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*

We present a case of venous hemangioma which is seen beneath a clavus (corn) developed in the interdigital area of the foot. Clinically, a violaceous papule was located on the third and fourth interdigital spaces under an overlying corn. Histopathologic examination showed a non-encapsulated dermal mass composed of thick-walled and thin walled vessels lined by a single layer of endothelial cells. Some thick-walled vessels had protruding endothelial cells into the lumen and through Verhoeff-van Gieson and Masson-trichrome stain of the tissue section, we found that the vascular mass was composed of vein.
Endothelial Cells ; Foot ; Hemangioma* ; Veins ; Zea mays

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.
Aorta, Thoracic*

PURPOSE: To evaluate the radiologic findings of alimentary anthrax. MATERIALS AND METHODS: 19 patients with alimentary anthrax, which was caused by ingestion of contaminated beef, were included in this study. The diagnosis was made .b.y demonstration of Bacillus anthracis in smear and culture of the contaminated meat. We evaluated the clinical manifestations and the findings of thoracic, abdominal radiographs, cervical, abdominal ultrasonograms and abdominal CT scans. RESULTS: Out of the 19 patients with the alimentary infection, 9 had oropharyngeal form, 18 had abdominal form and 8 had combination of oropharyngeal and abdominal form. The patients had general symptoms and signs such as fever, chill, myalgia. Clinical symptoms and signs were sore throat, throat injection, throat ulcer and patch in oropharyngeal form, and nausea, vomiting, abdominal pain, diarrhea, and gross GI bleeding in abdominal form. Radiologic findings included enlarged cervical lymph nodes(36%) in oropharyngeal form, and paralytic ileus(26%), ascites(26%), hepatomegaly(21%), enlarged mesenteric lymph nodes(26%), small bowel wall thickening(5%) in abdominal form. In two patients, late complications occurred as intestinal obstruction due to ileal stricture with perforation, and inflammatory changes of pelvic cavity due to ileovesical fistula. CONCLUSION: Radiologic findings of alimentary anthrax are difficult in differentiation from those of other inflammatory bowel disease, but those radiologic findings with clinical manifestations may be helpful in diagnosis and evaluation of disease process in patients with alimentary anthrax.
Abdominal Pain ; Anthrax* ; Bacillus anthracis ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Eating ; Fever ; Fistula ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intestinal Obstruction ; Meat ; Myalgia ; Nausea ; Pharyngitis ; Pharynx ; Tomography, X-Ray Computed ; Ulcer ; Ultrasonography ; Vomiting

No abstract available.
Hypereosinophilic Syndrome*

No abstract available.
T-Lymphocytes* ; Transplantation*

In a previous communication, we described a relatively simpli. method for assaying quantities of sweat using the skin surface hydrometer. In order to evaluate the pharmacologic response of weat glands in psoriasis, vitiligo and loalized scleroderma, we measured the basal skin conductance and the quantity of sweat induced by intradermal injections of pilocarpine nitrate in the lesional and per ilesional skin. The results were as follows : 1. In psoriatic plaques, based skin surface hydration and the sweat response to pilocarpine was markedly reduced (p<0.05), but there were no significant differences in normal perilesional skin. 2. In generalized vitiligo, basal skin surface hydration and the sweat gland response was normal. In the case of the segmental type, there was a slightly decreased sweat response in the lesion but, not significant statistically. 3. In the morphea plaque, basal skin surface hydration and the sw.at response to pilocarpine was markedly reduced but was normal in perilesional skin. This study presents evidence of the functional changes in the development of sweat secretion and surface hydration in the lesions of psoriasis, morphec and segmental type of vitiligo. The demonstration of ahnormalities in the pharmacolopic response to pilocarpine induction led us to suggest the possibility that some degree of sweat gland involvement is induced by the pathogenetic mechanisms of these diseases.
Injections, Intradermal ; Pilocarpine ; Psoriasis* ; Scleroderma, Localized ; Skin ; Sweat Glands* ; Sweat* ; Vitiligo*

No abstract available.
Carbon Dioxide* ; Carbon* ; Lasers, Gas* ; Vulva*