No abstract available.
Risk Factors*

In 1973, Daniel and Taylor reported the first successful microsurgical transplantation of the groin flap as a one-stage reconstrutive procedure. The free vascularized groin flap has several advantages, such as its potenitally large size, comfortable position of the patient during operation, minimal donor site morbidity, possible coverage of the donor site scar with a bikini, its multiple arterial and venous system, and the potential for incorporating bone with the overlying skin. The authors perfomed free groin flaps in 36 patients at Severance Hospital, Yonsei University College of Medicine from January 1985 to August 1988. The results were as follows : 1. Good results were obtained in 26 of 36 cases with a 72.2% success rate. The results were better in the upper extremity than the lower extremity. 2. The anatomical classification of the superficial circumflex iliac artery was as follows : a common origin of the superficial circumflex iliac artery and the superficial inferior epigastric artery in 39.5% of cases, an absent superficial inferior epigastric artery with a large compensatory superficial circumflex iliac artery in 36.8%, separate origins of the two vessels in 7.9%, and an origin from a profunda femoral artery in 15.8%. This result was similar to that of Daniel and Taylor. 3. The average diameter of the artery was 1.0mm and the average length of the vascular pedicle was 9.0mm. 4. The results were better in the end to side anastomosis than the end to end anastomosis, but there was no statistical significance. 5. In the 10 failed cases, free scapular flaps were performed in 4 cases, skin grafts in 5 cases, and the cross leg flap in one case. 6. The donor sites healed well by primary closure without functional disturbance except in one cases in which secondary closure was done. In conclusion, the free vascularized groin flap can be used without restriction as a onestage reconstruction of an extensive soft tissue injury of the extremity.
Arteries ; Cicatrix ; Classification ; Epigastric Arteries ; Extremities ; Femoral Artery ; Groin ; Humans ; Iliac Artery ; Leg ; Lower Extremity ; Skin ; Soft Tissue Injuries ; Tissue Donors ; Transplants ; Upper Extremity

A clinical review was made on 2,191 cases of general pediatric surgery under the age of 15 years which were operated upon at the Divisionof Pediatric Surgery, Department of Surgery, Chonnam University Hospital from January 1988 to December 1997. The number of operations in pediatric age were 13,144 (13.2%) out of total 99,555 operations at Chonnam University Hospital and the most prevalent age group was under 1 year of age (14.3%). The number of operations in Divisionof General Pediatric Surgery were 2,191 (16.7%) out of total 13,144 operations in pediatric age and the incidence of patients under 1 year of age in general pediatric surgery was 42.9% (941/2,191). The prevalent diseases under 1 month of age were anorectal malformations (20.6%) and hypertrophic pyloric stenosis (20.3%) and between 1 month to 1 year of age were inguinal hernia (32.4%) and intussusception (19.6%). The total motality rate in neonatal intensive care unit was 31.3%. Gastroschisis presented highest mortality.
Gastroschisis ; Hernia, Inguinal ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intussusception ; Jeollanam-do ; Mortality ; Pyloric Stenosis, Hypertrophic

No abstract available.

No abstract available.
Ankle*

No abstract available.
Coronary Vasospasm* ; Heart Arrest* ; Verapamil*

Wegener's granulomatosis is a systemic necrotizing vasculitis of unknown cause. The disease is characterized by the involvement of the upper airway, the lung, and the kidney. Skin lesions are frequent and the most common lesion is purpura distributed on the limbs and trunk. A 34-year-old female showed recurrent purpuric macules on the both lower extremities and buttocks. The patient. showed nasal septal perforation with saddle nose deformity and C-ANCA positivity. Histopathologic findings of purpuric lesion revealed the features of necrotizing vasculitis. The histologic specimen from the nasal cavity showed chronic inflammation with granuloma formation and kidney showed focal necrotizing glomerulonephritis. Therefore, we treated the patient with prednisolone and cyclophosphamide having diagnosed Wegener's granulomatosis.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Buttocks ; Congenital Abnormalities ; Cyclophosphamide ; Extremities ; Female ; Glomerulonephritis ; Granuloma ; Humans ; Inflammation ; Kidney ; Lower Extremity ; Lung ; Nasal Cavity ; Nasal Septal Perforation ; Nose ; Prednisolone ; Purpura ; Skin ; Vasculitis ; Wegener Granulomatosis

No abstract available.

BACKGROUND: The detection of specific autoantibodies in the sera of patients with systemic rheumatic diseases plays a key role in the differential diagnosis. Enzyme-linked immunosorbent assays (ELISA) is known as sensitive and semiquantitative method to detect autoantibodies and ELISA kits using a recombinant fusion protein as antigen have been developed. So, various commercial ELISA have recently become available in a diagnostic laboratory. We investigated the clinical value of antinuclear autoantibodies using commercial ELISA kits. METHODS: The serum of 90 patients were tested for autoantibodies to SSA/Ro, SSB/La, nRNP/Sm and Sm antigens by ELISA using four commercial kits, EL-ANA(TM) (TheraTest, IL, USA), DIASTAT(TM)(SHIELD, DUNDEE, UK), QUANTALit(TM) (INOVA, CA, USA), Varelisa(TM) (elias, WI, USA). We evaluated the clinical usefulness of panel test of Varelisa(TM) in the diagnosis of systemic rheumatic diseases. RESULTS: The concordance rates of four ELISA kits for autoantibodies to SSA/Ro, SSB/La, RNP/Sm and Sm antigens were 83.6%, 74.5%, 87.5% and 80.0%, respectively. Using panel test of Varelisa(TM), positive rates of autoantibodies to Ul-snRNP, nRNP/Sm, Sm, SSA/Ro, SSB/La, Scl-70, CENP and Jo-1 antigens in SLE were 30.0, 40.0, 33.3, 46.7, 20.0, 20.0, 10.0, and 0%, respectively. Of 30 patients with SLE, 16 (53.3%) were positive for 2 or more antibodies. CONCLUSIONS: EL-ANA(TM), QUANTALite(TM) and Varelisa(TM) show more positive rates than DIASTAT(TM). The difference in the positive rates among four commercial ELISA kits may come from the different antigen sources. The panel test of 8 autoantibodies using Varelisa(TM) ELISA kit offers discriminative power and enhances the specificity of the assay in patients who lack clear evidence of clinically definite autoimmune disease.
Antibodies ; Autoantibodies* ; Autoimmune Diseases ; Diagnosis ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay* ; Histidine-tRNA Ligase ; Humans ; Rheumatic Diseases ; Sensitivity and Specificity ; Staphylococcal Protein A

BACKGROUND: Recently-developed equipment based on bioelectrical impedance analysis (BIA) not only measures total body fat but also displays several estimated indicators that reflect intra-abdominal fat, such as waist circumference (WC) and waist-to-hip ratio (WHR). This study examined the usefulness of these indicators in the diagnosis of metabolic syndrome (MS). METHODS: A total of 632 people over 20 years of age (355 men and 277 women, mean age 48.61+/-11.08 years, mean BMI 23.62+/-3.00 kg/m2, 117 MS patients) were enrolled in the study. Measurements of WC and hip circumference were measured by one individual, and WHR was calculated. BIA was performed to estimate waist circumference (BIAWC) and waist-to-hip ratio (BIAWHR). Receiver operating characteristic (ROC) curve analysis was used to examine the usefulness of BIAWC and BIAWHR in diagnosing MS. RESULTS: The areas under the curve (AUCs) were 0.836 (95% CI 0.805-0.864) for WC, 0.814 (95% CI 0.782-0.844) for BIAWC, 0.815 (95% CI 0.782-0.844) for WHR, and 0.805 (95% CI 0.772-0.835) for BIAWHR. The difference between the AUCs of WC and BIAWC (0.022, 95% CI -0.004 to 0.048) and the difference between the AUCs of WHR and BIAWHR (0.010, 95% CI -0.015 to 0.034) were not significant. CONCLUSIONS: The indices for central obesity estimated by BIA had high agreement with the direct method, and they were not inferior to direct measured indices for predicting metabolic syndrome.
Adipose Tissue ; Area Under Curve ; Electric Impedance ; Female ; Hip ; Humans ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; ROC Curve ; Waist Circumference ; Waist-Hip Ratio