Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

Absorption ; Adult ; Animals ; Bicuspid ; Blood Platelets ; Bone Density ; Bone Development ; Centrifugation ; Dogs ; Humans ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Peri-Implantitis ; Platelet-Rich Plasma ; Transforming Growth Factor beta ; Transplants

Recently, much attention has been paid to the gut mucosal oxygenation in shock resuscitation, because many studies has been reported that the ultimate etiologies of death due to shock are mainly due to multiple organ failure caused by translocation of endotoxins and microorganisms from the ischemic gut mucosa. As there has been persistent controvesies over the relative merits of various kinds of resuscitation fluids in regard to the tissue oxygenation during management of shock, we studied the effects of various kinds of resuscitation fluids on the gut mucosal oxygenation with cats which were in hemorrhagic shcok 24 anesthetized cats were subjected to ge to decrease the mean arterial blood pressure to 40~45 mmHg and this pressure was maintained for 120 minutes (oligemic period). After this period, normal saline, hydroxyethyl starch and hypertonic saline/dextran mixture were administered respectively to raise systolic blood pressure up to 85 mmHg over 30 minutes and this level was maintained for another 120 minutes (post-oligemic period). Mesenteric venous oxygen tension, mesenteric venous-arterial lactate difference, carbon dioxide tension difference and arterial-venous pH difference were measured far evaluating the effects of three groups of resucitation fluids in regard to the gut mucosal oxygenation. There were no statistical significances among three groups by measuring the venous oxygen tension, venous-arterial carbon dioxide difference, arterial-venous pH difference. But venousarterial lactate difference in normal saline resuscitation group was significantly elevated from 5.0 +/-l.l mg/dl immediately after fluid resuscitation to 8.4+/-1.8 mg/dl 1 hour after fluid resuscitation (p<0.05). The difference in normal saline group was significantly high compared to the hydroxyethyl starch group which was 4.4+/-0.5 mg/dl and also compared to the hypertonic saline/dextran mixture group which was 4.1+/-0.9 mg/dl (p<0.05). Hydroxyethly starch and hypertonic saline/dextran mixture are more effective than normal saline in regard to the gut mucosal oxygenation in shock resuscitation, based on changes in venous-arterial lactate difference in each group. Further clinical studies may be needad.
Animals ; Arterial Pressure ; Blood Pressure ; Carbon Dioxide ; Cats* ; Endotoxins ; Hydrogen-Ion Concentration ; Lactic Acid ; Mucous Membrane* ; Multiple Organ Failure ; Oxygen* ; Resuscitation* ; Shock ; Shock, Hemorrhagic ; Starch

No abstract available.
Cystic Adenomatoid Malformation of Lung, Congenital* ; Lung*

PURPOSE: Nowadays, the population of foreign women who are married to Korean men is increasing. This study was undertaken to get clinical data for perinatal care of marriage immigrant women and their babies. METHODS: Retrospective analysis of medical records was conducted on marriage immigrant women and their babies who were admitted at Dongsan Medical Center, Keimyung University over a 5-year period (Jan. 2005-Dec. 2009). Additionally, birth year-, gestational age-, number (s) of fetus-, and gender-matched native parturient women and their babies were selected by random sampling with twice the number as the control group. RESULTS: Total 5,158 babies were born during the study period (male: 52.7%, female: 47.3%). The number of babies born from native mothers was 5,046 (97.8%). Babies born from immigrant women and other foreign mothers were 66 (1.3%) and 48 (0.9%), respectively. The most common nationality of immigrant women was Vietnam (n=43, 65.2%), and the others were China (n=13, 19.7%) and Philippines (n=6, 9.1%). Immigrant women (24.1+/-4.6 yr) were younger than native parturients (32.7+/-4.0 yr), and spouses were older in immigrant group (42.3+/-7.1 yr) than the control (35.1+/-4.5 yr) (P<0.001). The body weight of the immigrant women (59.2+/-10.5 kg) were lighter than the control (69.1+/-9.1 kg) around delivery (P<0.001). In maternal morbidity, the incidence of hepatitis B surface (HBs) antigenemia was higher in immigrant women (13.8%) than the control (3.8%) (P<0.05). Intrauterine growth retardation was more frequently developed in immigrant women, whereas hypertension and diabetes were more frequent in the control, but not significant. In babies born from immigrant women, birth weight (2,680+/-630 g) and head circumference (32.4+/-2.3 cm) were less than that (2,870+/-590 g and 33.2+/-2.1 cm) of native mothers' babies (P<0.05). Birth height was similar in two groups (47.3+/-3.3 cm vs. 47.8+/-3.3 cm). There were no differences between two groups in terms of presence of perinatal diseases in babies. CONCLUSIONS: Marriage immigrant women have a higher incidence of HBs antigenemia and their spouses tend to be elders. Babies born from immigrant women may show significant differences in physical measures including birth weight and head circumference in comparison with native mothers' babies. Therefore follow-up evaluation of growth and development during infancy is necessary.
Birth Weight ; Body Weight ; China ; Emigrants and Immigrants ; Ethnic Groups ; Female ; Fetal Growth Retardation ; Growth and Development ; Head ; Hepatitis B ; Humans ; Hypertension ; Incidence ; Infant, Newborn ; Marriage ; Medical Records ; Mothers ; Multiple Endocrine Neoplasia Type 1 ; Parturition ; Perinatal Care ; Philippines ; Retrospective Studies ; Spouses ; Vietnam

No abstract available.

The authors analyzed 8 cases of the patients with congenital fibrous syndrome for clinical and histological study. In addition we observed the histological findings for the relationship between the clinical manifestations and fibrosis of the muscles and the cause of the fibrosis. All of the patients had hypotropia and 7 of whom had bilateral tendency, six patients showed exotropia and two patines showed esotropia. Associated ocular problems were amblyopia (88%), ptosis (88%), nisometropia (50%) and nystagmus (62%). The most common abnormal head posture was chin up position (88%). There were improvement of abnormal head position in six patients but no change of abnormal head posture in two patients after operation. In histological study the muscle fiber showed generalized degeneration. Clumping of the nuclei of the muscle fiber was replaced by many nuclei of the fibroblasts in light microscopy. The authors observed the proliferation of the collagen fibers among the fibroblastic nuclei and amorphous diffuse particle stained by lightred color in the intercellular space. In electron microscopy the premature collagen fibers appeared among amorphous particles and some particles had close relationship with collagen fibers. From these findings, it would appear that formation of the collagen fiber occurs in extraocular space and degenerated myofibrils are responsible for the formation of the collagen fiber, and abnormal head posture results from fibrosis of muscle fiber and ptosis.
Amblyopia ; Chin ; Collagen ; Esotropia ; Exotropia ; Extracellular Space ; Fibroblasts ; Fibrosis* ; Head ; Humans ; Microscopy ; Microscopy, Electron ; Muscles ; Myofibrils ; Posture

Since G.N. Hounsfield's clinical use of computed tomography in 1971, digital imaging technique using computers has shown an eye opening progress. Progress has made 3-dimensional understanding of not only facial bones but muscles and other connective tissues possible through 3-dimensional reconstruction of preexisting tomographical images. Also, quantitative analysis of density, distance, volume has become possible, allowing objective analysis of preoperative and postoperative states through imaging. The authors measured the masseter muscle volume of 20 normal individuals and 8 female patients through 3-D reconstructive CT imaging and made a statistical analysis of the measurements. The method used in our study may be applied to the diagnosis of disease causing the change of the facial volume and presurgical design as a useful tool to provide objective information on the evaluation of surgery outcome.
Connective Tissue ; Diagnosis ; Facial Bones ; Female ; Humans ; Masseter Muscle* ; Muscles

BACKGROUND: Basal cell carcinoma(BCC) is the most common primary cutaneous neoplasm in Korea. Since the majority of BCCs occur on the head and neck and the goal of the BCC treatment is the complete removal of tumor, Mohs micrographic surgery is ideally suited for maximizing cure rate with minimizing tissue loss. OBJECTIVE: The purpose of this study is to evaluate the depth of excision as well as the lateral margins of BCC and to correlate these with the clinicopathologic aspects of the tumors. METHODS: Twenty patients with 21 BCCs (10 primary, 11 recurrent) diagnosed in the Department of Dermatology of Dong-A University Hospital from March, 1992 through December, 1993 were studied prospectively. RESULTS: 1. Sixty percent of tumors in primary BCCs in our series had a 2-mm maximal margin and 81.8% of recurrent BCC were eradicated with 4-mm or more lateral margin. 2. All the recurrent basal cell carcinomas (8 cases) measuring greater than 15-mm required more than 4-mm margin for the total removal. 3. More than 90% of BCC on the nose in our series required the removal of periosteum/perichondrium or the excision of whole layer. CONCLUSION: Mohs micrographic surgery is an appropriate tool to use in proposing guidelines for the treatment of skin cancer because the most accurate method of determining the actual extent of skin cancer can be achieved.
Carcinoma, Basal Cell* ; Dermatology ; Head ; Humans ; Korea ; Methods ; Mohs Surgery* ; Neck ; Nose ; Prospective Studies ; Skin Neoplasms