This study, involving thirty-two patients with carcinoma of uterine cervix treated by high dose rate intracavitary irradiation using a remotely controlled afterloading system, compares the doss at point A and B with the Curie-minutes prescription. A linear least-square regression analysis was used to compare the two sets of date. Correlation coefficients between doses at points A and B arid the Ci-min prescription are 0.92(p<0.001) and 0.90 (p<0.001), respectively, and linear relationship is observed between these two system. The limitation and significance of the comparison of the two approaches to intracavitary dosimetry is discussed.
Cervix Uteri ; Dioctyl Sulfosuccinic Acid ; Female ; Humans ; Prescriptions ; Uterine Cervical Neoplasms*

OBJECTIVE: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia. METHODS: This study was designed as a matched comparative study. Twenty-four patients who had dysphagia after ischemic stroke were recruited, and they were divided into two groups after matching for age and stroke lesion. The patients in group A received rTMS over the brain cortex where motor evoked potential (MEP) was obtained from the suprahyoid muscle. Group B received rTMS over the brain cortex where MEP was obtained from the abductor pollicis brevis muscle. rTMS was performed at 110% of MEP threshold, 10 Hz frequency for 10 seconds, and then repeated every minute for 10 minutes. Dysphagia status was measured by the Functional Dysphagia Scale (FDS), the Penetration-Aspiration Scale (PAS), and the Dysphagia Outcome and Severity Scale (DOSS) using the results of a videofluoroscopic swallowing study. These evaluations were measured before, immediately, and 4 weeks after rTMS. RESULTS: Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS. There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS. CONCLUSION: rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.
Brain ; Deglutition ; Deglutition Disorders* ; Dioctyl Sulfosuccinic Acid ; Evoked Potentials, Motor ; Humans ; Stroke* ; Transcranial Magnetic Stimulation*

OBJECTIVE: To develop a new tool for aspiration risk prediction based on pharyngeal width at rest in older adults with symptoms of aspiration. METHODS: Lateral cervical spine roentgenograms were obtained from 33 older adult patients who complained of dysphagia and from 33 healthy, age-matched controls. Pharyngeal width at rest was measured at two points. We named the average of these two pharyngeal widths ‘JOSCYL Width’, calculated ‘JOSCYL Scale’, and compared these parameters between dysphagia and control groups. Correlations of individual JOSCYL Width and JOSCYL Scale, with Penetration Aspiration Scale (PAS) and Dysphagia Outcome and Severity Scale (DOSS) scores were analyzed for the dysphagia group. To determine optimal cutoff points for predicting aspiration, a receiver operating characteristic curve analysis was performed on JOSCYL Width and JOSCYL Scale. RESULTS: Both JOSCYL Width and JOSCYL Scale of the dysphagia group were larger than those of the control group (p<0.001). The correlation between JOSCYL Width and severity of dysphagia was significant for the dysphagia group (PAS p=0.007; DOSS p=0.012). The correlation between JOSCYL Scale and the severity of dysphagia was also significant for the dysphagia group (PAS p=0.009; DOSS p=0.011). Optimal cutoffs for JOSCYL Width and JOSCYL Scale for predicting aspiration were 20.0 mm and 5.9, respectively. CONCLUSION: JOSCYL Width and JOSCYL Scale can be new indicators for predicting aspiration in older adults. They are both precise and easy to use.
Adult ; Aged ; Deglutition Disorders ; Dioctyl Sulfosuccinic Acid ; Humans ; Pharynx ; ROC Curve ; Spine

The aim of this study was to compare the efficacy of three forms of cleansing enema for rigid proctosigmoidoscopy. One hundred fifty five patients referred for proctosigmoidoscopy to the Department of Surgery at the FEU-NRMF Medical Center were randomly assigned by simple random sampling into three groups to receive three forms of cleansing enema: monobasic sodium phosphate dibasic sodium phosphate (Fleet Enema ) for Group 1 (n=42), sorbitol and dioctyl sulfosuccinate ( Clyss Go) for Group 2 (n=38) and soap sud enema (SS Enema) for Group 3 (n=45). Quality of bowel preparation was graded as good, fair or poor. The cleansing enema was administered one hour prior to the procedure. It was readministered in case the patient did not have bowel movements. Another dose of the designated enema was given if the bowel preparation was poor. The reinfusion rate for the SS enema group was only 17 percent, significantly lower than the 45 percent of the Fleet Enema group (p=0.01), but not statistically different from the 39 percent of the Clyss Go group (p=0.05). The cost-effective analysis using direct costs showed SS enema was more cost- effective than Fleet Enema or Clyss Go enema. The SS enema was a good alternative for cleansing the bowel prior to rigid proctosigmoidoscopy. It had a low reinfusion rate and was more cost-effective than Fleet enema or Clyss Go. (Author)

Human ; Male ; Female ; Sigmoidoscopy ; Sodium Phosphate ; Dioctyl Sulfosuccinic Acid ; Soaps ; Sorbitol ; Enema ; Phosphates ; Defecation ; Intestines

STUDY DESIGN: A Cross-sectional study OBJECTIVE: This study evaluated the degree of osteoporosis of adolescent idiopathic scoliosis (AIS) and neuromuscular scoliosis (NMS) and compared bone mineral density. LITERATURE REVIEW: In osteoporosis, bone mineral density was not as dense even in the outer layer, and the cortex was thinner than normal. A larger screw doss not enhance the screw stability and can break the thin cortex in osteoporotic vertebrae. MATERIALS AND METHODS: This study reviewed the cases of consecutive patients with scoliosis, who underwent an osteoporosis examination before surgery between August 2004 and June 2006. The osteoporosis examination included DEXA in lumbar vertebrae and proximal femur. The mean osteoporotic degree of both femurs was recorded. The data was analyzed using the BMD(bone mineral density, g/cm(2)) and Z value of the BMD according to age, gender, and ethnicity. RESULTS: The mean degree of the coronal deformity was 48.4 in AIS and 62.9 in NMS. A comparison of both groups revealed a significantly lower BMD and Z value of Femur, and BMD of the vertebra in the NMS patients (p<0.05). A comparison between AIS and non-ambulant NMS showed that all parameters were significantly lower in the non-ambulant NMS (p<0.05). Neither the BMD and Z value of the AIS nor the NMS were associated with the severity of the spinal deformity. CONCLUSION: A lower BMD was measured in patients with non ambulant NMS than AIS. The degree of the osteoporosis, particularly of the non ambulant NMS patients need to be considered before undergoing surgery.
Adolescent* ; Bone Density* ; Congenital Abnormalities ; Cross-Sectional Studies ; Dioctyl Sulfosuccinic Acid ; Femur ; Humans ; Lumbar Vertebrae ; Osteoporosis ; Scoliosis* ; Spine

This study is to prepare the W/O microemulsion containing NaCl and fluorouracil (5-Fu) as a model drug to investigate the transdermal characteristics and skin irritation of the microemulsion in vitro. Isopropylmyristate (IPM) acting as oil phase, Aerosol-OT (AOT) as surfactant, Tween 85 as cosurfactant, NaCl solution was added dropwise to the oil phase to prepare W/O microemulsion at room temperature using magnetic stirring, and then 5-Fu powder was added. According to the area of microemulsion based on the pseudo-tertiary phase diagrams, the optimum formulation was screened initially. And the permeation flux of fluorouracil across excised mice skin was determined in vitro using Franz diffusion cells to study the influence of the amount of water and the drug loading capacity and optimize the formulation further. Refer to 5-Fu cream, the irritation of microemulsion on the rat skin was studied. The optimum formulation was composed of 0.7% (w/v) 5-Fu, 50% NaCl solution (0.05 mol x L(-1)), 20% mix-surfactant (AOT/Tween 85, K(m) = 2) and 29.3% oil (IPM). The cumulative amount of fluorouracil permeated in 12 h was (2 013.4 +/- 41.6) microg x cm(-2), 20.23 folds and 10.38 folds more than 0.7% fluorouracil aqueous solution and 2.5% (w/w) fluorouracil cream, respectively. Microemulsion exhibited some irritation, but could be reversed after drug withdrawal. The addition of NaCl significantly increased the content of water and the drug loading in microemulsion systems. The NaCl/AOT-Tween 85/IPM microemulsion system promoted the permeation of fluorouracil greatly, which may be a promising vehicle for the transdermal delivery of fluorouracil and other hydrophilic drug.
Administration, Cutaneous ; Animals ; Antimetabolites, Antineoplastic ; administration & dosage ; adverse effects ; pharmacokinetics ; Dioctyl Sulfosuccinic Acid ; chemistry ; Drug Carriers ; Drug Delivery Systems ; Emulsions ; Exanthema ; chemically induced ; Fluorouracil ; administration & dosage ; adverse effects ; pharmacokinetics ; In Vitro Techniques ; Male ; Mice ; Myristates ; chemistry ; Oils ; chemistry ; Polysorbates ; chemistry ; Rats ; Rats, Sprague-Dawley ; Skin Absorption ; Sodium Chloride ; chemistry ; Surface-Active Agents ; chemistry ; Water

This study is to prepare the microemulsion-based gel based on the W/O microemulsion and fluorouracil (5-Fu) as a model drug to study the transdermal characterization and observe its skin irritation of the microemulsion-based gel in vitro. IPM acted as oil phase, AOT as surfactant, Tween 85 as cosurfactant, water was added dropwise to the oil phase to prepare W/O microemulsion at room temperature using magnetic stirring, then 5-Fu powder was added. The gelatin was used as substrate to prepare 5-Fu microemulsion-based gel. The permeation flux of 5-Fu from 5-Fu microemulsion-based gel across excised mice skin was determined in vitro using Franz diffusion cell to study the influence of the amount of gelatin and the drug loading capacity. Refer to 5-Fu cream, the irritation of microemulsion and microemulsion-based gel on the rat skin was studied. Based on the water/AOT/Tween 85/IPM microemulsion, only the gelatin can form the microemulsion-based gel. At 25 degrees C, 32 degrees C and 40 degrees C, the amount of gelatin required for the formation of microemulsion-based gel were 7%, 14% and more than 17%, respectively. The 12 h transdermal cumulated permeation amount of 5-Fu from microemulsion-based gel containing 14% gelatin and 0.5% drug loading were (876.5 +/- 29.1) microg x cm(-2), 12.3 folds and 4.5 folds more than 0.5% 5-Fu aqueous solution and 2.5% (w/w) 5-Fu cream, respectively. Microemulsion-based gel exhibited some irritation, but could be subsided after drug withdrawal. Microemulsion-based gel may be a promising vehicle for transdermal delivery of 5-Fu and other hydrophilic drug.
Administration, Cutaneous ; Animals ; Antimetabolites, Antineoplastic ; administration & dosage ; adverse effects ; pharmacokinetics ; Dioctyl Sulfosuccinic Acid ; Drug Carriers ; Drug Delivery Systems ; Emulsions ; Exanthema ; chemically induced ; Fluorouracil ; administration & dosage ; adverse effects ; pharmacokinetics ; Gelatin ; chemistry ; Male ; Mice ; Myristates ; chemistry ; Polysorbates ; chemistry ; Skin ; pathology ; Skin Absorption ; Succinates ; chemistry ; Surface-Active Agents ; Viscosity