OBJECTIVE: To investigate the clinical impact of absent or reversed end-diastolic (ARED) umbilical artery flow detected before the 34th week of pregnancy in high-risk pregnancies. METHODS: Fifty-eight singleton pregnant women with high-risk factors were included in this retrospective study. Based on the umbilical artery Doppler finding, pregnant women were divided into 3 groups: group 1 (12 subjects) with normal Doppler systolic/diastolic (S/D) ratios; group 2 (30 subjects) with significant abnormal umbilical artery S/D ratios, and group 3 (16 subjects) with ARED flow in the umbilical artery between the 25+0 and 33+6 gestational weeks. Incidence of intrauterine growth retardation (IUGR) and pregnancy-induced hypertension, detection week, diagnosis-to-delivery interval, birth weight and gestational ages at delivery, Apgar scores, emergency cesarean section, neonatal intensive care unit (NICU) admission, admission-to-discharge interval, perinatal mortality (PNM) and morbidity, and neonatal morbidity were registered. Perinatal outcomes were assessed. The data was analyzed using the Mann-Whitney U-test and X-square test. A significant difference was considered present if p was<0.05. RESULTS: The PNM in group 3 in the study was 25% (4/16). Sixteen had ARED flow. Our study shows that fetuses with ARED flow tend to be more severely growth-retarded. Our results also show ARED flow to be associated with poor perinatal outcome. There was a higher incidence of cesarean section for fetal distress, neonatal intensive care unit admission, and lower Apgar scores. Birth weight and gestational age at delivery were lower. The diagnosis-to-delivery interval was shorter. The admission-to-discharge interval was longer. CONCLUSION: An early ARED finding before the 34th week in the umbilical artery is a very serious sign of likely fetal compromise. The perinatal mortality and morbidity rate were high, and there was evidence of acute or chronic hypoxia in most fetuses. It is an indication that extremely careful surveillance should be followed but not necessarily an indication for an emergency delivery.
Anoxia ; Birth Weight ; Cesarean Section ; Emergencies ; Female ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Perinatal Mortality ; Pregnancy* ; Pregnancy, High-Risk ; Pregnant Women ; Retrospective Studies ; Umbilical Arteries*

Both primary choriocarcinoma and endodermal sinus tumor of the stomach are very rare entities. Combination of these two tumors is even rarer, and only a single such case has been reported in English literature. The case had gastric adenocarcinoma in addition to these tumors. We experienced a case of combined, pure choriocarcinoma and endodermal sinus tumor in the stomach of a 74 year-old man. He had no gonadal or any other primary tumor. Huge exophytic tumor was located in the lesser curvature of the body. Two components of the tumor was separated and clearly defined. Human chorionic gonadotropin(HCG) was demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also demonstrated in serum and in tissue sections. Alpha-fetoprotein(alpha-FP) was also elevated in the serum. Possible tumor origin was speculated.
Humans ; Adenocarcinoma

Primary carcinoma arising in the diverticular wall of the urinary bladder is the most serious complication. The clinical importance is that the carcinoma is difficult to diagnose early, widespread at diagnosis and has poor prognosis. Recently, vigilant studies including bladder mapping reveal premalignant changes and carcinoma in situ adjacent to carcinoma and suggest these premalignant changes evolve to flank carcinoma. For early detection and improving the prognosis, be required through cystoscopic examination including diverticular wall and multiple punch biopsies as well as consecutive urine cytologic examination. Author report two cases of primary carcinoma arising in bladder diverticulum. One revealed carcinoma in situ accompanied with adjacent atypical hyperplasia in diverticula mucosa incidentally found at the pathologic examination on the divertiuclectomy specimen. The other case showed invasive transitional cell carcinoma(Grade IV, Stage D) of diverticulum. The two cases described suggest that vesical diverticulum should be removed into to with a good amount of surrounding bladder wall.
Biopsy ; Carcinoma in Situ ; Diagnosis ; Diverticulum* ; Hyperplasia ; Mucous Membrane ; Prognosis ; Urinary Bladder

In adenomatous polyposis coli there are many colonic and extracolonic manifestations, and various combinations of these induce different clinical presentations and syndromes. We experienced a unique case of adenomatous polyposis of the large intestine and stomach in a 39-year-old man. In the colon, small cell neuroendocrine carcinoma rather than adenocarcinoma had developed, which did not contain adenomatous or carcinomatous foci. The adenomatous polyps in the colon were all small and sessile with no cancerous or precancerous change two years after the resection of the symptomatic gastric adenomas, even though the gastric adenomas were larger and showed dysplastic change. We think this case is another variant of adenomatous polyposis syndrome.
Adenocarcinoma ; Adenoma

No abstract available.
Blood Platelets* ; Hemagglutination*

BACKGROUND AND OBJECTIVES: Epidermal growth factor (EGF), directly stimulates epidermal growth and differentiation. The combination of EGFR activation and genetic alternations may lead to neoplasia and metaplasia. To study the change of chromosomal number and the aberrations of chromosomal structure of KUMA3 cell line treated with high dose EGF. MATERIALS AND METHODS: The high dose EGF treated cell clones were obtained from KUMA3 cell line which was established from squamous cell carcinoma of the lower lip by culturing cells in medium containing high dose EGF for 6 months. The chromosomal analysis and subculture were performed at subsequent passage of 1 month interval. RESULTS: In high dose EGF treated cell clones, there was no apparent change in chromosomal number, but the ratio of the number of chromosome 7 to mode chromosome number was similar to normal value (0.043). The new chromosomal structural aberrations appeared first from 30 passage of IR-200 cell clone. The chromosomal aberrations were del(1)(q23-->qter) and del(4)t(1:4)(1qter-->1q23: : 4p16-->4qter). CONCLUSION: There was no change in chromosomal number, but the ratio of the number of chromosome 7 to mode chromosome number was similar to normal value (0.043), and the new chromosomal structural aberrations were appeared.
Carcinoma, Squamous Cell ; Cell Line ; Chromosome Aberrations ; Chromosomes, Human, Pair 7 ; Clone Cells* ; Cytogenetics* ; Epidermal Growth Factor* ; Lip ; Metaplasia ; Reference Values

The Iinvolvement of subaortic structures in the aortic valve endocarditis appears more commonly than previously recognized. These subaortic complications are most commonly located in the mitral-aortic intervalvular fibrosa and may be presented as abscess, or as pseudoaneurysm with or without perforation. Perforated pseudoaneurysm can lead to the development of communication between the left ventricular outflow tract and various cardiac chambers, most commonly the left atrium. These complications are related with poor prognosis. Early and precise recognition of these complications is important for optimal treatment. At present, transesophageal echocardiography (TEE) has been validated as the technique of choice. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa featuring the connection of the fistulous simultaneously to the left atrium and aorta. In our case, accurate interpretation of TEE imaging revealing the subaortic structures was not so easy due to interference of both aortic and mitral prosthetic valves. We expect the further development of (Ed-confirming that here you don't intend, "We expect to further develop") TEE and other imaging modalities to substantially improve the future diagnosis of these undesirable complications.
Abscess ; Aneurysm, False* ; Aorta ; Aortic Valve* ; Diagnosis ; Echocardiography, Transesophageal ; Endocarditis* ; Fistula* ; Heart Atria ; Prognosis

Somatosensory evoked potentials(SEPs) in response to median nerve stimulation have been recorded as a guide to cortical function during temporary occlusion of the parent vessels in the treatment of 27 aneurysms of middle cerebral artery and internal carotid artery. The central conduction time(CCT), the time between the N14 peak and the N20 peak, were preserved for variable times during temporary occlusion, ranging from no significant change after 18 minutes of occlusion to disappearance of the N20 after 2 minutes. The rapid disappearance of N20 within three minutes after temporary occlusion was observed in all three cases which was developed new postoperative neurological deficits, neither permanent, and in one case of death. The total arterial occlusion time of each of these postoperative deficit cases was no longer than 20 minutes and the shortest time was 12 minutes. The rapid loss of the cortical wave after temporary occlusion, therefore, suggests the safty duration of the temporary occlusion would be short. Monitoring of the SEPs during intracranial aneurysm surgery can help the surgeon in the management of proximal vessel control and reduce the morbidity of aneurysm operation.
Aneurysm ; Carotid Artery, Internal ; Evoked Potentials ; Evoked Potentials, Somatosensory* ; Humans ; Intracranial Aneurysm* ; Median Nerve ; Middle Cerebral Artery ; Monitoring, Intraoperative ; Parents

Somatosensory evoked potentials(SEPs) in response to median nerve stimulation have been recorded as a guide to cortical function during temporary occlusion of the parent vessels in the treatment of 27 aneurysms of middle cerebral artery and internal carotid artery. The central conduction time(CCT), the time between the N14 peak and the N20 peak, were preserved for variable times during temporary occlusion, ranging from no significant change after 18 minutes of occlusion to disappearance of the N20 after 2 minutes. The rapid disappearance of N20 within three minutes after temporary occlusion was observed in all three cases which was developed new postoperative neurological deficits, neither permanent, and in one case of death. The total arterial occlusion time of each of these postoperative deficit cases was no longer than 20 minutes and the shortest time was 12 minutes. The rapid loss of the cortical wave after temporary occlusion, therefore, suggests the safty duration of the temporary occlusion would be short. Monitoring of the SEPs during intracranial aneurysm surgery can help the surgeon in the management of proximal vessel control and reduce the morbidity of aneurysm operation.
Aneurysm ; Carotid Artery, Internal ; Evoked Potentials ; Evoked Potentials, Somatosensory* ; Humans ; Intracranial Aneurysm* ; Median Nerve ; Middle Cerebral Artery ; Monitoring, Intraoperative ; Parents

Pelvic inflammatory disease (PID) is a common disease associated with gynecologic infection, occurring mainly in fertile women. We report a case of phlegmon caused by chronic PID mimicking pelvic malignancy in a 39-year-old woman. The patient suffered from chronic pelvic pain, intermittent fever, and dysuria. A palpable lower abdominal mass was associated with progressive weight loss. A pelvic MRI revealed a 9x8x7cm sized, ill-defined soft tissue mass in the right pelvic cavity. On exploratory laparotomy, the pelvic mass was severly adhesed to the small intestine, mesentery, and urinary bladder. An incisional biopsy of the pelvic mass was performed. Histologically, the pelvic mass was composed of inflammed fibrous tissue with granulation tissue proliferation. The patient was treated with metronidazole and ciprofloxacin for two weeks. Fever and abdominal pain were relived. On a follow up abdomino-pelvic CT, the pelvic mass was not visible. Awareness of such an unusual case of chronic PID mimicking pelvic malignancy will facilitate a more accurate diagnostic approach for a variety of pelvic mass lesion.
Abdominal Pain ; Adult ; Biopsy ; Cellulitis* ; Ciprofloxacin ; Dysuria ; Female ; Fever ; Follow-Up Studies ; Granulation Tissue ; Humans ; Inflammation* ; Intestine, Small ; Laparotomy ; Magnetic Resonance Imaging ; Mesentery ; Metronidazole ; Pelvic Inflammatory Disease ; Pelvic Pain ; Urinary Bladder ; Weight Loss