Since the introduction of surgical microscope in microvesael surgery by Jacobson and Suarez in 1960, many surgeons have succeeded replantation, transplantation of composite segment of tissues so called free fiap-free bone graft and toe to hand transfer. McCraw & Furlow reported successfully transfered dorsal foot flap using dorsalis pedis artery in 1975 and Cobett transfered great toe to band for reconstruction of the amputated thunb. The authors experienced six cases of microsurgery using dorsalis pedis artery durig the recent two years in the department of Orthopaedic surgery of Soon Chun Hyang College and results in this paper. 1. Four cases out of six were dorsalis pedis free flap, one case was second toe to thumb and tbe other one was reconstruction of an amputated thumb in one stage using iliac bone graft and dorsalis pedis flap. 2. One case out of four cases of dorsalis pedis free flap was performed for reconstruction of contracted first web and the other cases were performed for foot. 3. Five cases out of six were successfully transfeed, one case which was toe to thumb was failed. The cause. of fail was probably due to post-operative hematoma. 4. Composite tissue using dorsalis pedis artery is one of the good donor site for composite tissue transfer for not only skin defect and scar contracture of the hand and foot but also reconstruction of the amputated fingers because it has several advantages; an acceptable thickness, a constant arterial supply, venous drainage through the saphenous system, and constant innervation through the terminal branches of the superficial and deep peroneal nerve.
Arteries ; Cicatrix ; Contracture ; Drainage ; Fingers ; Foot ; Free Tissue Flaps ; Hand ; Hematoma ; Humans ; Microsurgery ; Peroneal Nerve ; Replantation ; Skin ; Surgeons ; Thumb ; Tissue Donors ; Toes ; Transplants

The ten cases of metallic failure after I-M nailing & plate fixation who were treated at depart tment of orthopaedic surgery, Soon Chun Hyang University during nine years from June, 1974 to May, 1983 were clinically analysed. The survey as summerized as follows: l. Of the ten cases, six cases were seen the breakage of plate, two cases were the loosening of screw, one case was the brakage of nail & one case was the angulation of nail. Of the six cases of plates, two cases were DCP, three cases were ordinary plate & one case was Thornton plate. 2. Of the six cases who metallic failure occurred as plate failure, five cases were the femur fractures, one case was the tibia fracture. All case who metallic failure occurred as nail failure were ferumr fractures. Of the two cases of screw loosening, one case was the fermur fracture. One case was the tibia fracture. 3. The average interval between operation and metallic failure. 1) The plate breakage was 6.3 months. 2) The screw loosening was 7 months. 3) The nail breakage was 6 months. 4) The nail angulation was 8 months. 4. The causes of failure after internal fixation. 1) The causes of plate breakage.
Femur ; Fractures, Comminuted ; Internal Fixators ; Overweight ; Tibia ; Weight-Bearing

No abstract available in English.
Fracture Fixation, Intramedullary

Thirty-seven patient who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Soonchunhyang University Hospital from Jan. 1979 to March 1982. The obtained results are as follow; 1. Nineteen cases out of 37 cases of the forearm bone fracture were both forearm bones, 10 cases were ulna and 8 were radius fracture. 2. Twenty-three cases out of 37 were closed and 13 cases were open fracture, respectably. 3. The applied treatment were manual reduction with cast immobilization, intramedullary naliing, plate and screw fixation and combined. 4. Mean duration of primary bone union of the forerm bone fracture which were treated by plate and screw was 12. 4 weeks, combined fixation was 12.8 weeks, intramedullary nailing was 15.3 weeks and that of manual reduction and cast was 16 weeks in order. 5. Functional result was classified according to the rating system of Smith and Sage. The best method was plate and screw and the worst was manual reduction and cast immobilization. 6. D.C.P. fixation seems to be one of the best method in this series. Combined method, in a way of D.C.P. for radius and I–M nailing for ulna, is a method when shortening of operation time is inevitable.
Adult ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Immobilization ; Methods ; Orthopedics ; Radius ; Radius Fractures ; Ulna

It is not uncommon that an endoscopist should differentiate metastatic or invasive cancer to the colorectum from primary colorectal cancer with its endoscopic appearances. This study reviewed the endoscopic appearances of 7 patients who were proved to have metastatic or invasive cancers to the colorectum, both clinically and pathologically. The primary cancers were uterine cervix cancers in 3 patients, advanced gastric cancers in two, and prostatic cancer in one. The endoseopic appearances of metastatic or invasive cancer showed several characteristic features with regard to those of primary colorectal cancer, as follows. 1) Multiplicity of lesions 2) Nodular lesion with unaffected mucosa or with mild degree of erosions 3) Concentric defarmities with conical extremities and the absence of shelving margins 4) Inflammatroy lesions with mucosal hyperemia, erosion, ulceration, and bleeding, but without definite mass formation.
Cervix Uteri ; Colorectal Neoplasms ; Extremities ; Female ; Hemorrhage ; Humans ; Hyperemia ; Mucous Membrane ; Prostatic Neoplasms ; Stomach Neoplasms ; Ulcer

PURPOSE: The incidence of multiple primary malignant tumor has ranged from 0.7% to 11% in the medical literature. Various organs in the digestive system are the sites of multiple primary cancer (MPC). MPC may be synchronous or metachronous depending on the interval between their diagnosis. To the best of our knowledge, there are only rare reports of resected cases of synchronous primary carcinomas that developed in the GB and duodenum. METHODS: We present here a patient who underwent an operation for synchronous primary carcinomas of the GB and duodenum. A 51-year-old female was admitted for postprandial abdominal discomfort. CT scan and MRI of the abdomen showed a 3 x 2 cm sized heterogenously enhancing mass in the GB and a 3.7 x 2.7 cm sized hetrogenously enhancing mass in the 2nd portion of the duodeum. The laboratory findings, including the tumor markers, were non-specific. An elective operation was done under the impression of combined GB cancer and cancer in the 2nd portion of the deuodenum. On the operative findings, there was a 3 x 2.5 cm sized mass in the GB and a 5 x 4 cm sized duodenal mass with near complete luminal obstruction 3 cm distal from the pyloric ring. Radical cholecystectomy with wedge resection of the liver bed and Whipple's operation was performed. RESULTS: On microscopic examination, the GB mass was well differentiated adenocarcinoma and the duodenal mass was moderately differentiated adenocarcinoma, and one lymph node (a lymph node along the common hepatic artery) among the 18 dissected lymph nodes was invaded by tumor cells. The microscopic findings showed that the GB mass and duodenal mass were synchronous primary carcinomas. The patient recovered uneventfully and is alive and doing well without evidence of recurrence at 21-months of follow up evaluation. CONCLUSIONS: We report here on a case of combined curative resection for synchronous primary carcinomas of the gallbladder and duodenum.
Abdomen ; Adenocarcinoma ; Cholecystectomy ; Diagnosis ; Digestive System ; Duodenum* ; Female ; Follow-Up Studies ; Gallbladder* ; Humans ; Incidence ; Liver ; Lymph Nodes ; Magnetic Resonance Imaging ; Middle Aged ; Phenobarbital ; Recurrence ; Tomography, X-Ray Computed ; Biomarkers, Tumor

Osteoclast-like giant cell tumor of the pancreas is a very rare neoplasm, of which the histiogenesis remains controversial. A 63-yr-old woman was hospitalized for evaluation of epigastric pain. An abdominal computerized tomography revealed the presence of a large cystic mass, arising from the tail of pancreas. A distal pancreatectomy with splenectomy was performed. Histologically, the tumor was composed of mononuclear stromal cells intermingled with osteclast-like giant cells. In addition, there was a small area of moderately to well differentiated ductal adenocarcinoma. The final pathologic diagnosis was osteoclast-like giant cell tumor of the pancreas with ductal adenocarcinoma. Here, we describe the histopathological, immunohistochemical, ultrastructural and molecular biological findings of this tumor with review of the literature pertaining to this condition.
Antigens, CD/analysis ; Antigens, Differentiation, Myelomonocytic/analysis ; CA-15-3 Antigen/analysis ; Carcinoma, Pancreatic Ductal/metabolism/*pathology/ultrastructure ; Diagnosis, Differential ; Female ; Giant Cell Tumors/metabolism/*pathology/ultrastructure ; Humans ; Immunohistochemistry ; Keratin/analysis ; Microscopy, Electron ; Middle Aged ; Osteoclasts/*pathology ; Pancreatic Neoplasms/metabolism/*pathology/ultrastructure ; Proliferating Cell Nuclear Antigen/analysis ; Vimentin/analysis