Leiomyosarcoma of the breast is extremely rare. The natural history of leiomyosarcoma of the breast remains largely unknown because of the low incidence and lack of long-term follow up. But leiomyosarcoma of the breast appears to be less aggressive biologically than other sarcomas of the breast such as rhabdomyosarcoma. In an attempt to define diagnostic criteria of smooth muscle tumors of the breast, the reported cases of leiomyoma of the breast and nipple were also reviewed and compared with leiomyosarcomas by Chen et al(1981). Based on the result of this review, tumors with three or more mitoses per 10 HPF are leiomyosarcoma and those with no mitosis, necrosis, and significant atypia are leiomyomas. We have experienced a case of leiomyosarcoma of the breast. The patient was a 39 year-old female and was admitted due to a rapid growing right breast mass. The breast mass was noted 4 years ago and then this year the mass growed rapidly. Simple mastectomy was performed. Grossly the mass measured 11.0x8.0x8.0 cm in dimensions and was well circumscribed, pinkish, multinodular, and it was protruded from the cut surface. Microscopically the mass is composed of interlacing bundles of spindle shaped cells and multifocal large areas of hyalinized collagenous tissue. The individual spindle cells are slightly pleomorphic and occasionally show mitotic figures, 6~7 per 10 HPF in the most cellular area.
Female ; Humans ; Incidence

No abstract available.
Carcinoma, Hepatocellular*

No abstract available.
Ampulla of Vater* ; Duodenum ; Tuberculosis*

No abstract available.
Hemoptysis*

PURPOSE: The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey. METHODS: Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2. RESULTS: Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group. CONCLUSION: Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.
Adult ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*epidemiology/pathology ; Exercise ; Female ; Humans ; Hypertension/epidemiology ; Life Style ; Male ; Middle Aged ; Nutrition Surveys ; Prevalence ; Republic of Korea ; Risk Factors ; Smoking ; Socioeconomic Factors ; Stress, Psychological ; Triglycerides/blood ; Unemployment

A case of xanthogranulomatous oophoritis is presented in a patient who had a 3-month history of intrapelvic mass protruding into the vagina. The sonographic findings are a well defined mass shadowing lower echogenicity than the echo of the uterus at the posteosuperior aspect of the uterus. The CT findings are an enhancing solid mass with central necrosis containing a multiseptated cystic component.
Female ; Humans ; Necrosis ; Oophoritis* ; Shadowing (Histology) ; Ultrasonography ; Uterus ; Vagina

No abstract available.
Drug Therapy* ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Leukemia, Myeloid, Acute*

Background: The highly lipid soluble opioid, fentanyl, has a rapid onset and short duration of action. The present study was designed to examine the analgesic efficacy and side effects of the combination of fentanyl with morphine in patients using intravenous PCA. Methods: Patients were randomly assigned to receive one of three PCA regimens: M4 group (40 mg morphine+90 mg ketorolac+1.5 mg dorperidol), M2F2 group (20 mg morphine+200 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol), or M2F4 group (20 mg morphine+400 ug fentanyl+90 mg ketorolac+1.5 mg dorperidol). All patients were given initial loading dose of 0.1 mg/kg morphine plus 1 mg droperidol at the end of surgery. Pain score, side effects, and overall satisfaction were assessed at 30 min, 1 hr, 8 hr, 24 hr, and 48 hr postoperatively. Results: The pain score was significantly higher in the M2F2 group than in the M4 group and M2F4 group during 1 hr and 8 hr postoperatively. The total opioid consumption was significantly greater in the M2F4 group than in the M4 group. Patient satisfaction was better in the M2F4 than other two groups. There were no differences in the overall incidence of side effects among three groups. Conclusions: The present results suggest that the combination of fentanyl with morphine for intravenous patient-controlled analgesia is a useful method, and the double dose of fentanyl in comparison with the equipotent morphine dose is recommended in the early postoperative period.
Analgesia, Patient-Controlled* ; Droperidol ; Fentanyl* ; Humans ; Incidence ; Morphine* ; Passive Cutaneous Anaphylaxis ; Patient Satisfaction ; Postoperative Period

BACKGROUND: Calcium channel blockers and volatile anesthetics have depressant effects on cardiac function. Both of them appear to exert, qualitatively and quantitatively, different effects on myocardial contractility, coronary flow, and myocardial oxygen balance. The aim of this study was to examine the direct cardiac effects of the enflurane in the presence of diltiazem. METHODS: Isolated Sprague-Dawley rat hearts (N=45) were perfused at constant pressure with oxygenated Modified-Krebs solution (pH 7.4, 37oC). Isovolumetric left ventricular pressure (LVP) and dP/dt were measured via a latex balloon and transducer. Also, coronary flow and oxygen tensions at the coronary inflow and outflow were measured. After stabilization period, all hearts were subjected to the application with diltiazem (100 ng/ml). Thereafter, they were subdivided into three groups; group 1, 2, 3. Groups subjected to the combination of diltiazem (100 ng/ml) with enflurane 1.1, 2.2, or 3.3 vol%, respectively. RESULTS: After the application of diltiazem, myocardial contractility and heart rate were significantly decreased, and coronary flow were significantly increased. The combination of diltiazem with enflurane depressed myocardial contractility, heart rate, myocardial O2 consumption, and percentage of O2 extraction more than diltiazem alone, and their effects were dependent on the concentration of enflurane. However, there was no difference in the change of coronary flow and oxygen delivery between diltiazem and the combination of diltiazem with enflurane. CONCLUSIONS: These in vitro findings demonstrate that the combination of diltiazem with enflurane shows greater direct negative inotropic and negative chronotropic effect, and is associated with less attenuation of coronary autoregulation, but with a larger reduction in O2 utilization. The present results suggest that high enflurane anesthesia in the diltiazem-pretreated patients could result in profound cardiac depression.
Anesthesia ; Anesthetics ; Animals ; Calcium Channel Blockers ; Depression ; Diltiazem ; Enflurane* ; Heart Rate ; Heart* ; Homeostasis ; Humans ; Latex ; Myocardial Contraction ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Transducers ; Ventricular Function, Left* ; Ventricular Pressure

During the past decade, major breakthroughs have been achieved in treatment of chronic hepatitis B. Currently, three therapeutic agents are approved for chronic hepatitis B: interferon-alpha, lamivudine and adefovir dipivoxil. In patients with HBeAgpositive chronic hepatitis B, all of these drugs achieve HBeAg loss (24-33%) and anti-HBe seroconversion (12-30%) rates that are superior to those observed in untreated controls. Interferon-alpha has several drawbacks, such as the parenteral administration and the development of frequent and potentially serious side effects. Lamivudine is a safe drug with rare and generally mild side effects. Lamivudine induces an initial virological remission in 70-90% of patients, but only 30-40% of patients remain in remission after the third year due to progressively increasing viral resistance. The main advantage of adefovir dipivoxil is the rare emergence of resistance, which has been identified in less than 2% of patients at 2 yr of treatment. Adefovir is also effective against lamivudine-resistant strains. This review will focus on the natural history and recently gained knowledge on the treatment of chronic hepatitis B.
Adenine/*analogs & derivatives/therapeutic use ; Antiviral Agents/*therapeutic use ; Hepatitis B/*drug therapy ; Humans ; Interferon-alpha/therapeutic use ; Lamivudine/therapeutic use ; Phosphonic Acids/therapeutic use ; Reverse Transcriptase Inhibitors/therapeutic use