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.
Humans ; Infant, Newborn*

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

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

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.

Small cell neuroendocrine carcinomas mainly occur in the lung. Four percent of small cell carcinomas arise in extrapulmonary sites. In the head and neck region, small cell carcinomas arise most commonly in the larynx and very rarely in the parotid gland. Although the prognosis for patients with small cell carcinoma of the salivary glands is better than for those with small cell carcinoma of the lung or larynx, it is a high grade malignancy that is treated aggressively. We have recently experienced a case of primary small cell neuroendocrine carcinoma of parotid gland with extensive neck metastases. The histopathologic findings showed undifferentiated small cells with hyperchromatic nuclei, numerous mitoses, ductal differentiations and squamous changes. The positive findings for CD56 and neuron specific enolase staining determined this carcinoma to be a neuroendocrine subtype, and the patient received chemoradiation after surgery. We present this case with a review of literatures.
Carcinoma, Neuroendocrine ; Carcinoma, Small Cell* ; Head ; Humans ; Larynx ; Lung ; Mitosis ; Neck ; Neoplasm Metastasis ; Parotid Gland* ; Phosphopyruvate Hydratase ; Prognosis ; Salivary Glands

The purposes of this study were to : (a) analyze the menus of food service operations using the menu analysis techniques of Kasavana & Smith, Miller, Merricks & Jones, Pavesic and Uman, (b) closely examine the characteristics of the five analysis techniques. Calculations for the menu analysis were done by computer using the MS 2000 Excel spreadsheet program. Menu mix% and unit contribution margin were used as variables by Kasavana & Smith, sales volume and food cost% by Miller, sales volume and cash contribution by Merrick & Jones, weighted contribution margin and food cost% by Pavesic, and total cash contribution and unit contribution margin by Uman. In each case, a four-cell matrix was created, and menu items were located in each according they achieved high or low scores with respect to two variables. Items that scored favorably on both variables were rated in the top category (e.g., star, prime, signature, group A, winner) and those that scored below average on both were rated in the lowest category (e.g., dog, problem, loser, group D, loser). While the 3 methods of Kasavana & Smith, Miller, Merrick & Jones focus on customers' viewpoints, the others consider the managers' viewpoints. Therefore, it is more likely to be desirable for decision-making on menus if the menu analysis technique chosen is suited to its purpose.
Animals ; Commerce ; Dogs ; Food Services

BACKGROUND: Chest radiographs (CXR) are the most commonly used imaging techniques by various clinicians and radiologists. However, detecting lung lesions on CXR depends largely on the reader's experience level, so there have been several trials to overcome this problem using post-processing of CXR. We investigated the added value of bone suppression image (BSI) in detecting various subtle lung lesions on CXR with regard to reader's expertise. METHODS: We applied a software program to generate BSI in 1,600 patients in the emergency department. Of them, 80 patients with subtle lung lesions and 80 patients with negative finding on CXR were retrospectively selected based on the subtlety scores on CXR and CT findings. Ten readers independently rated their confidence in deciding the presence or absence of a lung lesion at each of 960 lung regions on the two separated imaging sessions: CXR alone vs. CXR with BSI. RESULTS: The additional use of BSI for all readers significantly increased the mean area under the curve (AUC) in detecting subtle lung lesions (0.663 vs. 0.706; P < 0.001). The less experienced readers were, the more AUC differences increased: 0.067 (P < 0.001) for junior radiology residents; 0.064 (P < 0.001) for non-radiology clinicians; 0.044 (P < 0.001) for senior radiology residents; and 0.019 (P = 0.041) for chest radiologists. The additional use of BSI significantly increased the mean confidence regarding the presence or absence of lung lesions for 213 positive lung regions (2.083 vs. 2.357; P < 0.001) and for 747 negative regions (1.217 vs. 1.195; P = 0.008). CONCLUSION: The use of BSI increases diagnostic performance and confidence, regardless of reader's expertise, reduces the impact of reader's expertise and can be helpful for less experienced clinicians and residents in the detection of subtle lung lesions.
Area Under Curve ; Diagnosis ; Emergency Service, Hospital ; Humans ; Image Processing, Computer-Assisted ; Lung ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Thorax