The most important basic requirements for successful skin grafting are the accurate approximation of the edge of the skin graft to that of the wound and the application of even pressure to the graft by a carefully designed dressing. Pressure dressing is indicated for the protection of the graft and the prevention of shearing between the graft and its bed. One of the most widely used methods of pressure dressing is tie-over dressing. The traditional technique is based on the application of long silk sutures along the margin of the graft that are tied over bolus of antibiotics oint-impregnated nonadherent fluffed gauze. With the traditional tie-over dressing, it is impossible to inspect the graft bed for possible hematoma and seroma during the application of dressing. So we adopted another modification of the previously described tie-over dressing methods. From January 1997 to July 1997, we had performed 27 skin graft surgeries and 8 subdermal shavings in 35 patients with our new method of tie-over dressing. We can apply even pressure to the grafts by twisting the long silk sutures instead of typing.In comparison with the plethora of devices and techniques described previously in tie-over dressing construction, our technique offers simplicity and reliable fixation of the graft to the bed and allows further adjustment of the dressing by individual tightening of the threads. Other particularly attractive features are the ability to inspect the graft at any time with little difficulty and the reapplicability of tie-over dressing with the remaining long threads if needed.
Anti-Bacterial Agents ; Bandages* ; Hematoma ; Humans ; Seroma ; Silk ; Skin ; Skin Transplantation ; Sutures ; Transplants ; Wounds and Injuries

Trichoblastoma includes all benign follicular germinative cell tumors in skin. We presented a case of trichoblastoma which occurred on the scalp as a large pedunculated tumor. The tumor was composed of lobular aggregations of basaloid epithelial cells and numerous primitive papillary mesenchymal bodies. Stromal retraction was observed between the stroma adjacent to epithelial nests and surrounding normal dermis. Focal connection to the overlying epidermis was observed. The classification and terminology for the benign neoplasms with follicular differentiation was discussed.
Classification ; Dermis ; Epidermis ; Epithelial Cells ; Scalp ; Skin

No abstract available.

Among 7,500 patients whom we have performed gastrofiberoscopy from July 1979 to June 1,982, 226 cases of stomach cancer were diagnosed. The frequency was 3. 0%. The ratio of male to female was 2: 1, the peak incidence, 69 cases(30.5%) was in 5th decade. 1) The frequency of stomach cancer among the age were 0. 5% in 1st decade, 0.4% in 2nd decade, 1.2% in 3rd decade, 2.5% in 4th decade, 5.9% in 5th decade, 12.6% in 6th decade 16.8% in 7th decade. (continue...)
Female ; Humans ; Incidence ; Male ; Stomach Neoplasms* ; Stomach*

No abstract available.
Apolipoproteins* ; Blood Pressure* ; Child* ; Cholesterol* ; Humans ; Hyperlipidemias ; Hypertension ; Obesity* ; Potassium* ; Sodium* ; Statistics as Topic*

To assess the effect of postoperative radiotherapy on tumor recurrence and patient survival, 133 patients who received adjuvant postoperative radiotherapy for adenocarcinoma of the rectum were retrospectively analyzed. Sixty-one percent of the patients were in stage C2 by Astler-Coller staging system. A significant statistical difference was noticed in failure rates for lymph node negative vs lymph node positive patients;26%(9/35) vs 50%(49/98). The incidence of local failure was found to be strongly dependent on the pathologic stages; with 9%(3/35) of recurrence in stage B and 21% (21-98) in stage C. Distant metastasis has occurred in 29% (38/133) of the patients; 2% (7/35) in stage B and 32%(31-98) in stage C. The actuarial Survival at 3 years for patients in stage B2, stage C1, and stage C2, were 78%, 47%, and 38%, respectively. In conclusion, the postoperative adjuvant radiotherapy for rectal carcinoma appears to reduce local recurrence significantly.
Adenocarcinoma ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy* ; Radiotherapy, Adjuvant ; Rectal Neoplasms* ; Rectum ; Recurrence ; Retrospective Studies

Thirty eight patients with stage Iand II primary gastrointestinal non-Hodgkin's lymphoma were treated in the Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1984. There were 6 systemic disseminations during radiotherapy, and the overall failure rate were 31% in the cases with tumor bulk less than 5 cm in diameter before radiotherapy and 75% in the cases with tumor bulk greater than 5 cm in diameter (p<0.05). The overall 5 year survival rate were 69.2% in 28 patients who completed radiotherapay and 72% in 24 patients with tumor bulk less than 5 cm in diameter (small or no tumor bulk). The 5 year disease free survival rate were 71% in cases with tumor bulk less than 5 cm in diameter and 25% in cases with tumor bulk greater than 5 cm in diameter (p<0.01). But the initial stage was not related with treatment result in all cases or subgroups of cases. Thus the cases with small or no tumor bulk were shown to be curable with combined surgery and postoperative radiotherapy, but for the control of the cases with large tumor bulk that had a guarded prognosis combined radiotherapy and chemotherapy should be tried.
Disease-Free Survival ; Drug Therapy ; Humans ; Lymphoma, Non-Hodgkin* ; Prognosis ; Radiation Oncology ; Radiotherapy* ; Seoul ; Survival Rate

PURPOSE: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. MATERIALS AND METHODS: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. RESULTS: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). CONCLUSION Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

OBJECTIVES: Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. METHODS: The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. RESULTS: Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92 (28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). CONCLUSIONS: In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Antidepressive Agents ; Anxiety ; Citalopram ; Depression ; Hospitals, General ; Humans ; Inpatients ; Korea ; Mianserin ; Paroxetine ; Psychiatry ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

BACKGROUND: Liver failure due to ischemia-reperfusion injury is a serious problem in liver transplantation and radical wide resection of the liver. This injury is believed to be closely related to the generation of oxygen free radicals. Gabexate mesilate, a synthetic protease inhibitor, has an effect on the suppression of extracellular release of oxygen free radicals in the microvascular endothelium, as well as on protease inhibition. In order to understand the effects of gabexate mesilate on ischemia-reperfusion injury to the liver, we performed animal experiment with rats. METHODS: We divided the rats into two ischemia-reperfusion groups:the experimental group which received a 30 minutes ischemic injury along with the infusion of gabexate mesilate and a control group which received only the injury. Each group was subdivided into 4 sub-groups:ischemic injury only and ischemic injury plus 60, 120 or 180 minutes reperfusion injury. The test parameters were TNF-a and IL-6 in the serum, and superoxide dismutase(SOD), catalase, and malondialdehyde(MDA) in liver and lung tissues. RESULTS: The group receiving gabexate mesilate had a significantly higher level of liver SOD and liver catalase and a significantly lower level of liver MDA and lung MDA than the control groups. The TNF-a levels in the gabexate mesilate groups were significantly lower in the early phase, and a comparison of the IL-6 levels between two main groups yielded no significant results. The levels of lung catalase and SOD showed no significant difference between the two main groups. CONCLUSIONS: Protease inhibitor has the beneficial effect of liver ischemia-reperfusion injury suppression due to an increase in antioxidants or oxygen-free-radical suppression. The roles of TNF-a and IL-6 in liver reperfusion injury was not clear in our investigation. However, TNF-a might have an effect in the early phase. The mechanism of reperfusion injury to the lung in liver ischemia-reperfusion injury might be different from that to the liver.
Animal Experimentation ; Animals ; Antioxidants ; Catalase ; Endothelium ; Free Radicals ; Gabexate ; Interleukin-6 ; Liver Failure ; Liver Transplantation ; Liver* ; Lung ; Oxygen ; Protease Inhibitors* ; Rats* ; Reperfusion Injury* ; Superoxide Dismutase ; Superoxides