This study includes 40 patients of post-traumatic facial bone deformities to whom underwent realignment of zygomatic bone. In 13 cases, we modified the approach technique using limited exposure such as subciliary, intraoral and preauricular incisions instead of conventional wide exposure. Preoperative evaluation of deformity was done by using x-rays, photographs and detail communication with the patients. Through this limited exposure, osteotomy and repositioning of the zygoma were accomplished. There were no postoperative differences between wide and limited exposure, but limited exposure was more advantageous in terms of reduced operative time, transfusion, hospitalization and scaring. This approach was an effective method for the relatively simple tetrapod type-malunited fracture of zygoma without comminution.
Congenital Abnormalities ; Facial Bones ; Hospitalization ; Humans ; Operative Time ; Osteotomy ; Zygoma*

'Marjolin' ulcer' is used to describe the malignant transformation of a chronic ulcer which has developed in a burn scar. Clinically, although the lesions is slowly progressive, it comes to be more aggressive when the scar barrier is disrupted. We reviewed 24 cases in patients who complained of chronic burn wounds suspected to be Marjolin's ulcer. The mean latent period for developing pathologic lesions was 31 years. Histologically, chronic ulcer and pseudoepitheliomatous hyperplasia were 21% respectively, while malignancy including squamous cell carcinoma and leiomyosarcoma was 56%. The mean elapsed time to diagnose squamous cell carcinogma was 33.2 years. In pseudoepitheliomatous hyperplasia which is considered as a transitional state to malignant tumor, wide excision and reconstruction with free muscle flap was a better procedure than skin graft for the prevention of recurrence and malignant transformation. As well, the same modality of treatment was also applied in malignant tumors.
Burns* ; Carcinoma, Squamous Cell ; Cicatrix ; Humans ; Hyperplasia ; Leiomyosarcoma ; Recurrence ; Skin ; Transplants ; Ulcer ; Wounds and Injuries*

No abstract available.
Leukemia* ; Leukemia, Megakaryoblastic, Acute*

Among 666 premature infants or low birthweight infants who were admitted in NICU of St. Francisco General Hospital from January 1990 to Jun 1992, 96 infants were diagnosed as retinopathy of prematurity by indirect ophthalmoscope. The result were follows: 1) Among 666 patients, retinopathy of prematurity developed in 96 patients(14.1%) 2) The high incidence was observed in low birthweight and small gestational age. 3) Mean age of first diagnosing time was 42.0( 12 day of life and mean gestational age was 31.8 2.5 weeks and mean birthweight was 1646.5 (350.7gm. 4) In gestational age, birthweight and duration of oxygen therapy, there was statistically difference between cryotherapy group and spontaneous regression group. Other possible risk factors-hyaline membrane disease, apnea, anemia-were showed higher incidence in cryotherapy group. 5) Among the 20 infants who were treated with cryotherapy, 16 infants (80%) showed regression of neovascularization.
Apnea ; Cryotherapy ; Gestational Age ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Membranes ; Ophthalmoscopes ; Oxygen ; Retinopathy of Prematurity*

Most familial adenomatous polyposis (FAP) patients undergo total colectomy, but duodenal polyposis develops in up to 90% of patients with FAP and a 4% to 18% risk of duodenal and ampullary cancer remains. Laparoscopic pancreas-preserving near total duodenectomy is thought to be a potential option and can be an effective approach to preserve the pancreas. A 48-year-old male patient, who underwent laparoscopic total colectomy with end ileostomy because of FAP with colorectal cancer, was diagnosed with a 20 mm-sized duodenal adenoma in the second to the third portion. The operation was performed on December 27, 2021. Near total duodenectomy was done and type II Billroth gastrojejunostomy was done. Laparoscopic pancreas-sparing duodenectomy is shown to be safe, with favorable short-term oncologic outcome compared to laparoscopic pancreatoduodenectomy in terms of less blood loss, faster recovery time, and much less total cost.

Leiomyosarcoma is a malignant tumor showing smooth muscle differentiation, and it accounts for 2% to 8% of soft tissue sarcoma. Clinically, substantial mortality and morbidity are related to the propensity for distant metastasis and local recurrence, respectively. Microscopic findings characteristically reveal intersecting bundles of spindle-shaped cells having fibrillar cytoplasm and blunt-ended nuclei. Immunohistochemistry for intermediate filaments is helpful in establishing a definitive diagnosis. We experienced a case of large protruding leiomyosarcoma that developed on an old burn scar of the medial calf of a 45-year-old man. On preoperative evaluation, we recommended amputation due to a distant metastasis to the lung(stage IV). As the patient refused amputation of his lower leg, the tumor was radically excised and immediate reconstruction was done using free latissimus dorsi muscle flap and skin graft. Four months after excision despite adjuvant chemotherapy, amputation was performed due to local recurrence.
Amputation ; Burns ; Chemotherapy, Adjuvant ; Cicatrix ; Cytoplasm ; Diagnosis ; Humans ; Immunohistochemistry ; Intermediate Filaments ; Leg ; Leiomyosarcoma* ; Middle Aged ; Mortality ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Superficial Back Muscles ; Transplants ; Ulcer*

In the past 5 years, the authors have performed microsurgical reconstruction of the lower leg in 37 patients. Among them, modified microsurgical salvage procedures were performed in 11(29.7) cases with vascular compromise, suggested by the preoperative angiogram of the affected lower leg demonstrating no visible, or only one visible major arter. Modified salvage procedures included free flap operations using distally-based arterial inflow(n=2), temporary diversion of the single main artery with secondary vein grafting(n=2), Jungcross-leg fashioned free flaps(n=4), and end-to-side anastomosis of the main artery((n=1). In absence of arterial flow after lower leg trauma, as interpositional vein graft(n=2) was performed to restore blood flow. No vascular problems occurred after the free flap transfer. However, 9 patients experienced different degrees of limping gait, ranging from as mild(n=2), moderate(n=6) to severe(n=1) at the mean follow-up period of 18 months. In reconstruction of a vascular compromised lower leg, modified salvage procedures should be reviewed and selected after exploration of all vessels, both proximal and distal to the zone of the injury. When evaluating what method is the most appropriate, socioeconomic efficiency and patients' individual requirments should be considered.
Arteries ; Follow-Up Studies ; Free Tissue Flaps ; Gait ; Humans ; Leg* ; Veins

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Incidence*

PURPOSE: Bone involvement is known to develop in 40-70Yo of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement. METHODS: Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups. RESULTS: Twenty-seven patients were enrolled in this study with 14 patients(52Yo) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemo-therapy, but, one AML patient died due to induction failure. CONCLUSION: Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis. (J Korean Pediatr Soc 2000;43:806-813)
Bone Diseases, Metabolic ; Fractures, Spontaneous ; Humans ; Leukemia* ; Lower Extremity ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Radioactivity

NMP is a kind of protein relating to the internal structural framework of the nucleus, which is related to gene expression and regulation such as DNA replication and processing of RNA, and is made in tumor cell more than in normal cell. The object of this study is to evaluate the utility of NMP22 in urine as the possible marker of monitoring the transitional cell carcinoma of the bladder. Two groups attended the trial of NMP22; 1) 25 healthy volunteers 2) 25 patients with the transitional cell carcinoma of the bladder. The result is that the values of the mean NMP22 of the healthy volunteers and the patients with the transitional cell carcinoma of the bladder were 4.04+/-1.83 U/ml and 186.9+/-405.9 U/ml, respectively. The difference was statistically significant (p=0.028). The value of urinary mean NMP22 according to the tumor grade and the tumor stage didn`t show the significant difference statistically (grade I: 41.3+/-51.9 U/ml, grade II: 167.6+/-369.3 U/ml, grade HI: 362.7+/-605.5 U/ml, superficial TCC: 204.2+/-453.0 U/ml, invasive TCC:132.0+/-217.1 U/ml). In detecting the transitional cell carcinoma of the bladder, the sensitivity of urine cytology was 68% and the sensitivity of combining urinary NMP22 and urine cytology was 88%, when the value of the urinary NMP22 over 7.70 U/ml was considered as the positive. Urinary NMP22 is expected to increase the diagnosis and the detection of recurrence of the transitional cell carcinoma of the bladder if it is used together with the urine cytology as the urinary tumor marker of the transitional cell carcinoma of the bladder.
Carcinoma, Transitional Cell* ; Diagnosis ; DNA Replication ; Gene Expression ; Healthy Volunteers ; Humans ; Nuclear Matrix* ; Recurrence ; RNA ; Urinary Bladder Neoplasms ; Urinary Bladder*