ABSTRACT
BACKGROUND: Medium-sized congenital melanocytic nevi (CMN) require surgical excision because of the risk of malignant transformation and aesthetic concerns. There are various possible reconstruction methods after excision, such as primary repair, skin graft, local flap, and composite graft. In this study, we used skin-fat composite grafts for reconstructing full-thickness skin defects and assessed the aesthetic outcomes. METHODS: Facial nevi excision plus skin-fat composite grafts were performed in 11 children (range, 3-16 years old). All grafts were harvested from the preauricular area on one or both sides; they included the epidermis, full-thickness dermis, and subcutaneous fat. All procedures were performed simultaneously. Standardized photographs were taken preoperatively and at a mean follow-up of 10.5 months. Viewing the photographs, four plastic surgeons rated the aesthetic outcomes of all patients using the following scale: 1, poor; 2, fair; 3, good; 4, very good; and 5, excellent. RESULTS: No patient was diagnosed with malignancy. There were no complications, such as graft loss, infection, or aesthetic problems that required surgical revision. All donor sites healed well and exhibited only minimal scarring. The aesthetic outcomes of skin-fat composite grafts were outstanding with a mean score of 4.2 +/- 0.4. Most patients and parents were highly satisfied with the results. CONCLUSIONS: Skin-fat composite grafts provide good color match, texture, and contour. They are more tolerable, especially in children, because the technique involves simpler procedures and shorter operation times than local flaps. They may be the ideal option for facial defects after excision of medium-sized melanocytic nevi.
Subject(s)
Child , Humans , Cicatrix , Dermis , Epidermis , Follow-Up Studies , Nevus , Nevus, Pigmented , Parents , Reoperation , Skin , Skin Transplantation , Subcutaneous Fat , Surgical Flaps , Tissue Donors , TransplantsABSTRACT
BACKGROUND: A number of factors can cause dark circles around the eyes including excessive pigmentation, thin and translucent lower eyelid skin overlying the orbicularis oculi muscle, and shadowing due to skin laxity and tear trough. Autologous fat graft is an effective method for the treatment of lower lid dark circles, but irregularities caused by leaving visible lumps of the fat can occur. Tonnard et al. suggested 'nanofat' grafting and introduced its characteristics and clinical applications. The authors used their nanofat grafting to correct lower eyelid dark circles. METHODS: Nanofat grafting was performed in 19 patients for dark lower eyelids. The grafts were injected into subdermal layer using blunt cannula. Microfat grafting with nasojugal fold was performed to all the patients. Among them, 18 patients received transconjunctival fat removal at the same time. RESULTS: All the patients showed much improvement from preoperative dark coloration. There were no visible lumps of fat, contour irregularities, or fat necrosis. Postoperative edema and ecchymosis were minimal. CONCLUSIONS: Nanofat grafting methods provide a good alternative for correcting dark circles by augmenting thin skin with lower complications. This simple, cost effective procedure is suitable for correction of dark circles and various skin rejuvenation purposes.
Subject(s)
Humans , Catheters , Ecchymosis , Edema , Eyelids , Fat Necrosis , Hyperpigmentation , Pigmentation , Rejuvenation , Shadowing Technique, Histology , Skin , Transplantation , TransplantsABSTRACT
PURPOSE: The study was done to identify the relationship of treatment side effects, family support, and quality of life in patients with cancer, and factors influencing quality of life. METHOD: A convenience sample of 106 patients who were receiving cancer treatment at W hospital were interviewed using the Side Effects scale by Hur, Family Support scale by Kang, and QOL scale by Ro. RESULT: Results indicate that women experienced more severe side effects than men. There was a negative relationship between side effects and quality of life, and a positive relationship between family support and quality of life. The most bothersome side effects were changes in taste and appetite, followed by general weakness and fatigue. Side effects such as loss of hair, nausea, dizziness, numbness, pins and needles in fingers and toes, and dry mouth were also experienced. General weakness and family support were analysed as to whether they were factors influencing quality of life. CONCLUSION: The results revealed that relieving general weakness should be given high priority in nursing interventions for patients undergoing cancer treatment. In addition, nursing programs should be developed that can reinforce family support.
ABSTRACT
Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial beta-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.
Subject(s)
Pregnancy , Diagnosis , Early Diagnosis , Embryo Transfer , Embryonic Structures , Fertilization in Vitro , Gynecological Examination , Incidence , Pregnancy, Heterotopic , Reproductive Techniques, AssistedABSTRACT
OBJECTIVES: From February 1995 to April 1998, those patients who had visited for evaluation of infertility, shown abnormal endometrial pattern on hysterosalpingography underwent resectoscopic operation. We evaluated about its therapeutic effect, recurrence rate of uterine adhesion and effectiveness of its assisted method. METHOD: We have reviewed 45 cases of intrauterine adhesion, classified as a central type, marginal type and multiple type. We used 26F resectoscope made in Storz for operation and inserted Lippes loop or pediatric foley catheter for prevention of readhesion. For promoting reepithelialization, conjugated estrogens(premarin) 5mg daily for 30 - 50 days were given and then 10mg of medroxyprogesterone acetate(provera) were added daily for the last 10 days. We evaluated the uterine cavity condition preoperatively and postoperatively by using hysterosalpingography. RESULT: In 45 cases, 41 cases were followed up postoperatively. 21 cases were markedly improved, 12 cases were improved and 8 cases were not improved or recurred on hysterosalpingography. In 41 cases, for prevention of readhesion 20 cases were used pediatric foley catheter and 5 cases(25%) were recurred. 21 cases were used Lippes loop and 3 cases(14%) were recurred. Pregnancy outcome was as follows;15 cases were pregnant and 10 cases delivered a viable infant, 3 cases aborted spontaneously, 1 case was ectopic pregnancy and laparoscopic salpingectomy was done, 1 case was ongoing pregnancy. CONCLUSION: This report suggests that resectoscopic operation is very effective in the treatment of intrauterine adhesion(therapeutic rate of 81%) and that the use of Lippes loop seems like to have the less recurrence rate than the use of pediatric foley catheter in prevention of postoperative readhesion, but more experience and further follow-up are necessary to obtain more detailed conclusions.
Subject(s)
Female , Humans , Infant , Pregnancy , Catheters , Follow-Up Studies , Hysterosalpingography , Infertility , Medroxyprogesterone , Pregnancy Outcome , Pregnancy, Ectopic , Recurrence , SalpingectomyABSTRACT
One hundred and forty-nine infertile women underwent hysterosalpingography and di-agnostic laparoscopy as a part of their infertility work up at the Kwangju Christian Hospi-tal. The diagnostic value of hysterosalpingography was compared with diagnostic laparos- copy. It was found that hysterosalpingography is a sensitive means to determine tubal pat- ency. However, diagnostic laparoscopy revealed peritubal adhesion in 25.5% of patients, wh- ereas hysterosalpingography made an accurate diagnosis in only 10.5%. And in 61.7% of the cases, there was complete agreement between hysterosalpingogr- aphy and diagnostic laparoscopy. It is concluded that hysterosalpingography is a simple and non-invasive and useful method of assessing the tubal patency, and should remain an integral part of female infert- ility investigation. Diagnostic laparoscopy is a more useful method to evaluate pelvic patho- logy than hysterosalpingography, and thus should always be performed whenever a periton- eal factor is suspected in female infertility.