No abstract available in English.
Lasers, Gas ; Wound Healing ; Wounds and Injuries

The development of a safe method of transfer of the greater toe for thumb reconstruction, using dorsalis pedis artery and the great saphenous vein, suggested the possibility of one stage microvascular transfer of the second toe for reconstruction of surgery. Based upon our part experience with microsurgical experiments, limb transplantation and toe-to-thumb transplantation since 1975, we accomplished the second toe-to-index transplantation done in Korea on October 24, 1979, and succeeded in one stage second toe-to-index transplantation in two cases. Following results were obtained. I. Free second toe-to index transplantation on making a index is the most excellent method of index reconstruction with results in minimum functional and cosmetic impairment. 2. Technically, skin incision, isolation of blood vessels and flexor tendon in preparation for transplantation of second toe is more difficult than that of greater toe. 3. The specialized microsurgical training with skillful technique is essential for success.
Arteries ; Blood Vessels ; Extremities ; Korea ; Methods ; Microsurgery ; Saphenous Vein ; Skin ; Tendons ; Thumb ; Toes

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.
Chordoma ; Notochord ; Recurrence ; Sacrococcygeal Region

We herein report two patients with epidermolysis bullosa acquisita(EBA), who had showed the atypical clinical features. A 25-year-old male presented with multiple pruritic vesicles, erosion and crusts which occurred more severely on the face than any other sites of the skin and healed with atrophic scar formation. Histopathologically, there was a subepidermal neutrophilic blister with moderate perivascular lymphohistiocytic infiltrates in the dermis, and the diagnosis of EBA was confirmed by means of direct immunofluorescence and salt-split direct immunofluorescence test performed on the perilesional skin. The other patient was a 24-year-old female who had had multiple painful ulcerative lesions on the oral mucosa for 4 months. After then, vesicles and bullae developed to progressively generalize to the anterior neck, chest and lower leg. Histolopathologic examination of peribullous skin showed a subepidermal bulla with neutrophils and eosinophils. The salt-split skin direct immunofluence test showed IgG and IgM binding to the dermal side only. We diagnosed this patient as nonscarring inflammatory EBA. Both patients were treated with prednisolone, colchicine, and dapsone resulting in clinical improvement, but their skin lesions recurred several months after discontinuing medication.
Adult ; Blister ; Cicatrix ; Colchicine ; Dapsone ; Dermis ; Diagnosis ; Eosinophils ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Male ; Mouth Mucosa ; Neck ; Neutrophils ; Prednisolone ; Skin ; Thorax ; Ulcer ; Young Adult

Candida lipolytica is also called Yarrowia lipolytica, and this is now microbiologically classified as a member of the Yarrowia genus. Y. lipolytica is a rare opportunistic pathogen that was first isolated in 1976 from a patient with traumatic ocular candidiasis. Five cases of infant patients were reported in 2000 in Korea for the first time, and then in 2001 a case was reported from an AML patient. No more cases have been reported since then. The authors experienced the case of a patient with blood culture positivity for Y. lipolytica and this patient had a previous history of raw beef ingestion and long term antibiotics therapy. Thus, we report on this case along with a review of the literature.
Anti-Bacterial Agents ; Candidiasis ; Eating ; Fungemia ; Humans ; Infant ; Korea ; Yarrowia

Background/Aims: Quick sequential organ failure assessment (qSOFA) is believed to identify patients at risk of poor outcomes in those with suspected infection. We aimed to evaluate the ability of modified qSOFA (m-qSOFA) to identify high-risk patients among those with acutely deteriorated chronic liver disease (CLD), especially those with acute-onchronic liver failure (ACLF). Methods: We used data from both the Korean Acute-on-Chronic Liver Failure (KACLiF) and the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) cohorts. qSOFA was modified by replacing the Glasgow Coma Scale with hepatic encephalopathy, and an m-qSOFA ≥2 was considered high. Results: Patients with high m-qSOFA had a significantly lower 1-month transplant-free survival (TFS) in both cohorts and higher organ failure development in KACLiF than those with low m-qSOFA (Ps<0.05). Subgroup analysis by ACLF showed that patients with high m-qSOFA had lower TFS than those with low m-qSOFA. m-qSOFA was an independent prognostic factor (hazard ratios, HR=2.604, 95% confidence interval, CI 1.353–5.013, P=0.004 in KACLiF and HR=1.904, 95% CI 1.484– 2.442, P<0.001 in AARC). The patients with low m-qSOFA at baseline but high m-qSOFA on day 7 had a significantly lower 1-month TFS than those with high m-qSOFA at baseline but low m-qSOFA on day 7 (52.6% vs. 89.4%, P<0.001 in KACLiF and 26.9% vs. 61.5%, P<0.001 in AARC). Conclusions Baseline and dynamic changes in m-qSOFA may identify patients with a high risk of developing organ failure and short-term mortality among CLD patients with acute deterioration.