PURPOSE: Since the use of silicone-filled breast implants has been restricted, hydrogel has been used an alternative filler as a silicone elastomer shell filled with polysaccharide gel. However, its use has also been restricted since 2000 because of complications due to metabolic fate. The author observed the postoperative findings after implant rupture. METHODS: Among 22 cases with previous augmentation mammoplasty using hydrogel implants that received reoperation in M.D. Clinic from February 2006 to June 2008, 12 cases of implant rupture were included in this study. RESULTS: The mean interval from the previous hydrogel surgery was 7 years ranging from 3 to 9 years. Symptoms were unilateral deflation in 4, unilateral breast edema in 4, unilateral changes in texture in 3 and 1 without any symptoms. There was a significant spread of hydrogel into the surrounding tissue in 2 cases of deflation, 2 cases of edema and 1 asymptomatic case. The most severe spreading occurred 6 years after implant in a patient who had been delivered of a baby 2 months before her visit. The author performed total capsulectomy in 11 cases but was unable to remove all gel in 3 cases of multiple spread. Postoperative complications were mild capsular contracture in 2 patients with incomplete removal of surrounding gel and medial herniation in 1 in multiple spreading after childbirth. CONCLUSION: Rupture of hydrogel breast implants had a high risk of surrounding tissue damage and it is suggested that these implants should not be used for breast augmentation. Patients with hydrogel breast implants should be checked carefully for rupture.
Breast ; Breast Implants ; Contracture ; Edema ; Female ; Humans ; Hydrogel ; Mammaplasty ; Parturition ; Postoperative Complications ; Reoperation ; Rupture ; Silicone Elastomers

PURPOSE: Although breast reconstruction provides some advantages for women following mastectomy, few Korean breast cancer patients currently receive such reconstruction. Routine provision of breast reconstruction requires simplicity and easy availability for the procedure. This paper reports the possibility of performing breast reconstruction by insertion of a tissue expander by the breast surgeon. METHODS: We studied 22 cases of breast cancer patients who were treated in the Breast service of KangNam Cha Hospital. Nine cases were the group of immediate expander insertion and 13 were the group of MRM only. We evaluated age, histopathologic stage, starting time of chemotherapy, operation time, drainage amounts and periods, medication periods, time of discharge and depression score. RESULTS: The mean age of the expander insertion group was 41, which was younger than that of the MRM only group by 3 years. Histopathologic state was better in the expander insertion group and the time for chemotherapy start was almost the same between the two groups. Mean operation time in the expander insertion group was 2 hours and 41 minutes, and it was longer than the MRM only group by 1 hour, but it included additional wasting time to check the results of frozen biopsy. Periods for drainage were longer and amounts were larger, but this only delayed the medication period and time for discharge by two days. There were no other complications and mental suffering was alleviated. CONCLUSION: Tissue expander insertion for breast reconstruction could be offered on a routine basis by breast surgeons without problems. Breast reconstruction will become a more essential process for breast cancer patients to improve the quality of life. It is ideal if the same surgeon participates in both oncology and reconstruction surgery.
Biopsy ; Breast Neoplasms* ; Breast* ; Depression ; Drainage ; Drug Therapy ; Female ; Humans ; Mammaplasty* ; Mastectomy* ; Quality of Life ; Stress, Psychological ; Tissue Expansion Devices*

PURPOSE: Women with huge breasts suffer cervical, shoulder and back pain, breast pain and limitations of their daily activities, and all of this can create a functional disability and poor quality of life. Many patients with huge breasts need a reduction surgery not only for cosmetic purposes but also for functional improvement. METHODS: Fifty reduction mammoplasty cases that were operated in M.D. Clinic from April 2001 to August 2004 were retrospectively reviewed. Patient's age, the amount of removed breast tissue and the method of operation were evaluated, and 38 of these cases were surveyed by phone concerning the changes of their physical symptoms. RESULTS: The mean age of the cases were 37.3, and the ages ranged from 18 to 57. The amounts of removed tissue ranged from 50 g to 605 g (mean of right side: 275 g, and left side: 271 g). Nine cases of Benneli's circumareolar scar technique, 9 cases of inferior pedicle flap (inverted T scar) and 32 cases of circumvertical bipedicle flap were performed. Among the 38 cases that were surveyed by phone, most of them had suffered physical symptoms preoperatively, including cervical and shoulder pain (31 cases, 81.6%), back pain (35 cases, 92%), breast pain (21 cases, 55.3%), submammary rash (24 cases, 63.2%), fatigue (14 cases, 36.8%), headache (15 cases, 39.5%), numbness in hands (6 cases, 15.8%) and depression or nervousness (29 cases, 76.3%). The majority of survey respondents reported improvement in cervical and shoulder pain (100%), back pain (100%), fatigue (100%), headache (100%), breast pain (90.5%), submammary rash (91.7%), depression or nervousness (82.7%). Furthermore, there were additional gains including increased ability to enjoy physical exercise and social activity, improvement in the fit of their clothing and in their self-esteem. Adverse sequelae included scars (21 cases, 55.2%), asymmetry (11 cases, 28.9%), decrease in nipple sensation (13 cases, 34.2%), infection (1 cases, 2.6%) and hematoma (1 cases, 2.6%). CONCLUSION: Huge breast create physical symptoms including cervical and shoulder pain, back pain, breast pain, submammary rash, and other social and psychological problems. Reduction mammoplasty can improve the majority of these symptoms caused by huge breast, and this is an operation to help mend a functional disability.
Anxiety ; Back Pain ; Breast ; Cicatrix ; Clothing ; Surveys and Questionnaires ; Depression ; Exanthema ; Exercise ; Fatigue ; Female ; Hand ; Headache ; Hematoma ; Humans ; Hypesthesia ; Mammaplasty* ; Mastodynia ; Nipples ; Quality of Life* ; Retrospective Studies ; Sensation ; Shoulder ; Shoulder Pain

No abstract available.
Adenocarcinoma* ; Biopsy, Fine-Needle*

PURPOSE: The population of women with macromastia is continuously growing year after year in Korea, and macromastia is a common cause of physical and emotional suffering. This study analyzed the clinical results of 100 cases of reduction mammoplasty by single surgeon. METHODS: The author analysed 100 cases of reduction mammoplasty (200 breasts) operated in M.D. Clinic from Jan 2002 to Sep 2005. The operation techniques were vertical bipedicle flap for 74 cases (74%), inferior pedicle flap for 11 (11%), periareolar round block technique for 9 (9%) and liposuction assisted vertical bipedicle flap for 6 (6%). Patient's age, marital state, number of delivery, weight and height, basal metabolic index (BMI), the amount of removed breast tissue, operation time according to period and operation technique, and complications were studied respectively. Sixty one of cases (61%) were surveyed by phone concerning the improveness of their physical sufferings. RESULTS: The mean age of the cases were 35.8 and the ages ranged from 18 to 57. Forty two of cases (42%) were not married and 48 cases (48%) had not delivered yet. BMI based on body weight and height indicated normal (18.5~23) for 51cases, overweight (23<) for 40 and underweight(<18.5) for 9. The amounts of removed tissue per breast ranged from 85 g to 1,450 g (mean of right side: 305 g, and left side: 301 g). According to operation method, mean amounts of removed tissue were 337 g in vertical bipedicle flap, 540 g in inferior pedicle flap and 145 g in periareolar round block technique. Mean operation time were 4:10, 3:32 in periareolar bound block technique, 3:52 in vertical bipedicle flap and 4:45 in inferior pedicle flap. Because of learning curve and the operation time became shortened. The duration of drainage varied from 1 to 5 days and the mean was 2.5 days. Among the 61 cases that were surveyed by phone, most of them had suffered from physical symptoms preoperatively, and the majority of survey respondents reported improvement in cervical and shoulder pain (92.7%), back pain (89.1%), breast pain (90.5%). Adverse sequelae included infection (3 cases, 3%), hematoma (1 case, 1%), nipple necrosis (2 cases, 2%), decreased nipple sensation (31 cases, 31%), wound dehiscence (5 cases, 5%), hypertrophic scar (11 cases, 11%) and all the cases had a little asymmetry. CONCLUSION: Macromastia becomes common in Korea and we should discuss about reduction mammoplasty for adequate surgery. The cases were varied according to age distribution and marital state. There are several methods for reduction surgery, but the author concluded vertical bipedicle flap method is the best for Korean women.
Age Distribution ; Back Pain ; Body Weight ; Breast ; Cicatrix, Hypertrophic ; Drainage ; Female ; Hematoma ; Humans ; Korea ; Learning Curve ; Lipectomy ; Mammaplasty ; Mastodynia ; Necrosis ; Nipples ; Overweight ; Sensation ; Shoulder Pain ; Surveys and Questionnaires ; Wounds and Injuries

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer deaths in the world, especially in Korea where 6-12% of the general population show positive for HbsAg. The accumulating studies suggest that the HBV-X protein found in HBV DNA may be the causative factor in the development of a HCC. METHOD: We studied the role of retinoblastoma (Rb) protein in the suppression of the tumorigenicity of a HCC by using cytomegalovirus (CMV) co-transfected HBV-X protein with retinoblastoma protein (pRb) or N-terminal truncated retinoblastoma protein (pRb94) in HepG2 cell lines. RESULTS: First, culturing HepG2 cells with CMV-Rb/liposome or CMV-Rb94/liposome, we observed the suppression of cell growth by using hemocytometric counting of the cells stained by trypan blue and by using a [3H]thymidine incorporation assay. Then, by using a plasmid co-transfected with the chloramphenicol acetyl transferase(CAT) gene, we investigated the role of HBV-X gene in regulating the transcriptional activity in the HepG2 cells under the control of a kB-like sequence of HIV-1 enhancer and the suppression of its activity by pRb and pRb94. CONCLUSIONS: We concluded that both pRb and pRb94 were capable of suppressing cell growth of a HepG2 cell line containing recombinant plasmids coding HBV-X protein. Furthermore, it was demonstrated that the suppression activity of pRb94 was more potent and sustaining than that of pRb. These results suggest that if additional research is performed on the method of gene delivery, gene therapy using pRb94 might be used as a new modality for the treatment of a HCC.
Carcinoma, Hepatocellular* ; Chloramphenicol ; Clinical Coding ; Cytomegalovirus ; DNA ; Genetic Therapy ; Hep G2 Cells ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; HIV Enhancer ; Humans* ; Korea ; Plasmids ; Retinoblastoma Protein* ; Retinoblastoma* ; Trypan Blue

Poland syndrome is a rare anomaly characterized by a unilateral absence of the pectoral muscles, ipsilateral syndactyly and microdactyly. Associated anomalies include defects of the ipsilateral ribs and costal cartilages, and breast parenchyma in women. Herein, a case of a 22 years old woman is reported. She had no right pectoralis major, ipsilateral breast parenchyma and anterior parts of the ipsilateral 2nd, 3rd, 4th and 5th ribs. Under general anesthesia, a tissue expander was placed laterally between the subcutaneous and intercostal tissues and anteriorly to the pleura. A repeated saline injection via the expander connected port induced tissue expansion. The total amount of injected saline was 550 cc, and the expander was replaced with a 300 cc prefilled saline implant. The other breast was augmented by insertion of a 150 cc saline implant for symmetry as this was requested by the patient. There were no specific complications, with the exception of a persisting ipsilateral axillary wrinkle. To remove this wrinkle, a combined latissimus dorsi flap may be helpful.
Anesthesia, General ; Breast* ; Cartilage ; Female ; Humans ; Mammaplasty* ; Muscles ; Pleura ; Poland Syndrome* ; Poland* ; Ribs ; Superficial Back Muscles ; Syndactyly ; Tissue Expansion ; Tissue Expansion Devices ; Young Adult

A patient with glioblastoma multiforme was treated with postoperative radiotherapy and a simultaneous induction chemotherapy with CCNU(75mg/sqm), procarbazine(100mg/sqm), vincristine(1.4mg/sqm). Follow up C-T scanning showed a mild decreased density area of left frontal lobe and the patient was discharged without any evidence of neurological deficit except mild decreased visual acuity.
Drug Therapy* ; Follow-Up Studies ; Frontal Lobe ; Glioblastoma ; Humans ; Induction Chemotherapy ; Radiotherapy ; Visual Acuity

Interaction with Candida albicans (C. albicans) causes secretion of a variety of cytokines by macrophages. Although macrophages and neutrophils are thought to be major effector cell types in inflammation, fibroblasts have also been shown to participate in a wide array of inflammatory reactions. The patterns of cytokine gene (IL-4, IL-6, IL-10) expression have been examined in NIH 3T3 fibroblasts (NIH 3T3) and thioglycollate-elicited murine peritoneal macrophages (macrophages) in response to Candida spp. (C. albicans and C. tropicalis) and compared with NIH 3T3 and macrophage cells stimulated with lipopolysaccharide (LPS) by using RT-PCR. Active and heat inactivated (100'C, 30min) C. albicans and C. tropicalis were used at 1:10 (macrophages or NIH 3T3: yeasts ratio) concentration as a stimulators. Active and inactivated forms of Candidn spp. induced same patterns of cytokine gene expression on macrophages or NIH 3T3 cells. IL-6 mRNA was induced on both macrophages and fibroblasts, but IL-4 mRNA was not induced on both of them. Howerver, IL-10 mRNA expression was observed differently in that it was expressed in macrophages but not in fibroblasts. C. albicans-induced cytokine mRNA expression were same to C. tropicalis-induced one. C. albicans or C. tropicalis-induced cytokines gene expression (IL-4, IL-6, IL-10) showed same patterns to LPS-induced one. These observation provide that, although C. albicans and C. tropicalis have different pathogenic activity, they can induce the expression of Th2 cell-derived cytokine genes with same patterns, and IL-10 gene expression may be in a cell type specific manner. But further experiment with various kinds of fibroblasts is needed to determine cell type-specific manner in C. albicans or C. tropicalis-induced IL-10 gene expression.
Animals ; Candida albicans ; Candida* ; Cytokines ; Fibroblasts* ; Gene Expression* ; Hot Temperature ; Inflammation ; Interleukin-10 ; Interleukin-4 ; Interleukin-6 ; Macrophages ; Macrophages, Peritoneal* ; Mice* ; Neutrophils ; NIH 3T3 Cells ; RNA, Messenger ; Yeasts

OBJECTIVE: The purposes of the present study were to investigate the effect of gamma-radiation on the expression of inhibin-alpha proteins and genes for inhibin alpha, betaA, and betain the ovary. METHODS: Immature mice were whole-body gamma-irradiated with 25% of a lethal dose. At time 0, 3, 6, 12, and 24 hours after the irradiation,the ovaries were collected and used for immunohistochemistry for inhibin-alpha, and RT_PCR for inhibin-alpha, betaA, and betaB. RESULTS: The expression of the immunoreactive inhibins-alpha was maintained at 12 hours post-irradiation and reduced thereafter. The expression of inhibin-alpha mRNA was significantly increased with the time after the irradiation. However there were no significant changes in the expression of betaA and betaB mRNAs. CONCLUSION: It might be thought that inhibin acts as one of the regulatory factors in the gamma-radiation-induced follicular atresia in mice
Animals ; Female ; Follicular Atresia ; Immunohistochemistry ; Inhibins* ; Mice* ; Ovary* ; RNA, Messenger