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1.Histological and Histochemical Follow-up of the Resurfaced Heel Pad, Reconstructed by Free Flaps

Sang Soo KIM ; Hee Kyoung PARK ; Eung Ju MOON

The Journal of the Korean Orthopaedic Association 1985;20(5):761-768

The development of the microvascular surgery revolutionalized the reconstructive surgery of the lower ext tremity. Especially, the defects of the heel and sole, the weight bearing area, were quite difficult and complicate to reconstruct by conventional methods. Many papers reported successful resurfacing the heel pad by free cutaneous or myocutaneous flaps. However, only few reports were conceming the late results of the reconstructed free flaps. The authors studied the histological and histochemical changes of the free flaps under the weight bearing stress in 10 cases. 1. The authors reconstructed 10 cases of the heel pad defects by dorsalis pedis free Aaps (5 cases) and latissimus dorsi myocutaneous flaps(5 cases). 2. Before transfer, the homy layer was very thin(about 0.16–0.2 mm) and had an arrangement of basket-weave pattem in both flaps. Until one year after transfer, this layer was wom out (0.02–0.08mm) However, after one year, this layer became thick (0.05–0.7 mm) and the arrangement was compact in both free flaps. 3. The granular and prickle cell layers were also increased in thickness after one year. 4. In the suprabasilar area, friction blisters were observed before one year, especially in latissimus dorsi myocutaneous flap. However, they slowly disappeared after one year and then the epidermis was stabilized. 5. In the dermis, the contents of the amyloid and acid mucopolysaccharides were increased up to the level of those of the normal heel pad in both flaps. 6. As a conclusion, the transferred free flaps were in distress before one year. But after one year, they began to adapt well histologically and histochemically to the weight bearing stress.
Amyloid ; Blister ; Dermis ; Epidermis ; Follow-Up Studies ; Free Tissue Flaps ; Friction ; Glycosaminoglycans ; Heel ; Myocutaneous Flap ; Superficial Back Muscles ; Weight-Bearing

Clinical observation was done on 40 cases of renal cell carcinoma, who have been admitted to the Department of Urology, Kyung Hee University Hospital from January, 1978 to January, 1988. The results were obtained as follows. 1. Among 40 patients, there were 22 men and 18 women, with peak incidence at the sixth decade. 2. Hematuria was the most frequent symptom at the presentation followed by flank pain and abdominal mass. 3. On laboratory examinations, 4 patients had anemia and 2 patients had erythrocytosis. Among 7 patients with hypercalcemia, 2 patients had bone metastasis. 6 patients showed abnormal liver function and liver function became normalized after nephrectomy in 5 of them. 4. Comparing to pathologic stage, accuracy of CT scan in determining of stage was 82.3 %, 5. 3 year-survival rate was 75% in patients with stage I, and 33% in stage II, 40% in stage III. 6. In 14 patients, there were metastasis to lung, lymph node and bone in order of frequency.
Anemia ; Carcinoma, Renal Cell* ; Female ; Flank Pain ; Hematuria ; Humans ; Hypercalcemia ; Incidence ; Liver ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrectomy ; Polycythemia ; Tomography, X-Ray Computed ; Urology

7.Clinical Observation on Renal and Perinephric Abscess.

Soo Guen PARK ; Soo Eung CHAI

Korean Journal of Urology 1987;28(2):269-273

Renal and perinephric abscess are uncommon diseases with a multitude of clinical presentations. In past morbidity and mortality were high rate because of delay in diagnosis. Diagnosis and treatment approaches were challenged recently by newer imaging modalities as ultrasonography and CT scanning and by interventional uroradiology. A clinical observation was made in 9 patients with renal abscess and 1O patients with perinephric abscess admitted in the Dept. of Urology, Kyung Hee University Hospital during the period from Jan. 1981 to Jan. 1986. The following results were observed: 1. Among 19 patients, 11 patients were women and their age was ranged from 22 to 68 yrs old with mean of 44.5 yrs. In 12 cases, Lt. kidneys were involved. 2. In 5 patients who had positive urine culture, E. coli was recovered in 3 cases, and klebsiella sp. and staph. epldermidis were recovered in one case, respectively. Blood culture was positive in one case. Among 14 cases performed pus culture, bacteria was recovered in 8 cases: E. coli in 4 cases staph. aureus in 2 cases, and staph. epldermidis and peptococcus in one case, respectively. 3. In 15 cases, diagnosis could be confirmed by ultrasonography, but CT scan was needed in 4 cases to confirm the nature of lesion. The common findings of ultrasonogram were mixed echogenic mass and echolucent mass found in 8 cases and 7 cases, respectively. 4. Among 19 cases, 1O patients underwent open drainage, 5 cases were treated by antibiotics only, and 3 cases were managed successfully by closed drainage.
Abscess* ; Anti-Bacterial Agents ; Bacteria ; Diagnosis ; Drainage ; Female ; Humans ; Kidney ; Klebsiella ; Mortality ; Peptococcus ; Suppuration ; Tomography, X-Ray Computed ; Ultrasonography ; Urology