There are several factors to be considered while performing reduction mammoplasty in patients having giant breast with severe breast ptosis. These are degrees of breast ptosis, location of newly created nipple areolar complex, preservation of sensation, symmetry of both breasts, amount of breast tissues to be resected, and finally the postoperative scar. Among the above factors, postoperative scar seems to be the major problem that patients complain about. So several methods have been investigated in time to minimize the scar. Authors have performed 3cases of reduction mammoplasty in patients with severe ptotic large breast by applying the method of umbilicus creation in abdominoplasty, so that only periareolar and submammary scars remained without a vertical scar. The age were between 33 and 43 years old. Mean follow up period was about 6.5 months. Amount of the resected mammary tissues was about 750-1350g. Periareolar deepithelialization was made about 8cm diameter for better cirulation to the nipple areolar complex and wider contact area thus enhancing the stabilization and survival of the nipple areolar complex. Only 1 case with partial deepithelialization of the areola occurred but completely healed within 1 month. Patients were pleased with natural shape and size of the breast and the sensation of the nipple areolar complex was restored completely in all cases after surgery. Authors have performed reduction mammoplasty without leaving the vertical scar which considered to be the major problems of the classical methods. Other problems such as insufficient reduction, flattening of the breast and severe wrinkles around the nipple were also solved. This method not only improve the aesthetic importance but also minimize the functional complications such as sensory loss and difficulty in lactation.
Abdominoplasty ; Adult ; Breast ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Lactation ; Mammaplasty* ; Nipples ; Sensation ; Umbilicus

The purpose of this study was to verify whether small intestinal peristalsis could be observed and quantitatively assessed using pulsed-Doppler ultrasound. Pulsed-Doppler ultrasound was used to evaluate small intestinal peristalsis after a meal in ten normal dogs and ten sedated dogs. The small intestinal peristalses were measured 0, 1, 3, 6, 9, 12, and 24 hours after a 24-hour fast and after feeding. The number of small intestinal peristalsis were 0.133/min, 0.100/min, 0.033/min, 0.167/min, 0.070/min, 0.067/min, and 0.100/min in the fasted dogs, and 1.667/ min, 0.933/min, 1.133/min, 1.234/min, 1.933/min, 1.533/ min, and 0.533/min in fed dogs, respectively. In the dogs sedated with xylazine HCl, the number of small intestinal peristalsis was significantly reduced (p<0.01). However, in the dogs treated with ketamine HCl and acepromazine, the number of small intestinal peristalsis remained unchanged. Therefore, it can be concluded that pulsed-Doppler ultrasound allows graphic visualization of the intestinal movements, which can be subjected to qualitative and quantitative analysis, and may be suitable for a non-invasive study of small intestinal motility.
Acepromazine/pharmacology ; Animals ; Dogs ; Dopamine Antagonists/pharmacology ; Excitatory Amino Acid Antagonists/pharmacology ; *Gastrointestinal Motility/drug effects ; Intestine, Small/drug effects/*physiology/ultrasonography ; Ketamine/pharmacology ; Peristalsis/drug effects/*physiology ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.
Fibrosarcoma ; Humans ; Positron-Emission Tomography ; Sensitivity and Specificity

PURPOSE: The optimal surgical technique for inguinal hernia repair continues to be debated. This study was designed to investigate optimal surgical procedures in inguinal or femoral hernia. METHOD: We analyzed 153 cases of herniorrhaphy on inguinal or femoral hernias between August 1996 and November 2000. We divided patient into four groups according to the methods of hernia repair, i.e., 1) 78 cases of laparoscopic herniorrhaphy, 2) 42 cases of Lichtenstein herniorrhaphy, 3) 24 cases of Bassini herniorrhaphy and 4) 9 cases of McVay herniorrhaphy. RESULTS: The patient in the laparoscopic and Lichtenstein herniorrhaphy groups needed shorter hospital stays than those in the Bassini or McVay herniorrhaphy groups. The severity of pain was assessed by the total amount and duration of nonsteroidal anti-inflammatory drug injections, which was minimal in the laparoscopic group. There were no differences in complications between the groups. One patient in the laparoscopy group had a hernia recurrence and was reoperated with Lichtenstein herniorrhaphy. We compared two tension-free herniorrhaphies with each other. The numbers of patients not needing analgesic injections were more in the laparoscopic than the Lichtenstein herniorrhaphy group, reflecting less pain in the former group. Hospital stays were also shorter in the laparoscopic than the Lichtenstein herniorrhaphy group. CONCLUSION: We concluded that tension-free herniorrhaphy is superior to tension herniorrhaphy in terms of postoperative pain & recovery. Of the tension-free herniorrhaphies, laparoscopic herniorrhaphy is associated with less postoperative pain and shorter hospital stays than Lichtenstein herniorrhpahy.
Hernia ; Hernia, Femoral ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Laparoscopy* ; Length of Stay ; Pain, Postoperative ; Recurrence

Febrile morbidity after cesarean section is one of the major problems in obstetric practice. This morbidity is most often due to endometritis. Although parenteral prophylactic antibiotics or antibiotic irrigation has been reported to reduce the incidence of endometritis after cesarean section, its incidence remains high. Among the patients who were undergoing cesarean section at Yeungnam University Hospital from the beginning of March, 1985, three group were evaluated in the orders. 1) 30 cases as intrauterine irrigation group with cephradine solution, 2) 35 cases as intravenous injection group with cephradine, 3) 35 cases as control group are neither irrigated nor injected. Febrile morbidity was also evaluated by means of a fever index. The incidence of clinically diagnosed endometritis in the three group were 6.7%, 2.9%, and 22.9%. As these results, two study groups were markedly reduced the incidence of endometritis than control group. There was no significant difference between the intrauterine irrigation with cephradine and control, but significant difference between the intravenous cephradine injection and control (P<0.05). With the results of fever index analysis, both prophylactic intrauterine irrigation and intravenous injection markedly reduce the incidence of endometritis after cesarean section with statistical significance (P<0.05), and also markedly reduce the febrile degree.
Anti-Bacterial Agents ; Cephradine* ; Cesarean Section* ; Endometritis ; Female ; Fever ; Humans ; Incidence ; Injections, Intravenous* ; Pregnancy

Leiomyomatosis peritonealis disseminata is a rare benign condition characterised by the occurrence of multiple leimyomas scatterred throughout the peritoneal cavity, giving the clinical impression of a wide spread malignant tumor. The histopathology of leiomyomatosis peritonealis disseminata is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Three cases with malignant transformation were described among previous reported fifty cases. Many of the early reports described the disorder in premenopausal women, and now the histogenesis is considered to be a metaplastic change by abnormal tissue response to the relatively or absolutely elevated female sex hormone. We report a case of leiomyomatosis peritonealis disseminata, which was diagnosed by multiple scattered submucosal and subseroal leimyomas of stomach, small bowel and colon, combined with advanced gastric cancer in a 58 years old man, Multiple submucosal tumors of the stomach combined with advanced gastric cancer were demonstrated by fibergastroscopy, upper gastrointestinal barium study and abdominal ultrasonography. During radical subtotal gastrectomy multiple submucosal and subserosal tumors of stomach, and subserosal tumors of small bowel and colon were observed and these tumors were confirmed as leiomyoma without malignant potential.
Barium ; Colon ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Peritoneal Cavity ; Stomach ; Stomach Neoplasms* ; Ultrasonography

No abstract available.
Humans

No abstract available.
Humans

For the purpose of prenatal diagnosis of CAH, genetic linkage analysis by HLA genotyping with lymphocytes and cultured amniotic cells were performed in a family at risk in which two consecutive children had been affected with SW CAH. In addition, the response of serum 17-OHP to intravenous ACTH was determined in obligate carrier parents, and 17-OHP concentration of amniotic fluid was also measured at 16 weeks of gestation. As might be expected, the baseline levels of 17-OHP in obligate parents were significantly higher than that of normal control. Although the post stimulation response of 17-OHP to ACTH in the mother (I-2) was significantly higher than that of normal control, the post stimulation levels of 17-OHP were in normal range in the father (I-1). The 17-OHP level (5.7 ng/ml) in the amniotic fluid showed intermediate value compared to Pang's report (normal less than 30 ng/ml, CAH greater than 12.0 ng/ml) suggesting heterozygote of the fetus. Genetic linkage analysis by HLA genotyping with cultured amniotic cells revealed heterozygote in their fetus (II-3) who has received one chromosome No,6 containing HLA haplotype A24, B40, Cw3 (normal allele for 21-OH) from the father and the other chromosome No,6 containing HLA haplotype A2, Bw62, Cw4 (mutant allele for 21-OH D) from the mother. In conclusion, attempts to detect heterozygote for 21-OH deficiency by ACTH stimulation test were partially successful and prenatal diagnosis of CAH by the hormone studies in ammiotic fluid requires reliable values in normal, heterozygotes and patients group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
*Adrenal Hyperplasia, Congenital/*diagnosis/enzymology/genetics ; Adult ; Amniocentesis ; Cells, Cultured ; Female ; Fetal Diseases/*diagnosis/enzymology ; HLA Antigens/analysis ; Heterozygote Detection ; Humans ; Pedigree ; Pregnancy ; *Prenatal Diagnosis ; Steroid Hydroxylases

BACKGROUND: The purpose of this study was to investigate the estimated proportion for influenza vaccination and to identify factors associated with influenza vaccination in Korean diabetic patients. METHODS: Data from the fourth, fifth, and sixth (except for 2013) Korea National Health and Nutrition Examination Survey (n=3,726) was used. A chi-square test was performed to investigate the estimated proportion for influenza vaccination, and a multiple logistic regression analysis was used to identify the factors associated with self-reported influenza vaccination. RESULTS: In men, 28.8% of diabetes patients 30–64 years of age, and 76.1% of elderly (over 65 years of age) diabetes patients received influenza vaccination. In women, 37.7% of diabetes patients 30–64 years of age, and 78.4% of elderly diabetes patients received influenza vaccination (p < 0.0001). The determinants of influenza vaccination were marriage, hypertension (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07–2.24), residence within a mega city, unemployment (OR, 3.94; 95% CI, 1.24–12.54), and exercise via (weekly) walking for diabetic men; and hypertension (OR, 1.71; 95% CI, 1.16–2.52), chronic disease (OR, 1.81; 95% CI, 1.08–3.02), and exercise via walking (OR, 2.65; 95% CI, 1.49–4.73) for diabetic women. CONCLUSION: Influenza vaccination remains relatively low in young diabetic patients. It is necessary to recommend vaccination to young diabetic patients, and to devise other strategies to improve vaccination.
Aged ; Chronic Disease ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Influenza, Human ; Korea ; Logistic Models ; Male ; Marriage ; Nutrition Surveys ; Unemployment ; Vaccination ; Walking