The patient with unilateral or bilateral inverted nipple has both functional and cosmetic impairments. The structural and histopathologic features of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. For these reasons, surgical correction of inverted nipple requires release of the short lactiferous ducts and providing the bulkiness under the nipple. We combined the concept of both adding the bulkiness under the nipple and creating a tight neck at its base without sacrificing the duct system. We rotated the bilateral diamond shaped deepithelized dermal flaps around the nipple areolar complex for providing the nipple bulkiness without division of lactiferous duct and reinforced it with the purse-string suture around the dermal flap for providing the stability. This two rotational dermal flap method was applied 12 inverted nipple in 6 patients and followed up for 2 months to 24 months. We have got the satisfactory results in cosmetic and functional aspect without any complication such as sensory change, relapse, and nipple necrosis.
Diamond ; Humans ; Neck ; Necrosis ; Nipples* ; Recurrence ; Sutures

PURPOSE: We evaluated whether lipoic acid as antioxidant could inhibit expression of VEGF and STAT3 in experimental diabetic rat retina. METHODS: Diabetes was induced chemically by injection of streptozotocin in 12 rats of 18 Sprague-Dawley rats. After induction of diabetes, lipoic acid was injected into the peritonium in 6 rats. So all rats were divided into 3 groups, normal group (n=6), diabetes mellitus (DM) group (n=6), lipoic acid treated group (n=6). The ocular tissue of the rats were collected on 8 weeks after diabetes induction. Difference of VEGF and STAT3 expression was investigated by immunohistochemistry, RT-PCR, western blot. The change of VEGF and STAT3 in lipoic acid treated group were evaluated in these experimental model. RESULTS: The VEGF and STAT3 expression was elevated in diabetic rat retina. The active form STAT3, phosphorylated STAT3 was also elevated. The VEGF and STAT3 expression in lipoic acid treated group was lower than DM group. CONCLUSIONS: The lipoic acid could inhibit the VEGF and STAT3 expression in diabetic rat retina.
Animals ; Blotting, Western ; Diabetes Mellitus ; Diabetic Retinopathy ; Immunohistochemistry ; Models, Theoretical ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Streptozocin ; Thioctic Acid* ; Vascular Endothelial Growth Factor A*

The present study was aimed at investigating whether an altered role of nitric oxide (NO) is involved in chronic renal failure (CRF). Rats were subjected to 5/6 nephrectomy and kept for 6 weeks to induce CRF. On the experimental day, after measurement of arterial pressure under anesthesia, the arterial blood was collected, and thoracic aorta and kidney were rapidly taken. NO metabolites (NOx) were determined in the plasma, urine, aorta and kidney. The expression of NO synthase (NOS) isozymes was determined in the kidney and aorta by Western blot analysis. The expression of NOS mRNA in the glomeruli was also determined by RT-PCR. There were significant increases in arterial pressure and serum creatinine levels in CRF. Urine NOx levels were decreased in CRF, whereas plasma NOx levels were not altered. Aorta and kidney tissue NOx levels were also decreased in CRF. The expression of endothelial constitutive (ec) and inducible (i) isoforms of NOS proteins was decreased in the kidney and aorta in CRF. Accordingly, the expression of ecNOS and iNOS mRNA was decreased in the glomeruli in CRF. In conclusion, NO synthesis is decreased in the kidney and vasculature of CRF rats.
Animal ; Aorta, Thoracic/metabolism ; Comparative Study ; Enzyme Induction ; Isoenzymes/metabolism+ACo- ; Isoenzymes/genetics ; Kidney/metabolism ; Kidney Failure, Chronic/metabolism+ACo- ; Male ; Nephrectomy ; Nitrates/urine ; Nitrates/blood ; Nitric Oxide/deficiency+ACo- ; Nitric Oxide/biosynthesis ; Nitric-Oxide Synthase/metabolism+ACo- ; Nitric-Oxide Synthase/genetics ; Nitrites/urine ; Nitrites/blood ; Organ Specificity ; RNA, Messenger/biosynthesis ; Rats ; Rats, Sprague-Dawley

The present study was aimed at investigating whether an altered role of nitric oxide (NO) is involved in chronic renal failure (CRF). Rats were subjected to 5/6 nephrectomy and kept for 6 weeks to induce CRF. On the experimental day, after measurement of arterial pressure under anesthesia, the arterial blood was collected, and thoracic aorta and kidney were rapidly taken. NO metabolites (NOx) were determined in the plasma, urine, aorta and kidney. The expression of NO synthase (NOS) isozymes was determined in the kidney and aorta by Western blot analysis. The expression of NOS mRNA in the glomeruli was also determined by RT-PCR. There were significant increases in arterial pressure and serum creatinine levels in CRF. Urine NOx levels were decreased in CRF, whereas plasma NOx levels were not altered. Aorta and kidney tissue NOx levels were also decreased in CRF. The expression of endothelial constitutive (ec) and inducible (i) isoforms of NOS proteins was decreased in the kidney and aorta in CRF. Accordingly, the expression of ecNOS and iNOS mRNA was decreased in the glomeruli in CRF. In conclusion, NO synthesis is decreased in the kidney and vasculature of CRF rats.
Animal ; Aorta, Thoracic/metabolism ; Comparative Study ; Enzyme Induction ; Isoenzymes/metabolism+ACo- ; Isoenzymes/genetics ; Kidney/metabolism ; Kidney Failure, Chronic/metabolism+ACo- ; Male ; Nephrectomy ; Nitrates/urine ; Nitrates/blood ; Nitric Oxide/deficiency+ACo- ; Nitric Oxide/biosynthesis ; Nitric-Oxide Synthase/metabolism+ACo- ; Nitric-Oxide Synthase/genetics ; Nitrites/urine ; Nitrites/blood ; Organ Specificity ; RNA, Messenger/biosynthesis ; Rats ; Rats, Sprague-Dawley

Hematogenous spread from tuberculous lesions of other parts of the body represent the origin of intracranial tuberculomas. In most series of the literature, the cerebellum has about two thirds and the cerebral hemispheres about one third of the intracranial tuberculomas. It may occurs as a single lesion, but multiple intracranial tuberculomas varies from 10% to 33% of the cases due to the hematogenous spread. Calcium deposits are rare, occurring in about 6% of cases. Ramamurthi and Varadarajan described the two types of the intracranial tuberculoma; 1. Superficial and vascular type, produces early focal signs of increased intracranial pressure. 2. deep and avascular type, accompanied by signs of increased intracranial pressure. We have been experienced in one case of symmetrical and bilateral cerebellar tuberculomas probably originated from the pulmonary lesion.
Calcium ; Cerebellum ; Cerebrum ; Intracranial Pressure ; Tuberculoma* ; Tuberculoma, Intracranial

BACKGROUND: Acute tumor lysis syndrome(TLS) has been defined as the metabolic abnormalities that occur after rapid tumor breakdown. In this study, we have evaluated the types or degrees of metabolic abnormalities and clinical characteristics in patients with non-Hodgkin's lymphoma(NHL) who developed TLS. METHODS: Patients were considered to have 'laboratory TLS(LTLS)' if any two of the following metabolic abnormalities occurred spontaneously or within 4 days of treatment: hyperphosphatemia, hyperkalemia, hyperuricemia, azotemia, and hypocalcemia. 'Clinical TLS(CTLS)' was defined as LTLS plus one of the following: a serum potassium level greater than 6.0mEq/L, a creatinine level greater than 2.5mg/dL, a calcium level less than 6.0mg/dL, the development of a life-threatening arrhythmia, or sudden death. RESULTS: Of 111 cases with NHL, TLS occurred in 16(14.4%), LTLS in 11(9.9%), and CTLS in 5(4.5%). There was a significant difference of gender, histologic type, clinical stage, performance status, extranodal involvement, serum lactate dehydrogenase(LDH), LDH index, beta2-microglobulin, uric acid, and blood urea nitrogen(BUN) level in the TLS versus control group. In multiple regression analysis, TLS occurred more frequently in patients with pre-treatment azotemia, aggressive histologic type, and elevated serum LDH level(p< 0.05, respectively). Pre-treatment and post-treatment TLS occurred in 8 cases(50%) respectively. The common metabolic abnormalities included hyperphosphatemia(87.5%), azotemia(81.3%), and hypocalcemia(75%). Of 11 cases with conservative care, 8 cases recovered within several days, but 3 cases died with multi-organ failure from disease progression. All 5 cases after hemodialysis for TLS recovered without any significant complications. CONCLUSION: The current study suggests that all patients with high-grade lymphomas and pre-treatment azotemia or a high serum LDH level be carefully monitored for at least 4 days after chemotherapy.
Arrhythmias, Cardiac ; Azotemia ; Calcium ; Creatinine ; Death, Sudden ; Disease Progression ; Drug Therapy ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hyperuricemia ; Hypocalcemia ; Lactic Acid ; Lymphoma, Non-Hodgkin* ; Potassium ; Renal Dialysis ; Tumor Lysis Syndrome* ; Urea ; Uric Acid

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity

To evaluate the possibility that the ginseng saponins could be developed as an anti-arteriosclerotic agent, we examined the inhibitory effects of ginseng saponins (total saponin(TS), panaxatriol(PT), panaxadiol(PD)) on the expression of c-fos mRNA and the proliferation of cultured rat aortic vascular smooth muscle cells (VSMCs) stimulated by angiotensin II (Ang II). TS and PT (1.0 mg/ml) suppressed c-fos mRNA induction in VSMCs stimulated by 10-5 M Ang II. The order of inhibitory potency was PT>TS. Ginseng saponins (0.01~1.0 mg/ml) inhibited the proliferation of VSMCs stimulated by Ang II in a concentration dependent manner, the inhibitory potency was TS> PT> PD at 0.1~1.0 mg/ml. These results suggest that ginseng saponins may suppress Ang II-stimulated proliferation of aortic VSMCs which can be seen in atherosclerosis, hypertension and restenosis.
Angiotensin II* ; Angiotensins* ; Animals ; Atherosclerosis ; Hypertension ; Muscle, Smooth, Vascular* ; Panax* ; Rats* ; RNA, Messenger* ; Saponins*

PURPOSE: The purpose of this retrospective study was to evaluate the short- to mid-term results of thoracic endovascular aortic repair (TEVAR) in Wonkwang University School of Medicine & Hospital. METHODS: Between February 2009 and May 2011, 8 consecutive patients had undergone endovascular stent-grafting for thoracic aortic diseases. Five patients were treated for traumatic thoracic aortic injuries, two patients were treated for thoracic aneurysms and one patient was treated for a pseudoaneurysm due to penetrating aortic ulcers. Attempted stent-graft deployment was performed electively in 6 patients and emergently in 2. Follow-up was performed at 1-month, 6-month, 1-year, and annually thereafter. RESULTS: Technical success rates were achieved in 87.5% and the 30-day mortality rate was 0%. Mean hospital length of stay after TEVAR was 30 days in traumatic thoracic aortic injuries and 10 days in thoracic aneurismal diseases. Intra-operative Type I endoleak due to migration at deflation was visualized in 1 patient, which was treated by insertion of another stent-graft. During follow-up, a major complication was encountered in one patient who received carotid-subclavian bypass to relieve left arm ischemia. After 5 months he was treated with arch replacement for aortic arch aneurysm with type I endoleak at proximal site after endovascular treatment. The 30-day mortality rate was 0%. However, 1 case of mortality (12.5%) was observed during the follow-up period. CONCLUSION: The short and mid-term results of endovascular repair of thoracic aortic diseases are promising. TEVAR is an effective procedure in the management of thoracic aortic diseases.
Aneurysm ; Aneurysm, False ; Aorta, Thoracic ; Aortic Diseases ; Arm ; Endoleak ; Follow-Up Studies ; Humans ; Ischemia ; Length of Stay ; Retrospective Studies ; Ulcer

Purpose: To determine the clinical differences between prostate cancer detected on initial biopsy and repeated biopsy Materials and Methods: Between January 2003 and December 2006, 67 patients were evaluated in this study who were diagnosed prostate cancer by transrectal ultrasound-guided biopsies and their prostate specific antigen (PSA) were below 20 ng/ml and clinical stages were less than T2. Among 67 patients, 43 patients were diagnosed at the first biopsies (group A) and others were diagnosed at the repeate biopsies (group B). We retrospectively characterized differences in clinical features such as age, digital rectal examination (DRE), prostate volume, the number of biopsy core, rate of positive core, PSA, % free PSA, Gleason score and rate of insignificant cancer. Results: There were no significant differences in age, PSA, % free PSA, rate of insignificant cancer between groups A and B. However, positive rate of DRE, prostate volume and rate of patients whose PSA were 7 ng/ml or higher in group A were significantly higher than those in group B. Despite the number of biopsy core was higher in group A, there were no differences in the number of positive biopsy core. Conclusions: Compared to the patients who were diagnosed as prostate cancer in the initial biopsies, prostate volume, positive rate of DRE and rate of Gleason score 7 or more were significantly lower in repeated biopsy group. From now on we are planning to include more patients and compare these characteristics of biopsies with the final pathological features after radical prostatectomy.
Biopsy ; Digital Rectal Examination ; Humans ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies