No abstract available.
Adhesives* ; Nylons* ; Skin* ; Surgical Tape* ; Sutures* ; Wounds and Injuries*

The most common malignant renal neoplasm is renal cell carcinoma. It is estimated that renal cell carcinoma accounts for 1% of all primary malignancies in Korea. Rell cell carcinoma presents diverse clinical courses with gross, histopathologic features. It has been known to be very difficult tumor to predict its clinical prognosis. In Korea, many studies have been reported concerning the clinical aspects of renal cell carcinoma. However, pathological studies of renal cell carcinoma are very few even though studies of nuclear grade have been attempted recently. We reviewed 93 cases of renal cell carcinoma examined in the period from 1978 to 1987 in the department of pathology, Yonsei university college of medicine, Yongdong Severance hospital, Wonju college of medicine and analyzed the histopathologic classification, including nuclear grade according to the Fuhrman's method. We abtained the following results by studying the relationship of the factors which had been known as correlated with the prognosis. 1) The ages of patients ranged from 9 to 74 years with a peak in the 6th decade. 2) The most common symptoms of the patients were hematuria, mass and pain, in that oder, and 7 patients complained to specific symptoms. The incidentally found cases characterized stage I, nuclear grade 2 small tumor size (not more than 4 cm) and clear cell type. 3) The renal cell carcinoma was more frequently located in the left kidney than the right by a ratio of 1.25 : 1. The incidence of intrarenal location was divided to the upper pole, 40% : mid portion, 29% : lower pole, 23% : diffuse involvement, 8%. The tumor shoing diffuse growth pattern had a large size, high nuclear grade and mixed cells. 4) The tumor size averaged 8 cm and there was no significant relationship between the size and stage. Seven cases of neoplasms not more than 3 cm were seen, of which 2 cases revealed an outcome of distant metastasis. 5) The histological pattern showed major solid, 53% : tubular, 11% : mixed, 18% : papillary, 9% and sarcomatoid type 9%. The sarcomatoid type was characterized by grade 4, a larger size(more than 10 cm), advanced stage. 6) There was no special relationship between the stage and grade but mostly grade 2 occupied the stage I. 7) The clear cell type was predominantly noted at grade 2 (65%), at the stage I (63%), granular or mixed cell type at grade 3 (87%), 4 (70%). According to these results, the tumors showing a sarcomatoid histologic pattern, diffuse growth pattern had unfavorable prognostic factors, and are thus estimated to have a poor prognosis. But the case which were incidentally found have favorable prognostic factors and probably a better prognosis. The tumor size alone can not exactly predict the metastasis and is not correlated with the stage. Small renal cell neoplasm (not more than 3 cm) generally has unfavorable prognostic factors and should be considered potentially malignant. The high grade frequently has granular cytoplasm. This represents the relationship between grade and cytoplasm, poor prognosis in the granular cell than the clear. The renal cell carcinoma shows variable prognosis and thus the prognosis should be estimated by all the factors. Nuclear grade can be used as one of the useful prognostic factors.
Incidence ; Neoplasm Metastasis

The malar bones are major determinants of mid-facial shape. In an oriental population, malar prominences are considered an unpleasing and undesirable feature because they give the face a triangular shape and may produce an emaciated and sunken appearance. There are two main operative approaches to malarplasty. One is a coronal approach and the other is a intraoral approach. The former possess advantages of symmetricity, accuracy and superiorly, medially and posteriorly aesthetical transposition of the malar bone. However, it has drawbacks such as a long visible scar on the scalp and extensive operation. Though the latter is a simple method avoiding a visible scar, it has some problems of asymmetricity, cheekdrooping, partial transposition of the malar complex and difficulty of aesthetic transposition. The authors intended to perform intraoral malarplasty for symmetrically aesthetic transposition of the whole malar bone without cheekdrooping. From February 1996 to January 1999, 9 female patients with prominent malar complex, in whom the coronal incision was objectionable, had intraoral malarplasty performed with 2-point fixation after L-shaped osteotomy involving the zygomatic process of maxilla, resulting in symmetric and aesthetically desirable three dimensional transposition of the malar bone.
Cicatrix ; Female ; Humans ; Maxilla* ; Osteotomy ; Scalp ; Zygoma

No abstract available.
Humans ; Twins*

The association of colonic atresia in patients with Down syndrome is a rare anomaly. The incidence of congenital atresia of the gastrointestinal tract has been estimated to be about one in 1500 births. Colonic atresia is rarer still, and is throut to comprise about 5% to 10% of this group. This intestinal atresia occurs in about 30% to 50% of patient with Down syndrome. We experienced a case of Down syndrome associated with colonic atresia in a 1 day old male. His initial chief complaints at the admission were severe abdominal distension and Down appearance. Diagnosis was confirmed by chromosomal study and operative laparotomy with end-to-end ileodescending colostomy. We report the case with brief review of related literatures.
Colon* ; Colostomy ; Diagnosis ; Down Syndrome* ; Gastrointestinal Tract ; Humans ; Incidence ; Intestinal Atresia ; Laparotomy ; Male ; Parturition

BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

Until recently almost exclusively clinicochemical urine parameters have been used to determine the risk of urinary stone formation, because the urinary stone disease is considered as one of metabolic disorders. But the morpholgy of renal pelvocalyceal system also affects on the formation of stone particle and its growth, mainly by establishing urinary stasis. We reviewed 163 excretory urograms retrospectively, and pelvocalyceal systems of healthy persons and urinary stone formers were compared with regard to their morphology. In summary of the study, the majority of pelvocalyceal systems of urinary stone formers showed (1) an increased number of papillae; (2) a greater cranial and caudal exlension of pelvocalyceal sysrem:(3) an increased circular radius of the pelvocalyceal system and hence an increased pelvocalyceal system volume ;(4) an increased pelvic area, especially an enlarged total calyx area and hence a larger total area. (5) a higher degree of ramification and a higher number of branches in the calyx groups ; (6) a more sharp angle between the most caudally situated calyx neck and the direction of pelvic outlet :(7) a highly situated origin or the ureter more frequently ;(8) more frequent ampullary patterns of pelvocalyceal system. But the number of major calyx, the total calyx angle and the angle between the direction of pelvic outlet and the main direction of the ureter showed no statistically significant difference between the urinary stone formers and the healthy persons. The results indicate that the study on the morphology of the renal pelvocalyceal system by excretory urography may be used as a screening test to determine the risk of urinary stone formation.
Humans ; Mass Screening ; Neck ; Radius ; Retrospective Studies ; Ureter ; Urinary Calculi* ; Urography*

PURPOSE: The accuracy of CT in the detection of injuries of the solid visceral organ is well established, but the value of CT in diagnosing small bowel rupture after abdominal trauma is controversal. This study was conducted to ascertain CT finding of small bowel rupture result from abdominal trauma. MATERIALS AND METHODS: A retrospective analysis of preoperative abdominal CT findings in 40 patients was performed. Small bowel rupture was confirmed by surgery. Precontrast and postcontrast enhanced CT images were obtained in all patients. RESULTS: Diagnostic findings of small bowel rupture including pneumoperitoneum or retroperitoneal air, discontinuity of the bowel wall and extravasation of oral contrast materials were observed in 33 cases(83%). Intraperitoneal or retroperitoneal free air was seen in 31 cases(78%) and intraperitoneal or retroperitoneal free fluid collection was seen in 38 patients(95%). Small bowel wall was thickened in 31 cases(78%), bowel wall was enhanced in 12 cases(30%) and bowel wall discontinuity and extravasation of oral contrast material was seen in 5 cases, respectively. CONCLUSION: The CT scan is sensitive and effective modality for evaluation of small bowel rupture after abdominal trauma, because of high detectability of diagnostic and suggestive CT findings.
Contrast Media ; Humans ; Pneumoperitoneum ; Retrospective Studies ; Rupture* ; Tomography, X-Ray Computed

The diagnostic significance of ultrasonography, computed tomography and magnetic resonance imaging for predicting the stage of tumors was evaluated by comparing their results with preoperative and histopathologic findings. The 24 patients who were diagnosed as renal cell carcinoma by histopathologic finding have taken preoperative examination such as ultrasonography, computed tomography. Additionally, magnetic resonance imaging was performed in 15 patients among them. The T stage was determined correctly by magnetic resonance imaging in 87% of the cases, by computed tomography in 80%. We suggested that a computed tomography is reliable imaging method for evaluating the T,N category preoperatively, but magnetic resonance imaging is more sensitive than a computed tomography in predicting the stage of renal cell carcinoma and a magnetic resonance imaging can replace the computed tomography.
Carcinoma, Renal Cell* ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

Folliculosebaceous cystic hamartoma (FCH) is a recently recognized adnexal tumor and is composed of follicular, sebaceous and mesenchymal elements such as small vessels, adipocytes and neural component in the fibrous stroma. It usually presents as an exophytic papule or nodule on the central part of the face. We describe a 39-year-old woman with FCH on the right upper back, which is an unusual site. A biopsy specimen demonstrated a follicular structure in infundibuiar nature, sebaceous lobules attached to it, and compactly laminated fibrous stroma with an increased number of vessels in it. Immunohistochemically, many of the vessels in the stroma showed positive reaction for CD34, and Factor VIII.
Adipocytes ; Adult ; Biopsy ; Factor VIII ; Female ; Hamartoma* ; Humans