Paraovarian cysts arise in the mesosalpinx, between the ovarian hilum and the fallopian tube. Clinical significance of paraovarian tumors is considerably less frequent than ovarian tumors, and malignant paraovarian lesions are exceedingly rare. Paraovarian carcinomas or borderline malignancy mostly occur in young women. Abdominal enlargement and pelvic pain are the usual complaints. Usually they have a capsule, are unilateral and are connected to the broad ligament. Little is known about the biological behavior of the paraovarian borderline malignancies, since these lesions are so rare. The appropriate therapy for this unusual lesion have not been fully defined. We had experienced a case of papillary serous adenocarcinoma of borderline malignancy and report this case with a brief review of literature.
Adenocarcinoma ; Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Pelvic Pain

Internal jugular vein cannulation is commonly used for the anesthetic management of patients undergoing a major operation. Complications associated with internal jugular vein cannulation such as a carotid artery puncture, pneumothorax and hemothorax, have been reported; however, thrombotic complications of arteries due to accidental arterial punctures are rare. We report a case of thrombotic obstruction of the subclavian artery associated with inadvertent arterial puncture following an attempted internal jugular vein cannulation.
Arteries ; Carotid Arteries ; Catheterization ; Hemothorax ; Humans ; Jugular Veins ; Pneumothorax ; Punctures ; Subclavian Artery ; Thrombosis

Postinfarction ventricular septal rupture (VSR) is a rare but fatal complication of acute myocardial infarction. In many cases, postinfarction VSR leads to hemodynamic instability and urgent surgical treatment is necessary. Here we describe a case of a patient with right ventricular (RV) dysfunction caused by acute RV infarction and with cardiogenic shock, whose condition improved after development of postinfarction VSR, but the patient died after corrective surgery.
Hemodynamics ; Humans ; Infarction ; Myocardial Infarction* ; Shock, Cardiogenic ; Ventricular Dysfunction, Right ; Ventricular Septal Rupture*

BACKGROUND AND OBJECTIVES: Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. METHODS: We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. RESULTS: When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ≤3 mm), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). CONCLUSION: All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.
Humans ; Inflammation ; Microscopy ; Microsurgery* ; Phonation ; Polyps* ; Retrospective Studies ; Voice Quality* ; Voice*

PURPOSE: Presently, silicone rubber is chosen most frequently for nasal augmentation. However, there is a possibility of extrusion with this material. Sometimes, noses are prone to be traumatized, and then silicone rubber has a possibility of deformity or deviation resulting in trauma. We experienced cases with complications and traumatic deformities after the augmentation rhinoplasty. METHODS: A retrospective review was performed to determine the characteristics of the implanted nasal silicone prosthesis after trauma. The patients' data such as deviation of implant, shape of fracture, age and sex of the patient, time of treatment, operative methods were reviewed. From March 2001 to March 2008, this study was performed in 30 patients. The patients were 25 females and 5 males, from 24 to 60 years of age, with an average of 42. All patients had previous augmentation rhinoplasty with silicone implant. RESULTS: All of the 30 patients were confirmed as deviation of silicone and nasal bone fractures in the facial bone CT scan. The most common cause of fracture was traffic accident. The classification of nasal trauma after augmentation was done by facial bone CT. Class I: Deviation of silicone without nasal bone fracture without extrusion(12 cases, 40%), Class II: Deviation of silicone without nasal bone fracture and with extrusion(4 cases, 13%), Class III: Deviation of silicone with nasal bone fracture and without extrusion(8 cases, 27%), Class IV: Deviation of silicone with nasal bone fracture and with extrusion(3 cases, 10%), Class V: Mild deviation of silicone with nasal bone fracture(3cases, 3%). Specially, the comminuted or trapezoid nasal fracture was confirmed in 11 cases(Class III, IV). CONCLUSION: The problems of silicone implant have generally been related to foreign body reactions, rigidity of the material, encapsulation, infections, and extrusion. We experienced 11 cases of comminuted or comminuted trapezoid shaped fracture below nasal implant. So, we think this phenomenon could be used in late problem of silicone implant.
Accidents, Traffic ; Congenital Abnormalities ; Facial Bones ; Female ; Foreign Bodies ; Humans ; Male ; Nasal Bone ; Nose ; Prostheses and Implants ; Retrospective Studies ; Rhinoplasty ; Silicone Elastomers

During renal ischemia, ATP is degraded to hypoxanthine and xanthine oxidase is accumulated. When reperfusion develops, large amount of oxygen is supplied and superoxide radicals are generated. Free radical species were generated by a series of oxygen mediated reaction resulted in lipid peroxidation in the cellular membrane, which causes renal injury. Cyclosporin (CsA) is a potent immunosuppresant. however, one of the main adverse effects of CsA is nephrotoxicity. The mechanism of nephrotoxicity is still not fully understood. Only we proposed it as being responsible for the derangement of renal function, enhanced free radical species, vasoconstriction, ATP depletion, several vasoactive mediators. Based on the previously studied data with experimental animals, we studied a relationship between ischemia and reperfusion renal injury and cyclosporine with experimental rats. Four groups of Sprague-Dawley rats were studied: 1) a control group, only 60 minnites clamping and on day 3 is sacrified, 2) second control group, 60 minnites clamping and on day 5 is sacrified, 3) in the third and fourth group, after 60 minnites clamping, cyclosporine, 20 mg/kg/day was administrated intraperitoneally and were sacrified on day 3 and day 5, respectively. Antioxidant enzymes (SOD, Catalase), TBA-RS, GGT were measured by a specific biochemical method, and results were analyzed according to Wilcoxon rank sum test. p-value <0.05 was considered statistically significant. In cyclosporin administrated rats, GGT was elevated significantly on day 3 and day 5 (p=0.0367, p=0.0216), but SOD, Catalase, TBA-RS were not identified a significant change. In conclusion, on renal ischemia and reperfusion,cyclosporin induced renal injury is not related to free radical species, which suggests that other unknown mechanisms influence renal injury.
Adenosine Triphosphate ; Animals ; Catalase ; Constriction ; Cyclosporine* ; Free Radicals ; Hypoxanthine ; Ischemia ; Kidney ; Lipid Peroxidation ; Membranes ; Oxygen ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury* ; Reperfusion* ; Superoxides ; Vasoconstriction ; Xanthine Oxidase

PURPOSE: The aims of this study were to find the difference in frequency between genders and to determine the correlation between age-related disease and other diseases in obstructive defecation. METHODS: A consecutive series of 1,513 patients (343 males, 1,170 females) with obstructive defecation who undertook defecography and/or cinedefecography during 1 year period was analyzed. RESULTS: The causes of obstructive defecation in males showed as spastic pelvic floor syndrome (SPFS) (48.3%), rectal prolapse (RP) (31.4%), descending perineum syndrome (DPS) (25.9%), enterocele or sigmoidocele (7.6%), and rectocele (7%). However, in females, the causes were rectocele (83.8%), DPS (49.2%), RP (37.6%), SPFS (32.5 %), and enterocele or sigmoidocele (11.2%). The SPFS was negatively correlated with enterocele or sigmoidocele, DPS, RP in both genders, but SPFS had no statistical correlation with rectocele. DPS was correlated with RP in both genders and with enterocele or sigmoidocele in females, but no statistical correlation was seen in males. The size of the rectocele showed a slight correlation with age in females (r=0.102, P=0.01). Age was correlated with rectal prolapse in females; however, it showed a negative correlation with SPFS in females. CONCLUSIONS: The frequency of diseases causing obstructive defecation is different between genders. Age may not play a role in aggrevating the diseases causing obstructive defecation. Further pathophysiologic study of gender differences in patients with obstructive defecation is needed.
Defecation* ; Defecography ; Female ; Hernia ; Humans ; Male ; Muscle Spasticity ; Pelvic Floor ; Perineum ; Rectal Prolapse ; Rectocele

PURPOSE: The goal of oncoplastic breast surgery is to restore the appearance of the breast and improve patient satisfaction. Thus, the assessment of cosmetic results and patient-reported outcomes (PROs) using appropriately constructed and validated instruments is essential. The aim of the present study was to assess the long-term objective cosmetic results and corresponding PROs after oncoplastic breast surgery. METHODS: Cosmetic results were assessed by the patients, a medical panel, and a computer program (BCCT.core). PROs were assessed using BREAST-Q, a questionnaire that measures the perception of patients having breast surgery. The cosmetic results and PROs were analyzed in patients who underwent quadrantectomy and partial breast reconstruction utilizing the latissimus dorsi flap. RESULTS: The mean duration of the follow-up period was 91.6 months (range, 33.3-171.0 months), and mean age of the patients was 51 years old (range, 33-72 years). The mean tumor size was 2.1 cm (range, 0.9-5.5 cm). There was fair agreement between the medical panel and BCCT.core score (K = 0.32, P < 0.001), and a statistically significant correlation between the BCCT.core score and medical panel cosmetic results was identified (r = 0.606, P < 0.001). A better BCCT.core result was related to a higher PRO of each BREAST-Q domain-satisfaction with breasts (R2 = 0.070, P = 0.039), satisfaction with outcome (R2 = 0.087, P = 0.021), psychosocial well-being (R2 = 0.085, P = 0.023), sexual well-being (R2 = 0.082, P = 0.029), and satisfaction with information (R2 = 0.064, P = 0.049). CONCLUSION: Our long-term results of oncoplastic surgery achieved a high level of patient satisfaction with good cosmetic results. The medical panel and BCCT.core results correlated well with the PROs of the patients using valid, reliable, and procedure-specific measures.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Patient Satisfaction ; Pilot Projects* ; Quality of Life ; Superficial Back Muscles* ; Surgical Flaps