No abstract available.
Humans ; Infant, Newborn*

Marjolin's ulcer is a malignant degeneration of cicatrical tissue, especially in chronic burn scar. Since the first description by Jean Nicholas Marjolin(1828), many studies for Marjolin's ulcer have been performed and reported. From 1985 to 1997, we experienced 20 cases in 14 patients diagnosed as Marjolin's ulcer clinically, and we analysed malignant transformation rate, induction period of Marjolin's ulcer and prevention of Marjolin's ulcer, etc. The results are summarized as follows. 1) The sex distribution was predominant in male(64.3%). 2) The most common cause of injury was flame burn(78.6%). 3) The mean age at the time of diagnosis was 45.6 years and the average lag period was 20.6 years. 4) The pathologic types of Marjolin's ulcer were squamous cell carcinoma(57.2%), followed by dyspasia(28.6%), acnthosis and hyperkeratosis(14.2%). 5) The locations of ulcers were frequently on the lower extremity(42.9%), followed by upper extremity(35.7%) and trunk (21.4%). 6) The lymph node involvements were 3 patients out of the 8 patients who were confirmed as squamous cell carcinoma. 7) The modalities of treatment were skin graft (18 cases, 12 patients), myocutaneous flap(1 case, 1 patient), fasciocutaneous flap(1 case, 1 patient).
Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Diagnosis ; Humans ; Lymph Nodes ; Sex Distribution ; Skin ; Transplants ; Ulcer*

No abstract available.
Female ; Female* ; Genitalia, Female* ; Humans ; Incidence*

This article aims to summarize the development and application of menu engineering technique, 'Menu Engineering Modified by Preference (MEMP)'. The site selected for this project was a foodservice operation in Yonsei University residence hall. Sales and food costs data were collected from the daily sales reports for 1 month, and the survey of food preference was conducted during May, 1999. Statistical data analysis was completed using the SAS/Win 6.12 for descriptive analysis. The calculation for menu analysis were carried out with MS 2000 Excel spreadsheet program. This MEMP technique developed had 6 category criteria and 2 dimensions of the contribution margin (CM) and the menu mix modified% (MMM%). The MMM% was calculated by the sales volumes and also weighted by food preference. The CM and MMM% for each item were compared with a mean menu CM as well as a 70% rule. Four possible classifications by MEMP were turned out as 'STAR', 'PLOWHORSE', 'PUZZLE', 'DOG'. 'STAR' items were the most popular and profitable items and required to maintain rigid specifications for quality. The decision actions for 'PLOWHORSE' menu items which were relatively popular, but yield a low menu average CM included combining a plowhorse item with lower cost products and reducing the frequency of serving or serving size. There was a need for 'PUZZLE' items to be changed in the menu combination, improve recipe, and promote menu. The last 'DOG' items were desired to be deleted. This study demonstrates that menu information can be interpreted more easily with MEMP. The use of MEMP is therefore an effective way to improve management decisions about menu of university residence hall foodservice.
Classification ; Commerce ; Data Interpretation, Statistical ; Food Preferences ; Serving Size

OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. RESULTS: All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. CONCLUSION: Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.
Biliary Atresia ; Child ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Humans ; Liver Transplantation ; Male ; Methods ; Mortality ; Portal Vein* ; Recurrence ; Stents* ; Treatment Outcome ; Varicose Veins*

Cerebrotendinous xanthomatosis is a rare autosomal recessive disease that involves multiple organs, including the peripheral nervous system. The present study is the first to report the ultrasonographic findings of peripheral nerves in a patient with cerebrotendinous xanthomatosis. The patient presented with bilateral Achilles tendon enlargement and foot hypesthesia. Sonographic examination revealed hypoechoic, swollen peripheral nerves with enlarged bilateral Achilles tendons. Since the ultrasonographic findings revealed peripheral involvement, the diagnosis of cerebrotendinous xanthomatosis was established after laboratory and genetic studies along with clinical findings.
Achilles Tendon ; Diagnosis ; Foot ; Humans ; Hypesthesia ; Peripheral Nerves ; Peripheral Nervous System ; Polyneuropathies* ; Ultrasonography* ; Xanthomatosis, Cerebrotendinous*

Background: The anti-oxidative, anti-inflammatory, and anti-apoptotic effects of erythropoietin may provide neuroprotective effects. Erythropoietin also modulates autophagy signaling that may play a role in anesthesia-induced neurotoxicity (AIN). Herein, we investigated whether AIN can be attenuated by the neuroprotective effect of erythropoietin in the Caenorhabditis elegans (C. elegans). Methods: Synchronized worms were divided into the control, Iso, EPO, and EPO-Iso groups. The chemotaxis index (CI) was evaluated when they reached the young adult stage. The lgg-1::GFP-positive puncta per seam cell were used to determine the autophagic events. The erythropoietin-mediated pathway of autophagy was determined by measuring the genetic expression level of let-363, bec-1, atg-7, atg-5, and lgg-3. Results: Increased lgg-1::GFP puncta were observed in the Iso, EPO, and EPO-Iso groups. In the Iso group, only the let-363 level decreased significantly as compared to that in the control group (P = 0.009). bec-1 (P < 0.001), atg-5 (P = 0.012), and lgg-3 (P < 0.001) were expressed significantly more in the EPO-Iso group than in the Iso groups. Repeated isoflurane exposure during development decreased the CI. Erythropoietin could restore the decreased CI by isoflurane significantly in the EPO-Iso group. Conclusions Erythropoietin showed neuroprotective effects against AIN and modulated the autophagic pathway in C. elegans. This experimental evidence of erythropoietin-related neuroprotection against AIN may be correlated with the induced autophagic degradation process that was sufficient for handling enhanced autophagy induction in erythropoietin-treated worms.

PURPOSE: The most common cause of death in massive burn patients is burn wound sepsis. Therefore we have been using allograft skin for preventing burn wound sepsis. METHODS: Included in this study were 71 subjects who had sustained extensive burns from December 2003 through February 2006. 1. Early selective Escharectomy was performed for full thickness burn areas. 2. Allograft skins were grafted on excision area. 3. An autograft was performed for areas with a formation of granulation tissue after the allograft skin had come away. 4. A modified sandwich grafting technique (1 : 4 ~ 6 meshed autograft with Cultured Epithelial Autografts) was performed in large sized burns. 5. Acellular dermal substitute was concurrently used to prevent burn scar contraction on joint areas. RESULTS: Seventy one subjects were included (Fresh allograft: 9 cases, Cryo-preserved allograft: 42 cases, Glycerol preserved allograft: 20 cases). The average burn area was 41.8 (20 ~ 92) %TBSA (Total Body Surface Area). The mean area of the allograft skin used was 26.9 (8 ~ 70) %TBSA. The grafted allograft skins usually came away 3 weeks later. Four cases of initial take failure were occurred. All of these cases were pediatric patients using cadaver skin. Nine patients were dead from heart failure, severe inhalation, respiratory failure, pneumonia in old age, renal failure etc. There was no definite wound sepsis. Cultured Epithelial Autografts (CEAs) were used in fourteen cases. In twenty- five cases, acellular dermal substitute was simultaneously used. CONCLUSION: Early selective escharectomy, allograft skin coverage, acellular dermal substitutes and wide meshed autograft with CEA application would be immensely helpful techniques in patients with extensive burns.
Allografts* ; Autografts ; Burns* ; Cadaver ; Cause of Death ; Cicatrix ; Glycerol ; Granulation Tissue ; Heart Failure ; Humans ; Inhalation ; Joints ; Pneumonia ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Skin* ; Transplants ; Wound Infection ; Wounds and Injuries

BACKGROUND: Fecal continence is maintained by complex coordination of the sphincter mechanism and the anorectal sensation. Although most patients with fecal incontinence have a dysfunction of anal sphincter, fecal soiling seems to be related with a change in the anorectal sensation. PURPOSE: This study was done to evaluate the manometric findings and the methods of treatment for patients with fecal soiling. METHODS: The manometric findings from 25 patients with fecal soiling were compared with those from 22 normal controls. The patients were treated with biofeedback and with bulking agent. RESULTS: All the patients affected by fecal soiling were male except for one. There were no differences in the mean maximal resting pressure (MRP), and the mean maximal squeezing pressure (MSP) between the patients and the controls. The mean sphincter length and the mean length of the high pressure zone (HPZ) of the patients were significantly longer (50.5 vs. 55.6 mm and 28.2 vs. 31.3 mm, respectively; p<0.05 student t-test) than those of the controls. The minimal sensory volume (MSV) was significantly larger in the patient group, with a mean of 24.2 ml vs. 17.8 ml, than in the control group (p<0.05). The mean volume necessary to induce the recto-anal inhibitory reflex (RR) was 47.1 ml for the control group and 32.6 ml for the patient group (p<0.05). In the longitudinal profile of the anal sphincter, the HPZ was shifted proximally and the pressure peak was broader in the fecal soiling group. Of the 14 patients treated with biofeedback, 11 responded well. CONCLUSION: Almost all of the patients affected by fecal soiling were men. The MRP and the MSP of the patients with fecal soiling were not lower than those of the normal controls. The sphincter length was longer in the patients with soiling than in the controls(p<0.05). However, for the fecal soiling group the distribution of the pressure along the anal canal was different in the sense that the HPZ was shifted proximally and the pressure peak was broader. The changes in the MSV and the RR suggest that there may be a defect in the anorectal sensation. The patients responded well to the combined use of biofeedback and a bulking agent.
Anal Canal ; Biofeedback, Psychology ; Fecal Incontinence ; Humans ; Male ; Manometry ; Reflex ; Sensation ; Soil*

We report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus. A systemically healthy 1-year-old girl came to the outpatient clinic with a complaint of tearing on the temporal side of the right lateral canthus since birth. On examination, a small orifice was found in the skin on the temporal side of the lateral canthus. There was no evidence of inflammation or swelling within the opening. Surgeons carried out an operation under general anesthesia. They passed a probe through the lacrimal orifice and advanced it toward the lacrimal sac. Next, they introduced saline to the inferior punctum and found that it drained to the lateral fistula. The lower lid stretched as the dissected fistula was pulled. After the operation, the patient was free of the symptom. This paper is to report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus.
Diagnosis, Differential ; *Eye Abnormalities ; Female ; Fistula/*congenital/diagnosis ; Humans ; Infant ; Lacrimal Apparatus/*abnormalities ; Lacrimal Apparatus Diseases/*congenital/diagnosis