Basal cell carcinoma is the most common skin cancer, especially on the eyelid and nose. As it rarely invades to a underlying bone or metastasizes an distant site, and is usually found at an early stage, it is regarded as a curative disease. However, basal cell carcinoma on the eyelid and nose may be resected incompletely due to efforts to preserve important structures or as a result of esthetic considerations. We experienced two cases of basal cell carcinoma with local invasion to underlying bone. One was a recurred case on the nasal area extending to the nasal bone arts medial wall of the ethmoid sinus. The lesion was widely resected and covered with a radial forearm free flap. The other was on the eyelid extending to the orbit. It was treated with orbital exenteration and resection of the involved eyelid. The defect was reconstructed with the temporalis muscle flap with split-thickness skin graft. These patients were followed up for 7 months with no evidence of recurrence. Since basal cell carcinoma can invade to the bone and metastasize to a distance site, it should be resected radically in the regions of the eyelid and nose.
Carcinoma, Basal Cell* ; Ethmoid Sinus ; Eyelids ; Forearm ; Free Tissue Flaps ; Humans ; Nasal Bone ; Nose ; Orbit ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

The incidence of pelvic fractures with or without dislocation of the sacro-iliac or symphysis pubis, is continually increasing. Such injuries not only are serious but can result in disabling complications and deaths. The author reviewed 57 cases of Malgaigne fractures treated at the orthopedic department of Kyungpook National University Hospital during the period from January 1978 to December 1977, and analized as to the cause of injury by mechanical forces, type of fracture, average duration for treatment and complications. We have adopted the classification of unstable fractures of Dunn and Morris. The fractures were classified as followes: vertical shear, 11: bucket handle, 8: lateral compression, 6: straddle, 5: total pelvic disruption, 4: dislocation, 3. Twenty-four patients were male thirteen, female. Traffic accident caused the injury in twenty-seven of the patients, accident of mine and factory, each three. Two fell from heights. Frequent associated soft tissue injuries were rupture of bladder (6 patients) and rupture of urethra (10 patients) The principle of treatment consisted of skeletal traction through the lower limb (supracondyle of femur) on the involved side and balance skin traction on the normal side. Pelvic sling were used. In lateral compression type, reduction was obtained by application of lateral skeletal traction with pelvic screw. Traction was continued for eight weeks. After discarding the traction physiotherapy start in bed and continued for further four weeks. Complete reduction of the displaced fragment and an adequate period of immobilization in recumbency is necessary to obtain the best results in treatment of Malgaigne fractures.
Accidents, Traffic ; Classification ; Clinical Study ; Dislocations ; Female ; Gyeongsangbuk-do ; Humans ; Immobilization ; Incidence ; Lower Extremity ; Male ; Orthopedics ; Pubic Bone ; Rupture ; Skin ; Soft Tissue Injuries ; Traction ; Urethra ; Urinary Bladder

Craniofacial reconstructive procedures are frequently peformed with rigid fixation of the bone. During the period of active bone growth such manipulation may influence bone development. The purpose of this study was to determine the effects of metal plating of the mandible on the growth and morphology of the mandibulofacial skeleton. New Zealand white rabbits, 6 to7 weeks of age, were divided into 5 groups. They were designated as group I(nonoperated control, n=10), group II (rigid fixation of mandibular body after vertical osteotomy, n=10), group III(rigid fixation without osteotomy, n=10), group IV (interosseous wire fixation after osteotomy, n=10), and group V(rigid fixation and removal of plates and screws 4 weeks after osteotomy, n=7). Rabbits were sacrificed 12 weeks after operation and dry skull preparations were grossly measured and analyzed by direct measurement and by dorsoventral skull x-rays. Measurements taken were length, thickness, angle, and area of the mandibulofacial skeleton. Three-dimensional CT was used for volumetric measurement of the mandible. The data wee compared between the operated and nonoperated sides and significant differences between groups were evaluated using the paired t-test, the ANOVA test, and Dunn's test. The following results were obtained: 1. The length of the whole mandible and the anterior mandibular segment was decreased in groups II and III, compared with group I(p>0.05). These results show growth restriction of the plated mandible regardless of osteotomy. 2. The maxillary alveolus of the operated side was more anteriorly placed in groups II and III, compared with group I (p>0.05). 3. The thickness of the operated mandibular body showed a significant increase in groups II and III, compared with group I(p>0.05). 4. The length of the zygomatic arch of the operated side in all the experimental groups showed a significant decrease, compared with group I(p>0.05). The angular divergence of the mandibular ramus from the sagittal midline of the skull was increased in the operated side of groups II and III, compared with the nonoperated side (p>0.05). 5. Volume measurements of the mandible in groups II and III showed a significant reduction of the volume on the operated sides in the anterior mandibular segment, compared with group I(p>0.05). The volume of the operated mandibular body showed a significant increase in groups II and III, compared with group I(p>0.05). All gruops showed no significant difference in total hemiman dibular volume of the operated side compared with the nonoperated side. These results show that rigid fixation of mandibular fractures during the growth period causes a more severe growth restriction than either osteotomy or interosseous wiring.
Bone Development ; Electroplating ; Mandible ; Mandibular Fractures ; Osteotomy ; Rabbits* ; Skeleton ; Skull ; Zygoma

PURPOSE: No consistent histo-pathological characteristics of cystic renal cell carcinomas have previously been determined. In this study, attempts were made at our hospital to evaluate the histopathological characteristics of this cancer. MATERIALS AND METHODS: The medical records of 451 patients with renal cell carcinomas, having undergone a radical nephrectomy, between January 1995 and April 2002, were retrospectively reviewed. The renal cell carcinomas were classified, according to the criteria of the World Health Organization, as a cystic renal cell carcinoma in 31 of these patients (6.8%). The tumor size, nuclear grade and pathological stage were investigated. RESULTS: The mean age of the patients was 52 years, ranging from 35 to 75. Cancer stages were T1, T2 and T3 in 26 (84%), 3 (10%) and 2 (6%) patients, respectively. The nuclear grade and pathological stage were lower in patients with a cystic renal cell carcinoma. CONCLUSIONS: 81% of the cystic renal cell carcinoma cases were diagnosed incidentally. The cystic renal cell carcinomas were usually detected at lower stages and grades, and therefore were associated with a better prognosis than the renal cell carcinomas.
Carcinoma, Renal Cell* ; Humans ; Medical Records ; Nephrectomy ; Prognosis ; Retrospective Studies ; World Health Organization

PURPOSE: To evaluate the impact of adjuvant chemotherapy (AC) in patients with upper tract urothelial carcinoma and lymphovascular invasion (LVI) after radical nephroureterectomy (RNU). MATERIALS AND METHODS: We retrospectively analyzed the clinical records and clinicopatholgic outcomes of patients (n=552) treated with RNU between 1986 and 2013. Patients treated with neoadjuvant chemotherapy and those for whom LVI status was not recorded were excluded. Patients were divided into two groups according to LVI (n=86) or no LVI (n=256). RESULTS: The study included 344 patients (240 men and 104 women) with a median of 53.9 months of follow-up (range, 1-297 months) after RNU. Tumors were organ confined (T2/N0) in 211 (61.3%) and tumor grade high in 291 (84.6%). AC was administered in 64 patients (18.6%). A total of 280 patients (81.4%) were treated with surgery alone. Patients with LVI tended to be older (p=0.049), have a higher pT stage (pT3/T4, p<0.001), be pN+ (p<0.001), have a high tumor grade (p<0.001), and experience recurrence (p<0.001). In the multivariate analysis, LVI was an independent prognostic factor for cancer-specific survival and overall survival (p=0.002 and p<0.001, respectively). The multivariate analysis demonstrated that in the subgroup of patients with LVI, AC was a significant prognostic factor for cancer-specific survival and overall survival (hazard ratio, 0.51; p=0.027 and hazard ratio, 0.50; p=0.025, respectively). CONCLUSIONS: AC does not seem to reduce mortality in patients with advanced upper tract urothelial carcinoma after RNU. In the subgroup of patients with LVI, AC had a positive impact on cancer-specific survival and overall survival. LVI would be helpful for selecting patients who are appropriate for AC.
Aged ; Carcinoma, Transitional Cell/drug therapy/*mortality/surgery ; *Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms/drug therapy/*mortality/surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nephrectomy ; Prognosis ; Retrospective Studies ; Survival Rate ; Ureter/pathology ; Ureteral Neoplasms/drug therapy/*mortality/surgery ; Urinary Tract/pathology

Fitz-Hugh-Curtis syndrome has been described as focal perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhea and Chlamydia trachomatis. The highest incidence occurs in young, sexually active females. However, the syndrome has been reported to occur infrequently in males, according to the foreign literature. The predominant symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in men and women. In women, the spread of infection to liver capsule is thought to occur directly from infected fallopian tube via the right paracolic gutter. In men, hematogenous and lymphatic spread is thought to be postulated. Recently, we experienced a case of Fitz-Hugh-Curtis syndrome occurred in a man. As far as we know, it is the first report in Korea, and we report a case with a review of the literature.
Adult ; Anti-Bacterial Agents/therapeutic use ; Humans ; Male ; Mycoplasma Infections/*diagnosis/drug therapy ; *Mycoplasma genitalium ; Ofloxacin/therapeutic use ; Pelvic Infection/*diagnosis/drug therapy ; Tomography, X-Ray Computed

Obstructive jaundice associated with hepatocellular carcinoma (HCC) is an uncommon symptom caused by intraductal tumor growth, the migration of tumor necrosis, blood clots within the biliary tract, or compression of the biliary tract by the tumor. Most cases of icteric-type HCC involve a main tumor in the liver parenchyma. Bile duct HCC without a primary hepatic tumor is extremely rare, but because it shows similar clinical manifestations and imaging results to extrahepatic bile duct cancer, it is possible to misdiagnose this condition as a primary bile duct tumor or choldocholithiasis. Recently, we experienced a case of obstructive jaundice associated with an extrahepatic bile duct tumor in a 69-year-old woman. Upon radiologic studies and endoscopic cholangiography, the cause of obstructive jaundice was initially attributed to the bile duct tumor itself. However, subsequent analysis indicated that the condition was, in fact, due to bile duct thrombi associated with extrahepatic bile duct HCC.
Aged ; Bile Ducts ; Bile Ducts, Extrahepatic ; Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Female ; Humans ; Jaundice ; Jaundice, Obstructive ; Liver ; Necrosis ; Thrombosis