A universal ultrasound diagnostic system developed to support urology and coloproctological applications

In this study, we sought to describe a novel imaging apparatus that is lightweight, inexpensive, and highly eff ective for use in colorectal diagnostic and treatment settings. Typical probes for use in colorectal ultrasonic imaging applications are developed for surgeons to diagnose and stage rectal tumors and image the rectum and anus. Here we outline a new technique and use it for colorectal imaging in an animal. This technique involves use of an ultrasound array module positioned along the axis of rotation such that improved rotation is possible. This module is in the shape of a linear rod with a rotary linear component that allows for emission of focused ultrasonic echo signals from a linear section of the probe. The usability of the transducer and rectal image quality are satisfactory in a porcine model with the technique proposed here, axial/lateral resolution as 0.96/2.24 mm with 6 dB applied through the contour map using the point spread function. When compared to currently available methods, this technique provides superior diagnostic 3D volumetric image quality with reduced acquisition time. Given this, the ultrasound device proposed here may prove a viable and preferable method to those currently available for urology and colorectal imaging applications.

The Outcome of Pregnancy Combined with Idiopathic Thrombocytopenia Purpura and the Effect of Pregnancy on the Severity of This Disease / 대한주산의학회잡지

OBJECTIVE: The incidence of idiopathic thrombocytopenic purpura (ITP) is greatest in female during their childbearing years, so the concurrence of pregnancy and ITP is not unusual. Numerous studies have examined the outcomes of newborns, whereas fewer studies have been conducted with regard to the morbidity of obstetric patients with ITP. This study was aimed to find the outcome of pregnancy combined with ITP and the influence of the pregnancy on the severity of this disease. METHODS: From January 1996 to December 2005, a total of 62 pregnant women with ITP and their 73 deliveries were recruited for the study. Among them, 38 were diagnosed with ITP during pregnancy and the other 24 had pre-existing ITP before pregnancy. RESULTS: The severity of thrombocytopenia was exacerbated during pregnancy, but recovered to a level of non-pregnant period after delivery in most cases. The outcome of pregnancy of all the patients was uneventful except each one case of fetal demise at 35 gestational weeks and preterm delivery at 30 gestational weeks. One patient suffered from multiple subdural hemorrhage during pregnancy, which was spontaneouly recovered. Twenty newborns (27.8%) had transient congenital thrombocytopenia and 18 of them required treatment for hemostatic impairment. CONCLUSION: For women with ITP, Pregnancy can affect the severity of ITP, but life-threatening complication was almost lacking. Although, in not a few cases, there may need to treat both mothers and infants to raise their platelet counts, most mothers with ITP can proceed with their pregnancies and delivery healthy infant without complication.

Differential diagnosis of Thrombocytopenia newly developed during pregnancy / 대한산부인과학회지

OBJECTIVE: Gestational thrombocytopenia has a mild course as a common problem during pregnancy, whereas idiopathic thrombocytopenic purpura (ITP) presents with a chronic or moderate to severe course. Very few studies have been conducted so far to discriminate between the two diseases. This study was aimed to identify factors predictive of the subsequent development of ITP among pregnant women presenting with thrombocytopenia. METHODS: From January 1999 to June 2005, a total of 58 pregnant women newly diagnosed with thrombocytopenia were recruited for the study. Among them, 33 were finally diagnosed with gestational thrombocytopenia and the other 25 with ITP. The clinical factors for each of ITP and neonatal thrombocytopenia were evaluated, and final outcomes were also described. RESULTS: On multivariate analysis, thrombocytopenia diagnosed before 28 completed weeks and platelet count of less then 50 x 10(9)/L at the time of its presentation were found to be independently predictive of ITP (p<0.001 and p=0.004 respectively). In addition, platelet count of less then 20 x 10(9)/L at nadir during pregnancy was a significant risk factor for neonatal thrombocytopenia (p=0.013). CONCLUSION: The onset time of thrombocytopenia and platelet count at its presentation remain useful parameters to discriminate ITP from gestational thrombocytopenia. These findings may help in allowing an appropriate antenatal care and postpartum follow up.

The length of active labor in women with vaginal birth after cesarean section compared with nulliparas and multiparas / 대한산부인과학회지

OBJECTIVE: Despite the general information of vaginal birth after cesarean section (VBAC), little is known about the duration of active labor in women attempting VBAC. The aim of this study was to compare the time length of active labor in women attempting VBAC compared with nulliparas or multiparas, and then, provide further insight for better management of labor. METHODS: From January 1999 to December 2003, a total of 444 patients with VBAC were entered into the study. Women with two or more history of caesarean section or previous vaginal delivery were all excluded from the study. Time length of active labor in these patients was compared with 335 nulliparas and 218 multiparas consecutively visiting our unit for delivery in 2003. RESULTS: For patients with VBAC, the duration of active and second phase were 184.8+/-115.7, and 25.1+/-15.2 minutes, which was significantly shorter than nulliparas (p<0.05), but longer than multiparas (p<0.05). To eliminate confounding factors affecting the duration, 374 women without use of vacuum, oxytocin, or epidural anesthesia were selected for analysis. Consistently, the time length of active and second phase in women with VBAC was significantly shorter than in nulliparas, but longer than in multiparas (p<0.001) except for active phase compared with nulliparas (p=0.295). CONCLUSION: With regard to the time length of active labor, women attempting VBAC were in the intermediate group when compared with nulliparas or multiparas. Understanding of this unique time interval in women attempting VBAC may help in allowing an appropriate management for labor process.

Midtrimester Amniotic Fluid Levels and Each Ratio of Activn A, Inhibin A and B in Down's Syndrome and Other Complicated Pregnancies / 대한산부인과학회잡지

OBJECTIVE: To evaluate the amniotic fluid levels and each ratio of activin A, inhin A and B in Down's syndrome and other complicated pregnancies. METHODS: This study was performed in 71 women who had undergone a midtrimester amniocentesis with the clinical indications and whose pregnancy outcome was retrospectively determined. Ten Down's syndrome, 15 complicated pregnancies including, preeclamsia, gestational diabetesis mellitus, preterm labor, intrauterine growth restriction (IUGR), and 46 noncomplicated pregnancies with normal chromosome were included in this study. Amniotic fluid activin A, inhibin A and B were measured using enzyme linked immunosorbent assays (ELISA). Statistical analysis was performed with Mann-Whitney U test and regression analysis. RESULTS: There were significant positive correlation (r=0.277, p=0.011) between the ratio activin A/ inhibin B level and maternal age and significant positive correlation (r=0.261, p=0.015) between maternal age and the ratio inhibin A/inhibin B level. There were also significant positive correlation (r=0.202, p=0.045) between gestational weeks and inhibin A levels and significant positive correlation (r=0.474, p<0.001) between gestational weeks and inhibin B levels. Amniotic fluid inhibin A and inhibin B levels were significantly (p<0.05) decreased in Down's syndrome compared with the normal chromosomal groups but there was no difference in the ratio activin A/inhibin A and in the ratio activin A/inhibin B between these groups. The amniotic fluid levels of activin A, inhibins (A and B), each ratio of complicated pregnancies groups with normal chromosome was not significantly different from those of uncomplicated pregnancies with normal chromosome. CONCLUSION: This study revealed that amniotic inhibin levels were significantly decreased in Down's syndrome. But, activin A and each ratio were unchanged. The results suggest that activin A may be relatively decreased in each case of Down's syndrome.

Expression of alpha-smooth muscle actin and collagenIV in villous stroma of placental terminal villi and congestion fetal capillary in growth restricted pregnancies with severe preeclampsia / 대한산부인과학회잡지

OBJECTIVE: Preeclampsia is the major cause of prenatal mortality and morbidity. The functional disorder of uteroplacental insufficiecy is caused by the impaired uteroplacental blood flow and diffusion barrier in the villi. Functional disorders like placental circulating disorders results in morphological changes of terminal. villi as functional unit of placenta. We studied to investigate the differences in villous stoma of placental terminal villi and fetal capillary between growth restricted pregnancies with severe preeclampsia and normal preterm pregnancies. METHOD: Terminal villi was examined using light microscopy and by immunohistochemical localization of matrix molecule (alpha-smooth muscle actin and collagenIV) and the immunoreactivity of alpha-smooth muscle actin and collagenIV were evaluated in 17 cases of severe preeclampsia with intrauterine growth restriction as a study group and in 17 cases of gestational age matched normotensive preterm pregnancies as a control group. Fetal capillary congestion in terminal villi was also evaluated by Hematoxylin-Eosin staining. The patterns of immunohistochemical staining were all determinated in a visual qualitative manner (0-25%: -, 25-50%: +, 50-75%: ++, 75-100%: +++) by one pathologist. Congestion was considered to be present in a failed where the majority (>90%) of the capillaries demonstrated densely packed erythrocyte. RESULT: Expression of alpha-smooth muscle actin in the terminal villous stroma was significantly increased in study group compared with control group (P=0.0001). Expression of collagen IV in the terminal villous stroma was significantly increased in study group compared with control group (P=0.0001). Fetal capillary congestion was also significantly increased in study group compared with control group (P=0.049). CONCLUSION: The result suggests that there be the structural or biochemical difference in the villous stroma between normotensive preterm pregnancies and severe preeclampsia with intrauterine growth restriction and that the extravascular contractile system might be in the villous stroma in the severe preeclampsia intrauterine growth restriction.

Effects of Prostaglandins and Oxytocin on the Contractility of Isolated Detrusor Muscle strips in Rabbit / 대한비뇨기과학회지

The effects of prostaglandins and oxytocin on the contractility of detrusor muscle was investigated in the isolated detrusor muscle strips of rabbit. Contractility was measured on the Physiograph with force transducer by means of Magnus method in the Locke`s solution. The results were summarized as follows. 1. Prostaglandin E, and F2a enhanced the contractility of detrusor muscle and that was more potent in prostaglandin E2. 2. Indomethacin reduced the contractility of detrusor muscle. 3. The effects of prostaglandin E2 and F2a on the contractility of detrusor muscle was not blocked by indomethacin and atropine. 4. Oxytocin enhanced the contractility of detrusor muscle significantly and the patterns of enhancement was similar that of the prostaglandins. 5. Progesterone reduced the contractility but the estrogen didn`t affect the contractility of detrusor muscle. 6. The effect of oxytocin on the contractility of detrusor muscle was not affected by progesterone estrogen and also was not blocked by indomethacin and atropine. From the above results, it was suggested that oxytocin enhance not only the contractility of detrusor muscle but also its action was similar that of prostaglandins.

A Case of Paratesticular Embryonal Rhabdomyosarcoma / 대한비뇨기과학회지

Rhabdomyosarcoma is the most frequent cancer involving the bladder, prostate, vagina and paratesticular tissues in children, and is highly malignant neoplasm with a tendency toward early infiltration of adjacent structures and metastases to regional lymph nodes and distant organs. We report a case of paratesticular embryonal rhabdomyosarcoma developed in 20-year-old male with brief review of literatures.

A Case of Sparganosis Infesting in the Epididymis / 대한비뇨기과학회지

Sparganosis is a parasitic infestation caused by sparganum of several species of tapeworm related to Diphyllobothrium latum. We experienced a 28 year old man who was suffered from adult thumb-tip sized mass on the tail of right epididymis. From the mass during epididymectomy, whitish yellow colored sparganum measuring about 7cm in length, 0.3cm in width, 0.2cm in thickness could be extracted. So we reported this case with a brief review of the literatures.