PURPOSE: Breast-conserving surgery (BCS) is a standard treatment for breast cancer. Occasionally, patients may be dissatisfied with the breast shape due to deformity after BCS. To ensure satisfactory cosmetic results, a procedure with absorbable mesh after BCS was introduced in 2005. The purpose of this study was to identify the safety and effectiveness of this procedure. METHODS: From November 2013 to December 2015, patients who underwent BCS for a malignant breast mass at Jeonju Presbyterian Medical Center were reviewed, and 63 patients were included in this study. Based on data collected from medical records and telephone interviews, the subjects were divided into two groups as follows and retrospectively compared and analyzed: BCS with absorbable mesh (n=31) and BCS without absorbable mesh (n=32). Patient data included age, body mass index, underlying disease, tumor location and size, specimen size, operative time, axillary dissection based on frozen biopsy results, postoperative wound infection, postoperative radiotherapy, adjuvant chemotherapy, and follow-up period. To compare patient satisfaction between the two groups, a brief questionnaire consisting of four items was administered. RESULTS: Infection occurred in six patients (19.4%) in the absorbable mesh group and one (3.1%) in the BCS only group; however, the difference was not significant (p=0.053). Overall satisfaction, postoperative pain and postoperative motion limitation between the two groups were also not statistically significantly different. However, patients who underwent BCS with absorbable mesh insertion were better satisfied with the breast shape than those who underwent BCS without mesh from 1 year after operation (p=0.011). CONCLUSION: BCS with absorbable mesh is a simple and easy method to improve patient satisfaction for breast shape.
Biopsy ; Body Mass Index ; Breast ; Breast Neoplasms ; Congenital Abnormalities ; Drug Therapy ; Follow-Up Studies ; Humans ; Interviews as Topic ; Jeollabuk-do ; Mastectomy, Segmental* ; Medical Records ; Methods ; Operative Time ; Pain, Postoperative ; Patient Satisfaction* ; Polyglactin 910 ; Protestantism ; Radiotherapy, Adjuvant ; Retrospective Studies ; Surgical Wound Infection

Cresol, a commonly used disinfectant, is an extremly toxic material and can cause systemic effects such as respiratory, neurological, gastrointestinal, hepatic and renal damage. Cresol intoxication can be caused by inhalation, cutaneous adsorption or oral ingestion. Cresol denatures and precipitates cellular proteins, thus exer ts their toxic effects directly on all cells. There is only one case of cresol intoxication in Korea, but a case of chemical burn. We report a case of acute renal failure caused by cresol ingestion. A 39-year-old male attempted suicide by ingesting 200 mL of 50% cresol solution. Acute renal failure developed, but he recovered by only supportive care. It was reported that the lethal dose of saponated cresol solution is approximately 60-120 mL and the lethal blood level is 71-190 microgram/mL. The amount of cresol ingested by the patient far exceeded the reported lethal dose. This is the first case of acute renal failure caused by cresol ingestion successfully treated with only supportive care in Korea.
Acute Kidney Injury* ; Adsorption ; Adult ; Burns, Chemical ; Eating* ; Humans ; Inhalation ; Korea ; Male ; Suicide, Attempted

In 17-30% of subjects, at least one kidney is supplied by more than one artery arising from the aorta. Subjects with multiple renal arteries have been reported to suffer more frequently from hypertension, But the precise association between hypertension and multiple renal arteries was not yet defined. A 20- year old woman presented clinical manifestations of renovascular hypertension. Basal renin activity was elevated, and time-activity curves showed delayed peak time at captopril renal scan. Angiography showed multiple renal arteries with 2 right and left 3 arteries. There was neither stenosis nor inflammation. We strated angiotensin-receptor blocker, calcium channel blocker, and beta-blocker. The patient currently remains normotensive in an outpatient unit. In general, accessory renal arteries are narrower and longer than main artery. As a results, the renal segments supplied by accessory vessels might have lower levels of blood pressure than the remainder of the parenchyma, thereby increasing the renin secretion. So hypertension associated with multiple renal arteries might be involved in renin-angiotensin-aldosterone system activation.
Angiography ; Aorta ; Arteries ; Blood Pressure ; Calcium Channels ; Captopril ; Constriction, Pathologic ; Female ; Humans ; Hypertension ; Hypertension, Renovascular* ; Inflammation ; Kidney ; Outpatients ; Renal Artery* ; Renin ; Renin-Angiotensin System

Congenital nephrogenic diabetes insipidus (NDI) is a rare inherited disorder. The X-linked recessive NDI, most of congenital DI (>90%), has been known to be caused by mutation of the AVPR2 gene. Less than 10% of congenital NDI has an autosomal recessive inheritance and mutations of the AQP2 gene. Although several adult cases of congenital NDI were reported in Korea, all of them had an X-linked recessive inheritance and no azotemia. We have experienced a case of autosomal dominant NDI with renal failure. A 38-year-old man was admitted due to polyuria and polydipsia. In his family, his grandfather, father, three sisters and nieces showed similar symptoms. On admission, serum creatinine level was 4.9 mg/dL and creatinine clearance decreased to 19.9 mL/min. On ultrasonography, both kidneys showed severe hydronephrosis. We performed water deprivation and vasopressin stimulation test, and the result was consistent with NDI. On gene mutational analysis of the two different genes, AVPR2 and AQP2, no specific mutations were found except polymorphism.
Adult ; Azotemia ; Creatinine ; Diabetes Insipidus, Nephrogenic* ; Fathers ; Humans ; Hydronephrosis ; Kidney ; Korea ; Polydipsia ; Polyuria ; Renal Insufficiency* ; Siblings ; Ultrasonography ; Vasopressins ; Water Deprivation ; Wills

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.
Adult ; Ascites ; Biopsy ; Collagen ; Follow-Up Studies ; Humans ; Immunosuppression ; Korea ; Lymphocytes ; Outpatients ; Parenteral Nutrition, Total ; Peritoneal Dialysis ; Peritoneum ; Peritonitis* ; Renal Dialysis ; Tomography, X-Ray Computed