Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

Vascularized fibular graft is one of the treatment option for avascular necrosis of femoral head (ANFH) and has been known as providing a strut mechanical support and new vascular bed. It is very important to evaluate a healing process in femoral head after vascularization procedure. But a plain radiographic finding has a problem to assess pathological changes of ANFH treated with vascularized fibular graft. Authors analyzed chronogical changes of Tc-99m-HDP bone scan in 31 cases of ANFH treated with vascularized fibular graft from April, 1991 to May, 1994 and following results were obtained. l. Until 2 months after surgery, no change in size of cold defect area and no significant change in extent of RI uptake in reactive zone were noted. 2. During 2 months and 6 months after surgery, slight decrease in size of cold defect area and minimal changes in extent of RI uptake in reactive zone were observed. 3. During 6 months and 12 months after surgery, size of cold defect area decreased to 1/2 and changes in extent and degree of RI uptake in reactive zone were observed. 4. During 1 year and 2 years after surgery, size of cold defect area were minimal and sometimes faded away. RI uptake with decreased density in reactive zone broadened and moved to subchondral area. 5. After 2 years after surgery, cold area faded away and small increased RI uptake were observed in same site. In conclusion, Tc-99m-HDP bone scan which is economic and easily applicable in a patient is very useful for follow up study in ANFH treated with vascularized fibular graft.
Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Transplants*

No abstract available.
Ligaments*

OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.
Aged* ; Delirium* ; Haloperidol ; Humans ; Risperidone* ; Sample Size ; Quetiapine Fumarate

PURPOSE: To investigate the in vivo proton MRS features of various focal hepatic lesions and to distinguish these features according to the involved. MATERIALS AND METHODS: Twenty-five hepatic lesions [hepatocellular carcinoma (n=7), cholangiocarcinoma(n=3), metastatic tumor (n=9), hemangioma (n=3), hepatic abscess (n=2), lymphoma (n=1)] underwent proton MR spectroscopy using a 1.5T unit and a localized proton STEAM sequence, without respiratory interruption, The findings of this in-vivo sequence were then reviewed, with particular attention to the presence and location of dominant peaks. RESULTS: In-vivo proton MR spectra were successfully acquired in all cases. A dominant lipid peak appeared in the MR spectra of the hepatocellular carcinomas, metastatic tumors, hepatic abscesses, lymphoma, one hemangioma and one cholangiocarcinoma(88%) at 1.3ppm, but not in two cholangiocarcinomas and one hemangioma. The spectral peaks of other metabolites appeared very irregular and even different in the same disease. CONCLUSION: In focal hepatic lesions, the spectra obtained during in-vivo proton MRS were useful, and a lipid peak was most frequent and dominant. Among the various neoplasms there were, however, no specific MR spectral features, and nor did such features vary according to the specific pathologic entity.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Hemangioma ; Liver Abscess ; Lymphoma ; Magnetic Resonance Spectroscopy ; Protons* ; Steam

Total hip arthroplasty in patients with chronically dislocated hips poses many challenging technical problems. Abnormal relationship of bones and soft tissues occurs in chronic complete dislocation of the hip (grade IV, Crowe's classification). Problems in placing the acetabular component in the true acetabulum include, first how to cover the acetabular component sufficiently, second how to fix it securely and last how to avoid excessive stretching of the neurovascular structures such as the sciatic nerve. The authors have introduced a technique of one stage distal femoral shortening in order to avoid excessive stretching of the neurovascular structures. From December 1988 to May 1996, the total hip arthroplasties combined with one stage distal femoral shortening were carried out in chronic complete dislocation of 44 hips (grade IV, Crowe's classification) and followed-up more than two years. This method has several advantages: It preserves wide and healthy proximal metaphysis of the femur, does not need greater trochanteric osteotomy, and provides many chances to choose the appropriate stem size and shape, especially in cementless total hip arthroplasty.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Hip Dislocation* ; Hip* ; Humans ; Osteotomy ; Sciatic Nerve

Increasing vigorous chemotherapy for cancers including primary and matastatic tumors has resulted in prolonged survival. However, there has been an associated increase in neurotoxicity as a result of it. All classes of chemotherapeutic agents contain drugs that are potentially neurotoxic. The authors has studied three cases of leukoencephalopthies developed during adjunctive therapy with 5-flurouracil and cisplatin for adenocarcinoma of the stomach. None of the patients had evidence of metastasis or any previous neurologic diseases. The duration of chemotherapy before onset of neurological symptoms ranged from 8 to 12 weeks. Two of the 3 patients presented progressive decline in mental status and ataxia after 2~3 weeks, while the third one had two unexplained episodes of loss of consciousness. In all of these patients, magnetic resonance imagings demonstrated prominent periventricular white matter lesions. Cerebral biopsies were performed stereotaxically in 2 patients. The morphological features were active demyelinating disease and edema. All three patients had improved after the cessation of chemotherapy and a short course of corticosteroid therapy, suggesting that these alarming events such as nausea, vomiting dizziness, dysarthria, and mental change were a toxic reversible side effects from these chemotherapeutic agents. This syndrome may represent the pathological basis for 5-fluorouracil neurotoxicity, however we cannot completely exclude the role of cisplatin in the occurences of the above syndromes.
Adenocarcinoma ; Ataxia ; Biopsy ; Cisplatin* ; Demyelinating Diseases ; Dizziness ; Drug Therapy ; Dysarthria ; Edema ; Fluorouracil ; Humans ; Leukoencephalopathies* ; Nausea ; Neoplasm Metastasis ; Stomach ; Unconsciousness ; Vomiting

PURPOSE: The purpose of this study was to evaluate change in the proton MR spectroscopic (1H-MRS) features of the liver according to changes in the severity of the chronic hepatitis spectrum (normal-chronic hepatitis-liver cirrhosis), and to determine the possibility of replacing liver biopsy by1 H-MRS. MATERIALS AND METHODS: Sixty profiles of 1H-MRS features from 15 normal volunteers, 30 cases of chronic hepatitis, and 15 of liver cirrhosis were evaluated. All cases of chronic hepatitis and liver cirrhosis were confirmed by biopsy, and histopathologic disease severity was categorized according to Ludwig 's classification. Using the STEAM(STimulated Echo-Aquisition Mode) sequence, 1H-MRS was performed. The ratios of peak areas of [glutamate+glutamine]/lipid, phosphomonoesters/lipid, [glycogen+glucose]/lipid, and [3.9-4 . 1ppm unknown peak]/lipid and their mean and standard deviation were calculated in normal, chronic hepatitis stages I and II, and early and late liver cirrhosis groups and the results were compared between these groups. One-way variable analysis was applied to the statistics. RESULTS: Mean and standard deviation of phosphomonoesters/lipid in the normal, chronic hepatitis grades I and II, and early and late liver cirrhosis groups were 0.0146 +/-0.0090, 0.0222 +/-0.0170, 0.0341 +/-0.0276, 0 . 0 6 9 8 +/-0.0360, and 0.0881 +/-0.0276, respectively, and [glycogen+ glucose]/lipid were 0.0403 +/-0.0267, 0.0922 +/-0.0377, 0.1230 +/-0.0364, 0.1853 +/-0.0667, and 0.2325 +/-0.1071, respectively. These results implied that the ra-tio of the above metabolites to lipid content increased according to increasing disease severity (p<0.05). For [g-lutamate+glutamine]/lipid however, the ratios for each group were 0.0204 +/-0.0067, 0.0117 +/-0.0078, 0.0409 +/-0.0167, 0.0212 +/-0.0103, and 0.0693 +/-0.0371, respectively, and there was no correlation with disease severity. In the chonic hepatitis grades I and II, and early and late liver cirrhosis groups, the ratios for [3.9 -4.1 ppm un-known peak]/l ipid were 0.0302 +/-0.0087, 0.0513 +/-0.0167, 0.1112 +/-0.0351, and 0.1504 +/-0 . 0 3 5 5 ,and these also increased according to increasing disease severity (p<0.05). On MR spectra of normal livers, an unknown peak at 3.9 -4.1ppm was not detected. CONCLUSION: Changes in MR spectroscopic features in cases of chronic hepatitic and liver cirrhosis correlated with changes in disease severity, and the sensitivity of the unknown peak at 3.9 -4.1ppm changed according to disease severity. It is therefore possible to differentiate between normal liver, chronic hepatitis and liver cirrhosis by analysis of the 1H-MRS features of the liver. These results indicate that in cases of chronic hepatitis and liver cirrhosis, biopsy of the liver can be replaced by 1H-MRS.
Biopsy ; Classification ; Healthy Volunteers ; Hepatitis ; Hepatitis, Chronic* ; Liver Cirrhosis* ; Liver* ; Protons*

OBJECTIVES: Patients with organic brain lesion can produce unique slow waves (delta and theta) in the EEG. Basic assumption of this study was that the low resolution electro magnetic tomography (LORETA), an inverse source localization program, can provide functional images representing increased slow wave activity in these patients compared to normal subjects. METHODS: The current study was performed by 18 channels digital EEG for 10 patients whose organic deficit have been visually confirmed by CT or MRI. The source images of slow wave (1-7 Hz) frequency were produced by LORETA-key program. RESULTS: We found that in eight out of ten subjects, LORETA successfully found out the source regions which were very closely matched to their original brain lesions. However in two subjects whose organic brain lesions were too small (<1 cm) and located out of gray matter, we failed to find any increased slow wave activity compared with normal control. CONCLUSION: We can conclude that LORETA could be a useful method to provide functional imaging in patients with gray matter deficits in their brain. Its usefulness and limitations were discussed.
Brain* ; Electroencephalography ; Functional Neuroimaging ; Humans ; Magnetic Resonance Imaging ; Magnets* ; Neuroimaging*

Astrocytes play important roles in normal brain development and the physiological processes. In particular, 30% of the brain volume consists of astrocytes, and they are the primary target cell in the brain for cellular injuries from chemical exposures. The present study attempts to establish an immortalized murine astrocyte cell line to study the mechanisms of chemical-induced carcinogenesis of astrocytes. Primary astrocytes isolated from mice were transfected with plasmid carrying the SV40 T antigen. Clonal cells obtained after G418 selection were continuously subcultured to establish an immortalized astrocyte cell line. The cell line was positive on GFAP expression and was sensitive to exposure to such chemicals as MNNG. Cells were treated with MNNG for 5 days, with doses ranging from 0.001ug/ml to 1ug/ml. Dose-dependent cellular transformations of astrocytes were observed. Treatments at 0.01ug/ml showed the most distinct characteristics of neoplastic transformation. Subsequent treatment with TPA produced higher levels of neoplastic cell transformation than MNNG treatment alone, as evidenced by increases of saturation density, soft-agar colony formation and cell aggregation. Promotional effects of TPA on cell transformation was further demonstrated by the shortening duration of foci appearance. Addition of hydrocortisone to the culture media resulted in further promotion of cell transformation in astrocytes treated with MNNG and TPA, suggesting that glucocortocoid also plays a role in the promotion of chemical-induced astrocyte transformation. The present study demonstrates that astrocytes are susceptible to chemical-induced carcinogenicity and subject to mechanisms of multistage carcinogenesis. Analysis of MNNG-transformed astrocytes showed that, while the expression of TGF-beta was decreased, expression of GFAP, IL-1betaand fibronectin were increased. The results suggest that these factors are associated with mechanisms of MNNG-induced astrocyte transformation and may be used as potential candidates for biomarkers representing astrocyte-related tumors and cell toxicities. The study showed scientific evidence that growth factors, cytokine and the extracellular matrix are involved in processes of chemical-induced transformation of astrocytes. In addition, the present work provided an excellent opportunity to develop an immortalized astrocyte cell line that can be used for studying mechanisms of astrocyte-related diseases.
Animals ; Antigens, Viral, Tumor ; Astrocytes* ; Biomarkers ; Brain ; Carcinogenesis* ; Cell Aggregation ; Cell Line ; Cell Transformation, Neoplastic ; Culture Media ; Extracellular Matrix ; Fibronectins ; Hydrocortisone ; Intercellular Signaling Peptides and Proteins ; Methylnitronitrosoguanidine ; Mice ; Physiological Processes ; Plasmids ; Transforming Growth Factor beta