ABSTRACT
Deep brain stimulation (DBS) is a neurosurgical intervention carried out in meticulously selected patients with a therapy-resistant obsessive-compulsive disorder (OCD). We describe the pre- and post-operative psychiatric care given to a 51-year-old woman before, during and after treatment with deep brain stimulation. The psychiatric follow-up included an intensive search for the optimal stimulation parameters, and considerable attention was given to psycho-education, psychotherapy and counselling. The procedure resulted in a marked improvement in the patient's OCD and made it easier for the patient to re-construct a meaningful life.
Subject(s)
Deep Brain Stimulation , Obsessive-Compulsive Disorder/therapy , Female , Follow-Up Studies , Humans , Middle Aged , Treatment OutcomeABSTRACT
A 50-year-old female complained of a painless abdominal distension. Histopathologic examination after cystectomy showed a primary poorly differentiated retroperitoneal mucinous cystadenocarcinoma with a sarcoma-like mural nodule. The patient subsequently underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, appendectomy, omentectomy and lymphadenectomy. Adjuvant chemotherapy consisted of 6 times carboplatin (AUC 7) in monotherapy (every 4 weeks). Based on 49 cases of primary retroperitoneal mucinous cystadenocarcinoma, we discuss the histogenesis and we define the appropriate treatment.
Subject(s)
Cystadenocarcinoma, Mucinous/pathology , Retroperitoneal Neoplasms/pathology , Antineoplastic Agents/therapeutic use , Appendectomy , Carboplatin/therapeutic use , Chemotherapy, Adjuvant , Cystadenocarcinoma, Mucinous/drug therapy , Cystadenocarcinoma, Mucinous/surgery , Female , Humans , Hysterectomy , Lymph Node Excision , Middle Aged , Omentum/surgery , Ovariectomy , Pelvis/surgery , Retroperitoneal Neoplasms/drug therapy , Retroperitoneal Neoplasms/surgery , SalpingectomyABSTRACT
Thirty-four infertile patients with regular cycles and endometriosis were studied and compared to a control group of 28 women. The endometriosis was classified as mild (n = 16), moderate (n = 9) and severe (n = 9) according to Acosta et al (1973). The interval between the LH peak and the onset of subsequent menstruation was shorter (P = 0.024) in patients with endometriosis than in the control group. In mild endometriosis, oestradiol-17beta levels fell on the day after the LH peak, but this was not the case in moderate and severe endometriosis. In mild, moderate and severe endometriosis the plasma progesterone concentration did not rise on the first day following the LH peak, and at laparoscopy significantly (P less than 0.005) less ovulation stigmata were present. We conclude that endometriosis is associated with luteinization in situ and that this may explain the associated infertility.