No abstract available.
Placenta* ; Trophoblasts*

It has been known that the improved drainage of a flap increases its survival and the increasing number of draining vein improves survival of flaps. But recently, researches have proved that the different orientation of venous outflow on the island flap is more important than the number of outflow tracts. The purpose of this study is to investgate the survival rates of flaps with various numbers or locations of draining veins. An 6 X 7cm flap was raised on the abdomen of 40 white rats (Sprague-Dowley, 350 - 400 gm). Rats were divided into 4 groups and each group consisted of 10 rats. In group 1 (A l$ flaps were based on the inferior epigastric artery and vein on the ipsilateral side. In group 2 (A-V), flaps were based on the inferior epigastric artery on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 3 (AV-V), flaps were based on the inferior epigastric artery and vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. In group 4 (Av-V), flaps were based on the inferior epigastric artery and lateral thoracoepigastric vein on the ipsilateral side and the inferior epigastric vein on the contralateral side. A definite assessment was made on the seventh day after flap elevation. The necrotic areas of flaps were determined with Computer Image Analysis System and barum-sulfate microangiographys were performed The necrotic area was 38.14% in group 1, 18.73% in group 2, 33.53% in group 3, and 31.94% in group 4 respectively. The microangiographs showed striking digerences in the vascular pattern in the flaps, and numerous collaterals and dilated anastomotic vessels were observed in group 2. These data indicate that the location of draining vein is more important than the number, and proper location of the draining vein allows the recruitment of an adjacent angiosome and can improve the survival rates of island flap.
Abdomen ; Animals ; Drainage ; Epigastric Arteries ; Rats* ; Strikes, Employee ; Surgical Flaps* ; Survival Rate ; Veins

Carcinoma ex pleomorphic adenoma is one of the rare malignant tumors arising in the salivary glands. Parotid gland is the most frequently affected site, while the other minor salivary glands have much lower incidence rates. There has been no clinical report of the carcinoma ex pleomorphic adenoma developed in the maxillary sinus. Carcinoma ex pleomorphic adenoma is very malignant and its prognosis is rarest among those of parotid gland tumors. We experienced a 24-year-old male patient who had a bulging mass on his left infraorbital area for 18 months. A carcinoma ex pleomorphic adenoma arising in the left maxillary sinus was diagnosed and medial maxillectomy, postoperative chemotherapy and concurrent radiotherapy were done. So far we have followed up the patient for 15 months and there is no sign or symptom of recurrence or metastasis.
Adenoma, Pleomorphic* ; Drug Therapy ; Humans ; Incidence ; Male ; Maxillary Sinus* ; Neoplasm Metastasis ; Parotid Gland ; Prognosis ; Radiotherapy ; Recurrence ; Salivary Glands ; Salivary Glands, Minor ; Young Adult

Recent studies have demonstrated that tumor necrosis factor-alpa(TNF-alpa) decreased production of type I and III procollagens and increased production of collagenase in cultured human dermal fibroblasts. The purpose of this study was to examine the effect of TNF-alpa on the level of expression of type I procollagen, collagenase mRNA in hypertrophic scar and keloid fibroblasts in culture. The cultured fibroblasts from normal skin, hypertrophic scar and keloid were exposed to 0, 1, 10, and 100 ng/ml of TNF-alpa for 24 hours. Then, type I procollagen mRNA and collagenase mRNA were measured by quantitative RT-PCR and quantified by computerized densitometry(TINA). In normal skin fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa and maximal enhancement for collagenase mRNA was noted at 100ng/ml of TNF-alpa. In hypertrophic scar fibroblasts, TNF-alpa significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. In keloid fibroblasts, TNF-alpa also significantly decreased the level of type I procollagen mRNA and increased collagenase mRNA. The maximal inhibition for type I procollagen mRNA was noted at 100 ng/ml of TNF-alpa which was the same as normal skin and hypertrophic scar fibroblasts but there were no significant differences among TNF-alpa treated groups for collagenase mRNA. These results strongly suggested that TNF-alpa might have a role in preventing progression of fibroproliferative disease, such as hypertrophic scar or keloid, and that the most effective concentration of TNF-alpa was found in 100 ng/ml.
Cicatrix, Hypertrophic* ; Collagen Type I* ; Collagenases* ; Fibroblasts* ; Gene Expression* ; Humans ; Keloid* ; Necrosis* ; Procollagen ; RNA, Messenger ; Skin

OBJECTIVE: To determine whether paternal age is associated with the risk of preterm birth. METHODS: Data were obtained from the 2003 birth certificates registry of 214,413 singleton infants born to women aged 25~29 years in Korea (Korea National Statistical Office). Odds ratios and 95% confidence intervals were calculated from multivariate logistic regression analyses to investigate the associations between paternal age and preterm delivery. RESULTS: The incidence of preterm birth showed a significant difference among the different paternal age groups (p<0.01). 'U-shaped' distribution of preterm birth risk was observed in terms of paternal age, with that of 30~34 years group being the lowest. Compared with 30~34 years group, the odds ratios for preterm birth were 1.14 for <24 years (p>0.05), 1.08 for age 25~29 years (p<0.01), 1.20 for age 35~39 years (p<0.01), and 1.50 for > or =40 years (p<0.01) groups. CONCLUSION: Paternal age is a risk factor for preterm birth and advanced paternal age increases the risk of preterm birth.
Birth Certificates* ; Female ; Humans ; Incidence ; Infant ; Korea ; Logistic Models ; Odds Ratio ; Parturition* ; Paternal Age* ; Premature Birth* ; Risk Factors

Sinonasal malignant melanoma comprises 0.5% ~ 1.5% of all malignant melanomas. Malignant melanoma in the nasal cavity is relatively more predominant than in the paranasal sinus. The maxillary sinus is the most common sinus cavity affected by malignant melanoma, and the sphenoid sinus is a very rare site regardless of a primary or secondary origin. We encountered a patient with frequent epistaxis who was found to have malignant melanoma at the nasal septum and sphenoid sinus. She was treated successfully with endoscopic sinus surgery, and we report this case, along with the associated literature.
Epistaxis ; Humans ; Maxillary Sinus ; Melanoma* ; Nasal Cavity ; Nasal Septum ; Sphenoid Sinus*

OBJECTIVE: To investigate the influence of laparoscopic surgery on the pregnancy rate of infertile women with endometriosis. MATERIALS & METHODS: Retrospective analysis was performed in 33 infertile patients with endometriosis and infertility who had operative laparoscopy at Seoul National University Hospital from January 1991 to February 1998. We investigated the pregnancy rate during the 12 months following conservative laparoscopic surgery. RESULTS: The overall rate of spontaneous intrauterine pregnancy rate (IUP) during the 12 months was 48.5% (16/33). Most of spontaneous pregnancy occurred during the 3 months after surgery (12/16). There was no correlation between spontaneous pregnancy rate and the revised American Fertility Society (rAFS) classification or laparoscopic findings. The rate of IUP was 50% (7/14) for patients with stage I or II endometriosis and 47.4% (9/19) for the patients presenting stage III or IV endometriosis. CONCLUSION: Conservative laparoscopic surgery may be an effective treatment for infertile patients with endometriosis and most of spontaneous pregnancy occurred during the 3 months after surgery .
Classification ; Endometriosis* ; Female ; Fertility ; Humans ; Infertility ; Laparoscopy* ; Pregnancy Rate* ; Pregnancy* ; Retrospective Studies ; Seoul

OBJECTIVE: To evaluate the relationship between parathyroid hormone (PTH) gene BstBI polymorphism, bone mineral density (BMD) and bone responsiveness to hormone replacement therapy (HRT). METHODS: PTH BstBI polymorphism was determined by restriction fragment length polymorphism (RFLP) in 444 postmenopausal Korean women. Among these women, 309 women received sequential HRT for 1 year. Serum bone alkaline phosphatase, CrossLaps, osteocalcin, calcitonin, and parathyroid hormone levels were measured by immunoassay and serum calcium and phosphorus levels by atomic absorptiometry. BMD at the lumbar spine and proximal femur was determined by dual energy X-ray absorptiometry before and after HRT of 1 year. RESULTS: PTH genotype frequencies were 81.1% for BB, 18.0% for Bb, and 1.2% for bb (uppercase letters signifying the absence and lowercase letters the presence of the restriction site). BMD at the femoral neck in women with the bb genotype was higher than that in women with the Bb or BB genotype respectively. Similar trend was found in BMD of lumbar spine and Ward's triangle. The PTH genotypes were not distributed differently between HRT-responders and HRT-nonresponders (women who lose more than 3% of bone mass per year) and were not related with annual percent change of BMD after HRT. There were no significant differences in levels of PTH, calcitonin, calcium, phophorus and bone turnover markers or their 6 month percentage changes after HRT among PTH genotypes. CONCLUSION: PTH BstBI polymorphism is not associated with bone responsiveness to HRT but BMD in Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density* ; Calcitonin ; Calcium ; Female ; Femur ; Femur Neck ; Genotype ; Hormone Replacement Therapy* ; Humans ; Immunoassay ; Osteocalcin ; Parathyroid Hormone* ; Phosphorus ; Polymorphism, Restriction Fragment Length ; Spine

BACKGROUND: Thymus and Activation-Regulated Chemokine (TARC) is a highly specific ligand for CCR4 expressed in Th2 lymphocytes. Local production of TARC may play an important role in the induction and maintenance of allergic inflammation with the infiltration of Th2 lymphocytes. However, the cellular sources of TARC among patients with allergic rhinitis (AR) remain unclear. OBJECTIVE: We investigated that nasal epithelial cells from AR could produce TARC and that they could produce TARC differently by various stimulation of cytokines. METHODS: Inferior turbinate mucosal tissues were collected from six patients with AR sensitized to house dust mite. Nasal epithelial cells were isolated, cultured and stimulated with IL-4, IL-13 or TNF-a alone or in combination. The level of TARC in the supernatant was measured by ELISA and mRNA expression of that in the cells by RT-PCR. RESULTS: The level of TARC from cultured nasal epithelial cells (CNEC) among allergic rhinitis patients was higher than that in the control group. IL-4 or IL-13 or TNF-a alone did not upregulate TARC production from CNEC. However, Th2 cytokines in combination with TNF-a increased the production of TARC in CNEC. CONCLUSION: IL-4, IL-13 and TNF-a could upregulate TARC production from nasal epithelial cells in allergic rhinitis and contribute to the infiltration of Th2 cells to the tissue during allergic inflammation.
Chemokine CCL17 ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Humans ; Inflammation ; Interleukin-13 ; Interleukin-4 ; Lymphocytes ; Mucous Membrane ; Pyroglyphidae ; Rhinitis ; Rhinitis, Allergic, Perennial ; RNA, Messenger ; Th2 Cells ; Tumor Necrosis Factor-alpha ; Turbinates

OBJECTIVE: The purpose of this study was to evaluate the effect of hormone replacement therapy on endometrial thickness in postmenopausal women and to assess the difference in endometrial thickness by the type of hormone replacement therapy (HRT). MATERIALS AND METHODS: Endometrial thickness was measured in 258 postmenopausal women before and/or during 12 months of HRT. The subjects were grouped into the sequential therapy group (Group 1, 72 women) and continuous combined therapy group (Group 2, 186 women). Group 1 received 0.625 mg of conjugate equine estrogen (CEE) daily with cyclic addition of medroxyprogesterone acetate (MPA, 10 mg/day for 12 days per month). Group 2 received 0.625 mg of CEE with daily addition of MPA (2.5 mg/day). RESULTS: The sequential group showed no significant change in endometrial thickness during HRT compared to that before HRT. However, a significant increase in endometrial thickness was found in the continuous combined group at 12 months of treatment. Before HRT, the endometrial thickness in the continuous combined group was thinner than that of the sequential group. During 12 months of treatment, there was no difference in endometrial thickness between the types of HRT. And the proportion of patients with endometrial thickness of 8mm or greater at 12 months of treatment did not differ significantly from that before treatment in both groups. CONCLUSION: Sequential HRT did not influence the endometrial thickness during treatment. However, continuous combined HRT increased the endometrial thickness during 12 months of treatment compared to that before treatment. The different endometrial responses to each HRT regimen may be due to the difference in endometrial thickness before treatment in each group.
Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Medroxyprogesterone Acetate