The reconstruction of a mutilated thumb is one of the most fascinating aspect of hand surgery. The hand deprived of the thumb loses approximately 40 per cent of its function. it corresponds to a total body loss of 22 per cent, which is compatible with the loss of an eye. Recently reconstructive operations were performed for the restoration of the mobility, sensibility, and length of thumb. 4-flap Z-plasty were performed for the skin contracture in the first web space. For the sensibility, we transferred the neurovascular island flap from the middle or ring fingers. And we reconstructed the loss of thumb by pollicization, microsurgical reattachment, and toe-to-thumb transfer operation. We selected 11 cases who were followed over one year after operation.
Contracture ; Fingers ; Hand ; Skin ; Thumb

The biological characteristic of the silastic rod which in vivo induce the pseudosheath formation has popularized its application in the reconstructive surgery of flexor tendon injury of the digit, especially in the zone I, no-man's-land. We performed staged tendon graft in 14 digits(9 cases) and the following were the results. Clinical results of the 13 digits were good in 10 digists(77%). One case showed the untoward ill effect postoperatively. The above study has also shown that this staged tendon graft operation is applicable even to the higher grade of injury by Boyes. For the prevention of bowstring effect, A2 and A4 pulleys seem to be more essential than A1, A2. and A3.
Clinical Study ; Hand ; Humans ; Male ; Population Characteristics ; Tendon Injuries ; Tendons ; Transplants

No abstract available.
Amyloidosis*

Bicuspid ; Crowding ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Orthopedics ; Osteotomy ; Palatal Expansion Technique ; Recurrence ; Temporomandibular Joint ; Temporomandibular Joint Disorders

The 56-kilodalton protein genes of Orientia tsutsugamushi TA678, TA686, TA716, TA763 strains were amplified by PCR. The amplified products were sequenced and cloned into pIH821 vector. The recombinant proteins were expressed in Escherichia coli as fusion proteins with maltose binding protein. The recombinant proteins were purified and used for the sensitization of sheep RBCs and the reactivity of the recombinant 56-kDa proteins of Orientia tsutsugamushi TA 678, TA686, TA716 strains were analyzed with 40 sera from scrub typhus patients in Korea, 40 sera from scrub typhus in Thailand, Malaysia and Philippines. The 56-kDa protein coding DNA sequence of Orientia tsutsugamushi TA678, TA686, TA716 show 70 to 88% homology with other known strains and four variable regions are also observed. 39 of 40 sera from scrub typhus patients in Korea showed the strongest reactivity to the recombinant protein of Boryong strain and one sera showed the strongest reactivity to the recombinant protein of Gilliam strain. 14 of 40 sera from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of TA686 strain and 12 sera showed the strongest reactivity to the recombinant protein of TA716 strain. No serum from patients in Thailand, Malaysia and Philippines showed the strongest reactivity to the recombinant protein of Boryong strain.
Asian Continental Ancestry Group* ; Base Sequence ; Chungcheongnam-do ; Clinical Coding ; Clone Cells ; Cloning, Molecular* ; Escherichia coli ; Hemagglutination Tests* ; Hemagglutination* ; Humans ; Korea ; Malaysia ; Maltose-Binding Proteins ; Orientia tsutsugamushi* ; Philippines ; Polymerase Chain Reaction ; Recombinant Proteins ; Scrub Typhus ; Sheep ; Thailand

No abstract available.
Child* ; Glomerulonephritis* ; Humans

We report a case of spinal subdural abscess spreading from a epidural abscess. A 70-year-old man was hospitalized for a mild fever, chill and severe back pain. Neurological examination on admission revealed back pain with numbness, sensory deficiency on left lower extremity and without bowel or bladder dysfunction. Lumbar magnetic resonance imaging(MRI) showed pyogenic spondylitis on L1, 2, 3 with epidural abscess. A patient was treated by empiric antibiotic therapy for 6 weeks. Six weeks later, follow-up MRI showed that the pyogenic spondylitis with epidural abscess had decreased, but a cylinder like subdural abscess after arachnoiditis. After surgery, the majority of the initial symptoms were relieved except a mild both lower extremities numbness.
Abscess* ; Aged ; Arachnoid ; Arachnoiditis ; Back Pain ; Epidural Abscess* ; Fever ; Follow-Up Studies ; Humans ; Hypesthesia ; Lower Extremity ; Magnetic Resonance Imaging ; Neurologic Examination ; Spondylitis ; Urinary Bladder

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.
Agrochemicals ; Alcoholism ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Korea ; Liver Diseases

No abstract available.
Antibodies* ; Blood Donors* ; Chemistry* ; Chlamydia* ; Chlamydophila pneumoniae* ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Prevalence*

PURPOSE: To investigate the shifting trends of pathogenic organisms, antibiotic resistance, and clinical characteristics of patients with Gram-positive bacterial keratitis and to elucidate the prognostic factors. METHODS: We performed a retrospective chart review of 152 isolates in 146 eyes with Gram-positive bacterial keratitis between January 1998 and December 2012. The study was divided into 5 periods for analysis of the bacteriological profiles and in vitro antibiotic resistance. The epidemiological and clinical characteristics were compared according to bacterial isolates. Logistic regression analysis was performed to determine the risk factors. RESULTS: Gram-positive bacterial keratitis tended to decrease and significant change in the distribution of isolates was not observed. Commonly isolated organisms were S. epidermidis (48.7%), S. aureus (25.0%), and S. pneumoniae (7.2%) in order of frequency. The resistance to fluoroquinolone tended to increase (p = 0.104) and resistance to gentamicin was significantly decreased (p = 0.01). S. epidermidis had the shortest corneal epithelium healing time (p = 0.035) and the most favorable visual outcome after treatment (p = 0.035) compared with the other species. Risk factors for poor visual outcomes included a best corrected visual acuity less than 0.1 at initial evaluation and an epithelial healing time greater than 10 days. CONCLUSIONS: Gram-positive bacterial keratitis tended to decrease and S. epidermidis was the most common isolate. The clinical prognosis was most favorable in S. epidermidis. The BCVA less than 0.1 at initial evaluation was an important risk factor for poor visual outcome and surgical treatment in Gram-positive bacterial keratitis.
Drug Resistance, Microbial ; Epithelium, Corneal ; Gentamicins ; Humans ; Keratitis* ; Logistic Models ; Pneumonia ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus ; Staphylococcus epidermidis ; Visual Acuity