Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.
Free Tissue Flaps ; Microsurgery ; Thumb ; Toes

No abstract available.
Tomography, Emission-Computed, Single-Photon*

The diagnosis of death by drowning is one of the hardest challenges in forensic pathology. Circumstantial factors and physical evidence such as autopsy findings are both important in drowning. However, drowning findings are not specific and no laboratory tests can specifically detect drowning. It has been suggested that fluid in the paranasal sinuses, especially the sphenoid sinuses, is a sign of drowning, in conjunction with other autopsy findings. This study aimed to determine the frequency of detection of fluid in the sphenoid sinuses in cases of death by drowning. From 2003 to 2012, 54 autopsied cases of drowning were selected and reviewed in the Department of Forensic Medicine, Kyungpook National University School of Medicine, Daegu. The most common autopsy findings were foaming at the mouth and nostrils (13%), frothy fluid in the airways (28%), pulmonary edema with overexpansion of lungs (87%), drowning liquid in the stomach and duodenum (52%) and hemorrhages in the petromastoid part of the temporal bone (93%). Fluid in the sphenoid sinuses was detected in 45/54 cases (83%). The plankton test was positive in 33/54 cases (87%), however, in 26 of these cases, plankton was found only in the lung tissue. In conclusion, detection of fluid in the sphenoid sinuses could be a diagnostic sign for death by drowning. The sphenoid sinuses are easily accessible on autopsy, so it is highly recommended to look for fluid in the sphenoid sinuses when performing an autopsy on bodies recovered from water.
Autopsy ; Cause of Death ; Drowning ; Duodenum ; Forensic Medicine ; Forensic Pathology ; Hemorrhage ; Humans ; Lung ; Mouth ; Paranasal Sinuses ; Plankton ; Pulmonary Edema ; Sphenoid Sinus ; Stomach ; Temporal Bone

BACKGROUND: Various surgical techniques are used for the cure of hemorrhoid according to the extent of disease and severity of symptom. Purpose : We compared the postoperative clinical course after submucosal hemorrhoidectomy and ligation and excision of hemorrhoids. MATERIAL AND METHODS: Between February 1995 and May 1997, 221 patients underwent submucosal hemorrhoidectomy and 111 patients underwent ligation and excision of hemorrhoids at the Department of Surgery, Eulji General Hospital. We compared the hospital course and postoperative complications in two group. RESULTS: For submucosal hemorrhoidectomy group, mean operation time was 38 minutes, the improvement of postoperative pain, is based on no needs of analgesics after 48 hours of postoperation, was seen in 115 patients(52.0%), wound healing took 19.5 days in average, and mean hospital stay was 6.4 days. For ligation and excision group, these findings were mean operation time 21 minutes, the improvement of postoperative pain in 47 patients(42.3%), wound healing 25.4 days, and hospital stay 7.2 days. Postoperative complications such as skin tag, edema, and were more common in submucosal hemorrhoidectomy group. But anal fissure, stenosis were more frequent in ligation and excision group, although they did not occur later. CONCLUSION: We think that submucosal hemorrhoidectomy is a better method than ligation and excision in respect of postoperative course and complications.
Analgesics ; Constriction, Pathologic ; Edema ; Fissure in Ano ; Hemorrhoidectomy ; Hemorrhoids* ; Hospitals, General ; Humans ; Length of Stay ; Ligation ; Pain, Postoperative ; Postoperative Complications ; Skin ; Wound Healing

Diastematomyelia is an uncommon congenital malformation of the vertebral axis characterized by a localized longitudinal separation of the spinal cord with an interposed septum. It may be found in association with congenital scoliosis. The Authors experienced a case of congenital scoliosis with diastematomyelia. Diastematomyelia was surgicallv resected and scoliosis was corrected by Dwyer operation 5 months later. The results of both operations were satisfactory in 10 months follow up.
Follow-Up Studies ; Neural Tube Defects ; Scoliosis ; Spinal Cord

BACKGROUND: Psoriasis is a disabling and intractable disease influencing the psychosocial life of the patients. Patients who are frustrated with orthodox medicine may explore alternative therapies. OBJECTIVE: This study was done to research on the actual condition of the use of alternative medicine in the patients with psoriasis. METHODS: A self-administered questionnaire was constructed, and was given to the patients to answer our questions. RESULTS: Among 128 patients with psoriasis, 61 (47.7%) reported previous use of one or more forms of alternative medicine. The absence of satisfactory long-term effects of physician-provided therapy was the main reason for patients trying alternative medicine. Persons without skin s disease and the mass media were the main sources of information on alternative medicine. CONCLUSION: Alternative therapies were widely utilized by subjects participating in this study, and dermatologists need to be aware of alternative treatments employed by their patients.
Complementary Therapies* ; Humans ; Mass Media ; Psoriasis* ; Skin

Ichthyosis hystrix is characterized by extensive bilateral systemic involvement of thick hyperkeratotic verrucous papules forming confluent plaques or linear arrangement and is currently classified into a systematized epidermal nevi, which was once conaidered as an extreme variant of congenital ichthyosiform erythroderma. Here is presented a case with typical clinical features and characteristic histopathologic findings of epidermolytic hyperkeratosis. Our patient exhibited no skeletal or CNS abnormalities reported to be associated with this condition. Marked improvement was obtained with oral administration of etretinate.
Acitretin* ; Administration, Oral ; Eating ; Etretinate* ; Flushing ; Humans ; Hyperkeratosis, Epidermolytic ; Hypertrophy ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis* ; Mandible ; Nevus ; Porcupines* ; Sclerosis ; Sweat ; Sweating ; Sweating, Gustatory* ; Young Adult

The prognosis of malignant ovarian tumor is poorer than that of borderline malignant ovarian tumor, Therefore an accurate diagnosis and estimation of the biologic behavior of the tumor are necessary for proper management of the patient. The histologic investigation of the tumor may provide information on the estimation of the malignant potential of tumor cells, but it may be a questionable method because of the subjective determination of tumor grade. Quantification of proliferative activity of tumor cells may play a role as an objective method to provide an estimation of the malignant potential of tumor cells. An evaluation of histologic findings was done on 84 cases of ovarian mucinous and serous tumors that were surgically resected and diagnosed during the period from January 1981 through July 1992. The proliferating cell nuclear antigen (PCN A) labelling index estimated from the immunohistochemical stain for PCN A and the Sphase fraction and porliferative index obtained from flow cytometric DN A analysis were assessed each other with histologic findings. The results are as follows: The presence of aneuploidy in malignant tumors was statistically significant as compared with benign tumors. The borderline malignant tumors showed no significant difference between the number of diploidy and aneuploidy. The PCNA labelling index, S-phase fraction and proliferative index tended to increase as the histologic grade of tumors went up. They were higher in malignant tumors than in others. The PCN A labelling index, S-phase fraction and proliferative index were higher in tumors with aneuploidy than in those with diploidy. In contrast to borderline malignant tumors, the PCNA labelling index in malignant tumors revealed a significant relation with the mitotic index. The S-phase fraction and proliferative index showed, in malignant tumors, a close correlation with the architectural grade and nucleolar grade, but not in borderline malignant tumors. Considering these results, the presence of aneuploidy, PCNA label.

The aim of this study was to quantitatively estimate the effect of hypertension upon the left ventricle, using the systolic time intervals. The subjects for this study consist of 72 hospitalized hypertensive patients including 38 males and 34 females. The measurements of the systolic time intervals were obtained from simultaneous high speed recording(100mm/sec) of an electrocardiographic lead best displaying the onset of left ventricular depolarization, a carotid pulse tracing, and a phonocardiogram best displaying the initial high frequency vibrations of the aortic valve closure sound. All data were corrected for heart rate and sex using the regression equations of Weissleretal. The results were follows: 1) As the diastolic blood pressure increased, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 2) As the electrocardiographic findings related to hypertension became severe shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 3) As the hypertensive retinopathy became severe, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. It was suggested that the measurement of the systolic time intervals are useful in assessing the effects of hypertension upon the left ventricular function and in detecting early recognition of cardiac dysfunction in hypertension, even though not necessarily associated with overt heart failure.
Aortic Valve ; Blood Pressure ; Electrocardiography ; Female ; Heart Failure ; Heart Rate ; Heart Ventricles ; Humans ; Hypertension ; Hypertensive Retinopathy ; Male ; Systole* ; Ventricular Function, Left ; Vibration

BACKGROUND AND OBJECTIVES: Intracardiac electrocardiographic finding using as a guide for selective catheter ablation in patients with AV nodal reentrant tachycardia (AVNRT) is not specific. Therefore, we evaluated the efficacy and safety of the anatomical approach for catheter ablation in patients with AVNRT. MATERIALS AND METHOD: Among the patients diagnosed as AVNRT by electrophysiologic study, total 66 patients (M:F=26:40) were included in this study. In the right anterior oblique radiographic view, the septal annulus of tricuspid valve, extending from the most posterior region of the annulus adjacent to coronary sinus ostium (posterior) to His bundle recording site (anterior), was divided into posterior (P), mid (M), and anterior (A) sites. Radiofrequency (RF) energies were applied from the posterior part to the anterior part sequentially along the septal annulus of tricuspid valve until successful ablation. RESULTS: Successful anatomical sites were located in posterior (11 patients), mid (48 patients), and anterior (7 patients) sites. The most patients (62 patients) were treated with slow pathway ablation except 4 patients in whom fast pathway was ablated. Probable slow potentials were observed in 8 patients (12%, 3 in posterior sites and 5 in mid sites). Transient complete AV block followed by first degree AV block and delayed complete AV block was occured in one case whose ablation site was A1. And another 3 patients had postablation first degree AV block. CONCLUSION: In patients with AVNRT, the ablated pathway were different according to successful anatomical site. And RF catheter ablation of atrioventricular nodal reentrant circuit guided by anatomical landmark is safe and efficacious.
Atrioventricular Block ; Bundle of His ; Catheter Ablation* ; Catheters* ; Coronary Sinus ; Electrocardiography ; Humans ; Tachycardia, Atrioventricular Nodal Reentry* ; Tricuspid Valve