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 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

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*

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

We report two cases of vulvar syringorna in a 40-year-old women and a 28-year-old woman who had 2-3mm sized, brownish papules on both valvar areas an l-3rnm sized, yellow-brownish papules on both vulvar ares with yellowish milia-like lesion the surface, respectively. Microscopically the lesions revealed characteristic findings of syrinzoiza However the second case showed a small cystic duct in the papillary dermis, which is lineilly a stratified epithelium and filled with concenteric lamellae of keratin.
Adult ; Cystic Duct ; Dermis ; Epithelium ; Female ; Humans ; Syringoma* ; Vulva

As modern society becomes increasingly complex, there has been a steady increase in violence, as well as in automobile and industrial accidents. This has resulted in an increased incidence of facial injuries, including mandibular fractures. Many methods have been advocated to achieve reestablishment of normal feature and function. The choice generally depends upon such factors as location of the fractures, displacements, status of the dentition and favorability of the fracture line. Many cases of mandibular fracture are treated by intermaxillay fixation using an arch bar or bite block(acrylic splint)for rapid bone union and minimal displacement. However, there had been some problems, such as discomfort to patients, limitation to eating and weight loss, poor oral hygiene, and temporomandibular joint ankylosis. As a consequence, we have modified the shape of the acrylic splint and method of fixation for circum-mandibular fixation instead of intermaxillary fixation. Acrylic splints are rigid, strong, easily adjusted and repaired, translucent, lightweight and well tolerated by the oral mucosa. The splints are properly secured to each tooth and bind all the teeth together as a single unit. Authors have used modified acrylic splints as tools of circum-mandibular fixation in 12 cases of mandibular symphysis and body fracture from May 1997 to August 1998, achieving the results of very good occlusal relationship, oral hygiene and comfort to patients.
Accidents, Occupational ; Ankylosis ; Automobiles ; Dentition ; Eating ; Facial Injuries ; Humans ; Incidence ; Mandibular Fractures* ; Mouth Mucosa ; Oral Hygiene ; Splints* ; Temporomandibular Joint ; Tooth ; Violence ; Weight Loss

To examine the usefulness of cardiac MRI in assessing patients (pt) with congenital heart diseases(CHD), informations obtained from MRI and echocardiogrphy (echo) were compared in 91 consecutive pt with CHD and was correlated with findigs at cardiac catheterization (53pt) and at surgery (71pt). Pt were studied with 1.5 Tesla MRI unit and multiplanar images of the heart and great vessels were obtained using ECG-gated multislice spin-echo technique. Age ranged from newborn to 22 years. We obtained the following results. MRI was vary useful in providing important diagnostic informations in 19pt, provided informations which was not crucial to the clinical decision in 28pt, and did not provide additional informations in 44pt. MRI was very useful in assessing complex lesions, particularly in identifying atrial situs, rudimentary ventricular chamber, criss-cross atrioventricular connection, total anomalous pulmonary venous connection, anatomy of ventricular septal defect in double outlet right ventricle, anomalous ventricular muscles, aortopulmonary collateral artery and distal pulmonary artery anatomy. En face view of the ventricular septum was very useful in clearly outlining the ventricular septal defect. MRI gave false information in 17pt. Diagnostic accuracy of MRI was poor for coarctation of the aorta in neonates and small infants, patent ductus arteriosus and pulmonary stenosis. Cardiac MRI is recommended for preoperative planning in selected pt with CHD, particularly with complex lesions.
Aortic Coarctation ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Ductus Arteriosus, Patent ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Muscles ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Ventricular Septum

No abstract available.