No abstract available.
Myocardial Infarction*

To investigate the effect of carbon disulfide on blood pressure, the BP measurements in the periodic health examination results and the medical records of factory clinic were reviewed The study subjects were composed of 1336 male and 544 female workers, who were categorized into three groups by the exposure status-highly exposed, moderately exposed and non-exposed group. The results of the study were as follows; 1. The age-adjusted mean systolic and diastolic BP of male workers were 122.35 mmHg/79.11mmHg in highly exposed, 121.57mmHg/79.05mmHg in moderately exposed and 122.67mmHg/82.27mmHg in non-exposed group. For female workers, BP were 115.13mmHg/74.49mmHg in moderately exposed and 113.48mmHg/74.30mmHg in non-exposed group. 2. In multiple regression analysis of maximum BP against Age and tenure, the slope coefficients of age and tenure on the systolic BP were 0.379, 0.667 respectively and those on the diastolic BP were 0.331, 0.405 respectively in highly exposed male workers. Tenure was a significant variable in this study. For female workers, however, the slope coefficients of tenure on BP were significant only for systolic BP of moderately- expected group. 3. In multiple regression analysis of Bp against age, cumulative exposure index(CEI), cholesterol, all the variables showed significant slope coefficients in male, but age and CEl on systolic BP were significant for female workers (P<0.05). 4. In the multiple analysis of the amount of Bp change and the velocity of Bp change among male workers, the slope coefficients of tenure tended to increase as exposure level increased. Among female workers, the slope coefficients of tenure were significant on the amount of Bp change and the velocity of Bp change in moderately exposed group.
Blood Pressure* ; Carbon Disulfide* ; Carbon* ; Cholesterol ; Female ; Humans ; Male ; Medical Records

OBJECTIVE: To evaluate the learning curve of laparoscopic radical hysterectomy (LRH) for gynecologic oncologists who underwent residency- and fellowship-training on laparoscopic surgery without previous experience in performing abdominal radical hysterectomy (ARH). METHODS: We retrospectively reviewed 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer who underwent LRH (Piver type III) between April 2006 and March 2014. The patients were divided into two groups (surgeon A group, 42 patients; surgeon B group, 42 patients) according to the surgeon with or without ARH experience. Clinico-pathologic data were analyzed between the 2 groups. Operating times were analyzed using the cumulative sum technique. RESULTS: The operating time in surgeon A started at 5 to 10 standard deviations of mean operating time and afterward steeply decreased with operative experience (Pearson correlation coefficient=-0.508, P=0.001). Surgeon B, however, showed a gentle slope of learning curve within 2 standard deviations of mean operating time (Pearson correlation coefficient=-0.225, P=0.152). Approximately 18 cases for both surgeons were required to achieve surgical proficiency for LRH. Multivariate analysis showed that tumor size (>4 cm) was significantly associated with increased operating time (P=0.027; odds ratio, 4.667; 95% confidence interval, 1.187 to 18.352). CONCLUSION: After completing the residency- and fellowship-training course on gynecologic laparoscopy, gynecologic oncologists, even without ARH experience, might reach an acceptable level of surgical proficiency in LRH after approximately 20 cases and showed a gentle slope of learning curve, taking less effort to initially perform LRH.
Gynecology ; Humans ; Hysterectomy* ; Laparoscopy ; Learning Curve* ; Learning* ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Uterine Cervical Neoplasms

OBJECTIVE: The purpose of this study is to validate the Gynecologic Oncology Group (GOG) criteria for adjuvant treatment in a different cohort of patients and to evaluate the simplified risk criteria predicting the prognosis and tailoring adjuvant treatment in patients with surgically staged endometrial cancer. METHODS: We performed a retrospective analysis of 261 consecutive patients with surgically staged endometrial cancer between January 2000 and February 2013. All patients had complete staging procedures and were surgically staged according to the 2009 International Federation of Gynecology and Obstetrics staging system. Clinical and pathologic data were obtained from medical records. We designed the simplified risk criteria for adjuvant treatment according to the risk factors associated with survival. The patients were divided into low and low-intermediate, high-intermediate, and high-risk groups according to the GOG criteria and simplified criteria and their survivals were compared. Receiver-operating characteristic curve analysis was used to evaluate the prognostic significance of both criteria. RESULTS: Median follow-up time was 48 months (range, 10 to 122 months). According to the GOG criteria, we identified 197 low and low-intermediate risk patients, 20 high-intermediate risk patients, and 44 high-risk patients. There were significant differences in disease-free (p<0.001) and overall survival (p<0.001) among the three groups. Using the simplified risk criteria, we identified 189 low and low-intermediate risk patients, 28 high-intermediate risk patients, and 44 high-risk patients. There were significant differences in disease-free (p<0.001) and overall survival (p<0.001) among the three groups. The performance of the simplified criteria (area under the curve [AUC]=0.829 and 0.916 for disease recurrences and deaths, respectively) was as good as the GOG criteria (AUC=0.836 and 0.921 for disease recurrences and deaths, respectively). CONCLUSION: The simplified criteria may be easily applicable and offer useful information for planning strategy of adjuvant treatment in patients with surgically staged endometrial cancer as the GOG criteria.
Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant ; Endometrial Neoplasms/pathology/surgery/*therapy ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors ; Survival Analysis

Neutrophilic dermatosis of the dorsal hands (NDDH) is a recently described skin disorder regarded as a localized variant of acute febrile neutrophilic dermatosis (Sweet syndrome). The lesions of NDDH are characterized by erythematous plaques, pustules, and hemorrhagic bullae on the dorsal surface of the hands. Herein, we report a case of NDDH in a 52-year-old man with concomitant involvement of the ankle. The patient presented with well-demarcated erythematous papules, patches, and plaques on the dorsum of the hands as well as erythematous papules on the left ankle for 3 days. The lesions responded rapidly to systemic corticosteroid therapy.
Animals ; Ankle ; Blister ; Hand ; Humans ; Middle Aged ; Neutrophils ; Skin ; Skin Diseases ; Sweet Syndrome

Castleman's disease (CD) is a rare benign disorder of unknown etiology characterized by proliferation of lymphoid tissues. Seventy percent of this tumor occurs in the mediastinum and it is seldom found in neck, pancreas or pelvis. We report a case of asymptomatic pelvic CD initially presenting as an adnexal tumor in a 27-year-old woman. Initial transvaginal sonography revealed 7-cm-sized hyperechoic mass adjacent to the right ovary and the following abdominal computed tomography scanning showed the same sized mass located on the right extraperitoneal pelvic cavity. Laparoscopic mass excision was performed without any complication and pathological diagnosis was made as CD. CD should be included in the differential diagnosis of female pelvic masses which are noted in the pelvic cavity. In this report, we review the clinicopathological findings in a presentation of CD.
Adult ; Diagnosis ; Diagnosis, Differential ; Female ; Giant Lymph Node Hyperplasia* ; Humans ; Lymphoid Tissue ; Mediastinum ; Neck ; Ovary ; Pancreas ; Pelvis

Lichen planus is a chronic papulosquamous disease that affects the skin and mucous membranes. It is characterized by pruritic violaceous papules that are most commonly seen on the extremities of middle aged adults, but the elderly are rarely affected. Hypertrophic lichen planus usually occurs on the extremities and especially on the shins, and it tends to be the most pruritic variant. An 82-year-old female presented with severe pruritic multiple papules and plaques on the both the upper and lower extremities for 1 year. At first, the lesions began as small, polygonal papules that formed verrucous plaques over several months. Histopathologic examination showed marked hyperkeratosis, irregular acanthosis and wedge-shaped hypergranulosis. The vacuolar alteration and the lymphocytic inflammatory infiltrate were accentuated at the base of the rete ridge. From these findings, we diagnosed these lesions as hypertrophic lichen planus. The lesions were treated with topical steroid and intralesional injection of steroid, and they were slightly improved after 2 months of therapy.
Adult ; Aged ; Aged, 80 and over ; Extremities ; Female ; Humans ; Injections, Intralesional ; Lichen Planus ; Lichens ; Lower Extremity ; Middle Aged ; Mucous Membrane ; Skin

Colpotomy ; Disease-Free Survival ; Gynecology ; Humans ; Hysterectomy ; Magnetic Resonance Imaging ; Minimally Invasive Surgical Procedures ; Obstetrics ; Patient Selection ; Recurrence ; Uterine Cervical Neoplasms

Objective: To evaluate oncologic outcomes of minimally invasive radical hysterectomy (RH) in early cervical cancer before and after the application of parametrial invasion (PMI) criterion on magnetic resonance imaging (MRI) and vaginal colpotomy (VC). Methods: A total of 216 International Federation of Gynecology and Obstetrics stage IB–IIA cervical cancer patients who underwent minimally invasive RH was identified between April 2006 and October 2018. Patients were classified into the pre-PMI intracorporeal or VC (IVC) (n=117) and post-PMI VC groups (n=99). In the pre-PMI IVC group, PMI criterion (intact stromal ring) on MRI was not applied and the patients received IVC. In the post-PMI VC group, surgical candidates were selected using the PMI criterion on MRI and all patients received VC only. Oncologic outcomes and prognostic factors associated with disease recurrence were analyzed. Results: The rate of positive vaginal cuff margins in the pre-PMI IVC group was higher than that in the post-PMI VC group (11.1% vs. 1.0%, p=0.003). Two-year disease-free survival was different between the 2 groups (84.5% in pre-PMI IVC vs. 98.0% in post-PMI VC groups, p=0.005). Disrupted stromal ring on MRI (hazard ratio [HR]=20.321; 95% confidence interval [CI]=4.903–84.218; p<0.001) and intracorporeal colpotomy (HR=3.059; 95% CI=1.176–7.958; p=0.022) were associated with recurrence. Conclusion The intact cervical stromal ring on MRI might identify the low-risk group of patients in terms of PMI and lymphovascular/stromal invasion in early cervical cancer. Minimally invasive RH should be performed in optimal candidates with an intact stromal ring on MRI, using VC.

OBJECTIVE: The purpose of this study is to investigate the incidence of lymph node metastasis in early endometrial cancer patients and to evaluate preoperative clinicopathological factors predicting lymph node metastasis. METHODS: We identified 142 patients with endometrial cancer between January 2000 and February 2013. All patients demonstrated endometrioid adenocarcinoma with grade 1 or 2 on preoperative endometrial biopsy. Preoperative magnetic resonance imaging showed that tumors were confined to the uterine corpus with superficial myometrial invasion (less than 50%), and there were no lymph nodes enlargements. All patients had complete staging procedures and were surgically staged according to the 2009 FIGO (International Federation of Gynecology and Obstetrics) staging system. Clinical and pathological data were obtained from medical records and statistically analyzed. RESULTS: Of the 142 patients, 127 patients (89.4%) presented with stage 1A, 8 (5.6%) with stage IB, 3 (2.1%) with stage II, and 4 (2.8%) with stage III disease. Three patients (2.1%) had lymph node metastasis-2 IIIC1 and 1 IIIC2 disease. Age, preoperative tumor grade, and myometrial invasion less than 50% on preoperative MRI were not associated with lymph node metastasis. A high preoperative serum CA-125 level (>35 IU/mL) was a statistically significant factor for predicting lymph node metastasis on univariate and multivariate analyses. Lymph node metastasis was only found in patients with preoperative grade 2 tumors or a high serum CA-125 level. CONCLUSION: Preoperative tumor grade and serum CA-125 level can predict lymph node metastasis in apparent early endometrial cancer patients.
Biopsy ; Carcinoma, Endometrioid ; Endometrial Neoplasms* ; Female ; Gynecology ; Humans ; Incidence ; Lymph Nodes* ; Magnetic Resonance Imaging ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis*