Accessory axillary breast tissue has received little attention in the surgical literature although it is not an uncommon kind of aberrant breast tissue. Twenty-six patients who have been treated with an exicision of accessory breast tissue from January 1988 to June 1995 at the Department of Surgery, College of Medicine, Soonchunhyang University were analyzed retrospectively. The age of the patients ranged from 18 to 58 years, median age, 34 years. All were female including two postmenopausal females. We observed a palpable mass in the left axillae in 6 patients, in the right axillae in 8 patients and in the both axilla in 12 patients. Of the 41 masses of 26 patients, 19 masses were located on tne anterior axillary line, 20 masses on the midlle axillary line and 2 masses on the posterior axillary line. The size of the accessory breast tissue ranged from 0.5 to 8cm, with a median of 3.4cm. The presenting symptoms were mass in all cases, pain in 12 cases, growing mass in 4 cases and redness in one case. Histological diagnosis of total 41 masses revealed 28 normal breast tissue, 9 fibrocystic disease, 1 ductal ectasia, 1 fibroadenoma, 1 fibrocystic disease with ductal ectasia and 1 infiltrating ductal carcinoma. There were no typical clinical characteristics for differential diagnosis preoperatively. Of a total of 38 excisional operations, 4 complications developed (two hematoma, one wound infection and one skin tag). The postoperative hospital stay ranged from 1 to 17 days. The accessory breast tissue might be regarded as a more important disease than before, because various pathologic changes could occur in it including malignant change. Early diagnosis and correct excision are usually recommended.
Axilla* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Diagnosis, Differential ; Dilatation, Pathologic ; Early Diagnosis ; Female ; Fibroadenoma ; Hematoma ; Humans ; Length of Stay ; Retrospective Studies ; Skin ; Wound Infection

OBJECTIVE: To evaluate the clinical efficacy of transabdominal ultrasound-guided embryo transfer for in vitro fertilization and embryo transfer (IVF-ET) according to age of women. METHODS: A total of 211 cycles of IVF?ET were included in this study. The pregnancy outcomes were compared between transabdominal ultrasound?guided embryo transfer (USG-guided group, n=108) and clinical touch technique (Clinical touch group, n=103) groups. Then, comparative analysis was performed in women aged <35 years, 35~37 years and in those > or =38 years. RESULTS: Clinical characteristics of study subjects did not differ between the two groups. There was no difference between the two groups in terms of duration of controlled ovarian hyperstimulation, dose of gonadotropins used, numbers of oocytes retrieved and embryos transferred. Clinical pregnancy rate was significantly higher in USG-guided group than Clinical touch group (27.8% vs. 16.5%, p<0.05). This difference was also found in women 35~37 years (27.6% vs. 8.6%, p<0.05), but not in those <35 years. USG-guided group showed a significantly higher implantation rate in women 35~37 years (10.5% vs. 3.4%, p<0.05), but not in those <35 years. In women at 38 years or older, USG-guided group showed higher clinical pregnancy and implantation rates than Clinical touch group (15.0% vs. 7.6%; 4.8% vs. 2.5%, respectively), however the differences were not statistically significant. CONCLUSION: Transabdominal ultrasound-guided embryo transfer may improve the pregnancy outcomes in IVF-ET cycles, especially in women at age 35 years or older.
Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Gonadotropins ; Humans ; Oocytes ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Ultrasonography

PURPOSE: Wound infection after an ileostomy reversal is a common problem. To reduce wound-related complications, purse-string skin closure was introduced as an alternative to conventional linear skin closure. This study is designed to compare wound infection rates and operative outcomes between linear and purse-string skin closure after a loop ileostomy reversal. METHODS: Between December 2002 and October 2010, a total of 48 consecutive patients undergoing a loop ileostomy reversal were enrolled. Outcomes were compared between linear skin closure (group L, n = 30) and purse string closure (group P, n = 18). The operative technique for linear skin closure consisted of an elliptical incision around the stoma, with mobilization, and anastomosis of the ileum. The rectus fascia was repaired with interrupted sutures. Skin closure was performed with vertical mattress interrupted sutures. Purse-string skin closure consisted of a circumstomal incision around the ileostomy using the same procedures as used for the ileum. Fascial closure was identical to linear closure, but the circumstomal skin incision was approximated using a purse-string subcuticular suture (2-0 Polysorb). RESULTS: Between group L and P, there were no differences of age, gender, body mass index, and American Society of Anesthesiologists (ASA) scores. Original indication for ileostomy was 23 cases of malignancy (76.7%) in group L, and 13 cases of malignancy (77.2%) in group P. The median time duration from ileostomy to reversal was 4.0 months (range, 0.6 to 55.7 months) in group L and 4.1 months (range, 2.2 to 43.9 months) in group P. The median operative time was 103 minutes (range, 45 to 260 minutes) in group L and 100 minutes (range, 30 to 185 minutes) in group P. The median hospital stay was 11 days (range, 5 to 4 days) in group L and 7 days (range, 4 to 14 days) in group P (P < 0.001). Wound infection was found in 5 cases (16.7%) in group L and in one case (5.6%) in group L (P = 0.26). CONCLUSION: Based on this study, purse-string skin closure after a loop ileostomy reversal showed comparable outcomes, in terms of wound infection rates, to those of linear skin closure. Thus, purse-string skin closure could be a good alternative to the conventional linear closure.
Body Mass Index ; Fascia ; Humans ; Ileostomy ; Ileum ; Length of Stay ; Operative Time ; Skin ; Sutures ; Wound Infection

OBJECTIVE: The objective of this study was to compare the outcomes of cryopreserved-thawed blastocyst transfer (CT-BT) in natural or programmed cycles using exogenous steroid hormones. METHODS: A total of 221 CT-BT cycles were included and divided into two groups according to endometrial preparation protocols. In natural cycle group (n=116), monitoring was performed by transvaginal ultrasonography to detect ovulation. In programmed cycle group (n=105), oral estradiol valerate, 6 mg/day, was started on the third day of the menstrual cycle and administered continuously, and progesterone in oil 100 mg i.m. daily injection was started on cycle day 15. CT-BTs were performed on five days after ovulation in natural cycles and five days after the initiation of progesterone administration in programmed cycles. Pregnancy rates, implantation rates, and other clinical characteristics of the two groups were compared. RESULTS: Clinical characteristics of study subjects did not differ between the two groups. Post-thaw survival rates, number of transferred blastocysts, and number of good-quality blastocysts were not different. There were no statistically significant differences in implantation rates (21.1% vs. 19.4%), clinical pregnancy rates (36.2% vs. 36.2%), and ongoing pregnancy rates (28.4% vs. 27.6%) between the two groups. CONCLUSIONS: No statistically significant differences were found in pregnancy rates and implantation rates between the two protocols. Our results suggest that both protocols are equally effective for endometrial preparation in CT-BT cycles.
Blastocyst* ; Embryo Transfer* ; Estradiol ; Female ; Menstrual Cycle ; Ovulation ; Pregnancy Rate ; Progesterone ; Survival Rate ; Ultrasonography