Purpose: Lymph node metastasis (LNM) is the most significant prognostic factor in cervical cancerthat was recently incorporated into the International Federation of Gynecology and Obstetrics(FIGO) staging system. This study was performed to evaluate whether the prognosticsignificance of LNM differs according to disease status. Materials and Methods: Patients with FIGO stage IB or higher cervical cancer who had pretreatment computedtomography and/or magnetic resonance imaging studies as well as long-term follow-upwere enrolled in this retrospective study. The hazard ratio (HR) of Cox regression was usedto determine the prognostic significance of LNM. The HRs were compared between the differenttumor groups (based on stage, histology, tumor size, primary treatment, age, parametriuminvolvement, and lymphovascular space invasion). Results: A total of 970 patients treated between January 1999 and December 2007 were included.The pretreatment LNM had prognostic significance in patients with stage IB1/IIA (HR forprogression-free survival 2.10, p=0.001; HR for overall survival 1.99, p=0.005). However,the significance gradually decreased or disappeared with advancing stages. Similarly, theprognostic significance of the pretreatment LNM decreased with advancing disease status,including old age, parametrial involvement or lymphovascular space involvement. In contrast,the tumor size was associated with the prognostic significance of LNM with advancingstatus. The significance of the clinical LNM did not reflect the significance of the clinicalstage. In contrast, the tumor size, parametrial involvement, and significance of the pathologicLNM reflected the clinical stage. Conclusion In patients with cervical cancer, pretreatment LNM on imaging has different clinical significancedepending on the tumor status.

Rhabdomyoma is the most common fetal cardiac tumor, and its development is related to tuberous sclerosis. Fetal cardiac rhabdomyomas often spontaneously regress in utero or after birth, but large tumors can cause hemodynamic obstruction. Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been used as an immunosuppressant after organ transplantation. The mTOR inhibitors are well-known to have anti-tumor activity, and they have been used for the treatment of patients with tuberous sclerosis. In the current case, fetal cardiac rhabdomyoma was completely resolved in utero during oral sirolimus treatment in the mother with tuberous sclerosis. This case shows that oral sirolimus therapy in pregnancy may be a treatment for multiple or large fetal cardiac rhabdomyomas.
Female ; Fetal Therapies ; Heart Neoplasms ; Hemodynamics ; Humans ; Mothers ; Organ Transplantation ; Parturition ; Pregnancy ; Pregnant Women ; Rhabdomyoma ; Sirolimus ; Transplants ; Tuberous Sclerosis

Gastrointestinal stromal tumor (GIST) is a mesenchymal tumor derived from Cajal cells originating from the myotonic plexus. The expression of tyrosine kinase (KIT) membrane receptors that are active on KIT is inhibited by the KIT inhibitor imatinib mesylate. GISTs are resistant to conventional chemotherapy, and radiation therapy is not significantly beneficial for GISTs. With the development of imatinib mesylate, approximately 81.6% of patients with advanced and metastatic GIST exhibit an effect above the stabilization response, thereby increasing the survival time. However, imatinib mesylate alone is unlikely to cure metastatic GISTs. Even with a partial or stable response, imatinib mesylate may be used for a longer time period. However, resection of grossly visible lesions should be considered for patients with a stable response during surgical treatment. In this study, we present a case of GIST with liver metastasis after imatinib mesylate treatment, which was followed up without recurrence after partial resection.
Drug Therapy ; Gastrointestinal Stromal Tumors ; Humans ; Imatinib Mesylate ; Liver ; Membranes ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Recurrence

Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
Angioplasty, Balloon ; Aspirin ; Coronary Vessels* ; Dilatation ; Dilatation, Pathologic ; Humans ; Liver Cirrhosis* ; Liver* ; Myocardial Infarction* ; Platelet Aggregation Inhibitors ; Prognosis ; Stents ; Thrombosis*

Coronary artery ectasia (CAE) is a rare condition defined as the dilatation of coronary artery to at least 1.5 times larger than the normal adjacent coronary artery. Clinical manifestations of CAE vary, ranging from asymptomatic to ST-segment elevation myocardial infarction (STEMI). Because of its rarity and clinical diversity, the best treatment strategy and prognosis for CAE remain unclear. We describe a case of STEMI caused by intracoronary thrombus formation within an ectatic area in a patient with liver cirrhosis (LC). The patient was successfully managed by thrombus aspiration only, without balloon angioplasty or stent implantation, and maintained by dual antiplatelet therapy with aspirin and ticagrelor, a potent new P2Y12 inhibitor.
Angioplasty, Balloon ; Aspirin ; Coronary Vessels ; Dilatation ; Dilatation, Pathologic ; Humans ; Liver Cirrhosis ; Liver ; Myocardial Infarction ; Platelet Aggregation Inhibitors ; Prognosis ; Stents ; Thrombosis

We report our experience of unexpected low expiratory concentration of sevoflurane 0.8 vol%, low inspired fraction of oxygen 31%, and high value of bispctral index (BIS) 62 with sevoflurlane vaporizer setting 2.0 vol% and the inspired fraction of oxygen 50% during general anesthesia of a 56-year-old man undergoing elective laparoscopic hemicolectomy. The anesthesia machine (Cato edition, Drager, Lubeck, Germany) with a piston-based, electronically controlled ventilator was used for anesthesia. We checked thoroughly all the possible causes of the discrepancy of anesthetic gas concentration, and then detected the partial disconnection of fresh gas outlet. But there were no alarm signs of anesthetic monitor with adequate ventilator function. This malfunction of anesthetic gas supply without alarm signs may lead to hypoxia and awareness of patients. The intraoperative monitoring of anesthetic gas analyzer and BIS may be essential to detect the malfunction of anesthesia machine.
Anesthesia ; Anesthesia, General* ; Anoxia ; Humans ; Methyl Ethers ; Middle Aged ; Monitoring, Intraoperative ; Nebulizers and Vaporizers ; Oxygen ; Ventilators, Mechanical

We report our experience of unexpected low expiratory concentration of sevoflurane 0.8 vol%, low inspired fraction of oxygen 31%, and high value of bispctral index (BIS) 62 with sevoflurlane vaporizer setting 2.0 vol% and the inspired fraction of oxygen 50% during general anesthesia of a 56-year-old man undergoing elective laparoscopic hemicolectomy. The anesthesia machine (Cato edition, Drager, Lubeck, Germany) with a piston-based, electronically controlled ventilator was used for anesthesia. We checked thoroughly all the possible causes of the discrepancy of anesthetic gas concentration, and then detected the partial disconnection of fresh gas outlet. But there were no alarm signs of anesthetic monitor with adequate ventilator function. This malfunction of anesthetic gas supply without alarm signs may lead to hypoxia and awareness of patients. The intraoperative monitoring of anesthetic gas analyzer and BIS may be essential to detect the malfunction of anesthesia machine.
Anesthesia ; Anesthesia, General* ; Anoxia ; Humans ; Methyl Ethers ; Middle Aged ; Monitoring, Intraoperative ; Nebulizers and Vaporizers ; Oxygen ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to identify the effectiveness of back pain prevention intervention program on reducing back pain of patients undergoing percutaneous coronary intervention (PCI). METHODS: The patients were divided into two groups as the experimental group and control group. In the experimental group, the participants took bedrest for 4 hours after PCI and then received back pain prevention intervention program (BPPIP). Total of 5 times BPPIP with 1 hour interval for 5-10 minutes per each intervention was administered to the patients taking bedrest for 4 hours after PCI. In the control group, total of 5 times routine nursing care with 1 hour interval was administered to the patients taking bedrest for 4 hours after PCI. The data were collected on admission in the ICU and after the 5 exercise sessions. The collected data were analyzed using SPSS/WIN program. RESULTS: No significant differences in the occurrence of hemorrhage after the BPPIP were observed between the experimental group and the control group. After the BPPIP, back pain outcomes were significantly low in the experimental group. However, urination disorder and cortisol level did not show a statistically significant differences between two groups. CONCLUSION: It is clear that BPPIP is a useful nursing intervention for reducing back pain of patients undergoing PCI.
Back Pain* ; Bed Rest ; Hemorrhage ; Humans ; Hydrocortisone ; Nursing ; Nursing Care ; Percutaneous Coronary Intervention* ; Urination Disorders

No abstract available.

PURPOSE: We evaluated the correlation between the expression of CXCR4 and prognostic factors in patients with prostate cancer. MATERIALS AND METHODS: A total of 57 patients who had undergone surgery for prostate cancer were enrolled. Specimens were obtained before any treatment and were stained with antihuman CXCR4 antibody. The intensity of staining was graded as low or high. The age, pretreatment prostate-specific antigen (PSA) level, Gleason score, T stage, biochemical recurrence, local recurrence, and distant metastasis were compared according to the expression of CXCR4 in patients with prostate cancer. RESULTS: Local recurrence was higher in the group with high expression, in 11 of 36 cases (30.6%), than in the group with low expression, in 1 of 21 cases (4.8%), with statistical significance (p=0.040). Distant metastasis was also associated with expression, occurring in 10 of 36 cases (27.8%) in the group with high expression and in 1 of 21 cases (4.8%) in the group with low expression (p=0.041). In the logistic regression test, CXCR4 expression was the only factor in determining local recurrence (p=0.016) and distant metastasis (0.022). Furthermore, the group with high CXCR4 expression showed significantly longer cancer-specific survival than did the low expression group (p=0.041). CXCR4 showed no association with age (p=0.881), pretreatment PSA level (p=0.584), Gleason score (p=0.640), T stage (p=0.967), or biochemical recurrence (p=0.081). CONCLUSIONS: The high expression of CXCR4 was associated with local recurrence and distant metastasis. CXCR4 expression was shown to be a useful prognostic factor for patients with prostate cancer.
Humans ; Logistic Models ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Recurrence