No abstract available.
Ischemia* ; Skin*

Cutaneous leishmaniasis (oriental sore) is usually a self-limited infection of the skin caused by the protozoan Leishmania tropica. The disease is endemic to the Mediterranean, Asia, Africa, and the Middle East. It has been seen in this country among many Korean technical experts and labourers working in the endemic areas of the disease. Our patient had acquired cutaneous leishmaniasis in Saudi Arabia and it had remained active for six months. He had been treated with antimony and metronidazole but failed because of severe side effects. And then we treated the patient witb cryosurgery and the skin lesions were followed by resolution with cosmetically acceptable scar in 4 months. The brief review of literature on the treatment of cutaneous leishmaniasis was undertaken.
Africa ; Antimony ; Asia ; Cicatrix ; Cryosurgery ; Eczema* ; Humans ; Leishmania tropica ; Leishmaniasis, Cutaneous ; Metronidazole ; Middle East ; Saudi Arabia ; Skin

PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. METHODS: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. RESULTS: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

No abstract available.
Vibration*

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed. Due to high tissue thromboplastin concentration in cerebral tissue, more serious coagulation and fibrinolytic abnormalities may occur when concomitant head trauma is present. The aim of this study was to determine the changes in coagulation and fibrinolysis after trauma and the effects of head trauma on coagulation and fibrinolysis. METHODS: This study includes 35 trauma patients: 16 patients with head trauma (group A) and 19 patients without head trauma (group B). We measured the plasma levels of functional protein C, antithrombin III (AT III), thrombin antithrombin III complex (TAT), plasmin alpha 2 plasmin inhibitor complex (PIC), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor-1 antigen (PAI-1) on admission and on days 1, 2, 4, and 6 after the trauma. RESULTS: The TAT and the TAT/PIC were significantly higher in group A than in group B on all days. PIC was significantly lower in group A than in group B on all days except the day of admission. Over the course of time, the TAT and the TAT/PIC decreased in both groups and PIC increased. On admission, the PAI-1 of both groups was increased, but it decreased over the course of time. The t-PA was increased on admission, was suppressed on the 1st day, and then increased again. The PAI-1 and the t-PA showed no significant difference between the two groups. CONCLUSIONS: After multiple trauma, coagulation was enhanced and fibrinolysis was suppressed. Enhanced coagulation and suppressed fibrinolysis were significantly greater in group A than in group B.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Craniocerebral Trauma ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Protein C ; Thrombin ; Thromboplastin ; Tissue Plasminogen Activator

PURPOSE: Adenosquamous carcinoma, a rare malignant tumor of the stomach, is characterized by two different cell components, one adenomatous and the other squamous component. Its clinicopathologic feature and prognosis are quite different from the ordinary adenocarcinomas. We report our experience of 9 such cases. MATERIALS AND METHODS: Clinical and pathologic features were reviewed for the 9 patients who undenwent gastrectomies and were confirmed as adenosquamous carcinoma by pathologists during the 10-year period of from 1987 to 1998. Postoperative adjuvant therapy and prognosis were also reviewed. RESULTS: The ages of 6 male and 3 female patients ranged from 30 to 59, with the median age of 48. Total gastrectomy was done in 4 cases, while other underwent subtotal gastrectomy. Curative resection was done in four cases. Fourteeen additional organs were resected concomitantly due to suspicious tumor invasion and among them 9 organs were histologically confirmed for tumor invasion. The mean tumor size was 7.4 cm (2.5-27 cm) and all cases were pathologically advanced. One case showed peritoneal seeding and 3 cases showed hepatic metastases. There were 7 cases of stage IV disease by the UICC TNM classification (5th ed.) and the other two were stage II and stage IIlb respectively. Eight cases received postoperative adjuvant chemotherapy comprising S-FU, DDP, adriamycin, picibanil or VP-16. Of 9 patients, 6 died and the overall 5-year survival rate was 15.3%. CONCLUSION: Adenosquamous cancer of stomach is regarded as a disease of unfavorable prognosis, which was confirmed by this study. The treatments were not quite different from those for other stomach cancers. Although more cases and further investigations are essential for complete understanding of the clinical prognosis and proper treatment of the gastric adenosquamous cancer, early diagnosis, curative resection and close postoperative follow-ups are currently available options for better outcome of this disease.
Adenocarcinoma ; Carcinoma, Adenosquamous* ; Cellular Structures ; Chemotherapy, Adjuvant ; Classification ; Doxorubicin ; Early Diagnosis ; Etoposide ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Neoplasm Metastasis ; Picibanil ; Prognosis ; Stomach ; Stomach Neoplasms ; Survival Rate

BACKGROUND: Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged. METHODS: Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5+/-1%. After discontinuance of infusion, recovery profiles were measured with accelerography. RESULTS: The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5+/-1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups. There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r2=0.37, recovery time: r2=0.28). Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r2=0.76). CONCLUSION: The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage.
Blood Volume ; Body Weight ; Cesarean Section* ; Female ; Hemorrhage ; Metabolism ; Muscle Relaxation ; Obstetrics ; Pregnancy ; Pseudocholinesterase

BACKGROUND: Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged. METHODS: Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5+/-1%. After discontinuance of infusion, recovery profiles were measured with accelerography. RESULTS: The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5+/-1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups. There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r2=0.37, recovery time: r2=0.28). Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r2=0.76). CONCLUSION: The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage.
Blood Volume ; Body Weight ; Cesarean Section* ; Female ; Hemorrhage ; Metabolism ; Muscle Relaxation ; Obstetrics ; Pregnancy ; Pseudocholinesterase

PURPOSE: To analyse the MR imaging characteristics of the soft tissue hemagiomas of the extremity. MATERIALS AND METHODS: We retrospectively reviewed histopathologically proven 18 cases of hemangiomas of the extremity including 15 cavernous hemangiomas, 2 venous hemangiomas and 1 capillary hemangioma. The lesions were frequent in female and low extremity. We analyzed the site, extent, margin, signal intensity, enhancement pattern, the homogeniety of internal architecture, and abnormal vessels near the lesion. RESULTS: The extensive lesions involving multiple muscle and tissue layers were more frequent than localized lesions (12/18). Twelve cases had ill defined margin. In most cases, the lesion was heterogeneous mass composed of nodular and septal components. The nodular component showed intermediate signal intensity in T1WI and hign signal intensity in T2WI. The setal component showed mixed inconstant signal intensity. One case of capillary hemangioma showed relatively homogeneous signal intensity than cavernous hemangioma and the main portion of 2 venous hemangiomas had mutilple tubular signal voids. At least some portion of the lesion was enhanced in all enhanced cases. CONCLUSION: The soft tissue hemangiomas of the extremity showed characteristic MR findings and MRI would be an useful method in the diagnosis of the soft tissue hemangiomas of the extremity.
Diagnosis ; Extremities* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies

PURPOSE: To analyse the MR imaging characteristics of the soft tissue hemagiomas of the extremity. MATERIALS AND METHODS: We retrospectively reviewed histopathologically proven 18 cases of hemangiomas of the extremity including 15 cavernous hemangiomas, 2 venous hemangiomas and 1 capillary hemangioma. The lesions were frequent in female and low extremity. We analyzed the site, extent, margin, signal intensity, enhancement pattern, the homogeniety of internal architecture, and abnormal vessels near the lesion. RESULTS: The extensive lesions involving multiple muscle and tissue layers were more frequent than localized lesions (12/18). Twelve cases had ill defined margin. In most cases, the lesion was heterogeneous mass composed of nodular and septal components. The nodular component showed intermediate signal intensity in T1WI and hign signal intensity in T2WI. The setal component showed mixed inconstant signal intensity. One case of capillary hemangioma showed relatively homogeneous signal intensity than cavernous hemangioma and the main portion of 2 venous hemangiomas had mutilple tubular signal voids. At least some portion of the lesion was enhanced in all enhanced cases. CONCLUSION: The soft tissue hemangiomas of the extremity showed characteristic MR findings and MRI would be an useful method in the diagnosis of the soft tissue hemangiomas of the extremity.
Diagnosis ; Extremities* ; Female ; Hemangioma* ; Hemangioma, Capillary ; Hemangioma, Cavernous ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies