A total of 162 patients with invasive cervical cancer was investigated retrospectively with a view to elucidate the efficacy of pretreatment staging procedures of application with intravenous pyelography, cystoscopy, rectosigmoidoscopy. All 72 intravenous pyelograms, 155 sigmoidoscopies, 158 cystoscopies were normal. Of 111 patients with stage Ib who had paraaortic lymph node biopsies, two patients had a positive node(0.02%). Of 51 patients with stage II who had paraaortic lymph node biopsies, five patients had positive paraaortic lymph node(10%). And the accuracy of computed tomography and magnetic resonance imaging in the evaluation of invasive cervical cancer was assessed. In evaluating stage of cervical cancer, clinical staging had an accuracy of 78.9%, compared with 65.7% for CT and 58.9% for MRI. And for detection of parametrial invasion, clincal staging had an accuracy of 85.9%, compared with 85.1% for CT and 78.9% for MRI. Both modalities were comparable in evaluating lymph node metastasis ( 76.1% for CT, 74.4% for MRI ). IVP, cystoscopy and sigmoidoscopy for staging procedure evaluated in this study are unnecessary and should no longer be performed in patients with early stage cervical cancer. In addition, paraaortic lymph node biopsies in the absence of clinically suspicious nodes are not warranted. Compared with CT and MRI, pelvic examination offered improved evaluation of cervical cancer staging, parametrial invasion, but CT and MRI was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.
Biopsy ; Cystoscopy ; Gynecological Examination ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Retrospective Studies ; Sigmoidoscopy ; Urography ; Uterine Cervical Neoplasms

No abstract available.
Lung* ; Neoplasm Metastasis* ; Uterus*

Purpose: Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion of the medial longitudinal fasciculus. It typically manifests bilaterally and is commonly caused by multiple sclerosis. We report a case of pediatric unilateral INO, which is rare in the pediatric population.Case summary: A 14-year-old female, with a history of traumatic head injury 9 days previously, presented with diplopia, nausea and vomiting for the past 5 days. Her ophthalmic examination revealed severely impaired adduction of the right eye and abduction nystagmus in the left eye. Orbital computed tomography showed no evidence of orbital wall fracture or muscle impingement. However, an magnetic resonance imaging of her brain demonstrated an infarct in the right paramedian midbrain, leading to a diagnosis of unilateral INO. Diplopia and impaired adduction of the right eye resolved completely 7 weeks after the trauma. Conclusions Demyelinating diseases, such as multiple sclerosis, account for most of the pediatric INO cases. Although most of these cases are bilateral, this reports highlights a pediatric case of unilateral INO following head injury, which is an uncommon occurrence in this age group.

Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common hereditary colorectal cancer syndrome and accounts for about 5% of colorectal cancer. It is inherited as autosomal dominant type and is caused by germline mutations in mismatch repair genes such as MLH1, MSH2, MSH6, and PMS2. Patients with HNPCC are characterized by a high level of microsatellite instability. They commonly develop colorectal cancer at young age and increase risk of extra-colic malignancies, especially endometrial cancer. They also show better oncologic outcomes compared to sporadic colorectal cancer. Several tools are used in diagnosis of HNPCC, including history taking, microsatellite instability test, immunohistochemistry for mismatch repair protein, and gene test. Affected patients and their families should get genetic counseling and regular surveillance for cancers, which can improve their survival rate.
Colorectal Neoplasms ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; DNA Mismatch Repair ; Endometrial Neoplasms ; Female ; Genetic Counseling ; Genetic Testing ; Germ-Line Mutation ; Humans ; Immunohistochemistry ; Microsatellite Instability ; Survival Rate

We present two cases, a 15 and a 24 year-old females, showing extensive involvement of dermal melanocytic nevi, so called bilateral Ota nevus and bilateral Ito nevus, and nevus anemicus. Both females had bilaterally brownish or slate-bluish pigmented patches on the eyelids, the scleras, the zygomatics, the frontal and temporal areas, the alae nasi, the nasal bridges (bilateral Ota nevus), and, the suprascapular regions(bilateral Ito nevus). Nevus amenicus was noticed on the left anterior neck in both females. In addition, a 15 year old female has had a diffush bluish pigmented patches on the nearly whole body (Mongolian spot), reticulate patches of nevus anemicus on the dorsal back and both arms and nevus flammeus on the right cheek. These cases are showing extensive melanocytic nevi associated with vascular anomalies, which are very rare in the literatures.
Adolescent ; Arm ; Cheek ; Eyelids ; Female ; Humans ; Neck ; Nevus of Ota* ; Nevus* ; Nevus, Pigmented* ; Port-Wine Stain ; Sclera ; Young Adult

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; Pregnancy

No abstract available.

OBJECTIVE: The role of steroid hormones in the control of human parturition has been a subject of debate. The objective of the study was to examine if changes in fetal plasma cortisol or dehydroepiandrosterone sulfate (DHEA-S) are associated with human term parturition. METHODS: Fetal plasma cortisol and DHEA-S were measured in 374 singleton pregnancies delivered at term. Umbilical cord blood was obtained from patients in the following 6 groups: 1) preterm gestations undergoing cordocentesis for clinical indications before 36 weeks of gestation (n=93), 2) women undergoing cordocentesis for clinical indications after 36 weeks of gestation (n=9), 3) elective cesarean section (C/S) at term without labor (n=140), 4) C/S at term with early labor (cervical dilatationp< or = 3 cm) (n=18), 5) C/S at term with active labor (cervical dilatation 4cm or greater) (n=26), 6) vaginal delivery at term (n=88). Corticosteroids were not administered before blood collection. RESULTS: 1) Fetal plasma cortisol remain unchanged until 36 weeks of gestation and increased thereafter to term; 2) Active labor was associated with a significant increase in fetal plasma cortisol; 3) Fetal plasma DHEA-S increased in term gestation (>36 weeks) but did not increase during active labor; 4) The cortisol/ DHEA-S ratio (stress index) increased with advancing gestation and with active labor at term. CONCLUSION: Human parturition at term is associated with an increase in fetal plasma cortisol and cortisol/DHEA-S ratio, but not DHEA-S.
Adrenal Cortex Hormones ; Cesarean Section ; Cordocentesis ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Dilatation ; Female ; Fetal Blood ; Humans ; Hydrocortisone* ; Parturition* ; Plasma* ; Pregnancy*

Vesicovaginal fistula is a uncommon status in the developed countries. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are seen. Fistula is a discomfort to the patient because of urine leakage, odor, and its inconvenience. We have experienced one case of fistula after abdominal hysterectomy and have repaired it by Latzko partial colpocleisis. So we report a case with some references.
Developed Countries ; Fistula ; Humans ; Hysterectomy ; Odors ; Vesicovaginal Fistula*

No abstract available.
Cytogenetics* ; Down Syndrome* ; Humans