Erythrocyte sedimentation rate and anaemia are independent predictors of survival in patients with clear cell renal cell carcinoma

Background:

The 1997 international consensus conference on renal cell cancer (RCC) prognosis suggested erythrocyte sedimentation rate (ESR), alkaline phosphatase (ALP), and anaemia as prognostic biomarkers, but most studies reviewed were limited by small sample sizes.

Methods:

The Cox proportional hazards model was used to evaluate whether ESR, ALP, haemoglobin (Hb), and haematocrit (Hct) could predict survival outcomes in 1307 patients with clear cell RCC (ccRCC) who underwent nephrectomy during 1994–2008.

Results:

During a median follow-up of 43 months, we found that the patients with preoperative high levels of ESR, had a 2.10-fold (95% confidence interval (CI): 1.21–3.67) greater risk of dying from RCC compared with patients with low levels (normal range). Patients with preoperative anaemia, assessed by Hb and Hct, had a 3.11-fold (95% CI: 1.17–8.25) and 6.20-fold (95% CI: 2.30–16.72) greater risk of dying from other illnesses, respectively, compared with patients without anaemia. ALP levels were not associated with ccRCC patients' survival. These associations for ESR and anaemia were more pronounced in patients with body mass index (BMI) <25 compared with patients with BMI ⩾25 kg m⁻².

Conclusion:

Preoperative high ESR, but not ALP, was a significant predictor for cancer-specific survival among ccRCC patients. Anaemia increases the risk of death from other illness.

Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome

This study was conducted to assess outcomes (according to patency) of vasectomy reversal (VR) in qualified patients with postvasectomy pain syndrome (PVPS). A total of 32 patients with PVPS undergoing VR between January 2000 and May 2010 were examined retrospectively. Of these, 68.8% (22/32) completed a study questionnaire, either onsite at the outpatient clinic or via telephone interview. Preoperative clinical findings, preoperative and postoperative visual analogue scale (VAS) pain scores, patency and pregnancy rate and overall patient satisfaction were analyzed. For the latter, a four-point rating of (1) cure, (2) improvement, (3) no change or (4) recurrence was used. The mean age was 45.09±4.42 years and the mean period of follow-up was 3.22 years (0.74-7.41). Patency rates were 68.2% (15/22) and pregnancy rates were 36.4% (8/22). The mean VAS was 6.64±1.00 preoperatively and 1.14±0.71 postoperatively (P<0.001). The difference in the mean preoperative and postoperative VAS was 6.00±1.25 (4-8) in the patency group and 4.43±0.98 (3-6) in the no patency group (P=0.011). A significant difference in procedural satisfaction with surgical outcome was observed between patency and no patency groups (P=0.014). In conclusion, in PVPS patients requiring VR, a significant difference was observed between the patency and no patency groups in terms of pain reduction and the degree of patient procedural satisfaction.

Contrast-enhanced MR cholangiography: comparison of Gd-EOB-DTPA and Mn-DPDP in healthy volunteers

OBJECTIVE

The purpose of this study was to compare the biliary enhancement dynamics of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic-acid (Gd-EOB-DTPA) and mangafodipir trisodium (Mn-DPDP) for contrast-enhanced MR cholangiography (MRC) in healthy subjects.

METHODS

15 healthy volunteers underwent MRI at 1.5 T with volumetric interpolated breath-hold examination sequence. Each volunteer was scanned once for each contrast agent. The signal-to-noise ratio (SNR) of the liver parenchyma and common hepatic duct (CHD) and the contrast-to-noise ratio (CNR) of CHD to liver parenchyma were evaluated and compared before and at several time points (5, 15, 30, 45, 60, 90, and 120 min) after injection of each agent.

RESULTS

SNR was significantly higher for Gd-EOB-DTPA than for Mn-DPDP in liver parenchyma after 5 min and in CHD after 15 min (p<0.05). CNR of CHD to liver parenchyma using Gd-EOB-DTPA showed an initial decrease at 5 min post-injection followed by a steep increase to a peak at 15 min post-injection. CNR using Mn-DPDP showed a steady increase to a peak at 15 min post-injection without an initial decrease. At 15 min, the value of CNR was significantly higher for Gd-EOB-DTPA than for Mn-DPDP (p<0.05).

CONCLUSION

For both contrast agents, CNR reached a peak at 15 min after contrast injection. At this time point, CNR of Gd-EOB-DTPA was significantly higher than that of Mn-DPDP. Therefore, Gd-EOB-DTPA may provide better contrast-enhanced MRC than Mn-DPDP at 15 min after contrast administration.

Distinguishing benign from malignant masses at breast US: combined US elastography and color doppler US--influence on radiologist accuracy

PURPOSE

To investigate the effect of the combined use of ultrasonographic (US) elastography and color Doppler US on the accuracy of radiologists in distinguishing benign from malignant nonpalpable breast masses and in making the decision for biopsy recommendations at B-mode US.

MATERIALS AND METHODS

This prospective study was conducted with institutional review board approval; written informed consent was obtained. A cohort of 367 biopsy-proved cases in 319 women (age range, 22-78 years; mean age, 48.6 years) with B-mode US, US elastographic, and Doppler US images was included. Five blinded readers independently scored the likelihood of malignancy for four data sets (ie, B-mode US alone, B-mode US and elastography, B-mode US and Doppler US, and B-mode US, US elastography, and Doppler US). The area under the receiver operating characteristic curve (A(z)) values, sensitivities, and specificities of each data set were compared.

RESULTS

The A(z) of B-mode US, US elastography, and Doppler US (average, 0.844; range, 0.797-0.876) was greater than that of B-mode US alone (average, 0.771; range, 0.738-0.798) for all readers (P = .001 for readers 1, 2, and 3; P < .001 for reader 4; P = .002 for reader 5). When both elastography and Doppler scores were negative, leading to strict downgrading, the specificity increased for all readers from an average of 25.3% (75.4 of 298; range, 6.4%-40.9%) to 34.0% (101.2 of 298; range, 26.5%-48.7%) (P < .001 for readers 1, 2, 4, and 5; P = .016 for reader 3) without a significant change in sensitivity.

CONCLUSION

Combined use of US elastography and color Doppler US increases both the accuracy in distinguishing benign from malignant masses and the specificity in decision-making for biopsy recommendation at B-mode US.

Serum selenoprotein P levels in patients with type 2 diabetes and prediabetes: implications for insulin resistance, inflammation, and atherosclerosis

CONTEXT AND OBJECTIVE

The dysregulation of hepatokines may be associated with the pathogenesis of insulin resistance and type 2 diabetes. A recent study has suggested that selenoprotein P (SeP), a novel hepatokine, may play a role in the regulation of glucose metabolism and insulin sensitivity. We examined the relationship between circulating SeP levels and clinical parameters associated with insulin resistance in humans.

PARTICIPANTS AND METHODS

We compared serum SeP concentrations in 100 subjects with diverse glucose tolerance statuses. Furthermore, we evaluated the relationship between SeP and cardiometabolic risk factors including insulin resistance, high-sensitivity C-reactive protein, and carotid intima-media thickness.

RESULTS

Serum SeP concentrations were significantly higher in patients with type 2 diabetes or prediabetes than those with normal glucose tolerance (all P < 0.01) and decreased in a stepwise manner [1032.4 (495.9-2149.4) vs. 867.3 (516.3-1582.7) vs. 362.0 (252.5-694.5), P = 0.004]. In addition, overweight and obese subjects had significantly increased SeP levels compared with lean subjects (P = 0.002). Spearman's partial correlation analysis adjusted for age and gender showed a significant relationship between SeP and cardiometabolic factors including body mass index, waist circumference, systolic blood pressure, triglycerides, glucose, hemoglobin A1c, aspartate aminotransferase, and insulin resistance. Furthermore, in multiple regression analyses, SeP showed an independent association with carotid intima-media thickness as well as high-sensitivity C-reactive protein, even after adjustment for other confounding factors.

CONCLUSIONS

Circulating SeP concentrations were elevated in patients with glucose metabolism dysregulation and were related to various cardiometabolic parameters including insulin resistance, inflammation, and atherosclerosis.

Prevalence and correlates of obesity and overweight among asian immigrant women in Korea

This study examines the prevalence of obesity and overweight as well as associations between obesity and overweight and demographic, sociocultural, and lifestyle factors among Asian immigrant women in Korea. Data were collected from physical measurements and standardized questionnaires from 287 adult women from China, Vietnam, the Philippines, and other Asian countries. The mean BMI (body mass index) was 22.0 kg/m(2); 15.0% of the sample were obese (BMI ≥ 25.0), and 17.1% were overweight (23.0 ≤ BMI < 25.0). The highest obesity proportion was found in Filipino (22.0%) and the lowest in Vietnamese women (7.8%). Adjusted for demographic, sociocultural, and lifestyle variables, individuals with greater length of residence (5+ years; odds ratio = 3.22, P = .010) were more likely to be obese or overweight. For prevention of excess body weight, public health efforts need to be targeted to immigrants starting at arrival in Korea.

Central washout sign in computer-aided evaluation of breast MRI: preliminary results

BACKGROUND

Although computer-aided evaluation (CAE) programs were introduced to help differentiate benign tumors from malignant ones, the set of CAE-measured parameters that best predict malignancy have not yet been established.

PURPOSE

To assess the value of the central washout sign on CAE color overlay images of breast MRI.

MATERIAL AND METHODS

We evaluated the frequency of the central washout sign using CAE. The central washout sign was determined so that thin, rim-like, persistent kinetics were seen in the periphery of the tumor. Then, sequentially, plateau and washout kinetics appeared. Two additional CAE-delayed kinetic variables were compared with the central washout sign for assessment of diagnostic utility: the predominant enhancement type (washout, plateau, or persistent) and the most suspicious enhancement type (any washout > any plateau > any persistent kinetics).

RESULTS

One hundred and forty-nine pathologically proven breast lesions (130 malignant, 19 benign) were evaluated. A central washout sign was associated with 87% of malignant lesions but only 11% of benign lesions. Significant differences were found when delayed-phase kinetics were categorized by the most suspicious enhancement type (P < 0.001) and the presence of the central washout sign (P < 0.001). Under the criteria of the most suspicious kinetics, 68% of benign lesions were assigned as plateau or washout pattern.

CONCLUSION

The central washout sign is a reliable indicator of malignancy on CAE color overlay images of breast MRI.

Eccrine spiradenoma arising in the breast misdiagnosed as an epidermal inclusion cyst

Eccrine spiradenomas are rare, benign, cutaneous tumors that originate in the sweat glands. Eccrine spiradenomas in the breast are very rare and only a few cases have been reported. We report here on the case of a 47-year-old woman with superficial masses in the breast and these masses had gradually increased in size during follow-up. They were confirmed to be an eccrine spiradenoma on pathologic examination. There have been a few reports about the radiologic findings of eccrine spiradenomas of the breast. This is the first case of an eccrine spiradenoma in the breast that was characterized by multiple imaging modalities, including mammography, ultrasonography and MRI. The lesion in our patient was first diagnosed as an epidermal inclusion cyst based on the imaging findings and the mass's superficial location. Although the mammographic and ultrasonographic imaging findings of eccrine spiradenomas and epidermal inclusion cysts are similar, the MRI findings are different between epidermal inclusion cysts and eccrine spiradenomas. Eccrine spiradenomas should be considered in the differential diagnosis of cutaneous and subcutaneous lesions of the breast.

Lipogranuloma with osseous metaplasia in the breast that developed after "Bu-Hwang" oriental medicine treatment

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.

Effect of warfarin withdrawal on thrombolytic treatment in patients with ischaemic stroke

BACKGROUND AND PURPOSE

  Abruptly discontinuing warfarin may induce a rebound prothrombotic state. Thrombolytic agents may also paradoxically induce prothrombotic conditions, which include platelet activation and thrombin generation. Therefore, prothrombotic states may be enhanced by withdrawing warfarin in patients under thrombolytic treatment. This study was aimed to determine whether patients with warfarin withdrawal have different clinical outcomes from those without warfarin use after thrombolytic treatment.

METHODS

  A total of 148 consecutive patients with atrial fibrillation who were not on anticoagulants at admission and who received thrombolysis were included in this study. We compared the outcomes between a warfarin withdrawal group and a no-warfarin group.

RESULTS

  Fourteen patients (9.5%) were included in the warfarin withdrawal group. Although baseline National Institute of Health Stroke Scale (NIHSS) scores, recanalization rates, and hemorrhage frequencies did not differ between the groups, the warfarin withdrawal group showed poorer outcomes. Increased NIHSS scores during the first 7days were more frequent in the warfarin withdrawal group (57.1% vs. 26.9%, P=0.029). The median percent improvement in NIHSS scores at 24h after thrombolysis was also lower in the warfarin withdrawal group. After adjusting for covariates, warfarin withdrawal was a strong predictor of poor functional outcome at 3months (modified Rankin score≥3) (odds ratio, 17.067, 95% CI 2.703-107.748).

CONCLUSIONS

  Discontinuing warfarin was associated with early neurologic deterioration and poor long-term outcomes after thrombolytic treatment.

Aliasing artifact depicted on ultrasound (US)-elastography for breast cystic lesions mimicking solid masses

BACKGROUND

It has been reported that ultrasound (US)-elastography is helpful in differentiation of benign and malignant solid masses and in reducing benign biopsy procedures for the supplemental breast US in addition to screening mammography. Furthermore, potential application of US-elastography in distinguishing cystic lesions which is known to be a major source of benign biopsy results has been suggested.

PURPOSE

To describe the aliasing artifact on US-elastography for breast cystic lesions that mimic solid masses.

MATERIAL AND METHODS

We retrospectively reviewed 13 lesions which showed a blue-green-red pattern artifact on US-elastography in 13 women (mean age 50 years; age range 3-66 years). They disappeared immediately after a needle biopsy. Breast composition, mammography and US findings, histology and follow-up imaging findings were analyzed.

RESULTS

All 13 patients showed heterogeneously dense (n=5) or extremely dense breast parenchyma (n=8). The most common US findings were an irregular shape (n=7, 54%) and a circumscribed margin (n=7, 54%). All 13 lesions had internal echogenicity and were initially considered as solid masses; 62% (n=8) showed hypoechogenicity and 38% (n=5) had echogenic and anechoic components. Posterior shadowing was seen in 31% (n=4) of the lesions. All 13 lesions have been proven to be fibrocystic changes on biopsy histology. Follow-up US performed for 10 of 13 lesions showed no residual lesion (n=9) or decreased its size (n=1).

CONCLUSION

An aliasing artifact that appears as a blue-green-red pattern in a breast mass as depicted on US-elastography is suggestive of a possible cystic breast lesion.

High claudin-7 expression is associated with a poor response to platinum-based chemotherapy in epithelial ovarian carcinoma

BACKGROUND

Claudin-7 (CLDN-7) is a tight junction protein that has been shown overexpressed in several human cancers. We investigated prognostic significance of CLDN-7 overexpression in patients with epithelial ovarian carcinoma (EOC) and its functional role on cell proliferation in ovarian carcinoma cell lines.

PATIENTS AND METHODS

CLDN-7 expression was evaluated by real-time RT-PCR and immunohistochemical analysis in 71 patients with EOC. We assessed the association of CLDN-7 expressions with prognosis of the patients including sensitivity to platinum-based chemotherapy. In vitro experiment was performed with and without inhibition of CLDN-7 by its siRNA to evaluate the sensitivity of the human ovarian cancer cells to cisplatin chemotherapy.

RESULTS

CLDN-7 transcripts in EOCs were significantly up-regulated compared with normal ovarian tissues (P<0.001). The expression of CLDN-7 protein was observed in majority (69/71, 97.1%) of the EOCs but not in normal ovarian tissues (P<0.001). High CLDN-7 expression in primary tumour correlated with shorter progression-free survival (PFS) of the patients (P=0.005) and poor sensitivity to platinum-based chemotherapy (P=0.024). Moreover, CLDN-7 was highly expressed in 2774 and HeyA8 human ovarian cancer cells and inhibition of CLDN-7 by its siRNA significantly enhanced the sensitivity of 2774 and HeyA8 cells to cisplatin treatment.

CONCLUSION

These findings suggest CLDN-7 expression is an independent prognostic factor for PFS and it may play a role in regulating response to platinum-based chemotherapy in the treatment of EOC.

Background enhancement in breast MR: correlation with breast density in mammography and background echotexture in ultrasound

OBJECTIVE

This study aimed to determine whether background enhancement on MR was related to mammographic breast density or ultrasonographic background echotexture in premenopausal and postmenopausal women.

MATERIALS AND METHODS

We studied 142 patients (79 premenopausal, 63 postmenopausal) who underwent mammography, ultrasonography, and breast MR. We reviewed the mammography for overall breast density of the contralateral normal breast according to the four-point scale of the BI-RADS classification. Ultrasound findings were classified as homogeneous or heterogeneous background echotexture according to the BI-RADS lexicon. We rated background enhancement on a contralateral breast MR into four categories based on subtraction images: absent, mild, moderate, and marked. All imaging findings were interpreted independently by two readers without knowledge of menstrual status, imaging findings of other modalities.

RESULTS

There were significant differences between the premenopausal and postmenopausal group in distribution of mammographic breast density, ultrasonographic background echotexture, and degree of background enhancement. Regarding the relationship between mammographic density and background enhancement, there was no significant correlation. There was significant relationship between ultrasonographic background echotexture and background enhancement in both premenopausal and postmenopausal groups.

CONCLUSION

There is a significant correlation between ultrasonographic background echotexture and background enhancement in MR regardless of menopausal status. Interpreting breast MR, or scheduling for breast MR of women showing heterogeneous background echotexture needs more caution.

Curcumin interrupts the interaction between the androgen receptor and Wnt/β-catenin signaling pathway in LNCaP prostate cancer cells

Recently, studies have investigated the significance of the Wnt/β-catenin pathway in prostate cancer. The transcriptional activity of the androgen receptor (AR) is modulated by interaction with coregulators, one of which is β-catenin. Curcumin, a dietary yellow pigment of Curcuma longa, has emerged as having a chemopreventive role. Although curcumin has been shown to inhibit AR expression, its molecular mechanism has not been fully elucidated. In this study, whether curcumin mediates the Wnt/β-catenin signaling pathway with regard to AR/β-catenin interactions was studied. Curcumin was shown to induce significant inhibition of AR expression in a dose-dependent manner. Marked curcumin-induced suppression of β-catenin was shown in the nuclear and cytoplasmic extracts as well as whole cell lysates. Further analysis revealed that phosphorylation of Akt and glycogen synthase kinase-3β were attenuated, but phosphorylated β-catenin was increased after curcumin treatment. Finally, cyclin D1 and c-myc, the target gene of the β-catenin/T-cell factor transcriptional complex, were also decreased. These findings suggest that curcumin modulates the Wnt/β-catenin signaling pathway and might have a significant role in mediating inhibitory effects on LNCaP prostate cancer cells.

Optical performance monitoring technique using asynchronous amplitude and phase histograms

We report a new optical performance monitoring technique based on the amplitude and phase histograms of the optical signal. The amplitude and phase histograms are obtained by using an intradyne receiver and the asynchronous delay-tap sampling method. From these histograms, we can evaluate the amplitude and phase Q-factors of the optical signal regardless of its modulation format. In addition, by using these Q-factors, we can estimate the bit-error rate (BER) of the monitoring signal.

Electronic Raman scattering of two-band superconductors: a time-dependent Landau-Ginzburg theory approach

Electronic Raman scattering of two-band superconductors is studied based on the time-dependent Landau-Ginzburg theory. The focus is on the possible features of the π phase shift between the two superconducting order parameters which may be realized in the Fe-pnictides. The Raman response was computed up to the Gaussian fluctuations in the functional integral formalism including the long range Coulomb interaction with the four channels of symmetric and antisymmetric combinations of the phases and amplitudes of the two order parameters. The Raman spectra is found to be composed of the quasiparticle and the phase collective mode contributions without mixing between them. The contributions from the quasiparticle and the symmetric phase collective mode (the Anderson-Bogolyubov mode) are similar to the two-band superconductors without the π phase shift. The antisymmetric phase mode (the Leggett mode) originates from the fluctuations of the relative phase of the two order parameters. It lies between twice the smaller gap and twice the larger gap and is damped by the quasiparticles. However, this mode is eliminated by the long range Coulomb interaction in the zero-wavenumber limit.

Transmission of 108-Gb/s PDM 16ADPSK signal on 25-GHz grid using non-coherent receivers

We demonstrate the transmission of 108-Gb/s polarization-division-multiplexed (PDM) 16-ary amplitude- and differential phase-shift-keying (16ADPSK) signal by using a non-coherent receiver. We generate the 16ADPSK signal by using a differential 8-ary phase-shift-keying (D8PSK) modulator and a phase-distortion-free amplitude-shift-keying (ASK) modulator. On the other hand, the receiver is implemented by using a delay interferometer based on a 3x3 fiber coupler and the data-aided phase-noise estimation (DAPNE) algorithm. By using these transmitter and receiver, we achieve a nearly quantum-limited receiver sensitivity in the back-to-back condition. In addition, we examine the possibility of transmitting 108-Gb/s signals on a 25-GHz grid without using the coherent detection technology. The results show that we can secure a sufficient optical-signal-to-noise (OSNR) margin after the transmission of 80-km long dispersion managed link. The achieved spectral efficiency is 4.0 bit/s/Hz.

Prediction of recurrence-free survival in postoperative non-small cell lung cancer patients by using an integrated model of clinical information and gene expression

PURPOSE

One of the main challenges of lung cancer research is identifying patients at high risk for recurrence after surgical resection. Simple, accurate, and reproducible methods of evaluating individual risks of recurrence are needed.

EXPERIMENTAL DESIGN

Based on a combined analysis of time-to-recurrence data, censoring information, and microarray data from a set of 138 patients, we selected statistically significant genes thought to be predictive of disease recurrence. The number of genes was further reduced by eliminating those whose expression levels were not reproducible by real-time quantitative PCR. Within these variables, a recurrence prediction model was constructed using Cox proportional hazard regression and validated via two independent cohorts (n = 56 and n = 59).

RESULTS

After performing a log-rank test of the microarray data and successively selecting genes based on real-time quantitative PCR analysis, the most significant 18 genes had P values of <0.05. After subsequent stepwise variable selection based on gene expression information and clinical variables, the recurrence prediction model consisted of six genes (CALB1, MMP7, SLC1A7, GSTA1, CCL19, and IFI44). Two pathologic variables, pStage and cellular differentiation, were developed. Validation by two independent cohorts confirmed that the proposed model is significantly accurate (P = 0.0314 and 0.0305, respectively). The predicted median recurrence-free survival times for each patient correlated well with the actual data.

CONCLUSIONS

We have developed an accurate, technically simple, and reproducible method for predicting individual recurrence risks. This model would potentially be useful in developing customized strategies for managing lung cancer.

Sargaquinoic acid and sargahydroquinoic acid from Sargassum yezoense stimulate adipocyte differentiation through PPARalpha/gamma activation in 3T3-L1 cells

We screened active compounds from natural marine products able to increase PPARalpha/gamma transcriptional activity. Sargaquinoic acid (SQA) and sargahydroquinoic acid (SHQA) from Sargassum yezoense were identified as novel PPARalpha/gamma dual agonists. The binding affinity of SQA with PPARgamma was higher than that of the specific PPARgamma agonist troglitazone, leading to an activation of PPARgamma transcriptional activity. In parallel, treatment of 3T3-L1 cells with SQA and SHQA led to an increase in adipocyte differentiation and increased expression of adipogenic marker genes such as aP2, PPARgamma, resistin, adiponectin, C/EBPalpha and Glut4. Collectively, our data suggest that SQA and SHQA are novel PPARalpha/gamma dual agonists and may be beneficial for reducing insulin resistance through regulation of adipogenesis.

Neurosurgical aspects of sedimentation levels in acute intracerebral haematoma

We describe the neurosurgical aspects of sedimentation levels that are rarely found in acute intracerebral haematomas (ICH). We had four patients with acute ICH whose cerebral computed tomography revealed sedimentation levels. Two patients had received thrombolytic therapy for ischaemic heart disease and one for ischaemic stroke. Another patient, who was diagnosed later as having a coagulation disorder, did not have any medical history on admission. All patients had emergency ICH drainage under local anaesthesia. In the immediate postoperative period, we observed dramatic improvement in all the patients, without surgical complications. The sedimentation level in an ICH should be identified as a specific indicator of a coagulation defect and a thorough search for possible underlying coagulopathy is warranted. We believe that simple ICH drainage should be performed as the haematoma is in a liquid form.

[Ten cases of Fitz-Hugh-Curtis syndrome]

Fitz-Hugh-Curtis syndrome, a kind of perihepatitis, occurs approximately in 3 to 10 percent of patients with pelvic inflammatory disease. It is not easy to detect in clinical settings due to requirement of invasive methods for diagnosis, for example, like a laparoscopic examination. Now, it has become possible to recognize it easily with the aid of non-invasive methods including an abdominal dynamic CT scan and laboratory tests. Moreover, it can be improved after the oral administration of antibiotics. Therefore, noninvasive diagnosis is desirable. Herein, clinical characteristics of ten cases of Fitz-Hugh-Curtis syndrome are reported, with a review of the literature.