Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

Median raphe cyst is not a cornmon disease and represents a defect in the embryologic development of male genitalia. It occurs most commonly near the glans penis, but may occur anywhere from the urethral meatus to the anus, and is lined by entodermal or ectodermal epithelium. Surgical excision is the treatment of choice. Recently we observed a 29-year-old male patient who had had a typical median raphe cyst since childhood on the ventral aspect of the glans penis. On histological examination, the cyst was lined by stratified columnar epithelium varied from four to eight cells in thickness.
Adult ; Anal Canal ; Ectoderm ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis*

No abstract available.
Aorta, Thoracic*

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

No abstract available.
T-Lymphocytes* ; Transplantation*

We reviewed 50 skin biopsies obtained from 40 patients with cutaneous leiomyoma during a 10 year period from January 1980 to December 1989. The result.s were summarized as follows: 1) Sex distribution showed a female preponderance with male.female ratio of 1: 1.9. 2) The age distribution was relatively even from childhood to old age. The mean age was 47,8 years, 3) The most common site of lesion was lower leg(34%) followed by hand(24%), foot(12% ), anterior chest(8% ), face(6% ), neck(4%), upper arm(4% ), labia major(2 %) and nipple(2%). 4) The lesions were relatively well circumscribed subcutaneous nodule, papule, plaque and nodule which measured between 0.3cm to 5cm in size and their colors were erythematous to light brown. 5) The most common clinical and histopathologic type was angioleiomyoma(75%) followed by solitary piloleiomyoma(12.5%), multiple piloleiomyoma(7,5%) and solitary genital leiomyoma(5% ). Angioleiomyomas were clincally associated with cavernous hemangioma, myoma of uterus and systemic lupus erythematosus. 7) The clinical diagnoses were mass(30% ), epidermal cyst(20%), dermatofibroma (12.5% ), leiomyoma(12,5%), neurilemmoma(5%), lipoma(5%), calcifying epithelioma(2.5%), metastatic carcinoma(2.5%), morphea(2.5% ), fibrocystic disease(2.5%), glomus tumor(2.5 % ) and Dupuytrens contracuture(2..5%).
Age Distribution ; Angiomyoma ; Biopsy ; Diagnosis ; Female ; Hemangioma, Cavernous ; Histiocytoma, Benign Fibrous ; Humans ; Leiomyoma ; Lupus Erythematosus, Systemic ; Myoma ; Sex Distribution ; Skin ; Uterus

No abstract available.
Hypereosinophilic Syndrome*

Primary role of ultrasound in patients with thyroid nodule is to determine the multiplicity and detect occult carcinoma. We analyzed US findings of 53 thyroid carcinomas with multiple nodular lesions from january 1988 to december 1991. The results were as follows: 1. 109 malignant nodules in 53 cases and 24 benign in 23 were comfirmed. 2. The nature of the masses were solid in 72 malignant nodules (74.2%), and complex in 25 (25.8%) of which 19 were predominantly solid. 3. The echo pattern of the solid and solid predominant masses were hypoechoic in 78 malignant nodules (80.4%), hyperechoic in 10 (10.3%), and isoechoic in 3 (9.3%) 4. Internal punctate calcifications within the masses were observed in 31 malignant nodules (31.9%). 5. Halo sign was present in 16 malignant nodules(16.5%). 6. The preoperative sonographic diagnosis of thyroid carcinoma was made in 39.4% of 53 cases with multiple nodules on US. In conclusion, the number, and halo formation of nodules were insignificant to differentiate the benign nodule from the malignant. The heterogeneous hypoechoic nodules with size greater than 4cm, multiple stippled calcifications, displacement of the trachea or other surrounding structures of combined lymph node enlargements seem to indicate the possibility of malignancy.
Diagnosis ; Goiter* ; Humans ; Lymph Nodes ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Trachea ; Ultrasonography

BACKGROUND: Hydration, the water content of the stratum corneum, is an important factor in both the appearance and the barrier function of the skin. Many non-invasive methods have been developed in order to assesa the hydration state of the skin and the effect of various moisturizers. The hydrometer and carneometer are commercially available instruments which are widely used in dermatologic research. OBJECTIVE: Our purpose was to compare the measuring usefulnes of both instruments on normal subjects with a wide range of hydration states of the hornylayer. METHODS: We measured the conductance with the hydrometer and the capacitance with the corneometer in various hydrating eonditions and compared both insruments. RESULTS: Conductance had a non linear correlation with capacita ice. Capacitance measured with the corneometer had a high sensitivity to moisture in a wide range of hydration levels. On the other hand, conductance guaged with the hydrometer showed a few sensitivity to moisture at a low level. When the hydretion level was measured after a moiturizer was added, 10 % urea cream showed a sharp increase by 256% in terms of conductanae, and H-base by 97.8%. Mineral oil decreased by 41.5% and petrolatum by 62% respectively. On the other hand, when measured in terms of capacitance under the same conditions as above, 38.9 increase in 10% urea cream, 19.3% increase in H-base, 20% decrease in mineral oil, and 43.5 % decrease in petrolatum were reported. Conductance showed a higher hygroscopicity and a lower water holding capacity than capacitance did. When the measurement of the moisture level iri virious parts of the human body is performed, the corneometer provided us with more stable alies than the hydrometer. While the hydrometer can not the available and appropriate under the condition of insulation, the corneometer can measure moisture levels even down at the depth of 250mm. When measured after the oily surface of the forehead was cleansed with soft tissue, conductance and capacitance revealed higher values of moisture levels than before the eleanin. However, there is no statistical significance in these values. CONCLUSION: The hydrometer is a more appropriate tool for the measurement of moisture at a high level, and the corneometer at a low moisture level. The hydrcmeter is a more sensitive method of measuring the increase and the decrease in the moisture level.
Forehead ; Hand ; Human Body ; Ice ; Lasers, Gas ; Mineral Oil ; Petrolatum ; Skin* ; Urea ; Water ; Wettability

BACKGROUND: Hydration, the water content of the stratum corneum, is an important factor in both the appearance and the barrier function of the skin. Many non-invasive methods have been developed in order to assesa the hydration state of the skin and the effect of various moisturizers. The hydrometer and carneometer are commercially available instruments which are widely used in dermatologic research. OBJECTIVE: Our purpose was to compare the measuring usefulnes of both instruments on normal subjects with a wide range of hydration states of the hornylayer. METHODS: We measured the conductance with the hydrometer and the capacitance with the corneometer in various hydrating eonditions and compared both insruments. RESULTS: Conductance had a non linear correlation with capacita ice. Capacitance measured with the corneometer had a high sensitivity to moisture in a wide range of hydration levels. On the other hand, conductance guaged with the hydrometer showed a few sensitivity to moisture at a low level. When the hydretion level was measured after a moiturizer was added, 10 % urea cream showed a sharp increase by 256% in terms of conductanae, and H-base by 97.8%. Mineral oil decreased by 41.5% and petrolatum by 62% respectively. On the other hand, when measured in terms of capacitance under the same conditions as above, 38.9 increase in 10% urea cream, 19.3% increase in H-base, 20% decrease in mineral oil, and 43.5 % decrease in petrolatum were reported. Conductance showed a higher hygroscopicity and a lower water holding capacity than capacitance did. When the measurement of the moisture level iri virious parts of the human body is performed, the corneometer provided us with more stable alies than the hydrometer. While the hydrometer can not the available and appropriate under the condition of insulation, the corneometer can measure moisture levels even down at the depth of 250mm. When measured after the oily surface of the forehead was cleansed with soft tissue, conductance and capacitance revealed higher values of moisture levels than before the eleanin. However, there is no statistical significance in these values. CONCLUSION: The hydrometer is a more appropriate tool for the measurement of moisture at a high level, and the corneometer at a low moisture level. The hydrcmeter is a more sensitive method of measuring the increase and the decrease in the moisture level.
Forehead ; Hand ; Human Body ; Ice ; Lasers, Gas ; Mineral Oil ; Petrolatum ; Skin* ; Urea ; Water ; Wettability