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*

The use of self-expanding metal stent has been widely reported that its utility can make a palliative decompression treatment and one stage operation without doing colostomy in the patient with unresectable and resectable obstructive colorectal cancer, respectively. It, however, can sometimes cause complications such as intestinal perforation. We report that the conservative treantment could be possible without removing stent or performing laparotomy in case of intestinal perforation during chemoradiotheraphy after insert of stent for relieving colonic obstruction in the 53 years old female patient with stage IV rectal cancer.
Colon ; Colorectal Neoplasms ; Colostomy ; Decompression ; Female ; Humans ; Intestinal Perforation ; Laparotomy ; Middle Aged ; Rectal Neoplasms* ; Stents*

OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

PURPOSE: We investigated the effectiveness and safety of DA-3030 for prophylatic use in patients receiving chemotherapy for malignant disease. MATERIALS AND METHODS: Seventy cancer patients were randomized to receive chemotherapy alone (36 patients) or with DA-3030 administered (34 patients) after stratified block randomization according to chemotherapeutic regimen. DA-3030 was subcutaneously administered at the dose of 100 pg/m/day for 10 days from 24 hours after the completion of chemotherapy. RESULTS: Of the 70 enrolled patients, 62 patients were evaluable. The neutropenia (absolute neutrophil count [ANC] <1,000/mm) occurred in 9 of 32 (28.1%) of the DA-3030 group and 21 of 30 (90.0%) of the control group, giving relative risk for control group of 0.154 (95% confidence interval [CI], 0.05 to 0.45; p-0.0001). Severe neutropenia (ANC 500/mm') occurred in 4 of 32 (12.5%) of the DA-3030 group and in 20 of 30 (66.7%) of the control group (relative risk for control group of 0.316 [95% CI, 0,18 to 0.55]; p=0.0001). The mean duration of neutropenic period (+/-standard error) was 1.13+/-0.34 days in the DA-3030 group and 6.73+/-0.69 days in the control group respectively, and was significantly shorter in the DA-3030 group (p<0.0001). And, there was higher nadir ANC in the OA-3030 group than that in the control group (p=0.0001); the mean nadir ANC was 2,547+/- 343/mm and 442+/-120/mm, respectively. The DA-3030 group had significantly higher incidence of myalgia in comparison to the control group (43.8% compared with 3.3%; p=0.001). However, it was tolerable and was easily managed by conservative therapy CONCLUSION: The use of DA-3030 was effective in preventing chemotherapy-induced neutropenia.
Drug Therapy* ; Humans ; Incidence ; Myalgia ; Neutropenia* ; Neutrophils ; Random Allocation

No abstract available.
Metallothionein*

PURPOSE: Soft tissue sarcomas are uncommon primary malignancies. So studies on the effective chemotherapy for soft tissue sarcomas are limited. We started this study to evaluate the effectiveness of VIP (etoposide, ifosfamide, cisplatin) combination chemotherapy for advanced soft tissue sarcomas. MATERIALS AND METHODS: Thirty patients with recurrent or metastatic soft tissue sarcoma were treated with VIP combination chemotherapy between December 1989 and June 1996. Each patient was given etoposide 75 mg/m2, ifosfamide 1000 mg/m2, cisplatin 20 mg/m2 intravenously for five consecutive days every three weeks. Mesna (sodium-2-mercaptoethansulfonate) was given to avoid the urologic toxicity. RESULTS: Twenty-eight of 30 patients were evaluable for response, and among the 28 evaluable patients, there were 9 partial response (32%). Duration of response in 9 responders ranged from 4.1 to 16.2 months (median 8.8 months). Overall survival ranged from 1.7 to 41.5 months (median 11 months) and survival was better for patients with partial response (median survival 14.8 months vs. 9.7 months with stable disease vs. 5.1 months with progressive disease p=0.0006). Nausea and vomiting was noted in more than 90% of cycles, but was markedly severe in only 4%. Leukopenia was noted in 60% of cycles, including 11% of cycles with counts <2,000/mm3. There was no treatment related death, but we had to stop chemotherapy in 2 patients due to leukopenia (1 patient) and neurotoxicity (1 patient). CONCLUSION: Combination of etoposide, ifosfamide, and cisplatin was fairly active for advanced soft tissue sarcoma, with myelosuppresion and peripheral neuropathy being the most serious toxicities.
Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide* ; Humans ; Ifosfamide* ; Leukopenia ; Mesna ; Nausea ; Peripheral Nervous System Diseases ; Sarcoma* ; Vomiting

Kawasaki disease is an acute vasculitis of infancy and early childhood characterized by high fever, rash, mucositis, lymphadenopathy and coronary artery damage. The failure to indentify a causative organism using convetional culture and serological techniques, and the lack of response to antibiotics indicate that the disorder is probably not due to any known bacterial or viral pathogens. During the acute phase of the disease, the alterations of T and B cell functions, changes of cytokine and immunoglobulin levels have been reported. This study was performed to investigate the changes of immunoglobulins levels in patients with Kawasaki disease. IgG, IgA, IgM and IgG subclasses were measured using immunoprecipitation and EIA in the sera of patients with Kawasaki disease. The results were as follows: 1) Acute phase reactants such as CRP and ESR were significantly increased in Kawasaki patients compared to those in control patients(p<0.01). 2) Serum IgG levels in Kawasaki disease were markedly increased than those in control patients, while serum IgA and IgM levels showed no significant changes (P: No Significance). 3) IgG1 and IgG4 were predominantly increased increased in the sera of Kawasaki patients, while IgG2 and IgG3 were not significantly increased (P: No Significance). With these results, unidentified infectious organism with abnormal immune response could be suggested as an etiologic factor of Kawasaki disease.
Acute-Phase Proteins ; Anti-Bacterial Agents ; Child* ; Coronary Vessels ; Exanthema ; Fever ; Humans ; Immunoglobulin A ; Immunoglobulin G* ; Immunoglobulin M ; Immunoglobulins ; Immunoprecipitation ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome* ; Mucositis ; Vasculitis

Apocrine poroma is a benign cutaneous adnexal neoplasm differentiating in the direction of sebaceous and apocrine glands, and follicular germs. The clinical appearance of apocrine poroma is not distinctive, and the histologic finding is similar to that of eccrine poroma, which is typified by proliferation of poroid and luminal cells in continuity with the epidermis. But sebaceous, apocrine or follicular differentiation may also be found in the case of apocrine poroma. We herein report a case of apocrine poroma on the scalp. This case exhibited apocrine and sebaceous differentiation, and connection to an adjacent follicular epithelium.
Apocrine Glands ; Epidermis ; Epithelium ; Phenobarbital ; Poroma* ; Scalp

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

To evaluate the effect of shortening the latent period for distraction osteogenesis, the authors experimented with distraction osteogenesis for a 24-hour latent period in the mandibles of rabbits. This study was carried out on 32 New Zealand white rabbits, each weighting 2000 to 2500 gm. Twenty animals were used for the control group and 12 for the experimental group. A unilateral external fixation device was applied to the left mandible. The mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from the control group and three from the experimental group by random selection were sacrificed on the first day, and at the second, fourth and eighth week of the consolidation period. After lengthening bone densities at the site of the left mandibular bony lengthening were measured by quantitative computer tomography (QCT) and dual energy x-ray absorptiometry (DXA). As a result, the DXA value showed no difference compared to the control group after two week's consolidation. The trabeculae were thicker and had begun to be surrounded by lamellar bone both in the control and experimental groups histologically. In conclusion, the results of this study indicate that the osteogenetic effect in the experimental group was nearly the same as in the control group. If stable fixation and minimal periosteal dissection were performed during the procedure, the latent period would not be an important factor in distraction osteogenesis of membranous bone.
Absorptiometry, Photon ; Animals ; Bone Density ; External Fixators ; Mandible* ; Osteogenesis* ; Osteogenesis, Distraction ; Rabbits*