No Abstract Available.
Blepharoplasty*

No abstract available.
Appointments and Schedules*

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

OBJECTIVE: The patients with spinal cord injury (SCI) suffered by a lot of complications that influence the quality of life both physically and mentally. The purpose of this study was to evaluate the epidemiology of patients with spinal cord injury in incidence of the complication according to the injury level and period. METHOD: Retrospective study was done in 554 patients with SCI who discharged from Yonsei University Medical Center from January, 1987 to December, 1996. We investigated the incidence of each complication such as respiratory, cardiovascular, genitourinary, musculoskeletal, and dermatologic complications according to the neurologic level and each period (1987~1991, 1992~1996). RESULTS: Among the 554 cases, urologic complication (40.3%) was the most common complication followed by dermatologic (39.0%), musculoskeletal (33.6%), cardiovascular (27.1%) and so on. The most common complications of each system were autonomic dysreflexia (13.2%) in cardiovascular, pneumonia (9.6%) in respiratory, contracture (27.8%) in musculoskeletal, urinary tract infection (34.3%) in urologic, hemorrhoid in gastrointestinal, and central pain (24.0%) in neurogenic complications. The most common site of pressure sore was sacral area (58.9%). There was no significant difference in each complication according to the injury period. CONCLUSION: Urologic complication was the most prevalent in patients with SCI followed by dermatologic, musculoskeletal and so on. These basic results would be helpful for prevention and management of the complication of SCI.
Academic Medical Centers ; Autonomic Dysreflexia ; Contracture ; Epidemiologic Studies* ; Epidemiology ; Hemorrhoids ; Humans ; Incidence ; Pneumonia ; Pressure Ulcer ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Tract Infections

Purpose: The antitumor activity and toxicity of keyhole limpet hemocyanin (KLH) on bladder carcinomas induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) were investigated. Materials and Methods: Sixty 6 to 8-week-old female C3H2 mice were divided into three groups. Bladder carcinomas were induced by the addition of 0.05% BBN to the drinking water for 8 weeks. Group A received an intravesical instillation of 0.25ml KLH-free buffer, Group B received 0.5mg KLH in 0.1ml buffer subcutaneously and Group C received an intravesical instillation of 2mug KLH in 0.25ml buffer twice weekly for 8 weeks (day 15 to day 70). On day 91, all the animals were sacrificed. The tumor incidence, bladder weight and toxicity were evaluated. Results: The incidences of cancer in groups A, B and C were 80, 40 and 60%, respectively. The incidence of cancer was significantly reduced in group B compared to group A (p<0.05). The average bladder weights were 93.63+/-17.746, 71.5+/-7.540 and 77.5+/-9.530mg in groups A, B and C, respectively. The bladder weights in groups B and C were significantly reduced compared to group A (p<0.05). There was no liver, kidney or bone marrow toxicities in groups B and C. Conclusions: These results suggest that KLH act as an effective and safe immunotherapeutic agent for bladder cancer. Prospective randomized clinical trials should be used to evaluate the role of KLH as an immunotherapeutic agent in the prophylaxis of recurrent bladder cancer.
Administration, Intravesical ; Animals ; Bone Marrow ; Drinking Water ; Female ; Hemocyanin* ; Humans ; Immunotherapy ; Incidence ; Kidney ; Liver ; Mice* ; Models, Animal ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Weights and Measures

No abstract available.
HLA-DR Antigens* ; Thyroid Gland* ; Thyroid Neoplasms*

The association of thyroid carcinoma and Hashimotos thyroiditis in same thyroid gland is controversial. Incidence of carcinoma who has Hashimotos thyroiditis has been reported from 0.5 to 22.5 per cent by Crile and by Hirabayashi et al. The reason that there are such great diffarences in the reported incidences of carcinoma in Hashimotos disease is the result of the way the material is reported. The carcinomas of the thyroid which occur in association with Hashirnotos thyroiditis are predominently papillary tumors of lower grade malignancy. Thyroid carcinoma need not be feared in patimts with Hashimotos thymiditis, if one examines the ghmd catefully. When patients with Hashimotos disease are treated with thyroxine, there is little or no tendency for Hashimotos disease propess to clinieally detectable carcinoma of the thymid, and the microcarcinoma does not appear. In this case, single thyroid nodule was detected in Hashiimotos disease patient who was treated with thyroxine. There was no significant volume change of thyroid nodule despite of TSH suppression therapy during six months. Therefore we perforrned FNABC twice, the results were highly suspicious thyroid malignancy and subtotoal thyroidectomy was performed. The final pathologic result was microscopic papillary carcinoma with background Hashlmotos thyroiditis. In conclusion, we experienced a case of subsequent microscopic papillary carcinoma of the thyroid in patient with Hashimotos thyroiditis who was TSH suppression therapy with thyroxine.
Carcinoma, Papillary ; Hashimoto Disease ; Humans ; Incidence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis ; Thyroxine

No abstract available.
Humans ; Polyamines*

Ureteroscopy has been used widely to remove urethral calculi, especially distal ureter stones. In this study we tried to evaluate the exact role of ureteroscopic manipulation for ureter stones in the era of ESWL. We report our experience on performing ureteroscopic removal of ureteral calculi without anesthesia. Between August 1994 and August 1996, ureteroscopy was performed in 62 cases without anesthesia. We examined the feasibility of performing ureteroscopy under sedation only. Age distribution was 17~71 years old (mean 49.3). Overall success rate was 91.9% (57 cases among 62 cases). The success rates according to sex were 92.9% in male and 91.2% in female. The success rates according to location were 100% in proximal ureter, 83.3% in middle ureter and 92.6% in distal ureter. The success rates according to size were 92.7% in < or =10 mm and 85.7% in >10 mm stone patients. We could not find any statistical meaning about the success rates according to sex, location and size (p>0.05). In 7 cases the procedure were performed at outpatient department. Mean duration of hospitalization (in 55 cases) was 3.83 days. The associated complication rate was relatively low (8.1%), with most patients being treated conservatively. We conclude that ureteroscopy, when performed without general or regional anesthesia, does not increase the risk of complications or compromise the results of treatment. So we recommend ureteroscopy without anesthesia as a primary choice in the manipulation of urethral calculi.
Age Distribution ; Anesthesia* ; Anesthesia, Conduction ; Calculi ; Female ; Hospitalization ; Humans ; Male ; Outpatients ; Ureter* ; Ureteral Calculi* ; Ureteroscopy