PURPOSE: The purpose of this study was to analyze the results of treatment and prognosis of Marjolin's ulcer compared with primary squamous cell carcinoma. MATERIALS AND METHODS: Fourteen patients treated for Marjolin's ulcer were analyzed. Twenty patients with primary squamous cell carcinoma treated during the same time period was the control group. Mean age was 61.2 years. There were 24 males and 10 females. The locations, TNM stages, histological grades, recurrence, metastasis, and survival rate were analyzed and compared between two groups. RESULTS: The mean follow-up period was 54.8 months (range, 12-168 months). Local recurrences were found in 6 cases, 5 ones in Marjolin's ulcer patients, and one case in primary squamous cell carcinoma patients. The mean time interval between the initial presentation and occurrence of local recurrences was 9 months (range, 2-20 months). There were 6 metastases. 2 (14.3%) metastases were found in Marjolin's ulcer patients, and 4 (20.0%) metastases in primary squamous cell carcinoma patients. Total events (metastasis or local recurrence) were found in 10 pateients, 6 of them in Marjolin's ulcer group, and the remaining four in primary group. 5-year disease-free survival rate was 64.3% in Marjolin's ulcer group and 95.0% in primary squamous cell carcinoma group. CONCLUSION: Squamous cell carcinomas originating as Marjolin's ulcers revealed higher recurrence rate and lower survival rate despite of aggressive treatment. Therefore, new treatment modalities should be developed for improving outcomes.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Survival Rate ; Ulcer

No abstract available.
Duodenal Ulcer* ; Vagotomy, Truncal*

No abstract available.
Hypokalemic Periodic Paralysis*

PURPOSE: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. MATERIALS AND METHODS: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. RESULTS: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide further studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. CONCLUSION: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.
Allografts ; Artifacts ; Humans ; Kidney* ; Necrosis ; Radioactivity ; Tomography, Emission-Computed, Single-Photon* ; Ureter

A case of znelanotic whitlow is presented which resembles clinically as chronic paronichia. Patient was 71 years old man and he has had a single brownish pigmented spot on left mid. finger since 3 years ago which was progressively grow and skin biopsy could be established the pathological diagnosis of superficial malignant melanoma.
Aged ; Biopsy ; Diagnosis ; Fingers ; Humans ; Melanoma ; Skin

No abstract available in English.
Fracture Fixation, Intramedullary

The primary goal in the treatment of the nail bed avulsion injury is complete regrowing of the nail plate without any deformity. There are many procedures for treatment of the nail bed avulsion injury as a split-thickness skin graft, full-thickness nail bed graft, reverse dermal graft or split-thickness nail bed graft. From February, 1984 to June, 1985 at In-Chon Gill Hospital, 13 cases of nail bed avulsion injury were treated with split-thickness nail bed grafts. The intact residual part of the injured nail bed or the toe nail bed was served as a donor site. The results were as followings; 1. The incidence of nail bed avulsion injury of all hand injuries was 9.7%. 2. The main cause of injury was the industrial accident and more prevalent in the left hand. 3. The good result was obtained in the split-thickness nail bed graft for the nail bed avulsion injury, but in nail root portion, the poor result was noticed. 4. The average time for normal nail appearance is six months.
Accidents, Occupational ; Animals ; Congenital Abnormalities ; Gills ; Hand ; Hand Injuries ; Humans ; Incheon ; Incidence ; Skin ; Tissue Donors ; Toes ; Transplants

A clinical study was conducted to compare effectiveness of IV Globulin with that of steriod in childhood acute ITP. We carried out an experiment to 36 patients of acute ITP who recovered over 50.000/mm(3) of platelet count and not to recur in 6 months. Study group consist of 10 children who were treated with steriod only (Group A), 13 children who were treated with IV Globulin (0.4g/kg/d, 5 days, Group B), and 13 children combined with steroid (Group C) Study period was from January 1988 to December 1992, folllowing results were obtained. 1) There were no significant difference in sex ratio. age distribution, pretreatment hemoglobin level, platelet count and prolonged bleeding time among study groups. 2) The days which platelet count reached to 50.000/mm(3), 100,000/mm(3) were 3.7 days (Group A), 2.1 days (Group B), and 2.3 days (Group C), respectively (p<0.05). 3) Complete response rates within 4 weeks did not show significant difference (90% in Group A, 84.6% in Group B, 92.3% in Group C), the complete response rate within 1 week were significantly different among three group (44.4% in Group A, 90.9% in Group B, 83.3% in Group C)(p<0.05). In conclusion, it is more desirable for early treatment of a childhood ITP because IV Globulin is easy to normalize platelet count in a short time.
Age Distribution ; Bleeding Time ; Child ; Humans ; Platelet Count ; Sex Ratio

PURPOSE: The purpose of this study is to assess the clinical utility of multiplanar reformation images of helical CT in the evaluation of pancreatic diseases. MATERIALS AND METHODS: Helical CT scans of the pancreas were obtained in 30 patients with pancreatic diseases. Helical CT was performed with 5mm collimation at 5mm/sec table speed during rapid injection of intravenous contrast agent using power injector. After scanning, helical volume data were reconstructed at 2mm interval and then multiplanar reformation of the pancreas and adjacent structures was done. In both prospective reconstructed axial images and multiplanar reformation images, detection of pancreatic lesion, extent of lesion, and vascular and bile ductal changes were analyzed with a grading system of 1,2, 3. RESULTS: The mean grade of detection of pancreatic lesions was 2.37 in the prospective axial image and 2.83 in multiplanar reformation image, extent of diseases was 2.40 in prospective axial image and 2.97 in multiplanar reformation image, and vascular and bile ductal changes was 2.00 in the prospective axial image and 2.97 in multiplanar reformation image. All the differences were statistically significant (P<0.0001). CONCLUSION: Multiplanar reformation images of helical CT are useful in the evaluation of pancreatic diseases and especially in the demonstratibn of complex anatomic relationships between the pancreas and surrounding structures.
Bile Ducts ; Humans ; Pancreas ; Pancreatic Diseases* ; Prospective Studies ; Tomography, Spiral Computed*

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking