Leiomyosarcoma of the great saphenous vein: a case report and review of the literature.

Introduction: Leiomyosarcoma of the venous system is rare, even more so in the greater saphenous vein. In the 85 years since van Ree described the first case in 1919 only 25 cases have been reported in the world.

Methods: We describe a case of an 85-year-old woman who was successfully treated by excision of the tumour.

Does sunlight prevent cancer? A systematic review.

Accumulating evidence for beneficial effects of sunlight on several types of cancer with a high mortality rate makes it necessary to reconsider the health recommendations on sun exposure, which are now mainly based on the increased risks for skin cancer. We reviewed all published studies concerning sun exposure and cancer, excluding skin cancer. All selected studies on prostate (3 ecologic, 3 case-control and 2 cohort), breast (4 ecologic, 1 case-control and 2 cohort) and ovary cancer (2 ecologic and 1 case-control) showed a significantly inverse correlation between sunlight and mortality or incidence.

Epigenetic therapy with decitabine for myelodysplasia and leukemia.

New therapeutic approaches are being developed for the treatment of cancer patients. Increasingly, drugs are being produced based on new insight into the intracellular processes in the cancer cell. Recently the typical epigenetic changes in the tumor cell have been considered as a therapeutic target.

Animal models of ejaculatory behavior.

Premature ejaculation is generally regarded the most frequent male ejaculatory complaint and has been considered a psychosexual disorder with psychogenic aetiology. The efficacy of various antidepressants, however, to delay ejaculation in men and to pharmacologically treat premature ejaculation suggests a strong neurobiological involvement. Most of our current understanding of the neurobiology and neuroanatomy of sexual behavior and ejaculatory function has been derived from preclinical studies using several laboratory species.

A comparison of the OARSI response criteria with patient's global assessment in patients with osteoarthritis of the hip treated with a non-pharmacological intervention.

Objective: To compare the Osteoarthritis Research Society International (OARSI) response criteria for clinical trials with patient's global assessment in patients with osteoarthritis (OA) of the hip receiving a non-pharmacological intervention, i.e., manual therapy or exercise therapy.

An epigenetic approach to the treatment of advanced MDS; the experience with the DNA demethylating agent 5-aza-2'-deoxycytidine (decitabine) in 177 patients.

During the last 10 years, three European phase II studies were performed to investigate the treatment of elderly patients with myelodysplastic syndrome (MDS) with low-dose 5-aza-2'-deoxycytidine (decitabine, DAC). All these European trial data were reviewed on the basis of the International Prognostic Scoring System (IPSS) risk criteria and the response criteria as recently published by an international working group. To investigate the results in a larger cohort of patients and to determine risk factors, all data were pooled with some observations from the PCH 95-06 US phase II study.

Surgical treatment of atrial fibrillation; a systematic review.

Unlabelled: In this review the efficacies of the alternative sources of energy (radiofrequency-microwave and cryo ablation; group I) and the classical 'cut and sew' Cox-Maze III (group II), which claims a 97-99% sinus rhythm (SR) success rate, were evaluated in the surgical treatment of atrial fibrillation (AF). A computerized search in the PubMed and Medline database was conducted. Only original, English written, clinical manuscripts on the surgical treatment of atrial fibrillation using an alternative source of energy or the classical 'cut and sew' Cox-Maze III technique, citing the clinical outcome, including the postoperative sinus rhythm, were included.

A role for the fibrinolytic system in postsurgical adhesion formation.

Objective: To look for evidence of a fibrinolytic insufficiency as a cause of adhesion formation.

Design: Retrospective and prospective study.

Setting: University medical center.

Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

Objective: To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip.

Methods: A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of a large hospital. The manual therapy program focused on specific manipulations and mobilization of the hip joint.

Testing families with HFE-related hereditary haemochromatosis.

HFE-related hereditary haemochromatosis is the most common autosomal recessive disorder in the Caucasian population. In 1996 the responsible gene (called HFE) was identified. Two mutations (C282Y and H63D) are considered most important and occur frequently in the Caucasian population.

On-demand treatment of premature ejaculation with clomipramine and paroxetine: a randomized, double-blind fixed-dose study with stopwatch assessment.

Objective: To investigate the degree of ejaculation delay induced by on-demand treatment with 20 mg paroxetine and 25 mg clomipramine and to assess the type and severity of non-sexual side-effects of treatment at the day of and the day after treatment with these drugs.

Method: A randomized, double-blind, fixed-dose, on-demand study in 30 men with lifelong premature ejaculation was performed. During a 1-month baseline period and a 4-week drug treatment period patients assessed the intravaginal ejaculation latency time (IELT) at home with a stopwatch.

Percutaneous jejunostomy.

Direct percutaneous jejunostomy is considered in patients where percutaneous gastrostomy is not feasible (stomach removed or inaccessible). Percutaneous jejunostomy is more difficult than gastrostomy techniques. Direct jejunostomy is performed under fluoroscopic guidance, using a nasojejunal tube to distend the jejunum.

Utility of selective serotonin reuptake inhibitors in premature ejaculation.

The introduction of selective serotonin reuptake inhibitors (SSRIs) has revolutionized our understanding of the treatment of premature ejaculation. Lifelong premature ejaculation may be a neurobiological phenomenon, namely part of a biological variability of the intravaginal ejaculation latency time in men. Animal studies support this view, and an animal model for premature and delayed ejaculation has recently been developed.

Treatment of chronic tension-type headache with botulinum toxin: a double-blind, placebo-controlled clinical trial.

Botulinum toxin is increasingly advocated as effective treatment in chronic tension-type headache. We conducted a randomized, placebo-controlled clinical trial to prove efficacy of botulinum toxin in chronic tension-type headache. Patients were randomly assigned to receive botulinum toxin (maximum 100 units) or placebo (saline) in muscles with increased tenderness.

The effects of 5-aza-2'-deoxycytidine (Decitabine) on the platelet count in patients with intermediate and high-risk myelodysplastic syndromes.

5-Aza-2'-deoxycytidine, a DNA-hypomethylating agent, can induce clinical remissions in patients with high-risk myelodysplastic syndromes (MDS). During treatment an increase in platelet count is frequently the first positive event to be seen. In this study, we analyzed the platelet response of patients with high-risk MDS on low-dose 5-aza-2'-deoxycytidine therapy.

Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT.

Purpose: To compare ultrasonography (US), computed tomography (CT), and palpation for diagnosing supraclavicular lung cancer metastases and to assess the effect of proved metastases on TNM stage and diagnostic work-up.

Materials And Methods: One hundred seventeen consecutive patients (91 men and 26 women; mean age, 64.0 years) underwent palpation, US, and CT of supraclavicular regions and chest and upper abdominal CT.

Functional extracorporeal magnetic stimulation as a treatment for female urinary incontinence: 'the chair'.

Objective: To evaluate, in a prospective study, the efficiency and applicability of functional magnetic stimulation (FMS) of the pelvic floor for treating urinary incontinence in women.

Patients And Methods: FMS was provided by a 'magnetic chair'; 24 patients were treated twice weekly for 8 weeks (12 with urge incontinence and 12 with a mixture of urge and stress incontinence). The outcome was assessed urodynamically, by a pad test, and by patient satisfaction.

Role of first ray hypermobility in the outcome of the Hohmann and the Lapidus procedure. A prospective, randomized trial involving one hundred and one feet.

Background: The role of hypermobility of the first tarsometatarsal joint in the etiology of hallux valgus deformity is controversial. Consequently, the need to include an arthrodesis of this joint in the surgical treatment of hallux valgus has been questioned. We designed a study to evaluate the role of arthrodesis of the first tarsometatarsal joint on the outcome of surgical treatment of hallux valgus.

Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis.

The aim of this systematic review and meta-analysis is to evaluate whether the design and methodology of drug-treatment studies of premature ejaculation affect the efficacy outcome differently. Therefore, methodological, design and efficacy data from 79 studies (3034 males), published between 1943 and 2003, are reviewed. A meta-analysis is performed on 43 selective serotonin reuptake inhibitors (SSRIs) and clomipramine studies (1514 males), published between 1973 and 2003; these studies were pooled to provide a summary variance-weighted effect size.

Endometriosis of the rectovaginal septum: endovaginal US and MRI findings in two cases.

We report two patients with endometriosis of the rectovaginal septum in whom endovaginal ultrasound (US) and magnetic resonance imaging (MRI) played crucial roles in the diagnosis, staging, and follow-up of the disease. The specific features of endometriosis of the rectovaginal septum on MRI and transvaginal US enable a noninvasive diagnosis, thereby reducing diagnostic delay and avoiding unnecessary invasive procedures.

Lifelong premature ejaculation: from authority-based to evidence-based medicine.

Historically, four periods can be distinguished in the approach to and treatment of lifelong premature ejaculation. Although drug treatment has been an option for many decades, psychotherapy prevailed as the first choice of treatment. However, the application of the principles of evidence-based medicine shows that there is little evidence to support the psychological approach and behavioural treatment.