In the case of a soft tissue defect which requires thin & pliable tissues, the choice of donor site is limited due to flap bulkiness and donor site morbidity. To overcome these problems, a variety of perforator-based flaps such as paraspinous and parasacral perforator flap, deep inferior epigastric perforator flap, gluteal perforator flap, and thoracodorsal artery perforator flap have recently been introduced. We experienced 8 cases of soft tissue defects from December 1996 to March 1999 using the thoracodorsal artery perforator flap for reconstruction. We could elevate the cutaneous flap with preservation of the latissimus dorsi muscle flap only when it was based on one cutaneous perforator. Defatting procedure was possible for further thinning of skin flap. In one case, axillary defect after release of postburn scar contracture was repaired with island perforator flap and the other seven cases were repaired with free flap. The results were satisfactory. We believe the thoracodorsal artery perforator flap is useful for reconstruction of soft tissue defects which are large or under conditions requiring thin flap.
Arteries* ; Cicatrix ; Contracture ; Free Tissue Flaps ; Humans ; Perforator Flap ; Skin* ; Superficial Back Muscles ; Tissue Donors

BACKGROUND: Herpes zoster with generalized varicelliform eruptions occurs in 2 to 10% of patients with herpes zoster. It occurs mainly in old or debilitated persons especially those who have immunologic defects such as lymphoproliferative diseases, AIDS, or recipients of immunosuppressive therapy. The reported incidence of herpes zoster with generalized varicelliform eruptions is variable. OBJECTIVE: The purpose of this study was to elucidate the incidence and clinical features of herpes zoster with generalized varicelliform eruptions. METHODS: We reviewed the clinical data of 962 patients with herpes zoster by retrospective methods. The annual incidence, age, sex, seasonal variation, predilection sites, and associated conditions of herpes zoster with generalized varicelliform eruptions were analyzed from January 1990 to December 1996 (7 years). RESULTS: 1. Among 962 patients, 8 patients with herpes zoster revealed generalixed varicelliform eruptions (0.83%). 2. The age ranged from 20 to 85 and the majority of cases occurred in the 6th decade. There were 4 females and 4 males. 3. Past histories of malignancy were observed in 2 patients. However, there were no signs of malignancy at the time of diagnosis of herpes zoster with generalized varicelliform eruptions. 4. The most common site of initial lesion was the thoracic dermatome,followed by the lumbar and the cervical ones. CONCLUSION: From our observation, it is suggested that herpes zoster with generalized varicelliform eruptions may occur in patients without underlying malignancy or immunosuppressive disorders. Sudden incidental uprising of herpes zoster with generalized varicelliform eruptions was observed in 1996.
Clinical Study* ; Diagnosis ; Female ; Herpes Zoster* ; Humans ; Incidence ; Male ; Retrospective Studies ; Seasons

BACKGROUND: The obese patients increased recently in Korea due to excessive energy intake and decreased physical activity. We are well known that obesity is associted with an increased risk of cardiovascular disease, angina pectoris, hypertension, but not known to influence of weight gain to change in cardio-vascular risk factors. Once, the study of obesity are many but the study of influence of weight gain are small in Korea. This study investigated to influence of weight gain in cardio-vascular risk factors. METHODS: We gatherd case and control group among persons who has taken twice medical examination except disease person from October 1990 to October 1995 at SungAe General hospital. In our study, total 167 case, compare weight gain group(>3kg) with control group to change in cardiovascular risk factor. RESULTS: Sex, age, smoking history, obesity index were not statistically significant difference between two group in the first medical examination. systolic blood pressure, diastolic blood pressure, fasting blood sugar, HDL, total cholesterol/HDL were not statistically significant difference between two group for weight gain. Total cholesterol and triglyceride, LDL were stastistically significant increased. CONCLUSIONS: Weight gain was increased of total cholestrol and triglyceride, LDL, so weight control was important.
Angina Pectoris ; Blood Glucose ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Energy Intake ; Fasting ; Hospitals, General ; Humans ; Hypertension ; Korea ; Motor Activity ; Obesity ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Weight Gain*

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction

Dermatofibrosarcoma protuberans is an uncommon, locally aggressive fibroblastic tumor, characterized by infrequent metastasis and a marked tendency of local recurrence after excision. Histologically, it shows large uniformed spindle shaped cells arranged in a cartwheel or storiform pattern. We report a case of dermatoribrosarcoma protuberans on the lower abdomen of a man aged of thirty, treated with Mohs micrographic surgery and purse-string suture repair.
Abdomen ; Dermatofibrosarcoma* ; Fibroblasts ; Mohs Surgery* ; Neoplasm Metastasis ; Recurrence ; Sutures*

Ectopic pregnancy refers to gestation in which the fertilized ovum implants on any other tissure than tbe mucus membrane lining the uterine cavity. Cornual (intertitial) pegnancy is a relatively uncommon but potentially catastrophic form of ectopic pregnancy, defined as implantation in the intramural portion of a fallopian tube. A hydatidiform mole usually occupies the uterine cavity but it's occurrence in the uterine tube is extremely rare. Only a few cases of primary hydatidifm mole of the tube have been reported. We experienced a case of ectopic hydatidiform mole in the uterine cornua and so present it with brief review of literatures.
Fallopian Tubes ; Female ; Hydatidiform Mole* ; Membranes ; Mucus ; Pregnancy ; Pregnancy, Ectopic ; Zygote

We report a case of 64-year-old female patient who has had factitious skin lesions for 20 years. She complained formification sense and severe itching on her face. These symptoms were improved with squeezing and bleeding. There were scuare shaped ulcerated nodule on the right cheek and white depressed scar on the left cheek. She was treated with wet dressing and occlussive dressing, and skin lesions were nearly cleared within 3 weeks, but new lesion appeared. Pimozide 2mg #1 p.o were given under the diagnosis of delusion of parasitosis from June, 1984. Her symptoms were improved without recurrence till now. Treatment with pimozide in monosymptomatic hypochondriacal syndrome is discussed.
Bandages ; Cheek ; Cicatrix ; Delusions ; Dermatitis* ; Diagnosis ; Female ; Hemorrhage ; Humans ; Middle Aged ; Pimozide* ; Pruritus ; Recurrence ; Skin ; Ulcer

BACKGROUND: We conducted this study to verify whether a mechanical ventilator is adequate for cardiopulmonary resuscitation (CPR). METHODS: A self-inflating bag resuscitator and a mechanical ventilator were used to test two experimental models: Model 1 (CPR manikin without chest compression) and Model 2 (CPR manikin with chest compression). Model 2 was divided into three subgroups according to ventilator pressure limits (P(limit)). The self-inflating bag resuscitator was set with a ventilation rate of 10 breaths/min with the volume-marked bag-valve procedure. The mode of the mechanical ventilator was set as follows: volume-controlled mandatory ventilation of tidal volume (Vt) 600 mL, an inspiration time of 1.2 seconds, a constant flow pattern, a ventilation rate of 10 breaths/minute, a positive end expiratory pressure of 3 cmH2O and a maximum trigger limit. Peak airway pressure (P(peak)) and Vt were measured by a flow analyzer. Ventilation adequacy was determined at a Vt range of 400-600 mL with a P(peak) of < or = 50 cmH2O. RESULTS: In Model 1, Vt and P(peak) were in the appropriate range in the ventilation equipments. In Model 2, for the self-inflating bag resuscitator, the adequate Vt and P(peak) levels were 17%, and the P(peak) adequacy was 20% and the Vt was 65%. For the mechanical ventilator, the adequate Vt and P(peak) levels were 85%; the P(peak) adequacy was 85%; and the Vt adequacy was 100% at 60 cmH2O of P(limit). CONCLUSIONS: In a manikin model, a mechanical ventilator was superior to self-inflating bag resuscitator for maintaining adequate ventilation during chest compression.
Cardiopulmonary Resuscitation* ; Manikins* ; Models, Theoretical ; Positive-Pressure Respiration ; Thorax ; Tidal Volume ; Ventilation* ; Ventilators, Mechanical*

BACKGROUND: Hypertension is a major and growing public health problem and it calls for life-long management. The antihypertensive agents are still playing major roles in the management of hypertension. We studied the effect of the long-term therapy with a new calcium channel blocker, felodipine in patients with essential hypertension. METHODS: We recruited 31 patients with mild to moderate essential hypertention and gave them 5mg (1 tablet) of felodipine(Munobal(R)) once daily for 12 months. We measured the blood pressure and the heart rate every month and tried to detect any untoward symptoms and signs during the whole observation period. Baseline work-up for the hypertensive patients were done as usual before and after the study. RESULTS: The average systolic and diastolic blood pressures were 162.7+/-9.7/99.6+/-7.4mmHg respectively before the administration and they came down to the level of 139.7+/-15.0/87.3+/-8.6mmHg respectively at the end of the 1st month (p<0.05). This trend was maintained during the whole observation period, so they were 141.2+/-11.0/85.6+/-8.2mmHg respectively at the end of the study (p<0.05). Untoward drug reactions such as gastrointestinal troubles, facial edema, leg edema, chest pain and headache were present in 11 patients (35%) but they were not serious. There was no case in which the drug was withdrawn. There was one case in which the level of the serum triglyceride increased after the administration of the drug. CONCLUSION: Felodipine has good and persistent hypotensive effect and it is safe and easy to use.
Antihypertensive Agents ; Blood Pressure ; Calcium Channels ; Chest Pain ; Edema ; Felodipine ; Headache ; Heart Rate ; Humans ; Hypertension* ; Leg ; Public Health ; Triglycerides

Epidermal nevus syndrome is a rare disease which includes disorders of bone, central nervous system, eye, kidney, vasculature, body symmetry, skin, and rarely, hypophosphatemic rickets which have been observed in association with epidermal nevi. We experienced a case of epidermal nevus syndrome. He presented with epidermal nevi and bilateral abdominal wall hernias at birth and developed right hemiparesis, mental retardation, and multiple fractures due to hypophosphatemic rickets. He died of pneumonia at the age of 6.
Abdominal Wall ; Central Nervous System ; Hernia ; Intellectual Disability ; Kidney ; Nevus* ; Paresis ; Parturition ; Pneumonia ; Rare Diseases ; Rickets, Hypophosphatemic* ; Skin