The Effect of Vacuum-Assisted Closure (V.A.C.) Therapy in Pressure Ulcer

OBJECTIVE: To evaluate the effect of Vacuum-Assisted Closure (V.A.C.) therapy in stage 3 or 4 pressure ulcers refractory to traditional saline wet gauze dressing. METHOD: Ten patients who had stage 3 or 4 pressure ulcers which were failed to heal with saline wet gauze dressing over 4 weeks were investigated. We treated these subjects with V.A.C. therapy. The length, width and depth of pressure ulcers were evaluated every week for 3 weeks. Soft tissue biopsy from pressure ulcer was taken before starting V.A.C. therapy and after the scheduled therapy was done. RESULTS: The sizes of length, width and depth in pressure ulcer were significantly decreased after one week of V.A.C. application. And then healthy granulation tissue was formed. The length, width and depth of the pressure ulcer were decreased of 40.2%, 42.7% and 79.8% of their original size. Soft tissue biopsy in pressure ulcers was taken in 4 cases, the number and size of capillaries were more increased and inflammatory cells were decreased. CONCLUSION: V.A.C. therapy promoted wound healing and revealed favorable histological changes in pressure ulcers refractory to traditional dressing. We suggest that V.A.C. therapy can be used for the effective management of pressure ulcer.

Mean Platelet Component Change according to Stage in Stroke Patients

OBJECTIVE: Decrease of platelet density by degranulation of activated platelet is well correlated with decrease of mean platelet component (MPC) value. We intended to investigate the change of MPC, mean platelet volume, and platelet count according to the stroke stage and difference between ischemic and hemorrhagic infarction. METHOD: Thirty eight patients (ischemic stroke 28 men, hemorrhagic stroke 10 men) and twenty age-matched healthy persons were included in this study. They were divided into acute stage group and subacute stage group. Each of them were sampled by venously and investigated about mean platelet component, mean platelet volume, and platelet counts. RESULTS: In ischemic stroke, there was statically (p <0.05) meaningful decrease of MPC value in acute stage (27.5+/-1.7) compared to control group (28.8+/-0.9). And MPC value in subacute stage showed meaningful increase (28.1+/-1.3) compared to acute stage but still remained in statically lower value compared to control value. In hemorrhagic stroke, there was no meaningful difference of MPC value in acute stage group (28.6+/-2.0) and subacute stage group (27.9+/-1.1) compared to control group. CONCLUSION: In ischemic stroke patients, MPC value in acute stage decreased meaningfully and this change might be useful as a landmark in predicting the activity of infarction.

Clinical Analysis of Ductal Carcinma in Situ and Microinvasive Carcinoma of the Breast / 한국유방암학회지

BACKGROUND: In the past, the diagnosis of ductal carcinoma in situ (DCIS) was rare, but today the incidence of DCIS has become much more frequent, particularly in patients who underwent mammographic screening. The management of patients with DCIS has become a major clinical dilemma. It has become increasingly difficult to justify the routine use of mastectomy for patients with DCIS, because its natural history is uncertain and breast-conserving therapy (BCT) is currently used for the treatment of many patients with invasive breast cancer. METHODS: To investigate the incidence, clinicopathologic features and the outcome of treatment of DCIS and microinvasive carcinoma (MIC), the medical records and pathology slides of 91 patients with DCIS and MIC who had been treated at KCCH between 1983 and 1996 were reviewed retrospectively. Median follow-up period was 69.4 (4-158) months. RESULT: The results were as follewd; 1) The inciednce was 2.72% (91/3,343) and had been increasing (2.1% in 1980s and 3.3% 1990s). 2) The mean age was 44.2 years and peak age group was fifth decade. 3) The most common clinical features was a palpable mass (69%), followed by nipple discharge, MMG abnormality and Paget's disease in decreasing order of frequency. 4) According to the pathologic classification of Schwartz, comedo type was the most common (32%), followed by cribriform (23%), papillay (20%), mixed (11%), solid (9%) and micropapillary type (5%), 5) There were 58 cases (69%) of pure DCIS and 16 cases (17.5%) of MIC. In 17 case (18.5%) the presence of microinvasion was equivocal or could not be assessed. 6) There were no significant differences between DCIS and MIC in terms of mean age (44.5 years vs 43.8 years), mean tumor size (2.15 cm vs 2.25 cm), the frequency of comedo type (29% vs 36%), lymph node metastasis (0% vs 6%) and multicentricity (3.3% vs 3.0%). However, the palpable mass was more common in MIC than DCIS (82% vs 62%, p<0.05). 7) 75 patients (82%) were treated with mastectomy and 16 patients were treated with breast conserving surgery. 8) Bedsides 2 cases of systemic recurrence among MIC, there was no case of recurrence or disease-associated death during the period of follow-up. CONCLUSIONS: The incidence of DCIS and MIC showed increasing tendency primarily due to the increasing use of screening mammography. Even though the rates of BCT has been increasing, MRM was still the most common procedure for the treatment of DCIS and MIC. The outcome of treatment, in terms of recurrence or survival, was very excellent and almost the same for both groups of pure DCIS and MIC. More long-term follow-up and multicenter study seems to be neccessary to identify the differences in clinical features and outcome between pure DCIS and MIC in Korea.

Antitumor effects of recombinant human interferon-alpha and gamma on human malignant melanoma xenograft in nude mice and alteration in morphology and immunologic parameters / 대한암학회지

No abstract available.