Angiosarcoma arising from chronic lymphedema is referred to as Stewart-Treves Syndrome. It typically occurs as a complication of long-lasting lymphedema of the arm, after mastectomy and/or radiotherapy for breast cancer. Angiosarcoma associated with lymphedema of the lower extremity is rare. We report a case of angiosarcoma of the leg in a patient with a 15-year history of lymphedema due to cervical cancer operation and radiotherapy.
Arm ; Breast Neoplasms ; Hemangiosarcoma ; Humans ; Leg ; Lower Extremity ; Lymphedema ; Mastectomy ; Uterine Cervical Neoplasms

PURPOSE: To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). MATERIALS AND METHODS: Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had reccived surgical treatment. They were divided into two groups according to Child's classification and into subgroups according to different methods of THAE. Five-year survival rates among these groups were retrospectively Compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324:61 for those who received THAE (396:87 when only hepatic angiography was considered). RESULTS: In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. Moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum or 1-131-Lipiodol, were used. Embolization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of requency of chemoembolization. CONCLUSIONS: An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents,Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Classification ; Female ; Gelatin Sponge, Absorbable ; Humans ; Male ; Radiotherapy ; Retrospective Studies ; Survival Rate* ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Anesthesia, General* ; Shoulder*

No abstract available.
Anesthesia, General* ; Shoulder*

To evaluate the effect of cetylpyridinium chloride in a powder form when used concomitantly with a conmercial fleuride containing tooth paste on inhibition of plaque formation, on gingivitis, and on irritation of oral mucosa. a double-blind, randomized parallel study was set up. Cetylpyridinium chloride was incorporated into a light brown colored powder with menthol added for scent. There were no differences between the active agent and the placebo which did not contain cetylpyridinium chloride in appearance, color, smell, taste, or dispenser. 98 healthy volunteers were assigned to one of two groups: brushing 3 times a day with flouride toothpaste and cetylpyridinium chloride powder, or brushing 3 times a day with flouride toothpaste and placebo. Before the test period, the subjects received through tooth cleaning and polishing. At basteline, GI, PI, BOP, and GCF of the Ramfjord teeth were measured in the experimental and placebo groups including 58 and 42 subjects repectively. After 4 weeks, GI, PI, BOP, GCF, compliance, irritation of the oral mucosa(redness, pus drainage, edema) and adverse reactions were measured. The PI, GI, and BOP of the experimental group recorded at baseline are 0.19+/-0.19, 0.42+/-0.31, and 0.08+/-0. 15. These scores showed significant decrease after 4 weeks of test period(0.11+/-0.15, 0.22+/-0.24, 0.02+/-0.09 repectively at the end of the study) and inhibition of plaque accumulation and resolution of gingival inflammation could be observed. GCF shoed slight increase but this was not Statistically different. Comparison of changes in measured scores of control and experimental groupshow GI, PI of the test indices have decreased. Test group showed significantly greater decrease in gingivitis and plaque accumulation after 4 weeks. GCF and BOP also showed greater decrease thant the control group but this difference was not statistically significant. At no time of the study period did any of the subjects show signs of irritation of the oral mucosa or adverse reactions. Following conclusions could be obtained from this study. The combined use of cetl powder and flouride toothpaste showed greater inhibition of plaque accumulation and greater decrease of gingivitis than use of flouride toothpaste with placebo agent.
Cetylpyridinium* ; Compliance ; Dental Plaque ; Drainage ; Gingivitis ; Healthy Volunteers ; Inflammation* ; Menthol ; Mouth Mucosa ; Periodontitis ; Smell ; Suppuration ; Tooth ; Toothpastes

We evaluated tetanus specific IgG, IgM, IgG subclasses after DPT vaccination in infants and children. Tetanus toxoid specific IgG, IgM IgG subclasses were measured to characterize the isotope profile of antibody against tetanus toxoid. The values of the tetanus specific IgG in the positive group were significantly increased compared to those of the control group, and were significantly increased after two inoculation. Tetanus specific IgG was very low in adults and neonates. In our tetanus specific IgG subclasses study, forty-five of 56 cases (80%) showed predominantly IgG1 antibody responses to tetanus toxoid, while twenty-five of 56 cases (45%) showed IgG4 responses. Both IgG1 and IgG4 responses were demonstrated in 17 cases (30%). So we suggest that IgG was mainly involved in humoral immune response after DPT vaccination, and IgG1 may play an important role among IgG subclasses. IgG4, alone or together with IgG1, can also play a role in immune response to tetanus toxoid.
Antibodies, Bacterial/*biosynthesis ; Antibody Specificity ; Child ; Clostridium tetani/immunology ; Diphtheria-Tetanus-Pertussis Vaccine/*immunology ; Human ; Immunoglobulin G/biosynthesis/classification ; Immunoglobulin M/biosynthesis ; Infant

PURPOSE: To evaluate the radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies. MATERIALS AND METHODS: Thirteen patients with fourteen cases of carotid-vertebrobasilar anastomosis collectedfrom January 1992 to December 1997 were reviewed. Clinical diagnosis refered for cerebral angiography werecerebral infarction(n=3), intracranial hemorrhage(n=2), subarachnoid hemorrhage(n=1), brain tumor(n=3),arteriovenous malformation(n=3) and trigeminal neuralgia(n=1). Cerebral angiograms and clinical symptoms wereretrospectively analyzed. RESULTS: The fourteen carotid-vertebrobasilar anastomsis consisted of eleven cases ofpersistent trigeminal artery and three cases of type I proatantal intersegmental artery. Persistent trigeminalarteries were associated with anterior communicating artery aneurysm(n=1), posterior fossa arteriovenousmalformation(n=2) and persistent trigeminal artery variant(n=5). Type I proatantal intersegmental arteries wereassociated with hypoplastic vertebral arteries(n=2) : only proximal segment in one, and proximal and distalsegments in one case. Only one patient had clinical symptom related to the carotid-vertebrobasilar anastomosiswhich was trigeminal neuralgia. CONCLUSION: Knowledge of the anatomical and radiologic findings ofcarotid-vertebrobasilar anastomosis and associated anomalies will aid in the accurate diagnosis of neurovasculardisease and prevent possible complications during surgical and interventional procedures.
Arteries ; Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Trigeminal Neuralgia

Congenital thoracic ectopic kidney is a very rare developmental disorder and the rarest type of ectopic kidney. This condition is usually asymptomatic and detected incidentally on routine chest radiography. Most cases of thoracic ectopic kidney develop in adulthood and during the neonatal period, and congenital thoracic ectopic kidney rarely develops in children. Most patients are asymptomatic, and the treatment depends on the diagnosis. Herein, we report a rare case of ectopic thoracic kidney associated with a diaphragmatic hernia in a 15-month-old male infant, who presented with periodic severe irritability. The thoracic ectopic kidney was detected as a mass in the right base of the chest on routine chest radiography.
Child ; Diagnosis ; Hernia, Diaphragmatic* ; Humans ; Infant* ; Kidney* ; Male ; Radiography ; Thorax

Background:Ghrelin is a new endogenous ligand for the growth hormone secretagogue receptor. It activates the release of growth hormone from the pituitary and it also participates in the regualtion of energy homeostasis. The aims of the study were to characterize the changes in plasma ghrelin levels in obese subjects compared with lean control or overweight subjects, and their relationship to various parameters in obese subjects. METHODS:In this study, 121 elementary school children were divided into 3 groups according to their body mass index (BMI). The lean control subjects consisted of 28 children who had less than 85 percentile of BMI. The overweight subjects consisted of 22 children who had 85-95 percentile of BMI. The obese subjects consisted of 71 children who had over 95 percentile of BMI. All subjects in 3 groups were evaluated according to their age, height, weight, obesity index, plasma ghrelin, serum lipid, glucose and insulin levels. Leu72Met mutation of prepro-ghrelin gene was directly detected by digesting the PCR fragments with Bsrl. RESULTS:Among antropometric data, body weight, BMI and obesity index were higher in obesity and overweight subjects than those of lean control subjects (P<0.05). The plasma ghrelin levels were significantly lower in overweight and obese subjects (P<0.05). In addition, serum triglyceride and LDL cholesterol levels were significantly higher in these groups compared to the control subjects (P<0.05). The concentrations of plasma ghrelin were significantly negatively correlated with BMI, obesity index, serum triglyceride, LDL cholesterol and insulin in all the children. However, there was no significant relationship between plasma ghrelin levels and any various parameters in obese subjects. Leu72Met mutation was detected in about 30% of obese children. However, we could not find any differences between lean control and obese children. CONCLUSION: We proved a significantly lower plasma ghrelin levels in overweight and obese subjects. Further studies are now needed to establish the role of ghrelin in the pathogenesis of human obesity.
Body Mass Index ; Body Weight ; Child* ; Cholesterol, LDL ; Ghrelin* ; Glucose ; Growth Hormone ; Homeostasis ; Humans ; Insulin ; Obesity* ; Overweight ; Plasma* ; Polymerase Chain Reaction ; Receptors, Ghrelin ; Triglycerides

Fibromatoses comprise many different entities of well-differentiated fibroblastic proliferation with variable collagen production and form a firm nodular mass. Abdominal fibromatosis is distinguishable from other forms of fibromatosis because of its location and its tendency to occur in women of childbearing age during or following pregnancy. Abdominal fibromatosis in children is an extremely rare condition. A 15-month-old boy presented with an abdominal wall mass that had recently increased in size. Mass excision was perfomed. The tumor was 4.3x4.1 cm and partly circumscribed. Histologically, the tumor was composed of parallel long fascicles of spindle-cells with a uniform appearance. The edges of the resected mass were infiltrative, and the surgical margins were positive. Mitotic figures were <1/10 high power fields. No cellular atypia or necrosis was present. The tumor cells were positive for vimentin and nuclear beta-catenin staining.
Abdominal Wall ; beta Catenin ; Child* ; Collagen ; Female ; Fibroblasts ; Fibroma ; Fibromatosis, Abdominal* ; Humans ; Infant ; Necrosis ; Pregnancy ; Vimentin