The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.
Free Tissue Flaps* ; Humans ; Incidence ; Myocutaneous Flap ; Pliability ; Ribs ; Superficial Back Muscles ; Tissue Donors

For the reconstruction of various tissue defects, free tissue transfer has been a very popular method in recent years. A large thin flap is required for aesthetic and functional resurfacing of the extremity defects. As a result, anterolateral thigh free flap has been thought to be useful in reconstructing soft tissue defects requiring thin flap coverage of extremities. The anterolateral thigh flap is a septocutaneous flap based on the septocutaneous or musculocutaneous perforators of the lateral femoral circumflex system. It supplies a large area of skin on the anterolateral aspect of the thigh. The advantages of this flap are safe elevation, a long vascular pedicle, and large caliber vessel. The donor scar is inconspicuous and it could also be used in a sensated flap. From September 1996 to December 1997, 16 cases of soft tissue defect on extremities were resurfaced with anterolateral thigh free flap and the outcomes were satisfactory. This flap is considered useful in one-stage reconstruction of large soft tissue defects of extremities.
Cicatrix ; Equipment and Supplies ; Extremities* ; Free Tissue Flaps* ; Humans ; Skin ; Thigh* ; Tissue Donors

No abstract available.
Brain ; Scleroderma, Localized ; Scleroderma, Systemic

Pure red cell aplasia is characterized as a normocytic anemia associated with reticulocytopenia and the absence of erythroblasts in the bone marrow. Pure red cell aplasia can be induced by various causes such as thymoma, connective tissue disease, viral infection, lymphoma, and adverse drug reactions. There have been only a few reports of pure red cell aplasia associated with acute viral hepatitis A. In Korea, no case of pure red cell aplasia caused by acute hepatitis A has yet been reported. We recently experienced a case of acute viral hepatitis A complicated by pure red cell aplasia. The patient was successfully treated with corticosteroids. Here we report this case and review the literature.
Acute Kidney Injury ; Adrenal Cortex Hormones ; Anemia ; Bone Marrow ; Connective Tissue Diseases ; Drug Toxicity ; Erythroblasts ; Hepatitis ; Hepatitis A ; Humans ; Korea ; Lymphoma ; Red-Cell Aplasia, Pure ; Thymoma

Cyclooxygenase (COX)-1 and -2 expressions in the incisional wound healing of mouse skin were determined by immunohistochemistry and Western blot analysis. By Western blotting, compared to normal skin, COX-2 activity was increased at days 1, 4, 8, and 12 and was maximal at 4 day after incisional wound of mouse skin whereas COX-1 was barely detectable. In normal skin, COX-1 immunostaining was observed among the basal cells of epidermis whereas COX-2 immunostaining was detected in the more differentiated, suprabasal keratinocytes. At 1~4 days after wound, COX-2 staining was particularly prominent in the inflammatory cells, and at day 8, many macrophage-like cells were stained positively. COX-2 immunoreactive fibroblast, macrophage-like cells, and newly formed vascular endothelial cells were increased in number at 12 days after incision. These data suggest that COX-2 is constitutively expressed, just as is COX-1, in epidermis and is associated with keratinocyte differentiation. In addition, these findings support the well-established role for COX-2, the prostaglandins that they generate, as mediators of inflammatory response.
Animals ; Blotting, Western ; Endothelial Cells ; Epidermis ; Fibroblasts ; Immunohistochemistry ; Isoenzymes* ; Keratinocytes ; Mice* ; Prostaglandin-Endoperoxide Synthases* ; Prostaglandins ; Skin* ; Wound Healing* ; Wounds and Injuries*