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

No abstract available.
Cerebral Palsy* ; Equinus Deformity* ; Heel* ; Muscle Spasticity*

Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is 0.64+/-0.36mm(0.71+/-0.66%) in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.
Diagnosis ; Education ; Humans ; Skull ; Tomography, X-Ray Computed

PURPOSE: To observe MR findings of vascular abnormality in Sturge-Weber syndrome and to determine the value of MRI in diagnosis. MATERIALS AND METHODS: Ten patients with Sturge-Weber syndrome (age : 3 months-32 years)were evaluated by MR imaging ; in six and four cases, respectively, the results were correlated with those of CT and angiography. We retrospectively analysed changes in the cortical vein and deep venous system, including the medullary and subependymal vein, as well as an largement of the choroid plexus, leptomeningeal enhancement, and changes in diploic space. RESULTS: In all cases except one, in which non-contrast enhanced study had been performed, varying degrees of leptomeningeal enhancement were seen. In nine cases the cortical vein became smaller; enlargement of the choroid plexus was seen in eight cases, change in the diploic space in seven (including three in which there was angiomatous involvement), and enlargement of the deep venous system in seven. In younger patients, collateral pathways were less developed and leptomeningeal angiomatous changes were more pronounced than in those who were older. CONCLUSION: MRI is a useful modality for the evaluationn of vascular changes in Sturge-Weber syndrome. These changes vary according to a patient's age and the duration of the disease.
Angiography ; Choroid Plexus ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sturge-Weber Syndrome* ; Veins

Phosphoinositide-specific phospholipase C-gamma1 (PLC-gamma1) has two pleckstrin homology (PH) domains: an amino-terminal domain (PH1) and a split PH domain (PH2). Here, we show that overlay assay of bovine brain tubulin pool with glutathione-S-transferase (GST)-PLC-gamma1 PH domain fusion proteins, followed by matrix-assisted laser-desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), identified 68-kDa neurofilament light chain (NF-L) as a binding protein of amino-terminal PH domain of PLC-gamma1. NF-L is known as a component of neuronal intermediate filaments, which are responsible for supporting the structure of myelinated axons in neuron. PLC-gamma1 and NF-L colocalized in the neurite in PC12 cells upon nerve growth factor stimulation. In vitro binding assay and immunoprecipitation analysis also showed a specific interaction of both proteins in differentiated PC12 cells. The phosphatidylinositol 4, 5-bisphosphate [PI(4,5)P2] hydrolyzing activity of PLC-gamma1 was slightly decreased in the presence of purified NF-L in vitro, suggesting that NF-L inhibits PLC-gamma1. Our results suggest that PLC-gamma1-associated NF-L sequesters the phospholipid from the PH domain of PLC-gamma1.
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Rats ; Protein Interaction Mapping ; Protein Biosynthesis/drug effects ; Protein Binding/drug effects ; Phosphoproteins/chemistry/*metabolism ; Phospholipase C gamma/antagonists & inhibitors/chemistry/*metabolism ; Phosphatidylinositol 4,5-Diphosphate/metabolism ; Peptides/chemistry/metabolism ; PC12 Cells ; Neurofilament Proteins/chemistry/*metabolism ; Nerve Growth Factor/pharmacology ; Molecular Weight ; Molecular Sequence Data ; Microtubules/metabolism ; Microscopy, Fluorescence ; Isoenzymes/metabolism/pharmacology/physiology ; Glutathione Transferase/metabolism ; Blotting, Far-Western ; Blood Proteins/chemistry/*metabolism ; Binding Sites ; Animals ; Amino Acid Sequence

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

STUDY DESIGN: Retrospective study OBJECTIVES: To compare the surgical results of microendoscopic discectomy using a tubular retractor with those of a conventional discectomy for lumbar herniated nucleus pulposus. SUMMARY OF LITERATURE REVIEW: Minimally invasive approaches to the lumbar spine have been attempted with success over the past 25 years. MATERIALS AND METHODS: This study examined 36 cases who underwent lumbar discectomy using a tubular retractor and microendoscopy (Group A) and 30 cases who underwent a conventional discectomy (Group B). The operating time, intraoperative blood loss, postoperative hospital stay were recorded. The clinical results were assessed using the Korea Version Oswestry Disability Index (KODI), and the radiological results were evaluated from changes in disc height. RESULTS: The patients in Group A had a longer operation time(mean, 95.56+/-23.57 minutes vs 81.17+/-35.30 minutes, p=0.062), less intraoperative blood loss (mean, 58.61+/-97.08 cc vs 161.00+/-88.64 cc, p=0.001) and a shorter hospitalization stay (mean, 8.22 +/-4.99 days vs 17.33+/-10.98 days, p=0.001) than group B. There was significant improvement in the mean KODI score for Group A; 6.36+/-7.18 and Group B; 5.97+/-5.14. However, there was no significant difference in the pain improvement (mean, 1.14 +/-1.15 vs 1.30+/-1.06, p=0.559) and walking index (mean, 0.25+/-0.44 vs 0.30+/-0.47, p=0.656). In terms of social life, Group A had better results (mean, 0.20+/-0.48 vs 0.67+/-1.01, p=0.018). The disc height according to radiography decreased from 8.44+/-1.98 mm to 7.40+/-1.59 mm in Group A and 9.07+/-1.93 mm to 7.67+/-1.90 mm in Group B, but there were no statistical differences in the changes in disc height between the two groups (p=0.143). CONCLUSION: Microendoscopic discectomy is an effective procedure with good outcomes in treating lumbar disc herniation that allows less tissue trauma, compared with conventional open discectomy.
Diskectomy ; Hospitalization ; Humans ; Korea ; Length of Stay ; Postoperative Hemorrhage ; Retrospective Studies ; Spine ; Walking

PURPOSE: To determine the hemodynamics of the pancreas by investigating the enhancement patterns of pancreaticparenchyma, as seen on spiral CT, after the administration of various amounts of contrast medium, and to determineoptimal scan time by knowing the peak time of normal pancreatic parenchyma. MATERIALS AND METHODS: Between January1995 and April 1997 55 cases of normal abdominal CT with dynamic enhancement study on pancreas, the subject were38 cases(28 persons) with good image, aged 21-65 years, men were twenty-one and women were seven. Non-ioniccontrast medium, 30ml(n=15), 60ml(n=9), 990ml(n=7), and 120ml(n=7) were injected at a rate of 3ml/sec. From 20sec. after the start of injection, 15 images were obtained at 3-sec intervals. Before and after injection, R.O.I.was applied to each image, and for the aorta and pancreatic parenchyma, Hounsfield units(H.U.) were measured; timeof enhancement and maximal H.U. were also measured. RESULTS: After 30, 60, 90, and 120ml of contrast mediuminjection, mean maximal H.U. of pancreatic parenchyma was 36+/-7, 54+/-6, 68V13, and 92+/-8, respectively; mean valueat peak parenchymal enhancement of the pancreas was 27+/-3, 32+/-3, 42+/-3, and 52+/-3, respectively. Time intervalsof maximal enhancement of aorta and pancreatic parenchyma could not be obtained in 30ml injection, but 5,4+/-2.5,4.2+/-1.6, and 6.0+/-2.1sec in 60, 90, and 120ml injection, respectively. CONCLUSION: Maximal H.U. of parenchymalenhancement of the pancreas is directly proportional to the amount of injected contrast medium and the peak timeof parenchymal enhancement was 12sec after the injection of contrast material. Time interval of maximalenhancement of aorta and pancreatic parenchyma was 5.2+/-2.1sec.
Aorta ; Contrast Media ; Female ; Hemodynamics ; Humans ; Male ; Pancreas* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is a well-recognized cause of vomiting in infancy and is easily cured by a Ramstedt pyloromyotomy. However there have been no reports on the postoperative appearance of a pyloric mass in Korea. METHODS: Twenty infants with IHPS and 20 control infants were studied ultrasonographically during the first year of life at a regular interval. According to examination intervals, the IHPS infants (n=20) were divided into three groups: Group A (3 months, n=6), B (6 months, n=7), and C (12 months, n=7). At each examination, measurements were obtained concerning the length of the pyloric canal and the muscular thickness. RESULTS: The mean preoperative length of the pylorus of the IHPS group was 19.4+/-3.64 mm, ranging from 17 to 30 mm (control: 7.73+/-2.67 mm) (p<0.0001). The mean pyloric muscle thickness of the IHPS group was 5.08+/-0.67 mm, ranging from 3.5 to 6 mm (control: 2.37+/-0.58 mm) (p<0.0001). The preoperative and postoperative measurements were subsequently compared. Postoperatively, the length of the pylorus averaged 22.0+/-2.66 mm, and the muscular thickness was 6.53+/-1.68 mm (p<0.0001). The reduction rates in pyloric length were 23.5%, 46.3%, and 53.4% for the respective groups. Also, the muscle-thickness reduction rates were 31.8%, 48.9%, and 57.8% respectively. At 6 months after the operation, the pyloric muscular thickness was in the normal control range, and the pyloric length was reduced to the normal range after 12 months. CONCLUSIONS: This prospective study suggests that the pyloric mass undergoes a rapid reduction in size in the first 6 months, followed by a more gradual reduction to a normal value by 12 months after a pyloromyotomy.
Humans ; Infant ; Korea ; Prospective Studies ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Reference Values ; Ultrasonography ; Vomiting

OBJECTIVE: To evaluate the expressions of Ki-67, p53 and p21 waf1/cip1 according to the age and the histologic type of preinvasive and invasive cervical lesions. MATERIAL AND METHOD: Microwave-oven-processed formalin-fixed, paraffin-embedded, cervical biopsy specimens and hysterectomy specimens were obtained from 1997 to 1998 at the Soonchunhyang university Chunan hospital. These included 55 cervical intraepithelial neoplasm(CIN I-III), 14 invasive squamous cell carcinoma and 3 adenocarcinoma, and immunohistochemically evaluated by monoclonal MIB-1 antibody, monoclonal p53 antibody, and monoclonal p21 antibody. Positive index was expressed as a percentage of strong staining cells per 300 counted cells in evenly strong staining area. RESULT: Ki-67, p53 and p21 protein were expressed in the nuclei. Ki-67 was specifically expressed in all phases of cell cycles in proliferating cells. p21 expression was not seen in CIN I and CIN II, but was increased with increasing histologic grade. According to the age, Ki-67 expression was significantly higher in 30 > or =aged group than 30 < or = aged group, but p53 expresson was not significantly different according to age groups, and p21 expression was significantly lower in 50 < or = aged group than 30 > or =aged group. CONCLUSION: Conclusions of this study indicate that cell proliferating rate is higher in young age groups than old age groups. p53 expression was not significantly different according to age and histologic grade. These indicates that mutation of the p53 gene may be associated with the development of cervical cancer, but not associated with the progression of cervical cancer. Besides, p21 expression was increased in increasing histologic grade, but decreased in old aged women. Further study of this paradoxical increase in p21 expression in cervical carcinoma is necessary to clarify the mechanisms of p53 indepent pathway.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Proliferation* ; Chungcheongnam-do ; Female ; Genes, p53 ; Humans ; Hysterectomy ; Uterine Cervical Neoplasms