From March 1983, 20 patients had undergone reconstruction of the upper limb with 22 vascularized composite tissue grafts. The microsurgical procedures had several advantages for reconstruction of injured upper limbs as follows: 1. Free tissue transfer was quite an important and attractive procedure for reconstruction of an injured limb, expecially an upper limb. 2. Free vascularized transfer of composite tissue with its overlying skin was a reliable technique to obtain full thickness soft tissue coverage of a severely injured upper limb when more conservative procedures, such as the use of skin graft or local muscle flaps, had failed or were not feasible. 3. A simple skin flap could be transfered to close an open wound of the limb, but a sensory flap or a special flap such as a nail-skin, tendon-skin or muscle-skin flap was a much better donor for reconstructing the function of the upper limb. 4. When appropriate, the wrap-around procedure was the method of choice for thumb reconstruction because the great toe was preserved. The procedure provided length, stability and adequate sensibility for a functional pinch and grasp. 5. The cosmetic effect of a second-toe transplant might be inferior to the wrap-around flap, but it had the great advantage of being able to provide mobile joints in the reconstructed thumb. As far as the donor foot was concerned, no patients had real trouble functional impairment.
Extremities ; Foot ; Hand Strength ; Humans ; Joints ; Methods ; Microsurgery ; Skin ; Thumb ; Tissue Donors ; Toes ; Transplants ; Upper Extremity ; Wounds and Injuries

Xanthogranulomatous pyelonephritis, an uncommon chronic inflammatory renal disorder of middle-aged women, is rarely seen in childhood. A 10 year-old boy with focal type of this disease in upper and lower pole was experienced. Patient had a intermittent fever and right flank pain without palpable mass. The blood analysis only revealed ESR increase but no anemia, no leukocytosis. There was no history or signs of urinary tract infection or calculi. The urine analysis and culture showed nothing abnormal. An intravenous pyelogram, ultrasonogram, abdominal CT and selective renal arteriography only demonstrated a non functioning upper pole of right kidney. During operation, a gross finding and frozen section strongly showed xanthogranulomatous pyelonephritis and diagnosis was made on histological examination, After nephrectomy, there had been no evidence of disease recurrence during 2 years follow-up period.
Anemia ; Angiography ; Calculi ; Child* ; Diagnosis ; Female ; Fever ; Flank Pain ; Follow-Up Studies ; Frozen Sections ; Humans ; Kidney ; Leukocytosis ; Male ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous* ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Tract Infections

No abstract available.
Immunoglobulins* ; Tuberculosis, Pulmonary*

No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

No abstract available.
Peripheral Arterial Disease*

Tuberculosis of the bones and joints is not an uncommon condition in Korea, but extraosseous tuberculosis of the soft tissue is relatively rare. A few reports of extraosseous tuberculosis, tuberculous tenosynovitis and bursitis, hsve been published in the literature, but there have been no reports concerning soft tissue tuberculosis in other than the tendon, synovium and bursa. We reviewed 7 cases of soft tissue tuberculosis of the lower back at the Department of Orthopedic Surgery, Yonsei University College of Medicine from Jan. 1984 to Sept. 1986. Five cases had received steroid injection to the lumbosscral region, and two had undergone acupuncture, thus all seven cases had experienced injections to the lumbosacral region. We think that a possible route of infection is the hematogenous one, at an area of decreased local resistance after steroid injection, And that direct inoculation of the tuberculous bacilli was result of artificial injection and acupuncture. But, further studies are needed to support the proposal that the hematogenous route following steroid injection and direct inoculation by artifical puncture is the source of soft tissue tuberculosis. These results indicate that steroid injections into the soft tissue should be performed limitedly under sterile conditions.
Abscess ; Acupuncture ; Bursitis ; Joints ; Korea ; Lumbosacral Region ; Orthopedics ; Punctures ; Synovial Membrane ; Tendons ; Tenosynovitis ; Tuberculosis

To evaluate whether mast cells are involved in developing pathologic feature of psoriasis, 60 biopsy specimens of patients with psoriasis were analyzed. They had not been treated for at least 1 week before skin biopsy. Histological findings in early and fully developed lesions and numbers of mast cells in their dermal papillae were investigated. The results were as follows: 1. In epidermal changes of psoriatic lesions, parakeratosis and acanthosis revealed different findings between early lesions and fully developed lesions. While early lesions revealed mounds of parakeratosis and mild to moderate acanthosis, fully developed lesions revealed confluent parakeratosis and moderate to severe acanthosis. In dermal changes of psoriatic lesions, papillomatosis revealed different findings between early developed lesions and fully developed lesions. While early lesions revealed normal to moderate papillomatosis, fully developed lesions revealed moderate to severe papillomatosis. 2. Degree of acanthosis is related to the degree of papillomatosis. The more increase in the degree of acanthosis, papillomatosis, and parakeratosis, mast cell numbers in dermal papillae were more increased. 3. Mast cell numbers in dermal papillae were more increased in fully developed lesions than early lesions. 4. These findings suggest that mast cell may play an active role in developing pathologic finding of psoriasis.
Biopsy ; Humans ; Mast Cells* ; Papilloma ; Parakeratosis ; Psoriasis* ; Skin

Antiseptics are substances that kill or prevent the growth of microorganisms when applied to living tissue. They must be effective against microorganisms but must also retain their activity in presence of body fluids without being harmful locally or systemically. Among many antiseptics, Betadine(R) has been widely used because of its low toxicity and high germicidal efficacy. We reported 2 cases of allergic contact dermatitis to Betadine(R) in surgical patients. They had eczematous eruption along the Betadine(R) applying sites. Path tests Betadine(R) confirmed the diagnosis.
Anti-Infective Agents, Local ; Body Fluids ; Dermatitis, Allergic Contact* ; Diagnosis ; Humans

We report a case of trichorrhexis nodosa in 16-year-old male. Multiple broken hair patches were seen on the both eyebrows. Scanning electron micrascopic findings revealed typical trichorrhexis nodosa; nodular swelling of hair shaft, loss of hair cuticle, longitudinal fissuring and fracture of hair cortex, and paintbrush effect on the side of fracture. Simple avoidance of trauma gave some regrowth of hair. Intralesinional administration of triamcinolone acetonide was not to be effective.
Adolescent ; Eyebrows* ; Hair ; Humans ; Male ; Triamcinolone Acetonide

Simple bone cyst is a benign bone tumor occurring most frequently in the long bone. The pathogenesis is not yet fully known and there is no established mode of optimal treatment. In 1979, Scaglietti reported favorable results in the treatment of simple bone cyst with steroid injection. We have studied 23 cases of curettage with bone graft and 13 cases of steroid injection in 39 cases of histologically proven simple bone cyst in the department Orthopedic Surgery at College of Medicine Yousei University dating from Jan, 1970 to Jan. 1989. In 1 case out of 23 cases, there was no improvement in curettage with bone graft, and this cases was treated with steroid injection. There were 4 cases which did not receive any treatment except cast immobilization. In this case, the patient refused further treatment. The mean follow up period was 20.1 months and the results and conclusions were as follows:1. The average age of patients was 17.9 years, and incidence under 20 years was 74.4% The male to female ratio was 1.6 to l. 2. Twenty three cases were treated with curettage with bone graft. The average age of patients was 16.1 years, and there were 4 cases of recurrence of simple bone cyst (17.3% ). 3. Thirteen cases were treated with steriod injection. The average age of patient was 12.1 years, and there was 1 case of recurrence of simple bone cyst(7.6%). There were 6 cases who were completely healed after one steroid injection, 3 cases after 3 injections, 1 case after 4 injection, and 3 cases who had a maximun of 5 injections. 4. The difference was statistically significant from equality (p<0.05). The steroid injection method is a more simple and a more safe procedure than curettage with bone graft, and can be done at the Out-Patient Department. Steroid injection may be repeated in persisting and recurrent simple bone cyst.
Bone Cysts ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Orthopedics ; Outpatients ; Recurrence ; Transplants