Massive subchorionic hematoma (Breus' mole) complicated by intrauterine growth retardation.

We present here a case of massive subchorionic hematoma complicated by intrauterine growth retardation and oligohydramnios diagnosed at 22 weeks' gestation. The patient was managed with the following medications: (1) tocolysis with ritodrine infusion, (2) 10%maltose infusion therapy (1500mL/day), (3) antibiotic infusion (cefotaxim sodium, 2 g/dayx7) and (4) kampo therapy with Sairei-to until delivery. At 33 weeks and 0 days' gestation, a female baby weighing 1,342 g was delivered without complication by caesarean section. During surgery, an escape of about 500~600 g of dark brown blood with no clots was noted from the subchorionic space of the placenta. Examination of the placenta showed a large fibrosis with well-defined margins on the fetal surface.

Mechanical contraction property of the levator veli palatini muscle.

Twenty adult dogs anesthetized with sodium pentobarbital were used as experimental animals in an analysis of the mechanical contraction properties of the levator veli palatini muscle. The following results were obtained: the contraction time and half relaxation time of maximal isometric twitch of the muscle were revealed to be 43 msec and 33 msec, respectively; a summation curve was obtained with stimulation at 15 Hz and maximal tetanic tension was at 70 Hz. The average of the tetanic tension ratio was found to be 5.7. The maximum rate of tension rise was observed at 150 Hz, and the value was twice the rate of the twitch contraction. The duration time of the active state plateau showed values of 3.9 to 4.5 msec. The contraction time of the levator veli palatini muscle closely resembles that of the intrinsic laryngeal and the orbicularis oris muscle.

Coordination of the levator veli palatini and intrinsic laryngeal muscles: an evoked electromyographic study in the dog.

Fourteen dogs anesthetized with sodium pentobarbital were used as experimental animals in an electromyographic study of the functional relationships among the levator veli palatini and the intrinsic laryngeal muscles. The following results were obtained: A single pulse stimulation to the afferent fibers of the pharyngeal branches of the glossopharyngeal nerve evoked ipsilateral reflexes from the levator veli palatini and laryngeal adductor muscles. The laryngeal abductor muscle, however, did not respond to this stimulation. A repetitive pulse stimulation (3-5 Hz) to the afferent fibers of the pharyngeal branches of the glossopharyngeal nerve decreased the level of amplitude of the respiratory discharge from the laryngeal abductor muscle. The reflex discharges in the levator veli palatini muscle were decreased when the respiratory discharges in the laryngeal abductor muscle were enhanced. The present study indicates that there are relationships between the palatal and glottal movements and that the coordinate actions in these regions are influenced by two types of relationships among the palatal and laryngeal muscles. One is the relationship between the levator veli palatini and laryngeal adductor muscles, and the other is that between the levator veli palatini and laryngeal abductor muscle.

Quiet MRI with novel acoustic noise reduction.

Fast scan techniques, which are used to reduce scanning times, have raised scanning noise levels in magnetic resonance imaging (MRI) systems, resulting in greater patient discomfort and stress. It is well known that this noise is caused by vibration of the gradient coil due to the Lorentz forces generated by the current in the gradient coil, which is placed in a static magnetic field. We have confirmed that MRI noise can be substantially reduced by sealing the gradient coil in a vacuum chamber to block airborne vibration propagation, by supporting the gradient coil independently to block solid vibration propagation and by decreasing the eddy currents induced in RF coils, the RF shield and the static-field-magnet cryostat. Based on these findings, we have developed a silent MRI system in which scanning noise is markedly reduced under a wide range of scanning conditions.

The course of facial nerve innervation for the levator veli palatini muscle.

The present study was designed to determine the motor nerve pathway of the facial nerve to the levator veli palatini muscle. The experiments were carried out on 10 anesthetized rhesus monkeys. Recorded and analyzed were evoked EMG responses of the levator veli palatini and the orbicularis oris muscles by electrical stimulation to both the facial nerve and its branch within the cranium. Muscle action potentials (M-waves) from the two muscles could be recognized on stimulating the facial nerve at the petrosal area of the temporal bone. On stimulating the greater petrosal nerve, M-waves from the levator muscle could be elicited. By cutting off the greater petrosal nerve at the middle cranial fossa, M-waves from the levator muscle completely disappeared on stimulating the facial nerve at the petrosal area. Results indicated that the course of the facial nerve for the levator veli palatini muscle is through the greater petrosal nerve.

[Radial flap: a valuable fasciocutaneous flap for intra-oral reconstruction].

The radial forearm flap, or the forearm flap, is called "Chinese flap" for its development of the chinese doctors, and is originally designed for the correction to the post-burn contraction of the face and neck. The radial forearm flap is one of the fasciocutaneous flap, supplied by the radial artery, and transferred as a single-stage reconstruction micro-surgically. In oral and maxillofacial region, the deltopectral flap (D-P flap) and the pectralis major myocutaneous flap (P-M-M-C flap) are mainly used for the reconstruction. These flaps, however, are sometimes too bulky and limited to transfer, and more require two-stage operations. On the other hand, as the forearm flap being thin and pliable, some doctors use this flap micro-surgically at single-stage free flap reconstruction. Before two years, we have begun to transfer the radial forearm flap for the intra-oral reconstruction. The operation method is as follows. Design and Elevation of the Radial Forearm Flap 1. Using the ultrasonic doppler flow meter, the radial artery and the subcutaneous forearm veins are marked on the skin. 2. The flap is designed 20% larger according to the pattern to be reconstructed, with the distal section of the radial artery as an axis on the forearm and the median vein of forearm inclusively. 3. Before the operation, Allen test must be performed in order to determine whether the hand will survive without a radial arterial in-put. 4. The operation is performed with a arm tourniquet. The margin of the flap are incised down to the deep fascia, isolating and preserving the proximal subcutaneous veins as required.(ABSTRACT TRUNCATED AT 250 WORDS)

Herpes zoster of the maxillary branch of the trigeminus nerve. Virological and serological studies.

A 70-year-old male had erythematous and vesiculous lesions in the area of the right maxillary branch of the trigeminus nerve and was clinically diagnosed as having herpes zoster; virological and serological investigations of this case were carried out. Consequently, an electron microscopic observation revealed a great number of virus particles of herpes type in the vesiculous lesion and in baby hamster kidney BHK21/WI-21 cells, cultured after inoculating the fluid from the vesicle formed on the patient's upper lip or from serum harvested during the viremia. When BHK21/WI-21 cells infected with this virus were tested for antigenicity by an indirect immunofluorescent staining technique, they showed a positive staining to antivaricella-zoster virus. When serum of this patient was assayed fof the antibody level against varicella-zoster virus by the complement fixation test at various time intervals during the therapeutic period, this antibody titer on recovery period showed a threefold increase in comparison to that at onset. From these findings, this infectious disease was precisely diagnosed as herpes zoster.