This study was performed to define the adaptation patterns of each skeletal components to the flexures of cranial bases, using 91 males from the ages of 17 to 36 and 64 females from the ages of 16 to 34, without orthodontic or prosthetic treatment experiences and with pleasant profiles as subjects. The conclusions are as follow: 1. When considering the changes of flexure of cranial base (Ba-SE-FMN) in both sexes, changes in the anterior cranial base angle to the PM Vertical line (SE-FMN/PMV) were greater than the changes in the posterior cranial base angle to the PM Vertical line (Ba-SE/PMV). Subsequently the nasomaxillary complex showed antero-superior rotating effect as the cranial base angles were increased and postero-inferior rotating effect as they were decreased. 2. Horizontal mandibular angle (Ba-SE-Me) was increased in both sexes as cranial base angle increases (Ba-SE-FMN) and it decreased as the latter was decreases. There by indicating compensatory effects. 3. Maxillary angle (SE-FMN-A) was decreased in both sexes as cranial base angle (Ba-SE-FMN) increases and it increased as the latter was decreased. There by indicating compensatory effects. 4. Mandibular ramus angle to posterior cranial base was decreased in both sexes as cranial base angle increases. There by indicating compensatory effect to anteriorly displaced maxilla and the mandibular ramus angle was increased as the cranial base angle decreases. There by indicating compensatory effect to posteriorly displace maxilla. 5. The length of posterior upper facial height was decreased in both sexes as the cranial base angle increases and it increased as the latter was decreased.
Female ; Humans ; Male ; Maxilla ; Skull Base

BACKGROUND: It is believed that stimulation of the P6 acupoint minimizes nausea and vomiting, and has been used to prevent and treat nausea and vomiting in various situations. The present study was undertaken to investigate whether the transcutaneous electrical stimulation of the P6 acupoint prevents postoperative nausea and vomiting (PONV) in female patients undergoing laparoscopic cholecystectomy. METHODS: In this prospective, randomized, double-blind, placebo-controlled study, we investigated 59 ASA I or II female patients who underwent laparoscopic cholecystectomy under general anesthesia using isoflurane or enflurane. We used a ReliefBand(R) unit (NSTTM 600, Woodside Biomedical Inc, USA) for the transcutaneous electrical stimulation of the P6 acupoint. Patients were randomly divided into two groups; in the P6 group (n = 29) the activated ReliefBand(R) was placed at the P6 acupoint; and in the placebo group (n = 30) the inactivated ReliefBand(R) was placed at the P6 acupoint. The ReliefBand(R) was applied 10 min before the end of surgery and remained in place for 24 h. We evaluated the incidence and severity of PONV, and need for rescue antiemetics during the first 6 h and 24 h after surgery. RESULTS: No differences in age, weight, previous PONV history, or duration of anesthesia were present between groups. The incidence of PONV was significantly lower (34%) in the P6 group than in the placebo group (63%) during the first 24 h after surgery. The severity of nausea and vomiting was also significantly lower in the P6 group than in the placebo group. However, the need for rescue antiemetics was similar in the two groups. CONCLUSIONS: Transcutaneous electrical stimulation of the P6 acupoint significantly reduces the incidence and severity of PONV in female patients undergoing laparoscopic cholecystectomy during the first 24 h after surgery.
Acupuncture ; Acupuncture Points* ; Anesthesia ; Anesthesia, General ; Antiemetics ; Cholecystectomy, Laparoscopic* ; Enflurane ; Female ; Humans ; Incidence ; Isoflurane ; Nausea ; Postoperative Nausea and Vomiting* ; Prospective Studies ; Transcutaneous Electric Nerve Stimulation* ; Vomiting

No abstract available.
Depression* ; Myocardial Ischemia*

OBJECTIVE: The purpose was to evaluate the effect of the intravaginal misoprostol(prostaglandin E1,) for termination after second trimester. METHODS: Thirty pregnant women with intrauterine fetal death and with indications for therapeutic termination of intrauterine pregnancy at least fourteen weeks of gestation were recruited. They were evaluated the mean time from induction to termination, maternal side effects, and total dose of the powdered 100ug misoprostol adminstered in the posterior vaginal fornix every six hours. RESULTS: The mean time from induction to termination was 21.1+/-8.2 hours after administration of the intravaginal misoprostol. Only two patients had not been delivered within 48hours. Vomiting, diarrhea, and fever were not accompanied except nausea. The total dosage of misoprostol was 412.5+/-156.1ug. CONCLUSION: This study shows that intravaginal misoprostol appears to be safe, effective and inexpensive method for the labor induction for termination of pregnancy in the second or third trimester of pregnancy.
Diarrhea ; Female ; Fetal Death ; Fever ; Humans ; Misoprostol* ; Nausea ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Pregnant Women ; Vomiting

BACKGROUND: The prognostic outlook for Hodgkin's disease has markedly improved in recent decades and 70 to 80% of patients can be cured with the modern combination chemotherapy. However, there is no standard treatment strategy according to each stage of the disease. In the present work we analysed retrospectively the therapeutic outcomes of 66 newly diagnosed patients with Hodgkin's disease treated with the strategy of Korea Cancer Center Hospital (KCCH) between 1989 and 1998. Also we studied to identify prognostic factors influencing the therapeutic outcome of the disease. METHODS: The treatment strategy of our institute was as follows; Patients in clinical stage IA with cervical, inguinal or mediastinal involvement and favorable histology (lymphocyte predominant) received radiotherapy without staging laparotomy. However, other patients of IA and the patients in IB, IIA, IIB, IIIA1 were recommended staging laparotomy to determine pathologic stage. The patients who were contraindicated to or refused staging laparotomy, or who were in clinical stage IIIA2, IIIB, IVA, IVB received chemotherapy. The patients in pathologic stage I or II received radiotherapy, and who in IIIA, IIIB, IIB, IV were treated with chemotherapy. The patients who have had massive tumor in any stage received additional radiotherapy following chemotherapy and who had residual lymph node after chemotherapy received additional radiotherapy to involved area. RESULTS: Of all 66 patients, 13 patients received radiotherapy alone and 53 patients were treated with chemotherapy +/- radiotherapy. Staging laparotomy was performed in 6 patients and pathologic stage tended to be upstaged after laparotomy. A complete response (CR) rate following treatments was reached to 81.8% (54/66, 95% C.I.=72.3~91.3%). Five-year progression free survival and overall survival rate were 59.1% and 74.3%, respectively. In prognostic factors analysis, age (P=0.0323) and performance status (P=0.0183) were the independent prognostic factors influencing overall survival. CONCLUSION: The outcome of Hodgkin's disease treated with our strategy was as good as that in other institutes. However, the prognosis of the patients who did not reach complete remission was poor. The prognostic factors analysis showed that age and performance status, which were not considered in establishment of treatment strategy, were the independent factors influencing the outcome of Hodgkin's disease. Further studies to develop treatment strategy considering all important prognostic factors including age and performance status and to increase complete response rate and ultimately overall outcome were warranted.
Academies and Institutes ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Hodgkin Disease* ; Humans ; Korea ; Laparotomy ; Lymph Nodes ; Prognosis ; Radiotherapy ; Retrospective Studies* ; Survival Rate ; Treatment Outcome*

BACKGROUND AND OBJECTIVES: The intracoronary injection of acetylcholine (Ach) has been shown to induce coronary spasms in patients with variant angina. Clinical significance and angiographic characteristics of patients with a significant response to lower Ach dosages are as-yet non-clarified compared with patients responding to higher Ach doses. SUBJECTS AND METHODS: A total of 3034 consecutive patients underwent coronary angiography with Ach provocation tests from January 2004 to August 2010. Ach was injected in incremental doses of 20, 50, 100 microg into the left coronary artery. Significant coronary artery spasm was defined as focal or diffuse severe transient luminal narrowing (>70%) with/without chest pain or ST-T change on the electrocardiogram (ECG). We compared the clinical and angiographic characteristics of patients who responded to a lower Ach dose (20 or 50 microg, n=556) to those that responded to a higher Ach dose (100 microg, n=860). RESULTS: The baseline clinical and procedural characteristics are well balanced between the two groups, except diabetes was higher in the lower Ach dose group and there were differences in medication history. After adjusting for confounding factors, the lower Ach dose group showed more frequent temporary ST elevation and atrioventricular block on the ECG. Furthermore, the group of patients who responded to the lower Ach dose was associated with a higher incidence of baseline and severe spasm than those who responded to a higher Ach dose. CONCLUSION: Patients with a significant response to a lower Ach dose were associated with more frequent ST elevation, baseline spasm, and more severe spasm compared with those who responded to a higher Ach dose, suggesting more intensive medical therapy with close clinical follow-up is required for those patients.
Acetylcholine ; Angina Pectoris, Variant ; Atrioventricular Block ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Electrocardiography ; Humans ; Incidence ; Phenobarbital ; Spasm

BACKGROUND AND OBJECTIVES: In the era of stents, lesion length remains an important predictor of restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore, we investigated the impact of DESs on clinical outcomes in patients with diffuse coronary lesions. SUBJECTS AND METHODS: Between January 2004 and January 2005, 80 patients (94 lesions) with lesions >20 mm in length were treated with one or more DESs and underwent follow-up coronary angiography. The patients were divided into three groups: Group 1 was composed of those with lesions 21 to 35 mm in length, Group 2 was composed of those with lesions 36 to 50 mm in length, and Group 3 was composed of those with lesions > or =51 mm in length. RESULTS: The mean clinical follow-up duration was 9 months. On the 6-month follow-up angiogram, 6.4% of the lesions had binary ISR (5.0% in group 1, 8.7% in group 2, and 9.1% in group 3). The percent diameter stenosis was 6.0+/-18.15% in Group 1, 12.61+/-21.99% in Group 2, and 19.81+/-31.26% in Group 3(p< 0.05). Late lumen loss was 0.17+/-0.50 mm in Group 1, 0.39+/-0.66 mm in Group 2, and 0.59+/-0.93 mm in Group 3 (p<0.05). Lesion length was associated with an increase in percent diameter stenosis and late lumen loss (of 6.9% and 0.21 mm per 15 mm). CONCLUSION: DES implantation is considered safe and effective in the treatment of diffuse lesions. However, lesion length may be associated with an increase in percent diameter stenosis and late lumen loss at 6-month follow-up.
Constriction, Pathologic ; Coronary Angiography ; Coronary Restenosis ; Coronary Stenosis ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Stents

BACKGROUND/AIMS: There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. METHODS: The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LAVOL) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. RESULTS: IAS thickness was significantly correlated with maximal LAV (LAVmax) (r = 0.288, p = 0.003), mean LAVOL (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEFtotal; r = -0.213, p = 0.030), and active LAEF (LAEFactive; r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (> or = 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAVmax, minimal LAV, mean LAVOL, LVEFtotal, LVEFactive, and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LAVOL and LAEFactive were independent risk factors for recurrence. CONCLUSIONS: Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.
Action Potentials ; Adult ; Aged ; Area Under Curve ; Atrial Fibrillation/physiopathology/*radiography/surgery/*ultrasonography ; *Atrial Function, Left ; *Atrial Remodeling ; Atrial Septum/physiopathology/*radiography/*ultrasonography ; Catheter Ablation ; Chi-Square Distribution ; *Echocardiography, Doppler ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; *Multidetector Computed Tomography ; Multivariate Analysis ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Recurrence ; Risk Factors ; Time Factors ; Treatment Outcome

OBJECTIVES: Intracoronary injection of acetylcholine (Ach) has been shown to induce significant coronary artery spasm (CAS) in patients with vasospastic angina. Clinical significance and angiographic characteristics of patients with ischemic electrocardiogram (ECG) changes during the Ach provocation test are not clarified yet. METHODS: A total 4,418 consecutive patients underwent coronary angiography with Ach provocation tests from 2004 to 2012 were enrolled. Ischemic ECG changes were defined as transient ST-segment depression or elevation ( > 1 mm) and T inversion with/without chest pain. Finally, a total 2,293 patients (28.5% of total subjects) proven CAS were enrolled for this study. RESULTS: A total 119 patients (5.2%) showed ECG changes during Ach provocation tests. The baseline clinical and procedural characteristics are well balanced between the two groups. Ischemic ECG change group showed more frequent chest pain, higher incidence of baseline spasm, severe vasospasm, multi-vessel involvement, and more diffuse spasm ( > 30 mm) than those without ischemic ECG changes. At 5 years, the incidences of death, major adverse cardiac events (MACE) and major adverse cardiac and cerebral events (MACCE) were higher in the ischemic ECG change group despite of optimal medical therapy. CONCLUSIONS: The patients with ischemic ECG changes during Ach provocation tests were associated with more frequent chest pain, baseline spasm, diffuse, severe and multi-vessel spasm than patients without ischemic ECG changes. At 5-years, the incidences of death, MACE and MACCE were higher in the ischemic ECG change group, suggesting more intensive medical therapy with close clinical follow up will be required.
Acetylcholine ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Depression ; Electrocardiography ; Follow-Up Studies ; Humans ; Incidence ; Spasm

Intravascular lymphomatosis is a rare lymphoma characterized by neoplastic proliferation of malignant cells within the lumen of small blood vessels, usually presenting in the central nervous system or on the skin. Intravascular lymphomatosis is manifested clinically by fever, dementia, cutaneous nodules or plaques, and occasionally, dyspnea. The diagnosis of intravascular lymphomatosis is difficult because of misleading clinical features mimiking vasculitis, infection, stroke, or other neoplasm. We report two cases of intravascular lymphomatosis pesented as fever and skin rash. Those are confirmed by involved tissue biopsy. All cases were treated by combination chemotherapy, but the response was not good. Infectious problems were complicated and disease were progressed.
Biopsy ; Blood Vessels ; Central Nervous System ; Dementia ; Diagnosis ; Drug Therapy, Combination ; Dyspnea ; Exanthema ; Fever ; Lymphoma ; Skin ; Stroke ; Vasculitis