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

Two cases of ectopic kidney were reported in conjunction with review of literatures. The ectopic kidneys, measuring 13 cm-,15 cm in length of their ureter, were located between the L3 .and S1. Operative removal of the ectopic kidney disclosed aberrant arteries in their both pole. histological examination revealed normal findings.
Arteries ; Kidney* ; Ureter

BACKGROUND: Accessory tragi contain a central core of cartilage, which is the most important pathological factor, but often are misdiagnosed as soft fibroma/hair follicle nevi if sections cannot show a central core of cartilage. OBJECTIVES: The purposes of this study were aimed at comparing transverse sections with vertical sections and demonstrating the value of transverse sections about histological diagnosis for accessory tragus. METHODS: We studied 14 cases of patients with accessory tragi. All cases were totally excised and all 16 biopsy specimens (bilateral in 2 cases) were obtained. We classified these biopsy specimens into two groups regarding the removal of cartilage.All specimens were vertical or transverse seiral sectioned and we compared these histologic findings with established histologic diagnostic criteria which Satoh et al. reported. RESULTS: On the specimens of group 1 in which there was cartilage, subcutaneous prominent connective tissue framework whirling around cartilage could be observed on all transverse sections, but was not always present on vertical sections. Prominent connective tissue framework and pilosebaceous units with circular arrangement of eccrine glands were simultaneously in the center of transverse sections regardless of the presence of cartilage. CONCLUSIONS: In this study, transverse sections showed all diagnostic histologic important features for accessory tragus: presence of central cartilage, prominent subcutaneous connective tissue framework, and various degree of pilosebaceous unit, especially with circular arrangement of eccrine glands. So transverse sectioning could be a useful method for accurate histological diagnosis of accessory tragi regardless of the removal of cartilage when doing excisional biopsy.
Biopsy ; Cartilage ; Connective Tissue ; Diagnosis ; Eccrine Glands ; Humans ; Nevus

Analyzing HI tests of 110 cases of clinical Japanese Encephalitis in 1982, the following results are obtained. 1. The results of HI test are positive in 39 (35.5%), borderline positive in 19 (9.1%), negative in 14 (12.7%) and undetermined in 47 (43.7%) cases. 2. In 49 cases of positive HI test, 14 cases reveal the positive result on the first HI test requested in 5-27 days after the clinical onset of symptoms, and 35 cases show increasing HI titers on the follow-up studies. There is a tendency of increasing HI titers upto 3-4 weeks of onset and sustaining the value for more than two months. 3. In 35 cases with increasing titers on follow-up study, the highest titer is 1:80 in 5 cases, and the half of HI negative cases maintain that value throughout the course. 4. There is no significant statistical differences in clinical characteristics, laboratory and cerebrospinal fluid studies between the patient group of HI positive or borderline and group of HI negative or undermined, except mean hospital day and incidence of coma and death.
Cerebrospinal Fluid ; Coma ; Encephalitis, Arbovirus* ; Encephalitis, Japanese ; Follow-Up Studies ; Hemagglutination Inhibition Tests* ; Hemagglutination* ; Humans ; Incidence ; Korea*

Spontaneous perforation of bile duct in adults is very rare, with less than 30 cases described in the literature to date. We repoit a case of a 65-year-old man who presented with severe colicky abdominal pain and fever, just like symptoms of peritonitis. ERCP provided a preoperative noninvasive confirmation of the diagnosis of the rupture of right intrahepatic duct. The patient was performed T-tube choledochotomy and drainage of retroperitoneal bile collection. The etiolgy, diagnosis, and treatment of spontaneous perforation of bile duct is discussed.
Abdominal Pain ; Adult ; Aged ; Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Drainage ; Fever ; Humans ; Peritonitis ; Rupture

Four members of a family suffering from frequent attacks of flaccid paralysis with asymptomatic myotonia were evaluated. There was an autosomal dominant pattern of inheritance and their earliest symptoms were noticed between 1-3 years of age. The plasma potassium level rised during the attack and an EMG demonstrated myotonic discharge. Treatment with acetazolamide was beneficial. These findings were consistent with adynamia episodica hereditaria. The clinical features and pathogenesis were also described.
Acetazolamide ; Humans ; Myotonia ; Paralysis ; Paralysis, Hyperkalemic Periodic* ; Plasma ; Potassium ; Wills

This is a case report of oculocraniosomatic neuromuscular disease with "ragged-red fibers". The patients is 36 years old female who is revealing slowly progressive ptosis, external ophthalmoplegia, general weakness and mild right hemiparesis and hemianesthesia. The EMG findings are suggestive of diffuse myopathic process and the frozen muscle specimen from the left deltoid muscle shows the characteristic "ragged-red fibers" with classical myopathic changes.
Adult ; Deltoid Muscle ; Female ; Humans ; Neuromuscular Diseases* ; Ophthalmoplegia ; Paresis

This is a case report of oculocraniosomatic neuromuscular disease with "ragged-red fibers". The patients is 36 years old female who is revealing slowly progressive ptosis, external ophthalmoplegia, general weakness and mild right hemiparesis and hemianesthesia. The EMG findings are suggestive of diffuse myopathic process and the frozen muscle specimen from the left deltoid muscle shows the characteristic "ragged-red fibers" with classical myopathic changes.
Adult ; Deltoid Muscle ; Female ; Humans ; Neuromuscular Diseases* ; Ophthalmoplegia ; Paresis

Based on our experience with 23 frontotemporal reconstructions performed, this paper attempts to provide guidelines for appropriate selection among the four most commonly employed materials (e.g., autogenous parietal bone, silicone rubber, methylmethacrylate, and porous polyethylene) so that optimal results can be achieved. Clinical follow-up ranged from 6 to 91 months (mean 32 months). Every patient was analyzed clinically by ordinary scale method. The mean defect size was 134.8 cm2 in the silicone rubber, 36.5 cm2 in the methylmethacrylate, 17.4 cm2 in the autogenous bone graft and 7.3 cm2 in the porous polyethylene. The clinical assessment was excellent (mean, 29.3 points) in silicone rubber, excellent (mean, 28.6 points) in autogenous bone, excellent (mean, 26.8 points) in methylmethacrylate, and good (mean, 24.8 points) in polyethylene. To sum up, a large bony defect of congenital calvarial anomaly produced an excellent result using custom-made silicone implant. A relatively small bony defect with a scarred bed produced an excellent result using autogenous parietal bone grafting. Unexpected and medium-sized defect was reconstructed successfully through a simple procedure using methylmethacrylate. Porous Polyethylene was used at an incidental small defect because of its expensiveness.
Cicatrix ; Follow-Up Studies ; Humans ; Methylmethacrylate ; Parietal Bone ; Polyethylene ; Silicone Elastomers ; Transplants

We report two cases of recurrent BCC in a 51- year-old woman and a 39-year-old woman which had been misdiagnosed aind treated as pigrnented nevi. Complete surgical resections were done followed by reconstruction using local rhombic transposition flaps. Final cosmetic results were excellent and no local recurrence was noticed during one year follow-up.
Adult ; Carcinoma, Basal Cell* ; Female ; Follow-Up Studies ; Humans ; Nevus ; Recurrence