No abstract available.
Rectus Abdominis* ; Thigh*

No abstract available.
Rectus Abdominis* ; Thigh*

No abstract available.
Free Tissue Flaps* ; Rectus Abdominis*

Histiocytic necrotizing lymphadenitis that causes unusual lymphadenopathy is a newly recognized disease of unknown etiology and may be mistaken for other conditions such as malignant lymphoma and tuberculosis, in which specific treatment will be required. Local lymph node enlargement especially in neck is the only characteristic feature, sometimes accompanied by pain, tenderness, fever and chill like a cold, nausea, vomiting. Laboratory investigations are usually noncontributory with an occasional case showing leukopenia or an elevated erythrocyte sedimentation rate. For further understanding of this disease and helping make diagnosis, clinical features were reviewed in 15 patients (29 lymph node enlargement), who were diagnosed as histiocytic necrotizing lymphadenitis on clinical evaluation (9 patients) or excisional biopsy (6 patients). The results are as follows; Disease was more common in female(1:2) and young patient. It involved left sided neck nodes frequently (67%) and the most common site was suboccipit-al triangle (62%). 47% of patient showed multiple enlargement of lymph nodes and the size of nodes were varied from 8 to 23 mm (mean: 12.4 mm). Most nodes were movable and showed oval in shape. Fever (47%), pain (33%), tenderness (53%), recent history of upper respiratory infection (33%), leukopenia (47%) and increased erythrocyte sedimentation rate (67%) were showed in many cases. Ultrasonogrphic and CT scan showed well defined oval to round lymph nodes enlargement with inhomogenous enhancement. All affected nodes are resolved spontaneously within 3-10 weeks (mean 5.1 weeks) without specific treatment. After reviewing all of above results, it is concluded that histiocytic necrotizing lymphadenitis is self-limiting disease without characteristic clinical features, but some factors like fever, pain, tendrness, leukopenia and increased erythrocyte sedimentation rate with cervical lymphadenopathy in young female patient are thought to be very helpful in diagnosis and in these circumstances, lymph node biopsy must be delayed for 2-3 months.
Biopsy ; Blood Sedimentation ; Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Leukopenia ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Nausea ; Neck ; Tomography, X-Ray Computed ; Tuberculosis ; Vomiting

Traumatic loss of a finger in part or in which inevitably leads to significant functional deficit and a distortion in body image of the inflicted individual. The available reconstructive option in these circumstances have been toe to finger transfer using microsurgical technique, flap coverage after bone graft, and osteodistraction of the remnant finger. Each method carries advantages and drawbacks inherent in the technique, and generally requires long operative time and hospitalization. Furthermore, the postoperative results after such procedures can be said to be less satisfactory in aesthetic perspectives. Apart from the toe to finger transfer, not much can be sought in terms of functional recovery of the reconstructed part, For a long time finger prosthesis have been used as a replacement of the lost finger part, but it fails to deliver functional strength and tends to be dislodged rather easily. To overcome these shortcomings in the technique, an osseointegrated finger prosthesis has recently been devel-oped. Thumb, index and middle finger in 3 patients were reconstructed with this osseointegrated finger prosthesis. The procedure requires two procedures; the first stage involves placement of a titanium screw in the phalangeal or metacarpal bone proper, followed by fixation of an abutment onto the titanium screw 3 months after the primary operation. The skin surrounding the abutment is thinned out to minimize mobility of the prosthesis at this second stage of operation. After wound stabilization in 2-3 weeks, a custom-made silicone finger prosthesis is made and attached to the implanted abutment using super power magnets. The entire procedure requires 4 months up to the completion, but the procedures can be carried out on the outpatient basis under local anesthesia, not having to interfere with the daily activities of the patient. The aesthetic results with osseoperception have been found to be rewarding, and usual activity like a hand writing and typewriting have been possible. This alternative method could be used for finger reconstruction in cases of usual reconstructive surgery being impossible.
Anesthesia, Local ; Body Image ; Fingers* ; Hand ; Hospitalization ; Humans ; Operative Time ; Outpatients ; Prostheses and Implants* ; Reward ; Silicones ; Skin ; Thumb ; Titanium ; Toes ; Transplants ; Wounds and Injuries ; Writing

No abstract available.
Nose*

Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

No Abstract Available.

BACKGROUND: Early diagnosis and proper therapy of malfunctioning prosthetic heart valves remain a challange. Transthoracic echocardiography(TTE) is the diagnostic procedure of choice for the evaluation of malfunctioning prosthetic heart valves. Howerver, TTE may be limited owing to poor acoustic windows. Some of these limitations can be overcome by transesophageal echocardiography(TTE). METHODS: The study comprised 33 consecutive patients(20 male and 13 famale patients, age range 20 to 59) in congestive heart failure after remote mitral valve replacement with bioprosthesis. The patients were examined between 1987 and 1994. All the 33 patients were studied by TTE and 19 patients among these patients furthermore by TEE. The morphology of the explanted bioprosthesis was confirmed by surgery in all cases. RESULTS: The abnormalities of the bioprosthesis were diagnosed correctly by TTE in 32 cases. The more detailed morphology of the valves could be observed by TEE(19 cases). Only in one case a small thrombus in left atrium was overlooked in TTE examination, on the otherhand it was detectedd by TEE. The severity grade of mitral regurgitation was estimatedca. I' severer by TEE in 8 cases. In all TEE examination spontaneous echocontrast was observed in left atrium. The bioprostheses from CE(Carpentier-Edwards) showed higher tendency to cuspal tearing and perforation. CONCLUSION: TTE is the diagnostic procedure of choice on patients with bioprosthetic mitral valve replacement. TTE examination confirms immediately clinical diagnosis of bioprosthetic failure. The transesophageal approach promises more detailed informations about lesions of the degenerated bioprosthetic valves and left atrium.
Acoustics ; Bioprosthesis ; Diagnosis* ; Early Diagnosis ; Echocardiography, Transesophageal* ; Estrogens, Conjugated (USP)* ; Heart Atria ; Heart Failure* ; Heart Valves ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve* ; Thrombosis

No abstract available.
Epinephrine* ; Skin* ; Transplants*