Malignant mixed miillerian tumors(MMMTs) are uncommon neoplasms of the female genital tract that are histologically defined by the presence of malignant epithelial and stromal elements. MMMTs can arise hom the uterine body, cervix, vagina, ovary, and fallopian tube and constitute less than 1% of all overian malignancies. These tumors are usually advanced when diagnosed and follow an aggressive clinical course. We had experienced a cas#e of MMMT of the ovary and presented with a brief review of literature.
Cervix Uteri ; Fallopian Tubes ; Female ; Humans ; Ovary* ; Vagina

OBJECTIVE: The purpose of our study is to find out the therapeutic effectiveness, reproductive outcome, and the diagnostic pathologic findings of the patients treated with resectoscopy. METHODS: We examined 110 patients who complained infertility, abnormal uterine bleeding and menorrhagia from May. 1995 to Dec. 2000 via office. Among the infertility and abnormal uterine bleeding patients with abnormal endometrial lesion, resectoscopy was performed and then the resected tissues was sended for pathologic examination, except IUA, uterine septum, and double uterus. After resectoscopy, we inserted Lippes loop and medicated premarin 2.5 mg, 54 days and medroxyprogesterone acetate 10 mg, 10 days to the IUA patients. In AUB patients, we only injected methergin for bleeding control. They visited office after 1 month, and the follow up for endometrial state was done through TVS, HSG, or hysteroscopy. RESULTS: Among the 44 infertility, 41 (93%) had normal endometrium findings. Of twenty pregnancy (48.8%), seven (35%) ended in a second trimester abortion, thirteen (65%) in a full-term infant. Among the 66 with abnormal uterine bleeding, the 62 (93%) had normal endometrial finding and normal menstruation pattern. But 2 patients recurred their symptom, then hysterectomy was done 3, 5 years later respectively. Most of the patients who performed histopathologic study were diagnosed as leiomyoma (59.4%), and then endometrial or endocervical polyp (25.3%) and residual placenta tissue (3.8%) respectively. CONCLUSION: The 101 patients (91.8%) improved their symptoms and intrauterine lesion. we suggest this technique which of diagnostic accuracy, cost safety, convenience, operation time, and patient's satisfaction.
Endometrium ; Estrogens, Conjugated (USP) ; Female ; Follow-Up Studies ; Gynecology* ; Hemorrhage ; Humans ; Hysterectomy ; Hysteroscopy ; Infant ; Infertility ; Leiomyoma ; Medroxyprogesterone Acetate ; Menorrhagia ; Menstruation ; Methylergonovine ; Placenta ; Polyps ; Pregnancy ; Pregnancy Trimester, Second ; Uterine Hemorrhage ; Uterus

In systemic sclerosis, digital ulcers and gangrene are somewhat common clinical characteristics of obliterative vasculopathy. These manifestations increase morbidities, such as pain, infections, and acroosteolysis. However, patient responses to the appropriate treatments are often inadequate. We treated a patient with systemic sclerosis who had a refractory digital ulcer and gangrene with bosentan, an endothelin receptor antagonist, and observed improvement. Here we systematically review this case.
Acro-Osteolysis ; Gangrene* ; Humans ; Receptors, Endothelin ; Scleroderma, Systemic* ; Ulcer*

Chronic intestinal pseudo-obstruction (CIPO) is a rare digestive syndrome characterized by symptoms and signs of intestinal obstruction in the absence of mechanical obstruction. A 48-year-old female presented at our facility with severe abdominal pain and vomiting. Simple abdominal radiography revealed small bowel gas and ileus. Computed tomography also revealed a dilated small bowel, but there was no evidence of mechanical obstruction. Esophageal function was decreased based on high-resolution manometry and the gastric emptying time was prolonged on a gastric emptying scan. The patient recovered with conservative treatment. We report a case of chronic intestinal pseudo-obstruction with esophageal and gastric dysfunction.
Abdominal Pain ; Female ; Gastric Emptying ; Humans ; Ileus ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction ; Manometry ; Middle Aged ; Radiography, Abdominal ; Vomiting

OBJECTIVES: The role of rheumatoid factor (RF) in vascular stiffness and cardiovascular risk in subjects without joint symptoms remains unclear. We investigated vascular stiffness in subjects without joint symptoms using pulse wave velocity (PWV), calculated Framingham risk scores (FRS), an estimator of cardiovascular risk, and analyzed whether vascular stiffness and FRS were affected by RF. METHODS: Two hundred forty-two subjects were included in this population-based study. RF was quantified with turbid immunometry using a cut-off of RF > 15 IU/ml to denote RF positivity. Information was then obtained on joint symptoms. Brachial-ankle PWV (baPWV) was measured using an automated device. RESULTS: Of the 242 subjects, 15 were RF-positive. RF-positive subjects without joint symptoms had a higher baPWV and FRS than RF-negative subjects without joint symptoms, but the difference did not reach statistical significance. However, when we stratified the subjects into two groups (group A – high RF: RF ≥ 40 IU/ml; group B – low RF: RF < 40 IU/ml), group A showed significantly higher baPWV (1640.7 ± 179.6 ㎝/s vs. 1405.7 ± 225.7 ㎝/s, P = 0.008) and FRS (25.7 ± 4.87 vs. 11.8 ± 9.6, P < 0.001). Multiple regression analysis was used to examine potential confounders, and RF exhibited significant but modest effects on baPWV (adjusted R-squared = 0.038, P = 0.030). CONCLUSIONS: In a sample of the general population without joint symptoms, higher levels of RF were associated with increased vascular stiffness, suggesting a pathophysiologic link between RF and endothelial dysfunction.
Joints* ; Pulse Wave Analysis ; Rheumatoid Factor* ; Vascular Stiffness*

PURPOSE: The aim of this study was to evaluate whether long-term, postoperative ureteral stenting is necessary after ureteroscopic removal of stones (URS) during an uncomplicated surgical procedure. MATERIALS AND METHODS: We prospectively examined 54 patients who underwent URS for lower ureteral stones from February 2010 to October 2010. Inclusion criteria were a stone less than 10 mm in diameter, absence of ureteral stricture, and absence of ureteral injury during surgery. We randomly placed 5 Fr. open-tip ureteral catheters in 26 patients and removed the Foley catheter at postoperative day 1. The remaining 28 patients received double-J stents that were removed at postoperative day 14 by cystoscopy under local anesthesia. All patients provided visual analogue scale (VAS) pain scores at postoperative days 1, 7, and 14 and completed the storage categories of the International Prostate Symptom Score (IPSS) at postoperative day 7. RESULTS: The VAS scores were not significantly different on postoperative day 1 but were significantly smaller in the 1-day ureteral catheter group at postoperative days 7 and 14 (p<0.01). All of the storage categories of the IPSS were significantly lower in the 1-day ureteral stent group (p<0.01). The ratio of patients who needed intravenous analgesics because of severe postoperative flank pain was not significantly different between the two groups (p=0.81). No patients experienced severe flank pain after postoperative day 2, and no patients in either group had any other complications. CONCLUSIONS: One-day ureteral catheter placement after URS can reduce postoperative pain and did not cause specific complications compared with conventional double-J stent placement.
Analgesics ; Anesthesia, Local ; Catheters ; Constriction, Pathologic ; Cystoscopy ; Flank Pain ; Humans ; Pain, Postoperative ; Prospective Studies ; Prostate ; Stents ; Ureter ; Ureteroscopy ; Urinary Catheterization ; Urinary Catheters

The midpalatal suture area and maxillary interdental area are suitable site for the placement of orthodontic mini-implant. The purpose of this study was to provide a guideline to indicate the best location for mini-implant placement as it relates to the thickness of soft tissue and cortical bone. Fifteen maxilla from 15 cadavers were cut in midsagittal plane and buccopalatal plane to measure the thickness of soft tissue and cortical bone of midpalatal and maxillary posterior interdental areas. Sectioned samples were scanned and the thickness was measured. The thickness of soft tissue and cortical bone were measured at 6 points from the interdental papilla with 5-mm intervals in the mid-sagittal section. And, the thickness of soft tissue and cortical bone were also measured at 5 points from the alveolar crest with 1-mm intervals in the buccopalatal section. The mean and standard deviation of the measurement were calculated. Soft tissue thickness at the midpalatal suture area was 1.46 mm at 15 mm from the interdental papilla and remained uniformly thick posterior to this point, and steeply increased at 35 mm area posteriorly. Cortical bone thickness were greatest (2.13 mm) at 20 mm from the interdental papilla and remained uniformly thick posterior to this point, and decreased at 30 mm area posteriorly. Palatal soft tissues thickness in all groups was thinnest at the 1 mm from the alveolar crest and gradually increased from alveolar crest to apical portion. Cortical bone thickness in all groups was thickest at the 1 mm from the alveolar crest and slightly decreased from alveolar crest to apical portion. Buccal soft tissue thickness in all groups was thickest at the 1 mm from the alveolar crest and gradually decreased from alveolar crest to apical portion. Cortical bone thickness in all groups was thinnest at the 1 mm from the alveolar crest and slightly increased from alveolar crest to apical portion. Soft tissue thicknesses were greater on the palatal side than on the buccal side. Cortical bone thicknesses of the buccal side were thicker than the palatal side. These results provide anatomical data of soft tissue and cortical bone thickness to assist in the determination of safe location for the mini-implant placement in the midpalatal and maxillary interdental areas.
Cadaver ; Gingiva ; Maxilla ; Sutures

We already reported that genetically engineered resveratrol-enriched rice (RR) showed to down-regulate skin melanogenesis. To be developed to increase the bioactivity of RR using calli from plants, RR was adopted for mass production using plant tissue culture technologies. In addition, high-pressure homogenization (HPH) was used to increase the biocompatibility and penetration of the calli from RR into the skin. We aimed to develop anti-melanogenic agents incorporating calli of RR (cRR) and nanoparticles by high-pressure homogenization, examining the synergistic effects on the inhibition of UVB-induced hyperpigmentation. Depigmentation was observed following topical application of micro-cRR, nano-calli of normal rice (cNR), and nano-cRR to ultraviolet B (UVB)-stimulated hyperpigmented guinea pig dorsal skin. Colorimetric analysis, tyrosinase immunostaining, and Fontana-Masson staining for UVB-promoted melanin were performed. Nano-cRR inhibited changes in the melanin color index caused by UVB-promoted hyperpigmentation, and demonstrated stronger anti-melanogenic potential than micro-cRR. In epidermal skin, nano-cRR repressed UVB-promoted melanin granules, thereby suppressing hyperpigmentation. The UVB-enhanced, highly expressed tyrosinase in the basal layer of the epidermis was inhibited by nano-cRR more prominently than by micro-cRR and nano-cNR. The anti-melanogenic potency of nano-cRR also depended on pH and particle size. Nano-cRR shows promising potential to regulate skin pigmentation following UVB exposure.
Animals ; Epidermis ; Guinea Pigs* ; Guinea* ; Hydrogen-Ion Concentration ; Hyperpigmentation* ; Melanins ; Monophenol Monooxygenase ; Nanoparticles* ; Particle Size ; Plants ; Skin Pigmentation ; Skin*

Raynaud syndrome is a medical condition that causes pain, numbness, and changes in skin color at the distal extremities. Raynaud syndrome can be subdivided into primary Raynaud's and secondary Raynaud's. The former is diagnosed when the cause is unknown and the latter is caused by an underlying condition, such as connective tissue diseases, injury, smoking, or certain medications. Both cancer chemotherapy and β-blockers are relatively common causes of Raynaud syndrome but there are no reports of its association with methimazole administration. The authors encountered a 43-year old woman with hyperthyroidism who developed digital ulcers associated with Raynaud syndrome after a methimazole treatment. Her digital ulcers and Raynaud syndrome were improved after methimazole was replaced with propylthiouracil and conventional therapy. This paper reports this case along with a review of the relevant literature.
Connective Tissue Diseases ; Drug Therapy ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypesthesia ; Methimazole* ; Propylthiouracil ; Skin Pigmentation ; Smoke ; Smoking ; Ulcer

BACKGROUND: The relationship between Helicobacter pylori (H. pylori) infection and chronic idiopathic thrombocytopenic purpura (ITP) has been confirmed; however, no clear evidence for the effectiveness of H. pylori eradication on ITP exists thus far. The purpose of this study was to investigate platelet recovery in chronic ITP after H. pylori eradication. METHODS: A total of 25 patients (18 male, 7 female; the median age of 55 years) diagnosed with ITP, whose platelet counts were less than 100x10(3)/microliter, were enrolled. They were tested for H. pylori infection by the rapid urea test or urea breath test. All patients received triple therapy for 7 or 14 days to eradicate H. pylori infection. RESULTS: Of the 25 patients, 23 (92%) were diagnosed with H. pylori infection. Of all the ITP patients, 11 (44%) exhibited a complete response (CR) to H. pylori eradication therapy; 6 (24%), a partial response (PR); and 8 (32%) were nonresponsive (NR). Predictive factors of response after H. pylori eradication therapy were platelet counts at the initial response (27.3% responders among patients with platelet counts <100x10(3)/microliter vs 100% responders among patients with platelet counts > or =100x10(3)/microliter, P<0.001) and H. pylori infectivity (73.9% responders among the H. pylori positive patients vs 0% responders among the H. pylori negative patients, P=0.032). CONCLUSION: This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in ITP patients. Further studies with a larger number of patients are necessary to identify the crucial predictive factors responsible for platelet recovery in chronic ITP patients with the H. pylori infection.
Blood Platelets ; Breath Tests ; Helicobacter ; Helicobacter pylori ; Humans ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Urea