Access to the craniofacial skeleton and skull base requires osteotomies. An adequate exposure of neoplasms occupying the skull base and the oral cavity and oropharynx, especially retromolar trigone, is very important for precise tumor ablation. The demonstration by Tessier of the capacity for large segments of bone to survive removal and replacement has enabled skull base tumor surgery to grow into a subspeciality. Through the refined craniofacial exposure osteotomies, the surgery is safer, the operation shorter, and the result better both oncologically and reconstructively. We experienced 24 cases of exposure osteotomies consisting of 12 cases transzygomatic approaches, 1 case tranglabellar osteotomy, 1 case lateral transmaxillary approach, 1 case Le Fort II & midline splitting, and 9 cases mandibulotomy. There was no significant complication except a local wound infection in transzygomatic approach and one case of minimal malocclusion after parasymphyseal mandibulotomy. The orthotopic bone graft and the rigid fixation enables the postoperative morbidity to decrease. It seems that the previously inaccessible craniofacial tumors can be treated through the various exposure osteotomies.
Malocclusion ; Mouth ; Oropharynx ; Osteotomy* ; Skeleton ; Skull Base ; Transplants ; Wound Infection

The nodular vasculitis described by Montgomery on 1945 and is characterized by relatively chronic, persistent, or recurrent nodular lesions of nontuberculous origin chiefly on the legs. In the differential diagnosis the following must also be considered; erythema induratum, eythema nodosum, Weber-Christian disease, erythema nodosum migrans, recurrent thrombophrebitis and periarteritis nodosa. The authors observed one case of nodular vasculitis caused by sulfa drug. This patient was diagnosed to papulonecrotic tuberculid at first and treated by prednisolone 20 mg, INH 300 mg and streptomycin l.0 gm BIW. By the treatment, the patient, was cured completly within 3 months but visited again because of recurrence after 6 months. Therefore, same medication was given, but did not show improvment and added sulfa drug, Lederkyne. But, unfortunately the skin lesions was aggrevated after sulfa medication. It was suggestive that the cause of aggrevation was sulfa drug and discontinued the sulfa drug. The skin lesions were completely cured after the drug was discontinued.
Diagnosis, Differential ; Erythema Induratum ; Erythema Nodosum ; Humans ; Leg ; Panniculitis, Nodular Nonsuppurative ; Polyarteritis Nodosa ; Prednisolone ; Recurrence ; Skin ; Streptomycin ; Tuberculosis, Cutaneous* ; Vasculitis*

We analysed forty-six cases of femoral neck fracture treated with internal fixation and followed for more than one year at Korea University Hospital from January 1979 to June 1986 and the following results were obtained. 1. Sex distribution was 23 cases(50%) male and 23 cases(50%) female, and average age was sixty years old (range from 21 to 91 years). 2. The most common cause of injury was slip down(76%). 3. The most common type of fracture was Garden's type III(46%) and Pauwels' type III (67%). 4. In cases of internal fixation, the most commonly used method was closed reduction and multiple pinning under the local aneshtesia(83%). 5. Bony union was established within 5.9 months in average. 6. Among forty six cases, 7 cases(15%) of avascular necrosis, 4 cases(9%) of malunion, and 2 cases(4%) of nonunion was occurred. 7. The clinical results were excellent in twenty cases(43%), good in sixteen cases(35%), fair in seven cases(15%), and poor in three cases(7%) according to Lunceford's assessment.
Clinical Study ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Korea ; Male ; Methods ; Necrosis ; Sex Distribution

PURPOSE: To investigate the significance of E-cadherin expression in transitional cell carcinoma of bladder, as the prognostic value. MATERIALS AND METHODS: We have analyzed its immunoreactivity in 41 transitional cell carcinomas using a labelled streptavidin-biotin immunoperoxidase technique on the formalin-fixed and the paraffin-embedded tissues. E-cadherin is a Ca2+-dependent intracellular adhesion molecule of the epithelial tissue and the urothelium. We determined the E-cadherin expression in bladder carcinoma using immunohistochemical method and investigated relationship between pathological and clinical data. RESULTS: The percentage of cases showing weak pattern was higher in cases with high-grade or high-stage tumors as compared with those of low grade or low stage. The E-cadherin was expressed in a normal membranous pattern in all control cases. Abnormal E-cadherin expression was found in 8 of 20 superficial tumors and in 19 of 21 invasive tumors. Abnormal immunoreactivity was related to tumor differentiation and stage. Eight of 13 well-differentiated tumors showed preservation of membranous E-cadherin immunoreactivity, while 2 of 28 moderately and poorly differentiated tumors demonstrated normal staining patterns. CONCLUSIONS: We conclude that the loss of expression of E-cadherin in high grade or high stage transitional cell carcinoma of bladder is associated with bladder wall invasion, indicates metastasis, and may be clinical value in the assessment of prognosis.
Cadherins* ; Carcinoma, Transitional Cell* ; Immunoenzyme Techniques ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder* ; Urothelium

No abstract available.
Bronchial Arteries* ; Hemoptysis*

We attempted to investigate the effects of curricular change on a basic medical science, anatomy, based on academic achievements including Basic Medical Education Examination (BMEE). We performed an analysis between the academic years of 2011 and 2012. Independent-samples t-test for the academic achievements, paired-samples t-test for the promotion, and correlation analysis for the related subcategory of the anatomy based on the results of BMEE, which was done with SPSS 22.0. In this follow-up study for two academic years, the academic achievements decreased as the students went to the next grade under the changed curriculum of anatomy. The academic achievements decreased as the students went to the next grade in the academic year 2012 while it increased in 2011 (p<0.01). Although averages of school evaluations were similar between the academic years, the academic achievements were different from each other: it was higher in first BMEE for 2012, and in second BMEE for 2011 (p<0.05). Although the correlation was not found among school evaluations, first and second BMEE of 2011, the associations were seen both between school evaluations (p<0.01) and each BMEE (p<0.05), respectively, in 2012. These results suggested that professors of medical school should continue to lead the direction of the curriculum improvement and management depending on the academic achievement, and also to monitor all the processes, maintaining a quality of the assessment system although it might be difficult to be representative or generalize for all medial schools.
Curriculum ; Education, Medical* ; Educational Measurement ; Follow-Up Studies ; Humans ; Schools, Medical

Differential surgical procedures have been described on the treatment of patients with obstructing carcinoma of the left colon and rectum, and these vary from classical three stage approach to primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy. Staged colonic prcedures are associated with significant morbidity and mortality eventhough its initial easy performance, and many patients, unfit for further surgery, are left with a permanent colostomy. We have already reported the initial results of intraoperative antegrade colonic irrigation for one-stage operation in obstructing left colorectal cancers. In this investigation, we evaluated the results of prospective trials of primary resection and anastomosis using intraoperative colon irrigation and subtotal colectomy in obstructing left colon and rectal carcinomas. During recent five years, 19 cases of obstructing left colon and rectal carcinomas which could not received regular colon preparation due to marked abdominal distension were enrolled to this study. There were 12 men and 7 women, and mean age was 61. 14 of the 19 patients which tumors located below mid-descending colon were subjected to primary resection and anastomosis using intraoperative antegrade colonic irrigation, 4 patients which tumors located above the mid-descending colon were treated with subtotal colectomy, and remaining one patient which tumor located upper rectum was performed subtotal coloectomy because of underlying colonic ischemia. There was no mortality and significant postoperative complications such as anastomotic lealrage, pelvic abscess or intraabdominal sepsis which seemed to be related with anastomotic dehiscence. Therefore, primary resection and anastomosis using intraoperative colonic irrigation or subtotal colectomy depending on tumor locations in cases of obstructing left colon and rectal carcinomas might be useful methods to obtain safe one-stage restorative colorectal resections.
Abscess ; Colectomy ; Colon* ; Colorectal Neoplasms ; Colostomy ; Female ; Humans ; Intestinal Obstruction ; Ischemia ; Male ; Mortality ; Postoperative Complications ; Prospective Studies ; Rectum ; Sepsis

No abstract available.
Blood Cells* ; Leukemia*

In May 1974, authors encountered a 37 year old Korean male who was suffering from very serious condition of acute abdomen. On exploratory laparotomy, a ruptured granulomatous mass in the proximal portion of the ileum showing extensive inflammatory and gangrenous changes was found and about 4 ft. long of the bowel was resected. From the honey-combed fibrous capsules in the mass, four plerocercoid larvae, spargana, measuring about 3 to 7 cm in lengths were extirpated. The patient had a past history of having eaten the raw flesh of a snake as a tonic about 7 months prior to admission. Four cases of intra-abdominal sparganosis reported previously in Korea and the present case were discussed briefly. Snakes and frogs in Korea are very important second intermediate hosts for the 1arva, Sparganum stage. It is most preferable that the habitual ingestion of the raw fleshes of them should be avoided in this country.
parasitology-helminth-nematoda ; Spirometra sp. ; sparganum ; sparganosis ; laparatomy ; intestine ; perforation ; case report

PURPOSE: This study was performed to evaluate the pre-emptive analgesic effects of a small dose of intravenous ketamine on postoperative pain in patients undergoing a hysterectomy. METHOD: Sixty patients undergoing a hystrectomy under general anesthesia were randomly allocated to 2 groups. The experimental group(30 patients) received 0.3mg/kg of ketamine after induction of anesthesia, approximately 5 min prior to surgery, but the control group(30 patients)did not receive ketamine. Data was collected in a double-blind manner from April 1st, to October 30th, 2004. Postoperatively, the patients used a patient-controlled analgesia(PCA) pump. Blood pressure, pulse rate, pain, anxiety, count of times pressing the PCA button, administeration of additional analgesics and side effects of ketamine were measured at 1 hour, 3 hours, 6 hours and 24 hours after the operation. RESULT: There were no statistical differences in blood pressure, pulse rate, pain and anxiety between the experimental and control groups. There were statistical differences in blood pressure, pulse rate, pain and anxiety during the 24 hours postoperatively. In the experimental group, the number of times pressing the PCA button and administering additional analgesic drugs were significantly lower than those of the control group. CONCLUSION: A 0.3 mg/kg dose of ketamine given at approximately 5 min before surgery resulted in decreasing the number of times pressing the PCA and the administration of additional analgesics.
Pain, Postoperative/drug therapy/*prevention & control ; Middle Aged ; Ketamine/*administration & dosage ; Injections, Intravenous ; *Hysterectomy ; Humans ; Female ; Double-Blind Method ; Anesthesia, General ; Analgesics/*administration & dosage ; Analgesia, Patient-Controlled ; Adult