Marjolin is ulcer may be defined briefly as a cancer arising in a bum scar. A 41-year-old female had a Marjolin is ulcer(12x10x3cm) on her right lower leg. This ulcerated tumor has been present for two and half months and the induction period sinnc her bum was 29 years. The pathologic diagn.osis was squamous cell carcinoma, grade 2. Roentgenograms of her right lower leg revealed several soft tissue masses densities which, in part, horizontally connected with the periosteum of the tibia. So she was treated by above-knee amputation with dissection of several, unenlarged inguinal nodes which showed no evidence of metastases. She developed large, single, fixed metastatic node in right inguinal area one month after amputation and dissection was done.
Adult ; Amputation ; Carcinoma, Squamous Cell ; Cicatrix ; Female ; Humans ; Leg ; Neoplasm Metastasis ; Periosteum ; Tibia ; Ulcer*

Ofloxacin, one of the new quinolone derivatives, is found to be highly effective against both PPNG and non-PPNG urethritis. The objective of this trial was to establish the efficacy of two ofloxacin regimens in the treatment of uncomplicated male gonococcal urethritis. A total of 138 patients with uncomplicated gonococcal urethritis seen at the VD Clinic, Choong-Ku Public Health Center, in Seoul in the period of March Jun 1988, were subjected to this study. The patients were divided randomly into two groups and assigned to one of two treatment regimens of afloxacin, 400mg, PO and 200mg, PO, twice a day for 2 days. No failure case was seen in both groups. Both of these ofloxacin regimens were found to be highly effective and safe in the treatment of gonococcal urethrithis. It is suggested that, because of high rate of PPNGs among circulating N. gonorrhoeae, they can be recommended as the first line treatment for gonorrhea in Korea.
Gonorrhea ; Humans ; Korea ; Male* ; Ofloxacin* ; Public Health ; Seoul ; Urethritis*

BACKGROUND: Majority of hypertension is essential in type, so its clear cue usually is not found, and the patients are tend to be persisted of psychopathy such as emotional tension, depression, anger, anxiety and psychologic conflict, also not to be adapted to stressful event. So we decide to survey the personality characteristics of essential hypertensive patients and factors of psychopathology. METHODS: Patient group-50 persons(male 23, female 27) are selected in the course of antihypertensive medication, being in or outpatient treatment at the dept. of F.M. or I.M. in Kae-jung, Dae-sung or Jung-ang Hospital from August 1, 1995 to July 31, 1996. Control group 52 persons(male 25, female 27) are selected. Exclusision criteria are any clinical disease hystory, over 140/90mmHg of BP, under 20-year old age or no cooperation. We assessment of the MMPI, BDI and STAI results about both group. RESULTS: Comparing hypertensive group with normal control group, significantly higher F, Hs, D, Hy, Pd, Pt and Sc scales of MMPI and BDI(p<0.01), and anxiety scale of STAI(p<0.05). There were no significant differences in all scales comparing between both sexs in the hypertensive and control groups, except comparing hypertensive male with hypertensive female in Pt scale(p<0.05) and control female with control male in Hy scale(p<0.05). CONCLUSIONS: Comparing essential hypertensive group with normal control group, significant higher score was found in scales of Hypochondriasis, Depression, Hysteria, Psychopathic deviate, Psychasthenia, Schizophrenia and anxiety. And in the treatment of hypertensive patient with antihypertensive drugs, appropriate additive psychotherapy appears useful in the case of revealing psychopathy.
Anger ; Antihypertensive Agents ; Anxiety* ; Cues ; Depression* ; Female ; Humans ; Hypertension* ; Hypochondriasis ; Hysteria ; Life Change Events ; Male ; MMPI ; Outpatients ; Psychopathology ; Psychotherapy ; Schizophrenia ; Weights and Measures ; Young Adult

Transpedicular Screw fixation and Harrington distraction rod are effective means of managing unstable thoracolumbar fracture and fracture dislocation. The authors analysed the 52patients who were treated with above 2methods from March 1986 to February 1993. The results were as follows: 1. Most of patients were in 5th decade compare to younger group and most common cause of injury was fall down, but traffic accident is increasing. 2. The most commonly involved sites were T12and L1 vertebrae and most common type of injury is bursting fracture. 3. Postoperative anterior and posterior column of vertebrae body correction rate were 35.0%/34.4% in ISF group and 29.3%/27.9% in Harrington group. Postoperative correction loss rate were 0.13/0.04 in ISF group and 0.06/0.04 in Harrington group. 4. Postoperative correction of kyphosis angle were average 18 in ISF goup and average 15° in Harrington group. Loss of correction angle was average 23° in ISF group and average 4.4° in Harrington group. 5. Range of spinal fixation was average 3.1 segments in ISF group and average 6.2 segments in Harrington group. 6. There was no significant difference in neurologic recovery between ISF group and Harrington group. The patients who had been recovered neurologically more than 1 grade were 28.6% in Harrington group and 29.2% in ISF group. 7. ISF has some benefit in spnal vertebral body height correction and in maintenance of correction compare to Harrington group. Nevertheless disadvantages of ISF group such as long operative time and possibility of cord compression by pedicular screw, ISF has advantages of almost anatomical reduction and the least spinal fusion.
Accidents, Traffic ; Body Height ; Dislocations ; Humans ; Kyphosis ; Operative Time ; Spinal Fusion ; Spine

Lymphoepithelioma-like carcinoma (LELC) that histologically resembles nasopharyngeal lymphoepithelioma has been reported in various sites including the stomach, salivary gland, lung, skin, thymus, tonsil and uterine cervix. LELC of the stomach was rarely reported after the first report by Burke et al. in 1990. More than 60% of them were associated with Epstein-Barr virus (EBV). Most commonly affecting elderly Asians with slight male predominance (M/F ; 1.2/1), it usually is located in the proximal portion of the stomach and distinguished from lymphoid-rich adenocarcinoma by the absence of definitive glandular differentiation in the LELC. We recently experienced 4 cases of LELC of the stomach associated with EBV. Patients consisted of two Korean females and two Korean males with one in 3rd decade, one in 5th decade and two in 6th decade. The tumors of all cases were located in the proximal portion of the stomach. Gross types were 1 Borrman type I, 2 Borrman type II and 1 early gastric carcinoma type IIc. The size of the tumors varied from 0.8 cm to 7 cm. Microscopic findings were similar in all 4 tumors.; The tumors were composed of syncytial nests of undifferentiated cells having vesicular nuclei with prominent nucleoli, admixed with abundant lymphoplasma cell infiltration in the stroma. Immunohistochemical staining revealed that the tumor cells were reactive for cytokeratin and the stromal lymphocytes were mostly T cells. There were dark hybridization signals in the nuclei of most of the tumor cells but no signals in the stromal lymphocytes in three cases on in situ PCR hybridization and on all cases PCR amplification for EBNA-1. It is concluded that LELCs of the stomach have distinctive histologic characteristics and the usual association with EBV. Further accumulation of these cases will define the prognosis.
Adenocarcinoma ; Aged ; Asian Continental Ancestry Group ; Cervix Uteri ; Female ; Herpesvirus 4, Human* ; Humans ; Keratins ; Lung ; Lymphocytes ; Male ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Skin ; Stomach* ; T-Lymphocytes ; Thymus Gland

To investigate the correlation between EBV infection and p53 overexpression in laryngeal carcinomas (LC) and nasopharyngeal carcinomas (NPC) in Korea, we analyzed 37 laryngeal squamous cell carcinomas and 33 nasopharyngeal (11 squamous cell and 22 undifferentiated) carcinomas. We used the immunohistochemistry and polymerase chain reaction-single stranded conformational polymorphism (PCR-SSCP) for p53 overexpression and p53 gene mutation, respectively, and EBER-1 in situ hybridization and PCR using primer for EBNA-1 and EBNA-2 type 1 and 2 for prevalence and the subtype of EBV. The results were as follows; 1) The p53 expression was found in 43.2% of squamous cell LCs, in 54.6% of squamous cell NPCs and in 22.7% of undifferentiated NPCs. The p53 gene mutation was detected in 6 of 23 squamous cell LCs and 3 of 14 undifferentiated NPCs. 2) EBV was detected more frequently in undifferentiated NPCs (95.5%) than in squamous cell NPCs (63.6%) and squamous cell LCs (37.0%). Only type 1 was found in squamous cell LCs and NPCs, whereas both type 1 and type 2 were detected in undifferentiated NPCs. 3) There was no difference according to EBV infection (EBV+ ; 7 cases, EBV- ; 7 cases) in the cases with p53 protein overexpression but mutaion. From the above results, it can be concluded that squamous cell LCs and NPCs are associated with both p53 and EBV, whereas undifferentiated NPCs are more closely associated with EBV than p53. In Korea, both type 1 and 2 are detected in undifferentiated NPCs. Also, our result suggests that EBV infection does not seem to contribute to p53 overexpression. The interrelationship between EBV infection and p53 remains to be further defined.
Carcinoma, Squamous Cell ; Epstein-Barr Virus Infections ; Genes, p53 ; Herpesvirus 4, Human* ; Immunohistochemistry ; In Situ Hybridization ; Korea ; Polymerase Chain Reaction ; Prevalence

No abstract available.
Diskectomy*

No abstract available.
Humans ; Mortality* ; Risk Factors*

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

The occurrence of the colonic obstruction secondary to colorectal carcinoma (CRC) has been reported in 7~30% of the CRC patients. It is generally believed that obstructive CRC is associated with a poor prognosis with respect to operative mortality and five-year survival. A series of 1064 cases of the CRC treated surgically at Asan Medical Center from June 1989 to December 1996 has been analyzed to compare clinicopathological findings between obstructive and non-obstructive CRC and to evaluate surgical treatment options in obstructive CRC. Complete obstruction was present in 49 cases (4.6%). There were no differences between obstructive and non-obstructive CRC in tumor location, size, Dukes' stage, and differentiation. In forty-nine obstructive CRC cases, primary resections were performed in 29 cases after peri-operative bowel decompression. In this group, right colon cancer was more prevalent than staged operation group (45% vs. 5%, P<0.05) and hospital stay was significantly short (16 days vs. 38 days, P<0.05). Postoperative complication rate was higher in staged operation group (65% vs. 28%, P=0.01). It may be due to stoma related wound complication. In obstructive left colon cancer, there was a significant difference in complication rate between primary resection and staged operation (P<0.05). Overall 5-year survival rate were 66% and 53% in non-obstructive and obstructive group, respectively. Survival rate according to the Dukes' B and C stages did not show statistical differences, either. Conclusively, primary resection is preferred to the obstructive CRC when supportive care, preoperative bowel decompression, and intraoperative colonic irrigation were performed adequately.
Chungcheongnam-do ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Decompression ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Preoperative Care ; Prognosis ; Survival Rate ; Wounds and Injuries