No abstract available.
Polychondritis, Relapsing*

No abstract available.
Hypopituitarism*

Malignant deciduoid mesothelioma is a rare malignant neoplasm occurring in the peritoneum of young women. We report a case of malignant deciduoid mesothelioma that occurred in the omentum of a 47-year-old woman. The patient had never exposed to asbestos and had no history of cesarean section. The lesions were multiple infiltrative nodules affected the peritoneal cavity, omentum, and surface of the uterus with both ovaries. Microscopically, the nodules were composed of mesothelial cells similar to decidual cells
Asbestos ; Cesarean Section ; Female ; Humans ; Mesothelioma* ; Middle Aged ; Omentum ; Ovary ; Peritoneal Cavity ; Peritoneum ; Pregnancy ; Uterus

BACKGROUND: The Y-composite graft of internal thoracic artery and radial artery is commonly used in coronary bypass surgery. The aim of this study is to look for a way to raise the free flow of the internal thoracic graft and to see flow dynamics of the Y-graft. MATERIAL AND METHOD: In 15 patients undergoing coronary bypass surgery, free flow of the in-situ internal thoracic artery graft was measured using two different papaverine application methods; extraluminal papaverine spray in 7 patients and intraluminal papaverine injection in 8. In 18 other patients for whom the Y-graft was used, total free flow and flow changes from the two ends were measured. RESULT: The free flow of the in-situ internal thoracic artery graft almost doubled with internal papaverine injection than with external papaverine spray (47.7+/-9.6 mL/min vs. 100.8+/-26.3 mL/min, p<0.001). Total flow of the Y-composite graft was significantly more than either flow of the internal thoracic artery end or radial artery graft end (173.3+/-45.3 mL/min vs. 121.1+/-34.3 mL/min or 117.5+/-42.8 mL/min). When both ends of the Y-composite graft were opened, free flows from the two ends were similar (85.4+/-27.8 mL/min vs. 87.9+/-42.4 mL/min, p=0.772). The flow of one end of the Y-composite graft was increased significantly by clamping of the other-end than when both ends were opened. CONCLUSION: Intraluminal papaverine injection is very effective in raising free flow of the internal thoracic artery graft, and the free flow of the Y-composite graft of in-situ internal thoracic artery and free radial artery graft is more than that of the in-situ internal thoracic artery graft. The flow of one end flow of the Y-graft may be altered by the flow change of the other end.
Arteries* ; Constriction ; Coronary Artery Bypass ; Humans ; Mammary Arteries* ; Papaverine ; Radial Artery ; Transplants*

PURPOSE: The purpose of this study was to evaluate the relationship between osteoporosis and skin thicknessas shown by CT scanning. MATERIALS AND METHODS: Eighty- six women with osteoporosis (mean age, 52) and 51 normalcontrols (mean age, 50) participated in the study. For a quantitative CT examinations, a CT scanner(Somatom Plus,Siemens) was used. Osteoporosis was defined as present when spinal bone mineral density was more than 2.5 standarddeviations below young normal density, as determined by quantitative CT. Patients with endocrinologic, malignantor collagen disease and undergoing antimetabolite or steroid therapy were excluded. The thickness of back skin wasretrospectively measured at the third lumbar vertebra level, as seen on CT films, using a conventional magnifier.For statistical analysis, Students' t test and Spearman's rank correlation were used. RESULTS: On the basis of CTscans, the mean thickness of back skin in the osteoporotic group(0.50+/-0.20 mm) was significantly less than innormal control subjects(0.80+/-0.23 mm) (p<0.001). Significant correlation was observed between skin thickness andbone mineral density(r=0.523, p<0.0001). Sensitivity, specificity, accuracy, and positive and negative predictivevalues were measured as 76, 78, 76, 88, 62% with a cut-off value of 0.6 and 84, 61, 77, 81, 66% with a cut-offvalue of 0.7, respectively. CONCLUSION: The present study demonstrated that the thickness of back skin, asmeasured by CT scanning, is predictive of osteoporosis.
Bone Density ; Collagen Diseases ; Female ; Humans ; Osteoporosis* ; Sensitivity and Specificity ; Skin* ; Spine ; Tomography, X-Ray Computed*

BACKGROUND AND OBJECTIVES: Until now, only a little is known about the mode of parotid involvement in external auditory canal (EAC) carcinoma. We examined the incidence of parotid node metastasis and direct parotid invasion in patients with EAC carcinoma. The purpose of this study was to evaluate the role of parotidectomy and to provide the guidelines for performance of parotidectomy when dealing with EAC carcinoma. MATERIALS AND METHOD: The study comprised of 11 patients with squamous cell carcinomas (SCC) and 10 patients with adenoid cystic carcinomas (ACC). A retrospective review of the surgical specimens was undertaken with specific reference to parotid node metastasis and parotid invasion. RESULTS: Parotid node metastasis was noted only in two cases of advanced staged SCC, whereas none of the ACC patients showed parotid node metastasis. Direct parotid invasion occurred only in advanced staged SCC;however, it did occur in early stage ACC. CONCLUSION: Our data indicated that elective parotidectomy for control of occult parotid node metastasis is necessary only in advanced SCC carcinoma, whereas parotid management to secure adequate safety margin is mandatory for advanced SCC and all cases of ACC.
Carcinoma, Adenoid Cystic ; Carcinoma, Squamous Cell ; Ear Canal* ; Humans ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Parotid Gland ; Retrospective Studies

No abstract available.
Humans

As extra-mammary Paget's disease is rare and usually diagnosed at early stage when it is highly curable with surgical resection, it is much rarer to see patients with recurrent metastatic disease. Thrombotic thrombocytopenic purpura in patients with metastatic solid cancer is also a rare disease and may result from bone marrow metastasis or bone marrow necrosis. For the latter, the majority of cases are not eligible for systemic chemotherapy for rapid disease progression and poor performance status. Herein, authors report a patient with thrombotic thrombocytopenic purpura associated with bone marrow necrosis complicating extra-mammary Paget's disease who was successfully treated with docetaxel and carboplatin combination chemotherapy.
Bone Marrow* ; Carboplatin ; Disease Progression ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Necrosis* ; Neoplasm Metastasis ; Paget Disease, Extramammary* ; Purpura, Thrombotic Thrombocytopenic* ; Rare Diseases

OBJECTIVES: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. DESIGN : Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. MATERIALS AND METHODS: After blood sampling for basal FSH and estradiol (E2) on cycle day two, 0.5 ml (0.525 mg) GnRH agonist (Suprefact, Hoechst) was injected subcutaneously. Serum E2 was measured 24 hours later. Initial E2 difference (deltaE2) was defined as the change in E2 on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by deltaE2; group A (n=30):deltaE2<40 pg/ml, group B (n=52): 40 pg/ml< or =deltaE2<100 pg/ml, group C (n=20): deltaE2< or =100 pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-EF was followed. Ratio of E2 on day of hCG injection over the number of ampules of gonadotropins used (E2hCGday/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as E2 hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. RESULTS: Mean age (+/-SEM) in group A, B and C were 33.7+/-0.8*, 31.5 +/-0.6 and 30.6+/-0.5*, respectively (*: p<0.05). Mean basal FSH level of group A (11.1+/-1.1 mIU/ml) was significantly higher than those of B (7.4+/- 0.2 mIU/ml) and C (6.8+/-0.4 mIU/ml) 0<0.001). Mean E2hCGday of group A was significantly lower than those of group B or C, i.e., 1402.1+/-187.7 pg/ml, 3153.2+/- 240.0 pg/ml, 4078.8+/-306.4 pg/ml respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: 38.6+/-2.3, 24.2+/-1.1 and 18.5+/-1.0 (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: 6.4+/-1.1, 15.5+/-1.1 and 18.6+/-1.6, respectively (p<0.0001). By stepwise multiple regression, only deltaE2 showed a significant correlation (r=0.68, p<0.0001) with E2HCGday/Amp, while age or basal FSH level were not significant. Likewise, only deltaE2 correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). CONCLUSIONS: These data suggest that initial E2 difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial E2 difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.
Estradiol ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Cysts ; Ovary ; Ovulation Induction* ; Prospective Studies

BACKGROUND AND OBJECTIVES: Increasing evidence supports that psychological factors may be related to development of coronary artery disease (CAD). Although psychological well-being, ill-being, and control strategy factors may play a significant role in CAD, rarely have these factors been simultaneously examined previously. We assessed comprehensive psychological factors in patients with acute coronary syndrome (ACS). SUBJECTS AND METHODS: A total of 85 ACS patients (56 unstable angina, 29 acute myocardial infarction; 52.6+/-10.2 years; M/F=68/17) and 63 healthy controls (48.7+/-6.7 years, M/F=43/20) were included. Socio-demographic information, levels of psychological maladjustment, such as anxiety, hostility, and job stress, health-related quality of life (HRQoL), and primary and secondary control strategy use were collected through self-report questionnaires. RESULTS: There was no significant difference between the ACS group and control group in levels of anxiety, hostility, and job stress. However, ACS patients had significantly lower scores on the general health perception and bodily pain subscales of HRQoL than the control group. The ACS group, as compared with the controls, tended to use primary control strategies more, although not reaching statistical significance by univariate analysis. Multivariate logistic regression analysis after adjusting age and gender identified the physical domain of HRQoL {odds ratio (OR)=0.40}, primary control strategy (OR=1.92), and secondary control strategy (OR=0.53) as independent predictors of ACS. CONCLUSION: Poor HRQoL and primary control strategy, proactive behaviors in achieving ones' goal, may act as risk factors for ACS, while secondary control strategy to conform to current situation may act as a protective factor for ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Anxiety ; Coronary Artery Disease ; Hostility ; Humans ; Logistic Models ; Myocardial Infarction ; Psychology ; Quality of Life* ; Risk Factors* ; Stress, Psychological ; Surveys and Questionnaires