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*

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

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

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 development of postischemic irreversible brain damage depends upon the length of ischemia and its severity during arterial occlusion, although release of the occlusion always leads to restoration of normal or above noraml cerebral blood flow. The experiment was planned to determine the effects of mannitol on cerebral ischemia on subsequential regional cerebral blood flow(rCBF) and somatosensory evoked potential(SEP) following reperfusion after ischemia and also define the proper time of vascular occlusion without irreversible brain damage. Cerebral ischemia was induced in cat by transorbital occlusion of the left MCA with a Sugita clip for period of 30 minutes and the ischemic brain was reperfused for 180 minutes by removing the clip. Forty adult cats, weighing 2.5 to 4.0 Kg were divided into 5 group ; control(Group I, n=8), permanent MCA occlusion(Group II, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), permanent MCA occlusion with mannitol infusion(Group III, n=8), 30 minutes MCA clipping followed by reperfusion(Group IV, n=8) and 30 minutes MCA clipping with mannitol infusion followed by reperfusion groups(Group V, n=8) respectively. The rCBF and SEP measurents were carried out in each animal immediately, after MCA occlusion, at 30 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes and 180 minutes followed by perfusion. The rCBF was measured by the hydrogen clearance technique. Mannitol was given in bolus of lg/kg body weight as a 25% solution delivered via the femoral vein. The results were as follows : 1) Gradual elevation of intracranial pressure(ICP) and systolic blood pressure were observed after MCA occlusion. Treatment with mannitol in MCA occlusion animals(Group III & V) decreased ICP immediately after infusion of mannitol. 2) Normal control rCBF(ml/100 g/min) were 51.94+/-5.05 in the left temporal(LT) and 50.80+/-4.87 in the left perietal lobes(LP). 3) The MCA occlusion resulted in a reduction of the blood flows to 72% of the normal control ones(LT : 14.29+/-4.81 ml/100 g/min) at the left temporal area immediately after occlusion and also a reduction of flows to 80.4% of the normal control ones(LT : 10.24+/-3.69 ml/100 g/min) at 180 minutes after occlusion in Group II. 4) In the mannitol-treated group(group IV), reperfused animals, with removal of the clip on MCA had an improved postischemic recovery of blood flow and ipsilateral cerebral blood flows were restored to 42.5% of the normal control ones(LP : 21.2+/-4.13 ml/100 g/min) at 180 minutes after occlusion in Lt. parietal CBF. 5) In the reperfusion group(group IV), reperfused animals, with removal of the clip on MCA had an increase in rCBF to the level of 83.3% of the control value(LT : 45.78+/-6.80 ml/100 g/min) at 180 minutes after reperfusion and also reperfused animals, with treated mannitol had further increase the blood flow up to the level of 92.5% of the control value(LT : 49.04+/-43.6 ml/100 g/min) at 180 minutes after reperfusion. 6) After the MCA occlusion, the SEP was present but markedly altered in shape and particularly the early components of the SEP were suppressed in the ipsilateral occlusion hemisphere. 7) In the mannitol-treated reperfusion group(Group V) the amplitude of the SEP was restored to 80% of control value. The SEP was significantly suppressed if the rCBF fell below 10-14 ml/100 g/min. These result suggest that provided CBF can be restored to above the 40% threshold well within 30 minutes, prevention of ischemic brain damage can be expected and also the mannitol may of benefit in prolongation of the time threshold for the formation of the cerebral ischmia after vessel occlusion.
Adult ; Animals ; Blood Pressure ; Body Weight ; Brain ; Brain Ischemia* ; Cats ; Evoked Potentials ; Femoral Vein ; Humans ; Hydrogen ; Ischemia ; Mannitol* ; Perfusion ; Rabeprazole ; Reperfusion

In order to observe the development of ventricular arrhythmia during regional myocardial ischemia and reperfusion, especially under the presence or absence of ST-T electrical alternans on epicardial EKG. The proximal left descending coronary artery(LAD) was ligated for 20 minutes and then reperfused suddenly in twenty-three cats. Standard lead EKG(Lead??, chest lead EKG and epicardial lead EKG were recorded simultaneously during the occlusion and reperfusion respectively. During the ligation of LAD, STEA was observed in thirteen cats(56.5%). In occlusion period, the incidence of ventricular tachycardia in STEA positive group was significantly higher than in the negative group(p<0.01) and arrhythmic score was significantly higher(p<0.005) also In the reperfusion period the incidence of vefntricular fibrillation in STEA positive group was significantly higher than in the negative group(p<0.025). But there was the tendency to be higher in arrhythmic score of STEA positive group. There were no differences in heart rate, systolic left ventricular pressure, ST elevation and ST width in both groups. Most forms of ST-T of sinus rhythm before and after development of ventricular premature beat was low form(L). It was concluded that at the presence of STEA on EKG, the incidence of ventricular arrhythmia was more prevalent. So, STEA can be available as a marker of ventricular arrhythmia and prognostic factor.
Animals ; Arrhythmias, Cardiac* ; Cardiac Complexes, Premature ; Cats ; Electrocardiography* ; Heart Rate ; Incidence ; Ligation ; Myocardial Ischemia ; Reperfusion ; Tachycardia, Ventricular ; Thorax ; Ventricular Pressure

Mucoepidermoid carcinoma was initially recognized as occurring only in the salivary gland and only later was it appreciated that it occurred in the bronchus and trachea as well. Mucoepidermoid carcinoma of bronchial gland origin is extremely rare, and little is known about their natural history. This carcinoma is derived from the minor salivary gland of the proximal tracheobronchial tree and it is divided into low-grade and high-grade by gross, histologic, and ultrastructural criteria. Also Its clinical and biologic behaviors are closely related with histologic grade of carcinoma. We have experienced a rare case of bronchial mucoepidermoid carcinoma associated with adenocarinoma which obstructed the left main bronchus and was successfully removed by the pneumonectomy.
Adenocarcinoma ; Bronchi ; Carcinoma, Mucoepidermoid* ; Lung ; Natural History ; Pneumonectomy ; Salivary Glands ; Salivary Glands, Minor ; Trachea ; Trees

In a patient presenting with clinical features of obstructing hydrocephalus, stenosis of aqueduct of Sylvius was demonstrated by contrast ventriculography and C-T scan. The case of aqueduct stenosis in a dult has been described by spiller and Allen, 1907. Ventriculoperitoneal shunting resulted in clinical improvement with significant change in ventricular size and subarachnoid space.
Cerebral Aqueduct ; Constriction, Pathologic* ; Humans ; Hydrocephalus ; Subarachnoid Space ; Ventriculoperitoneal Shunt*