During the microvascular operation, vasospasm can be disastrous because it may cause necrosis of the flap. But we could not fully understand the pathophysiology of contraction of operated vessels. We performed microvascular anastomosis of the femoral artery in the rats and decided the maximum initia tension and intensity of electrical stimulus. At the site of operation, postoperative 1st, 2nd, 3rd, 5th and 7th days, we took the samples of vessels including microvascular anastomotic site. Using myometry, we observed the responses of the samples responding to the stimuli and compared the results to that of the other unoperated femoral artery. The contractibility of the artery was increased in the first day and remained continuously until the postoperative 7th days.
Animals ; Arteries ; Femoral Artery* ; Necrosis ; Rats*

Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Graves Disease* ; Humans ; Myasthenia Gravis* ; Neck ; Thymectomy* ; Thymus Hyperplasia ; Thyroid Gland ; Thyroidectomy*

Saponin has been known to be a major antioxidant component in panax ginseng. Recent experimental study suggests that some antioxidant materials prevent Parkinson's disease caused by 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) in an animal model. The present study was performed to demonstrate the effect of ginseng saponins in the Parkinson's disease model induced by MPTP. To verify the effect of ginseng saponin on dopaminergic neurons in the mice brain, the tyrosine hydroxylase-immunoreactive (TH-ir) neurons were observed by immunohistochemical stain and immunoelectron microscopy (preembedding method). Also, in order to estimate the immunoreactivity of dopaminergic neuropils, they were quantified by image analysis. The number of TH-ir neurons of substantia nigra was significantly increased in the high-dose (0.46 mg/kg) ginseng saponin group compared with the MPTP injected group. The immunoreactivity of TH-ir neuropils in striatum was significantly increased in both high and low-dose (0.1 mg/kg) ginseng saponin groups compared with the MPTP injected group. In immunoelectron microscopic observation, TH-ir neurons of the control and both ginseng saponin injected group showed normal nuclei and well preserved cytoplasmic organelles. In the MPTP injected group, dying dopaminergic neurons showed destroyed nuclei and cytoplasmic organelles. These results suggest that ginseng saponin has a protective effect on the Parkinson's disease model induced by MPTP.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Brain ; Cytoplasm ; Dopaminergic Neurons* ; Mice* ; Microscopy, Immunoelectron ; Models, Animal ; Neurons ; Neuropil ; Organelles ; Panax* ; Parkinson Disease* ; Saponins* ; Substantia Nigra ; Tyrosine ; Tyrosine 3-Monooxygenase

BACKGROUND: Infracochlear approach indroduced by Ghorayeb et al. in 1988, was performed to reach the petrous apex with the canal wall-down procedure. Giddings et al. described the transcanal infracochlear approach preserving the posterior wall of the external auditory canal for treatment of the cholesterol granuloma in the petrous apex in 1991. OBJECTIVES: Surgical anatomy for the infracochlear approach to the petrous apex was reviewed in order to understand clinical applicability of this approach. MATERIALS AND METHODS: This study was performed using 20 human cadaveric temporal bones by the microscopic dissection. Measurements were obtained between different structures to find reliable angles and distances to guide working in the petrous apex region. RESULTS: The petrous apex was entered through the fenestra between the cochlea, carotid, and jugular bulb. The mean area of the fenestrae was 11.7+/-5.5mm2. The distance from the vertical segment of the facial nerve to the petrous apex was 25.3+/-2.4mm. The angle of the approach to the petrous apex was 37.3+/-5.1degrees to the axis of the internal auditory canal. CONCLUSION: The infracochlear approach could be used to obtain the route for a drainage procedure or a biopsy at the petrous apex without damaging hearing organs and major vessels. The canal-down procedure was needed to assess the petrous apex successfully.
Axis, Cervical Vertebra ; Biopsy ; Cadaver ; Cholesterol ; Cochlea ; Drainage ; Ear Canal ; Facial Nerve ; Granuloma ; Hearing ; Humans ; Temporal Bone

OBJECTIVES: To compare the diagnostic and prognostic performance of amniotic fluid white blood cell(AF WBC) count and amniotic fluid culture for the prenatal diagnosis of intrauterine infection and the prediction of neonatal outcomes in patients with preterm labor and intact membranes. Methods: Amniocentesis was performed in 75 patients with preterm labor and intact membranes, who delivered preterm neonates within 72 hours after amniocentesis. AF WBC was determined and amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasma. The relations among placental histologic findings, perinatal outcome, AF WBC count, and AF culture were examined. Student t test, Mann Whitney U test, lamda2 test, Fisher's exact test, modified t test, and logistic regression analysis were used for statistical analysis. RESULTS: Microbial invasion of the amniotic fluid was more frequent in the patients with histologic chorioamnionitis than patients without histologic chorioamnionitis (28.9% vs 5.4%, p<0.05), and patients with histologic chorioamnionitis had significantly higher amniotic fluid white blood cell counts than those patients without such lesion (median 99, range 0-3024 cells/mm3 vs median 1, range 0-180 cells/mm3, p<0.01). Amniotic fluid white blood cell count (> or = 50cell/mm3) had a sensitivity of 55.3%(21/38) and a specificity of 94.6%(35/37) for the diagnosis of histologic chorioamnionitis and a sensitivity of 47.5%(19/40) and specificity of 90.9%(30/33) for the prediction of significant neonatal morbidity (defined as neonatal sepsis, respiratory distress syndrome, pneumonia, intraventricular hemorrhage, bronchopulmonary dysplasia, or necrotizing enterocolitis). These sensitivities were significantly higher than those of amniotic fluid culture (for histologic chorioamnionitis, 55.3% vs 28.9% ; for significant neonatal morbidity, 47.5% vs 25.0%, p<0.01 for each). CONCLUSION: Amniotic fluid WBC count is a more sensitive test for the prenatal diagnosis of intrauterine infection and for the prediction of significant neonatal morbidity than amniotic fluid culture in the patients with preterm labor and intact membranes.
Amniocentesis ; Amniotic Fluid* ; Bacteria, Anaerobic ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infant, Newborn ; Leukocyte Count* ; Leukocytes* ; Logistic Models ; Membranes* ; Mycoplasma ; Obstetric Labor, Premature* ; Pneumonia ; Pregnancy ; Prenatal Diagnosis* ; Sensitivity and Specificity ; Sepsis

BACKGROUND AND OBJECTIVES: There are several factors affecting the result of the ossiculoplasty such as the severity of the pathology, the operating technique and the reconstruction material, etc. So far, most of the ossicular materials that have been developed were not perfect and some of the commercialized materials are not suitable for Koreans. We investigated the dimensions of the Korean ossicles and the space between the handle of the malleus and the plane of the stapes in order to standardize the artificial ossicles to fit Koreans. MATERIALS AND METHODS: Sixteen cadaveric Korean temporal bones which did not have any pathology of tympanic membrane and ossicles were used for this study. We dissected the temporal bones and measured the related dimensions of ossicles under a surgical microscope. RESULTS: The dimensions of the part of ossicles are as follows: (1) length (mm),1) malleus head 3.46+/-0.57, neck 0.91+/-0.17, handle 4.40+/-0.29: 2) incus short process 2.42+/-0.35, long process 3.31+/-0.57: 3) stapes head and neck 0.79+/-0.19, height of crura 2.24+/-0.34: (2) diameter (long, short) (mm), stapes head 0.95+/-0.20, 0.73+/-0.11, footplate 2.91+/-0.20, 1.38+/-0.16. The distance between the stapes head and the malleus handle was 3+/-0.3 mm, and between the stapes footplate and the malleus handle 5.1+/-0.4 mm. The angle between a line from the malleus handle to the head of stapes and a perpendicular line of stapes footplate passing the center of stapes head was 29+/-7 degree. The angle between a line from the malleus handle to the stapes footplate and a perpendicular line of stapes footplate passing the center of stapes head was 17+/-5 degree. CONCLUSION: We collected normal data of dimensions of the Korean ossicles from cadaveric temporal bones. The differences in the dimensions between ossicles of the Korean and the non-Koreans were observed. The observed data from this study should be useful in the development of the artificial ossicular materials suitable for the Koreans.
Cadaver ; Head ; Incus ; Malleus ; Neck ; Pathology ; Stapes ; Temporal Bone ; Tympanic Membrane

OBJECTIVES: Our purpose was 1) to determine whether elevated maternal serum alpha- fetoprotein(MSAFP) predict increased risk of spontaneous preterm delivery and indicated preterm delivery; 2) to determine whether elevated maternal serum human chorionic gonadotropin(MSHCG) predict increased risk of preterm delivery. Methods: Between September 1995 and April 1998, 945 of 2105 pregnant women who received midtrimester MSAFP screening were identified and evaluated. 81 women with MSAFP levels of 2.0 MoM or more were included in the study group while 864 women with levels less than 2.0 MoM served as controls. Pregnancy outcome were obtained from hospital records and statistical analysis were performed. RESULTS: Women with elevated MSAFP levels showed an increased risk for preterm delivery(p<0.05), fetal growth restriction(p<0.05) and hypertensive disorders(p<0.05), but not for preterm premature rupture of membrane, fetal death in utero. There was a strong association between unexplained elevated MSAFP levels and spontaneous preterm delivery(p<0.05) but our study does not support an association between unexplained elevated MSAFP levels and indicated preterm delivery. There was no association between elevated MSHCG levels and preterm delivery regardless of MSAFP levels. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP were associated with an elevated risk of spontaneous preterm delivery but not with a risk of indicated preterm delivery. Elevated MSHCG levels were not associated with a risk of preterm delivery and spontaneous preterm birth.
alpha-Fetoproteins* ; Chorion ; Extraembryonic Membranes ; Female ; Fetal Development ; Hospital Records ; Humans ; Mass Screening ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Premature Birth* ; Rupture

The treatment of moya moya disease, a chronic occlusive cerebrovascular disease of unknown etiology, isn't settled ut various operative methods to maximize cerebral revascularization have been reported. Two cases in children treated surgically are presented, one with cerebroarteriosynangiosis and the other with encephalo-duro-arterio-synangiosis(EDAS). The methods of cerebral revascularization are discussed in detail.
Cerebral Revascularization ; Child* ; Humans ; Moyamoya Disease*

Pulmonary lymphangitic carcinomatosis is a common secondary neoplasm of the lung that may result from hematogenous dissemination to small pulmonary arteries and arterioles followed by invasion of the interstitial space and lymphatics, or from the retrograde spread of tumors from mediastinal or hilar lymph nodes. Radiologically, irregular interlobular septal thickening, bronchovascular interstitial thickening and/or lymph node enlargement are observed. In this report, we describe an atypical radiological manifestation of lymphan-gitic metastasis of stomach cancer in a 37-year-old woman admitted for dyspnea on exertion and a cough which had been present for one month. HRCT scanning revealed bilateral multifocal ground glass opacity or consolidation, mild diffuse axial interstitial thickening, and slight pleural effusion. These findings were thought to indicate the existence of an air-space disease rather than metastasis. Open lung and endoscopic biopsy, however, demonstrated the presence of lymphangitic metastasis from stomach cancer.
Adult ; Arterioles ; Biopsy ; Carcinoma ; Cough ; Dyspnea ; Female ; Glass ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Pleural Effusion ; Pulmonary Artery ; Stomach Neoplasms

PURPOSE: We aim to identify what potential bias factors affected students' overall course evaluation, and to observe what factors should be considered in the curriculum evaluation system of medical schools. METHODS: This study analyzed students' ratings of preclinical instructions at the Ajou University School of Medicine. The ratings of instructions involved 41 first-year and 45 second-year medical students. RESULTS: There was a statistically significant difference between years of study and ratings' scoring. Learning difficulty, learning amount, student assessment, and teacher preparation from second-year students were significantly higher than first-year students (p<0.05). The analysis results revealed that student assessment was the predictor of ratings from first-year students, while teacher preparation was the predictor of ratings from second-year students. CONCLUSION: We found significant interactions between year of study and the students' rating results. We were able to confirm that satisfaction of instructions factors perceived by medical students were different for the characteristics of courses. Our results may be an important resource for evaluating preclinical curriculums.
Bias (Epidemiology)* ; Curriculum ; Humans ; Learning ; Schools, Medical ; Students, Medical