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

We have analyzed 27 cases(38.8%) of scapho-lunate(SL) dissociation which were the most com- mon type of total 72 cases of post-traumatic wrist instabilities since 1985. As a result, SL dissociations associated with wrist fracture were 23 cases, more common than simple dynamic SL dissociation(4 cases). Early diagnosis and treatment influenced on their prognosis, and both wrist PA roentgenograms were useful for the confirmative diagnosis of SL dissociation. In 16 cases with early diagnosis, closed reduction, 2 or 3 K-wires fixation under C-arm image and short arm cast for 8 weeks were effective. But in 11 cases with neglected diagnosis and with wrist fractures showed poor results. Excessive wrist ligamentous reconstruction in chronic cases should be avoided because of osteoporosis and wrist stiffness. Conclusively, clinical wrist symptoms are more important than radiological changes in wrist insta- bilites. So if the symptoms are not so severe, we must consider the patient's age, occupation and their social activities etc. to decide the proper way of treatment.
Arm ; Diagnosis ; Early Diagnosis ; Ligaments ; Occupations ; Osteoporosis ; Prognosis ; Wrist

Phakomatosis pigmentova.scularis is a disease complex with dermal melanocyto sis such as nevus of Ota, nevus of Ito, or Mongolian spots and extensive hemangiomatous change such as nevus flammeus, which are associated with systemic organ involvement. We report a 23-year-old female, who showed bilateral nevus of Ota and nevus of Ito with widespread nevus flammeus and Mongolian spots since birth. She was also associated with megalocornea due to congenitol glaucoma and cataract.
Cataract ; Female ; Glaucoma ; Humans ; Mongolian Spot ; Neurocutaneous Syndromes* ; Nevus ; Nevus of Ota ; Parturition ; Port-Wine Stain ; Young Adult

This study was carried out to find out changes in regional cerebral blood flow(r-CBF) in relation to(i) clinical status of patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms ; (ii) the degree of subarachnoid hemorrhage as indicated by brain CT scanning ; (iii) the severity of angiographic vasospasm, and (iv) other neuropathological condition. Measurement of r-CBF were performed, using 133Xe inhalation method, on 50 patients with ruptured intracranial aneurysms. Some of the major findings were as follows : 1) The degree of abnormalities of blood flow correlated well with the clinical severity of neurological deficits. 2) A marked reduction in r-CBF was found in patients with intracerebral hematoma, ischemic lesion and hydrocephalus. 3) In angiospasm area, r-CBF was found in patients with intracerebral hematoma, ischemic lesion and hydrocephalus. 3) In angiospasm area, r-CBF decreases below 30ml/100gm/min in almost all of the patients, and severity of vasospasm correlated with the decrease of CBF. 4) The measurement of CBF on patients with subarachnoid hemorrhage was thought to the useful for foreseeing the clinical outcome of the patients.
Brain ; Hematoma ; Humans ; Hydrocephalus ; Inhalation ; Intracranial Aneurysm* ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

POEMS syndrome is an unusual plasma cell dyscrasia with multisystemie manifestations featuring polyneuropathy, organomegaly, endocrinopsthy, M protein and skin changes. We have seen a 49-year-old woman presenting with hyperpigmentation, hypertrichosis, hyperhidrosis, and taut thickened skin of the extremities as a skin manifestation of this syndrome. We review the literature and report a case.
Extremities ; Female ; Humans ; Hyperhidrosis ; Hyperpigmentation ; Hypertrichosis ; Middle Aged ; Paraproteinemias ; POEMS Syndrome* ; Polyneuropathies ; Skin ; Skin Manifestations

Acute arterial occlusion of the extremity may result from obstruction of an artery by embolism or by thrombosis in situ. This results in the sudden cessation of blood flow to an extremity. So immediate managements are required to prevent propagation of the clot and to restore blood flow to the ischemic extremity promptly. We report a case of a acute arterial occlusion which was developed during prolonged fasting. A 59-year-old male was transferred due to severe ischemic pain, coldness and loss of pulse in left lower extremity during fast. The arteriogram shows a complete obstruction of external iliac artery and non-visualization of femoral artery and popliteotibial artery in the left lower extremity. Selective intra-arterial urokinase thrombolytic therapy and percutaneous transluminal angioplasty resulted in recannulation of obstructed artery and relief of symptoms.
Angioplasty ; Arteries ; Embolism ; Extremities ; Fasting* ; Femoral Artery ; Humans ; Iliac Artery ; Lower Extremity* ; Male ; Middle Aged ; Thrombolytic Therapy ; Thrombosis ; Urokinase-Type Plasminogen Activator

A 34-year-old female had an unusual case of cellular blue nevus which had behaved in a locally aggressive fashion. The lesion infiltrsted the adjacent soft tissue of left nail bed and extended into deep phalangeal bone. The involved left thumb was partially amputated because complete excision was impossible and we were quite concerned about malignant transformation. Histologically biphasic pattern without cellular atypism, a characteristic features of cellular blue nevus, was shown. About 2 years later, the lesion had not recurred.
Adult ; Female ; Humans ; Nevus, Blue* ; Thumb

Hydrofluoric acid(HF) burn is characterized by progressive tissue necrosis and severe pain. A 31 year old employee in the semiconductor industry came in contact with the 50% aqueous HF through a pin hole in the thumb of his protective gloves. About 2 hours after exposure, h noted deep, severe burning, excruciating pain and svtelling of right thumb. Thereafter, clark bluish eclematous necrotic patches were visible through the nail plate and on the distal end of right thumb. Pain was not effectively relieved by digital nerve block.
Adult ; Burns* ; Gloves, Protective ; Humans ; Hydrofluoric Acid* ; Necrosis ; Nerve Block ; Semiconductors ; Thumb

It is desirable to use more safe, objective, non-invasive method than visual scoring for the evaluation of irritation reaction and determine the optimum eoncentration of sodium lauryl sulfate(SLS) as a positive irritant control in routine patch test. In this study, SLS was applied to the volar forearm of ll non-atopic, healthy volunteers in concentrations of 0.5, 1.0, 2.0, and 5.0% under occlusion for 24h. The blood flow in test sites exposed to SLS was tecorded by laser Doppler velocimetry (LDV). The test sites were scored visually and the skin blood flow was measured at 24h, 48h, and 72h after the application of FiLS. We obtained the following results,' 1. There was a good correlation between visual scoring and skin blood flow using LDV(p = 0.4547). 2. 5.0% SLS could be used as a positive irritant control in routine patch test (p<0,05).
Forearm ; Healthy Volunteers ; Laser-Doppler Flowmetry* ; Patch Tests ; Skin ; Sodium Dodecyl Sulfate* ; Sodium*

The papillary eccrine adenoma is a rare benign sweat gland neoplasm charscterized by potentislly locally aggressive clinical course. We report herein a case of papillsry eccrine adenoma in a 28-year-old female who presented single intradermal tumor on the right postauricular ares. Histopathological findings showed dilated ducts containing eosinophilic or keratinous materials and intraluminal papillary rowths.
Adenoma* ; Adult ; Eosinophils ; Female ; Humans ; Sweat Gland Neoplasms