Our purpose was to evaluate the clinical significance of large (>5cm) placental chorioangioma. Obstetrical and neonatal records which were confirmed chorioangioma in pathology and greater than 5 cm in diameter, were reviewed retrospectively from April. 1, 1991, to March. 31, 1996. 11 cases of placental chorioangioma greater than 5 cm were diagnosed prenatally by ultrasonography except one. I'hey were associated with maternal or fetal complications-6 cases of polyhydramnios, 2 cases of PIH, 1 case of neonatal anemia, 2 cases of preterm birth, 2 cases of neonatal hyperbilirubinemia, 1 case of cardiomegaly, 1 case of IUGR and 1 case of oligohydramnios. Nevertheless, there were not remarkable neonatal morbidity and mortality. These uncommon large tumors were often associated with maternal or fetal complications. But, we could get good neonatal outcome through thorough antenatal surveillance.
Anemia, Neonatal ; Cardiomegaly ; Female ; Fetal Growth Retardation ; Hemangioma* ; Hyperbilirubinemia, Neonatal ; Infant, Newborn ; Mortality ; Oligohydramnios ; Pathology ; Polyhydramnios ; Pregnancy ; Premature Birth ; Retrospective Studies ; Ultrasonography

BACKGROUND: It is known that immunotherapy promotes the development of allergen-specific Thl-like lymphocytes whose products are effective in inhibiting clinical response of sensitized atopic patients to allergen exposure. At the single cell level in short term culture, however, IL-4 and IL-5 are co-expressed, while IL-4 and IFN-y are exclusively expressed. OBJECTIVE: IL-4, IL-5, and IFN-y mRNA were measured in Der pI-specific T-cell clones (TCCs) to evaluate whether expression of cytokine in allergen-specific TCC is fixed regardless of stimuli. METHOD: Seven Der pI-specific TCCs were made from two asthmatics sensitive to D. pteronyssinus. IL-4, IL-5, and IFN-y mRNA were measured by RT-PCR in these TCCs after antigen-specific (Der pI) and nonspecific (PHA + TPA) stimuli. RESULTS: IL-4 and IL-5 mRNA were expressed in four and six of seven TCCs, but IFN-y mRNA was not expressed in any TCCs after Der pI-specific stimuli. Meanwhile, after the stimulus of TPA plus PHA, IFN-y mRNA as well as IL-4 and IL-5 mRNA were expressed in four of seven TCCs, and in one TCC, only IFN-y mRNA was expressed without expression of IL-4 mRNA. CONCLUSION: The expression of cytokine may be variable in allergen-specific TCC according to the type and amount of stimuli.
Asthma ; Clone Cells* ; Humans ; Immunotherapy ; Interleukin-4* ; Interleukin-5* ; Lymphocytes ; RNA, Messenger* ; T-Lymphocytes*

This study was designed to examine the influences of antioxidants on toxicity of paraquat in male rats. Paraquat and ascorbic acid were given orally ad libitum with tap water containing paraquat 30 ppm and 100 ppm and ascorbic acid 1000ppm for 10 days, respectively, alpha-tocopherol(60 mg/kg) was administered orally by sonde at 2 days intervals for 10 days. Paraquat at given doses produced markedly a dose-related reduction in water-intake, ratio of liver weight/body weight and glutathione along with the increased aspartate aminotransferase, alkaline phosphatase, serum lipid and ratio of lung weight/body weight. However the combined administration of ascorbic acid and paraquat did not affect the toxic effects of paraquat, whereas combined administration of paraquat and alpha-tocopherol showed relative reduction in the toxicities of paraquat. From these experimental results, it could be concluded that alpha-tocopherol has detoxifying effect on paraquat poisoning as the antioxidant, meanwhile ascorbic acid, one of the antioxidance, does not exert any detoxifying effects.
Alkaline Phosphatase ; alpha-Tocopherol ; Animals ; Antioxidants ; Ascorbic Acid ; Aspartate Aminotransferases ; Glutathione ; Humans ; Liver ; Lung ; Male ; Paraquat* ; Poisoning ; Rats* ; Water

BACKGROUND: Skin incision has been used as a standard stimulus in most concentration versus response relationship studies for anesthetics. However, skin incision is not the most intense stimulation and inconvenient method during operation. Mean arterial blood pressure, but not heart rate, is convenient and predicts surgical stress as well as propofol blood concentration. We evaluated the effects of different fentanyl concentration on propofol-fentanyl-N20 anesthesia using mean arterial blood pressure as an indicator of surgical stress during operation. METHODS: Eighty ASA I or II patients (age: 20~55 yrs) scheduled for spine fusion were randomly allocated to four groups according to expected fentanyl blood concentration (Group 1, 2, 3, 4: 0, 1.5, 3.0, 4.5 ng/ml respectively, n=20 for each group). Fentanyl was infused according to isoconcentration nomogram, and propofol infusion rate was titrated by changes of mean arterial blood pressure (0~12 mg/kg/hr). Fifteen minutes before expected end of surgery, propofol and fentanyl infusion were discontinued. Thereafter IV-PCA using fentanyl was applied for postoperative pain relief. Average propofol flow rate, recovery of orientation, verbal rating scale were cheked. RESULTS: Group 2, 3, 4 showed decreased average propofol flow rate, delayed recovery and decreased postoperative 24 hr fentanyl requirement for pain relief gradually compared with group 1. Group 4 showed ceiling effect in terms of average propofol flow rate, recovery of orientation and 24 hr fentanyl requirement for postoprerative pain relief compared with group 1~3. CONCLUSIONS: Keep the fentanyl concentration below 3.0~4.5 ng/ml and titrate propofol flow rate was reasonable method for adequate control of drug infusion during a propofol-fentanyl-N20 anesthesia.
Anesthesia* ; Anesthetics ; Arterial Pressure ; Fentanyl* ; Heart Rate ; Humans ; Nomograms ; Pain, Postoperative* ; Propofol ; Skin ; Spine

PURPOSE: We wanted to evaluate the accuracy of the alignment of the lower extremity in 661 cases of total knee arthroplasty (TKA) with using a navigation system. MATERIALS AND METHODS: We evaluated 661 cases (431 patients) that underwent TKA using a navigation system from June 2006 to September 2008. To analyze the mechanical axis, the weight bearing full length lower extremity radiographs were taken preoperatively and the again at3 weeks after the operation. The results from a well- experienced surgeon (423 cases) were compared with those from a less-experienced surgeon (238 cases), and they both used the navigation system. RESULTS: The mean of the mechanical axis was -13.3degrees (range: -33.3degrees-10.6degrees) preoperatively, but it was corrected to -2.0degrees (range: -14.3degrees-7.5degrees) after TKA using a navigation system. There was no significant difference between the mean of, -1.8degrees (range: -13.4degrees-6.8degrees) by a well-experienced surgeon and the mean of, -2.2degrees (range: -14.3degrees-7.5degrees) by a less-experienced one. CONCLUSION: According to the radiologic results, the navigation system is beneficial for the accuracy of the mechanical axis in TKA. The navigation system helps a less-experienced surgeon increase the accuracy of the lower extremity alignment.
Arthroplasty ; Axis, Cervical Vertebra ; Knee ; Lower Extremity ; Statistics as Topic ; Weight-Bearing

PURPOSE: We wanted to evaluate the mechanical strength of proximal tibia as resection distance increased from the joint surface. MATERIALS AND METHODS: We obtained the CT images of twenty knee osteoarthritis patients undergoing total knee arthroplasty. The finite element models were created based on the computed tomography images. The 8-node hexahedron element was made from BIONIX(TM) (CANTIBio. Co, Suwon, Korea), which is automatic mesh generation software program. The finite element model of the proximal tibia was resected at 6 mm, 8 mm, 10 mm, 12 mm, 15 mm and 18 mm from the lateral joint surface. A 1% strain rate was applied to a model by using HyperMesh(TM) software (Altair Engineering. Inc, Seattle, USA). The ultimate stress was calculated from the finite element analysis with using ANSYS 9.0 (ANSYS. Inc, Orlando, USA). RESULTS: The mean ultimate stress was 906.84 MPa, 877.22 MPa, 895.93 Mpa, 852.70 MPa, 742.90 Mpa and 585.51 Mpa at the 6 mm, 8 mm, 10 mm, 12 mm, 15 mm and 18 mm resection levels. As compare to the 6 mm resection level, the bone strengths at 15 mm and 18 mm were decreased with statistical significance (15 mm: p=0.005, 18 mm: p=0.000). CONCLUSION: The ultimate stress was decreased as the resection distance increased from the joint surface. But within a 12 mm resection distance from the lateral condyle articular surface of the tibia, the ultimate stress was not significantly decreased (p>0.05).
Arthroplasty ; Finite Element Analysis ; Humans ; Joints ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Sprains and Strains ; Tibia

OBJECTIVE: To evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT). MATERIALS AND METHODS: CT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth (< or = 1 or > 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium. RESULTS: Of the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was 16.4 +/- 8.6 mm. The mean length and depth of a tunneled segment for deep MB were 27.6 +/- 12.8 mm and 3.0 +/- 1.4 mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%. CONCLUSION: The depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type.
Contrast Media/diagnostic use ; Coronary Angiography/*methods ; Electrocardiography ; Female ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Male ; Middle Aged ; Myocardial Bridging/*radiography ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

BACKGROUND: Target Controlled Infusion (TCI) is designed to achieve a predicted target blood concentration based on population pharmacokinetics and it provides the closest approximation for any individual patients. This study determined which target is appropriate for propofol induction using a TCI in korean adullt patients premedicated with midazolam. METHODS: Sixty six patients (ASA I or II, 18~55 years) premedicated with midazolam were allocated randomly to receive an infusion to achieve and maintain a target blood concentration of 3, 4, 5 and 6 microgram/ml using a TCI. Induction time was measured as the interval from the start of the infusion to loss of verbal contact and induction within 3 min was considered as successful. Calculated concentration, induction dose, context sensitive decrement time, vital signs, pain score and side effects were checked and compared each other during induction period. RESULTS: The success rate when the target was 3 microgram/ml was 25%, 58.8%, 77.8% and 100% when targets were 4 microgram/ml, 5 microgram/ml and 6 microgram/ml respectively. EC50 for induction was 3.87 microgram/ml and EC95 was 5.71 microgram/ml. Calculated concentration, induction dose, context sensitive decrement time in 3, 4, 5 microgram/ml group showed no differences among groups, but 6 microgram/ml group showed statistically significant differences compared with other groups. Vital signs, pain score and side effects showed no differences among groups. CONCLUSIONS: Target concentration of 5~6 microgram/ml would successfully induce anesthesia in the majority of patients premedicated with midazolam without major hemodynamic changes.
Anesthesia* ; Hemodynamics ; Humans ; Midazolam ; Pharmacokinetics ; Propofol* ; Vital Signs

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Consolidation Chemotherapy ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Paclitaxel ; Survival Rate

PURPOSE: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation. MATERIALS AND METHODS: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy). RESULTS: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively. CONCLUSION: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Consolidation Chemotherapy ; Follow-Up Studies ; Humans ; Joints ; Multivariate Analysis ; Paclitaxel ; Survival Rate