Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild
Brain Edema* ; Brain Ischemia* ; Brain* ; Edema ; Ischemia ; Oxygen ; Perfusion ; Tissues

OBJECTIVE: We investigated the effect of preeclampsia, birth weight, fetal sex, maternal body mass index(BMI) on cord blood leptin concentrations. This study is to test whether leptin would be increased in preeclampsia and to test cord leptin concentrations for correlation with maternal leptin concentrations. METHOD: Maternal blood samples were obtained from 56 normal pregnancies and 24 preeclampsia women prior to delivery. Umbilical cord blood were obtained from the all cases studied immediately after delivery. The total leptin levels were determined by radioimmunoassay. RESULTS: Mean maternal leptin level was 16.4+/-6.4ng/ml in normal pregnancy and was 19.4+/-7.9 ng/ml in preeclampsia. Mean cord leptin level was 5.4+/- 3.4ng/ml in normal pregnancy and 4.6+/-3.2ng/ml in preecalmpsia. Mean cord blood leptin level in female fetus was 6.6+/-3.7ng/ml and 4.8+/-2.8ng/ml in male fetus. CONCLUSION: This study shows that there are correlation with leptin level and fetal birth weight, body mass index, and fetal gender. Furthermore, physiologic role and mechanism of leptin of maternal serum and umbilical cord would be studied.
Birth Weight ; Body Mass Index ; Female ; Fetal Blood ; Fetus ; Humans ; Leptin* ; Male ; Plasma* ; Pre-Eclampsia ; Pregnancy* ; Radioimmunoassay ; Umbilical Cord*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels* ; Echocardiography*

BACKGROUND: Pulmonary hypertension (PH) associated with end stage liver disease is rare but the risk of hemodynamic deterioration during liver transplantation may be high. This study was done to characterize the pulmonary hemodynamics during liver transplantation and to seek the relationship between pulmonary artery pressure (PAP) and other hemodynamic variables. METHODS: One hundred patients undergoing liver transplantation were chosen and we divided patients into normal and PH groups (mean pulmonary artery pressure [MPAP] > 25 mmHg). Hemodynamic data was collected throughout the surgery. Studied variables between groups were analyzed with an unpaired t-test. The relationship between MPAP and other hemodynamic variables was analyzed with a linear regression test. Survival analysis was performed by cumulative survival analysis (Logrank test). RESULTS: Incidence of PH during liver transplantation was 34%, and true PH (pulmonary vascular resistance index [PVRI] > 150 dyne.sec/cm5/m2, MPAP > 25 mmHg) was 7%. MPAP, systemic vascular resistance index, cardiac index, right ventricular ejection fraction, maximum elastance, central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP), and right ventricular end-diastolic volume index were significantly higher in the PH group. In the PH group, right ventricular function curve was abnormal. MPAP correlated significantly with PAOP, and CVP (P < 0.01). One year survival rate showed no significant difference between groups (Logrank test P = 0.49). CONCLUSIONS: Episodes of increased pulmonary artery pressure during liver transplantation was not infrequent. PAP was more dependent on preloads. In patients with high PAP, RV diastolic dysfunction was usually observed. Early mortality rate after liver transplantation was not associated with PH.
Central Venous Pressure ; End Stage Liver Disease ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Incidence ; Linear Models ; Liver Transplantation* ; Liver* ; Mortality ; Pulmonary Artery* ; Stroke Volume ; Survival Rate ; Vascular Resistance ; Ventricular Function, Right

A considerable body of evidence has been accumulated suggesting that invasive squamous cell carcinoma develops from cervical intraepithelial neoplasia(CIN). Most women with invasive cancer of the cervix are from lower socioeconomic groups, have begun heterosexual activity early in life, marry early, are multiparous, and have many sexual partners. Although the epidemiology of the cervical cancer is known well, the pathogenesis of the cervical cancer from CIN is subtle yet. Apoptosis, including the programmed cell death, is important event in normal cell turnover and maintenance of adult tissues. Apoptosis exerts a homeostatic function in relation to tissues dynamics, as the steady state of continuously renewing tissues achieved by a balance between cell replication and cell death. The specific labelling of nick ends of fragmented DNA was used to see the apoptotic cells from normal epithelium of the cervix to invasive cervical cancer. The apoptotic cells were found normally in the parabasal layer of the epithelium. As the grade of CIN increase, the apoptotic cell were found in superficial of the cervix and number of the apoptotic cell were increased. In the cervical cancer, the apoptotic cell were found in the cancerous tissues more than in the normal epithelium. This results suggest that the cell proliferation is more important than the inhibition of the apoptosis in the carcinogenesis of the cervical cancer.
Adult ; Apoptosis* ; Carcinogenesis* ; Carcinoma, Squamous Cell ; Cell Death ; Cell Proliferation ; Cervix Uteri ; DNA ; Epidemiology ; Epithelium ; Female ; Heterosexuality ; Humans ; Sexual Partners ; Uterine Cervical Neoplasms*

We report a case of prenatal diagnosis of fetal congenital goiter at 31weeks of gestation by ultrasonogram and fetal hypothyroidism confirmed at birth as thyroid function test by umbilical cord blood sampling. Maternal Graves' disease and the drugs used to treat hyperthyroidism in pregnant women can affect the fetus, causing hyperthyroidism or hypothyroidism and goiter. Fetal hypothyroidism may be caused by transplacental passage of either maternal thyrotropic-binding inhibitory immunoglobulin(TBII) antibodies or maternal treatment with propylthiouracil(PTU). Untreated fetal hypothyroidism may result in mental retardation, perceptual-motor, visual-spatial, and language developmental problems. In this article fetal thyroid function was not assessed by cordocentesis, but fetal congenital goiter was detected ultrasound. Ultrasound should be used to detect fetal goiter from 20 weeks onward. Fetal goiter should resolve when maternal PTU treatment is decreased. We have diagnosed fetal hypothyroidism in utero by ultrasonography. Significance of in utero management of fetal hypothyroidism is discussed.
Antibodies ; Congenital Hypothyroidism ; Cordocentesis ; Female ; Fetal Blood ; Fetus ; Goiter* ; Graves Disease ; Humans ; Hyperthyroidism* ; Hypothyroidism ; Intellectual Disability ; Language Development ; Mothers* ; Parturition ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography

The operative treatment of intraarticular calcaneal fractures has three principal aims; restoration of the height and width of the calcaneus, reconstruction of the subtalar and calcaneocuboid joint surfaces, and stable osteosynthesis. The purpose of this study is to demonstrate the effectiveness of the open reduction and internal fixation by the extended lateral approach for the treatment of the intraarticular calcaneal fractures. Twenty-one calcaneal fractures of 20 patients were treated by open reduction and internal fixation using an extended lateral approach from April, 1993 to March, 1994. The autogenous iliac bone graft was done in all patients. These patients were evaluated from 12 to 24 months (average 15.2 months) after surgery. The following results were obtained; 1. Seventecn cases (80%) out of 21 were estimated as good or excellent result. 2. Preoperative Bohler's angles, Gissane's angles and inclination angles were observed as average -0.5degrees, 101degrees and 38degrees respectively, and these were improved as average 23.3degrees, 117degrees and 54degrees, postoperatively. 3. There were two cases of skin necrosis as complication. In conclusion, the extended lateral approach is one of the good methods for the treatment of intraarticular calcaneal fractures. We think that accurate reduction of the posterior facet, acceptable recovery of Bohler's angle and early postoperative mobilization are the most important things for the best result of the intraarticular calcaneal fracture surgery.
Calcaneus ; Humans ; Intra-Articular Fractures ; Joints ; Necrosis ; Skin ; Transplants

Sacral perineural cyst is one group of extradural meningeal cyst at the sacral region. These lesions are distinguished from other spinal cysts because perineural cyst does not communicate with subarachnoidal space. Fluid filled cysts may compress adjacent nerve roots causing low back pain and sciatica which are dramatically improved by surgical excision. Differential diagnosis from other cysts can be accomplished by failure of collection of dye into cyst by initial myelography. C-T myelography rules out other mass lesions and often reveals communication of perineural cyst that filled with contrast medium. Magnetic resonance imaging well demonstrates three dimensinnal configures of an intraspinal cystic mass in initial study. However it is important to recognize that these cysts are one of causes of radiculopathy. We report three cases of sacral perineural cysts with radiculopathy.
Diagnosis, Differential ; Low Back Pain ; Magnetic Resonance Imaging ; Myelography ; Radiculopathy ; Sacrococcygeal Region ; Sciatica ; Tarlov Cysts*

PURPOSE: To analyze the diurnal change in intraocular pressure (IOP) and corneal biomechanical properties measured using the Ocular Response Analyzer (ORA; Reichert Inc., Depew, NY, USA) in Korean patients with normal tension glaucoma (NTG) patients. METHODS: Intraocular pressure (Goldmann applanation tonometer IOP [GAT IOP], Goldmann-correlated IOP [IOPg], corneal-compensated IOP [IOPcc]) and corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) were measured in 21 eye of NTG patients (12 males, 9 female) at 3 hour intervals for 48 hours using ORA. We recorded the time of each parameter that showed the lowest and the highest values of during the 48 hour testing period (Day 1 and Day 2) and evaluated the change of diurnal variation using Repeated measures analysis of variance (Re-ANOVA). RESULTS: Peak IOP measured with GAT and ORA occurred at 6 AM-9 AM, 3 PM-6 PM and the trough IOP at 9 PM-12 AM during the 48 hour period. CCT, GAT IOP, IOPcc and IOPg measurements showed statistically significant variations (p<0.05). CH and CRF variations were not statistically significant (p>0.05). CONCLUSIONS: In Korean NTG patients, IOP exhibits significant diurnal variation, with higher values during the dawn and afternoon and lower values before retiring. Clinically, measurements of IOP performed in the afternoon could aid in the detection of relatively elevated IOP.
Humans ; Intraocular Pressure* ; Low Tension Glaucoma* ; Male

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult