Immediate breast reconstruction following subcutaneous mastectomy for early breast carcinoma remains controversial. According to the recent reports however, it has become a recommendable option for the care of breast cancer patients whether it involves prosthetic implantation or myocutaneous flap procedure. Many technical problems have been introduced to reconstruct the breast; choice of incision, volume estimation, mobility of skin flap including nipple-areolar complex, irregularity of flap thickness, location of inframammary fold and choice of implant type. We have experienced 43 cases of immediate breast reconstruction by using tissue expander, breast implant and transverse rectus abdominis musculocutaneous(TRAM) flap after subcutaneous mastectomy. We believe that immediate breast reconstruction with autogenous tissue is very satisfactory in aesthetic, economic aspects, whereas reconstruction with prosthetic implantation is a convenient method but prone to unsatisfactory long-term results.
Breast Implants ; Breast Neoplasms* ; Breast* ; Female ; Humans ; Mammaplasty ; Mastectomy, Subcutaneous* ; Myocutaneous Flap ; Rectus Abdominis ; Skin ; Tissue Expansion Devices

Despite many successful reports of cartilage tissue engineering, actual clinical application has not been performed due to several critical problems in this new pioneering field of tissue restoration. The problems of progressive absorption and distortion of engineered cartilage are one of those problems preventing clinical application. Distortion of tissue engineered cartilaginous tissue may be induced by internal and external factors such as gradual absorption of biomaterials, inappropriate production of matrix and contractile force in the process of wound healing. Naturally, cartilage tissue is completely enveloped by a layer of connective tissue, the perichondrium, and it continually provides chondrocytes and cartilage matrix. The author's speculation is that we may need the perichondrial layer in cartilage tissue engineering. Perichondrium may be another important element of cartilage tissue engineering. After harvesting a cartilaginous tissue from ear of 12 rabbits, we cultured rabbit ear chondrocytes. Polylactide-co-polyglycolide(PLGA) and fibrin glue were used as chondrogenic scaffold to compare the effect of different biomaterials in cartilage tissue engineering. Tissue engineered construct (TEC) were incubated for 4 weeks and autogenous implantation was performed. During the implantation procedure, some of the TEC were wrapped with perichondrial graft to find out the effect of perichondrium on cartilage tissue engineering. Four weeks after implantation, gross and histologic examinations were performed.With this experiment, we could obtain perichondrium covered cartilage tissue similar to natural cartilage. It was observed that there was less distortion or absorption in TEC with perichondrial graft than TEC without perichondrial graft. As far as the biomaterials are concerned, PLGA group showed less distortion or absorption than fibrin glue group after 4 weeks of in vivo implantation. In conclusion, we could find out the positive effect of perichondrium in cartilage tissue engineering with simple perichondrial graft on TEC. Also, less absorbable biomaterial such as PLGA, seems to provide more reliable results than fibrin glue which is quite easily degraded.
Absorption ; Biocompatible Materials ; Cartilage* ; Chondrocytes ; Connective Tissue ; Ear ; Fibrin Tissue Adhesive ; Rabbits ; Tissue Engineering* ; Transplants ; Wound Healing

Sertoli-Leydig cell tumor (SLCT) which belong to the group of sex-cord stromal tumors is a rare ovarian tumor. It usually develops the symptom of masculinization by excessive testosterone from the Leydig cell. In most cases, SLCTs are unilaterally localized (97-98%) and prognosis prove generally favorable with 5-year survival rate (79-90%). Recurrence is rare after a complete resection as well. Rare SLCTs secrete the alpha-fetoprotein (AFP). There is a increasing tendency for the SLCTs that have heterologous elements and low differentiation to secrete the AFP, which is useful in diagnosis of recurrence. The association of a thyroid adenoma and a SLCT has been described rarely. The relation between these two tumors has been suggested on the basis of a relatively high incidence of thyroid adenomas in the presence of such an uncommon ovarian neoplasm. It seems likely that this tumor complex is genetically determined by the aspect of familial neoplastic syndromes. We experienced a case of Sertoli-Leydig cell tumor with AFP-producing Sertoli cells in a 33-years old woman who has past history of thyroid adenoma, amenorrhea and a huge abdominal mass. Therefore, we present it with a brief review of literature.
Adult ; alpha-Fetoproteins* ; Amenorrhea ; Diagnosis ; Female ; Humans ; Incidence ; Ovarian Neoplasms ; Prognosis ; Recurrence ; Sertoli Cells ; Sertoli-Leydig Cell Tumor* ; Survival Rate ; Testosterone ; Thyroid Gland* ; Thyroid Neoplasms*

Hemangioma is one of the most common tumor in the region of the head and neck. There are many methods were tried for the treatment of hemangioma, however no single satisfactory method was introduced. The hemangioma which arised from the external ear are rare. Authors report three cases of the hemangioma which involved the external ear. The hemangioma was aesthetically treated with surgical reduction and ligation
Ear, External* ; Head ; Hemangioma* ; Ligation* ; Neck

Vitamin D (vit-D) is essential for bone health, although many osteoporosis patients have low levels of 25-hydroxy-vit-D [25(OH)D]. This randomized, open-label study compared the effects of once weekly alendronate 70 mg containing 5600 IU vit-D3 (ALN/D5600) to alendronate 70 mg without additional vit-D (ALN) on the percent of patients with vit-D insufficiency [25(OH)D <15 ng/mL, primary endpoint] and serum parathyroid hormone (PTH, secondary endpoint) levels in postmenopausal, osteoporotic Korean women. Neuromuscular function was also measured. A total of 268 subjects were randomized. Overall, 35% of patients had vit-D insufficiency at baseline. After 16-weeks, there were fewer patients with vit-D insufficiency in the ALN/D5600 group (1.47%) than in the ALN group (41.67%) (p<0.001). Patients receiving ALN/D5600 compared with ALN were at a significantly decreased risk of vit-D insufficiency [odds ratio=0.02, 95% confidence interval (CI) 0.00-0.08]. In the ALN/D5600 group, significant increases in serum 25(OH)D were observed at weeks 8 (9.60 ng/mL) and 16 (11.41 ng/mL), where as a significant decrease was recorded in the ALN group at week 16 (-1.61 ng/mL). By multiple regression analysis, major determinants of increases in serum 25(OH)D were ALN/D5600 administration, seasonal variation, and baseline 25(OH)D. The least squares mean percent change from baseline in serum PTH in the ALN/D5600 group (8.17%) was lower than that in the ALN group (29.98%) (p=0.0091). There was no significant difference between treatment groups in neuromuscular function. Overall safety was similar between groups. In conclusion, the administration of 5600 IU vit-D in the ALN/D5600 group improved vit-D status and reduced the magnitude of PTH increase without significant side-effects after 16 weeks in Korean osteoporotic patients.
Adult ; Aged ; Alendronate/adverse effects/*therapeutic use ; Cholecalciferol/adverse effects/deficiency/*therapeutic use ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal/*drug therapy ; Vitamin D Deficiency/*drug therapy