RESUMO
PURPOSE: Many studies reported anatomy of posterior tibial artery perforator. But, it is not easy to use this flap in clinical case. METHODS: Authors performed cadaver dissection on 26 legs from 13 cadavers and identified the number, location, type, length and diameter of perforator. Based on anatomic study, posterior tibial artery perforator flap was performed on 3 clinical cases. RESULTS: The perforator was found on a line drawn from the medial boarder of central patella to posterior boarder of medial malleolus. The main perforator which was longer and greater caliber than others was found was found 13 to 17cm distant from medial boarder of central patella in 23 of 26 leg(88.5%). Average length was 6.2cm and average diameter was 1.4mm. The main perforator was musculocutaneous perforator at 20 of 26 leg(77%). The posterior tibial artery perforator flap was clinically use in 3 cases. All flap were survived without any complication. CONCLUSION: The author found the main perforator of posterior tibial artery perforator flap was located 15cm distant from medial boarder of central patella within the circle drawn with a radius of 4cm. The posterior tibial artery perforator flap is expected to be used as one of the option for the reconstruction of hand and foot.
Assuntos
Cadáver , Pé , Retalhos de Tecido Biológico , Mãos , Perna (Membro) , Patela , Retalho Perfurante , Rádio (Anatomia) , Artérias da TíbiaRESUMO
PURPOSE: Condyloma acuminatum is a common sexually transmitted disease of the external genitalia and anus. Approximately 5% of patients demonstrate urethral involvement. Electrical fulguration or excision using a pediatric resectoscope has been used in the management of such lesions. Holmium(Ho):YAG laser, 5-FU(fluorouracil), or interferon may be helpful in eradicating them. We reviewed the results of intraurethral condyloma acuminatum treatment with Ho:YAG laser and 5-FU solution. MATERIALS AND METHODS: From January 2001 to July 2002, seven patients with intraurethral condylomata acuminata were enrolled in the study. The mean age of the subjects was 19.5(range 25~43) years. Under local anesthesia with 10% lidocaine spray and jelly, all of the intraurethral lesions were removed with the Ho:YAG laser followed by coverage with 10mL of 5% 5-FU solution. Intraurethral injection of 5-FU was performed weekly up to six times. Urethroscopy for detection of recurrence was done 3 months after initial laser therapy. RESULTS: Most patients had multiple intraurethral lesions. Six patients (86%) responded to initial therapy without local recurrence with a mean follow-up of 15.8 (range 9.1-23.2) months. One patient had a recurrence at 2 months. CONCLUSIONS: We believe that the Ho:YAG laser plus 5% 5-FU solution is a useful option for the treatment of intraurethral condyloma acuminatum.
Assuntos
Humanos , Canal Anal , Anestesia Local , Condiloma Acuminado , Fluoruracila , Seguimentos , Genitália , Hólmio , Interferons , Terapia a Laser , Lasers de Estado Sólido , Lidocaína , Recidiva , Infecções Sexualmente TransmissíveisRESUMO
We experienced a case of candida albicans cystitis resembling a bladder tumor. The case involved a 75 year-old female patient who complained lower abdominal pain and voiding difficulty. A pelvic ultrasonograph, a pelvic CT and the cystoscopic findings indicated a bladder tumor. The mass lesion was diagnosed from a cystoscopic biopsy as candida albicans cystitis. The mass disappeared and the voiding symptoms improved two weeks later after Itraconazole (Sporanox ) oral medication.
Assuntos
Idoso , Feminino , Humanos , Dor Abdominal , Biópsia , Candida albicans , Candida , Cistite , Itraconazol , Neoplasias da Bexiga Urinária , Bexiga UrináriaRESUMO
PURPOSE: A non-randomized study was performed to assess the efficacy of Mitomycin C (MMC) plus hyperthermia as a primary therapy after an initial transurethral resection (TUR) for treating superficial bladder tumors or as a salvage modality for recurrent T1 tumors after adequate BCG therapy. MATERIALS AND METHODS: A total of 31 patients from Nov. 1992 to Aug. 2001 with follow-up of 11 to 94 months (mean 27.4) were enrolled in this study. Of the 31 patients, 27 underwent MMC plus hyperthermia as the primary agent after TURB and among those 27 patients 7 had a tumor recurrence and were allocated to receive BCG. Of the 31 patients, 4 were given BCG initially, and at the time of first or second recurrence, MMC plus hyperthermia was attempted. RESULTS: Of the 27 patients who received MMC plus hyperthermia, 20 (74%) responded to the initial therapy without a local recurrence and the mean follow-up was 26.4 months with a range of 12 to 94 months. Seven patients had a tumor recurrence and the median interval to recurrence was 21.6 months. Of the 7 patients who had a tumor recurrence, the histology (stage or grade) had changed at the time of the recurrence in 4 (57%). Four patients who received BCG as an initial therapy had a tumor recurrence and the mean interval to recurrence was 14.5 months. These patients were treated with MMC plus hyperthermia and 3 those patients remain free of recurrence with a follow-up of 11 to 71 months. One of those patients underwent a cystectomy and urinary diversion. CONCLUSIONS: MMC plus hyperthermia is a viable option for appropriately selected patients who developed recurrent superficial bladder tumors after adequate BCG therapy.
Assuntos
Humanos , Cistectomia , Febre , Seguimentos , Mitomicina , Mycobacterium bovis , Recidiva , Neoplasias da Bexiga Urinária , Bexiga Urinária , Derivação UrináriaRESUMO
Lichen spinulosus is a benign follicular eruption seen primarily in younger persons and is frequently classified a disorder of keratinization. The lesion is characterized by the development of patches of small perifollicular papules that have a central horny spine. We report a case of lichen spinulosus developed in an 8-year-old male patient who had atopic dermatitis.
Assuntos
Criança , Humanos , Masculino , Dermatite Atópica , Líquens , Coluna VertebralRESUMO
A 11-days-old female was diagnosed as incontinentia pigmenti by skin biopsy was referred for ophthalmological examination.The fundus of the right eye showed vacularization only in the posteroir pole and neovascularization in the junctional area between vascular and avascula retina.Systemic evaluation revealed no associated abnormality.At 22 days of age, we ablated avascular retina with indirect diode laser photocoagulation under general anesthesia. Despite extensive 360 degree photocoagulation, fibrovascular proliferation was found to extend into vitreous cavity from optic disc 3 weeks after photocoagulation.
Assuntos
Feminino , Humanos , Anestesia Geral , Biópsia , Incontinência Pigmentar , Lasers Semicondutores , Fotocoagulação , Retina , PeleRESUMO
So-called, the double channel pylorus has been, relatively rarely, reported through out the world. All reported cases were almostly those of gastroduodenal fistula as a complication of peptic ulcer disease. The congenital forms of double pylorus were reported even more rarely. We found three cases of double channel pylorus in 25,000 cases endoscopy done at our unit. All those three cases were thought to be acqired form endoscopically, radiographically and histologically. One of those was undergone to operative resection because of uncontrollable bleeding and the others were on medical theraphy with satisfaction.