High-voltage electrical burn injuries on the scalp often result in scalp and cranial bone necrosis. Repetitive debridements and rich-vascularized flap coverage of the cranium are required. However, despite successful flap coverage, chronic osteomyelitis of cranial bones may occur. Treatment of chronic osteomyelitis of cranial bones is surgical debridement of the necrotic bone with re-coverage by a well-vascularized flap. The latissimus dorsi musculocutaneous flap is suitable not only for coverage of the cranium after the burn injury, but also for treatment of chronic osteomyelitis of the skull.

No abstract available.
Ovarian Neoplasms* ; Prognosis

Thrombocytosis(a platelet count>400,000/mm3) is found to be frequently in association with malignant disease and recently has been suggested to be a poor prognostic indicator in patients with certain cancers. The objective of this retrospective study was to determine the relevance of a preoperative platelet count in ovarian cancer with a possible prognostic significance of thrombocytosis in this disease. Between June 1989 and December 1995, eighty-five patients with epithelial ovarian cancer were evaluated, who were managed at Asan Medical Center by cytoreductive surgery and chemotherapy, and had at least 6 months' follow-up. Prevalence of thrombocytosis was 22.4% and significantly correlated with FIGO stage(p=0.003), histologic subtype(p=0.002), tumor grade(p=0.040), performance status of patient(p=0.006) and preoperative serum CA 125 level(p=0.002). And the linear regression analysis revealed a significant correlation(p<0.001) between platelet count and preoperative serum CA 125 level, which suggested that platelet count was positively associated with tumor volume. No difference in survival between patients with or without thrombocytosis was found(p=0.68), whereas residual tumor size and serum CA 125 level after 2nd chemotherapy were found to be independent prognostic factors. In conclusion, thrombocytosis is not a useful prognostic factor in epithelial ovarian cancer, but significantly associated with tumor volume.
Blood Platelets ; Chungcheongnam-do ; Drug Therapy ; Follow-Up Studies ; Humans ; Linear Models ; Neoplasm, Residual ; Ovarian Neoplasms* ; Platelet Count ; Prevalence ; Retrospective Studies ; Thrombocytosis* ; Tumor Burden

Pulmonary sequestration is a relatively rare congenital anomaly in which a mass of abnormal pulmonary tissue without a normal connection to the tracheobronchial tree receives its blood supply from one or more anomalous systemic arteries. Its incidence increased as prenatal ultrasound become a routine component of prenatal care. We report one case of intra-abdominal extralobar pulmonary sequestration detected by prenatal ultrasound and diagnosed at surgery after birth.
Arteries ; Bronchopulmonary Sequestration* ; Incidence ; Parturition ; Prenatal Care ; Ultrasonography*

Benign intestinal tumors are rare in infancy, however the authors describe an inflammatory myofibroblastic tumor (IMT) of the mesentery in a 3-month-old infant who was diagnosed incidentally. During operation, huge mass which was attached to proximal jejunum was resected, from which a histological diagnosis of IMT was made. A review of the literature for this rare condition was done to delineate the natural history of this tumor. Because of the risk of local recurrence and malignant transformation, IMT cases needed a long-term follow up.
Follow-Up Studies ; Humans ; Infant ; Jejunum ; Mesentery ; Myofibroblasts ; Natural History ; Recurrence

Huge chondrosarcoma is a rare form of primary malignant tumor of the chest wall. We operated on a 60 year old female patient who had a huge anterior chest wall mass with local invasion into the pericardium and satellite tumors on the visceral pericardium of the heart. En-bloc resection of the huge tumor including both upper 3 ribs, both clavicles, manubrium of the sternum, pleura, and pericarium, was followed by complex chest wall reconstruction using a Gore-tex soft tissue patch and latissimus dorsi musculocutaneous free flap.
Chondrosarcoma* ; Clavicle ; Female ; Free Tissue Flaps ; Heart ; Humans ; Manubrium ; Mediastinal Neoplasms ; Middle Aged ; Pericardium ; Pleura ; Polytetrafluoroethylene ; Ribs ; Sternum ; Superficial Back Muscles ; Surgical Flaps ; Thoracic Wall* ; Thorax*

Several medications are associated with the production of crystals that are insoluble in human urine. Intratubular precipitations of these crystals can lead to acute renal insufficiency. Many patients who require treatment with these medications have additional risk factors, such as volume depletion, underlying renal insufficiency and immunocompromised state that increase the risk of drug induced intrarenal crystal deposition. We experienced a case of crystal-induced acute renal failure due to acyclovir in a 44 year-old male renal allograft recipient. He was diagnosed as Varicella Zoster at 12 days after transplantation, and treated with intravenous (IV) acyclovir (IV infusion of acyclovir 250 mg mixed with normal saline 100 mL within several minutes three times a day, total seven times). Two days after initiation of IV acyclovir, serum BUN was increased up to 160 mg/dL, serum creatinine was increased up to 9.9 mg/dL and urine output was decreased to anuria. With discontinuation of acyclovir, hemodialysis was started as treatment of renal insufficiency. Renal function was restored after discontinuation of acyclovir.
Acute Kidney Injury* ; Acyclovir* ; Adult ; Allografts ; Anuria ; Chickenpox ; Creatinine ; Herpes Zoster ; Humans ; Male ; Renal Dialysis ; Renal Insufficiency ; Risk Factors

Basaloid squamous cell carcinoma of the uterine cervix is an extremely rare malignancy of the female genital tract with a poorer clinical outcome than squamous cell carcinoma of the uterine cervix. We report a case of pure basaloid squamous cell carcinoma of the uterine cervix. A 70-yr-old woman with vaginal bleeding was referred to our institute. A basaloid squamous cell carcinoma of the uterine cervix, of International Federation of Gynecology and Obstetrics (FIGO) stage Ib1, was diagnosed by a loop electrosurgical excision procedure cone biopsy. A radical hysterectomy was performed, along with bilateral salpingo-oophorectomy, pelvic lymph node dissection, and para-aortic lymph node sampling. Pathologic findings were consistent with a basaloid squamous cell carcinoma confined to the cervix without an extracervical tumor. No further treatment was administered and there was no clinical evidence of recurrence during the 12 months of follow-up. Follow-up for the patient is ongoing. Although basaloid squamous cell carcinoma of the uterine cervix is thought to behave aggressively, accumulation of data on these rare tumors is necessary to determine whether their behavior differs significantly from that of conventional cervical squamous cell carcinoma of similar clinical stage. These data would be useful for defining the best diagnosis and treatment for these rare tumors.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Female ; Humans ; Hysterectomy ; Magnetic Resonance Angiography ; Uterine Cervical Neoplasms/*diagnosis/pathology/surgery

OBJECTIVE: To evaluation of the effect of pelvic or paraaortic lymphadenectomy on survival rates in the management of clinical stage I endometrial cancer METHODS: A retrospective analysis was performed on a total 303 clinical stage I endometrial cancer patients from 1989 to 2004 at Asan Medical Center. Two hundred-sixty-three (86.8%) underwent a total hysterectomy and bilateral salpingo-oophorectomy with pelvic or paraaortic lymphadenectomy, while forty (13.2%) underwent a total hysterectomy and bilateral salpingo-oophorectomy only. Characteristics of patients and 5-year survival rate of each patients group were analyzed. RESULTS: Seventeen (6.5%) showed lymph node metastases and overall 5-year survival rate of clinical stage I endometrial cancer was 96.9%. The 5-year and 10-year survival rate of a group with lymphadenectomy were 96.4% and 86.6%, and those of a group without lymphadenectomy were 100% and 75.2%, respectively (p=0.48). The 5-year survival rate of a group with positive lymph nodes was 73.3%, that of a group with negative lymph nodes was 97.7% (p<0.05). CONCLUSION: The complete staging operation including lymphadenectomy did not improve the survival rates in a group with lymphadenectomy significantly. But the debates regarding the necessarity of lymphadenectomy in clinical stage I endometrial cancer still remains and a large randomized prospective study is needed.
Chungcheongnam-do ; Endometrial Neoplasms* ; Female ; Humans ; Hysterectomy ; Lymph Node Excision* ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate*

In this retrospective study, we assessed the clinical usefulness of postoperative decline of serum CA 125 level after initial surgery to predict the size of residual disease in patients with advanced epithelial ovarian cancer. Between June 1989 and December 1995, sixty-three patients with advanced epithelial ovarian cancer (FIGO stage II-IV) were evaluated, who were managed at Asan Medical Center by cytoreductive surgery followed by chemotherapy. All patients had elevated preoperative serum CA 125(>35U/ml) and had another serum CA 125 assay 7~10 days after surgery. Preoperative CA 125 levels were similar in patients with residual disease below 2 cm and in those with larger residuum. The postoperative decline of serum CA 125 was significantly higher in patients with smaller residual disease only if preoperative serum CA 125 value was over 400U/ml. By taking 70% as the cutoff of CA 125 decline for discriminating patients with residual disease above 2 cm, the specificity and positive predictive value of this parameter improved when we considered patients with increasing preoperative serum levels. Hence, in the subset of patients with preoperative serum CA 125 level over 400U/ml, 95.2% (20/21) of patients with residual disease below 2 cm showed postoperative decline of serum CA 125 level over 70%, and 91.7%(11/12) of patients with postoperative decline of serum CA 125 level below 70% had residual disease over 2 cm. In conclusion, postoperative decline of serum CA 125 level after initial surgery does not exactly reflect the size of residual disease, but shows limited clinical usefulness in subset of patients with preoperative serum CA 125 level over 400 U/ml.
Chungcheongnam-do ; Chymopapain* ; Drug Therapy ; Humans ; Ovarian Neoplasms* ; Retrospective Studies ; Sensitivity and Specificity