Simultaneous determination of six aniline compounds in workplace air by high performance liquid chromatography / 中国职业医学

Objective To establish a high performance liquid chromatography (HPLC) method for simultaneous determination of six aniline compounds (ADs) in workplace air. Methods GDH-1 air sampling tube was used to collect six co-existing ADs such as aniline, o-toluidine, N-methylaniline, m-methylaniline, p-methylaniline and N,N-dimethylaniline in the vapor and aerosol of workplace air. The samples were desorbed and eluted using a methanol solution containing 1.00% ammonia water, followed by separation on a C18 chromatographic column and detection using a diode array detector. Results The quantification range of the method was 0.19 -253.50 mg/L, with the correlation coefficient of 0.999 9 for all six ADs. The minimum detection range was 0.02-0.06 mg/m3, and the minimum quantitation range was 0.04-0.19 mg/m3 [both calculated for a 15.0 L sample with a desorption (elution) solution volume of 3.00 mL]. The average desorption and elution efficiencies were 92.15%-104.41% (silica gel) and 94.29%-104.29% (filter membrane). The intra-assay relative standard deviation (RSD) ranged from 0.90%-9.72% (silica gel) and 0.57%-6.96% (filter membrane). The inter-assay RSD ranged from 2.03%-9.78% (silica gel) and 2.50%-8.62% (filter membrane). The samples were stable at room temperature for seven days. Conclusion This method can be used for the simultaneous determination of six ADs in workplace air.

COVID-19 mortality and synergy with coexisting chronic diseases, in the province of Neuquén, Argentina, 2020 / Mortalidad por covid-19 y sinergia con enfermedades crónicas coexistentes en la provincia del neuquén, argentina, 2020

RESUMEN INTRODUCCIÓN: Las enfermedades crónicas coexistentes (ECC) tienen mayor prevalencia a medida que se avanza en la edad de la población. El término síndemía refiere a problemas de salud sinérgicos que afectan la salud de una población en el contexto de inequidades sociales y económicas persistentes. El objetivo de este estudio fue describir la relación entre COVID-19 y ECC con la mortalidad en la provincia del Neuquén y proponer algunas intervenciones para reducir el impacto de la pandemia (síndemía) en esta población. MÉTODOS: Estudio observacional que describe la mortalidad por COVID-19 registrada en la provincia del Neuquén durante el período de marzo a octubre de 2020, según el grupo etario, el sexo, el lugar de residencia y la prevalencia de ECC. RESULTADOS: Se registraron 335 defunciones en el período estudiado (62,7% de hombres y 37,3% de mujeres). El 78,5% de las personas fallecidas tenían 60 y más años y el 68,7% presentaba al menos una comorbilidad, de las cuales las más frecuentes fueron hipertensión arterial (39,2%), diabetes (21,6%) y obesidad (9,8%). DISCUSIÓN: Los casos con formas graves y la tasa de letalidad por COVID-19 aumentan con la edad, y gran parte de las defunciones por COVID-19 se encuentran potenciadas o determinadas por la presencia de las ECC. El riesgo de mayor susceptibilidad se manifiesta en personas que no se mantienen bajo seguimiento clínico y terapéutico con las necesarias adecuaciones según su evolución.

ABSTRACT INTRODUCTION: Coexístíng Chroníc Díseases show hígher prevalence as the populatíon age íncreases and the more severe presentatíons and the case-fatalíty rísk of COVID-19 do so líkewíse. The term "syndemíc"refers to synergístíc health problems that have an effect on populatíon health wíthín the context of persístent socíal and economíc ínequalítíes. The objetíve of thís study ís to descríbe the relatíonshíp between COVID-19 and Coexístíng Chroníc Díseases wíth mortalíty ín the provínce of Neuquén, and propose some ínterventíons to reduce the ímpact of the pandemíc (syndemíc) ín thís populatíon. METHODS: Thís observatíonal study descríbes deaths and mortalíty due to COVID-19, occurríng ín the provínce of Neuquén, duríng the March-October 2020 períod, and the frequency and dístríbutíon accordíng to age groups, males and females, place of resídence wíthín the províncíal terrítory and prevalence of rísk factors or coexístíng chroníc díseases ín the study group. RESULTS: Duríng the study períod 335 deaths occurred, of whích 62.7% were men and 37.3% women. 78.5% were íncluded ín de 60 years and over age group, and 68.7% recordedat least one co-morbídíty, beíng mostpredomínant hígh bloodpressure (39.2%), díabetes (21.6%) obesíty (9.8%). DISCUSSION: Severe presentatíons of COVID-19 and case fatalíty íncreases wíth age, and a greater part of the deaths are potentíated or determíned by the presence of coexístíng chroníc díseases. The rísk of hígher susceptíbílíty ís shown ín persons that are not kept under contínuous clínícal and therapeutíc follow-up wíth the necessary adjustments accordíng to the evolvíng progress of dísease.

Clinical analysis of 1 057 patients with critical illnesses in a dermatological ward / 中华皮肤科杂志

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.

Factores asociados a mortalidad en pacientes Covid-19 en un Hospital del norte de Perú / Factors associated with mortality in Covid-19 patients in a Hospital in northern Peru

Objetivo. Determinar los factores de riesgo sociodemográficos y clínicos relacionados con la mortalidad en pacientes COVID-19 en un Hospital del norte de Perú. Material y Métodos: la investigación se llevó a cabo en un Hospital del norte de Perú. La población la constituyeron 208 Historias Clínicas de pacientes COVID-19 atendidos entre Marzo a Julio del 2020. La variable independiente fueron los factores sociodemográficos tales como la edad, sexo y el estado civil y los factores clínicos como antecedentes epidemiológicos, los factores de riesgo (co-morbilidades) y el estado de salud y la variable dependiente fue la mortalidad Covid-19. Resultados: La mortalidad COVID-19 alcanzó al 46,20 % en pacientes mayores 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %), con antecedentes epidemiológicos (37,5%), y factores de riesgo (comorbilidad) un 74,50 %, principalmente asociados con hipertensión arterial (8,2%), obesidad (3,4%) y diabetes mellitus II (1,9%), y comorbilidades indeterminadas (Otras) un 6,7%. No se presentó mortalidad en los pacientes cuyo estado de salud era Estable, mientras que los pacientes con estado de salud reservado y fallecieron representaron un 46,2%. Conclusión: La mortalidad por COVID-19 alcanzó un 46,20%; mayores de 65 años (51,90 %), de sexo masculino (60,40 %) y casados (65,40 %). Se encontró relación significativa entre factores sociodemográficos como la edad, factores clínicos (comorbilidad), en su mayoría hipertensión arterial, obesidad y diabetes mellitus II, y pacientes con estado de salud reservado con la mortalidad del COVID-19.

Objetive. To determine the sociodemographic and clinical risk factors related to mortality in COVID-19 patients in a Hospital in northern Peru. Material and Methods: the research was carried out in a Hospital in the north of Peru. The population was made up of 208 Clinical Histories of COVID-19 patients seen between March and July 2020. The independent variable was sociodemographic factors such as age, sex and marital status, and clinical factors such as epidemiological history, risk factors (co-morbidities) and health status and the dependent variable was Covid-19 mortality. Results: COVID-19 mortality reached 46.20% in patients older than 65 years (51.90%), male (60.40%) and married (65.40%), with an epidemiological history (37.5%) , and risk factors (comorbidity) 74.50%, mainly associated with arterial hypertension (8.2%), obesity (3.4%) and diabetes mellitus II (1.9%), and indeterminate comorbidities (Others) 6.7%. There was no mortality in patients whose health status was Stable, while patients with reserved health status and who died represented 46.2%. Conclusion: mortality from COVID-19 reached 46.20%; older than 65 years (51.90%),male(60.40%) and married (65.40%). A significant relationship was found between sociodemographic factors such as age, clinical factors (comorbidity), mostly arterial hypertension, obesity and diabetes mellitus II, and patients with a reserved health status with the mortality of COVID-19.

A Case of Acute Type B Aortic Dissection Subsequent to Asymptomatic Chronic Type A Aortic Dissection Which Was Difficult to Distinguish from Acute Type A Aortic Dissection / 日本心臓血管外科学会雑誌

Aortic dissection presents with acute chest or back pain. However, it can be asymptomatic in the acute phase with delayed symptomatic presentation or incidental diagnosis upon chest imaging. We report a case of acute type B aortic dissection subsequent to chronic type A aortic dissection which was difficult to distinguish from acute type A aortic dissection. A 45-year-old man was admitted to a hospital with sudden back pain. An enhanced chest CT revealed a suspected acute type A aortic dissection. The patient was transferred to our hospital and we performed an emergent total arch replacement. Intraoperative findings showed that there were two entries at the origin of the brachiocephalic artery and the left subclavian artery. The ascending aorta presented wall thickening but the descending aorta did not present wall thickening. Histopathologically, the adventitia was obviously thickened with dissection findings in the tunica media. Thus it was diagnosed as acute type B aortic dissection subsequent to chronic type A aortic dissection. Great caution should be taken in asymptomatic chronic aortic dissection.

Discussion on safety of Xanthii Fructus and consideration on its rational use / 中国中药杂志

Xanthii Fructus is a traditional Chinese medicine for the treatment of sinusitis and headache,rich in medicinal materials and is widely used for more than 1 800 years. Modern pharmacological studies have showed that Xanthii Fructus has anti-inflammatory,analgesic,anti-tumor,anti-bacterial,hypoglycemic,anti-allergic,immunomodulatory and other pharmacological effects,which can be commonly used in the treatment of diseases relating to immune abnormalities,such as rheumatoid arthritis,acute and chronic rhinitis,allergic rhinitis,and skin diseases,with a high medicinal value. Toxicological studies have shown that Xanthii Fructus poisoning can cause substantial damage to organs,such as the liver,kidney,and gastrointestinal tract,especially to liver. Because of the coexisting of its efficacy and toxicity,Xanthii Fructus often leads to a series of safety problems in the clinical application process. This study attempts to summarize its characteristics of adverse reactions,analyze the root cause of the toxicity of Xanthii Fructus from such aspects as processing,dose,course of treatment and eating by mistake,discuss the substance of its efficacy/toxicity from chemical compositions,and put forward exploratory thinking about how to promote its clinical rational application from the aspects such as strict processing,reasonable compatibility,medication information,contraindication,strict control of the dose,and course of treatment,so as to promote the safe and reasonable application of Xanthii Fructus.

Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. METHODS: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. RESULTS: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/ varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. CONCLUSION: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

Discussion and consideration on safety of Sophorae Tonkinensis Radix et Rhizoma and its rational use / 中草药

Sophorae Tonkinensis Radix et Rhizoma is known as the important drug for treating sore throat and is widely used in clinic. Because of the coexisting of its efficacy and poison, Sophorae Tonkinensis Radix et Rhizoma often leads to a series of safety problems in the clinical application process. In this study, we attempt to analyze the ultimate cause of the toxicity of Sophorae Tonkinensis Radix et Rhizoma by reviewing nearly 20 years of literature, discuss the substance of its efficacy/toxicity from the point of view of chemical composition, and put forward exploratory thinking on its clinical rational application.

Twin pregnancy with one normal fetus and one complete mole.

Twin pregnancy with a complete mole and a coexisting healthy fetus is a rare condition. There is increased risk of developing severe complications and development of persistent trophoblastic disease. A 28 years old 2nd gravida, with 1 st vaginal delivery reported to the hospital at 20 weeks gestation as a case of dichorionic twin pregnancy. On routine USG, it showed a complete mole with a coexisting live fetus. The patient had features of anemia and severe preeclampsia. After explaining the risk to the patient and bystanders, they requested to terminate the pregnancy. She was induced for the same and delivered a normally appearing fetus. This was accompanied by evacuation of the mole. Diagnosis of complete mole was confirmed by histopathology. Twin pregnancy with acomplete mole and a coexisting healthy fetus is a rare condition. The decesion regarding management of this condition is difficult due to the various complications associated especially development of choriocarcinoma.

Quality of life and coexisting depression and anxiety of female nurses in general hospitals / 中华行为医学与脑科学杂志

Objective To investigate the relationship between coexisting depression and anxiety (CDA)and quality of life of female nurses in general hospitals.Methods Seven hundred and ninety-three female nurses completed Zung' s Self-rating Depression Scale (SDS),Zung' s Self-rating Anxiety Scale (SAS) and the World Health Organization' s Quality of Life Questionnaire-Brief Version (WHOQOL-BREF).According to the cut-off scores of SDS and SAS,all subjects were divided into 4 groups (non-depression and non-anxiety,pure depression,pure anxiety,and CDA).Group differences in SDS,SAS and WHOQOL-BREF scores were compared.Results Of these 4 groups,CDA group had the highest SDS and SAS scores (P ＜ 0.001) (SDS scores:(34.3 ±5.4),(47.1 ±4.0),(39.4 ± 2.4) and (49.7 ±4.2)) and the lowest WHOQOL-BREF scores (P≤0.033)(WHOQOL-BREF physical domain scores:(15.6 ± 2.0),(13.8 ± 2.0),(13.6 ± 1.6) and (12.1 ± 2.0)).The corresponding stratification analysis (controlling for confounding factors) showed consistent results.Conclusion CDA nurses have the most severe depressive and anxious symptoms and the worst quality of life,and thus are the key target population of mental health service.

Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group / 부인종양

OBJECTIVE: To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia. METHODS: Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients were divided into two groups: the hyperplasia-benign group (261 cases) and the hyperplasia-malignant group (125 cases). Several clinical parameters including age, menopausal status, history of abnormal uterine bleeding, obstetrical history, medical history of diabetes and hypertension, BMI, and preoperative pathologic results were investigated. RESULTS: Age > or =53 (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.26 to 4.57), menopausal status (OR, 2.07; 95% CI, 1.14 to 3.76), diabetes history (OR, 7.33; 95% CI, 2.79 to 19.26), abnormal uterine bleeding (OR, 3.99; 95% CI, 1.22 to 13.02), atypical endometrial hyperplasia (OR, 7.38; 95% CI, 4.03 to 13.49), and body mass index > or =27 (OR, 3.24; 95% CI, 1.76 to 5.97) were independent risk factors for prediction of endometrial hyperplasia coexisting with endometrial carcinoma. The diagnostic efficacy of atypical endometrial hyperplasia to predict the endometrial hyperplasia coexisting with endometrial carcinoma was better than or similar to those of other independent factors and combinations of these factors. CONCLUSION: Coexisting malignancy should be considered when examining endometrial hyperplasia patients with the related risk factors, especially atypical endometrial hyperplasia.

Analysis of the risk factors predisposing to fungal, bacterial & Acanthamoeba keratitis in south India.

Background & objectives: Infective keratitis is rare in the absence of predisposing factors. The pattern of risk factors predisposing to infective keratitis varies with geographical regions and also influences the type of infection that occurs. The present study was aimed to identify the specific risk factors that predispose the infective keratitis (non viral) and to determine the association between the risk factors identified and the microbial aetiology of infective keratitis in a geographic region (south India). Methods: A retrospective analysis of all patients clinically diagnosed infective keratitis (non viral) presenting between September 1999 and September 2002 was performed to identify risk factors. After diagnosing infective keratitis clinically, corneal scrapes were performed and subjected to microscopy and culture. Results: A total of 3295 patients with infective keratitis were evaluated, of whom, 1138 (34.5%) patients had fungal growth alone, 1066 (32.4%) had bacterial growth alone, 33 (1%) had Acanthamoeba growth alone, 83 (2.5%) had mixed microbial growth and the remaining 975 (29.6%) had no growth. Corneal injury was identified in 2356 (71.5%) patients and it accounted for 91.9 per cent in fungal keratitis (P<0.0001) (OR: 73.5; 95%CI: 61.3-98.5), 28.1 per cent in bacterial keratitis and 100 per cent in Acanthamoeba keratitis (P<0.0001). Injuries due to vegetative matter (61.2%) was identified as significant risk for fungal keratitis (P<0.0001) (OR: 15.73; 95%CI: 12.7-19.49) and mud (84.85%) for Acanthamoeba keratitis (P<0.0001) (OR: 16.52; 95%CI: 6.35-42.99). Co-existing ocular diseases predisposing to bacterial keratitis accounted for 724 (69%) patients (P<0.0001) (OR: 33.31; 95%CI: 26.98-41.12). Bacterial pathogens alone were recovered from all 35 patients with contact lens associated keratitis (100%). Co-existing ocular diseases (78.3%) were frequently documented among patients older than 50 yr (P<0.0001) (OR: 27.0; 95%CI: 25.0-28.0) and corneal injury (89.7%) was frequently recorded among patients younger than 51 yr (P<0.0001) (OR: 72.0; 95%CI: 70.0-73.0). Interpretation & conclusions: Corneal injury was found to be the principal risk factor for fungal and Acanthamoeba keratitis, while co-existing ocular diseases for bacterial keratitis. Corneal injury with vegetative matter was more often associated with fungal keratitis and injury with mud with Acanthamoeba keratitis.

A Case of the Complete Hydatidiform Mole with Two Coexisting Fetuses / 대한주산의학회잡지

Hydatidiform mole with a coexisting fetus is rare, but this condition has recently shown an increased incidence because of assisted reproduction technology. In most of the reported cases, termination at diagnosis was preferred due to poor fetal survival and maternal risk factors such as vaginal bleeding, preeclampsia, hyperthyroidism, potential of malignant change. However, considering the value of pregnancy by assisted reproduction technology, whether to continue or to terminate this condition is a dilemma. Based on currently available information, it seems that it is reasonable to allow the pregnancy to continue in the absence of maternal complications. We report on a case of the complete hydatidiform mole with two coexisting fetuses with a brief reviews of the literature.

CT analysis and differentiation of pancreatic carcinoma coexisting with chronic pancreatitis from chronic pancreatitis / 重庆医科大学学报

Objective:To analyze CT characteristics of pancreatic carcinoma coexisting with chronic pancreatitis versus chronic pancreatitis in order to improve its CT differential diagnostic accuracy.Methods:CT findings in 14 cases of pancreatic carcinoma coexisting with chronic pancreatitis and 15 cases of chronic pancreatitis were retrospectively analyzed.Both plain and enhanced CT scans were performed in all cases.Thin-layer scan was practiced when required.Observation was focused on the size,shape,density of pancreas,its relationship with Peripancreatic tissues,the images of enhancement,and the location,size,density of pancreatic carcinoma.Moreover,observation was focused on the dilation of common bile duct,main pancreatic duct and hepatic bile duct Then,CT characteristics of pancreatic carcinoma coexisting with chronic pancreatitis and chronic pancreatitis were analyzed and compared.Results:In the pancreatic carcinoma coexisting with chronic pancreatitis group,all cases have mass,and noenhancement in the arterial phrase.Peripancreatic blood vessels were invaded or surrounded(5 cases and 4 cases respectively).Peripancreatic adipose were not seen enough(5 cases).Lymph node enlargement(4 cases),Liver metastasis(5 cases).Dilation of common bile duc(t8 cases,9.67 mm?2.64 mm),6 of which showed broke off abruptly.Pancreas atrophy(6 cases),Calcification(4 cases),Dilation of main pancreatic duc(t7 cases),Pseudocys(t2 cases).In chronic pancreatitis group,pancreatic mass(2 cases),one of which showed no enhancement in the arterial phrase;Peripancreatic blood vessels was surrounded by Peripancreatic mass and the boundary between blood vessels and adipose was not clear(1 case);None of the cases was seen Peripancreatic blood vessels invasion;no liver metastasis or Lymph node metastasis.Dilation of common bile duc(t3 cases,7.53 mm?1.45 mm),one of which showed broke off abruptly.Pancreas atrophy(7 cases),Calcification(5 cases),Dilation of main pancreatic duct(7 cases,4.73 mm?3.04 mm),Pseudocyst(4 cases).Conclusion:Style of mass dynamic enhancement of pancreatic carcinoma coexisting with chronic pancreatitis,Peripancreatic blood vessels invasion,liver metastasis,and lymph node metastasis are important basis of CT differentiation of pancreatic carcinoma coexisting with chronic pancreatitis from chronic pancreatitis.

A Case of Partial Hydatidiform Mole with a Coexistent Live Fetus / 대한산부인과학회지

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin, and a major risk for persistent trophoblastic tumor. Partial hydatidiform moles appear to be a milder version of complete moles with both normal and cystic villi, focal trophoblastic hyperplsia, a fetus or indication of previous fetal existence, 69 chromosomes with a maternal contribution, and a malignant potential less than described for complete moles. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies. Due to advances in cytogenetics and ultrasonography, now permit the diagnosis of this pregnancy antenatally. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 12 gestational weeks, and confirmed normal karyotype (diploid) of the coexistent fetus. A brief reviews of related literature was done.

Laparoscopic Total Proctocolectomy with Ileal pouch-anal Anastomosis for Patients of Familial Adenomatous Polyposis with or without Coexisting Colorectal Cancer

PURPOSE: Familial adenomatous polyposis (FAP) normally appears in the early twenties and needs a restorative total proctocolectomy with ileal pouch-anal anastomosis (TPC/ IPAA). Thus, most patients with FAP are young, in socially active stage, and very concerned about their body image. Vast experience with laparoscopic colorectal surgery led us to perform laparoscopic-assissted TPC/IPAA for patients with FAP with or without cancer, and we evaluated the results from technical and oncologic aspects. METHODS: Seventeen of 20 FAP patients underwent laparoscopic- assisted surgery between July 1996 and June 2004. All procedures were done in a totally laparoscopic, a laparoscopic-assisted, or a hand-assisted laparoscopic fashion. RESULTS: Fifteen patients underwent laparoscopic-assisted TCP/IPAA; two others had a total colectomy with ileorectal anastomosis and a TCP with permanent ileostomy laparoscopically. Eight patients showed coexisting colorectal cancers. The mean operation time was 396.5 min. Patients passed flatus or liquid at the 2.2 post-operative day (POD), resumed meals at the 4th. POD, and were discharged at the 10th. POD. There were no intra-operative complications or open conversions. Post-operative complications occurred in 5 different patients. One patient with colon cancer had multiple hepatic metastases at 11 months after the operation and died at 24 months after the operation. CONCLUSIONS: Laparoscopic-assisted surgery for the patients with FAP was technically feasible and could be an alternative method. The systematized and experienced approach could reduce a operation time to be acceptable. In selected cases and with a vast of experience, coexisting colorectal cancer would not be contraindicated for laparoscopic approach for the treatment of FAP.

A Case of Partial Hydatidiform Mole with Coexisting Twin Pregnancy Following In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

Hydatidiform mole, characterized by abnormal fetoplacental development and placental villous trophoblast hyperplasia, results from genetically abnormal conception. Twin pregnancy consisting of hydatidiform mole (H-mole) and a coexisting fetus occurs with an estimated incidence of 1 per 10,000-100,000 pregnancies. There are several data which H-mole and a coexisting fetus can carry out viable fetus recently. However this unusual pregnancy has the risks of malignant change and severe medical complications, so it is a dilemma to decide continuation or termination of pregnancy. We present a twin pregnancy with partial H-mole and a coexisting fetus that occurred following IVF-ET, which was terminated at 16 weeks of gestation.

A Case of Partial Hydatidiform Mole with a Coexistent Live Fetus / 대한산부인과학회잡지

Hydatidiform moles are generally separated into two classifications. Complete hydatidiform moles are characterized by cystic swelling of all villi, often pronounced diffuse trophoblastic hyperplasia, lack of fetal parts, all 46 chromosomes of paternal origin (androgenesis). Partial hydatidiform moles appear to be focal trophoblastic hyperplasia, a fetus or indications of previous fetal existence, 69 chromosomes. Hydatidiform mole with coexistent fetus is a very rare phenomenon, with an estimated incidence of 0.005 to 0.01 percent of all pregnancies and associated with a risk of persistent gestational trophoblastic tumor. Recently, hydatidiform moles with a fetus have become more common due to use of assisted reproductive technology. Most patients with hydatidiform mole and coexisting normal fetus must cautioned about the potential for risks of malignant change and severe medical complications, such as preeclampsia, hyperthyroidism and antepartum hemorrhage, that may necessitate prompt pregnancy termination. We experienced a case of partial hydatidiform mole with coexistent live fetus, which was diagnosed by ultrasonography at 15 gestational weeks. A brief reviews of related literature was done.

A Case of Twin Pregnancy with a Complete Hydatidiform Mole and co-existing Fetus / 대한산부인과학회잡지

The estimated incidence of twin pregnancy consisting of hydatidiform mole and co-existing fetus is one per 22,000-100,000 pregnancies. Most patients with hydatidiform mole and co-existing normal fetus must be cautioned about the potential for risks of malignant change and severe medical complications, such as preeclampsia, hyperthyroidism and antepartum hemorrhage, that may necessitate prompt pregnancy termination. We experienced a case of twin pregnancy with a hydatidiform mole and co-existing fetus in hypogonadotropic hypogonadismal woman who had been treated with gonadotropin for ovulation induction. A brief reviews of related literatures was done.