Soft tissue coverage of heel defects has long been a difficult problem. In 1982, Iron reported eight cases of heel defects in children using an ipsilateral posterior thigh flap with use of the Hoff-man's skeletal fixation apparatus for immobilization. We report three cases of heel defects treatment in children using ipsilateral posterior thigh flap and detach flap in an average 13 days with aid of single photon emission computed tomography(SPECT) for evaluation of circulation status of flap.
Child ; Fracture Fixation ; Heel ; Humans ; Immobilization ; Iron ; Thigh ; Tomography, Emission-Computed, Single-Photon

Bilateral absence of the patella as an isolated congenital abnormality is an extremly rare condition. Three members in a family were found to be afflicted with the condition. Clinical examination failed to reveal any stigmata of hereditary osteo-onychodysplasia.
Christianity ; Congenital Abnormalities ; Humans ; Nail-Patella Syndrome ; Patella

We report one case of aseptic necrosis of both talus which has developed without any evidence of previous trauma. Aseptic necrosis of the talus is known to occur after any trauma which result in iterruption the blood supply to talus. Atraumatic aseptic necrosis of talus is extremely rarre condition. Some cases of atraumatic aseptic necrosis of talus were repoted by some authers, in whom Garcia described the first case in 1928. Most of the reported atraumatic aseptic necrosis were due to long term steroid therapy for unrelated medical problems and others were related to Alcoholism, Sepsis and Tuber culosis. ln this case we think for it may be caused or contributed by steroid therapy.
Alcoholism ; Necrosis ; Sepsis ; Talus

Melorheostosis is a rare from of hyperostosis characterized by candle greasing down along the major axis of long bones. A case of melorheostosis combined with exostosis in the fifth toe was presented here because of its rarity.
Exostoses ; Hyperostosis ; Melorheostosis ; Toes

Thrombotic thrombocytopenic purpura(TTP) is characterized by fluctuating neurologic signs, microangiopathic hemolytic anemia, thrombocytopenia, fever and renal abnormalities. Neurologic involvement occurs in over 90% of patients with TTP. TTP is rarely associated with large intracerebral hemorrhage and peripheral neuropadiy. The authors report a case of TTP associated with large intracerebral hemorrhage confirmed by brain MRI and peripheral neuropathy diagnosed electrophysiologic findings and sural nerve biopsy.
Anemia, Hemolytic ; Biopsy ; Brain ; Cerebral Hemorrhage* ; Fever ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Peripheral Nervous System Diseases ; Purpura, Thrombotic Thrombocytopenic* ; Sural Nerve ; Thrombocytopenia

Rhinocerebral mucormycosis, which is a fulminant and progressive disease often seen in debilitated hosts! Requires a high degree of clinical suspicion to promptly diagnose and an aggressive medical and surgical therapy. The prognosis is grave, especially in case of bilateral cavernous sinus thrombosis. We report a case of 69-year-old female patient with bilateral cavernous sinus thrombosis caused by rhinocerebral mucormycosis, who showed orbital swelling and lateral bulging of bilateral cavernous sinus in orbital CT, and large branching nonseptate hypae in biopsed specimen of the left periorbital necrotic tissue.
Aged ; Cavernous Sinus Thrombosis ; Cavernous Sinus* ; Female ; Humans ; Mucormycosis* ; Orbit ; Prognosis

BACKGROUND:Acute seizures that increase neuronal activity cause a rapid and transient induction of the immmediate early c-fos in specific brain regions. C-fos gene may mediate long-term changes in cell function, such as growth, differeniation, and development, in response to acute extracellular stimulation. This study is designed to compare the expression of Fos protein in hippocampus after single and repeated injections of kainic acid (KA). METHODS:In KA-single injection model, twelve adult male Sprague-Dawley rats were treated with single intraperitoneal injection of convulsive dose(20-30 mg/kg) of KA, and. in KA-multiple injections model, seven rats received KA by repeated daily intraperitoneal injections for 15 days. Eight control rats received normal saline. Expression of Fos protein was tested in hippocampus by immunohistochemical staining, and was scored by the degree of staining intensity and the ratio of stained cells to tested ones. RESULTS:The scores tended to increase in CA3 and dentate gyrus were significantly higher in KA-single injection model than in control (p<0.05). In comparison with scores in KA-model. CONCLUSION:These results show that repeated seizure produces some blockade of c-fos induction in CA2, CA3 and dentate gyrus. This may be a long-term adaptive response by the nervous system to repated neuronal activation
Adult ; Animals ; Brain ; Dentate Gyrus ; Genes, fos ; Hippocampus* ; Humans ; Injections, Intraperitoneal ; Kainic Acid* ; Male ; Nervous System ; Neurons ; Rats* ; Rats, Sprague-Dawley ; Seizures

The Saville's index of the lumbar spine and the Singh's index of the femoral neck is very simple method to measure degree of osteoporosis. Authors compared Singh's index and Savilles index with Dual Photon Absorptiometry(D.P.X.) and studied the reliability and clinical usefulness of two indices. We took the D.P.X. and simple L-spine lateral view in 103 patients in same time and also performed D.P.X. and both hips A-P view in 70 patients, then analyzed and compared each two indices with D.P.X. The Singh's index had less interpersonal difference and intrapersonal difference compared with Saville's spine index. There was some confidence of Singh's index and Saville's spine index compared with the D.P.X., but the relationship between Saville's spine index and D.P.X. was less promising than that of Singh's index. Authors suggest that the Saville's spine index has less clinical usefulness than Singh's index in measurement of osteoporosis.
Femur Neck ; Hip ; Humans ; Methods ; Osteoporosis ; Spine

No abstract available.
Lupus Erythematosus, Systemic* ; Pregnancy*

BACKGROUND: Video-assisted thoracic surgical procedure via thoracoscopy has recently gained popularity, as it avoids a thoracotomy, reducing intraoperative blood loss, postoperative pain, respiratory dysfunction and hospital stay. However, to visualize adequately the intrathoracic structures, creation of artificial pneumothorax by carbon dioxide insufflation during thoracoscopy would cause significant hemodynamic compromise. The aim of this study was to evaluate the effect of CO2 insufflation into the pleural cavity on the hemodynamics and the arterial blood gas tension under general anesthesia. METHODS: Twenty-five patients, after intubation with single lumen endotracheal tube, underwent enflurane (1~2%) and N2O-O2 (1:1) general anesthesia. Before placement of a thoracoscope, the baseline mean arterial pressure and heart rate were obtained. Measurements were taken at 5, 10, and 20 min. after the beginning of carbon dioxide insufflation (3~5 mmHg) and 10 min. after gas evacuation. Blood gas analyses were done before, during CO2 insufflation and after CO2 evacuation. Data were analyzed using Student t-test. RESULTS: Positive-pressure CO2 insufflation (3~5 mmHg) caused a decrease of mean arterial pressure (5~7%) and an increase of airway pressure (1.5 times) and heart rate (13~20%) throughout the gas insufflation period (p<0.05). Blood gas analyses revealed no significant change. CONCLUSIONS: These results suggest that low CO2 insufflation pressures (3~5 mmHg) may cause cardiovascular depression during thoracoscopy. Therefore careful monitorings should be done during this procedure.
Anesthesia, General* ; Arterial Pressure ; Blood Gas Analysis ; Carbon Dioxide* ; Carbon* ; Depression ; Enflurane ; Heart Rate ; Hemodynamics* ; Humans ; Insufflation* ; Intubation ; Length of Stay ; Pleural Cavity ; Pneumothorax, Artificial ; Postoperative Hemorrhage ; Thoracic Surgical Procedures ; Thoracoscopes ; Thoracoscopy* ; Thoracotomy