No abstract available.
Female ; Germ Cells* ; Neoplasms, Germ Cell and Embryonal* ; Ovary*

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; Pregnancy

No abstract available.
Blood Cells* ; Leukemia*

Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy.
Bone Marrow ; Breast ; Breast Neoplasms ; Female ; Femur ; Humans ; Hydrazines ; Middle Aged ; Neoplasm Metastasis ; Recurrence

Apocrine sweat gland carcinoma is a very unusual malignant skin adnexal tumor and mostly occurs in areas where apocrine elands are abundant namely. axilla. upper arm. scalp. eyelid. vulva and external auditory meatus. The scrotal location is not yet reported. We report a case of apocrine sweat gland carcinoma of scrotum in a man aged 85, which was managed by local excision. The histologic finding is that of poorly differentiated adenocarcinoma. Evidence of decapitation secretion typical or apocrine glands. is present in some areas.
Adenocarcinoma ; Apocrine Glands ; Arm ; Axilla ; Decapitation ; Eyelids ; Scalp ; Scrotum* ; Skin ; Sweat Glands* ; Sweat* ; Vulva

It is essential to estimate the liver size in the diagnosis of liver disease. Many approaches have beenattempted in the evaluation of liver size such as measurement of length, area and volume. Among these, area andvolume measurements are accurate but complicated. So various linear measurements including Pfahler's method havebeen commonly used. But to our knowledge, there was no report about linear diameter of liver in Korean adualts. Asingeneral, larger patients are likely to have larger liver than smaller ones, it seems to be more ideal toevaluate the liver size using relative ratio rather than absolute linear diameters. The main objectives of ourinvestigation were to determine the various diameters of normal and enlarged liver and the criteria ofhepatomegaly in Korean adults using absolute and relative ments. Our cases consisted of 95 clinically normalsubjects and 51 patients suffering from liver disease and diagnosed to have hepatomegaly on abdominal palpationand simple abdomen in the Dept. of Radiology, St, Mary Hospital during the period of 6 months since Jan. 1981. Wemeasured the liver size using 3 linear diameters. And as the reference measurement, the distance from the rightmargin of the liver to the left margin of spleen was also measured. We called this “abdominal transversediameter”(ATD). The results were as follows; 1. The diameters of liver were 13.4±1.6cm, 18.4±2.4cm, 19.2±2.6cmin normal group and 18.8±3.1cm, 23.5±3.0cm, 24.2±3.2cm in hepatomegaly group using midline verticaldiameter(MIVD), maximum vertical diameter (MAVD) and diagonal diameter(DD), respectively. The difference betweentwo groups were statistically very significant in every method(p<0.01). 2. The 99% tolerance limits of liverdiameters were 13.0-13.8cm, 17.8-19.0cm, 18.5-19.9cm in normal and DD, respectively. The midpoints between theupper limit of normal group and the lower limit spectively. These points are warranted to suggest criterias ofhepatomegaly. 3. There were statistical significant difference in the ratio of each diameter to ATD between normaland hepatomegaly group (p<0.01). We called this“hepato-abdominal ratio”. The “hepato-abdominal in hepatomegalygroup using MIVD, MAVD and DD, respectively. 4. The 99% tolerance limits of “hepato-abdominal ratio” were0.43-0.45, 0.59-0.63, 0.62-0.64 in normal group and 0.60-0.62, 0.75-0.77, 0.77-0.79 in hepatomegaly group usingMAVD, MAVD and DD, respectively. The midpoints between the upper limit of normal group and the lower limit ofhepatomegaly group were 0.52, 0.69, 0.70 using MIVD, MAVD and DD, respectively. These points are alsowarranted tosuggest criterias of hepatomegaly.
Abdomen ; Adult ; Diagnosis ; Hepatomegaly ; Humans ; Liver Diseases ; Liver ; Methods ; Spleen

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

PURPOSE: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. METHODS: We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. RESULTS: The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. CONCLUSION: We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.
Abdominal Pain ; Checklist ; Curriculum ; Educational Measurement ; Empathy ; Humans ; Nonverbal Communication ; Physical Examination ; Reproducibility of Results ; Students, Medical

Patient with osseous metastatic prostatic cancer can clinically be detected by bone scanning, which usually is sensitive and qualitative but is not specific and quantitative. For quantitative evaluation of skeletal lesions, we measured bone mineral density (BMD) in whole body, total spine and lumbar spine. All patients also were assessed with bone radiography, radionuclide bone scan, prostate specific antigen (PSA), and prostatic acid phosphatase (PAP). We compared mainly bone scan and BMD in monitoring tumor response between before hormonal treatment and 6 month after hormonal treatment. Fifteen patients with stage D2 prostate cancer and 25 controls were entered in this study. Of 8 patients whose scan showed response in 12 patients with metastatic lumbar spine lesion, they had either 7 responded or 1 unchanged BMD level in the lumbar spine. Of 9 patients whose scan showed response in 15 patients with metastatic total spine lesion, they had either 6 responded or 3 unchanged BMD level in the total spine. The alterations of BMD levels in total spine and lumbar spine closely correlated with the therapeutic responses assessed by the National Prostatic Cancer Project Criteria of bone scintigraphy in patients with prostatic cancer (spine: r=0.04, p<0.05; lumbar: r=0.1, p<0.05). In contrast, BMD changes in whole body (response rate: 20.0%, P<0.05) was less than that in total spin (response rate: 53.3%, P<0.01) and lumbar spine (response rate: 58.3%, P<0.01). In conclusion, when compare BMD to the hot spot region in bone scan, BMD may be helpful to the urologist for the accuracy of the staging and evaluation of the treatment response to androgen deprivation therapy in metastatic prostate cancer.
Acid Phosphatase ; Bone Density ; Densitometry* ; Evaluation Studies as Topic ; Humans ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Radiography ; Radionuclide Imaging ; Spine

A virus-associated hemophagocytic syndrome is characterized by high fever, liver dysfunction, coagulation abnormalities, pancytopenia, and a benign histiocytic proliferation with prominent hemophagocytosis in bone marrow, lymph node, spleen, and liver. Three phases of disease progression can be defined. In the first week, there is mild leukocytosis and myeloid hyperplasia in the marrow and the fever is resistant to antipyretics and antibiotics. In the second phase, usually corresponding to the 2nd to 3rd week of the illness, the fever persists and jaundice and hepatosplenomegaly may develop and the marrow now reveals the presence of atypical or transformed T lymphocytes and a scattering of histiocytes with hemophagocytosis. In the third phase, the disease progresses to a full-blown hemophagocytic syndrome with coagulopathy and lung infiltrates. The marrow in this stage is usually hypoplastic with florid histiocytic proliferation and hemophagocytosis and the patients usually die within 1-2 months. We describe a pregnant woman with fatal hemophagocytic syndrome. Virologic study strongly suggests that Epstein-Barr virus implicated in the pathogenesis of this patient.
Anti-Bacterial Agents ; Antipyretics ; Bone Marrow ; Disease Progression ; Female ; Fever ; Herpesvirus 4, Human* ; Histiocytes ; Humans ; Hyperplasia ; Jaundice ; Leukocytosis ; Liver ; Liver Diseases ; Lung ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Pregnancy* ; Pregnant Women ; Spleen ; T-Lymphocytes