OBJECTIVE: To examine a normal range for nuchal translucency thickness between 9 and 14 weeks' gestation in normal fetuses. METHODS: Nuchal translucency was measured prospectively in 124 fetuses between 9 and 14 weeks' gestation resulted in normal pregnancy outcome. The nuchal translucency measurement was expressed as the median and the 5th, 25th, 75th, and 95th percentiles according to complete weeks of gestation based on ultrasound measurement. RESULTS: The median nuchal translucency thickness was 1.8 mm at 9 weeks' gestation and it declined to 1.6 mm at 10 weeks. But the median thickness increased from 1.95 mm at 11 weeks to 2.3 mm at 12 weeks, after which it slightly declined to 2.25 mm at 13 weeks. And then it increased to 2.5 mm at 14 weeks. A nuchal translucency thickness greater than 2.5 mm was not found at 9 and 10 weeks' gestation, but found in 21.8% of fetuses from 11 weeks to 14 weeks. CONCLUSION: In normal fetuses, there is a physiologic variation in the thickness of nuchal translucency between 9 and 14 weeks' gestation. The calculation of risk for trisomies based on this thickness should take this variation into account. The adoption of a gestational age-dependent cutoff point, based on the deviation of a given measurement from the median, may reduce the invasive procedure for karyotyping. And this study suggest that if the nuchal translucency measurement is greater than 2.5 mm before 10 weeks, it may advise the karyotyping.
Female ; Fetus* ; Karyotyping ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Reference Values ; Trisomy ; Ultrasonography

Cervical pregnancy is a rare form of ectopic pregnancy and it can cause life-threatening bleeding. Until recently abdominal hysterectomy has been considered the standard therapy for fear of profuse hemorrhage. Methotrexate, however, can be useful agent to conserve further fertility and it is used in various routes of administration. We report a case of cervical pregnancy that was successfully treated by intraamniotic methotrexate injection under the guidance of transvaginal ultrasonography and subsequent four systemic doses thereafter.
Female ; Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate* ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography

Urinary cytology has become an essential element in the diagnosis and management of transitional cell carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology in the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis. The overall inci- dence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.
Cystoscopy ; Diagnosis ; Humans ; Kidney Pelvis ; Nocturnal Enuresis* ; Retrospective Studies ; Risk Factors* ; Thyroid Gland ; Ureter ; Urinary Bladder ; Urinary Tract

No abstract available.
Gastrectomy*

No abstract available.
Idiopathic Pulmonary Fibrosis*

No abstract available.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Humans ; Biomarkers, Tumor*

Major surgery in a patient with pancytopenia might be associated with increased surgical risks, especially for bleeding and infection. A 66-yr-old man was admitted to the hospital due to shortness of breath. His dyspnea was classified by the New York Heart Association (NYHA) as functional class III. Prior to admission, he had a 5-yr history of medical management for idiopathic aplastic anemia. The severity of aplastic anemia of the patient was graded as non-severe aplastic anemia. Echocardiography revealed reduced left ventricular function and severe aortic valve regurgitation (grade IV) with left ventricular end diastolic dimension measuring 87 mm. Because of dyspnea and echocardiographically documented aortic valve insufficiency, the patient underwent elective aortic valve replacement. Although extracorporeal circulation for valve operations might be associated with aggravation of impaired blood cell function, the patient recovered from surgery uneventfully. Here, we report a successful cardiac surgery with extracorporeal cardiopulmonary bypass in a patient with severe aortic valve insufficiency and concomitant idiopathic aplastic anemia.
Aged ; Anemia, Aplastic/*surgery/*therapy ; Anticoagulants/therapeutic use ; Aortic Valve/pathology ; Aortic Valve Insufficiency/*surgery ; *Cardiac Surgical Procedures ; Echocardiography/methods ; Heart Valve Prosthesis ; Humans ; Male ; Treatment Outcome

OBJECTIVE: To analyze the relationship between the degree of expression of E-cadherin and presence of high risk prognostic factors (lymph node metastasis or parametrium involvement), clinical stages and pathologic types in invasive cervical cancer. METHODS: An immunohistochemical technique has been applied to formalin-fixed, paraffin- embedded samples from 20 radical hysterectomy without risk factors and 16 radical hysterectomy with risk factors. The degree of expressions of E-cadherin immunostaining was compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, presence of high risk prognostic factors, and pathologic types. RESULTS: The difference of the degree of expression of E-cadherin was not statistically significant between high-risk group (lymph node metastasis or parametrium invasion) and non-risk group. The difference of the degree of expression of E-cadherin was not statistically significant according to clinical stages and variable pathologic types either. CONCLUSIONS: These results suggest that the degree of the expression of E-cadherin has no relationship with known high risk prognostic factors, clinical stages and pathologic types in invasive cervical cancer.
Cadherins* ; Gynecology ; Humans ; Hysterectomy* ; Neoplasm Metastasis ; Obstetrics ; Risk Factors ; Uterine Cervical Neoplasms*

Although a lot of articles examining concomitant intrauterine and ectopic pregnancy have been presented, we have not found any reports on ectopic implantation of chorionic villi in the vagina with normal intrauterine pregnancy. We experienced a case of chorionic villi on the vaginal wall as a hemorrhagic mass during the second trimester of pregnancy. A pregnant woman (gestational age of 16 weeks and 1 day) visited our hospital due to vaginal bleeding. There was no abnormal finding except vaginal hemorrhagic mass, and the mass revealed a product of conception.
Chorion* ; Chorionic Villi* ; Female ; Fertilization ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Uterine Hemorrhage ; Vagina

The VATER syndrome is a group of congenital anomalies with a nonrandom tendency for concurrence. Defects include vertebral, anorectal malformation, tracheoesophageal fisutla with esophageal atresia, radial-limb, vascular, and renal abnormalities. The critical period of organogenesis is at or before the sixth or seventh week of gestation. We experienced one case of VATER syndrome in a 1 day old male neonate having vertebral anomalies, esophageal atresia with tracheoesophageal fistula to the distal esophageal segment, imperforated anus, left renal dysplasia with hydronephrosis of the right kidney and both hydroureter, patent ductus arteriosus. We report a case of VATER syndrome with brief review of related literature.
Anal Canal ; Critical Period (Psychology) ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney ; Male ; Organogenesis ; Pregnancy ; Tracheoesophageal Fistula