Reconstruction of extensive soft tissue defects of the lower extremity, especially when complicated by open fracture and bone loss, is usually a difficult problem for the plastic surgeon. Many methods have been devised to treat these conditions Musculocutaneous flaps add a valuable surgical alternative that bring vascularized cover to the defects, and the free microvascular transfer of these flaps gives the surgeon an added dimension of versatility. The latissimus dorsi is an extremly reliable musculocutaneous flap with a long, large-caliber vascular pedicle, so that dissection of the muscle can be performed with relative ease. The size of the latissimus dorsi muscle lends itself to coverage of large defects. While these characteristics appear to make the free latissimus dorsi musculocutaneous transfer ideal in many circumstances, it has some disadvantages. At the recipient site, the flap is ofter too bulky, and donor-site closure requires skin grafts if the flap is wider than 10cm. These skin grafts on the posterior thorax seriously detract from the final appearance of the donor site. The authors have experienced 12 cases of reconstruction of extensive lower extremity soft tissue defect in which the latissimus dorsi muscle alone was transferred and covered with a split-thickness skin graft. This method improves the recipient-site contour by decreasing the bulk of the flap and it also improves the donor-site appearance. We described technical considerations in each case and the advantages of free latissimus dorsi muscle flap and skin graft for the reconstruction of extensive soft tissue defect in the lower extremity.
Fractures, Open ; Humans ; Lower Extremity ; Myocutaneous Flap ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors ; Transplants

No abstract available.
Antibodies, Monoclonal* ; Treponema pallidum* ; Treponema*

On a total 233 sera from the VDRL reactive patients without a history of syphilitic symptoms or treatment for syphilis, TPHA and 19S(IgM)-FTA tests were performed, Also the reactivities of the 19 S (IgM)-FTA test in relation to the VDRL and the TPHA titers were observed. The results are summarized as follows: 1. Among 233 sera, 103 sera(44%) showed negative results in the 19S(IgM)- FTA test. 2. Reactivities of the 19 S(IgM)-FTA test were significantly increased in relation to the VDRL, titers arnong 233 sera reactive in the VDRL test: 47% in the VDRL titer 1: 1, 61% in 1: 2, 71% in 1: 4, 62% in 1: 8, 96% 1: 16 or more. 3. There was no relationship statistically (IgM)-FTA test and the TPHA titers. It can be derived from the above results that when a person with no history of treatment for syphilis and clear of any signs of syphilis shows a positive reaction in the VDRL test, he is less likey to be a syphilis patient when the VDRL titer is low.
Humans ; Immunoglobulin M* ; Syphilis

No abstract available.
Alcoholism* ; Mass Screening*

Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

Dubin-Johnson Syndrome is a form of benign, familial idiopathic jaundice presenting with chronic intermittentconjugated hyperbilirubinnmia and a melamin-like pigment has been found in the parenchymal liver cells. This disorder is rarely diagnosed in the neonatal period. We report a case of Dubin-Johnson syndrome presenting with neonatal cholestasis.
Cholestasis ; Jaundice ; Jaundice, Chronic Idiopathic* ; Liver

No abstract available.
Anxiety* ; Depression*

No abstract available.
Antibodies* ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin G* ; Immunoglobulin M* ; Tinea*

There are several different methods of purifying Treponema pallidum(TP) from rabbit testicular tissue. Among them, we compared the use of differential centrifugation, which has been most widely used, to Percoll density gradient centrifugatian, a newly applied method, in purifying TP from rabbit testicular tissue by checking the protein concentration of the TP suspension, hemagglutination assay using sheep erythrocytes sensitized by TP, IgM-TP-enzyme-linked immunosorhent, assay(IgM-TP-ELISA) and eJect,ron microscopic observation. The protein concent,ration af TP antigen suspension (2x10(8)TP/ml) purified by Percoll density gradient centrifugation (lower band) was the lowest (129.0pg/ml) when compared to those purified by differential centrifugation (324.0pg/ml) and Percoll density gradient centrifugatian (upper band) (560.2pg/ml). Sheep erythrocytes sensitized by TP purified by Percoll density gradient centrifugation(lower band) showed the same resiilts as those using a commercii1 TPHA kit when tested with positive and negative control sera. The sensitivity and specificity of the IgM-TP-ELISA were 88.5%(23/26') and 86.4%(19/2Z) respectively using TP as an antigen purified by differential centrifugation. The rates were 96.29% (25/26) and 95.5%(2l/22) using TP purified by Percoll density gradient centrifugation. As shown by the electron microscopy, T. pizllida purified by clifferential centritugation and Percoll density gradient centrifugatiori were structurally unaltered, and Percoll-purified TP contained much less tissue debris than TP prepared by differ ential centrifugation. Therefor e, Percoll density gradient centrifugation is considered to be a better method of purifying TP from rabbit testicular tissue when compared to differential centrifugatian, as a matter of fact, Perrol1 density gradient centrifugation has been applieci successfully in the study of the physiology, recombinant DNA techniques, and antigenic structure of TP and to the preparation of the antigen for the FTA-ARS and TP-ELISA
Centrifugation ; Centrifugation, Density Gradient ; DNA, Recombinant ; Erythrocytes ; Hemagglutination ; Microscopy, Electron ; Physiology ; Sensitivity and Specificity ; Sheep ; Treponema pallidum* ; Treponema*

Traumatic hyphema accounts for about 6.7% of ocular trauma and its visual threatening associated ocular injuries are commotio retinae, retinal detachment, macular hole. cataract and rebleeding. The authors reviewed the medical records of 98 patients (98 eyes) having been admitted to the Joongang Gil Hospital between March 1989 and February 1991 with the diagnosis of nonperforating traumatic hyphema. Prospective study was performed as to the effect of epsilon-aminocaproic acid (EACA) in the clearance time of blood clot in the anterior chamber and the frequency of rebleeding. The avlrage clearance time of blood clot was significantly longer in the EACA treated group (5.8 days) than in the control group (3.5 days)(t-Test P<0.01). The frequency of rebleeding was not statistically significantly different between the EACA treated group (3.9%, 2/52 patients) and the control group (87%, 4/46 patients)(X2-Test P>0.05).
Aminocaproic Acid ; Anterior Chamber ; Cataract ; Diagnosis ; Humans ; Hyphema* ; Medical Records ; Prospective Studies ; Retina ; Retinal Detachment ; Retinal Perforations