Colorecal cancer undergo relatively long preneoplastic processes before being invasive. Fecal occult blood test (FOBT) has been a useful tool to detect the advanced colorectal cancers with cost-effectiveness. However, the patient’s compliance to FOBT was poor because of low sensitivity and annual sampling. The sigmoidoscopy and colonoscopy have the ten-year preventive effect for the advanced cancer. Recently the DNA stool test for detection of mutations has showed excellent sensitivity and specificity. It has several adventages such as collection of samples and automated analysis. Virtual colonoscopy, especially CT colonograpy, can be a viable option for the colorecal cancer screening. In November 2001, the Korean Society of Coloproctology (KSCP) and the Natinal Cancer Center (NCC) developed the guidelines on screening and surveillance for early detection of colorectal cancers in Korea. Average-risk men and women should start colonoscopic examination with a 10-year interval at the age of 50. Individuals with increased risk such as those with a family or personal history of colorectal cancer or colorectal adenomas, or family history of familial adenomatous polyposis, hereditary non-polyposis colorectal cancer should consult their surveillance to the specialty-physicians. The ideal screening tools may change by age.
Adenoma ; Adenomatous Polyposis Coli ; Colonography, Computed Tomographic ; Colonoscopy ; Colorectal Neoplasms* ; Compliance ; DNA ; Early Detection of Cancer ; Female ; Humans ; Korea ; Male ; Mass Screening* ; Occult Blood ; Sensitivity and Specificity ; Sigmoidoscopy

No abstract available.
Pyloric Stenosis, Hypertrophic*

Aging process of the forehead in human reflects imbalance of the forehead muscles, forehead ptosis including eyebrow, and winkles of the forehead and glabella. Forehead lifting through bicoronal incision was adopted as an universal method to correct these problems of the aging process. In a view of the aesthetic surgery, however, there are several problems such as large scar alopecia, and numbness beyond the incision line in the scalp for the correction of the forehead aging stigma. During the part few decades, minimally invasive technology forced many surgical specialities to undergo dramatic changes. In plastic & reconstructive surgery also minimally invasive technology using endoscope gave many advantages. Therefore it has reduced morbidity rates and got greater patient acceptances for the forehead lifting. When we perform endoscopic blow-forehead lift to get a good results in oriental people, 1. it needs a extended periorbital dissection. 2. we have to concern lift in the lateral part of forehead rather than in medial forehead. 3. it needs more aggressive tissue modifications (e.g. myotomies, neurotomy) 4. it needs more strong fixation such as permanent microscrew fixation or cortical bone drill hole technique. We performed 13 cases of the eyebrow-forehead lifting by using endoscope from August 95 to September 96 followed up them from 3 to 12 months and obtained satisfactory result. We would like to report our experiences with literature review.
Aging ; Alopecia ; Cicatrix ; Endoscopes ; Eyebrows ; Forehead ; Humans ; Hypesthesia ; Lifting* ; Muscles ; Plastics ; Scalp

We performed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian car accident from January, 1986 to June, l994. The mean age of patients was 5.6 years old (3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.8 months (2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months (2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extensor digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in I case, the base of 4th metatarsal bone in I case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months (12-102 months). The clinical results were analyzed by Srinivasan criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in l case, mild flat foot deformity in I case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.
Child* ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Disabled Persons ; Flatfoot ; Follow-Up Studies ; Foot* ; Free Tissue Flaps* ; Humans ; Metatarsal Bones ; Postoperative Complications ; Skin ; Tarsal Bones ; Tendon Transfer* ; Tendons*

Natural look of breast after augmentation mammoplasty is a common end of both plastic surgeons and patients. Palpability and visible rippling after augmentation mammaplasty is not a simple complication to correct in relatively thin patients especially when there is not much soft tissues remain to cover the implant for smooth contour. And asymmetry of the breast in accordance with the skeletal deformity, such as pectus excavatum, can not be easily reformed with insertion of silicone implant alone. In the present study, volume enhancement was accomplished by silicone implant augmentation and contour management was improved with the help of fat graft technique. We named the technique "Hybrid Augmentation Mammoplasty". From May 2011 to Feb. 2012, the hybrid augmentation mammoplasty procedure were performed on 9 patients who expected to have palpable implants, visible rippling or asymmetry due to their soft tissue and skeletal condition. Breast augmentation with silicone implant was done in regular pattern followed by grafting fat tissues utilizing Harvest-jet device into the pre-pectoral, sub-glandular and subcutaneous layer. During the follow-up period, any patient complained palpability of the implant and all of them were satisfied with the contour of their breast. Hereby we suggest that the hybrid augmentation mammoplasty can be an ideal, effective and useful option in management of thin skinned patients or patients with chest wall deformities.
Breast ; Breast Implants ; Chimera ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Funnel Chest ; Humans ; Mammaplasty ; Silicones ; Skin ; Thoracic Wall ; Transplants

BACKGROUND: Soluble IL-2R, soluble CD8 and TNF-alpha are elevated in sera of some patients with hematological malignancies, and a marked elevation of these cytokines could be used to assess disease activity and prognosis in this malignancy group. METHODS: The serum levels of sIL-2R, sCD8 and TNF-alpha were assessed in 28 patients with myelodysplastic syndrome (MDS) and 32 patients with acute myeloid leukemia (AML), and 39 cases of healthy control subjects to define clinical usefulness as prognostic markers by sandwich enzyme immunoassay. RESULTS: In MDS patients, serum sIL-2R levels were significantly higher as compared with controls, and a more pronounced increase of serum sIL-2R levels was found in patients with RAEB RAEB-t and CMML as compared with RA and RARS. Serum sCD8 levels were higher as compared with controls, but not related with FAB classification. In patients with leukemic conversion. sCD8 levels tended to be higher as compared with patients with non-conversion. The sIL-2R levels of AML patients were significantly higher than controls, and a significant correlation was detected between the levels of sIL-2R and WBC counts. Higher sIL-2R levels( >2000 U/ml) tended to affect both complete remission rate and survival. Serum sCD8 levels were higher than controls, but not related to FAB classification. No differences of serum TNF-alpha levels were detected as compared with healthy controls. CONCLUSIONS: From these results, this study indicates that serum sIL-2R and sCD8 are significantly increased in some patients with MDS and AML, and increased levels of serum sIL-2R and sCD8 may be useful for predicting prognosis of these patients.
Anemia, Refractory, with Excess of Blasts ; Classification ; Cytokines ; Hematologic Neoplasms ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes* ; Prognosis ; Tumor Necrosis Factor-alpha*

The importance of garlic as a cause of hand eczema has been a matter of debate. Diallyldisulfide is considered as the main allergen in garlic. Twentv two antigens of the modified European standard series and diallyldisulfide of 5%, 2%, 1%, 0.5%, 0.1% in petrolatum were patch tested in 44 patients with hand eczema. Diallylclisi.!lfide was also tested in 13 women as a control. The results were summerized as follows. l. In patch testing with the European standard series, nickel sulfate (22.7%), cobalt chloride (18.2%), fragrance mix (13.6%), balsam of Peru (9.1%) and termerosal (6.8%) were the cornmon allergens which showed positive reactions. The overal positive rate was 59.1 % (26/44). 2.5% diallyldisulfide showed an irritant reaction in 6 (46.2%) out of 13 controls and in 16 (36.4% ) out of 44 patients. 2% diallyldisulfide showed an irritant reaction in 2/13 (15.4 %) in the control group and 6/44 (13.6%) in the patient group. All 13 controls and 44 patients were negative iin tests with diallyldisulfide of 1%, 0.5%, 0.1%. Our results indicate that patch testing with diallyldisulfide of 1% petrolatum is reommended in order to avoid an irritant reaction when contact allergy to garlic is suspetel. 3. Garlic is suspected as an irritant in provoking hand eczema. True contact allergy to garlic in hand eczema seems to be rare.
Allergens ; Cobalt ; Eczema* ; Female ; Garlic* ; Hand* ; Humans ; Hypersensitivity ; Nickel ; Patch Tests ; Peru ; Petrolatum

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum

Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures

To study the relation between ectoparasite, Rickettsia and hantaan virus in bats, four order of Athropoda were collected from Rhinolophus ferrumequinum captured in Cheju and Eptesicus serotinus captured in Chungnamin from July 1989 to March 1998. Also antibody of Rickettsia and hantaan virus were detected by immunofluoroscent antibody technique and RT-PCR. The results are as follows. 1. Five species of Acarina were identified from E. serotinus: Leptotrobidium subakamushi of Trombiculidae, Macronyssus coreanus, Steatonyssuss spinosuss and Steatonychus superans of Macronyssidae, Argas vespertilionis of Metastigmata. 2. Ischnopsyllus needhami of Siphonaptera and Cimex of Hemiptera were identified from E. serotinus. 3. Cyteribia uenoi and Brachytarsina kanoi of Diptera were identified from R. ferrumequinum. 4. The positive rate of rickettsial antibodies in E. serotinus were 17.58%, 15.15%, 22.22%, 52.73% against R. tsutsugamushi, R. typhi, R. sibirica and R. thai tick typhus, respectively. The high positive rate of antibody related to the high content of Arthropoda. 5. The Positive rate of hantaan virus IFA antibodies were 3.4% (27 of 802) and hanntan virus infection rate 36.7% (22 of 60) by RT-PCR in bats. According these result, we showed that certain species of Athropoda isolated play a role as vector of Rickettsia in E. serotinus. Also bats play a role as a reservoir of hantaan virus in nature.
Antibodies ; Argas ; Arthropods ; Asian Continental Ancestry Group ; Bedbugs ; Chiroptera* ; Diptera ; Hantaan virus* ; Hemiptera ; Humans ; Jeju-do ; Rickettsia* ; Siphonaptera ; Ticks ; Trombiculidae ; Typhus, Epidemic Louse-Borne