OBJECTIVES: The purposes of this study were to determine the usefulness of transvaginal ultrasonographic assessment of the uterine cervix and to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in predicting a successful induction of labor. STUDY DESIGN: One hundred-one singleton term pregnancies without ruptured membranes admitted for the labor induction were included in this study. Digital examination and transvaginal ultrasonography of the uterine cervix were performed at the time of admission. Cervical parameters evaluated included cervical length, presence of funneling, funnel length, and funnel width. Labor induction was underwent by prostaglandin E2 (PGE2) vaginal suppository and/or pitocin intravenous infusion. Outcome variable was a successful labor induction within 48 hours after beginning of the induction. RESULTS: The prevalence of induction failure was 10.9% (11/101). Receiver-operator characteristic (ROC) curve and multiple logistic regression analysis indicated a significant relationship between the successful induction of labor and cervical length <3.1 cm. The diagnositic indices of endocervical length was superior to those of Bishop's cervical score in predicting a successful induction of labor. In patients with cervical length <3.1 cm, the labor was induced successfully with fewer tablets of PGE2, less use of pitocin infusion, and shorter induction-delivery interval. CONCLUSION: Transvaginal ultrasonographical examination of the uterine cervix is more accurate than digital examination of the cervix in the prediction of a successful induction of labor in term gestation.
Cervix Uteri* ; Dinoprostone ; Female ; Humans ; Infusions, Intravenous ; Logistic Models ; Membranes ; Oxytocin ; Pregnancy* ; Prevalence ; Suppositories ; Tablets ; Ultrasonography

BACKGROUND: Surgical excision is generally recommended for the treatment of nodular fasciitis (NF) to rule out sarcoma. However, in cases of NF occurring on the face, the reported recurrence rate is higher and the surgical approach may result in considerable aesthetic concern. OBJECTIVE: To describe our experience with NF occurring on the face and evaluate the outcomes of surgical and nonsurgical methods of treatment. METHODS: We performed a retrospective review of 16 patients with NF on the face. The patients were treated with surgical excision or nonsurgical methods such as triamcinolone intralesional injection (TA ILI) and pinhole method with a carbon dioxide (CO2) laser. RESULTS: Among the 16 patients, surgical treatment was performed in 9 and recurrence occurred in 7 of these 9 patients (77.8%). The recurred lesions showed regression after repeated TA ILI. On the other hand, five patients underwent nonsurgical treatment after the histologic exclusion of malignancy. Their lesions showed regression after repeated pinhole treatment and TA ILI. In one case, NF spontaneously regressed. On a visual analogue scale, the nonsurgical approach showed superior results. However, the values were not statistically significant (6.90+/-1.56 vs. 5.61+/-1.36; p=0.163). The satisfaction level was lower in patients who experienced recurrence after surgical excision. CONCLUSION: Surgical treatment for NF on the face showed a noticeable recurrence rate and resulted in scarring. Therefore, considering the possibility of spontaneous regression, the nonsurgical method can be considered as an alternative treatment option for NF on the face.
Carbon Dioxide ; Cicatrix ; Fasciitis* ; Hand ; Humans ; Injections, Intralesional ; Laser Therapy ; Recurrence ; Retrospective Studies ; Sarcoma ; Triamcinolone

PURPOSE: To evaluate the safety and visual outcome of intravitreal triamcinolone acetonide combined with photodynamic therapy for subfoveal choroidal neovascularization in patients with age-related macular degeneration. METHODS: We evaluated 32 eyes of 32 patients with choroidal neovascularization due to age-related macular degeneration. The study group received photodynamic therapy and intravitreal triamcinolone acetonide (combined group), while the control group received photodynamic therapy only (PDT group). RESULTS: Three months after treatment, no difference was detected between the two groups in visual acuity changes (p>0.05), but the leakage in fluorescein angiography and macular edema in optical coherent tomography decreased (p<0.05) in the combined group. The retreatment rate in the combined group (6.0%) after 3 months was lower than that of the PDT group (53.3%). CONCLUSIONS: Photodynamic therapy with intravitreal triamcinolone acetonide to choroidal neovascularization reduced the retreatment rate at 3 months significantly. These results may have been be due to the short-term anti-inflammatory effect of steroids.
Choroid* ; Choroidal Neovascularization* ; Fluorescein Angiography ; Humans ; Macular Degeneration* ; Macular Edema ; Photochemotherapy* ; Retreatment ; Steroids ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity

Background: Melanoma arising from the scalp is rare and often diagnosed at advanced stages due to difficulty in detection. Objective: This is the first study that aimed to analyze the clinicopathological findings of scalp melanoma among Korean patients at a single institution. Methods: In this single-centered retrospective study, medical records were used to review data of patients with scalp melanoma between 2006 to 2021. Chronic sun damage (CSD) was evaluated by reviewing histopathological findings of scalp melanoma. Results: Fifteen patients were identified. Mean age at diagnosis was 53.93 years. In 14 cases, the tumors were located on hair-covered areas. Mean Breslow’s thickness was 6.06 mm. Nodular melanoma was the most common histologic type (n=9), followed by superficial spreading (n=5), and lentigo maligna (n=1). Ulceration was present in five cases. In nine cases, CSD was moderate. Elective neck node dissection was performed in 13 cases, with five revealing nodal involvement. At initial staging, three patients were in stage I, six were in stage II, four were in stage III, and two were in stage IV. Recurrence occurred in seven of the 15 cases. There were five confirmed mortalities during a mean follow-up period of 35 months. Conclusion In this study, the Breslow’s thickness of scalp melanoma was relatively deep, and the most frequent type was nodular melanoma. Since detection can be affected by black hair among Koreans, it may result in delayed diagnosis and poor prognosis. Therefore, more caution is needed when examining suspicious lesions on the scalp.

Psoriasis vulgaris and bullous pemphigoid represent 2 clinically and histologically distinct, chronic inflammatory skin conditions. The concomitant occurrence of these 2 diseases is rare, and the pathogenic relationship between psoriasis and bullous pemphigoid remains unclear. The development of bullous pemphigoid in patients with psoriasis is considered to be related to treatments for psoriasis, especially ultraviolet therapy. However, some recent reports have suggested that an immunologic or biochemical association between these two diseases plays a role in the pathogenesis. Herein, we report 3 cases of bullous pemphigoid occurring in patients with psoriasis, and we discuss the possible pathogenic mechanisms of an association between psoriasis and bullous pemphigoid.
Humans ; Pemphigoid, Bullous* ; Psoriasis* ; Skin ; Ultraviolet Therapy

Primary liver cancer has traditionally been classified as either hepatocellular carcinoma (HCC) or cholangiocarcinoma (CCC). However, primary liver cancer occasionally consists of elements from both HCC and CCC. Intermediate hepatic carcinoma and primary liver cancer of the intermediate type are extremely rare subtypes of primary liver cancer that show features intermediate between HCC and CCC. First reported in 1998, the clinical, radiologic, and histopathologic characteristics of this entity remain unclear. In this case report, we describe the clinical, magnetic resonance imaging, histopathological, and immunohistochemical findings in a patient with intermediate hepatic carcinoma who was initially thought to have intrahepatic cholangiocarcinoma.
Carcinoma, Hepatocellular ; Chlormequat ; Cholangiocarcinoma ; Humans ; Liver Neoplasms ; Magnetic Resonance Imaging

BACKGRUOND: Several angiogenic factors such as bFGF and VEGF have been shown angiogenesis of placenta. PGE2 and PGI2 may be important in successful establishment of pregnancy. OBJECTIVE: We studied to investigate whether PGE2 and PGI2 regulate expression of VEGF and bFGF gene in the cultured human trophoblast cells. METHODS: Human trophoblasts were isolated from the placenta of early gestation (6-12 weeks). Isolated trophoblasts were cultured in the different concentration of PGE2 and PGI2 and according to the different cultured time of PGE2 and PGI2, respectively. Total RNA was extracted and RT-PCR was performed. RESULT: Expression of bFGF was increased in 10-7M and 10-6M of PGE2 and was always increased in the all different concentration of PGI2. Four isoforms (VEGF121, VEGF165, VEGF189, VEGF206) were always expressed in the all different PGE2 and PGI2 concentration compared to the control group. However, there was no significant difference in the all different PGE2 and PGI2 concentration. In both PGE2 and PGI2 treatment group, expression of bFGF was decreased at 60 min compared to the control group and was gradually increased in time-dependent pattern. At 180 min, its expression was similar to the control group. CONCLUSION: Our data suggest that the expression of bFGF gene is influenced by cultured time and concentration of PGE2 and PGI2, although the expression of VEGF gene is not influenced.
Angiogenesis Inducing Agents ; Dinoprostone* ; Epoprostenol* ; Fibroblast Growth Factor 2* ; Humans* ; Placenta ; Pregnancy ; Protein Isoforms ; RNA ; Trophoblasts* ; Vascular Endothelial Growth Factor A*

Skin neoplasms can result in large skin defects after surgical removal. Skin grafting has been used commonly to repair large defects, but it is associated with esthetic and functional problems. Herein, we report three cases with application of the keystone island flap in large skin defects of the trunk and extremities. A 53-year old male with recurred dermatofibrosarcoma protuberans on his thigh was repaired by the keystone island flap after Mohs micrographic surgery, and a 52-year old male with malignant melanoma on his back was successfully reconstructed by the keystone island flap after wide excision. Lastly, a 59-year old male diagnosed with dermatofibrosarcoma protuberans on the inguinal area was closed by the keystone island flap with commendable cosmetic outcome. Due to the ease of performance, excellent cosmetic and functional results, we recommend the keystone island flap for the reconstruction of large skin defects on the trunk and extremities.
Dermatofibrosarcoma ; Extremities ; Humans ; Male ; Melanoma ; Mohs Surgery ; Skin Neoplasms ; Skin Transplantation ; Skin* ; Thigh

Solanum lycopersicum, commonly known as tomato, is widely used in raw, cooked, or liquid forms because it contains nutritional compounds that are beneficial for human health, including carotenoids, lycopene, ascorbic acid, vitamins, and minerals. The tomato is perhaps the most widely studied fruit, especially with respect to its cardioprotective effects. In this study, we aimed to identify the anti-inflammatory mechanisms by which the tomato elicits its anti-inflammatory properties. We treated murine macrophage RAW 264.7 cells with a tomato ethanol extract and performed various biochemical assays including nitric oxide inhibition, cell viability, RNA extraction, expression of pro-inflammatory mediators and cytokines, and immunoblotting, as well we assessed cell survival rates. Our results have shown for the first time that a tomato ethanol extract treatment can suppress nitric oxide production in a dose-dependent manner without cytotoxicity. Moreover, it inhibits the expression of pro-inflammatory mediators and cytokines and elicits its anti-inflammatory effects via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. In addition, administration of tomato syrup potently rescued mice from septic shock induced by lipopolysaccharide injection. Collectively, our results elucidate details regarding the anti-inflammatory mechanisms of tomato.
Animals ; Ascorbic Acid ; B-Lymphocytes ; Carotenoids ; Cell Survival ; Cytokines ; Ethanol* ; Fruit ; Humans ; Immunoblotting ; Lycopersicon esculentum* ; Macrophages ; Mice* ; Minerals ; Miners ; NF-kappa B* ; Nitric Oxide ; Protein Kinases ; RAW 264.7 Cells ; RNA ; Shock, Septic* ; Solanum* ; Vitamins

PURPOSE: To assess the estimate prevalence and risk factors for age-related maculopathy (ARM) in Seoul, Korea. PATIENTS AND METHODS: We examined 9,530 subjects with, 40 years of age or older between January 2006 and December 2006 in Seoul, Korea. Subjects underwent fundus photography, clinical examinations (including blood analyses), and completed detailed questionnaires. Fundus images were graded according to definitions from the Wisconsin Age-Related Maculopathy Grading System. RESULTS: ARM was present in 235 subjects, corresponding to an estimate prevalence of 2.46%. Hepatitis B infection (positive status for HBsAg and HBcAb), serum triglyceride levels and high density lipoprotein levels remained as significant risk factors after age-adjustment. Multivariate analyses showed that the prevalence of ARM was significantly higher in older subjects [odds ratio (OR) 1.134; 95% CI 1.114-1.154] and those who were seropositive for hepatitis B surface antigen (OR 2.566; 95% CI 1.519-4.335). CONCLUSION: The estimated prevalence of ARM was 2.46%. Age and hepatitis B infection may increase the risk of ARM.
Adult ; Age Factors ; Aged ; Female ; Hepatitis B/complications ; Humans ; Korea/epidemiology ; Lipoproteins, HDL/blood ; Macular Degeneration/blood/*epidemiology/etiology ; Male ; Middle Aged ; Risk Factors ; Triglycerides/blood