Primary malignant melanornn of the vagina is rare, with only about 130 reported cases worldwide. They presumably arise from melanocytes that are present in the vagina in 3% of normal wornen. Vaginal melanoma accounts for less than 1% of melanomas and less than 3% of primary malignant tumors of the vagina. Most of patients complain vaginal bleeding, vaginal discharge, foreign body sensation in order. The best treatment of vaginal melanoma rernains eni.gmatic, Many authors indicate that radical surgery may be the pcferred approach and the number of reported cases treated with radical surgery is increasing. But other author comment that no significant change in survival is apparent with radical surgery. Overall prognosis is poor as most patients have deeply penetrating lesions at the time of diagnosis. Recently, not only the effort to increase the survival rate but the quality of life including sexual function after treatment is becoming an important issue about treatment ot cancer patients. We experienced a case of primary malignant melanoma of the vagina treated with radical surgery and restored the sexual function by vulvovaginal reconstruction using gracilis myocutaneous flap. So we report this case with brief literature review.
Diagnosis ; Foreign Bodies ; Humans ; Melanocytes ; Melanoma* ; Myocutaneous Flap ; Prognosis ; Quality of Life ; Sensation ; Survival Rate ; Uterine Hemorrhage ; Vagina* ; Vaginal Discharge

Extraskeletal bone-forming lesions are myositis ossificans, fibrodysplasia(myositis) ossificans progressiva, and extraskeletal osteosarcoma. It is of paramount importance to clearly distinguish these lesion from extraskeketal osteosarcoma. Myositis ossificans, by far the most common among these lesions, is a benign, ossifying process that is generally solitary and well circumscribed. It is found most commonly in the musculature, but it may also occur in other tissue, especially in tendons and subcutaneous fat. It occur as the result of various kinds of soft tissue injury(surgical scars, burns, dislocation of joints etc.) and also observed in patients with tetanus, in paraplegics secondary to traumatic spinal injury. Although there is general agreement that myositis ossificans is a nonprogressive benign process without nerplastic potential, its pathogenesis is still poorly understood.We experienced a myositis ossificans associated with chronic, extensive pressure sore in patient with paraplegia secondary to spinal injury.
Burns ; Cicatrix ; Dislocations ; Humans ; Joints ; Myositis Ossificans* ; Myositis* ; Osteosarcoma ; Paraplegia ; Pressure Ulcer* ; Spinal Injuries ; Subcutaneous Fat ; Tendons ; Tetanus

No Abstract Available.
Blepharoplasty*

There remains many difficult problems for plastic surgeons when they try to reconstruct soft tissue defect, especially defect on lower extremity with poor vascularity. We experienced two kinds of artificial dermis, Alloderm (LifeCell Corporation, USA) and Terudermis(Terumo, Japan). We applied them for 12 patients from October 1998 to May 1999. Their wounds had various causes. The authors debrided the necrotic tissue and got the artificial dermis soaked enough in saline. After fixing the artificial dermis with suture fixation, thin STSG was harvested. Applying the thin STSG on artificial dermis and Tie-over dressing were done to prevent mobilization. From our experience we had several suggestions to keep in mind. Preoperatively, you have to decrease the discharge with frequent dressing change. Intraoperativeiy, in order to avoid the mobilizaion between the artificial dermis and STSG, you have to fix them well with suture fixation. Postoperatively, the larger is the exposed bone or tendon, the longer the splint applying time is required. Nine patients out of 12 patients(75%) had no problem. Three patients underwent partial loss. Two patients suffered from infection or rough dressing. One patient failed due to careless mobilization before the artificial dermis is completely settled. The authors recommend to appky the artificial dermis rather than more aggressive procedures when the wound size is smaller than 2 x 4 cm with bone or tendon exposure. The authors think that the artificial dermis is also very useful to prevent postoperative scar contracture.
Bandages ; Cicatrix ; Contracture ; Dermis* ; Humans ; Lower Extremity ; Splints ; Sutures ; Tendons ; Wounds and Injuries

No abstract available.
Brain* ; Meningitis* ; Tuberculoma*

Neurothekeoma is a relatively uncommon tumor of nerve sheath origin. Most of these tumors are benign and malignant transformation was not reported. Usually, these tumors arise during childhood or early adulthood life with female preponderance. They have a predilection for the head, neck and shoulder region but any part of the body may be affected. Their usual size is between 0.5-3.0 cm. Rapid growth and ulceration are rare, and local recurrence tends to occur after incomplete excision. We report a case of neurothekeoma developed in the scalp of a 21-year-old woman. It was first noticed about 1year ago. This mass had been increasing in size slowly. On physical examination, 2 x 1.5 cm sized papule with localized alopecia was identified on the frontal scalp area. It was excised in 5.5 x 3.6 cm. The histologic finding of the lesion showed that lobules, fascicles or rests of spindle shaped or epitheloid cells in a myxoid of mucosubstance. The tumor cells were positive for S-100 and vimentin but showed negative for EMA, cytokeratin, desmin, actin and HMB45. After surgical excision of tumor, split-thickness skin graft was done. Three months after the operation, rectangular shape tissue expander (180 cc Sebbin(R)) was inserted on both sides of the previous wound. After removal of tissue expander, the wound closed with local flap. The patient did not have any evidence of recurrence for 6 months.
Actins ; Alopecia ; Desmin ; Female ; Head ; Humans ; Keratins ; Neck ; Neurothekeoma* ; Physical Examination ; Recurrence ; Scalp* ; Shoulder ; Skin ; Tissue Expansion Devices ; Transplants ; Ulcer ; Vimentin ; Wounds and Injuries ; Young Adult

This study is designed to draw out new integrated subjects of the Korean Oriental Pharmacists' Licensing Examination (KOPLE). In 2004, for the revision of subjects, we have analyzed the curriculums of the Oriental Pharmacy department, the oriental pharmacist's (OP's) job description book, and the elementary items of KOPLE. We also examined the system of the Chinese Herb Pharmacists' Examination and other health personnel licensing examinations and studied the data of items and compared them with KOPLE. We heard the public opinion on the present KOPLE. We developed a subfield of 18 subjects, a middle category of 188 items, and a small category of 1,026 items. We proposed a new KOPLE that consists of three subjects: basic oriental pharmacy, applied oriental pharmacy, and laws and regulations.
Asian Continental Ancestry Group ; Curriculum ; Health Personnel ; Humans ; Job Description ; Jurisprudence ; Licensure* ; Pharmacy ; Public Opinion ; Social Control, Formal

Torsades de pointes (TdP) is a form of polymorphic ventricular tachycardia associated with a prolonged QT interval or increased U wave. It may occur either in the congenital(idiopathic) form or in the aquired form. Although aquired TdP could be found in many clinical settings such as various drugs, bradycardia, or electrolyte imbalance, it is most commonly induced by drugs. The underlying mechanism is though to be the triggered activity arising as a consequence of early afterdepolarization. Phenothiazine has many derivatives that can lead to occur the cardiovascular events including hypotension, syncope, tachycardia and various ECG changes. Chloropromazine is a propylamine derivative of phenothiazine. We report a case of TdP occurred after chloropromazine usual dosage.
Bradycardia ; Chlorpromazine ; Electrocardiography ; Hypotension ; Syncope ; Tachycardia ; Tachycardia, Ventricular ; Torsades de Pointes*

Osteoma is a benign tumor arising from cancellous or compact bone. Frontal sinus is the most common site, followed by the ethmoidal sinus, maxillary sinus, sphenoidal sinus, maxilla and mandible. Very few cases involving the mandible have been described. A 26-year-old woman who had a limited range of mouth opening was reffered to our clinic. The limited opening had been gradually increasing in severity after first operation(reduction malarplasty and angle resection). Computed tomography images showed a radiopaque mass between left mandibular notch and zygomatic arch. After surgical removal of mass, diagnosis of mass was osteoma from clinical pathology. The postoperative course was uneventful, the patient could open the mouth about 40 mm, 5 months after the operation.
Adult ; Diagnosis ; Female ; Frontal Sinus ; Humans ; Mandible ; Maxilla ; Maxillary Sinus ; Mouth ; Osteoma* ; Pathology, Clinical ; Sphenoid Sinus ; Zygoma

Primary small intestinal lymphoma is relatively uncommon. Small bowel tumors are difficult to diagnose, because they are usually asymptomatic in the initial phase, and they are not easily detected by traditional methods of investigating the small intestine. This case shows a successfully detected and treated gastrointestinal bleeding from rare ileal mucosa-associated lymphoid tissue lymphoma, using double balloon endoscopy.
Aged ; Arteries ; Capsule Endoscopy ; Constriction, Pathologic ; Gastrointestinal Hemorrhage ; Humans ; Ileal Neoplasms/*diagnosis/pathology ; Intestinal Mucosa/pathology ; Lymphoid Tissue/*pathology ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology ; Male