No abstract available.
Adrenalectomy*

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

Albinism is an inherited ongenital disarder in which there is sgr neralized decrease or absence of pigrnent in the eyes, skin, and hair. There are two general groups (1) Oculocutneou albinism, (2) Ocular albinism. Skin cancers in albinos are rare in ternperate clirnats and t.hey occur rnostly on sun ex posed areas. We present a case of recurrance of squarnous cell carcinoma ir a Korean albinoid on both sides of the neck and right ear. On liistopathologic examination, we find I or pearls, and irregular mases of epidermal cells that proliferite downward into the devmis. The invaing cell masses are composed of atypical squamous cells.
Albinism ; Albinism, Ocular ; Carcinoma, Squamous Cell* ; Ear ; Hair ; Neck ; Skin ; Skin Neoplasms ; Solar System

Eccrine nevus is an unusual entity with various clinical manifestations. Histologically the eccrine apparatus appears simply increased in number and/or size, but structurally normal. We present a case of eccrine nevus on the dorsum of the left 3rd and 4th fingers in a 20 year-old female. The lesions were 3 × 2cm sized, well demarcated, smooth surfaced, brownish plaques with mild hyperhidrosis. Histological examination revealed hyperkeratosis in the stratum corneum and hyperpigmentation of basal layer, and an increased number of eccrine sweat glands and many eccrine coils in the dermis was seen.
Dermis ; Female ; Fingers ; Humans ; Hyperhidrosis ; Hyperpigmentation ; Nevus* ; Sweat Glands

Authors performed film mammography in 2167 patients with breast complaints who had visited to Yong DongSeverance hospital, Yonsei University from October 1, 1983 to September 30, 1985. Authors analysed 62 cases offilm mammographic findings and 35 cases of ultra mammographic findings among confirmed 62 fibroadenomas and alsoauthors analysed histopathologic cell type and ultra mammographic findings of confirmed fibroadenomas. The resultsfollowed: 1. The most prevalent age group was 3rd and 4th decade(74%). 2. The common dense breast pattern by Wolfeclassification were P2 and DY patterns(80%) in film mammograhy. 3. The most common size of fibroadenomas was1.1-3.0cm (71%) in long diameter. 4. Film mammographic findings of fibroadenoma generally showed single mass in 54lesions(87%), well defined margin of mass in 45 lesions (58%) and halo sign in 62 lesions(80%). Well definedmargin of mass is prominant in ductal cell dominant fibroadenoma(71%) , however lobulation of margin is commonlyseen instromal component dominant fibroadenoma(15%) and spiculated margins of mass can be seen in mixedfibroadenoma(6%) and stromal component dominant fibroadenoma(3%). Halo sing of fibroadenoma was commonly seen inductal cell dominant fibroadenoma(86%) and stomal component dominant fibroadenoma(85%). 5. Ultra mammographicfindings of fibroadenoma showed oval shaped mass in 26 lesions(15%) with smooth margin of mass in 43 lesions(84%)and showed mostly intermediate internal echo in 48 lesions(94%). Relationship between histopathologic cell typeand ultra mammographic findings were. Round shaped mass(67%), lateral shadowing (74%) was common in mixed type offibroadenoma, lobulated margin of mass(45%), intermediate(94%) with unifrorm(78%) internal echo was common instromal dominant type of fibroadenoma and smooth contour (100%), uniform internal echo fo mass(83%) was common inductal cell dominant type of fibroadenoma. Most ultra mammographic L/T Iratio of fibroadenoma was 0.5-1.0 in 37lesions(73%) 6. The diagnostic accuracy of film mammogahy in fibroadenoma was 92%, however combined imagingmodalities raised the diagnostic accuracy into 95%.
Breast ; Clothing ; Fibroadenoma ; Humans ; Mammography ; Shadowing (Histology)

Deep infection following total hip replacement arthroplasties remains one of the most serious complications in orthopaedic surgery. Between Jan. 1986 to Dec. 1991, 1130 cementless total hip arthroplasties were performed at Wilson rehabilitation hospital. Among them, fourteen patients (incidence :1.2%) developed deep wound infection, and they were retrospectively reviewed including clinical features, laboratory datas and their managements. The infection was noted in ten patients within three months, in one patient between three to twelve months and in three patients after twelve months from cementless total hip replacement arthroplasties. All of them were suffered from hip pain, six patients were manifested with generalized fever, and twelve patients with draining fistulas. Thirteen patients showed elevated ESR. Major infecting organism was Staphylococcus in ten patients. They were initially treated with meticulous debridement, ingress and eress tube irrigation, and antibiotics, but four patients had to be operated Girdlestone arthroplasties due to recurrence of infection and loosening of the prosthesis. Eight patients got quiescency from infection for at least five months from the last drainage operation. But two patients still have draining fistulas inspite of bony ingrowth achieved to the prosthesis.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Clinical Study ; Debridement ; Drainage ; Fever ; Fistula ; Hip ; Humans ; Prostheses and Implants ; Recurrence ; Rehabilitation ; Retrospective Studies ; Staphylococcus ; Wound Infection

The authors carriod out lumbodorsal fasciotomy on six cases of paralytic scoliosis with pelvic obliquity. In our experience, in those older children and adolescents with paralysis in whom scoliotic curve is not severe and is more or less static, correction and maintenance of the correction can be achieved by lumbodorsal fasciotomy without resorting to spine fusion. While it is a common practice to leave a mild and static curve uncorrected, even a mild degree of scoliosis, when associated with pelvic obliquity, abduction contracture of the hip, instability of the other hip and leg length discrepancy, is a major problem in paralytic patients. Initial results indicate that lumbodorsal fasciotomy, combined with contralateral Soutters or Campbells fasciotomy if necessary, is a simple and effective method in correcting these deformities and restoring balance and function.
Adolescent ; Child ; Congenital Abnormalities ; Contracture ; Health Resorts ; Hip ; Humans ; Leg ; Methods ; Paralysis ; Scoliosis ; Spine

Schizencephaly, first described by Yakovlev and Wadsworth in 1946, is a rare congenital anomaly characterized by gray matter-lined clefts that extend through the entire cerebral hemisphere, from the ependymal lining of the lateral ventricle to the subarachnoid space. Clinically, patients with schizencephaly present motor dysfunction such as hemiparesis, seizures, and variable developmental delay. Absence of septum pellucidum, gray matter heterotopia, polymicrogyria, and hypoplasia of optic nerves were also frequently found to be associated with schizencephaly. We experienced a case of open-lip schizencephaly in a one-day-old male infant with wide, tense fontanel, which was confirmed by MRI.
Cerebrum ; Humans ; Infant ; Lateral Ventricles ; Lip* ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development* ; Optic Nerve ; Paresis ; Seizures ; Septum Pellucidum ; Subarachnoid Space ; Transcutaneous Electric Nerve Stimulation

Langerhans sell bistiocytosis(LCH) is a reactive disease in which abnomal Langerhans cells accurnulate in various body sites and cause damage to affected organs. LCH usually occurs in childrea bur can also affect adults although rarely. LCH in a case of 65-year-old man initially involwed the lymph nodes (left supraclacicular and right inguinal area) and pelvis bone, and eight months later curancous involvement was noted. The skin lesions were waxy from the waxy papules showed that the dense infiltrate, ptedominantly of histiocytes, was present in the dermis, Immunohistochemistry for S-100 protein showed positive staining snd electron miscoroscopy disclosed Birbeck granules, which is characteristic findings of Langerhans cells.
Adult* ; Aged ; Dermis ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Humans ; Immunohistochemistry ; Langerhans Cells ; Lymph Nodes ; Pelvis ; S100 Proteins ; Skin

Airway foreign body aspiration in children can lead to accidental death, due to the foreign body itself or the removal procedure. Depending on its location, removal of the foreign body can be challenging. Here, we present a case of successful removal of a foreign body from the left upper lobar bronchus via ventilating bronchoscopy with a rigid bronchoscope and Fogarty arterial embolectomy catheter. Tracheobronchial foreign bodies in locations that are difficult to reach with forceps, due to an acute angle or the small diameter of the pediatric bronchial tree, can be effectively removed with a Fogarty arterial embolectomy catheter.