Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages : (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operative field. But, we also have some disadvantages of difficult handling of the pliable veins and the tmcertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.
Arteries ; Edema ; Forearm ; Hand* ; Veins ; Wounds and Injuries*

We report a case of a 30 year-old woman who presented with acute scalp hair loss induced by isonicotinic acid hydrazide gap (INH). Considerable hair loss started within 4 weeks of INH administration. There was no evidence of dermatitis, allergic reaction, or any other cause for the hair loss. INH was discontinued, and the hair loss stopped within 4 weeks, with new hair growth seen. There was complete recovery of hair loss after 12 weeks of alopecia. Medication-induced hair loss is an occasional adverse effect of many drugs, however hair loss induced by INH has been reported in only 1 case. The complete recovery from anagen effluvium is difficult to explain, but it could have been due to the early discontinuance of INH.
Adult ; Alopecia ; Dermatitis ; Female ; Hair ; Humans ; Hypersensitivity ; Isoniazid ; Scalp

BACKGOUND: Interferon-alpha2b has already proven to be effective in the clinical treatment of virus-originated diseases such as hairy cell leukemia, condyloma acuminatum, and AIDS-related Kaposi's sarcoma. The use of recombinant interferon-alpha2b may allow various types of wart to be treated relatively atraumatically and with less incidence of recurrence. OBJECTIVE: We tried to compare the effectiveness and safety of intralesional injections of recombinant interferon-alpha2b with natural interferon-alpha2b in the treatment of patients with various types of wart. METHOD: Patients with more than two warts were treated by injecting the different warts with 0.5 to 1.0X105 IU/1mm3 of recombinant and natural interferon-alpha2b, twice per week for 4 to 20 weeks. The response to treatment was followed up at 36 weeks. RESULTS: At the end of treatment, clearing of the treated warts had occurred in 83.3% of the recombinant interferon-alpha2b group and 91.6% of the natural interferon-alpha2b group. A more rapid cure rate was observed in the natural interferon-alpha2b group than in the recombinant interferon-alpha2b group. The rest showed partial improvement. With evaluation for relapse up to 16 weeks after treatment, warts were found to relapse in 11.1% of both the recombinant and natural interferon groups. CONCLUSION: Intralesional natural interferon-alpha2b has a better therapeutic effect than recombinant interferon-alpha2b, and may be considered as a therapeutic modality of recalcitrant verruca or when it can be anticipated that destructive techniques or blistering agents will not be tolerated.
Blister ; Humans ; Incidence ; Injections, Intralesional ; Interferons ; Leukemia, Hairy Cell ; Recurrence ; Sarcoma, Kaposi ; Warts*

OBJECTIVE: Paraclinoid segment internal carotid artery (ICA) aneurysms have historically been a technical challenge for neurovascular surgeons. The development of microsurgical approach, advances in surgical techniques, and endovascular procedures have improved the outcome for paraclinoid aneurysms. However, many authors have reported high complication rates from microsurgical treatments. Therefore, the present study reviews the microsurgical complications of the extradural anterior clinoidectomy for treating paraclinoid aneurysms and investigates the prevention and management of observed complications. METHODS: Between January 2004 and April 2008, 22 patients with 24 paraclinoid aneurysms underwent microsurgical direct clipping by a cerebrovascular team at a regional neurosurgical center. Microsurgery was performed via an ipsilateral pterional approach with extradural anterior clinoidectomy. We retrospectively reviewed patients' medical charts, office records, radiographic studies, and operative records. RESULTS: In our series, the clinical outcomes after an ipsilateral pterional approach with extradural anterior clinoidectomy for paraclinoid aneurysms were excellent or good (Glasgows Outcome Scale : GOS 5 or 4) in 87.5% of cases. The microsurgical complications related directly to the extradural anterior clinoidectomy included transient cranial nerve palsy (6), cerebrospinal fluid leak (1), worsened change in vision (1), unplanned ICA occlusion (1), and epidural hematoma (1). Only one of the complications resulted in permanent morbidity (4.2%), and none resulted in death. CONCLUSION: Although surgical complications are still reported to occur more frequently for the treatment of paraclinoid aneurysms, the permanent morbidity and mortality resulting from a extradural anterior clinoidectomy in our series were lower than previously reported. Precise anatomical knowledge combined with several microsurgical tactics can help to achieve good outcomes with minimal complications.
Aneurysm ; Carotid Artery, Internal ; Cerebrospinal Fluid Rhinorrhea ; Cranial Nerve Diseases ; Endovascular Procedures ; Hematoma ; Humans ; Microsurgery ; Retrospective Studies ; Vision, Ocular

A giant colonic diverticulum is a rare complication of diverticulosis, and an inguinal hernia is a common diagnosis for patients presenting with a painful groin mass. A 52-year-old male presented to the emergency room with a 3-hour complaint of progressive, constant, right-groin pain with an inguinal mass. After manual reduction of the inguinal hernia, the patient complained of pain in the right upper quadrant. Operative findings showed a transverse colon diverticulitis without perforation. We report here that case of a transverse colon giant diverticulum presenting as an atypical incarcerated inguinal hernia.
Colon, Transverse* ; Diagnosis ; Diverticulitis* ; Diverticulum ; Diverticulum, Colon ; Emergency Service, Hospital ; Groin ; Hernia, Inguinal* ; Humans ; Male ; Middle Aged

OBJECTIVE: The purpose of study was to demonstrate the presence of motor input from the spinal accessory and the branches of the upper cervical plexus. METHOD: Twenty-four patients were studied during modified radical neck dissection. The entire length of the spinal accessory nerve, the contributions from the upper cervical plexus and some cervical plexus branches to run to the trapezius independently were preserved in each of these patients. Compound muscle action potentials were measured to each part of the trapezius muscle on stimulation of the spinal accessory, C2, C3, and C4 nerves. RESULTS: Spinal motor nerve evoked responses were obtained from all 24 patients in the upper, middle, and lower trapezius. C2 contributions were seen in 2 out of 24 patients, but were in no patient supplying all three parts of the muscle. C3 contributions were seen in 11 out of 24 patients, but C3 nerve supplied all three parts of the muscle in 8. C4 contributions were seen in 20 out of 24 patients, supplying all three parts of the muscle in 16. CONCLUSION: This study demonstrated that the spinal accessory nerve provided the most important and consistent motor input to the trapezius muscle. Although C2, C3, and C4 provided motor input to the trapezius muscle, they were not consistently present and if present, did not consistently innervate all three parts of the trapezius. Compared with other studies, it was interesting to note that C4 gave more consistent motor input to the trapezius than other cervical branches.
Accessory Nerve ; Action Potentials ; Cervical Plexus ; Humans ; Neck Dissection ; Neural Conduction* ; Superficial Back Muscles*

We report here on an uncommon case of peliosis hepatis with hemorrhagic necrosis that was complicated by massive intrahepatic bleeding and rupture, and treated by emergent right lobectomy. We demonstrate the imaging findings, with emphasis on the triphasic, contrast-enhanced multidetector CT findings, as well as reporting the clinical outcome in a case of peliosis hepatis with fatal hemorrhage.
Tomography, X-Ray Computed/*methods ; Rupture ; Peliosis Hepatis/complications/*radiography/surgery ; Necrosis ; Humans ; Hemorrhage/etiology/*radiography/surgery ; Female ; Adult

The incisional hernia through trocar site is an uncommon complication of gynecologic laparoscopy. Its incidence is less than 1% and most of them are occurring through 10 mm trocar site. Small bowel herniation through 5 mm trocar site is very rare. Furthermore, 5 mm trocar site bowel herniation with drain tube in situ has not yet been reported. We present a case of small bowel herniation through 5 mm trocar site with drain tube in situ and its reduction by laparoscopy with a brief review of literature.
Drainage ; Hernia ; Incidence ; Laparoscopy ; Surgical Instruments

PURPOSE: To qualitatively analyse barium coating status in the intestinal mucosa, we used scanning electronmicroscopy to observe barium particles coated in the small intestinal mucosa of rabbit, and we attempted to assessthe relationship between electron microscopic findings and radiographic densities. MATERIALS AND METHODS: Sixdifferent combinations of barium and methylcellulose suspensions were infused into the resected small intestinesof 15 rabbits. Barium powders were mixed with water to make 40% and 70% w/v barium solutions, and also mixed with0.5% methylcellulose solution to make 40% and 70% w/v barium-methylcellulose mixtures. 0.5% methylcellulosesolutions were used as a double contrast agent. After the infusion of barium suspensions, a mammography unit wasused to obtain radiographs of the small intestine, and their optical densities were measured by a densitometer.Thereafter, photographs of barium-coated small intestinal mucosa were obtained using a scanning electronmicroscope (x8,000), and the number of barium particles in the unit area were measured. To compare therelationship between the electron microscopic findings and optical densities, statistical analysis using Spearmancorrelation was performed. RESULTS: With a Spearman coefficient of-0.544, correlation between the number of smallbarium particles of less than 1 micrometer and optical densities was statistically significant(p<0.05). CONCLUSION: Thisstudy shows that by using scanning electron microscopy, barium particles coated on the small intestinal mucosa canbe qualitatively analysed. It also shows that the number of small barium particles measured by scanning electronmicroscopy is related to optical densities.
Animals ; Barium* ; Intestinal Mucosa* ; Intestine, Small ; Mammography ; Methylcellulose ; Microscopy, Electron, Scanning ; Powders ; Rabbits ; Suspensions ; Water

PURPOSE: To explore the role of cell cycle and apoptosis regulators during hepatocarcinogenesis, the expression of cell cycle-related proteins (cyclin D1 and p27kip1) and apoptosis-related proteins (p53, survivin, caspase 3). METHODS: Sprague-Dawley rats were given 120 ppm diethylnitrosamine (DEN) as a carcinogen and sequentially sacrificed. The expression of cell cycle and apoptotic related proteins were examined by light microscopy and immunohistochemistry. RESULTS: During the DEN-induced hepatocarcinogenesis, sequential histologic changes from preneoplastic lesions (altered hepatic cellular foci, hyperplastic nodules, and hepatocellular adenomas) and ultimately overt hepatocellular carcinomas and metastatic lesions were noted. The cyclin D1 were progressively increased from preneoplastic lesions to hepatocellular carcinomas. However, the p27kip1 and the survivine proteins did not show any other difference with the increasing degree of carcinogenesis. The p53 and caspase 3 proteins were more significantly increased in hepatocellular carcinomas than preneoplastic lesions. The cyclin D1 protein expression did not show any correlation with the expression of p27Kip1 protein, but the p53 expression was related to the expression of survivin and caspase 3. CONCLUSION: From the above results, over-expression of cyclin D1 plays a role in the early and late stages of hepatocarcinogenesis. In addition p53 and caspase 3 might be useful markers for evaluating the risk of malignant transformation.
Animals ; Apoptosis ; Carcinoma, Hepatocellular ; Caspase 3 ; Cell Cycle ; Cyclin D1 ; Cyclin-Dependent Kinase Inhibitor p27 ; Diethylnitrosamine ; Light ; Microscopy ; Proteins ; Rats ; Rats, Sprague-Dawley