No abstract available.

No abstract available.
Vulva* ; Vulvar Neoplasms*

No abstract available.
Vulva* ; Vulvar Neoplasms*

No abstract available.
Agenesis of Corpus Callosum*

No abstract available.
Agenesis of Corpus Callosum*

No abstract available.
Trisomy*

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs

Tuberous sclerosis is reported rarely and is associated with systemic lesions including central nervous system, skin, heart, eye and kidney. Approximately 5-15% of individuals with tuberous sclerosis will develop brain neoplasia, almost invariably subependymal giant-cell astrocytoma (SGCA). We experienced a case of SGCA with tuberous sclerosis operated by the transcallosal approach and report with literature review.
Astrocytoma* ; Brain ; Central Nervous System ; Heart ; Kidney ; Skin ; Tuberous Sclerosis*

Coloring Agents ; Cytomegalovirus ; Endothelial Cells ; Humans ; Intranuclear Inclusion Bodies ; Male ; Methenamine ; Mouth ; Oral Manifestations ; Stomatitis ; Tongue ; Ulcer

OBJECTIVE: To evaluate the various effects of hormone replacement therapy (HRT) on bone mineral density (BMD) for 4 years in postmenopausal women and to compare the characteristics of non-responders to HRT. METHODS: A total of 100 postmenopausal women have been treated with HRT or estrogen replacement therapy for 4 years. Spinal BMD was measured by dual energy X-ray absorptiometry. RESULTS: The mean age and menopausal age of the study subjects was 53.3+/-3.6 and 4.7+/-4.0 years. According to the baseline BMD, 32 and 9 women were osteopenic and osteoporotic. Compared with the baseline value, the lumbar BMD increased significantly after one and two years of HRT, but after three years the rate of increment has slowed. However, the change of BMD has significantly increased again after four years of HRT (3.98%, 5.36%, 5.41%, 6.16%, in each year, respectively). Women with baseline osteopenia and osteoporotis gained significantly more BMD after 1 year of HRT than women with baseline normal BMD (p=0.02). There were no significant differences of BMD changes among the 3 treatment regimens (continuous combined, cyclic combined, and estrogen only). After 1 year of HRT, 14 non-responders were indentified who had reduced BMD (-1.7+/-1.6%) compared with baseline BMD whereas 86 responders had increased BMD (4.9+/-4.1%). In the non-responder, BMD increased in two year of HRT but decreased in the three and four year of HRT while BMD increased in the two, three and four year of HRT in responders. After 4 years of HRT, 17 nonresponders (-3.0%+/-1.8%) and 83 responders (8.2+/-7.1%) were indentified. There was no significant difference in age, year since menopause, body mass index and baseline BMD between non-responders and responders. However, non-responders loose their BMD after 1 and 4 year of HRT. CONCLUSION: After HRT, the BMD increased not only first and second year but also fourth year of treatment. The BMD changes did not different according to the treatment regimens. The lower the women's baseline BMD, the greater the BMD increase after HRT. After four years of HRT, 17% of women lose their BMD compared to baseline BMD. The BMD changes in the first year of HRT may be an important predictive factor for the long-term BMD response to HRT in postmenopausal women.
Absorptiometry, Photon ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Estrogen Replacement Therapy ; Estrogens ; Female ; Hormone Replacement Therapy* ; Humans ; Menopause ; Osteoporosis