The hemostatic effect of endoscopic microwave coagulation method for upper gastrointestinal bleeding was evaluated clinically. Hemostasis over 72 hours was achieved in 18 of 20 cases (90%) with upper gastrointestinal bleeding by the endoscopic microwave coagulation method. It is noteworthy that this method was effective in all 4 cases of pulsatile bleeding from exposed vessels. We conclude that this method is useful for emergency endoscopic hemostasis on upper gastrointestinal bleeding, especially bleeding from exposed vessels.
Emergencies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Microwaves*

We report two cases of malignant schwannoma of skin in association with non-familial neurofibromatosis. Case 1, a 47 year old man, had a large subcutaneous tumor on the sacral area and case 2, a 62 year old woman, a painful, ulcerating tumor on the posterior aspect of the left arm. Both cases were histopathologically confirmed as malignant schwannomas and immunohistochemical studies showed 5-100 protein in the tumor cells. After surgical excision of the tumors, case 1 was lost to follow up, while case 2 remained without evidence of disease for more than one and half years.
Arm ; Female ; Humans ; Lost to Follow-Up ; Neurilemmoma* ; Neurofibromatoses* ; Skin ; Ulcer

BACKGROUND: The prognostic value of motor evoked potentials(MEP) by transcranial magnetic timulations(TMS) in acute stroke has not been well established. To determine the value of MEP as predictors of motor and functional recovery we examined correlations of neurophysiological measurements of central motor conduction time(CMCT) and functional assessments. METHOD: A longitudinal study was performed on 32 first-ever acute ischemic stroke patients. The cortical and cervical motor evoked potentials(MEPs) along with the degree of extremity weakness, the NIH stroke scale, and the Barthel index were performed in the period immediately following stroke and after 3-4 months of the onset. RESULTS: Five groups of patients were divided on the basis of MEP responses following the cortical stimulation; initial normal response following the normal one (group I; 11), initial delayed response following a normal or still delayed one (group II; 3/group III; 0), and an initial absent response with the reappearance of CMCT or still absent one (group IV; 8/group V; 10). Patients in group I,II and IV had consistently lower scores in motor weakness degree and NIH scale and higher scores in the Barthel index both at initial and follow-up studies, and achieved significantly better functional recovery(p<0.01). CONCLUSIONS: Discordant results of MEP in predicting the prognosis of stroke may result from the disregard of group IV, which had previously been considered as a poor outcome group solely because no cortical MEP responses were recorded at the initial study. As the MEP alone during the acute stage could not differentiate group IV from group V which had a persistent absence of cortical MEP responses, the evaluation of the neurological deficit at the same time is needed for better prediction of prognosis.
Evoked Potentials ; Evoked Potentials, Motor* ; Extremities ; Follow-Up Studies ; Humans ; Longitudinal Studies* ; Prognosis ; Stroke*

Short nose is characterized by decreased distance from the nasion to tip defining point and increased nasolabial angle with increased nostril show. Lengthening the short nose is arguably the most difficult operation in aesthetic rhinoplasty. We have described here a simple and easy technique that lengthen the short nose by using silicone implant has been popular among Asian for augmentation rhinoplasty. Through open rhinoplastic approach, wide undermining of the nasal skin is performed to allow redraping of the skin over the lengthened skeletal framework without excessive tension. Alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, silicone implant is inserted in subperiosteal pocket and immobilized by nonabsorbable suture material at dorsal aspect of septal cartilage. Narrow caudal end of implant is sutured between medial crura of alar cartilage which were caudally rotated. This implant not only raise the nasion but can move the tip-defining point caudally by keeping the alar cartilage in new position. Tip graft is done with conchal cartilage. We have got the satisfactory result in cosmetic aspect without any complications.
Asian Continental Ancestry Group ; Cartilage ; Humans ; Nose* ; Rhinoplasty ; Silicones* ; Skin ; Sutures ; Transplants

No abstract available.
Mucocutaneous Lymph Node Syndrome*

This retrospective study comprised patiens with facial bone fractures in various accidents and treated in the department of Plastic and Reconstructive Surgery, Pildong hospital, Chung Ang university during the past 5 years from January 1994 to December 1998. The medical records of these patients (fractures) were reviewed and analysed in order to gain insight into a clinical pattern and understnad the therapeutic modalities. The following results were obtained: 1. The monthly incidence was highest in August and most common accident time was between 6:00 p.m and midnight. 2. The mean age of patients was 28.3 years, and age range was 3 to 69 years. The most prevalent age group was the third decade of life (42.9%). Males predominated more than female in the ratio of 4.1:1. 3. The most common etiology was assault (29.6%) followed by traffic accidents (28.5%), fall (23.1%), sports (7.9%). 4. 369 facial fractures in 277 patients were classifed. The most common sites were nasal bone, followed by zygoma, mandible, maxilla, orbit. 5. Associated soft tissue injuries were combined in 168 patients (60.6%), and fractures other than facial bone were developed in 61 patients (22%). 6. Treatment of facial bone fracture consisted of open reduction (42.6%), closed reduction (40.1%), and conservative treatment (17.3%). 7. The complication rate was 11.6% and the most common complication was the eye problem.
Accidents, Traffic ; Facial Bones* ; Female ; Humans ; Incidence ; Male ; Mandible ; Maxilla ; Medical Records ; Nasal Bone ; Orbit ; Plastics ; Retrospective Studies ; Soft Tissue Injuries ; Sports ; Zygoma

Epidermal cysts are intradermal or subcutaneous cystic tumors that frequently occur in the face, scalp, neck, and body trunk. Acquired cases of epidermal cyst commonly occur as a result of various surgical operations, chronic irritation, or trauma, all of which may trigger the occurrence of the invagination of squamous epithelium. A 57-year-old man presented with a palpable mass 7 cm×2 cm in size in the upper lip. The patient had a 3-year history of wearing a denture to restore missing bilateral maxillary central and lateral incisors, accompanied by inflammatory findings on the buccal mucosa due to chronic lip irritation. The resected oval-shaped cyst had a size of 5.5 cm×3.0 cm×2.5 cm, and it was an encapsulated mass with a well-defined margin. The histopathology was typical of epidermal cyst. This case of a rare giant upper lip epidermal cyst in a patient wearing a denture may be of interest to clinicians.
Dentures* ; Epidermal Cyst* ; Epithelium ; Humans ; Incisor ; Lip* ; Middle Aged ; Mouth Mucosa ; Neck ; Scalp

No abstract available.

Although our present knowledge of the etiology of peptic ulcer is incomplete, the presence or absence of peptic ulcer is determined by the delicate interplay between aggressive factors (secreted gastric acid and pepsin) and defensive factors (mucosal resistance). Peptic ulcer is produced when the aggressive effects of acid-pepsin dominate the protective effects of gastric or duodenal mucosal resistance by predominance of aggressive factors or interruption of defensive factors. KU-54 enhances mucosal resistance to tissue injury by the increase of gastric mucosal blood flow, the stimulation of gastric mucosal metabolism, the increase of glycoprotein of gastric mucus, and the increase of ATP of gastric mucosa. We have treated 38 cases of gastric ulcers with KU-54 300 mg daily for 4-12 weeks for the evaluation of the therapeutic efficacy. Endoscopic, clinical, and laboratory assessments were undergone before and after 4 ~ 12 weeks of the treatment. Major symptoms of gastric ulcer have been improved in 83.3% after the medication with KU-54. The healing rate of gastric ulcer evaluated by endoscopy was observed in 33.3% after 4 weeks, 73.3% after 8 weeks, 76.6% after 12 weeks of the medication with KU-54. The utility rate of KU-54 was 86.7%. We could conclude that KU-54 is the utilizable drug for gastric ulcer.
Adenosine Triphosphate ; Endoscopy ; Gastric Acid ; Gastric Mucosa ; Glycoproteins ; Metabolism ; Mucus ; Peptic Ulcer ; Stomach Ulcer*

No abstract available.
Blotting, Western ; Cells, Cultured ; Connective Tissue Cells/drug effects/metabolism ; Endothelin-1/*biosynthesis ; Fibroblasts/*drug effects/metabolism ; Humans ; Transforming Growth Factor beta1/*pharmacology