PURPOSE: The surgical treatment of anal stenosis includes internal sphincterotomy, rotaton flap and advancement flap according to the stenosis degree, recently, Christensen performed house shaped advancement flap and reported fair results. We compared and analyzed the surgical methods and results in patients with moderate and severe anal stenosis who underwent house shaped advancement flap and C-anoplasty. METHODS: We have performed this study with 6 cases using the house shaped advancement flap and 6 cases using the C-anoplasty. The out come was assessed by clinical characteristics, surgical method, operation time, duration of hospitalization, healing time, postoperative complications, results. RESULTS: The average operation time was 38 min in those house shaped advancement flap cases and 63 min in C-anoplasty cases. The average time of hospitalization was 6 days and 9 days, respectively, and the average time of healing was 28 days and 46 days, respectively. In those house advancement flap cases, surgery could be done in 2 directions at the same time in 4 cases and 3 directions in 2 cases; as for those C-anoplasty cases, surgery could be done in 1 direction in 4 cases and 2 directions in 1 case. Two complications were observed in C-anoplasty, one flap infection and one flap necrosis, and in house shaped advancement flap, no complication was observed. CONCLUSIONS: House shaped advancement flap have several advantages compared to the C-anoplasty, and since house shaped advancement flap could be performed in 2 to 3 directions or even 4 directions at the same time, the anus could sufficiently expanded in severe anal stenosis patients. The house shaped advancement flap might be one of the good method in treating anal stenosis.
Anal Canal ; Constriction, Pathologic* ; Hospitalization ; Humans ; Necrosis ; Postoperative Complications

No abstract available.
Cystectomy* ; Lasers, Gas* ; Volatilization*

Ankle arthrodesis has been regarded as a good operative treatment for post traumatic and rheumatoid arthritis of ankle, and ankle arthroplasty has been also developed with several types, from 1970, by Lord & Marotte. Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come. The authors operated 6 cases of total ankle arthroplasty for posttraumatic and rheumatoid arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Prosthesis Design

Hydrochlorothiazide is a diuretic drug used in the treatement of edema and hypertension. We report a case of hydrochlorothiazide induced photosensitivity in a 54 year old woman who had taken hydrochlorothiazide for 3 years for hypertension. She complained of itching and burning sensation with erythematous papules and lichenified plaques on light-exposed areas. Fhototest showed marked decrease of the minimal erythema dose(MED) for UVA. The symptoms subsided after the use of topical steroid and the substitution atenolol for hydrochlorothiazide.
Atenolol ; Burns ; Edema ; Erythema ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Middle Aged ; Pruritus ; Sensation

Pneumomediastinum is a relatively uncommon, infrequently reported entity, In the evaluation of these entity, it is important to exclude pathological causes, including Boerhaave's syndrome which carries a high mortality. Spontaneous pneumomediastinum is related to excessive intraalveolar pressure leading to rupture of perivascular alveoli in the setting of a Valsalva maneuver without communication to gut material. So, it has a benign self-limited course and rarely requires medical intervention. On the contrary, secondary pneumomediastinum caused by instrumental, traumatic, and spontaneous perforation of esophagus. Although the prognosis have been improved since the advent of broad-spectrum antibiotics and nutritional support, pneumomediastinum due to esophageal perforation still has a high morbidity and mortality. The most important prognostic factor is the time interval between perforation and initiation of therapy, and an awareness and a high clinical suspicion is critical in the early diagnosis and treatment. Recently, we have experienced 2 cases of pneumomediastinum, one case was spontaneous pneumomediastinum and the other may be caused by instrumental esophageal perforation. We report the clinical course of the patients with a current literature review.
Anti-Bacterial Agents ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Fibrinogen ; Humans ; Mediastinal Emphysema* ; Mortality ; Nutritional Support ; Prognosis ; Rupture ; Valsalva Maneuver

No abstract available.
Daegu* ; Gyeongsangbuk-do* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymorphism, Restriction Fragment Length*

Zygomatic arch fracture is one of the most commonly seen facial bone fractures and there have been many methods of reduction designed so far. However, for a simple fracture, the Gillies temporal approach is most commonly used because of the easy reducibility, and also because the depressed fracture can be approached without a facial incision. The Gillies temporal approach starts in the temporal area, between the temporalis muscle and deep temporal fascia. We have developed a new route which starts in the postauricular hair margin area and then reaches to the periosteum of the temporal bone. An elevator is then inserted to penetrate the periosteum and subperiosteal dissection is performed toward the zygomatic process of the temporal bone. At the origin of the zygomatic process, the route of dissection changes to the posterior aspect of the zygomatic arch using a curved palate elevator or the authors' modified Langenbeck elevator. This method of approach has been used in 6 cases of zygomatic arch fracture with good results and we report this method along with written reports.
Elevators and Escalators ; Facial Bones ; Fascia ; Hair ; Palate ; Periosteum ; Temporal Bone ; Zygoma*

Trichogenic tumors are a very rare group of primary cutaneous neoplasms and a few tumors have been recognized. Trichofolliculoma is a benign, papular, organoid adnexal tumor of the skin and presents as a solitary skin-colored nodule. We report six cases of trichofolliculoma occurred in Korean patients consisting of three male and three female patients. The duration of disease was variable from 3 months to 5 years. The site of tumor was limited to the face and included eyelid in two cases, nose in two cases, cheek and posterior aspect of ear in each one case. The size of the mass varied from 4 to 8 mm in diameter. Microscopically, all the cases showed large central cystic hair follicle with numerous secondary follicular buds, producing a radiating pattern. The stroma was fibrotic and well demarcated from the adjacent dermis.
Cheek ; Dermis ; Ear ; Eyelids ; Female ; Hair Follicle ; Humans ; Male ; Nose ; Organoids ; Skin

Fibrous dysplasia is a benign bony disorder that contains trabeculae of poorly calcified primitive bone formed by osseous metaplasia. It is also characterized by replacement of normal spongiosa by abnormal fibrous tissues. We retrospectively analyzed the computed tomographic (CT) findings of 29 cases with clinically and radiologically diagnosed craniofacial fibrous dysplasia. In 2 cases, only cranial bones were involved and in 7 cases only facial bones were involved. Involvements of both cranial and facial bones were noted in the remained 20 cases. The commonly involved bones in the decreasing order of frequency were as follows: frontal, sphenoidal, ethmoidal and temporal bones in cranium and maxilla, zygoma, lacrimal bones and mandible in facial bones. Even though plain films are enough to diagnose the fibrous dysplasia, we think that CT is useful in more accurate diagnosis by demonstrating amorphous "ground-glass" appearance in the lesion and defining the exact extent of craniofacial fibrous dysplasia.
Diagnosis ; Facial Bones ; Mandible ; Maxilla ; Metaplasia ; Retrospective Studies ; Skull ; Temporal Bone ; Zygoma

Colon cancer is a major cause of cancer deaths in Western countries and is increasing rapidly in the East where Western nutrition and life-styles are being adopted. About 75% of the individuals with colon cancer will have a primary surgical resection with the hope of complete tumor eradication. Despite the high resectability rate and a general improvement in therapy, nearly half of all patients with colon cancer still die of metastatic tumor. Over the past three decades, many clinical studies have failed to demonstrate benefits from adjuvant therapy. Recently, new data from several studies have demonstrated delays in tumor recurrence and increase in survival for specific groups of patients. (Objectives) This study was designed to evaluate the efficacy of 5-fluorouracil plus low-dose leucovorin as postoperative adjuvant therapy for patients with Dukes' stage B and C colon cancer. (Methods) Eighty seven patients with surgically resected colon cancer in Dukes' stage B and C from Jan 1991 to Dec 1994 were included in this study and divided into two groups. First group (LF arm) included 53 patients who received combination chemotherapy of 5-FU and low-dose leucovorin following surgical resection of colon cancer and the second group (control arm) included 34 patients who received no adjuvant treatment. 5-FU and low-dose leucovorin chemotherapy consisted of leucovorin 20mg/m2, intravenously, plus 5-FU 400mg/m2, intravenously, on days 1-5 every 4 weeks for 12 cycles. (Results) There were significantly less recurrences and distant failure in LF arm than in the control arm. The 4-year disease-free survival rate was 84.2% in LF arm and 54.5% in control arm(p=0.0074). The 4-year overall survival was 89.7% in LF and 48.4% in control arm(p=0.0005). The suvival differences between LF arm and control arm were significant in Dukes' stage B and C respectively. Age of patients, number of metastatic lymph nodes, histologic differentiation and whether or not patients received 5-FU/Leucovorin chemotherapy, were each found to have prognostic significance. (Conclusions) This study strongly suggests that treatment with 5-FU plus low-dose leucovorin significantly prolongs disease-free survival and results in a significant benefit relative to overall survival in patients with surgically resected Dukes' stage B and C colon cancer.
Arm ; Chemotherapy, Adjuvant ; Colon* ; Colonic Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil* ; Hope ; Humans ; Leucovorin* ; Lymph Nodes ; Recurrence