PURPOSE: To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. MATERIALS AND METHODS: A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. RESULTS: In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. CONCLUSION: When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.
Cesarean Section ; Cicatrix ; Cosmetics ; Electrons ; Female ; Humans ; Hyperpigmentation ; Keloid ; Ovary ; Postpartum Period ; Pregnancy

OBJETIVE: This study was performed to investigate the effect of metformin therapy on ovulation induction & pregnancy rate in clomiphene citrate-resistant PCOS women. METHOD: This study used a randomized, single-blinded, case-controlled methods. Total study group consisted of 21 women who showed clomiphene citrate-resistant parttern on previous ovulation induction cycles. Patients of metformin group received metformin 500 mg three times daily, for 7 weeks. Control group received none. Metformin group was consisted of 10 women and control group was consisted of 11 women. Then clomiphene was administrated at daily 50 mg for 5 days to both groups. Clomiphene dosage was increased to daily 150 mg until ovulation was occurred. Before and After metformin treatment, blood samples for measurement of insulin, glucose, steroids were obtained. RESULTS: In the metformin and control groups, 6 of 10 women (60%) and 2 of 11 women (18%) ovulated. And 4 of 10 women (40%) and 0 of 11 women (0%) conceived. Comparisons between the groups were significant. CONCLUSION: In PCOS women who are resistant to CC, metformin use increased the ovulation rate and pregnancy rate from CC treatment, significantly.
Case-Control Studies ; Clomiphene* ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Metformin* ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Pregnancy Rate ; Steroids

No abstract available.
Female ; Mammaplasty*

OBJECTIVE: To evaluate the efficacy of low-dose aspirin on IVF outcome and endometrium in patients undergoing IVF-ET. MATERIALS AND METHODS: From February, 2001 to Jun, 2001, 60 infertile patients were randomly divided into study group (28 cycles) and control group (32 cycles). The study group received a daily oral dose of 25 mg of aspirin for at least 2 weeks from first visiting day. Controlled ovarian hyperstimulation was initiated in all patients with the GnRH agonist starting in the midluteal phase of the previous cycle. RESULTS: There were no significant differences in age of the patients, basal serum E2, LH, FSH level and endometrial thickness among two groups. There were no statistically significant differences between the study group and the control group respectively in dosage (26.5+/-4.8 vs 26.2+/-5.3 amples) and duration (10.4+/-4.2 vs 9.8+/-5.3 days) of gonadotropin administration, serum E2 level on the hCG administration day (1823+/-342 vs 1854+/-543), LH (14.5+/-2.7 vs 14.8+/-3.1), FSH (16.7+/-3.4 vs 18.3+/-4.7), the number of follicles p> 15 mm (13.2+/-6.3 vs 12.8+/-5.9), the number of oocytes retrieved (9.2+/-2.4 vs 8.4+/-1.7), the number of embryos transferred (4.7+/-2.0 vs 4.7+/-2.0), fertilization rate (68.4% vs 64.5%), implantation rate (21.3% vs 17.6%), and clinical pregnancy rate (28.4% vs 26.2%). The endometrial thickness and the percentage of endometrial trilaminar pattern on hCG day were significantly higher in study group than control group (12.9+/-3.7 mm vs 10.4+/-2.8 mm, 78.3% vs 64.5%). CONCLUSION: Many reports suggest that low-dose aspirin improve ovarian response, implantation rate, fertilization rate, implantation rate, and pregnancy rate by increasing the blood flow, but we couldn't prove the significant effect of low-dose aspirin on the IVF outcome except on endometrium. This may be affected by dose of aspirin, duration, and number of patients studied. This trial is small, so our results highlight the need for a large randomized controlled trial to identify the effect of low-dose aspirin on IVF-ET outcome.
Aspirin* ; Embryonic Structures ; Endometrium ; Female ; Fertilization ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Oocytes ; Pregnancy Rate

No abstract available.
Diagnosis* ; Osteoma, Osteoid*

Recently there has been remarkable improvement in the treatment of chondrosarcoma, accompanied with the development of diagnostic tools, operative technique, replacement materials and designs, anticancer-chemotherapy and radiotherapy. In well-deferentiated chondrosarcom, wide excision is the only treatment required. Nevertheless, in dedifferentiated chondrosarcoma, anticancerchemotherapy or radiotherapy is usually recommended after the wide excision. From 1984 to 1994, 22 patients diagnosed as chondrosarcoma had been treated at Seoul National University Hospital. We analysed anatomic distributions, size, methods of treatment and their results. The avereage age was 38 years and 10 months(15 years 73 years) and the average follow-up period was 3 years and 10 months(1 year and 6 months
Chondrosarcoma ; Classification ; Fibula ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Methods ; Neoplasm Metastasis ; Osteochondroma ; Radiotherapy ; Seoul ; Transplants

Simple bone cyst was first described by Virchow over a century ago and has been the subject of numerous articles. Nevertheless considerable confusion still exists regarding its etiology. clinical behavior and optimal management. Eighteen cases of pathologically proven simple bone cyst were treated in the Department of Orthopedic Surgery, Seoul National University Hospital during the thirteen year period from June 1966 to May 1979, and following results were obtained. 1. Age distributions were between five and forty-three years (Average ; seventeen years), and 72.2% (thirteen cases) were during first two decades of life. 2. Male to female ratio was 2.6 to 1 3. The most frequently involved location was proximal humerus followed by proximal femur. 4. Pathologic fracture, pain, incidental roentgenography and swelling were the first clues of diagnosis in our series. 5. In twelve cases curettage and fresh autogenous iliac bone graft was performed and good results were obtained in all of them. Of five cases only curettage had been done, no case recurred, another case showed residual cystic area, and the rest healed without further event. In one case with huge cyst curettage, iliac and fibular bone graft and bone cementing was performed with satisfactory result. 6. Bone shortening was noticed in two cases of active bone cysts in proximal humerus 2cm and 3cm, respectively.
Age Distribution ; Bone Cysts ; Curettage ; Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Humerus ; Male ; Orthopedics ; Radiography ; Seoul ; Transplants

Although osteltis fibrosa cystica was the clinical manifestation originally recognized as a feature of the primary hyperparathyroidism, its frequency in diagnosed cases currently has decreased. Affected patients are now being detected in earlier stages of the disease. We have experienced a case of primary hyperparathyroldism with the typical bony changes and the pathologic, subtrochanteric fracture of left femur. We have treated the fracture with Zickel nalling and parathyroidectomy was performed. Four months after the removal of parathyoid adenoma the fractured femur healed well.
Adenoma ; Femur ; Fractures, Spontaneous ; Humans ; Hyperparathyroidism, Primary ; Parathyroidectomy

No abstract available.

Delirium is a common psychiatric disorder and occurs in many hospitalized older patients and has serious consequences including increased mortality rate. Despite its importance, health care clinicians often fail to recognize delirium or misdiagnosed as other psychiatric illness. Awareness of the etiologies and risk factors of delirium should enable clinicians to focus on patients at risk and to recognize delirium symptoms early. To improve early recognition of delirium, emphasis should be given to terminology, psychopathology and knowledge regarding clinical rating scale for delirium in the specific medical and surgical clinical settings. In this study, authors introduce rating scales for delirium and knowledge of clinical diagnostic process for delirium and give rise to appropriate assessment of delirium in the clinical situation.
Delirium ; Delivery of Health Care ; Humans ; Psychopathology ; Risk Factors ; Weights and Measures