Sixteen multiple primary carcmomas were found in 674 patients with gynecologic malignancies who were treated in our departiment from 1980 to 1992. Cases with possible metastasis or recurrence were not included in this study, The incidence of rnultiple primary carcinomas in gynecologic rnalignancies was 2.1%, Multiple primary carcinomas were encountered in 2.4% of 674 cervical cancers, 1.4% of 73 ovarian cancers respectively. The most frequent sites of uther cancers were seen in the stomach(5/16) and lung(3/l6).
Humans ; Incidence ; Neoplasm Metastasis ; Ovarian Neoplasms ; Recurrence

Although foreign body ingestion is relatively common in children aged 6 months-3 years, small bowel obstruction rarely develops, and few cases require surgical interventions. We report a case of 12-month-old girl who presented to the emergency department with new-onset seizure after projectile bilious vomiting. The initial diagnosis was seizure caused by hyponatremia based on laboratory findings, plain abdominal radiograph, brain magnetic resonance imaging, and electroencephalography. Despite fluid resuscitation, clinical manifestations did not improve, and severe ileal obstruction was found on computed tomography. Emergency laparoscopy showed a foreign body (a water bead [superabsorbent polymer], 3 cm in diameter) that was subsequently removed by enterotomy. After the surgery, bilious vomiting continued, and gastrografin did not pass on fluoroscopy. The second laparoscopy showed a residual foreign body that was crushed and then removed by minimal enterotomy. She was discharged in good condition 5 days after the second surgery. This case suggests a particular danger of water beads as foreign bodies and the need for differential diagnosis of multiple foreign bodies in children with poor communication skills.
Brain ; Child ; Diagnosis ; Diagnosis, Differential ; Diatrizoate Meglumine ; Eating ; Electroencephalography ; Emergencies ; Emergency Service, Hospital ; Female ; Fluoroscopy ; Foreign Bodies ; Humans ; Hyponatremia ; Infant ; Intestinal Obstruction ; Laparoscopy ; Magnetic Resonance Imaging ; Resuscitation ; Seizures ; Vomiting ; Water

PURPOSE: Varicose veins requiring operative treatment have been more common recently, but there are not enough studies among children dermographics because most patients belong to the adult population. We concentrated on varicose vein of under 18 years old, and here intend to report cases of our clinical experiences. METHODS: From January 2003 until December 2014, there were 6 children under 18 years old who required varicose vein management. Data was collected by the investigation of medical records retrospectively, including preoperative symptoms, diagnostic tools, treatment methods, results of treatment, and complications. RESULTS: The mean age was 11 years (range, 3-17 years), and gender ratio was 1:2 (2 male, 4 female). The involved legs were on the right in 3 cases, on the left in 2 cases, and on both in 1 case. The most common symptoms were venous bulging and tortuosity in 6 cases, and other symptoms were Klippel-Trenaunay-Weber syndrome in 2 cases, pain and fatigue in 1 case, port-wine stain in 1 case, and telangiectasia in 1 case. Duplex sonography was performed to confirm venous reflux in all cases. The additional venography was performed to check for anatomical variation in 1 case, and three-dimensional CT in 2 cases. Treatments were high ligation and stripping in 3 cases, and endovenous laser therapy in 3 cases. Additionally, remnant varicosities after first operations were treated by endovenous laser therapy in all cases. During the mean postoperative follow-up period of 60 months, complications included edema of the foot and petechia in 2 cases each, and were not severe. CONCLUSION: Operative treatments including high ligation and stripping, and endovenous laser therapy are very effective for the management of varicose vein in the pediatric population, with improvements in quality of life including relief of symptoms and management of the cosmetic aspect.
Adult ; Child ; Edema ; Fatigue ; Follow-Up Studies ; Foot ; Humans ; Klippel-Trenaunay-Weber Syndrome ; Laser Therapy ; Leg ; Ligation ; Male ; Medical Records ; Phlebography ; Port-Wine Stain ; Quality of Life ; Retrospective Studies ; Telangiectasis ; Varicose Veins*

OBJECTIVE: Although hemodialysis using heparin bound Hemophan (HBH-HD) has been reported to be a possible modality in patients at risk of bleeding, the efficiency and safety of HBH-HD is not certain. Therefore, we prospectively compared the safety and efficiency of HBH-HD with those of saline flushing HD (SF-HD) and HD using low dose heparin (LDH-HD) in 13 HD patients at risk of bleeding in a cross-over design. METHODS: The safety and efficiency were evaluated by measuring activated partial prothrombin time (aPTT) before and during HD, hemostasis time after needle removal, total blood compartment volume (TBCV) loss of dialyzer, urea clearance (K) and Kt/V. RESULTS: There was no difference in compression time needed to achieve hemostasis at puncture site after needle removal between HBH-HD, SF-HD and LDH-HD. During HBH-HD, there was a slight increase in aPTT at 15 min (50.6+/-4.5 sec), compared to predialysis levels (40.9+/-4.7 sec). In this cross- over study, aPTT during dialysis session was markedly higher in LDH-HD than those in HBH-HD or SF-HD (p<0.05). The loss of TBCV of the dialyzer was greater in SF-HD than HBH-HD or LDH-HD (17.4+/-1.9% vs. 12.4+/-1.4% vs. 10.1+/-1.8%). However, there was no difference in K (212.0+/-30.7 vs. 217.2+/-36.9 vs. 221.6+/- 29.5 mL/min) and Kt/V (1.22+/-0.12 vs. 1.24+/-0.16 vs. 1.26+/-0.18). CONCLUSION: We concluded that the safety and efficiency of HBH-HD are not different compared to SF-HD or LDH-HD and HBH-HD could an alternative hemodialysis method in patients at risk of bleeding.
Anticoagulants ; Cross-Over Studies ; Dialysis ; Flushing* ; Hemorrhage* ; Hemostasis ; Heparin* ; Humans ; Needles ; Prospective Studies ; Prothrombin Time ; Punctures ; Renal Dialysis* ; Urea

Wheat is the most widely cultivated grain and an important source of food and dietary protein. Wheat proteins are classified based on extraction in different solvents, which are albumin, globulin, prolamin (gliadin) and glutenin. The term 'gluten' contains approximately equal amounts of gliadin and glutenin and is the major determinant of the properties of wheat flour conferring cohesiveness and viscoelasticity that allows its dough to be processed into many kinds of food. Gluten is known to be responsible for triggering celiac disease and wheat allergy. Wheat allergy is primarily an IgE-mediated response. Clinical manifestations of wheat allergy are similar to those of other food allergies, with symptoms on the skin, gut and respiratory tract. Recent studies have shown that IgE to gliadin can be an indicator for risk of severe immediate reaction-like anaphylaxis and wheat-dependent, exercise-induced anaphylaxis (WDEIA). However, current in vitro test reagents for the diagnosis of wheat allergy mainly contain water-soluble wheat protein and a small amount of gluten, so there are some limitations to diagnose gluten allergy. Furthermore, there is no acceptable method to measure gluten in food products for preparing effective gluten-free diet. To overcome these limitations and to improve quality of life of wheat allergy sufferers, more work is needed. We report a case of a 4-year-old boy with gluten allergy who presented with urticaria after ingestion kneaded wheat flour with a brief review of the literature.
Anaphylaxis ; Celiac Disease ; Edible Grain ; Diet, Gluten-Free ; Dietary Proteins ; Eating ; Flour ; Food Hypersensitivity ; Gliadin ; Glutens ; Hypersensitivity ; Immunoglobulin E ; Indicators and Reagents ; Preschool Child ; Proteins ; Quality of Life ; Respiratory System ; Skin ; Solvents ; Triticum ; Urticaria ; Wheat Hypersensitivity