BACKGROUND AND OBJECTIVES: In general, Asians have noses characterized by a wide flat dorsum, a bulbous thick nasal tip, thick subcutaneous tissues with alar flare, and a short, retracted columella. Such anatomical characteristics have resulted in augmentation rhinoplasty to be the most popular procedure for Asian noses. In augmentation rhinoplasty, it is important to choose proper implant material and insert it into the exact position. But it is hard to insert relatively soft graft or implant such as cartilage and Gore-tex in the exact site. A new kind of forceps, named Jung's forceps, has been developed for implant insertion in augmentation rhinoplasty. We will introduce a new insertion technique using the Jung's forceps. MATERIALS AND METHODS: More than 300 cases of augmentation rhinoplasty was performed using the new forceps since January, 1999. The forceps was designed for grasping whole graft materials. It has 2 mm chink at the tip. This 2 mm chink was designed for passing the 26 gauge needle. When inserting a graft using the forceps, the 26 gauge needle could fix the graft percutaneously at the exact site by passing it through the chink of forceps. We compared the new technique with several previous methods and examined the differences among them. RESULTS: The procedure using the forceps was very easy, exact, and took less time than any other techniques. CONCLUSION: We concluded that the new forceps are useful in augmentation rhinoplasty and other cosmetic surgery.
Asian Continental Ancestry Group ; Cartilage ; Hand Strength ; Humans ; Needles ; Nose ; Polytetrafluoroethylene ; Rhinoplasty* ; Subcutaneous Tissue ; Surgery, Plastic ; Surgical Instruments* ; Transplants

BACKGROUND: Renin-ngiotensin system (RAS) blockers have been used to delay the progression of various renal diseases, but these medications cause hyperkalemia and the elevation of serum creatinine which impede the continuation of the medications. So far, there have been no data on the changes of serum creatinine or serum potassium after withdrawal of the RAS blockers. METHODS: We reviewed medical records of 60 patients who stopped the RAS blockers due to the elevation of serum creatinine or hyperkalemia between March 1995 and May 2005. They were assigned to either the elevated creatinine group or the hyperkalemia group according to the cause of the withdrawal. RESULTS: In the elevated creatinine group (n=37), the serum creatinine and GFR values at the point of withdrawal were 4.0+/-1.8 mg/dL and 18.2+/-10.4 mL/min/1.73m2, respectively. After discontinuation of the medications, a decrease in serum creatinine and an increase in GFR were noted at one month. After one month, however, serum creatinine increased continuously up to 6 months. Serum potassium levels decreased significantly after the drug withdrawal until the end of the study period. In the hyperkalemia group (n=23), the serum creatinine and serum potassium values at the point of withdrawal were 3.0+/-1.0 mg/dL and 6.4+/-0.4 mEq/L, respectively. A significant decrease in serum potassium was also noted after the withdrawal and this decrease lasted up to 6 months. But the transient decrease of serum creatinine, observed in the creatinine group, was not seen in this group. CONCLUSION: It was found that there was a beneficial effect on serum creatinine and GFR immediately after the withdrawal of RAS blockers only when they were stopped due to elevation of the serum creatinine concentration. The serum potassium levels were consistently decreased after the withdrawal of RAS blockers in both elevated creatinine and hyperkalemia groups.
Angiotensin II* ; Angiotensin Receptor Antagonists ; Angiotensins* ; Creatinine* ; Humans ; Hyperkalemia ; Medical Records ; Potassium* ; Renal Insufficiency, Chronic*

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Leucovorin*

The increased survival of patients with breast cancer has given rise to other problems associated with the complications of chemotherapy. One major complication is premature ovarian failure, an especially harmful outcome for women of reproductive age. This study was performed to evaluate the efficacy of GnRH agonist (GnRHa) treatment on protecting ovarian function in young breast cancer patients (30.59+/-5.1 yr) receiving chemotherapy after surgery. Twenty-two women were enrolled and given subcutaneous injections of leuprolide acetate (3.75 mg) every 4 weeks during chemotherapy. Follow-up laboratory tests (luteinizing hormone [LH], follicle stimulating hormone [FSH], and estradiol) were performed 1, 3, and 6 months after chemotherapy. Menstruation patterns and clinical symptoms were followed up for a mean duration of 35.6+/-1.7 months. FSH and LH levels were normal in all patients 6 months after completing chemotherapy (8.0+/-5.3, 4.4+/-2.7 mIU/mL, respectively). During follow-up, none of the patients complained of menopausal symptoms and 81.8% experienced recovery of menstruation. This report is the first trial of GnRHa as a treatment modality to protect ovarian function during adjuvant chemotherapy in young Korean breast cancer patients.
Adult ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Agents, Hormonal/therapeutic use ; Breast Neoplasms/diagnosis/*drug therapy/surgery ; Combined Modality Therapy ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Follicle Stimulating Hormone/analysis ; Gonadotropin-Releasing Hormone/*agonists ; Humans ; Leuprolide/administration & dosage ; Luteinizing Hormone/analysis ; Menstruation ; Ovarian Function Tests ; Primary Ovarian Insufficiency/etiology/*prevention & control ; Republic of Korea ; Tamoxifen/therapeutic use ; Time Factors

No abstract available.
Adult* ; Cytarabine* ; Cytosine* ; Humans ; Leukemia* ; Mitoxantrone*

BACKGOUND: The progression rate of IgA nephropathy is known to be variable. We tried to draw an equation that can predict the interval till end stage renal disease (ESRD). METHODS: We retrospectively checked the risk factors of the progression such as demographic, clinical, laboratory, and histologic data by using simple linear regression in eighty eight (M:F=53:35) patients with biopsy-proven IgA nephropathy from Oct 1994 to Aug 2004. By multiple linear regression, a semiquantitative equation estimating the rate of progression was developed. We also evaluated whether there is a "point of no return" that progresses to ESRD which was shown by D'Amico ('93) and Scholl ('99) by receiver operating characteristic (ROC) curve analysis. RESULTS: Mean age and follow-up period were 34.1+/-13.6 years and 55.7+/-31.4 months. Among the risk factors, spot urine protein to creatinine ratio and mean arterial pressure during the follow-up period were significantly associated with the rate of progression (p<0.05). A semiquantitative equation estimating the rate of progression using the two factors was developed as follow. (delta)CCr=2.206-(0.128 x PCR(follow-up))-(0.023 x MAP(follow-up)) (MAPfollow-up:mean arterial pressure; regression coefficient=-0.023, PCRfollow-up:spot urine protein/creatinine; regression coefficient=-0.128). By ROC curve analysis, all patients with maximum serum creatinine over 4.1 mg/ dL during follow-up were found to progress to ESRD. CONCLUSION: We conclude that in Korean IgA nephropathy patients we could predict the rate of decline in renal function for individual patients semiquantitatively and we could confirm the existence of a "point of no return" during the course of IgA nephropathy.
Arterial Pressure ; Creatinine ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Kidney Failure, Chronic ; Linear Models ; Retrospective Studies ; Risk Factors ; ROC Curve

BACKGROUND: The question of which dialysis modality should be recommended to end-stage renal disease (ESRD) patients with a history of coronary artery disease (CAD) is encountered frequently in clinical practice, and the answer is still controversial. We tried to explore the patient's survival difference by the dialysis modality in incident ESRD patients with CAD. METHODS: We retrospectively analyzed survival differences by dialysis modality in 56 new ESRD patients with preexisting CAD (HD: PD=30: 26) at yearly intervals with Poisson regression from September 1994 to February 2000. We also investigated the predictors of mortality with multivariate analysis by time-dependent Cox regression. RESULTS: There were no significant differences in age, sex, diabetes, co-morbidity, severity of CAD on commencement of dialysis between HD and PD patients with CAD. Cardiovascular deaths were observed in only HD group. In the CAD group, the relative risk (RR) of mortality in HD patients was equal or higher than that in PD patients for the first 3 years, but RR became lower in HD patient after 3 years. The significant predictors of mortality in CAD group were age, diabetes, arrhythmia and history of cardiac arrest at the time of dialysis initiation. CONCLUSION: When we choose a dialysis modality in incident ESRD patient with preexisting CAD, we could consider an early survival benefit of PD over HD and integrated dialysis approach as a treatment option in this patient group. Further investigation including control group is needed to evaluate in the multicenter, large-scaled manner.
Arrhythmias, Cardiac ; Coronary Artery Disease* ; Coronary Vessels* ; Dialysis* ; Heart Arrest ; Humans ; Kidney Failure, Chronic* ; Mortality ; Multivariate Analysis ; Retrospective Studies

BACKGROUND: For endometrioid carcinoma patients, International Federation of Gynecologists and Obstetricians (FIGO) histologic grading is very important for identifying the appropriate treatment method. However, the interobserver discrepancy with this three-tiered grading system is a serious potential problem. In this study, we used immunohistochemistry to analyze the relationship between FIGO histologic grading score and myoferlin expression. METHODS: We studied the endometrioid carcinoma tissues of 60 patients from Gyeongsang National University Hospital between January 2002 and December 2009. Immunohistochemical analysis of myoferlin was performed on tissue microarray blocks from surgical specimens. RESULTS: Myoferlin expression was observed in 58 of 60 patients. Moderate and strong myoferlin expression was observed in low-grade endometrioid carcinoma, while there was a tendency toward loss of myoferlin expression in high-grade endometrioid carcinoma (p < .001). CONCLUSIONS: Our study revealed that myoferlin loss is significantly correlated with high FIGO grade of endometrioid carcinoma.
Carcinoma, Endometrioid ; Drug Therapy ; Humans ; Immunohistochemistry ; Methods

Multiple primary malignant neoplasms (MPMN) are defined by the presence of multiple primary cancers of multicentric origin and/or different tissues. The incidence of MPMN is less than 1% in Korea and recently seems to be increased due to early detection of cancer and prolonged survival of cancer patients. Previous investigations suggest that non-Hodgkin's lymphoma (NHL) may be associated with chronic liver disease and hepatocellular carcinoma (HCC). The pathogenesis of this association is thought to be due to chronic antigenic stimulation, the presence of HBsAg, and immunosuppressive therapy. We report a case of synchronous NHL and HCC in a 54-year-old man which is thought to be associated with hepatitis B virus infection. Pathological examination and immunohistochemical study of neck lymph node and liver mass biopsies showed diffuse large cell lymphoma and HCC, respectively. He was treated initially with EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide and prednisolone) chemotherapy for NHL and transarterial chemoembolization with doxorubicin, mitomycin-c, lipiodol, and gelfoam for HCC.
Biopsy ; Carcinoma, Hepatocellular* ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Early Detection of Cancer ; Ethiodized Oil ; Gelatin Sponge, Absorbable ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Incidence ; Korea ; Liver ; Liver Diseases ; Lymph Nodes ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin* ; Middle Aged ; Mitomycin ; Neck ; Vincristine

PURPOSE: To study clinical features and patterns of recurrence after breast-conserving treatment (BCT) for three molecular subtypes of early stage breast cancer. METHODS: The sample studied included 596 patients with T1-2N0-1 breast cancer who received BCT. Three groups were defined by receptor status. Luminal: estrogen receptor (ER) or progesterone receptor (PR) positive; triple negative (TN): ER, PR, and epidermal growth factor receptor-2 (HER2) receptor negative; and HER2 overexpressing: ER and PR negative but HER2 receptor positive. RESULTS: The number of patients in each group was 408 (68.5%), 105 (17.6%), and 83 (13.9%), respectively. The median follow-up period was 79 months. The TN and HER2 subtypes occurred in younger patients (p=0.0007) and had higher nuclear grade and poorer histologic grade (p<0.0001 and 0.0071, respectively). During the follow-up period, locoregional recurrence was detected as the first site of recurrence in 26 (6.4%), 11 (10.5%), and 9 (10.8%) patients in the luminal, TN, and HER2 subtypes, respectively (p=0.1924). Thirty-one (7.6%), 7 (6.7%), and 7 (8.4%) patients in each group had distant metastases as the first sign of recurrence (p=0.8996). Median time to locoregional and distant recurrence was shorter in the HER2 subtype (p=0.0889 and 0.0780, respectively), and the HER2 subtype was significantly associated with poor overall survival (p=0.0009). CONCLUSION: After BCT in Korean women with early stage breast cancer, the patterns of recurrence were not different among the molecular subtypes, although the TN and HER2 subtypes were associated with younger age, higher nuclear grade, and poorer histologic grade.
Breast ; Breast Neoplasms ; Epidermal Growth Factor ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Segmental ; Neoplasm Metastasis ; Phenobarbital ; Receptor, erbB-2 ; Receptors, Estrogen ; Receptors, Progesterone ; Recurrence