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*

Primary carcinoid tumor of the kidney is extremely rare ; only 29 previous reports have been described in the world literature, 3 cases of which were known to arise in horseshoe kidneys. Because of the scarcity of primary renal carcinoid tumor, its clinicopathologic features and prognosis are not well characterized, and its histogenesis is unknown. We present a case of primary carcinoid tumor arising in the horseshoe kidney of a 43-year-old man. The lesion is morphologically identical to those of gastrointestinal or respiratory tracts. In addition, this tumor contains clusters of intestinal epithelium with goblet cells and mature bony trabeculae. The cytoplasm of the tumor cells are immunoreactive for keratin, NSE, and synaptophysin, but are negative with Grimelius and Fontana-Masson stains. Membrane-bound cytoplasmic neurosecretory granules are observed by electron microscopic examination. This is the first case of primary renal carcinoid tumor arising in a horseshoe kidney documented in Korea. We describe the gross features, light and electron microscopic, and immunohistochemical findings of renal carcinoid and review the literature, with speculations on the possible histogenesis of this unusual neoplasm.

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

The injury of the epiphysis or epiphyseal plate produces undesirable effects on the normal growth of the bone, such as bone bridge, growth arrest and angular deformity. Authors performed vascularized fibular epiphysis and epiphyseal plate transplantation in 7 years old girl, who received the excision of the exostosis on distal ulna, followed by progressive varus deformity of right forearm and growth arrest of distal ulna. With follow
Congenital Abnormalities ; Epiphyses ; Exostoses ; Female ; Forearm ; Growth Plate ; Humans ; Methods ; Transplantation ; Ulna

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

Epithelioid hemangioendothelioma of liver is a very rare tumor of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. We present a primary epithelioid hemangioendothelioma of liver in a 40-year-old male. This tumor was composed of an ill-defined yellowish white, 7 x 4cm sized, firm, solid mass and small satellite nodules in the right lobe of liver. Microscopically, two types of tumor cells-dendritic and epithelioid-were identified. The neoplastic cells infiltrated into sinusoids and intrahepatic veins. The background of tumor showed marked sclerotic change and focal proliferation of bile ductules. Confirmation of the endothelial origin of these cells was provided by positive immunoperoxidase staining for factor VIII-related antigen, and by electron mi-croscopic demonstration of Weibel-Palade body. This is the first case of epithelioid heman- gioendothelioma of liver documented in Korea. We report this case in view of its scarcity and distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma.

No abstract available.
Aged* ; Humans ; Pneumonia*

No abstract available.
Aged* ; Humans ; Pneumonia*

No abstract available.
Nasal Bone*

Epidemiological studies of monoclonal B-cell lymphocytosis (MBL) have been conducted in limited geographical regions. Little is known about the prevalence of MBL in Asia. We investigated the prevalence and immunophenotypic characteristics of MBL in Koreans who had idiopathic lymphocytosis (lymphocyte count >4.0×109/L) and were ≥40 years of age. A total of 105 leftover peripheral blood samples met these criteria among those from 73,727 healthy individuals who visited the Health Promotion Center, Samsung Medical Center, Korea, from June 2018 to August 2019. The samples were analyzed using eight-color flow cytometry with the following monoclonal antibodies: CD45, CD5, CD10, CD19, CD20, CD23, and kappa and lambda light chains. The overall prevalence of MBL in the study population was 2.9% (3/105); there was one case of chronic lymphocytic leukemia (CLL)-like MBL (CD5+CD23+), one case of atypical CLL-like MBL (CD5+CD23−), and one case of CD5−MBL with a lambda restriction pattern. This is the first study on the MBL prevalence in an East Asian population, and it reveals a relatively low prevalence of MBL in healthy Korean individuals with lymphocytosis.