-shot fast spin-echo technique. Heavily T2-weighted source images(axial and coronal) 3 -5 mm thick and 12 projection images with 15- degree rotation and 5-cm thickness were obtained. All images were reviewed blindly and indepen-dently by two radiologists specialized in the interpretation of abdominal imaging information. Choledocholithiasis was evaluated in eight segments of the intrahepatic duct(IHD), extrahepatic duct(EHD) and gall bladder lumen. Final diagnosis was established on the basis of operative (n=31) and other radiological (n=12) findings. The sensitivity, specificity and accuracy of the MRC findings were assessed, and using kappa measurement (cross-table analysis,SPSS Windows for 8.0), interobserver agreement was determined. RESULTS: Thirty of the 43 patients, had choledocholithiasis (IHD stones in 7 cases, EHD stones in 15, and GB stones in 18). For radiologist 1, sensitivity, specificity and accuracy were 86%, 100% and 98%, respectively, in the diagnosis of IHD stones; 100%, 89% and 93%, respectively, in the diagnosis of EHD stones; and 81%, 96% and 91%, respectively, in the diagnosis of GB stones. For radiologist 2, the corresponding figures were 86%, 94% and 93% (1HD stones); 87%, 89% and 88% (EHD stones); and 81%, 86% and 84% (GB stones). Interobserver agreement for the diagnosis of choledocholithiasis was excellent in all cases. The kappa mesurement was 0.91 for 1HD stones, 0.77 for EHD stones, and 0.70 for GB stones. CONCLUSION: MRC is an excellent imaging modality for the diagnosis of choledocholithiasis, and interobserver agreement was also excellent.
Cholangiography* ; Choledocholithiasis ; Cholelithiasis* ; Diagnosis* ; Female ; Humans ; Male ; Sensitivity and Specificity ; Urinary Bladder

PURPOSE: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. MATERIALS AND METHODS: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). RESULTS: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. CONCLUSION: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.
Chondrosarcoma ; Curettage ; Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

PURPOSE: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). MATERIALS AND METHODS: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months. RESULTS: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. CONCLUSION: Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.
Amputation ; Cartilage ; Chondrosarcoma ; Enchondromatosis ; Female ; Follow-Up Studies ; Humans ; Male ; Osteochondroma ; Osteochondromatosis ; Puberty ; Recurrence ; Retrospective Studies