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.
Papilloma* ; Recurrence*

A study of the effectivity and reliability of discectomy and anterior interbody fusion with autogenous iliac bone graft for spondylogenic and discogenic back pain and/or radiating pain has been done on 48 patients who had been hospitalized at Severance Hospital between January 1976 to June 1978. To the preoperative symptoms and signs such as the presence of back pain, sciatica, muscle atrophy, sensory change, motor change, spinal motion, deep tendon reflex, S.L.R., knee-chest compression test and Patricks test were checked, and after the operation, the same symptoms and signs were checked as to how they were improved or not. The age range of patients was 17 to 64 years and 40% of them were in the 3rd decade. Before the operation, for the confirmation of the origion of the back pain, we did perform dynamograms for instability and myelograms for root compression and spinal stenosis. The approach to the lesion was mainly retroperitoneal with anterior approach. Bony union after the operation was decided by a plane roentgenogram or clinical signs, and a dynamogram in some cases. The following results were obtained from analysis of the cases studied. 1. Eighty percent of the cases showed improved back pain in postoperative 3rd day and 83% showed improved sciatica in 6 months after the operation. 2. During the operation, the operative dislcogram could be done to verify the level of the lesion and the disc degeneration, disc protrusion, bony spur, narrowing of the joint space and instability during the operation could be confirmed in direct vision, so we could perform the operation for the accurate lesion. 3. Rather than the posterior approach, the anterior approach could allow all the remnants of the disc to be removed thoroughly. 4. In anterior interbody fusion, the strut of iliac bone was firmly impacted with two blocks, so its stability could be maintained, and patient could be mobilized earlier. 5. Clinical union of bone grafts was obtained in between 3 to 6 months and 96% of the cases showed bony union in 9 months. In 14 cases of two level fusions, the bony union was delayed compared to the one level fusion. 6. After the operation, the patient could return with the brace on to the office only within three months. The brace was taken off after the bony union was verified by plane roentgenogram and dynamogram.
Back Pain ; Braces ; Diskectomy ; Humans ; Intervertebral Disc Degeneration ; Joints ; Muscular Atrophy ; Reflex, Stretch ; Sciatica ; Spinal Stenosis ; Transplants

No abstract available.
Laryngeal Muscles*

Excess hair growth in unwanted areas may result from heredity, endocrine disease, or drug therapy. Conventional methods of hair removal include shaving, wax epilation and chemical depilatories that frequently cause side effects such as contact dermatitis and that also have temporary effects. Electrolysis is a well-established medical method for permanent destruction of terminal hair follicles. However, this method is tedious and efficacy has been reported to range from 15-to-50% permanent hair loss. The evolution of the laser use for hair removal continues a year after Food and Drug Administration (FDA) approval of the first laser for these applications. The authors have experienced hair removal utilizing a long-pulsed alexandrite laser. This laser system employs the principle of thermokinetic selectivity, a revolutionary concept. The principle of thermokinetic selectivity involves the use of lasers with pulse durations below the thermal relaxation on a the large target such as the hair folllicle (40-100 msec), and significantly longer than the thermal relaxation time of smaller structures of the same chromophore (melanin) in epidermis (3-10 msec). The study was based on 76 patients treated with 20 msec pulse duration laser set to energy densities of 17-21 J/cm2. Treated areas included arms, legs, beard-chin, upper lips and bikini lines. Gross observation showed leaching of hair color, decresed size of the skin pores, easily broken hair shafts, and elimination of hair. Therefore, it can be assumed that the majority of hair follicles were destroyed by this procedure, Side effects included intermediary risk of hyperpigmentation and blister. Over 80% of treated patients were satisfied with the results. As the process of research and clinical application continues, we need the long-term results of this laser system to ensure its efficacy.
Arm ; Blister ; Dermatitis, Contact ; Drug Therapy ; Electrolysis ; Endocrine System Diseases ; Epidermis ; Hair Color ; Hair Follicle ; Hair Removal ; Hair* ; Heredity ; Humans ; Hyperpigmentation ; Lasers, Solid-State* ; Leg ; Lip ; Relaxation ; Skin ; United States Food and Drug Administration

No abstract available.
Keratoacanthoma*

Various proteomics and immunological methods including mass spectrometry combined with both liquid and 2-D PAGE, and immunodetection have been employed to identify and characterize nitrated proteins from pathological samples. Nitrosative modifications regulate cellular signal transduction and pathogenesis of inflammatory responses and neurodegenerative diseases. Nitric oxide generates reactive nitrosative species, such as peroxynitrite (ONOO-) that may be involved in a number of diseases. ONOO- can mediate protein tyrosine nitration which causes structural changes of affected proteins and leads to their inactivation. Protein tyrosine nitration is a biomarker of oxidative stress and also influences protein structure and function. Recent advances in mass spectrometry have made it possible to identify modified proteins and specific modified amino acid residues. This review focuses on the significance of protein tyrosine nitration and the progress achieved in analytical methods. Although mass spectrometry of nitrated peptides has become a powerful tool for the analysis of nitrated peptides, the low stoichiometry of protein tyrosine nitration clearly demands the use of affinity chromatography to enrich modified proteins (or peptides).
Chromatography, Affinity ; Mass Spectrometry ; Neurodegenerative Diseases ; Nitric Oxide ; Oxidative Stress ; Peptides ; Peroxynitrous Acid ; Proteins ; Proteomics ; Signal Transduction ; Tyrosine

ACL plays an important role in stability of knee joint and its injury causes instability of joint which is known as the initiation of problem knee. Reconstruction of the anterior cruciate ligament would be preferred to the primary repair in treatment. And recently with the advance of arthroscopic technique and development of bone-patellar tendon-bone (BPB) graft material, the result of reconstruction is somewhat superior to that of primary repair. Authors compared the results of 20 primary repairs (Group I ) and 20 reconstructions (Group II) among 64 acute ACL injury treated Sung-Ae General Hospital from January 1989 to December 1994. The results were as follows: 1. Most common associated injuries were medial collateral ligament rupture and medial meniscal tear. 2. Group I showed postoperatively 13 negative anterior drawer test, 12 negative Lachmann test and 12 negative pivot shift test and group II showed postoperatively 17 negative anterior drawer test, 15 negative Lachmann test and 17 negative pivot shift test. (p<0.05) 3. In postoperative Lysholm knee scoring scale, group I showed 86 points and group II showed 93 points (p<0.05). 4. In postoperative KT-1000 arthrometer, 12 cases in Group I and 16 cases in Group II showed less than 2mm difference with sound side (p<0.05).
Anterior Cruciate Ligament ; Collateral Ligaments ; Hospitals, General ; Joints ; Knee ; Knee Joint ; Rupture ; Transplants

No abstract available.
Bursitis*

A clinical study of the tibial fracture was made on patients, total 234 tibias, who were treated at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from 1974 to 1979. The results were as follows: 1. The ratio between male and female was 5. 5: 1 and majority was found between 3rd decade and 5th decade. 2. In the shape of fracture, commiuted fracture, transverse fracrure were common in order. 3. The most common cause of these fractures was traffic accident and the ratio between open and closed fracture was 1:2. 4. The most common associated injury was the fibular fracture. 5. More complications ensued in open reduction and internal fixation than in closed reduction. of 50 cases, which were treated by open reduction and internal fixation, delayed union in 32 cases (64%) and infection in 11 cases (22%) resulted. 6. In the treatment of open comminuted tibial fractures with skin and soft tissue loss or marked displacement, Hoffmans external fixation method and pin and resin external fixation method bad good results, Early motion of adjacent joint, easy care of wound and rigid fixation were obtained by it.
Accidents, Traffic ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Skin ; Tibia ; Tibial Fractures ; Wounds and Injuries