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

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

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*

BACKGROUND: Recently technetium-99m sestamibi (99mTc MIBI), which dose not require withdrawal of thyroid hormone, has been used for imaging of thyroid carcinoma. The aim of this study was to determine the clinical usefulness of Tc MIBI scintigraphy after total thyroidectomy for thyroid carcinoma. The results were compared with those of standard 131I scintigraphy. METHODS: One hundred twelve patients with a median age of 44 years (range, 14-76 years) were included in the study. After optimal endogenous thyroid stimulating hormone stimulation (>50 mIU/mL), whole body scintigraphy using 4 mCi of 'I and 20 mCi of Tc sestamibi were done simultaneously. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10ng/mL) were detected, diagnostic imaging studies were done to confirm the existence of the disease. And high dose (150-200 mCi) 'I was administered as therapy and then whole body scans were performed again after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose I scan findings. RESULTS: In 11 patients, Tc MIBI scan revealed positive accumulations which were not found on 131I scan, of whom 6 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 6 cases showed pathologic findings (2 lung, 1 lymph node, 1 lung and lymph node, 1 local recurrent cancer, and 1 false positive accumulation of 99mTc MIBI). Metastasis or residual cancer were confirmed histologically in 1 and radiologically in 4 cases. Negative 99mTc MIBI scans, despite of positive I scans, occurred in 9 patients, of whom 2 had abnormal thyroglobulin levels. Seven cases were interpreted to have thyroid remnant, 2 cases were confirmed to have lung metastasis, and another one was misinterpreted due to breast shadow. CONCLUSION: In conclusion, these results suggest that 99mTc MIBI scan may have similar sensitivity and specificity for the detection of residual or metastatic differentiated thyroid carcinoma. The 99mTc MIBI scan, especially in cases of negative 131I scan despite of abnormal thyroglobulin levels, can be used as a very useful complementary diagnostic tool.
Breast ; Diagnostic Imaging ; Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging

Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Extremities ; Gastroschisis ; Hernia, Umbilical ; Humans ; Prognosis ; Young Adult

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

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

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.
Adult* ; Ductus Arteriosus, Patent* ; Humans

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