PURPOSE: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. MATERIALS AND METHODS: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. RESULTS: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). CONCLUSION: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.
Early Diagnosis ; Female ; Humans ; Lower Extremity ; Lymph Nodes ; Male ; Melanoma ; Neoplasm Metastasis ; Survival Rate ; Upper Extremity

We experienced 3 cases of sporotrichosis confined to the face. They were lymphatic type, pustular type and fixed ulcerative type of cutaneous sporotrichosis respectively. Two types of them except the lymphatic type were very difficult to be diagnosed correctly with clinical features. So, we reviewed the types of sporotrichosis and the problems in establishing the diagnosis. 3 cases are as follows: Case l. A 57 years old female second hand dealer had a ulceration measuring 2-2cm in diameter on the right dorsum of the nose after injuring with sharp rusty iron material. Soon after ulceration healed, 5 beaded nodules measuring 0.5-1cm in diameter newly developed on the right side of the maxillary area. Case II. A 55 years old female house wife had a suppurated ulcer with serous exudate, which looked like impetigenous lesions, on the left mandibular area, without any apparent trauma history. Case III. A 52 years old female had a rice grain sized papule, which was grown slowly in size, on the left maxillary area without any apparent trauma history. Skin graft was performed after excision of the nodule, because it was diagnosed as skin cancer at a local clinic. A large ulceration with necrosis of the tissues developed on the very site of skin graft performed, accompanied by a bean sized nodule below the ulceration.
Edible Grain ; Diagnosis ; Exudates and Transudates ; Female ; Hand ; Humans ; Iron ; Middle Aged ; Necrosis ; Nose ; Skin ; Skin Neoplasms ; Sporotrichosis* ; Spouses ; Transplants ; Ulcer

Two cases with generalized G.A. were described. The first case was 42 years, old farmer representing slightly erythematous multiple papulonodular lesions on the face, neck, scapular areas, arms and dorsal hands. Coalescence of lesions in some areas of the dorsal hands and neck produced circinate or polycyclic pattern. The second case was 4 years old girl who developed purple to brown muliple papulonodular lesions and polygonal or round plague on the arms, dorsal hands, palms, neck, iliac crests, lower legs, dorsal feet and sole. The plague lesions mimick lichen planus.
Arm ; Child, Preschool ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Hand ; Humans ; Leg ; Lichen Planus ; Neck ; Plague

A case of sporotrichosis, developed on left upper eyelid in 2 weeks after double eyelid operation, was presented. Eruptions were distributed along the operation site and similar to pyoderma or keloid. Painless subcutaneous nodule appeared near the lateral angle of eye in 8 months after onset. Sporotrichum schenckii was cultivated from the tissue fluid of the lesion. PAS positive spores were found extra-cellularly and in histiocytes and multi-nucleated giant cells.
Eyelids* ; Giant Cells ; Histiocytes ; Keloid ; Pyoderma ; Spores ; Sporothrix ; Sporotrichosis*

A case of acquired lymphangioma was reported and the literature was reviewed. The patient was 28 yeara old pregnant woman at 7 months gestation who develo- ped multiple white-gray tense vesicles measuring 2-4mm in diameter on bilateral major labia following lymphedema of the lower extremities due to tubercuIous inguinal lymphadenitis.
Female ; Humans ; Lower Extremity ; Lymphadenitis ; Lymphangioma* ; Lymphedema ; Pregnancy ; Pregnant Women ; Transcutaneous Electric Nerve Stimulation

PURPOSE: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. MATERIALS AND METHODS: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. RESULTS: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. CONCLUSION: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.
Femur ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Joints ; Medical Records ; Survival Rate

STUDY DESIGN: This is a retrospective study. OBJECTIVES: The purpose of this study is to confirm the clinical usefulness of utilizing ProSet imaging for checking the nerve root compression and swelling in extraforaminal disc herniation. SUMMARY OF LITERATURE REVIEW: Diagnosing extraforaminal disc herniations can be neglected with using a conventional MRI. MATERIALS AND METHODS: A retrospective analysis was performed on 25 patients, who underwent both conventional & Principles of the selective excitation technique (ProSet) MR imaging for the evaluation of extraforaminal disc herniation, from April 2008 to October 2010. Radiographic analysis was based on the notion that the degree of nerve root compression and swelling was decided by Pfirrmann's classification. RESULTS: Severe compression in the ProSet 3D rendering image was observed in 21 subjects, as compared with 8 subjects in the conventional axial image. Especially, nothing was ever detected in the conventional sagittal image. Severe compression in the ProSet 3D rendering image was observed in 4 subjects, while their nerve root compression was not clear in the conventional axial image. Severe compression and severe swelling in the ProSet 3D & coronal image was observed in 15 subjects, while their nerve root compression was none or not clear in the conventional sagittal image. The swelling degree of the ProSet coronal image turned out bigger than the swelling degree of conventional axial image, and the signal intensity change was also obvious. CONCLUSIONS: ProSet imaging is regarded useful to investigate the symptom triggering nerves, because ProSet image not only observes better nerve root compression, but also identifies the swelling degree more easily than that of the conventional magnetic resonance imaging (MRI).
Humans ; Magnetic Resonance Imaging ; Radiculopathy ; Retrospective Studies

Thrombotic thrombocytopenic purpura (TTP) in the acute postoperative setting is a syndrome that presents with various symptoms such as microangiopathic hemolytic anemia, thrombocytopenia, fever, renal failure, and change of the patient's mental status. Though most of the previous reports of postoperative TTP have been in conjunction with cardiac or vascular surgery, it has also been reported following orthopedic and abdominal surgeries. We present here a case of a 78 year-old female who was diagnosed with rectal cancer and who developed TTP the 2nd day following her cancer surgery. Because the presentation can be confused with other early postoperative complications, TTP should be considered in the differential diagnosis of the patient who develops unexplained anemia and thrombocytopenia following an abdominal surgery. Awareness of this syndrome is essential because starting plasmapheresis early can be life-saving.
Anemia ; Anemia, Hemolytic ; Diagnosis, Differential ; Female ; Fever ; Humans ; Orthopedics ; Plasmapheresis ; Postoperative Complications ; Purpura, Thrombocytopenic ; Purpura, Thrombotic Thrombocytopenic ; Rectal Neoplasms ; Renal Insufficiency ; Thrombocytopenia ; Thymine Nucleotides

PURPOSE: This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady. MATERIALS AND METHODS: A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed. RESULTS: For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p< or =0.05, respectively) and the age at the time of diagnosis was younger (p< or =0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p< or =0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (> or =60 years) and a N1-2 and M1 status were the independent risk factors for overall survival. CONCLUSION: The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.
Adenocarcinoma, Mucinous ; Colectomy ; Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Humans ; Incidence ; Male ; Multivariate Analysis ; Risk Factors ; Splenectomy

Purpose: This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure. Methods: Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups. Results: LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012). Conclusion Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.