Bilateral frontal polymicrogyria is a recently recognized syndrome characterized by symmetric polymicrogyria of both frontal lobes that presents with delayed motor and language development, spastic quadriparesis, and variable mental retardation. However, the postmortem findings of this syndrome are not fully elaborated. Here we describe an autopsy case of bilateral frontal polymicrogyria in a male fetus delivered at 22 weeks gestation due to extensive chorioamnionitis. The microscopic findings included a thinned cortical plate with fair neuronal maturation. There were no signs of neuronal damage and the white matter was unremarkable.
Autopsy ; Chorioamnionitis ; European Continental Ancestry Group ; Female ; Fetus ; Frontal Lobe ; Humans ; Intellectual Disability ; Language Development ; Male ; Malformations of Cortical Development ; Muscle Spasticity ; Neuronal Migration Disorders ; Neurons ; Pregnancy ; Quadriplegia

Female ; Humans ; Labyrinth Diseases ; Middle Aged ; Semicircular Canals ; Syndrome

Cochlear Implants ; Congresses as Topic ; Hearing ; Hearing Aids ; Humans

Objective To study the relationship between parameter settings in the intensity-modulated radiation therapy (IMRT) planning in order to explore the effect of parameters on absolute dose verification.Methods Forty-three esophageal carcinoma cases were optimized with Pinnacle 7.6c by experienced physicist using appropriate optimization parameters and dose constraints with a number of iterations to meet the clinical acceptance criteria.The plans were copied to water-phantem,0.13 cc ion Farmer chamber and DOSE1 dosimeter was used to measure the absolute dose.The statistical data of the parameters of beams for the 43 cases were collected,and the relationships among them were analyzed.The statistical data of the dosimetry error were collected,and comparative analysis was made for the relation between the parameters of beams and ion chamber absolute dose verification results.Results The parameters of beams were correlated among each other.Obvious affiliation existed between the dose accuracy and parameter settings.When the beam segment number of IMRT plan was more than 80,the dose deviation would be greater than 3％ ; however,if the beam segment number was less than 80,the dose deviation was smaller than 3％.When the beam segment number was more than 100,part of the dose deviation of this plan was greater than 4％.On the contrary,if the beam segment number was less than 100,the dose deviation was smaller than 4％ definitely.Conclusions In order to decrease the absolute dose verification error,less beam angles and less beam segments are needed and the beam segment number should be controlled within the range of 80.

Objective With the Monte Carlo method to recaleulate the IMRT dose distributions from four TPS to provide a platform for independent comparison and evaluation of the plan quality.These results wiU help make a clinical decision as which TPS will be used for prostate IMRT planning.Methods Eleven prostate cancer cases were planned with the Corvus,Xio,Pinnacle and Eclipse TPS.The plans were recalculated bv Monte Cado using leaf sequences and MUs for individual plans.Dose-volume-histograms and isodose distributions were compared.Other quantities such as Dmin(the minimum dose received by 99% of CTV/PTV),Dmax(the maximum dose received by 1%of CTV/PTV),V110%,V105%,V95%(the volume of CTV/PTV receiving 110%,105%.95% of the prescription dose),the volume of rectum and bladder receiving>65 Gy and>40 Gy,and the volume of femur receiving>50 Gy were evaluated.Total segments and MUs were also compared.Results The Monte Carlo results agreed with the dose distributions from the TPS to within 3%/3 mm.The Xio,Pinnacle and Eclipse plans show less target dose heterogeneity and lower V65 and V40 for the rectum and bladder compared to the Corvus plans.The PTV Dmin is about 2 Gy lower for Xio plans than others while the Corvus plans have slightly lower female head V50(0.03%and 0.58%)than others.The Corvus plans require significantly most segments(187.8)and MUs(1264.7)to deliver and the Pinnacle plans require fewest segments(82.4)and MUs(703.6).Conclusions We have tested an independent Monte Carlo dose catculation system for dose reconstruction and plan evaluation.This system provides a platform for the fair comparison and evaluation of treatment plans to facilitate clinical decision making in selecting a TPS and beam delivery system for particular treatment sites.

ObjectiveTo measure the setup errors with infrared marker-based positioning system (IM-BPS) and electronic portal imaging device (EPID) for patients with esophageal carcinoma and lung cancer and investigate the accuracy and practicality of IM-BPS. MethodsFrom January 2007 to January 2008, 40 patients with esophageal carcinoma and 27 patients with lung cancer received three-dimensional conformal radiotherapy or intensity-modulated radiotherapy, setup errors during the treatment were measured with IM-BPS and EPID, and the data of setup errors were compared with paired t-test and agreement with x2-test. ResultsIt takes 10 - 12 mins to complete the validating for each patient by EPID) system, while IMBPS system only needs 2 -5 mins. The mean setup errors along x, y and z-axis for patients with esophageal carcinoma measured by IM-BPS and EPID were 3.49 mm, 3. 19 mm, 3.31 mm and 4. 03 mm, 3.41 mm, 3.43 mm, respectively. For the patients with lung cancer, the setup errors were 4. 23 mm, 3.51 mm, 3. 39mm and 4. 85 mm, 3. 53 mm, 3.74 mm, respectively. The difference of setup errors meanured by the two systems was within 1 mm for 65％ esophageal carcinoma patients ( x2 =51.09, P =0. 000), and 55％ lung cancer patients ( x2 =53. 35, P =0. 000).Conclusions The measurement results of setup errors for patients with esophageal carcinoma and lung cancer show that IM-BPS is mostly better than EPID. Though validating for patients can be measured accurately and be well quality controlled, IM-BPS is used easily because of macroscopic, homely,spare time and real-time monitoring.

Objective To compare the results of three dose verification solutions of esophageal carcinoma IMRT plans. Methods Seven esophageal carcinoma cases were planned with Pinnacle 8.0 h.The MATRIXX and Delta4 were chosen as the two-dimensional dosimetry and three-dimensional dosimetry.IMRT plans and Delta4 phantom plans were also recalculated by Monte Carlo. Gamma values were evaluated for MATRIXX and Delta4 with 3 mm/3% gamma criteria. For the comparison of Pinnacle, Delta4 and Monte gamma maps, the dose distribution in central plane, dose profiles and dose-volume histograms were used to evaluate the agreement. Results The gamma maps comparison show that with 3 mm/3% gamma criteria an over 98% pass ratio was obtained by MATRIXX measurement. A 94. 4% gamma pass ratio whicl.contains 4 fields gamma pass ratio lower than 90%, was obtained by Delta4 measurement. A 97.6% and 99. 8% gamma pass ratio was obtained between the Delta4 measurement and Monte Carlo simulation with 2 mm/2% and 3 mm/3% gamma criteria. The dose distribution in central plane and dose profiles from Pinnacle calculation were almost in agreement with both the Monte Carlo simulation and Delta4 measurement. The DVH plot have slightly differences between Pinnacle and Delta4 measurement as well as Pinnacle and Monte Carlo simulation, but have excellent agreement between Delta4 measurement and Monte Carlo simulation. Conclusions It was shown that all the three methods can be used very efficiently to verify esophageal carcinoma IMRT delivery, Delta4 and Monte Carlo simulation no data missed. The primary advantage of Delta4 is the fact it can measure true 3D dosimetry while Monte Carlo can simulate in patients CT images but not in phantom.

Objective To investigate the current situation of systematically holistic nursing in hospitals. Methods A total of 285 nurses from 6 first-class Grade 3 hospitals were investigated with a selfdesigned questionnaire in terms of current situation of systematically holistic nursing in hospitals. Results The present situation of systematically holistic nursing was not satisfactory, factors such as unreasonable allocation of human resources, low overall quality of the nursing team, imperfect assistant support system and nursing managers' paradigm problem had badly affected the thorough development of the systematic approach to holistic nursing. Conclusions We should change our conception and try to innovate according to China' s actual conditions, create a Chinese nursing way and our own nursing brand based on drawing lessons from advanced nursing model of other countries to realize the value of nursing.

A retrospective analysis was performed on 461 pediatric patients under one year of age who had received operation from 1983 to 1990 in department of anesthesiology of Ewha Womans University Hospital. Total number of operation showed incresing tendency, annually, 37 in 1983, 36 in 1984, 43 in 1985, 41 in 1986, 54 in l987, 89 in 1989, 81 in 1989, and 80 in 1990. The eletive and emergency operation com- prised 79% and 21%, respectively. The distribution of the patients by department was general surgery 217, plastic surgery l09, orthopedic surgery 23, neurosurgery l6, cardiothoracic surgery l6, urology 14, and otolaryngology 6. The average age distribution was 149 in 6.to l2 months, l00 in 1 to 3 months, 81 in 1 week to 1 month, 81 in 3 to 6 months, and 50 under 1 week of age. The male to female ratio was 2.7: l. The distribution of induction agents of general anesthesia was ketamine and succinylcholine (SCC) 317, without induction agent(awake intubation) 84, thiopental or diazepam and SCC 23, ketamine and pancronium or vecuronium l2. The most common technique of maintenence anesthesia was the balaced anesthesia. The distribution of disease entity by department was the following inguinal hernia was the most frequent in general surgery, cleft lip in palstic surgery, and hydrocephalus in neurosurgery. The postoperative complication developed in 31 of 461. The most common complications were the respiratory problems, the others were sepsis, heart failures, and convulsions. The motality rate was 1.73%.
Age Distribution ; Anesthesia ; Anesthesia, General ; Anesthesiology ; Cleft Lip ; Diazepam ; Emergencies ; Female ; Heart ; Hernia, Inguinal ; Humans ; Hydrocephalus ; Ketamine ; Male ; Neurosurgery ; Orthopedics ; Otolaryngology ; Postoperative Complications ; Retrospective Studies ; Seizures ; Sepsis ; Succinylcholine ; Surgery, Plastic ; Thiopental ; Urology ; Vecuronium Bromide

Osteochondrodysplasia is a heterogeneous group of disorders appearing short limbed dwarfism. Because many of these entities are lethal and hereditary, an accurate diagnosis is mandatory. The purpose of this study is to define the clinicopathologic features and radiologic findings of osteochondrodysplasia. We reviewed 29 autopsy cases of congenital short limbed dwarfism, consisting of thanatophoric dysplasia (TD) (12 cases), osteogenesis imperfecta (OI) (12 cases), asphyxiating thoracic dysplasia (ATD) (3 cases), short-rib-polydactyly syndrome (SRPS) (1 case) and hypochondrogenesis (1 case). The gestational age ranged from 16 to 41 weeks. Of 6 fetuses that were born alive, 3 were ATD, 2 were TD and 1 was hypochondrogenesis. TD was frequently complicated by hydramnios. Of 8 cases studied chromosomally, only 1 showed chromosomal abnormality -46XY, inv 9. Intrauterine growth retardation was frequently associated with OI. Pulmonary hypoplasia was present in 23 cases (79%), including all cases of ATD, SRPS and hypochondrogenesis, 11 in TD and 7 in OI. Other associated anomalies were present in 17 cases (59%).
Autopsy* ; Chromosome Aberrations ; Diagnosis ; Dwarfism ; Extremities ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Osteochondrodysplasias* ; Osteogenesis Imperfecta ; Polyhydramnios ; Thanatophoric Dysplasia