PURPOSE: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. MATERIALS AND METHODS: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. RESULTS: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. CONCLUSION: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate ; Ulcer

No abstract available.
Diagnosis* ; Growth Hormone* ; Humans*

PURPOSE: Matriderm(R) is a highly porous dermal substitute consisting of a collagen matrix (collagen type I, III, and V) cross-linked to an elastin hydrolysate. The 1 mm thickness Matriderm(R) is used in a one-stage procedure. On the other hand, 2 mm thickness Matriderm(R) has been used in two-stage procedures in combination with split thickness skin grafts (STSG) for reconstruction as dermal substitute. To the best our knowledge, there is no case that reports the single stage procedure with 2 mm thickness Matriderm(R). There are many expected advantages if a two-stage surgery could be performed by one-stage procedure as long as the result is guaranteed. The purpose of this study is to present capacity of 2 mm thickness Matriderm(R) as a dermal substitute in single stage skin grafting by the successful results of six cases. METHODS: We performed this one-stage procedure in five patients instead of soft tissue reconstruction. Those patients were required soft tissue reconstruction after trauma injuries or radial forearm harvest as a donor site in the period between 2011 and 2012. Five Patients were treated with a combination of STSG and 2 mm thickness Matriderm(R) solely. Three out of five patients who were injured by trauma got transplanted splint thickness skin that were range from 4/1000~8/1000 inches (Table 1). Patients' data were analyzed retrospectively by chart review and patients interviews. Each patient's chart was reviewed for age, gender, type of injury, complications, final outcome and successful rates. RESULTS: The patient group consisted of 4 men and 1 woman between ages of 5 and 70. The clinical results of these five treated patients concerning skin-quality and coverage of exposed soft tissue were very good. Using 2 mm thickness Matriderm(R) the wound could gain more dermal substitute compare to 1 mm thickness Matriderm(R). CONCLUSION: Matriderm(R) is a single-use three-dimensional matrix composed of native, structurally intact collagen fibrils and elastin for supporting dermal regeneration. In this study five patients with trauma injuries or radial forearm harvest as a donor site were treated with 2 mm thickness Matriderm(R) as a dermal substitute and STSG as a single-stage procedure to cover exposed structures. Compare to 1 mm Matriderm(R), 2 mm thickness Matriderm(R) provide more dermal collagen and enhance skin-elastisity. Achieving single stage STSG with 2 mm thickness Matriderm(R), patient's hospital days were reduced in half and infection chances were also decreased. In conclusion, single skin grafting with 2 mm thickness Matriderm(R) is feasible and it is time-effient and cost effective procedure.
Collagen ; Elastin ; Female ; Forearm ; Hand ; Humans ; Male ; Regeneration ; Retrospective Studies ; Skin Transplantation ; Skin* ; Splints ; Tissue Donors ; Transplants ; Wounds and Injuries

No abstract available.

No abstract available.
Humans ; Infant*

No abstract available.
Humans ; Hypertension* ; Infant, Newborn ; Infant, Premature* ; Magnesium*

The safety and efficacy of the CO2laser as a replacement for the steel scalpel is well documented in plastic surgery, but the use of the laser blepharoplasty has been controversy. This study compares and contrasts the use of the CO2 laser with conventional method in cosmetic upper eyelid blepharoplasty. Thirteen Patients underwent blepharoplasty in a paired comparison study. Four patients(Group A) underwent blepharoplasty by laser, another four patients (Group B) underwent blepharoplasty by conventional method, and the other five patients(Group C) underwent upper eyelid blepharoplasty using the laser on one eye and a conventional method on the other side. Preoperative factor(set up time, equipment), intraoperative factor(actual operation time, bleeding, visibility), postoperative factor(swelling, ecchymosis, immediate & short term result) were evaluated. The advantage of using the CO2 laser rather than the steel scalpel in blepharoplasty are less bleeding and superior intraoperative visibility. The disadvantage of using the laser compared with steel scalpel include the cost of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery There were no complications with either the scalpel or the laser.
Bleeding Time ; Blepharoplasty* ; Carbon Dioxide* ; Carbon* ; Ecchymosis ; Eyelids* ; Hemorrhage ; Humans ; Lasers, Gas* ; Matched-Pair Analysis ; Steel ; Surgery, Plastic

For many years the standard surgical treatment for carpal tunnel syndrome has been division of the transverse carpal ligament under direct vision through a palm incision. Although the effectiveness and Patient acceptability of the conventional open carpal tunnel release are good, disability from a painful palm cutaneous neuroma, and prolonged swelling are reported Endoscopic carpal tunnel release seems to result in less postoperative morbidity, and minimal serious complications. Because endoscopic carpal tunnel release leaves the overlying skin, the subcutaneous fat and the palmer fascia and its attachments to the thenar and hypothenar musculature intact its proponents maintain that their patient have less scar tenderness, quicker recovery of grip strength, and earlier to return activities of daily living and work The endoscopic approach(Agee single portal technique), which includes specific localization of the hook of hamate, flexor retinaculum and the superficial palmar arch utilizing topographical landmarks, avoids entry into Guyon's canal and common digital nerves. We experienced four cases of carpal tunnel syndrome. In four cases, patients with carpal tunnel syndrome have been performed endoscopic carpal tunnel release with minor complication.
Activities of Daily Living ; Carpal Tunnel Syndrome ; Cicatrix ; Fascia ; Hand Strength ; Humans ; Ligaments ; Neuroma ; Skin ; Subcutaneous Fat

PURPOSE: We investigated the autonomic nervous and complex modulation of heart rate and peripheral blood volume, and linear and nonlinear coupling between heart rate and peripheral blood volume in full-term and preterm infants. METHODS: In twenty healthy preterm infants and twenty full-term infants at postconceptional age of 30-37 and 38-41 weeks each, we recorded electrocardiogram and photoplethysmogram simultaneously during sleep in the supine position. To evaluate the autonomic and complex modulation, we performed power spectral analysis and analysis of the univariate nonlinear determinism. To quantify degree of linear and nonlinear couple between heart rates and peripheral blood volume, analyses of cross spectrum and bivariate nonlinear determinism were performed respectively. RESULTS: In the analysis of heart rates, preterm infants had significantly lower normalized high-frequency power (20.3+/-7.7% vs 30.7+/-15.1%, P<0.05), higher low-to high-frequency power ratio (3.0+/-2.1 vs 1.9+/-1.6, P<0.05), and significantly lower univariate prediction error (2.9+/-1.3% vs 4.1+/- 2.8%, P<0.05) when compared to full-term infants. In the analysis of peripheral blood volume, they showed no significant differences. Cross spectrum in all frequency ranges showed no significant difference between them. But preterm infants showed a significantly higher bivariate nonlinear prediction error (4.8+/-3.8% vs 3.1+/-2.2%, P<0.05) and a lower statistical coupling index (16.6+/-10.4 vs 22.9+/-9.2, P<0.05) than full-term infants. CONCLUSION: Compared to full-term infants, the heart rates of preterm infants are less modulated by cardiac parasympathetic activity and less complex. Furthermore, their peripheral blood volume was less nonlinearly coupled to heart rate.
Blood Volume* ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Nonlinear Dynamics ; Perfusion ; Supine Position

No abstract available.
Fever* ; Humans ; Infant, Newborn*