No abstract available.

Sick neonates often require periodic small volume transfusion (10mg/kg) to replace blood draw for laboratory monitoring during their hospital stay. The effect of packed red cel transfudion on the hematocrit, potassium, ionized calcium, acid base status, glucose and indirect bilirubin was investigated in 25 transfusions. Analysis of transfused blood by the age of the red cells, older red cells (more than 5 days old, 13+/-7 days) showed increased potassium (27.2+/-14.1mEq/L vs 11.3+/-4.9mEq/L), decreased bicarbonate (14.4+/-2.6mEq/L) and glucose (130+/-28mg/dl vs 203+/-93mg/dl) compared with newer red cells (less than 5 days)(p<0.05). No significant changes occured in hematocrit and pH. Inspite of these results, the transfusion of the older red cells did not affect the older red cells did not affect the serum potassium, ionized calcium, pH, bicarbonate, glucose and indirect bilirubin level in neonates. The hematocrit of infants increated significantly after transfusion from 29.6%+/-4.3% to 38.3%+/-6.1%(mean+/-SD)(P<0.05). Transfusion of older red cells seemed to be as equally effective as newer ones. The valus of hematocrit obtained immediately after transfusion does not show any differences compared to those obtained 30 min, 1, 2, 4, 6 and 24 hours after transfusion. The result in the study indicate that there was no adverse effect after transfusion with packed red cell more than 5 days old and no significant difference in hematocrit observed between 0 to 24 hours following transfusion. Therfore old red cell more than 5 days can be used safely for sick neonatal transfusion and the stored donor blood can be optimzed for repeated blood transfusion.
Bilirubin ; Blood Transfusion ; Calcium ; Glucose ; Hematocrit* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Length of Stay ; Potassium ; Tissue Donors

No abstract available.
Pancreas*

Occasionally, patients with gastrointestinal Crohn's disease (CD) develop granulomatous skin lesions at sites remote from the gastrointestinal tract, separated from other ulcerations by normal skin, a phenomenon that has been referred to as metastatic cutaneous CD. Although metastatic CD of the vulval region has been often reported in English literature, we could not find such cases with family history. We report a case of vulval CD occurring in siblings.
Crohn Disease* ; Gastrointestinal Tract ; Humans ; Siblings* ; Skin ; Ulcer ; Vulva*

There has been growing interest in using density porous polyethylence(Medpor) for reconstrctive facial bone surgery because of their perceived increased biocompatibility. the implant is a highly stable and somewhat flexible porous alloplast that has shown to exhibit rapid tissue ingrowth into its pores. A total of 77 Medpor implants were placed in 65 patients over a one and half year period Implants were used for orbital reconstruction, correction of craniofacial contour deformities, malar and chin area. Before operation, adequate photographic and radiologic examination was performed to carry out operation plan. Within 65 patients 38 patients were due to acute trauma, 23 patients due to posttraumatic facial deformity, and 4 patients cosmetic. the result was satisfactory: 95.4% of the patients were improved after operation. One complication occurred due to previously existed sinusitis and it was cured by conservative treatment. On the basis of our results, the Medpor implant is an excellent alternative to existing implant materials. They are easy to handle, shape, contour, position and fixate. If applied under adequate indications, the use of these implants will permit satisfactory results with little complications.
Chin ; Congenital Abnormalities ; Facial Bones ; Humans ; Orbit ; Sinusitis

The anterior communicating artery is one of common sites of intracranial aneurysms, and the anterior communicating artery aneurysms are operated by pterional approach most commonly. Anatomical variation around anterior communicating artery is one of the limiting factors in surgery. Pterional approach can be made from either left or right side according to many factors, such as, dominant feeding artery, shape, size and direction of aneurysm, vascular anomaly and variation around anterior communicating artery, existence of hematoma, and multiple aneurysms. Authors analyzed 62 cases of anterior communicating artery aneurysm and discussed optimal surgical direction in pterional approach and evaluated the usefulness of position of bilateral A1-A2 junction in lateral compression angiogram. The results were as follows: 1) In the existence of another aneurysm in the carotid or middle cerebral artery, optimal surgical direction is to the side of another aneurysm. 2) Significant amount of hematoma should be considered in selecting the surgical direction. 3) If the aneurysm is large, thrombosed, and fundus is broad, the approach should be made to the side which facilitate the exposure of the neck of aneurysm first. 4) Right side approach has advantages that nondominant hemisphere is retracted and surgical manipulation is convenient with small craniotomy. 5) Exposure of the neck of the aneurysm and temporary clip is easier when approach is made along the main feeding artery. 6) Approach to the side of posteriorly placed A1-A2 junction can be another useful option in selecting optimal surgical direction.
Aneurysm ; Arteries ; Craniotomy ; Hematoma ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck

The author analyzed the postoperative results in 96 patients who underwent temporary clipping during cerebral aneurysm surgery from July, 1990 to April, 1995. 1) The overall outcome were as follows:excellent(55.2%), good(21.9%), poor(16.7%), dead(6.3%) and its results were relatively similar to those of the patients who did not have the temporary clipping. 2) The patients were divided into 4 groups according to the site of the temporary clip application. The safe durations of temporary clipping were as follows:In the 1) anterior cerebral artery clipping group, 5 minutes for Hunt-Hess grade 1 & 2 patients and 2 minutes and 30 seconds for Hunt-Hess grade 3 & 4 patients, In the 2) middle cerebral artery clipping group, 5 minutes;In the 3) internal carotid artery clipping group, 5 minutes in Hunt-Hess grade 1 & 2 and 2 minutes for Hunt-Hess grade 3 & 4;The only one patient in the 4) basilar artery clipping group showed excellent outcome after 3 minutes of temporary clipping. Therefore, we concluded that the temporary clipping tecnique would be very useful to dissect the aneurysmal neck, to prevent and control the premature rupture without influencing the outcome. Furthermore, use of the cerebral protective agent, intraoperative cerebral blood flow monitoring and avoidance of excessive and prolonged hypotension during cerebral aneurysm surgery might be very helpful for preventing the cerebral ischemia and increasing the safety duration of the temporary clipping.
Aneurysm ; Anterior Cerebral Artery ; Basilar Artery ; Brain Ischemia ; Carotid Artery, Internal ; Humans ; Hypotension ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck ; Rupture

We examined the expressions of CD44 splice variants (v4/5, v6), alpha-smooth muscle actin, nm23 to evaluate their roles as prognostic factors in 70 cases of uterine cervical carcinoma (stage IB to IIB) who were surgically treated from January 1989 to June 1990 with a clinical follow-up of a minimum of 5 years. The expression was examined by an immunohistochemical method using archival formalin fixed paraffin embedded tissue. In the 70 cases, 61 cases were squamous cell carcinoma and 9 cases were adenocarcinoma. CD44v4/5, CD44v6, alpha-smooth muscle actin, and nm23 were detected in 41.4%, 70%, 100%, and 74.3% of tumor samples, respectively. CD44 splice variants and nm23 showed membrane and cytoplasmic staining of tumor cells, respectively. The expression of alpha-smooth muscle actin showed cytoplasmic staining confined to stromal cells and was classified into three grades by the extent in stromal cells: with less than 10% of stromal cells; 32.9%, 10-50% of stromal cells; 40.0%, more than 50%; 27.1%. These expressions were not correlated with histologic types, lymph node involvement, recurrence, and grades of tumor infiltrating lymphocyte (TIL). But CD44v4/5 had significantly inverse correlation with TIL (p=0.049). The expression of CD44v4/5 was significantly correlated with that of CD44v6 (p=0.05), and that of alpha-smooth muscle actin was inversely correlated with that of nm23 (p=0.049). In conclusion, in FIGO IB-IIB uterine cervical carcinoma CD44 variants, nm23, and SMA show high prevalence, however, with little prognostic significance assessed by recurrence and lymph node metastasis.
Actins* ; Adenocarcinoma ; Carcinoma, Squamous Cell ; Cytoplasm ; Follow-Up Studies ; Formaldehyde ; Lymph Nodes ; Lymphocytes ; Membranes ; Neoplasm Metastasis ; Paraffin ; Prevalence ; Recurrence ; Stromal Cells ; Uterine Cervical Neoplasms*

PURPOSE: To determine the MR parameters affecting India ink artifacts on opposed-phase chemical shift magnetic resonance (MR) imaging.MATERIALS AND METHODS: The use of a female Sprague-Dawley rat was approved by our Institutional Animal Care and Use Committee. Using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images, which is a modified Dixon method, axial opposed-phase images of the abdominal cavity were obtained with different MR parameters: series 1, different repetition times (TRs; 400, 2000, and 4000 ms); series 2, different echo times (TEs; 10, 50, and 100 ms); series 3, different field of views (FOVs; 6, 8, 16, and 24 cm); series 4, different echo train lengths (ETLs; 2, 4, and 8); series 5, different bandwidths (25, 50, and 85); and series 6, different slice thicknesses (1, 2, 4, 8, and 16 mm). Artifacts on opposed images obtained with different parameters were compared subjectively by two radiologists. For objective analysis, the thickness of the artifact was measured. Spearman's correlation between altered MR parameters and thicknesses of India ink artifact was obtained via objective analysis.RESULTS: India ink artifact was increasingly apparent using shorter TE, larger FOV and ETL, and thicker slices upon subjective analysis. The objective analysis revealed a strong negative correlation between the thickness of the artifact and TE (r = -0.870, P < 0.01); however, strong positive correlations were found between FOV (r = 0.854, P < 0.01) and slice thickness (r = 0.971, P < 0.01).CONCLUSION: India ink artifact was thicker with shorter TE, larger FOV, and larger slice thickness.
Abdominal Cavity ; Animals ; Artifacts ; Female ; Humans ; India ; Ink ; Methods ; Rats ; Rats, Sprague-Dawley ; Water

Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*