No abstract available.
Heart Valves* ; Heart* ; Return to Work*

Malignant transformation develops in a little less than 2% of mature cystic teratomas. A wide variety of malignant tumors may arise within benign mature cystic teratomas, and the most common of these is squamous cell carcinoma, which account for 75~85%. In general, the tumors are in an advanced stage and the prognosis is poor as most patients die within a year. However, when the tumor is confined to the ovary, they have a good prognosis and the 5-year survival rate is 63~83%. We experienced three cases of squamous cell carcinoma arising in mature cystic teratoma. Two of the carcinomas occurred in postmenopausal women: 58-(case 1) and 66-(case 2) year-old, and were confined to the ovaries. They were alive 37 months and 18 months after the operation, respectively. The third case was a 45-year-old premenopausal woman who had an extraovarian extension of the tumor and early recurrence within two months. Histologically, cases 1 and 3 were conventional well to moderately differentiated squamous cell carcinomas and case 2 showed a well-differentiated squamous cell carcinoma with exuberant proliferating trichilemmal tumor-like areas.
Carcinoma, Squamous Cell* ; Female ; Humans ; Middle Aged ; Ovary* ; Prognosis ; Recurrence ; Survival Rate ; Teratoma*

Background: Thickened coracohumeral ligament (CHL) is one of the important morphological changes of frozen shoulder (FS). Previous research reported that coracohumeral ligament thickness (CHLT) is correlated with anterior glenohumeral instability, rotator interval and eventually FS. However, thickness may change depending on the cutting angle, and measurement point. To reduce measurement mistakes, we devised a new imaging criteria, called the coracohumeral ligament area (CHLA). Methods: CHL data were collected and analyzed from 52 patients with FS, and from 51 control subjects (no evidence of FS). Shoulder magnetic resonance imaging was performed in all subjects. We investigated the CHLT and CHLA at the maximal thickened view of the CHL using our picture archiving and communications system. The CHLA was measured as the whole area of the CHL including the most hypertrophied part of the MR images on the oblique sagittal plane. The CHLT was measured at the thickest point of the CHL. Results: The average CHLA was 40.88 ± 12.53 mm2 in the control group and 67.47 ± 19.88 mm2 in the FS group. The mean CHLT was 2.84 ± 0.67 mm in the control group and 4.01 ± 1.11 mm in the FS group. FS patients had significantly higher CHLA (P < 0.01) and CHLT (P < 0.01) than the control group. The receiver operator characteristic analysis showed that the most suitable cut-off score of the CHLA was 50.01 mm2, with 76.9% sensitivity, 76.5% specificity, and area under the curve (AUC) of 0.87. The most suitable cut-off value of the CHLT was 3.30 mm, with 71.2% sensitivity, 70.6% specificity, and AUC of 0.81. Conclusion The significantly positive correlation between the CHLA, CHLT and FS was found. We also demonstrate that the CHLA has statistically equivalent power to CHLT. Thus, for diagnosis of FS, the treating physician can refer to CHLA as well as CHLT.

No abstract available.
Coxiella burnetii* ; Coxiella* ; Korea* ; Milk*

BACKGOUND: Cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) antagonists reduce the mechanical allodynia in neuropathic pain models. In this study our aim was to compare the antiallodynic effects between intrathecal cholinesterase inhibitors and NMDA antagonists on two well-characterized neuropathic pain rat models. METHODS: Male Sprague Dawley rats were anesthetized and either had the left L5 and L6 spinal nerves ligated (SNL group) or Freund complete adjuvant (FCA) administrated to the sciatic nerve (FCA group) in order to cause neuropathic pain. A catheter was implanted into the intrathecal space for drug administration. After obtaining baseline values, edrophonium (3-100microgram), neostigmine (0.3-10microgram), AP-5 (0.3-3microgram) and MK-801 (1-30microgram) were administered intrathecally to each group. The allodynic left hind paw withdrawal thresholds to von Frey hairs were assessed and converted to % MPE. Antiallodynic effects on the two groups were compared by analyzing dose-response curves and ED 50 values. Motor weakness was also checked. RESULTS: Intrathecal edrophonium, neostigmine, AP-5 and MK-801 had a dose-dependent antiallodynic effect on the two neuropathic pain models. Comparing the antiallodynic effect dose response curves, intrathecal cholinesterase inhibitors had lower ED 50 with steep slopes in the SNL model, whereas intrathecal NMDA antagonists had lower ED 50 in the FCA model, but there were no statistically significant differences between the two models. CONCLUSIONS: Intrathecal cholinesterase inhibitors and NMDA antagonists have relatively better antiallodynic effects on the SNL and FCA neuropathic pain rat models, respectively.
Animals ; Catheters ; Cholinesterase Inhibitors* ; Cholinesterases* ; Dizocilpine Maleate ; Edrophonium ; Hair ; Humans ; Hyperalgesia ; Male ; Models, Animal* ; N-Methylaspartate* ; Neostigmine ; Neuralgia* ; Rats* ; Rats, Sprague-Dawley ; Sciatic Nerve ; Spinal Nerves

No abstract available.
Autopsy* ; Enzyme-Linked Immunosorbent Assay*

BACKGROUND: Neuropathic pain can be induced by nerve injury or inflammation. An N-methyl-D-Aspartate (NMDA) antagonist (MK-801), and a sodium channel blocker (lidocaine) have been found to reduce mechanical allodynia. This study was conducted to determine whether intrathecal lidocaine or MK-801 had an antiallodynic effect on established mechanical allodynia in two well-characterized neuropathic pain rat models. METHODS: Male Sprague Dawley rats (n = 107) were anesthetized, and the left L5 and L6 spinal nerves were ligated (SNL group) or Freund complete adjuvant (FCA) was administrated to the same spinal nerves (FCA group) in order to cause neuropathic pain. A catheter was then implanted into the lumbar intrathecal space. After obtaining the baseline scores, time-effect curves of each drug were established for the antiallodynic effects of lidocaine (30g, 100g and 300g) and MK-801 (1g, 3g, 10g and 30g). The allodynic thresholds for the left hind paw withdrawal to von Frey hairs were assessed and converted to %MPE, and the ED50 value was then calculated using the %MPE. The antiallodynic effects of the two groups were then compared by analyzing the dose-response curves and the ED50 values. RESULTS: Both intrathecal lidocaine and MK-801 resulted in a dose dependent antiallodynic effect. ED50 values and the analysis of dose response curves showed that intrathecal lidocaine provided more effective antiallodynia in the SNL group, whereas intrathecal MK-801 resulted in a greater antiallodynic effect in the FCA group. CONCLUSIONS: In the SNL group, lidocaine had a better effect in reducing allodynic pain, whereas in the FCA group, MK-801 showed a greater antiallodynic effect.
Animals ; Catheters ; Dizocilpine Maleate* ; Hair ; Humans ; Hyperalgesia* ; Inflammation ; Lidocaine* ; Male ; Models, Animal* ; N-Methylaspartate ; Neuralgia* ; Rats* ; Rats, Sprague-Dawley ; Sodium Channels ; Spinal Nerves

BACKGROUND: Although the net atrioventricular compliance can be obtained by invasive catheterization (Ccath) in mitral stenosis (MS), feasibility of noninvasive echocardiographic calculation of the compliance (Cecho) and its hemodynamic significance were not tested. METHODS: Using valve area by 2D planimetry (A2D) and deceleration slope (dv/dt) of transmitral velocity decay in continuous wave Doppler echocardiographic tracing, Cecho was defined as -A2D/(gamma dv/dt), which was compared with Ccath obtained directly during the catheterization in 30 MS patients with sinus rhythm. Exercise Doppler echocardiography with symptom-limited treadmill was performed in 66 patients with moderate to tight MS: mean mitral gradient (MG) and peak pressure gradient of tricuspid regurgitation (PGTR) at baseline and immediately after exercise were obtained using continuous wave Doppler echocardiographic tracing. Hemodynamic variables including Cecho, MG, PGTR and mitral valve area were analyzed to determine the association with patients' exercise tolerance. RESULTS: Cecho in 30 patients with tight MS (valve area 0.9+/-0.2 cm 2) was 4+/-1 ml/mmHg (2-7 mmHg), which showed a significant correlation with Ccath (r=0.48, p=0.01). Exercise time in 66 patients with moderate to tight MS showed significant negative correlation with resting MG, resting and postexercise PGTR, and positive correlation with Cecho: exercise time in those patients did not show any significant correlation with resting valve area. In multivariate analysis, Cecho and postexercise PGTR were independent factors determining exercise time in MS. CONCLUSIONS: The net atrioventricular compliance in MS can be calculated by noninvasive echocardiography, and it is an important hemodynamic factor determining exercise tolerance in MS.
Catheterization ; Catheters ; Compliance* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Exercise Tolerance ; Heart* ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Multivariate Analysis ; Tricuspid Valve Insufficiency

BACKGROUND: The adequate intravascular ultrasound (IVUS) criteria for stent optimization have not been determined in long coronary stenting. We evaluated the predictors of angiographic restenosis and compared that according to stent lumen cross-sectional area (CSA) and stent length between short (stent length < 20 mm) and long (> or =20 mm) coronary stenting. METHODS: IVUS-guided coronary stenting was successfully performed in 285 consecutive patients with 304 native coronary lesions. Six-month follow-up angiogram was performed in 236 patients (82.8%) with 246 lesions (80.9%). Results were evaluated using conventional (clinical, angiographic, and IVUS) methodology. RESULTS: The overall angiographic restenosis rate was 22.8% (56/246)(short stent 17.6% vs long stent 32.2%, p=0.009). Using multivariate logistic regression analysis, the independent predictors of angiographic restenosis were the IVUS stent lumen CSA (odd ratio=1.51, 95% CI 1.18-1.92, p=0.001) and stent length (odd ratio=0.95, 95% CI 0.91-1.00, p=0.039). The angiographic restenosis rate was 54.8% in stent lumen CSA & 5.0 mm2 (short stent 37.5% vs long stent 73.3%, p=0.049), 27.4% between 5.0 and 7.0 mm2 (short stent 24.1% vs long stent 31.7%, p=0.409), 10.5% between 7.0 and 9.0 mm2 (short stent 10.0% vs long stent 12.5%, p=0.772), and 11.4% in stent lumen CSA > or =9.0 mm2 (short stent 10.4% vs long stent 13.3%, p=0.767)(p=0.001). CONCLUSIONS: Compared with short coronary stenting, long coronary stenting is effective treatment modality to cover long lesions with comparable long-term clinical outcomes in cases of stent lumen CSA > or =7.0 mm2. Regardless of the stent length, the most important factor determining the angiographic restenosis was the IVUS stent lumen CSA in relatively large coronary artery lesions.
Coronary Artery Disease ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Logistic Models ; Stents* ; Ultrasonography*

BACKGROUND: The chronic stent recoil of Palmaz-Schatz stent was minimal. However, the chronic stent recoil of other types of stents has not been determined. We evaluated the chronic stent recoil of different design of stents. METHODS: Serial (after stent implantation and follow-up) intravascular ultrasound images using automatic transducer pullback devices were obtained in 70 native coronary artery lesions: slotted-tube design of Palmaz-Schatz stent 30 and NIR 10, sinusoidal ring design of GFX 20, and coil design of CrossFlex 10. Measurements of stent cross-sectional area (CSA) (4 image slices in Palmaz-Schatz stent and 7 image slices in GFX, NIR and CrossFlex) using computerized planimetry were performed. Stent CSA post-stenting and follow-up was compared to evaluate the chronic stent recoil of different designs of stent. The chronic stent recoil (%) was defined as (post-intervention-follow-up) stent CSAx100/post-intervention stent CSA. RESULTS: The changes of stent CSA between post-intervention and follow-up period were minimal in NIR stent, Palmaz-Schatz and GFX. However, there was significant reduction of stent CSA in CrossFlex stent. Compared with other types of stents, the changes of stent CSA were significantly larger in CrossFlex stent (p=0.001). The chronic stent recoil was significantly larger in CrossFlex stent than in other types of stents (4.0+/-6.0% vs 0.7+/-5.8% in GFX stent, 0.4+/-5.0% in Palmaz-Schatz and 0.3+/-3.0% in NIR, p=0.001, respectively). There were no significant differences of chronic stent recoil among GFX, NIR and Palmaz-Schatz stent. CONCLUSIONS: The chronic stent recoil was minimal in slotted-tube and sinusoidal ring designs of stent. However, there was significant chronic stent recoil in coil design of stent.
Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Stents* ; Transducers ; Ultrasonography*