Acoustic stimulation test(AST), is currently being used as an alternative tool of nonstress test (NST). However, there are no standard guideline for analysis of AST. Computerized numerical analysis of AST would be helpful for development of diagnostic criteria of AST. Fifty-one normal pre-term pregnancies entered to this study after conventional 20-minutes NST and 10-minutes AST. Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. The loss of signal was increased about 2 fold(122.61%). The baseline FHR was increased from 144.57bpm to 156.81bpm(8.5%) after acoustic stimulation. Number of fetal movements was increased about 2 fold(from 2.1 to 4.12/10 minutes). FHR variability was also increased from 17.81 bpm to 26.37 bpm. After AST, number of FHR accelaration was increased 55.47%(10sec 10bpm) and 68.42%(15sec 15bpm), respectively. In this study, we acrumulated elemental FHR data using computerized system after AST. These data would be helpful in the accurate analysis of AST and also enable us to develop the objective interpretation system for AST.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

No abstract available.
Humans ; Male* ; Urethra*

PURPOSE: Phospholipase C (PLC) isozymes ply significant roles in transmembrane signal transduction. PLC-i 1 acts as the intracellular effector in signal transduction for cellular proliferation and differentiation. Ras oncoprotein is also involved in cell growth. We determined the biological significance of PLC and ras oncoprotein in regeneration following radiation and the effect of different modes of administration of 5-FU. MATERIALS AND METHODS: To determine the effect of the administration mode of 5-FU on the regeneration of intestinal mucosa of rats following radiation, we compared the expression of PLC and ras oncoprotein in six groups. Group I had no treatment. GroupII received radiation( 8 Gy) only. Group III received radiation(8 Gy) and 5-FU(150mg/kg) continuous intravenous (iv) infusion for 12 hours. Group iv bolus injection. Group V received only 5-FU(150mg/kg) iv bolus injection. Through immunoblotting and immunohistochemistry, we examined the expression of PLC and ras oncoprotein in rat jejunum at 96 hours after radiation or 5-FU administration and at 120 hours after radiation and 5-FU administration. We also investigated the histological findings using hematoxylin and eosin stain. RESULTS: In the immunohistochemistry study, PLC-i 1 expression was the highest in group III followed by groups II and VI in that order and was weakly positive in groups V and VI. PLC-i 1 was hardly detected in the control group. The expression of ras oncoprotein wss the same as the PLC-i 1 expression for all groups. These results were confirmed by the histological findings regarding the mucosal regeneration. In the immunoblotting analysis, PLC-i 1 expression was the highest in group III followed by group IV and II in that order. This difference between the immunoblotting and immunohistochemistry study was due to the high expression of PLC-i 1 on the damaged surface epithelium rather than to its expression in the regeneration region as observed in the immunohistochemistry study for group IV. The expression of PLC- 1 was positive only in group V and VI, which received both radiation and 5-FU, and the expression of PLC-b 1was negligible for all groups. CONCLUSION: These results suggest that PLC-i 1 mediated signal transduction and ras oncoprotein may have a significant role in mucosal regeneration after radiation, and that continuous iv infusion of 5-FU may induce active regeneration in intestinal mucosa following radiation. In addition, the expression of PLC- 1 in combined group of radiation and 5-FU implies that PLC- 1 may be involved in signal transduction mediated by concerted action between radiation and 5-FU.
Animals ; Cell Proliferation ; Eosine Yellowish-(YS) ; Epithelium ; Fluorouracil* ; Hematoxylin ; Immunoblotting ; Immunohistochemistry ; Intestinal Mucosa* ; Isoenzymes ; Jejunum ; Phospholipases* ; Rats* ; Regeneration* ; Signal Transduction ; Type C Phospholipases*

PURPOSE: To evaluate the clinical and radiological results of operative treatment for dorsal lip fracture of the base of the middle phalanx. MATERIALS AND METHODS: From 1992 to 2003 we experienced 9 cases of dorsal lip fracture of the middle phalangeal base that were treated surgically. Spinal needle fixation was used in cases with comminution. iniscrew fixation was performed in cases with a fragment larger than half of the articular surface. The pull-out technique was performed only in the cases with a fragment without comminution smaller than half of the articular surface. Bone union was evaluated using roentgenograms and clinical evaluations were done using Steel's scoring method. RESULTS: The average follow up after operation was 12.3 months. Cases showed union at an average of 7 weeks postoperatively. Two cases achieved excellent results, six cases good, and one case achieved a fair result; mean proximal interphalangeal joint flexion was 100 degrees (range 90-106). Extension deficit of 5 degrees was noted in 2 fingers. CONCLUSION: The pull-out technique, miniscrew fixation, and spinal needle fixation can produce a good clinical and radiological outcome in the treatment of dorsal lip fracture of the base of the middle phalanx.
Fingers ; Follow-Up Studies ; Joints ; Lip* ; Needles ; Research Design

The intrauterine fetal death(IUFD) is the death of the fetus prior to complete expulsion or extraction from its mother when the fetus is over 20 weeks gestation or weights more than 500 gm. This is a clinical study of 262 cases of IUFD and 262 control cases among 18542 deli-veries at Chung Goo Sung Sim Hospital during 10 years from 1987 to 1996. The results obtain-ed were as follows: 1. The incidence of IUFD was 1.41%. 2. The risk of IUFD was high in women older. 3. The risk of IUFD was high in women with parity of three or more, there was a previous history of IUFD in 11.2% of the IUFD cases and in 6.3% of the control cases, but there was no difference between the two groups of women in history of spontaneous abortion. 4. The sex ratio of male versus female was 1.24:1 in the IUFD cases, 1.11:1 in the control cases. 5. The low birth weight and preterm infants were much more frequent in the IUFD cases. 6. The mode of delivery IUFD was induced labor(77.5%), laparotomy(12.2%), spontaneo- us delivery(10.3%). The indications for laparotomy were placental abruption, placenta previa, transverse lie, previous cesarean section status, cephalopelvic disproportion and uterine rupture. 7. The most common cause of IUFD was unexplained causes(45.1%). 8. There were 67 cases(25.6%) of maternal complication, and the most common complica- tion was fever(35.8%). 9. In the incidence of abnormal coagulation test, the low platelet count(<100,000/mm3) was 8.0%, the prolonged prothrombin time(>14 seconds) was 7.2%, the prolonged partial thr- omboplastin time was 1.0%, the hypofibrinogenemia(<150mg/dl) was 7.2% and the elevated fibrinogen degradation products(>40 ug/ml) was 8.4%. 10. The risk of IUFD was lowered as the number of antenatal care was increased.
Abortion, Spontaneous ; Abruptio Placentae ; Blood Platelets ; Cephalopelvic Disproportion ; Cesarean Section ; Female ; Fetal Death* ; Fetus ; Fibrinogen ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Laparotomy ; Male ; Mothers ; Parity ; Placenta Previa ; Pregnancy ; Prothrombin ; Sex Ratio ; Uterine Rupture ; Weights and Measures

PURPOSE: To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. MATERIALS AND METHODS: Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by 99m TC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. RESULTS: SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). CONCLUSION: The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible.
Animals* ; Brain Infarction* ; Brain Injuries* ; Brain Ischemia ; Brain* ; Cats ; Infarction ; Ischemia ; Magnetic Resonance Imaging* ; Middle Cerebral Artery ; Models, Animal* ; Perfusion ; Reperfusion ; Tomography, Emission-Computed, Single-Photon

BACKGROUND AND OBJECTIVES: Parapharyngeal space tumors are extremely rare head and neck tumors. Therefore, there are just a few reports about them. The purpose of this study was to report our experiences of parapharyngeal space (PPS )tumors regarding clinicopathological features and management. SUBJECTS AND METHOD: This study included 51 patients with PPS tumors which were diagnosed from January 1990 through June 2004. Medical records were reviewed retrospectively. RESULTS: The male-to-female ratio was close to 1:1. The mean age was 47 years (6 mo -83 Y ). The most frequent presenting manifestation was asymptomatic neck mass. All patients were subjected to CT scan, while 31 patients underwent MRI in addition. Diagnostic accuracy of fine needle aspiration cytology of 28 cases matched with pathologic reports by 50%. Salivary gland neoplasms occupied the biggest parts (43.1%, 53.8%)of both benign and malignant PPS tumors. Thirteen patients (25.5%)had malignant lesions. Surgical excision was performed in 39 cases (76.5%). The transcervical (30.8%)and the transcervical-transparotid approaches (38.5%)were commonly performed surgical procedures. Overall postoperative morbidity rate was 23.1%. There were 3 recur-rences (42.8%)in malignant tumors and no recurrence in benign ones after surgical excision during the mean follow-up period of 35 months (13 -89 mo ). Close observation, sclerotherapy and radiotherapy were only applicable for a few selected benign lesions. CONCLUSION: Most benign PPS tumors could be removed surgically with low complication and recurrence rates. Optimal surgical approach based on transcervical approach allows safe removal of various types of PPS tumors.
Biopsy, Fine-Needle ; Follow-Up Studies ; Head ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Neck ; Neurilemmoma ; Paraganglioma ; Parotid Neoplasms ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salivary Gland Neoplasms ; Sclerotherapy ; Tomography, X-Ray Computed

OBJECTIVES: This study was undertaken to confirm the clinical characteristics of recurrent pleomorphic adenoma (RPA), and to identify those factors that affect the development of malignant transformation (MT) from RPA. METHODS: The medical records of 270 patients, who were operated upon for parotid PA, were retrospectively reviewed. The pathologic specimens of a selected series of 23 patients were reviewed for histologic subtype and microscopic multi-nodularity. RESULTS: Mean age of initial operation in RPA without MT (RPA(-MT)) group was significantly lower than that of primary PA group. Mean age of the revision operation in RPA with MT (RPA(+MT)) group was significantly greater than that of RPA(-MT) group. Mean interval from operation to recurrence shortened after each revision operation. The risk of MT and additional recurrence increased significantly with recurrence. In RPA(-MT) group tumor recurrence occurred in 21.4% of patients despite a clear resection margin. CONCLUSION: The risk factors for MT may be an age of over 45 yr and multiple recurrences. However, younger patients are more at risk of recurrence. A clear resection margin cannot guarantee a cure in RPA, and it seems that parotid pleomorphic adenomas slowly gain malignant characteristics after repeated recurrences.
Adenoma, Pleomorphic ; Humans ; Medical Records ; Recurrence ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVES: Regional recurrence of head and neck squamous cell carcinoma (HNSCC) is the most common single type of treatment failure, and thus a challenging problem for the clinician. When planning management of regional recurrence, the grave outcome of the recurrence itself, and benefits and morbidity owing to the intervention must be taken into account. We analyzed the factors affecting salvage treatment outcomes of regional recurrence in head & neck squamous cell carcinoma. SUBJECTS AND METHOD: A retrospective analysis of medical records over a 10 year period (1994-2003) was conducted. Sixty-two patients with regional and locoregional recurrence were identified. Patients with local recurrence or distant metastasis were excluded. RESULTS: The median age of the population was 62 years. Sixty percent of the cases were regional, and the remainders were locoregional recurrences. The median time of recurrence was 16 months with an overall survival rate of 46.1%. Recurrence in a surgically virginal neck was associated with a favorable outcome. Factors associated with poor outcomes were node positive at initial presentation, neck dissection at initial treatment, recurrence at contralateral neck, incorporation of chemotherapy for salvage treatment, and subsequent recurrence after salvage treatment. CONCLUSION: In the management of patients with regional recurrence of HNSCC, the factors mentioned above should be taken into consideration regarding patient selection, salvage management plan, and patient counseling.
Carcinoma, Squamous Cell* ; Counseling ; Drug Therapy ; Head and Neck Neoplasms ; Head* ; Humans ; Medical Records ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Patient Selection ; Recurrence* ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Treatment Outcome

BACKGROUND AND OBJECTIVES: The localization of parathyroid glands is a challenging problem to surgeons in parathyroidectomy. The purpose of this study was to introduce the intraoperative methylene blue infusion as a localization modality of parathyroid glands and to determine the usefulness of intraoperative methylene blue infusion for localization of parathyroid glands in secondary hyperparathyroidism. MATERIALS AND METHOD: Seven prospective cases of secondary hyperparathyroidism surgically treated from Sep. 2004 to Mar. 2006 were included in this study. In parathyroidectomy, intraoperative methylene blue infusion for localization of parathyroid glands was performed. RESULTS: In six cases of initial operation, four parathyroid glands were well stained and in a case of reoperation, three parathyroid glands were stained. After the surgery, all patients were well controlled in symptoms and calcium levels in blood serum, and 6 patients reached normal iPTH levels in serum. CONCLUSION: Intraoperative methylene blue infusion is an effective localization tool in parathyroidectomy for secondary hyperparathyroidism.
Calcium ; Humans ; Hyperparathyroidism, Secondary* ; Methylene Blue* ; Parathyroid Glands ; Parathyroidectomy* ; Reoperation ; Serum