BACKGROUND: There are a few methods, including primary intention, deleyed primary closure and secondary intention, to irpair several types of defects. But commonly-used primary intentional repair of a defect after surgical removal of a skin cancer by graft, flap or simple closure has several limitations such as the need of a skillful technique and various complications. OBJECTIVE: We undertook a secondary intention using occlusive dressing with a polyurethane film after skin cancer surgery instead of a primary repair and evaluated its efficacy, particularly in points of simplicity and safety, and cosmetic results. METHODS: We randomly chose 14 cases of skin cancers in 13 patients who had undergone simple surgical excision or Mohs micrographic surgery and then undertook secondary intention with polyurethane film after informed consent. Postsurgical wound care included cleansing with normal saline or boric acid, then covering the defect with antibiotic ointment, gauze and film a at regular intervals.
Humans ; Informed Consent ; Intention* ; Mohs Surgery ; Occlusive Dressings ; Polyurethanes ; Skin Neoplasms* ; Skin* ; Transplants ; Wounds and Injuries

Immunohistochemical study was performed for CEA staining patterns and PCNA indices. And the relationship between immunohistochemical findings and well-known clinical prognostic factors on the purpose of the clinical usefulness was evaluated. In forty seven cases of surgically removed colorectal carcinomas, the results were as follows; CEA staining patterns were apical (17 cases) and cytoplasmic (30 cases) type. Carcinomas with cyto plasmic pattern for CEA revealed more advanced Dukes' stage and more undifferentiated type and higher incidence of lymph node metastasis and were correlated with increased serum CEA levels. But PCNA indices showed no correlation with the Dukes' stage, histologic grade and CEA staining patterns. The cytoplasmic pattern of CEA immunohistochemistry may be a useful marker suggesting more aggressive biologic behavior of the colorectal carcinomas.
Colorectal Neoplasms* ; Cytoplasm ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Proliferating Cell Nuclear Antigen*

Mucormycosis is an opportunistic fungal infection caused by the mucorales, which consist of the Rhizophus, Absidia, Mortierella, and Mucor. The diverse clinical forms of mucormycosis can be categorized as rhinocerebral, pulmonary, disseminated, gastrointestinal, cutaneous and miscellaneous. Although it can cause disease in healthy people, it most commonly affects patients who are diabetic or immunosup-pressed. Rarely, mucormycosis develops confined to the subcutaneous tissue. We experienced a case of cutaneous mucormycosis developed in a well-controlled diabetic patient who had previously injected foreign material on her face for an aesthetic purpose at the behest of an unlicensed physician. The patient had tissue necrosis and purulent discharge on her left cheek. Following histologic examination, we diagnosed the condition as cutaneous mucormycosis and treated it by wide excision combined with amphotericin B therapy. The disease was cured without any significant sequelae within 6 months of follow up. Cutaneous mucormycosis is rarely reported but it can cause facial deformity due to tissue necrosis, so that early diagnosis and appropriate treatment are important. Currently, foreign material injection for aesthetic purposes is still performed by unlicensed physicians. We present a case report concluding that one should consider the possibility of fungal infection in skin lesion in diabetic or other immunosup-pressed patients. We also emphasize the seriousness of illegal injection of foreign material.
Absidia ; Amphotericin B ; Cheek ; Congenital Abnormalities ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortierella ; Mucor ; Mucorales ; Mucormycosis* ; Necrosis ; Paraffin* ; Skin ; Subcutaneous Tissue

No abstract available.
Animals ; Macrophages, Peritoneal* ; Mice* ; Mycobacterium bovis*

In analyzing the postoperative results or evaluating the velopharyngeal incompetence after palatoplasty, speech evaluation is the inevitable factor. However, a standardized method for evaluating the speech problem in Korean cleft palate patients has not been available until now. So, the authors tried to establish a method of speech evaluation which is simple, economic and applicable to young patients, and to make a scoring method of the speech results in cleft palate patients based on the 'hypernasality diagnosing tool for cleft palate patient (OK Ran Jung)' which is commonly used by domestic speech therapists. The authors adopted the 'hypernasality diagnosing tool for cleft palate patients (OK Ran Jung)' male and female of children and adults, each consisting of 10 patients and make them speak according to the items about hypernasality and misarticulation evaluation, and record the results. We also calcuted the degree of the formants of the vowels (/a/, /o/, /u/)using sound spectrography. We examined the interjudge and intrajudge reliance of speech evaluation among the 10 inverstigators, revised the evaluation tool, devised the scoring method according to the above results, and compared the scoring results with those of sound spectrography to prove the reliance of our speech evaluation tool. With the scoring method, the authors could estimate the degree of hypemasality and misarticulation in cleft palate patients with evidence of reliability based on point-to-point agreement in two items. In comparing the results of our scoring method with the formant of vowels using sound spectrography, staistical significance existed except /u/F2 and that meant that our scoring method was reliable. We suggest that this simple, economic and reliable method of speech evaluation in cleft palate patients can create the basis for speech evaluation in patients of cleft palate and velopharyngeal incompetence under circumstances in which the results of various speech treatments are evaluated in comparison to various methods of speech evaluation.
Adult ; Articulation Disorders ; Child ; Cleft Palate* ; Female ; Humans ; Male ; Research Design ; Sound Spectrography ; Velopharyngeal Insufficiency

Many methods of correcting secondary cleft lip nose deformity have been introduced, but a single best method that can be uniformly adjusted for all cases does not exist. Since it is difficult to make the nostril of the cleft side symmetric with that of normal side, the authors tried to formulate the basis for correction of unilateral secondary cleft lip nose deformity according to the varying amounts of deformed nostril. We then adopted 4 different methods of correcting the soft tissue and nostril deformity in 63 patients from 1996 to 1998 and surveyed the results. Our principles were as follows: 1) Alar rim incision was done in cases of different-shaped cleft-side nostrils with nearly the same measured area in comparison to the normal side. 2) When deformity of the alar-columellar web was severe, we performed modified Z-plasty. 3) When the nostril of the cleft-side nostril was smaller than the normal side with slight asymmetry, reverse W-plasty was done. 4) We adopted a reverse-U incision when there was a discrepancy in height with moderate asymmetry compared with the normal nostril. After dissection, repositioning of alar cartilage was done by same method in each case. A nasal stent was kept in position for at least 6 months postoperatively in almost all cases. After follow-up of 6 to 24 months, we concluded that our choice was correct in selecting the optimal operative method, considering the characteristics of deformity of the cleft side nostril in an effort to make it symmetric with that of the normal side.
Cartilage ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Nose* ; Stents

Desmoplastic trichoepithelioma is a rare benign adnexal tumor with female preponderance, most commonly located on the face. Clinically, the tumor measures from 3 to 8mm in diameter, and has a raised, annular border and a depressed nonulcerated center. The three characteristic histologic features are narrow strands of tumor cells, horn cysts, and a desmoplastic stroma. We report herein a case of desmoplastic trichoepithelioma in a 25-year-old woman who had an asymptomatic hard annular nodule with a raised border and depressed center on the left cheek.
Adult ; Animals ; Cheek ; Female ; Horns ; Humans

The incidence of hepatitis B has been reported to be high in dialysis centers. Dialysis patients are at increased risk of acquiring hepatitis B due to their immunodeficient state, which impairs elimination of the hepatitis B virus; chronic dialysis patients rarely clear hepatitis B surface antigen (HBsAg) spontaneously. Hepatitis B virus infection is associated with a high risk of hepatic complications. We report the case of a 66-year-old HBsAg-positive female patient who had undergone hemodialysis for 58 months due to end-stage renal failure and became HBsAg-negative followed by the development of hepatitis B surface antibody.
Aged ; Dialysis ; Female ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Humans ; Incidence ; Kidney Failure, Chronic ; Renal Dialysis*

So far with the advancement in treatment modalities for malignant bone and soft tissue sarcomas the survival rate become higher. Till now there are some questions who can survive. Temporary procedure not affecting the treatment schedule would have more advantages than primary permanent one. When there is higher possibility of survival, this can be switched to permanent one. From Dec. 1986 to Jan. 1994, we had performed 40 cases of temporary arthrodesis after segmental resection of malignant bone and soft tissure tumors around the knee by using intramedullary nail andbone cement. Thirty eight cases of bone tumors[osteosarcoma(33), malignant fibrous histiocytoma(MFH)(3), chondrosarcoma(1), Ewing's sarcoma(1)] and 2 cases of soft tissue sarcomas[MFH(1), squamous cell carcinoma(1)] were analysed. Types of intramedullary nail used were rigid(Huckstep, 23 cases) or flexible(Ender, 17 cases). Six cases(15%) showed mechanical implant failure due to fracture (Huckstep;5, Ender;1) between 2 to 20 months after operation. Rearthrodesis using Ender nail and bone cement(5) or arthroplasty using Kotz prosthesis(1) were done for fractured cases. The other complicaitons were deep infection(2), peroneal nerve palsy(2), or transfixing screw fracture(2). Second reconstruction procedure was carried out in 2 cases with arthroplasty using Kotz prothesis. For IM nail, multiple Ender nailing seems to be superior to the Huckstep in mechanical strength. Contrary to the primary permanent reconsturction of the bone defect, this procedure has several advantages: 1) simple and does not hinder postoperative chemotherapy, 2) even in the extensively involved cases, can save the limb if the neurovascular structures are spared, 3) in Stage III, can save the salvagable limb, 4) economic and immediate stability can be helpful in the patient's quality of life, 5) two years later, when the survival approaches plateau, we can switch to another kinds of salvage operation, 6) Ender nail was superior to Huckstep in mechanical stability, 7) can be used for children expecting leg lengthening near puberty. It is useful for sarcoma patients around knee who require prolonged chemotherapy anbd whose life expectancy is relatively unexpectable.
Adolescent ; Appointments and Schedules ; Arthrodesis ; Arthroplasty ; Child ; Drug Therapy ; Epithelial Cells ; Extremities ; Humans ; Knee ; Leg ; Life Expectancy ; Peroneal Nerve ; Puberty ; Quality of Life ; Sarcoma ; Survival Rate

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it’s origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.
Antibodies ; Basement Membrane ; Carcinosarcoma ; Connective Tissue Cells ; Epithelial Cells ; Immunohistochemistry ; Intercellular Junctions ; Keratins ; Microscopy, Electron ; Muramidase ; S100 Proteins ; Sarcoma, Synovial ; Stem Cells ; Synovial Membrane ; Vimentin