BACKGROUND: Gravity traction is a widely used conservative procedure, and several studies using various techniques have reported changes in blood pressure (BP) or heart rate (HR) or stress variables in the head-down tilting position, with varying results. The purpose of this study was to investigate BP, HR and serum lactic acid (LA) responses to inverted gravity traction at six angles. METHODS: Thirty volunteers (males 15, females 15) were assigned randomly to either of two experimental groups. After the resting BP, HR and LA concentration were measured in the sitting position, they were measured repeatedly at standing, supine, and inverted at -30, -60 and -90 degrees every 2.5 minute. RESULTS: Compared to the systolic BP (SBP) at sitting, SBP decreased at standing and at inverted -30degrees and increased at -60degrees and -90degrees in the males group, whereas SBP decreased at supine to inverted -60degrees and increased at -90degrees in the females group. Compared to the diastolic BP (DBP) at sitting, DBP diastolic blood pressure (DBP) decreased at standing to -60degrees in both groups and increased at inverted -90degrees. Compared to HR at sitting, HR decreased at supine to -90degrees in both groups. The results of the post hoc test comparisons showed that the SBP, DBP, and HR differed significantly at all six positions. However, compared to serum LA at sitting, LA at all positions were not significantly different in both groups. CONCLUSIONS: As seen in previous research, our results showed increases in BP and HR at inverted -90degrees. However, BP and HR at the other inverted positions including supine showed decreases. LA did not change significantly at any of the positions. Finally, our study showed that angles above -30degrees or -60degrees can benefits the cardiovascular system in young people.
Blood Pressure ; Cardiovascular System ; Female ; Gravitation ; Head-Down Tilt ; Heart ; Heart Rate ; Humans ; Lactic Acid ; Male ; Posture ; Traction

Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

PURPOSE: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. MATERIALS AND METHODS: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. RESULTS: The mean radial displacements were 2.26 (+/-1.03) mm in the control group and 3.05 (+/-1.97) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. CONCLUSION: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.
Consensus ; Displacement (Psychology) ; Head ; Head and Neck Neoplasms ; Humans ; Lymph Nodes ; Masks ; Neck ; Skull Base ; Spine

BACKGROUND: Whole body 131I scan is routinely performed in the postoperative evaluation of patients with differentiated thyroid carcinoma to detect recurrence and functioning metastasis. Previous reports suggested that posttreatment whole body scan had higher rate of detecting metastatic lesions that were not visualized by pretreatment images. We observed the frequency of discordance of the two scans and analysed the clinical significances. METHODS: Forty-one patients with differentiated thyroid carcinoma underwent radioactive iodine-131 whole body scans after administration of diagnostic dose (4 mCi) and then therapeutic dose (100~200 mCi of iodine-131). The median age of the patients was 46.9 +/- 15.7 years (range, 17~76). RESULTS: In 16 of the 41 patients (39.0%), pretreatment scan showed additional uptakes that were not seen in the pretreatment scan. Serum thyroglobulin was elevated in 13 of the 16 patients. Of the 22 patients who had been received radioactive iodine therapy previously, eight patients showed new additional lesions in the therapeutic scans but there was no significance according to the history of radioactive iodine therapy, Addisional uptakes after therapeutic dose were noted in neck area in 9 cases, lung in 2 cases, bone in 4 cases and mediastinum in one case. Diffuse hepatic uptake was definitely seen in 7 cases and there were 2 cases whose scans showed liver uptake without any thyroid uptake. CONCLUSION: Posttreatment whole body scan is more sensitive to detect residual tissues and metastasis compared to the usual pretreatment diagnostic whole body scan, and it is suggested that posttreatment whole body scan should be routinely performed after 'I therapy in patients with differentiated thyroid carcinoma for exact evaluation.
Humans ; Iodine ; Liver ; Lung ; Mediastinum ; Neck ; Neoplasm Metastasis ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Whole Body Imaging

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

Uterine rhadomyosarcoma (RMS) is a rare tumor accounting for 2~6% of the patients with uterine malignant neoplasm and it happens under 1% of the patients with genitourinary malignancies. RMS can be classified in four types; embryonal, alveolar, pleomorphic, and undifferenciated. About twenty percent of RMS occurs in the genitourinary tract, with sligtly more than half being embryonal rhadomyosarcoma. Alveolar rhabdomyosarcoma (ARMS) of the uterine cervix is very rare. Emerich et al. reported the first case of ARMS of the cervix in 1996. So, little information is available regarding its prognosis and therapy. We report a case of a 56 year-old woman with ARMS of the uterine cervix with a review of the literature. She was received the operation and radiotherapy. She has since been disease-free. We herein report a case of very rare ARMS of the cervix.
Accounting ; Arm ; Cervix Uteri ; Female ; Humans ; Prognosis ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Alveolar

Over the 1 year 3 month period from 7/11/1997 until 10/30/1998, we have attempted graft salvage with tacrolimus conversion in a total of 11 patients (mean age 41 years, range 31~64 years) with ongoing rejection on baseline CsA immunosuppression after failure of high dose corticosteroid to reverse rejection. The indications for conversion to tacrolimus were ongoing biosy confirmed rejection in all patients. Seven grafts showed vascular rejection and 4 had cellular rejection on biopsy. The median interval to tacrolimus conversion was 4 days (range 1 days to 840 days) after transplantation. Three patients (27.3%) were dialysis-dependent owing to the severity of rejection. All patients (100%) have been successfully rescued and graft function of the patients improved from an average serum creatinine level of 7.3 3.6 mg/dl to 1.4 0.5 mg/dl. During the mean follow-up of 8.1 months after conversion, there were 10 complications following tacrolimus conversion including cytomegalovirus (CMV) infection in 2 patient, herpes esophagitis in 1, aspergillosis pneumonia in 1, pneumocystis carinii pneumonia in 1, new-onset diabetes mellitus in 4, tremor in 1 and bleeding due to thrombocytopenic thrombocytopenic purpura (TTP) in 1. Two of these postconversion complications resulted in patient death. Treatment with tacrolimus may successfully suppress ongoing acute rejection, even if high dose corticosteoid treatment have failed to reverse rejection. Base on these data, we recommend that tacrolimus be used for refractory rejection therapy. An additional anti-infective prophylaxis seems to be necessary in preventing severe complications after rejection therapy.
Allografts* ; Aspergillosis ; Biopsy ; Creatinine ; Cytomegalovirus ; Diabetes Mellitus ; Esophagitis ; Follow-Up Studies ; Hemorrhage ; Humans ; Immunosuppression ; Pneumonia ; Pneumonia, Pneumocystis ; Purpura, Thrombocytopenic ; Tacrolimus* ; Transplants ; Tremor

No abstract available.
Humans ; Mucin-1*

Fifteen women with symptomatic uterine myomas, diagnosed by clinical examination and confirmed by pelvic ultrasonography, were treated with intranasal insufflation of Nafarelin acetate, 200 micrograms, twice a day, for a total treatment period of 6 months. Treatment was evaluated with respect to subjective symptoms, changes in myoma size and uterine volume, variations in blood estradiol, FSH, LH and CA 125, and side effects. The following results were obtained: 1. All patients showed a marked reduction(p<0.001) in uterine volume. Before treatment volume measured 312.3+/-24.2cm3, after 12 weeks volume was 132.4+/-40.6cm3, and after 24 weeks it was 123.6+/-48.3cm3. 2. Blood estradiol and LH levels were decreased significantly(p<0.05) after treatment. The FSH level was decreased, but not significantly. 3. Blood CA 125 levels were increased 6 cases(40.0%) before treatment. The levels were normalized in all 6 cases after treatment. 4. Symptoms of uterine myoma disappeared or decreased. 5. Minor side effects, such as hot flushes, headache, general myalgia and fatigue, and vaginal dryness were encountered frequently although none necessitating discontinuation of treatment, These data suggest that Nafarelin acetate is useful for the treatment of uterine myoma. However, appropriate indications should be selected in the treatment of uterine myoma because the possible regrowth of uterine myoma after treatment limits the use of GnRH agonist.
Estradiol ; Fatigue ; Female ; Gonadotropin-Releasing Hormone* ; Headache ; Humans ; Insufflation ; Leiomyoma* ; Myalgia ; Myoma ; Nafarelin ; Ultrasonography

No abstract available.
Myxoma*