Color Doppler Ultrasonographic Findings of Vascular Leiomyoma: Pathologic Correlation

PURPOSE: To evaluate the distribution of color flow signals on color Doppler ultrasonography of vascular leiomyomas and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively analyzed color Doppler ultrasonographic images and pathologic slides of six vascular leiomyomas. We classified the patterns of distribution of color flow signals into localized compact cluster types and non-cluster types, and the pathologic findings into three subtypes: solid, venous and cavernous. RESULTS: All cases showed well-defined homogenous hypoechoic subcutaneous masses on gray-scale ultrasonography. Three cases showed localized compact cluster types on color Doppler ultrasonography, one in each subtype (solid, venous and cavernous). For the three non-cluster types, again there was on in each subtype. In addition, on pathologic analysis the zone of the localized compact cluster of color flow signals coincided with a cluster of larger, vascular caliber masses. CONCLUSIONS: Localized compact clusters of color flow signals on color Doppler ultrasonography were seen in 50% of our cases and correlated with a cluster of larger vascular caliber in the mass. But the pattern of distribution of color flows didn't show a correlation with pathologic type.

Phase II Study to Topotecan and Cisplatin in Advanced Hepatocellular Carcinoma

BACKGROUND: Hepatocellular carcinoma remains a highly chemoresistant neoplasm and is a common malignancy with poor prognosis in Korea. We performed a phase II study to evaluate the efficacy and toxicities of topotecan and cisplatin combination chemotherapy for advanced hepatocellular carcinoma. METHODS: Between November 1999 and May 2001, ten patients with histologically proven hepatocellular carcinoma were enrolled in this study. The median age was 54 (range: 53~74) years and all were male. Six patients demonstrated stage IV, 1 stage IIIC, 2 stage IIIB and 1 stage IIIA. Six patients showed a ECOG performance status of 1. The treatment regimen consisted of topotecan 1.25 mg/m2 and cisplatin 20 mg/m2 for 5 days. The treatment was repeated every 4 weeks. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All ten patients were evaluable for response and toxicity. There was only one patient who achieved partial response. The overall response rate was 10% (95% C.I.) and the response duration was 46 weeks. The median survival of all patients was 21 (range: 17~54+) weeks. During a total of 24 cycles, neutropenia of WHO grade 3 and 4 occurred in 33%, thrombocytopenia in 33% and anemia in 21%. In non-hematologic toxicity, diarrhea and hepatoxicity of grade 3 occurred in 1 and 2 patients, respectively. But there was no treatment-related death. CONCLUSION: When used in this dose and schedule, topotecan and cisplatin combination chemotherapy does not seem to be effective for patients with advanced hepatocellular carcinoma.

Permanent cardiac pacemaker therapy in a patient with swallow syncope / 대한내과학회지

Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery. A 74-year-old man presented with multiple, recurrent episodes of syncope associated with swallowing beverages. Sinus pause and 2:1 atrioventricular block were induced by swallowing carbonated beverages. He was treated with permanent cardiac pacing for the prevention of syncope. Swallow syncope did not recur for one year after implantation of a cardiac pacemaker.

Permanent cardiac pacemaker therapy in a patient with swallow syncope / 대한내과학회지

Syncope is sudden transient loss of consciousness and postural tone with spontaneous recovery. A 74-year-old man presented with multiple, recurrent episodes of syncope associated with swallowing beverages. Sinus pause and 2:1 atrioventricular block were induced by swallowing carbonated beverages. He was treated with permanent cardiac pacing for the prevention of syncope. Swallow syncope did not recur for one year after implantation of a cardiac pacemaker.

The usefulness of wrist/height ratio as a predictor for the risk factors of coronary artery disease

BACKGROUND: The waist/hip ratio in an useful index of abodominal obesity, but it includes two variables which may result in a false interpretation. The purpose of this study is to evaluate the usefulness of waist/height ratio as a predictor for the risk factors of coronary artery disease(CAD). METHODS: 1,395 persons(818 men & 577 women) were selected as subjects who visited the Health Examination Center at Ewha Mokdong Hospital from October 1998 to March 1997. Waist circumference was measured at the level of umblicus with standing position. Hip circumference was measured at the level of the largest circumference of the hip. We set the criteria if the risk factors as hypertension(systolic BP > OR = 140mmHg and/or diastolic BP > OR = 90mmHg), glucose intolence (fastng blood glucose > OR = 115mg/dl) hypertriglyceridemia(>160mg/dl), hypercholesterolemia(> OR = 200mg/dl), and low HDL-cholesterol level(<35mg/dl). The morbidity index of CAD was calculated by the sim if the risk factor scores(one point per item if present). RESULTS: There was significant correlation between waist/height ratio, waist/hip ratio and body mass index(BMI)(p=0.0001). BMI had more strong correlation with waist/height ratio(r=0.81) than waist/hip ratio(r=0.48). According to the simple regression analysis, BMI, waist/hip ratio and waist/height ratio had significant correlation with all of the risk factors and the morbidity index, According to the multiple regression analysis, waist/height ratio had significant correlation with age, weight, height, systolic BP, triglyceride, cholesterol and HDL-cholesterol. The risk factor morbidity index of the groups with waist/height ratio over 0.45 was significantly more higher than the group of the lowest risk factor morbidity index(waist/height ratio under 0.4) in men(p=0.01). for women, 0.46 was the level which the risk factor morbidity index increased significantly (p<0.01). CONCLUSIONS: Waist/height ratio can be a useful index of abdominal obesity. And it may be used as a more easier and better predictor of multiple CAD risk factors than waist/hip ratio. We can predict that waist/height ratio over 0.45 in men and over 0.46 in women may have more higher coronary artery disease risk.