The authors report our experience of digital pulp reconstruction by free great toe pulp transfer. Twelve patients were treated with lateral great toe hemipulp. Twelve cases of digital pulp defect were reviewed, including 2 thumbs and 10 indices. There were 11 primary cases and 1 case of secondary reconstruction. We noted no necrosis and 5 patients suffered from cold intolerance. The flap sensibility, according to ASSH criteria, was excellent in 1 case, good in 10 cases, fair in 1 case and poor in no cases. The range of the stationary two-point discrimination test was between 4 and 15mm (mean S2-PD value; 7.2mm). The subjective evaluation found in 11 patients was satisfactory and dissatisfactory in 1. Performing this procedure during the acute phase may improve the management of trauma by reducing the time needed for cicatrisation and the length of disability. Furthermore, the principal advantages of this procedure are minimal donor site morbidity, as well as excellent functional and cosmetic gain.
Discrimination (Psychology) ; Humans ; Necrosis ; Thumb ; Tissue Donors ; Toes*

The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

No abstract available.
Nasal Bone*

Bromidrosis is a disorder characterized by rancid body odor which influences a patient's social life and mental health. The therapeutic modalities and the mechanism of bromidrosis have been carefully studied, however, there have been few reports about the genetic inheritance of bromidrosis. We investigated the family history of 42 patients who were operated on for bromidrosis and followed up to the third generation in 10 cases. The results were as follows: Results of investigation which were followed up the second generation. The fathers of five patients and the mothers of 11 patients had bromidrosis in 18 male patients. The fathers of six patients and the mothers of 12 patients had bromidrosis in 24 female patients. Thirty-four patient (81.0%) among a total of 42 have a single parent with bromidrosis. Result of investigation which were followed up to the third generation Bromidrosis was occurred in 17 of 42 patients (40.5%) in the second generation, and 18 of 27 patients (66.7%) in the third generation. In one case, a father transmitted bromidrosis to his three sons, and as a result, X-linked inheritance could be ruled out Bromidrosis was not skipped in every generation of all families. We on conclude that bromidrosis is an autosomal dominant inherited disorder.
Fathers ; Female ; Genes, X-Linked ; Humans ; Male ; Mental Health ; Mothers ; Odors ; Single Parent ; Wills*

PURPOSE: The purpose of this study was to examine the association between the parenting characteristics and problem behaviors of school-aged children living in poverty. METHODS: With a cross-sectional study design, the Child Behavior Checklist (CBCL) was utilized to collect data from 190 primary caregivers of children in low income families in one middle-size city in South Korea. RESULTS: Among the children's characteristics, only school performance showed significant association with problem behaviors and children's age and gender were not associated with problem behaviors. Among the primary caregivers' parenting characteristics, discipline style, rearing confidence, and concerns for their children showed significant association with problem behaviors for girls, but not for boys. Parenting attitude was not related to problem behaviors with either girls or boys. CONCLUSION: The findings of this study indicate that the parenting characteristics of low income primary caregivers are important in children's problem behaviors, especially for girls and parent education programs for child rearing, including methods of discipline for both boys and girls, are effective nursing interventions.
Caregivers ; Checklist ; Child Behavior ; Child Rearing ; Child* ; Cross-Sectional Studies ; Education ; Female ; Humans ; Korea ; Nursing ; Parenting* ; Parents* ; Poverty*

Fingertip injuries represent the most common type of injuries were seen in the upper extrimity. Reconstruction of a injured digit needs good aesthetic result as well as functional recovery. From August 1994 to August 1996, sixty two digits in the fifty four patients were treated by using the reverse digital island flaps. The age of the patients ranged from 13 to 64 years. We reviewed the medical records of our cases and analyzed them in several aspects. Majority of the cases (79%) were covered primarily. Neurorrhaphy was performed in 26 digits (42%). The survival of these flaps was successful in all cases except one case. The mean values of the static two point discrimination in sensate and nonsensate flaps were 6.5 mm and 10.3 mm retrospectively. In this study, venous congestion was the most common early complication (9.6%). Arterial insufficiency and flap loss (6.4%) were the troublesome early complications. Bulky mushroom shaped flap (24.6%), scar contracture (6.4%), paronychia (8.2%), cold intolerance (9.6%), hyperesthesia (3.2%) and flap atrophy (4.8%) were the late complications. In conclusion, despites of its complications, reverse digital island flap provide durable skin cover, superior aesthetic result and excellent sensory restoration.
Agaricales ; Atrophy ; Cicatrix ; Contracture ; Discrimination (Psychology) ; Humans ; Hyperemia ; Hyperesthesia ; Medical Records ; Paronychia ; Retrospective Studies ; Skin ; Surgical Flaps

Kimura's disease is a chronic inflammatory condition of unknown cause. It usually appears as a painless nodule in the head and neck region often associated with regional lymphadenopathy, but there have rarely been reports of penile involvement or clinical presentation as an ulcerative plaque. We present a case of Kimura's disease occurring on the penile shaft as an ulcerative plaque in a 44-year-old man. A vesicular eruption had occurred on his penile shaft followed by an ulcerative plaque for 2 months. He had suffered from recurrent regional lymphadenopathy for 15 years and he had also exhibited intermittent eosinophilia. Histopathologic findings revealed diffuse eosinophilic infiltration in the dermis of the skin and eosmophilic abscesses in the lymphoid follicles of the mguinal lymph node. After short-term systemic steroid therapy and local injection of triamcinolone acetonide, the ulcerative plaque was healed.
Abscess ; Adult ; Dermis ; Eosinophilia ; Eosinophils ; Head ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Skin ; Triamcinolone Acetonide ; Ulcer

No abstract available.
Carbon*

Enemas are sometimes used in hospital and domicilliary practice and occasionally by patients themselves without a valid indication. The present repart is one in which enernas were done for 3 months by a patient himself to treat his hemorrhoid and resulted in severe inflamimatory change with large-siaed illdefined shallow ulceration in rectum and sigmoid colon. This patient, a 53 year old male, entered the hospital with the complaint of diarrhea with passage of bloody muct.. Colonoscopic examination revealed severe inflammatory change, friable mucosa and several relatively large-sized ill-defined shallow ulceration in rectum and sigmoid colon. A biopsy was performed and microscapic examination revealed intense infiltrates and plasma cells and crypt abscess with decreased goblet cells in the lamiina propria. The submucosa showed edema with infiltrates of chronic inflammatory cells and neutrophils. Conservative treatment with discontinue of enemas and fluid supply was performed. And his symptoms were improved. After second week, follow-up colonoscopy revealed inflammatory changes were improved.
Abscess ; Biopsy ; Colitis* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Edema ; Enema* ; Follow-Up Studies ; Goblet Cells ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Mucous Membrane ; Neutrophils ; Plasma Cells ; Rectum ; Ulcer

Arotinolol, a now alpha and beta bloking agent, was administered orally in 32 hypertensive patients for 8 weeks in order to evaluate the antihypertensive effects and side effects. The doses were from 20mg to 30mg a day. The serum chemistries and chest X-ray were taken before and after Arotinolol administration. The results were as follows; 1) Blood pressure which was measured in sitting, supine and standing position was 176.37+/-4.73/116.54+/-4.34, 170.14+/-5.35/103.12+/-3.67, 156.37+/-7.54/104.31+/-3.34mmHg in control and 144.63+/-2.78/94.41+/-2.87, 146.47+/-5.41/89.12+/-4.34, 140.71+/-4.47/89.73+/-3.71mmHg in the treatment group. The differences between both blood pressure were statistically significant(P<0.001). 2) There was no significant change in pulse rate before and after medication. 3) There was no significant change in the laboratory findings such as CTR, GOT, GPT, alkaline phosphatase, CPK, creatinine, BUN, uric acid, cholesterol, fasting blood sugar and triglyceride before and after treatment. 4) The side effects of arotinolol were observed in 6 of 32 cases(18.7%), which were not required discontinuing the medication or decreasing the dose.
Alkaline Phosphatase ; Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Fasting ; Heart Rate ; Humans ; Hypertension ; Thorax ; Triglycerides ; Uric Acid