Doppler sonography has been introduced to evaluate uterine and ovarian diseases. It has been reported to be used to distinguish benign from malignant adnexal masses. The purpose of this study was to assess the blood flow characteristics of adnexal masses and to determine the optimal cut-off points for the Doppler indices obtained, resistance index and pulsatility index, to best differentiate benign from malignant lesions. We performed pulsed Doppler ultrasound in seventy-eight adnexal masses between February 1989 and June 1994. The pulsatility and resistance index were calculated from the waveforms generated from blood flow within the ovary. There were 51 benign and 27 malignant histologically proved ovarian lesions. All women have been operated on. The results were as follows ; Benign tumors and cysts had a significantly higher pulsatility index(mean, 1.23+/-0.74; range, 4.46-3.36) and resistance index(mean, 0.64+/-0.19; range 0.34-1.43) than did malignant tumors(pulsatility index : mean, 0.87+/-0.49; range, 0.31-2.27; resistance index : mean, 0.50+/-17; range, 0.23-0.8). However, some overlap in individual values for benign and malignant lesions was found. In conclusion, our data suggest that high pulsatility and resistance indices may indicate benign adnexal masses ; however, considerable overlap in pulsatility and resistance indices between benign and malignant lesions were noted, and further work will be needed before the validity of these factors is proved.
Female ; Humans ; Ovarian Diseases ; Ovary ; Ultrasonography

No abstract available.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

No abstract available.
Ifosfamide*

The recent introduction of chemotherapy in the treatment of gynecological malignancies has gained wide acceptance along with prstoperative and prostperative adjuvant therapy and with preradiation and concurrent chemoradiation therapy. But, the side effects of chemotherapy including bleeding and infection due to, bone marrow suppression have reaulted in delayed treatment and a reduction in the chemotherspeutic agent used. Recent efforts overcome this bone marrow suppression have led to development of the various human colony-stimulating factor indluding recombinant granulocyte colony-stimulating factor. The author investigated the clinical benefita and toxicity of G-CSF used during chemotherapy of various gynecological malignancies at the Departent of Obstetrics & Gynecology at Hanyang University between August, 1991 and July, 1992. The results were as follows ; 1. An increase in the number of neutrophils following a single injection of G-CSF was noted in 19 out of 21 cases(600~1,000/mm3 before injection, 4,500~12,000/mm3 after injection). The remaining 2 cases showed an increase after 3~5 continuous injections. 2. To assess the increase in neutrophils according to the dosage of G-CSF given, 100 and 300microgram/m* of G-CSF were injected in each trial of chemotherapy in a single case of ovarian cancer. The results were a 1.5 time increase when injected when injected with 300microgram/m*. 3. After injecting into a patient with recurrent endometrial cancer who was managed with 15gm of ifosfamide, 50gm of cis-platinum, 50gm of adriamycin and 3gm of mesna following surgery, no evidence of neutropenia could be found after 4days of prophylactic G-CSF injections. 4. Patients with cervix cancer with metastasis to the lung were first treated with GM-CSF in one trial and G-CSF in the nest. Patients treated with Gm-CSF for a period of 7 days showed leukocytosis(3,600/mm3) but the number was reduced to 1,400/mm3 after 7 days. On the other hand, patients treated with G-CSF showed an increase of 5,700/mm3 within one day and this figure did not decrease until 20 days later. 5. The toxic effects of G-CSF included on case of severe back pain was easily managed by administration acetaminophen. Others were headache, chills, general weakness and redness of the oral mucosa and injection area. Most of these symptoms disappeared within 2 days. The G-CSF is effective in neutropenia during chemotherapy thereby decreasing the incidence of treatment delay or dose reduction. It also increases the amount of chemotherapeutic agent administered and its toxicity is more tolerable making a rigid systemic chemotherapeutic regime possible.
Acetaminophen ; Back Pain ; Bone Marrow ; Chills ; Cisplatin ; Colony-Stimulating Factors ; Doxorubicin ; Drug Therapy* ; Endometrial Neoplasms ; Female ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Gynecology ; Hand ; Headache ; Hemorrhage ; Humans ; Ifosfamide ; Incidence ; Leukopenia* ; Lung ; Mesna ; Mouth Mucosa ; Neoplasm Metastasis ; Neutropenia ; Neutrophils ; Obstetrics ; Ovarian Neoplasms ; Uterine Cervical Neoplasms

Ovarian mucinous cystadenoma of borderline malignancy was consisted of intestinal mucinous cystadenomas of borderline malignancy and Mullerian mucinous papillary borderline tumors. Mullerian mucinous papillary tumors was lined by mucinous epithelium of endocervical type and characterized by papillae architecturally similar to those of serous borderline tumors. These tumors have clinical and pathologic differences from those of intestinal mucinous cystadenomas of borderline malignancy.We report a case of ovarian Mullerian mucinous papillary cystadenomas of borderline malignancy with review of literature.
Cystadenoma, Mucinous ; Cystadenoma, Papillary* ; Epithelium ; Female ; Mucins* ; Ovary

PURPOSE: Soft tissue defect of anterior chest wall is caused by trauma, infection, tumors and irradiation. To reconstruct damaged anterior chest wall does require to consider the patient's body condition, the cause, the location, the depth and the size of deletion, the circulation of surrounding tissue and minimization of functional and cosmetic disability. In this report, we suggest the algorithm of configuration for reconstruction methods. METHODS: A retrospective study of 20 patients who underwent anterior chest wall reconstruction with pedicled musculocutaneous flap and fasciocutaneous flap was conducted. We collected the information of the patient's body condition, the cause, the size, the depth and the location of deletion, implemented flap and complication. We observed and evaluated flap compatibility, functional and cosmetic results. Patients completed survey about the extent to their satisfaction. RESULTS: Follow up period after surgery was from 6 to 26 months, survival of flap were confirmed in all of patients' case. Two cases of local necrosis, one case of wound disruption were reported, but all these were cured by the debridement and primary closure. One hematoma and one seroma formation were observed in donor site. Longer surgery time, more bleeding amount and more transfusion volume were reported in the group of musculocutenous flap. CONCLUSION: Long term follow up result showed the successful reconstruction in all patients without recurrence and with minimal donor site morbidity. In addition, the patients' satisfaction for cosmetic and functional results were scaled relatively higher. This confirmed the importance of reconstruction algorithm for the chest wall reconstruction.
Cosmetics ; Debridement ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Necrosis ; Recurrence ; Retrospective Studies ; Seroma ; Thoracic Wall ; Thorax ; Tissue Donors

PURPOSE: Good color match is a key element in facial reconstruction for good aesthetic result. To correct the wide facial soft tissue defect were usually used the tissue expanded cheek flap, deltopectoral flap or radial forearm free flap. This study is aimed to analyse the color difference after flap surgery by using chromameter. METHODS: From August 1995 to December 2006, 30 patients who underwent flap operations were chosen randomly and evaluated color differences between flap site and adjacent skin. Reconstructive procedures included tissue expanded cheek flap(n=10), deltopectoral flap(n= 10), and radial forearm free flap(n=10). The measured sites were flap center within a radius of 1cm and four points of adjacent skin along the flap margin. The colors were quantified in a three dimensional coordinate system composed of L* (brightness), a*(redness), b*(yellowness). RESULTS: There were no significant color differences between the pedicled flaps(tissue expanded cheek flap and deltopectoral flap) and adjacent skin area. On the other hand, color values of the radial forearm free flap were statistically different from those of adjacent skin area. Total color difference(delta E) of tissue expanded cheek flap and deltopectoral flap were 7.45+/-5.78 versus 9.41+/-7.09, and that of radial forearm free flap was 11.74+/-3.85. It suggests that pedicled flaps have a potential of better color match than radial forearm free flap. CONCLUSION: Thus, better esthetic results and satisfaction is more likely to be expected in pedicled flaps as long as it could be applied comparing radial forearm free flap.
Cheek ; Forearm ; Free Tissue Flaps ; Hand ; Humans ; Radius ; Skin ; Surgical Flaps

In this study, we prepared alcohol extracts of the larva, pupa, queen, and cocoon (clony) of B. ignitus, B. terrestris, and B. h. sapporoensis, and tested the anti-inflammatory activity of the extracts by using a rat model of adjuvant-induced edema. The extracts derived from the queen of B. ignitus, the queen of B. terrestris, and the cocoon of B. ignitus decreased hind paw edema after 1 day of i.p. administration. These extracts also induced vasorelaxation and NO production in calf pulmonary artery endothelial cells. These results suggest that bumblebee alcohol extracts has anti-inflammatory and vasorelaxant properties.
Animals ; Edema ; Endothelial Cells ; Larva ; Pulmonary Artery ; Pupa ; Rats ; Vasodilation

PURPOSE: The loss of web space is caused by congenital syndactyly or acquired burn injury, trauma or surgery. Numerous surgical procedures have been described for restoration of the web space. Local flaps are usually preferred because of the easiness to perform and tolerable postoperative outcome. Among the various local flaps, the authors introduce V-M plasty for correction of web space contracture and syndactyly. METHOD: From March 2007 to Jun 2008, 4 patients underwent V-M plasty for correction of web space contracture and syndactyly. V-M plasty consists of 3 distinct triangular flaps. One triangular flap is designed next to the web region on the dorsal site of the hand, whereas the remaining 2 triangular flaps are placed on the volar site. The dorsal triangular flap is then placed between the volar adjacent triangular flaps. At the end of the operation, the involved fingers or toes are positioned in abduction to avoid kinking of the triangular flaps. RESULT: All the patients gained web functions with good esthetic appearance without any recurrence or complications. Mean follow-up was 8 months. CONCLUSION: V-M plasty is a safe, easy and rapid procedure to design and apply by using local tissues without the needs for a skin graft or risk of linear scarring and recurrence. The authors advise this versatile technique both in primary and recurrent cases of web space contracture and syndactyly.
Burns ; Cicatrix ; Contracture ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Recurrence ; Skin ; Syndactyly ; Toes ; Transplants

Ectropion in upper eyelid is often considered as a consequence of thermal burn injury or trauma and skin disease, that causes excessive scarring or shrinkage in the skin or subcutaneous tissue. Herpes zoster, known as shingles is caused by varicella zoster virus. After primary inoculation, this virus lies dormant in neuronal ganglia until it is triggered by any of an assortment of factors. In case of involving the ganglion of the fifth cranial nerve(trigeminal nerve), it can descend down the affected nerve into the skin, then producing an eruption in the dermatome which is innervated including forehead, ocular and periorbital area in recurrent episode. We report one patient with cicatricial ectropion of the left upper eyelid secondary to herpes zoster. As a result of repeated healing process of herpes vesicles, he had a total exposed palpebral conjunctiva and scar contracture of the left upper eyelid. Surgical scar release of the lid traction, excision of scars, and full thickness skin graft were done with satisfactory outcome.
Burns ; Cicatrix ; Conjunctiva ; Contracture ; Ectropion* ; Eyelids ; Forehead ; Ganglia ; Ganglion Cysts ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Neurons ; Skin ; Skin Diseases ; Subcutaneous Tissue ; Traction ; Transplants