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

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

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

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

PURPOSE: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. METHODS: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak grade(R)(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. RESULTS: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. CONCLUSION: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.
Alopecia ; Arm* ; Cicatrix ; Contracture ; Folliculitis ; Humans ; Scalp ; Skin* ; Tissue Donors ; Transplants*

OBJECTIVE: Hydrocephalus and vasospasm are the common complications of aneurysmal subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus and vasospasm are the causes of the neurological deficit and poor prognosis. This study was designed to investigate whether the frequency of a shunt-dependent hydrocephalus in patient suffering from aneurysmal subarachnoid hemorrhage and delayed cerebral ischemia can be related to the duration and amount of cerebrospinal fluid drainage and medical history. METHODS: Retrospective analysis of consecutive 96 patients with aneurysmal subarachnoid hemorrhage was made from January 2000 to December 2002. Eighty one of these patients underwent the procedure for CSF drainage and 15 patients did not. 81 patients with aneurysmal SAH were divided into two groups which underwent shunt procedure and did not. In these two groups, we investigated and compared the incidence of shunt-dependent hydrocephalus and ischemia according to age, sex, aneurysmal site, H-H grade, Fisher grade, medical history and the amout of CSF drainage. RESULTS: The incidence of hydrocephalus following SAH was 53.1% and shunt-dependent hydrocephalus was 16.7% in 96 patients. The duration, total volume, and daily volume of CSF drainage were 6.9+/-3.3 days, 1542.3+/-982.5 ml, and 211.5+/-49.2 ml, respectively. The relationship between the daily volume of CSF drainage and shunt-dependent hydrocephalus was determined to to be statistically significant (p<0.05). Cerebral infarction and shunt-dependent hydrocephalus were found to be statistically associated (p<0.05). CONCLUSION: The continous drainage of cerebrospinal fluid in patients of aneurysmal subarachnoid hemorrhage increase chance of delayed hydrocephalus and they have not shown decrease cerebral infarction as a result of vasospasm.
Aneurysm ; Brain Ischemia ; Cerebral Infarction ; Cerebrospinal Fluid ; Drainage* ; Humans ; Hydrocephalus ; Incidence ; Ischemia ; Prognosis ; Retrospective Studies* ; Subarachnoid Hemorrhage*