This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows: 1) Total number of respondents was 405; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized in surgery, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's major discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.
Surveys and Questionnaires ; Dentists* ; Fathers ; Hospitals, General ; Humans ; Internal Medicine ; Parents ; Surveys and Questionnaires ; Siblings ; Specialization ; Workplace

Internal hernia is an unusual cause of the intestinal obstruction. The advances of CT make the diagnosis more easier than in the past. We report one case of internal hernia with herniation of the ileum into the lesser omenturn. The diagnosis could be made when abdominal radiographs showed fixed clustering of the small bowel loops in upper abdomen medial to the stomach. CT and ultrasound showed characteristic interposition of the ileum between the left hepatic lobe and the stomach.
Abdomen ; Diagnosis ; Hernia* ; Ileum ; Intestinal Obstruction ; Stomach ; Ultrasonography

Angiogenesis, the induction of new capillaries and venules, is associated with tumor growth. This study was designed to determine whether cervical carcinomas are angiogenic, and to investigate whether tumor angiogenesis can serve as a prognostic factor in cervical carcinoma. Surgical specimens of 47 cervical carcinomas were immunohistochemically stained specifically for endothelial cells with factor VIII-related antigen to identify all vessels. Microvessels were counted from photographs of 200x microscopic fields. In addition, thirty-seven cases were studied by immunohistochemical means using the monoclonal antibodies for PCNA and for Ki-67 to determine tumor cell proliferation rates in cervical carcinomas. The microvessel count(MVC), the PCNA labelling index, and the Ki-67 index were calculated and compared with known prognostic factors and disease free survival rates in cervical carcinomas. A wide range in the MVC count(range 12-100 mean=38.2+/-19.2), the PCNA labeling index(8-69% mean=33.6+/-15.2%), and in the extent of Ki-67 staining(0-43% mean=10.3+/-10.5%) was observed, indicating considerable variation of tumor angiogenic activity and tumor growth rates. This study showed statistically significant correlations in disease free survival rates with both lymph node status and the microvessel count. However, there was no significant difference in disease free survival rates between tumor stage, age, the PCNA labelling index, and the Ki-67 index.
Antibodies, Monoclonal ; Capillaries ; Cell Proliferation ; Cervix Uteri* ; Disease-Free Survival ; Endothelial Cells ; Female ; Lymph Nodes ; Microvessels ; Proliferating Cell Nuclear Antigen ; Venules ; von Willebrand Factor

The etiology of spontaneous hemarthrosis of the knee joint in elderly pattents is still unknown. This report discusses seven spontaneous hernarthroses, three that were managed witla conservative measures such as aspiration, rest and knee immobilization because of poor general condition and four in which arthroscopic evaluation and treatment were performed. These patients were elderly indi.viduals without an obvious history of trauma. The roentgenograms of each involved knee demonstrated degenerative osteoarthritic changes of knee joint. Arthroscopic examination revealed denuded articular cartilage and subchondral bone exposure in four operative cases and degenerative meniscal tear in one case of four. These patients underwent mthroscopic debridement and did not experience recurrenees of the hemarthrosis. We think that the origin of the bleeding was most likely from the subchondral cancellous bone which was exposed due to degenerative change of the knee joint and the senile changes of the vessels around the knee joint with aging process may contribute the spontaneous bleeding into the knee joints.
Aged* ; Aging ; Cartilage, Articular ; Debridement ; Hemarthrosis* ; Hemorrhage ; Humans ; Immobilization ; Knee Joint ; Knee*

Intravascular papillary endothelial hyperplasia is a benign solitary turnor that may be histologically misdiagnosed as angiosarcoma. We present herein a case of intravascular papillary endothelial hyperplasia occuring in 40-year-old female who hsd a slowly growing tumor on the tongue for 3 years. the histopathologic findings revealed. papillary endothelial hyperplasia in blood vessel accompanied with thrombi.
Adult ; Blood Vessels ; Female ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Tongue*

A collodion baby is born with a tough, inelastic parchment-like membrane covering the whole body surface. As the meinbrane fissures and peels, a more characteristic ichthyosiform change is evident beneath the collodion membrane. Uncommonly, normal skin is found under it. We herein present two cases af collodion baby, which were confirmed as a sporadic case of lamellar ichthyosis and a case of lamellar exfoliation of the newborn, respectively, after long-term clinical observation. It is necessary that detailed genetical and molecular biological studies should be perforrned in order to elucidate the fur:damental, molecular changes that cause these dramatic cutaneous changes.
Collodion* ; Humans ; Ichthyosis, Lamellar ; Infant, Newborn ; Membranes ; Skin

No abstract available.
Animals ; Langerhans Cells* ; Mice ; Mice, Inbred C3H*

BACKGROUND: Conventional echocardiography provides fundamental information about mitral valve morphology and function but is often subjective and has a relatively low specificity in evaluating valve calcific deposit, which is critical information for the preoperative decision. We hypothesized that mitral valvular calcification could be detected in standard two-dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis so that we could overcome the subjectivity and low specificity of conventional echocardiography. METHODS: We tested this hypothesis by performing standard 2.5MHz two-dimensional echoes on mitral valve and myocardium in 30 patients with mitral stenosis, scheduled to undergo mitral valve replacement. We compared gray level of each region of interest in mitral valve and myocardium in stop-frame images with the degree of calcifications identified by pathologic and radiographic examinations. RESULTS: Ratio of mean gray level of mitral valve to mean gray level of myocardium was the most reliable value in evaluating degree of calcification. Quantitatively, region of calcification displayed the ratio of significantly higher value than that of no calcification. In case of anterior mitral valve, the ratio of the evident calcified region was greater than 3.11, that of the region without calcification was less than 2.42 and that of microcalcification was betwwn 2.42 and 3.11. For posterior mitral valve, the ratio of the evident calcified region was greater than 3.50, that of the region without calcification was less than 2.19 and that of microcalcification was between 2.19 and 3.50. The sensitivity and specificity of this method for assessment of degree of calcification was 75% and 100% for anterior mitral valve and 9% and 87.5% for posterior mitral valve. CONCLUSION: Mitral valvular calcification could be detected quantitatively in standard two dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis.
Echocardiography ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Myocardium ; Sensitivity and Specificity

Histopathological diagnosis of brain stem glioma should be performed for the purpose of the determination of its management and clinical course, but its surgical biopsy has been followed by high mortality and morbidity. We performed the tissue sampling for histological examination with BRW stereotaxic system under local anesthesia successfully.
Anesthesia, Local ; Biopsy* ; Brain Stem* ; Brain* ; Diagnosis ; Glioma* ; Mortality

Primary small cell carcinoma of the prostate is a rare malignancy of unknown origin and with poor prognosis. We report a case occurring in a 74-year-old man. Radiologic findings showed that the prostate was markedly enlarged, with a lobulated contour and unclearly defined internal architecture. It was therefore impossible to distinguish it from prostatic adenocarcinoma, but the huge mass and normal range of serum tumor markers (prostate-specific antigen and prostate acid phosphatase) suggested small cell carcinoma of the prostate.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Humans ; Prognosis ; Prostate* ; Reference Values ; Biomarkers, Tumor