The pulmonary cavernous hemangioma is usually from birth and there may be without symptoms until adulthood. Larger or multiple pulmonary angiomata with considerable pulmonary arteriovenous shunts may cause cyanosis, finger clubbing, dyspnea and frequently accompanyingbruit. Recently, we experienced a case of cavernous hemangioma of the lung. A 34-year-old woman was admitted to our hospital for surgical evaluation of a 4 cm solitary, round nodule in the right upper lobe on the chest X-ray and CT scan. She had no symptoms. Laboratory findings are within normal limits except for elevated glucose levels. At surgery, the mass was well encapsulated and easily excised from the peripheral portion of the posterior segment of the right upper lobe. Grossly, it consisted of a 4 cm in diameter, round, soft, sponge-like, hemorrhagic, slightly lobulated mass with a smooth external surface. Microscopically, the mass was composed of vessels, which were thin walled, dilated and filled with blood. The wall of the abnormal vessels was thin and composed of endothelium and fibrous connective tissue with only a little smooth muscle. Immunohistochemically, the wall of the dilated abnormal vessesls showed negative reaction for cytokeratin(low and high) and epithelial membrane antigen but weakly positive reaction for UEA-1 in focal areas.
Adult ; Male ; Female ; Humans ; Hemangioma

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

Two hundred and eighty six cases of the fracture of the tibial shaft treated at Orthopedic Department of the Chosun University Hospital during the period from January 1974 to December, 1978. The following results were obtained. 1. Most common cases of the tibial shaft fractures were traffic accidents (66.1%). 2. The incidence of trauma was high in the young man, most frequent in the 2nd and 3rd decade (43.0%). 3. The evaluation was done according to the classification of Ellis. Among 286 cases of the fractures of tibial shaft, 139 being mild severity, 70 moderate severity and 77 major severity. 4. The group of mild severity at the fracture of upper 1/3 of tibial shaft was shown the best prognosis and the average healing period was 9.3 weeks. 5. The wound infections in the open fractures of tibial shaft were revealed 37 cases (35%) and 8 cases of chronic osteomyelitis (8%). 6. Of 54 cases, we experienced 38 cases of delayed union (13.3%), 16 cases of non-union (5.6%) and the highest rate of delayed or non-union was shown in the group of major severity at the fracture of lower 1/3 of tibiai shaft. 7. The open reduction by the compression plating reduced the time of healing period and delayed the time of healing period by the intramedullary nailing.
Accidents, Traffic ; Classification ; Fracture Fixation, Intramedullary ; Fractures, Open ; Incidence ; Orthopedics ; Osteomyelitis ; Prognosis ; Wound Infection

Since Palmer's introduction of the torn medial collateral ligament, many clinical and anatomical studies were performed. But any reconstructive procedure of the medial collateral ligament of the knee known to us, has not solved the problem completely yet. The purpose of present study is to describe a technique of reconstruction, socalled Tatsuzawa's tenodesis surgery of transposed semitendinosus tendon, and is to report the clinical results of 45 cases treated by his procedure between April 1976 and June 1981. In addition, significance of the procerdure was compared with the result of primary closure group of the torn ligament. Tatsuzawa's procedure consists of reinforcement surgery of the repaired or unrepaired torn medial collateral ligament with forwardly transposed semitendinosus. The semitendinosus tendon was brought forward to lie adjacent to deep layer of the medial collateral ligament. The transposed part of the tendon was sutured throughout its length to the medial collateral ligament and to the medial aspect of the tibia and femoral condyle. Because the direction of transposed tendon as similar to the direction of fibers of medial collateral ligament, the procedure was very simple and anatomical one, and had some functional advantages. In this series some old cases are treated only with tendon reinforcement operation without repairing the laxed torn ligament. The results of the surgery were evaluated by the Asais modification of the Feltons evaluation criteria. Results obtained were as follows: 1. In semitendinosus tenodesis with or without primary repair of the torn ligament, satisfactory results were obtained (excellent and good) in 33 cases (73.3%). But in 20 cases of the primary repair group, the satisfactory results were obtained in 11 cases (55%). More satisfactory results were obtained with the semitendinosus tendon reinforcement operation of the torn ligament than only with primary repair. 2. In 29 cases with fresh injury of the medial collateral ligament in which the primary repair together with the tendon reinforcement procedure was performed, satisfactory (excellent and good) results were obtained in 72.4% (21 cases), and in 16 untreated old cases in which only the tendon reinforcement procedure were done, satisfactory results were obtained in 75%. 3. In 5 cases having medial collateral and anterior cruciate ligaments tear, excellent results were obtained in 3. This explains that semitendinosus tendon reinforcement procedure is the key one of the reconstructive operative procedures. It is thought that the procedure is also effective for the anterior cruciate tear to provide the anterior instability.
Anterior Cruciate Ligament ; Clinical Study ; Collateral Ligaments ; Knee ; Ligaments ; Surgical Procedures, Operative ; Tears ; Tendons ; Tenodesis ; Tibia

No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

Microform cleft lip is a mild form of incomplete cleft lip, also known as a minimal occult, abortive, forme fruste cleft lip. However, it has no definition and few methods have been reported for its correction. A microform cleft lip is characterized as the incomplete union of the superficial portion of the orbicularis oris muscle. It is more prominent during facial expression than in a resting state. We confined microform cleft lip in our study to the absence of philtral skin change and a contracted position on the top of cupid's bow. During the past 5 years, 17 patients of microform cleft lip were operated on. We corrected the defect of the upper vermilion border and nostril sill with minimal incision, and repaired the underlying lip musculature in superficial discontinuity. Reduction of the widened alar base was performed. Deformed alar cartilage was dissected via rim incision, and suspended in a medial and upper direction with pull-out sutures. The most important thing is precise repair of the superficial portion of the separated orbicularis oris muscle via minimal incision, and it is best to operate after 1-year of age for accurate repair. The results were satisfactory and the parents were also satisfied. The advantages of this procedure are as follows: 1. Less visible, minimal scar on upper lip 2. Simultaneous correction of vermillion notching, deformed cupid's bow and nasal deformity. 3. Eversion of philtral ridge due to tenting effect of horizontal mattress suture 4. Philtral elongation effect by reduction of alar base and Z-plasty of cupid's bow.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Facial Expression ; Humans ; Lip ; Microfilming* ; Parents ; Skin ; Sutures

In cross sectional fashion we recoreded the cone response in 98 adult diabetics and 20 normal controls according to the recommendation by the International Society for Clinical Electrophysiology of Vision. The photopic oscillatory potentials were extracted from the cone response by highpass filtering. The clear media and attached retina were criteria for inclusion in this study. The data were statistically analyzed expecting that this procedure may provide a feature that could have some clinical significance. The analysis of variance demonstrated that the summed amplitude of the oscillatory potentials, and second oscillatory potential amplitude were the most sensitive parameters to the diabetic retina. A timing delay in the first oscillatory potential wavelet, and a reduction in the second oscillatory potential amplitude and the summed amplitude of oscillatory potentials were the commonest abnormalities. Hence, the second oscillatory potential amplitude and the summed amplitude of oscillatory potentials may be the most valuable indicator among the photopic electroretinogram parameters representing a quantitative measure of overall retinal dysfunction.
Adult* ; Electrophysiology ; Humans ; Retina ; Retinaldehyde

As a contrast to the surgery described in part I, a lamellar undermining was performed in a conventional way. The sclera was lamellarly undermined on the retinal hole areas which extended at least 3 mm beyond the disc edge of the retinal breaks. If the scleral buckling with a circling element is indicated the location of the undermined area determines whether the circling band must follow the globe's equator or another great circle around the eye, The technique for decreasing a vitreoretinal traction used in this series of cases was that proposed by Schepens. Of 56 surgical procedures for retinal detachment, there was a case of an unsuccessful closure of the retinal break due to fishmouthing of the posterior edge of the break. The technique proposed by Schepens was sufficiently promising. But it has the following drawbacks; difficulties in exact hole localization in a high detached retina, anchoring sutures of the circling band behind the equator and problems to protect the vortex veins from the circling band etc. Our experience since 1978, led us to modify the conventional view, in favor of the circumferential buckling on the equator.
Retina ; Retinal Detachment ; Retinal Perforations ; Sclera ; Scleral Buckling ; Sutures ; Traction ; Veins

BACKGROUND: Recent evidences suggest that anesthetic action within the spinal cord is important in suppressing somatic responses to painful stimuli. Intrathecal endothelin-1 (ET-1) is known to have antinociceptive effect. The purpose of this experiment was to determine whether intrathecal ET-1 may influence the minimum alveolar concentration (MAC) of isoflurane in rats and access the role of the spinal cord as the sites of anesthetic action in blocking somatic responsiveness. METHODS: In Sprague-Dawley rats fitted with an indwelling intrathecal catheter, we determined the MAC of isoflurane using a tail-clamp technique as a painful stimulus, combined with end-tidal anesthetic sampling. In experiment 1, the control MAC was determined and changes of control MAC were observed after intrathecal ET-1 (4x10-2 nmol, 4x10-3 nmol) administration. In experiment 2, we observed the effects of L or N type Ca++ channel blocker such as verapamil (50 g) or W-conotoxin (0.5 g) on the MAC after measurement of the control MAC. In experiment 3, after measurement of the control MAC, ET-1 (10-2 nmol) was administered intrathecally and the MAC was determined again. Next, intrathecal verapamil (50 g) or W-conotoxin (0.5 g) was injected. After that, the MAC was determined again. RESULTS: In experiment 1, ET-1 decreased the MAC of isoflurane and its effect was sustained over 2 hours. In experiment 2, the MAC, determined following administration of verapamil or W-conotoxin, was not different from that of the control. In experiment 3, the MAC was decreased after ET-1 administration and then increased following injection of verapamil or W-conotoxin. CONCLUSIONS: These results suggested that ET-1, in relation to calcium, might play an important role in determining the MAC of isoflurane in the spinal cord.
Animals ; Calcium ; Catheters ; Endothelin-1* ; Isoflurane* ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Verapamil

Various surgical methods have been used to reconstruct severe soft tissue defects of the finger with exposed critical structures such as tendon, bone, and nerve. Some of these methods include rotation flap, cross finger flap, or regional flap similar to neurovascular island flap. However, there were often difficult situations where a flap could not be applied depending on the remaining surrounding tissue, injured area, and size of defect. As a result, free flap or distant flap may become necessary. However, distant flaps often cause stiffness of the finger joints since the hands need to be immobilized for a long time, while standard free flaps may be too thick to cover the finger and cause problems such as morbidities of the donor site. Since May, 1997, at Anam Hospital, we have performed reconstruction on 6 patients with soft tissue defect using a thin, flexible medial plantar septo-cutaneous free flap similar to the volar aspect of the finger in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitantes, or the subcutaneous veins. The mean size of the flaps was 2.75cm x 4.25cm. Primary repair or split-thickness skin graft was performed on the donor site depending on the size. All the flaps survived without significant complications, except one case of venous insufficiency. The composition of the transferred flaps was good with the recovery of pain, touch and temperature sensation. A free medial plantar septo-cutaneous flap has several advantages, e.g., it is small in comparison with other standard free flaps, having two draining venous pathways, good color and texture, and a good recovery of protective sensation. This flap can be used for the reconstruction of soft tissue defect on the heel and foot, as well as the volar aspect of fingers.
Arteries ; Finger Joint ; Fingers ; Foot ; Free Tissue Flaps* ; Hand ; Heel ; Humans ; Sensation ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants ; Veins ; Venous Insufficiency