No abstract available.
Brain Ischemia* ; Vertebral Artery*

The umbilical cord length may be a reliable indicator of fetal activity during gestation because it grows in response to tensile forces related to fetal movement. But there has been little attention to normal range of the umbilical cord length. We analyzed the umbilical cord length of 2342 cases de1ivered in Seoul National University Hospital to determine mean values according to the gestational age. The umbilical cord length increased linearly from 15.5cm of 13 week to 50.6 cm of 44 week. After 42 week, the growth was nearly stopped. There was no difference by fetal sex. The length of umbilical cord was variable even within same gestational age.

PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

Takayasu's arteritis(arteritis syndrome) is an inflammatory disease process affecting primarily the aorta and its main branches. It's etiology and pathogenesis are unknown. Controversy exists in treatment. Segmental stenoses, occlusions, and aneurysmal degeneration of the aorta and the proximal arterial tree are frequent findings. Clinical presentations may include cerebrovascular ischemia, limb ischemia, aortic valvular insufficiency, heart failure, renovascular hypertension, or renal failure. Recently, we experienced a case of Takayasu's arteritis in a 24 years old female with severe dizziness, claudication in right upper extremity. Patient was treated by angioplasty of left vertebral artery and concomitant left subclavian-to-right axillary artery bypass surgery followed by percutaneous transluminal angioplasty with stent therapy of right vertebral artery to prevent cerebrovascular ischemia during the operation. Postoperative result was excellent and dizziness and claudication of right arm were completely relieved.
Aneurysm ; Angioplasty ; Aorta ; Arm ; Axillary Artery ; Constriction, Pathologic ; Dizziness ; Extremities ; Female ; Heart Failure ; Humans ; Hypertension, Renovascular ; Ischemia ; Renal Insufficiency ; Stents ; Takayasu Arteritis* ; Upper Extremity ; Vertebral Artery* ; Young Adult

PURPOSE: To evaluate the effectiveness of optical coherence tomography angiography (OCTA) in investigating changes in the area of the foveal avascular zone (FAZ) in patients with diabetic retinopathy (DR) and normal subjects. METHODS: Eighty-five eyes of 50 DR patients and 50 eyes of 25 normal subjects were included. OCTA images of the FAZ were acquired using the split-spectrum amplitude decorrelation angiography algorithm of Optovue Avanti RTVue XR OCT. Patients were divided into three groups according to DR severity: mild-to-moderate non-proliferative diabetic retinopathy (NPDR) group, severe NPDR group, and proliferative DR group. The area of the FAZ was measured using built-in software and was compared between the patients and normal subjects and among the three groups. RESULTS: The area of the FAZ in patients with diabetic retinopathy (0.46 mm²) was significantly larger than that in normal subjects (0.30 mm², p = 0.001). A significant difference was observed depending on DR severity: 0.40 mm² in the mild-to-moderate NPDR group, 0.45 mm² in the severe NPDR group, and 0.53 mm² in the PDR group (p = 0.03). Correlation between area of the foveal avascular zone and visual acuity showed a tendency toward reduction in visual acuity (p = 0.002). CONCLUSIONS: OCTA effectively detected changes in the FAZ area in DR patients. OCTA has the potential to be used for noninvasive quantification and monitoring of the FAZ.
Angiography ; Diabetic Retinopathy* ; Humans ; Tomography, Optical Coherence ; Visual Acuity

Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.
Infant ; Male ; Female ; Humans ; Hamartoma

Cerebrovascular accident remains the second most common cause of death in Korea, following combined cancer mortality. It is one of the most common causes of disability, and atherothromboembolic ischemic infarction accounts for nearly half of stroke in Korea. Carotid endarterectomy is proven to be effective in preventing stroke from internal carotid artery stenosis. The authors report the results of prospective study of 63 carotid endarterectomies, performed from September, 1995 to November, 1997 at our institution, to clarify the persisting diversity of opinions as to ideal preoperative diagnostic tests, anesthetic management, intraoperative monitoring techniques for cerebral protection, type of arterial repair, and postoperative evaluation for cerebral function. We confirmed that preoperative diagnostic tests of duplex scanning and magnetic resonance angiogram can replace the invasive conventional cerebral angiography, and observation of consciousness under regional anesthesia is the most reliable and safe method for carotid endarterectomy utilizing selective shunting, if needed.
Anesthesia, Conduction ; Carotid Stenosis ; Cause of Death ; Cerebral Angiography ; Consciousness ; Diagnostic Tests, Routine ; Endarterectomy, Carotid* ; Infarction ; Korea ; Monitoring, Intraoperative ; Mortality ; Prospective Studies* ; Stroke

No abstract available.
Hernia, Umbilical* ; Ultrasonography*

No abstract available.
Carcinoma, Squamous Cell* ; Female ; Ovary*

Eight cases of combine hepatocellular-cholangiocarcinoma(HCC-CC) of the liver were analysed along with their growth patterns and histologic subtypes to draw a possible implication in understanding of their histogenesis. The relative incidence of combined HCC-CC among the surgically resected primary carcinomas of the liver(485 cases) was 1.6%. The combination patterns varied and were classified as follows; the multinodular tumor, each consisting of HCC or CC element(type 1) was found in 1 case, the single tumor mass with two distinct compartments of HCC and CC(type 2) in 3, and the single tumor with random mixture of two elements(type 3) comprised the remaining 4 cases. Of the 7 cases of single tumor mass(type 2 and 3) HCC and CC comprised the major component in 5 and 2 cases, respectively. The histologic features of both HCC and CC elements were not different from those of isolated HCC and CC, except for two of CC element in type 3 which disclosed the intermediated differentiation or socalled cholangiolocellular carcinoma in part. We conclude that there is no significant difference in the relative incidence of combined HCC-CC among primary carcinomas of the liver and their subtypes compared to that in other countries, regardless of high incidence of both HCC and CC in Korea. Also, we discussed a possible histogenisis along a hypothesis that some of the combined HCC-CC be the consequence of interposition of different cell type from a new subclone into the growth of an initial single cell type of primary carcinoma of the liver.
Incidence ; Carcinoma, Hepatocellular