간경변증 환자에서의 여성형 유방에 관한 연구

기춘석(Choon Suhk Kee),박동일(Dong Il Park),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Son),윤병철(Byung Chul Yoon),안유헌(Yoo Hern Ahn),함준수(Jun Su Ham),이민호(Min Ho Lee),박경남(Kyung Nam Park) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.5

N/A Gynecomastia occurs in about 30% to 50% of patients with cirrhosis of the liver. Since es- trogens stimulate breast tissue whereas androgens antagonize these effects, gynecomastia has long been considered the result of an imbalance between these hormones. Several mechanisms may operate to produce a relative estrogen excess in hepatic disorders, especially alcoholic cir- rhosis. We have studied the prevalence of gynecomastia and measured the estrogen/testoster- one ratio in cirrhotic subjects and control. Twenty male patients with hepatic cirrhosis were identified from the medical inpatient services of our institution and ten nonobese healthy rnedi- cal students with no history or physical findings of liver disease cornposed the noncirrhotic control group. The mean BMI in the control subjects was 21.3 + 0.8kg/m and that in the group with cirrhosis was 22.1 + l.lkg/m. Therefore, no statistical significance was found. Gy- necomastia was present in 30% of the control subjects and 25% of the cirrhotic subject. No significant correlation existed between breast tissue diameter and the BMI in the subjects with cirrhosis. In the control group, TT concentrations were higher and TE concentrations were lower than the cirrhotic groups, therefore the ratio of TE/TT were more decreased compared with the subjects with cirrhosis. In contrast, the mean total and free serum testosterone con- centrations were considerably lower and the mean total estrogen concentrations were higher in cirrhotic patients with gynecomastia compared with those without gynecomastia as were the ratio of TE/FT, E2/FT, TE/TT and E2/TT. In conclusion, the prevalence of gynecomastia in cirrhotic patients was 25%. Total and free serum testosterone concentrations did not differ statistically significant in the cirrhotic men with and without gynecomastia. Neither the TE FT ratio nor the E2 FT ratio was statistically increased in cirrhotic subjents with gynecomastia compared with those without gynecomastia. These findings imply that factors other than the estrogen testosterone ratio may play a role in the development of gynecomastia in both cirrhotic and control subjects. (Korean J Gastroente- rol 1994; 26: 842 849)

XPS® microresector(Shaver)를 이용한 여성형 유방증 수술

송재용,한병기,김정헌 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.6

Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Subcutaneous mastectomy was the first surgical treatment for gynecomastia. But because of the complications such as nerve injury and scar formation, subcutaneous mastectomy has been substituted with liposuction. Recently various techniques including ultrasound - assisted liposuction has been used for treatment of gynecomastia. The purpose of this study is to evaluate the results of XPS® microresector(Shaver) for treatment of gynecomastia. Methods: 17 patients, 33 breasts of gynecomastia, Simon grade I or II have been treated with XPS® microresector(Shaver). The mean age was 24.5. The subcutaneous tissue and glandular tissue were removed with XPS® microresector(Shaver). The operation time, the weight of removed tissue and patients' satisfaction score were accessed. Results: The mean operation time was 78.2 minutes. The mean weight of removed tissue was 113.8 g. There was no significant complications such as necrosis, hematoma, infection or scar contracture. Patients' satisfactory score of scar, shape and confidence were 8.4, 8.2 and 8.4 respectively. As the average score was 8.3, almost patients were satisfied with their breasts. Conclusion: The authors have treated 17 patients suffering from gynecomastia with XPS® microresector(Shaver). We obtained short operation time, early recovery, minimal operative scar and less complications with XPS® microresector(Shaver) for the treatment of gynecomastia, and patients were satisfied with the results of our method. We concluded XPS® microresector(Shaver) is an alternative option for the treatment of gynecomastia.

The Relationship between Psychopathology, Self-esteem, Body Perception and Serum Sex Steroids in Pubertal Gynecomastia

Semiha Comertoglu Arslan,Ibrahim Selcuk Esin,Atilla Cayır,Zerrin Orbak,Onur Burak Dursun 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.3

Objective: The current study aimed to investigate the psychopathology behind gynecomastia and potential associated problems regarding self-esteem and body perception, and the relationships of these variables with sex steroid levels in adolescents with pubertal gynecomastia. Methods: The study included 50 normal weight male adolescents aged between 11 and 18 years with gynecomastia but without any chronic organic pathology, and 50 healthy pubertal male adolescents matched for age. The adolescents underwent psychopathology assessment by Development and Well-Being Assessment interviews; self-esteem was assessed using the Rosenberg Self-Esteem Scale; body perception was evaluated using the Body Image Perception Scale, and the relationship between these variables and sex steroid levels were explored. Results: The results of the study revealed that the gynecomastia group had significantly greater internalization disorder (2 = 12.96, p < 0.001), and impairments in self-esteem (z = −1.975, p = 0.024) and body perception (z = −2.286, p = 0.022), and these variables were correlated with the gynecomastia stage. In the study group, cortisol levels were significantly higher (z = −2.330, p = 0.02) in adolescents with internalization disorder compared to those without, and cortisol levels increased in parallel with increased gynecomastia duration (r = 0.386, p = 0.006). Conclusion: In our study, we found that gynecomastia, depending on its stage, may lead to internalization disorder and impair self-esteem and body perception. It was found that there was no direct relationship between these parameters and sex steroids in pubertal gynecomastia, except for high cortisol levels in adolescents with internalization disorder.

Isoniazid를 포함한 항결핵약제 투여 후 발생한 여성형 유방 증례

허은영 ( Eun Young Heo ),정인아 ( In A Jeong ),이재석 ( Jae Seok Lee ),이창훈 ( Chang Hoon Lee ),정희순 ( Hee Soon Chung ),김덕겸 ( Deog Kyeom Kim ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.4

Gynecomastia is a benign enlargement of the male breast attributable to proliferation of the ductal elements. Gynecomastia has been rarely reported as an adverse effect of isoniazid therapy. We report the case of a 35-year-old man who was prescribed with isoniazid, rifampicin, ethambutol and pyrazinamide to treat pulmonary and lymphatic tuberculosis. After five months of treatment, the patient complained of painful engorgement in the bilateral breasts and the presence of male gynecomastia was confirmed with a physical examination and radiographical methods. The serum level of estradiol was also increased. Common causes of male gynecomastia were excluded through history taking and the laboratory findings. The anti-TB drugs were changed to a second line regimen due to radiographical progression and the intolerance of the patient to gynecomastia. Gynecomastia was relieved very slowly and a tender subareolar palpable mass decreased in size and consistency over five-month period after stopping the probable causative drug, isoniazid. From a review of the literature, gynecomastia has been shown to be a side effect of treatment with first line anti-tuberculosis drugs, and especially with isoniazid. We report the rare case. (Tuberc Respir Dis 2008;65:308-312)

Gynecomastia Surgery Is Associated with Improved Nipple Location in Young Korean Patients

이보형,권유진,박장완,황재하,김광석,이삼용 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.6

Background: Gynecomastia is benign enlargement of breast tissue in males and is fairlycommon. Mastectomy not only helps in improving the shape of anterior chest, but can alsoimprove the location of nipple. Therefore, a principle element of mastectomy design isdefining the normal location of nipple based on major anatomical reference points. Here, thenipple location was compared for before and after gynecomastia surgery. In addition, thesame was also compared between male patients undergoing gynecomastia surgery and controlgroup of subjects without gynecomastia. Methods: We retrospectively analyzed gynecomastia patients who underwent conventionalsubcutaneous mastectomy. Preoperative and postoperative anatomical landmark distancesand chest circumferences were measured and compared to the same anthropometric datafrom 20 healthy adult male controls. Results: Nipple locations were compared among 13 patients and 20 controls. The meanweight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 outof 5. In the patient group, the slopes for the height–distance from the sternal notch to thenipple and chest circumference–distance between the mid-line of the sternum and the nipplewere 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122and 0.177, respectively; these differences were statistically significant (P<0.05). Conclusions: Nipple positions were considerably lower in patients with gynecomastia than incontrol subjects. Subcutaneous mastectomy was associated with mild elevations, butpostoperative locations were still lower compared to controls. Further efforts are needed toimprove the location of postoperative nipple-areola complex in patients with gynecomastia.

Improved Nipple Location in Young Korean Patients

Lee, Bo Hyung,Kwon, Yu Jin,Park, Jang Wan,Hwang, Jae Ha,Kim, Kwang Seog,Lee, Sam Yong Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.6

Background Gynecomastia is benign enlargement of breast tissue in males and is fairly common. Mastectomy not only helps in improving the shape of anterior chest, but can also improve the location of nipple. Therefore, a principle element of mastectomy design is defining the normal location of nipple based on major anatomical reference points. Here, the nipple location was compared for before and after gynecomastia surgery. In addition, the same was also compared between male patients undergoing gynecomastia surgery and control group of subjects without gynecomastia. Methods We retrospectively analyzed gynecomastia patients who underwent conventional subcutaneous mastectomy. Preoperative and postoperative anatomical landmark distances and chest circumferences were measured and compared to the same anthropometric data from 20 healthy adult male controls. Results Nipple locations were compared among 13 patients and 20 controls. The mean weight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 out of 5. In the patient group, the slopes for the height-distance from the sternal notch to the nipple and chest circumference-distance between the mid-line of the sternum and the nipple were 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122 and 0.177, respectively; these differences were statistically significant (P<0.05). Conclusions Nipple positions were considerably lower in patients with gynecomastia than in control subjects. Subcutaneous mastectomy was associated with mild elevations, but postoperative locations were still lower compared to controls. Further efforts are needed to improve the location of postoperative nipple-areola complex in patients with gynecomastia.

여성형 유방증(Gynecomastia)의 개선된 수술적 치료방법: 팬 케이크 법(Pan-cake Method)

박진홍,이윤호 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.5

Purpose: Subcutaneous mastectomy has been accepted as a standard for the treatment of gynecomastia. Surgical managements including ultrasound-assisted liposuction(UAL) have had limited success and several combined approaches were tried to find the most effective method. We designed a modified subcutaneous mastectomy, which we call "pan-cake method". The purpose of this study is to evaluate the results of our method for the treatment of gynecomastia. Methods: 16 patients from 16 to 31 years of age having gynecomastia were operated using the pan-cake method. 11 patients were in grade I, and 5 patients were in grade II, no patient were in grade III or IV, according to Rod's classification. The pan-cake method started with modified periareolar incision. We executed subcutaneous dissection first and suprafascial dissection next. After dividing the breast into four equal quadrants, we removed breast tissue from each quadrant as necessary. The operation time for the resection was recorded and the weight of removed parenchyme tissues was measured. Results: All the operations were successful. There were no asymmetries, contour deformities, or irregularities. Only 6 cases needed the combined therapy with ultrasound-assisted liposuction(UAL) because of the step deformities. The average operation time was 24.1 minutes and the average weight of removed breast tissue was 98.1g. All the patients were satisfied with the aesthetic results. Conclusion: We concluded that the pan-cake method is an alternative option for the surgical treatment of gynecomastia, giving good aesthetic results and relatively short operation time.

유륜연 접근과 쌈지봉합을 이용한 여성형 유방의 교정술

김한구,김우섭,김승홍,김지욱 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.1

Gynecomastia is a benign enlargement of the male breast due to a physiological or pathological hormonal imbalance between estrogens and androgens in the serum. Managements of gynecomastia that have been advocated are radiotherapy, hormone therapy and surgical therapy. Most observers believe that radiotherapy offers no improvement and may be dangerous, and hormone treatment has been disappointing. Surgical removal is the most effective method for the correction of gynecomastia.Several approaches for surgical treatment have been reported. Some problems arise in patients who have significant enlargement and ptosis of the breast that will require skin reduction and in patients requiring nipple-areola complex reduction. Our technique involving the circumareolar approach with purse- string suture yield a good results including male chest shape, with fewer complications, in patients with severe ptotic breast that have skin redundancy combined with areolar enlargement. From August, 2001 to February, 2004, among a total 10 gynecomastia patients, 4 male cases with skin excess and large nipple-areola complex were treated using a circumareolar approach. All patients achieved a good aesthetic contour of the chest. One patient required a revision of the widened circumareolar scar and one patient had a temporary paresthesia postoperatively.

A Case Report of Gynecomastia Due to Rosuvastatin

정준훈,김윤성,이상권 대한가정의학회 2019 Korean Journal of Family Practice Vol.9 No.5

Gynecomastia is a common benign disease characterized by the progressive enlargement of the glandular tissue of the male breast due to an imbalance between the levels of estrogen and androgen in the blood. The etiology may vary and may be physiological, pharmacological, pathological, or even idiopathic. Among men, drug-induced gynecomastia may account for 10% to 20% of cases. The literature contains six case reports of rosuvastatin-induced gynecomastia. Withdrawal of statin or switching to a less potent statin can lead to symptom improvement and avoidance of unnecessary tests and patient anxiety. A 62-year-old male patient developed unilateral gynecomastia after 13 months of rosuvastatin therapy. After switching to a different statin (pravastatin), his symptoms improved within 2 months. Thus, clinicians should be aware of the possibility of occurrence of gynecomastia when statins are prescribed.

Gynecomastia: A Rare Adverse Effect of Methylphenidate in an Adolescent Boy

Ali Karayagmurlu,Ayse Tugce Varli,Murat Coskun 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.2

Gynecomastia is a benign condition developing in association with localized fat deposition and glandular tissue proliferation in the breast in males, and characterized by breast growth. Drug is one of the most important factors in the etiology of gynecomastia. Methylphenidate is a commonly preferred and well-tolerated drug in the treatment of attention deficit hyperactivity disorder in children and adolescents. Gynecomastia is an uncommon side-effect of methylphenidate use. We report a case of bilateral gynecomastia developing in a dose-dependent manner during methylphenidate monotherapy and resolving with discontinuation of medication in a 15-year-old patient with a history of a similar side-effect during previous use of the drug. To the best of our knowledge this is one of the few case reports of gynecomastia developing in association with methylphenidate.