No abstract available.

PURPOSE: The aim of this study was to investigate treatment results, toxicity and efficacy of hyperfractionated radiation therapy combined with paclitaxel for paraaortic node recurrence in cervix cancer. MATERIALS AND METHODS: Between September 1997 to March 1999, 12 patients with paraaortic node recurrence in cervix cancer who previously received radical or postoperative radiotherapy were treated with hyperfractionated radiation therapy combined with paclitaxel. Of these, 2 patients who irradiated less than 30 Gy were excluded, 10 patients were eligible for this study. Median age was 5 1 years. Initial FlGO stage was 1 stage IB1, 2 stage IIA, 7 stage IIB. For initial treatment, 7 patients received radical radiotherapy and 3 received postoperative radiotherapy. The paraaortic field encompassed the gross recur rent disease with superior margin at T 12, and inferior margin was between L5 and S 1 with gap for previously pelvic radiation field. The radiation field was initially anterior and posterior opposed field followed by both lateral field. The daily dose was 1.2 Gy, twice daily fractions, and total radiotherapy dose was between 50.4 and 60 Gy(median, 58.8 Gy). Concurrent chemotherapy was done with paclitaxel as a radiosensitizer. Dose range was from 20 mg/m to 30 mg/m (median, 25 mg/m'), and cycle of chemotherapy was from 3 to 6 (median, 4.5 cycle). Follow-up period ranged from 3 to 21 months. RESULTS: Interval between initial diagnosis and paraaortic node recurrence was range from 2 to 63 months (median, 8 months). The 1 year overall survival rate and median survival were 75% and 9.5 months, respectively. The 1 year disease free survival rate and median disease free survival were 30% and 3 7 months, respectively. At 1 month after treatment, 4 (40%) achieved a complete response and 6 (63%) experienced a partial response and all patients showed response above the partial response. There was distant metastasis in 6 patients and pelvic node recurrence in 2 patients after paraaortic node irradialion. There was 2 patients with grade 3 to 4 leukopenia and 8 patients with grade 1 to 2 nausea/ vom ting which was usually tolerable with antiemetic drug. There was no chronic complication in abdomen and pelvis during follow up period. CONCLUSION: Hyperfractionated radiation therapy combined with paclitaxel as a radiosensitizer showed high response rate and few complication rate in paraaortic node recurrence in cervix cancer. Therefore, present results suggest that hyperfractionated radiation therapy combined with paclitaxel chemotherapy can be used as optimal treatment modality in this patients.
Abdomen ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Paclitaxel* ; Pelvis ; Radiotherapy ; Recurrence* ; Survival Rate ; Tolnaftate ; Uterine Cervical Neoplasms*

Cervical tuberculous lymphadenitis is a commonly encountered disease, expecially in adults, Differentiation from other lymphadenopathy and benign conditions such as cystic neck masses is important. CT findings of tuberculous lymphadenopathy in the abdomen and thorax are reported in many literatures. But there are only a few articles concerning cervical tuberculous lymphadenopathy. The authors retrospectively analyzed CT findings of 33 cases with cervical tuberculous lymphadenitis regarding distribution, contour, enhancing pattern, changes of adjacent fascial plane, and dermal and subcutaneous manifestations. We concluded that the presence of conglomerated nodal masses with central lucency, thick irregular rim of contrast enhancement and inner nodularity, varying degree of homogenous enhancement in smaller nodes, dermal and subcutaneous manifestations of inflammation such as thickening of overlying skin, engorgement of the lymphatic and thickening of adjacent muscles, and diffusely effaced fascial plane are suggestive of tuberculous lymphadenitis. However, some CT patterns of tuberculous adenitis may be seen in other disease; for example, enhancement can occur in hyperplastic nodes, vascular metastasis(thyroid, melanoma, and hypernephroma), lymphoma, granulomatous disease, and Castleman's disease.
Abdomen ; Adult ; Giant Lymph Node Hyperplasia ; Humans ; Inflammation ; Lymphadenitis ; Lymphatic Diseases ; Lymphoma ; Melanoma ; Muscles ; Neck ; Retrospective Studies ; Skin ; Thorax ; Tuberculosis, Lymph Node* ; Yemen

No abstract available.
Aspergillosis*

BACKGROUND: Serological methods for screening blood and blood products for the presence of antibodies to human immunodeficiency virus( HIV) are efficient and sensitive. In repeatedly reactive cases confirmational tests such as Western blot are available. However, direct viral detection may be needed for a patient in seronegative window period and a newborn from a infected mother. In addition, a direct assay for the virus would provide a means to monitor both latent and actively replicating virus in patients on therapeutic drugs. However, direct detection of HIV in patient samples is difficult and disappointing even with co-cultivation and the successful recovery rate varies from 10 to 75%. Polymerase chain reaction (PCR) may provide the answer because it can do in vitro amplification of viral genome integrated into human genome (provirus). However, actual results of clinical application of conventional PCR do not show favorable sensitivity especially in samples containing very small amounts of HIV molecule copies. PURPOSE: We comparatively analyzed the sensitivity of single ( primary)PCR and double ( secondary) PCR in the detection of HIV to define whether double PCR can overcome the limited sensitivity of single( primary) PCR and if it can be a clinically promising method for detecting HIV. MATERIALS AND METHODS: Ten peripheral blood samples from individuals who had antibodies to human immunodeficiency virus were prepared and centrifuged in Ficoll-Hypaque to isolate lymphocytes and monocytes. After DNA extraction from the cell, 35 cycles of primary PCR was performed and a part of the PCR product of individual specimen was electrophoresed to elucidate the results of primary PCR. Secondary PCR with the other part of the individual primary PCR product was followed to compare the efficacies of single and double PCR. RESULTS: With primary PCR, only one specimen among 10 showed a suspicious corresponding band on polyacrylamide gel electrophoresis using ethidium bromide. The results of double PCR presented a striking contrast to those of primary PCR, elucidating 100O% sensitivity without using radioisotope. CONCLUSIONS: This study suggeststhat double PCR is a very potent method in detection of human immunodeficiency virus genome incorporated in human white blood cells.
Antibodies ; Blotting, Western ; DNA ; Electrophoresis, Polyacrylamide Gel ; Ethidium ; Genome ; Genome, Human ; Genome, Viral ; HIV* ; Humans* ; Infant, Newborn ; Leukocytes ; Lymphocytes ; Mass Screening ; Monocytes ; Mothers ; Polymerase Chain Reaction* ; Strikes, Employee

STATEMENT OF PROBLEM: Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE: This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS: Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS: The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION: To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.
Humans ; Molar ; Mucous Membrane ; Silicones ; Tooth

Discoid meniscus in the knee joint is common. From July 1990 through June 1994, the authors performed arthroscopy on 968 symptomatic knee joints. One hundred and six knees of 102 patients had discoid meniscus. Of the 106 knees, 14(13.2%) cases were associated with other intraarticular anatomic variants. There were 7(6.6%) cases with anomalous insertion of the anterior horn of the medial meniscus into the anterior cruciate ligament, and 7(6.6%) cases with anterior transposition of the insertion of the anterior cruciate ligament below the anterior tibial margin like the insertion of the posterior cruciate ligament. Of the 14 patients, the discoid meniscus were reshaped in 11 knees, partially resected in 2 knees, and one patient was treated with repair of a peripheral tear and reshaping. But had no treatment in associated intraarticular anatomic variants. The follow up was done from 24 to 54 months(average 37 months) after surgery. The results were excellent in 8 knees ; good in 4 knees and fair in 2 knees(Ikeuchi scale, 1982) The patients with excellent or good results were satisfied as were the authors, and these anatomical variants other than the discoid meniscus were not related to the patient's symptoms.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Follow-Up Studies ; Horns ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tears

We analyzed the mRNA expression patterns of major potassium channel genes to determine the mechanism of hypokalemia in familial hypokalemic periodic paralysis. We used quantitative RT-PCR to examine the mRNA levels of both inward (KCNJ2, KCNJ6, and KCNJ14) and delayed rectifi er (KCNQ1 and KCNA2) potassium channel genes in skeletal muscle cells from both normal and patient groups, prior to and after exposure to 4 mM and 50 mM potassium buffers. Quantitative RT-PCR analysis revealed no changes in the mRNA levels of these genes in normal and patient cells on exposure to 4 mM potassium buffer. However, after exposure to 50 mM potassium buffer, which was used to induce depolarization, normal cells showed a signifi cant decrease in KCNJ2, KCNJ6, and KCNJ14 expression, but no change in KCNQ1 and KCNA2 expression. In contrast, patient cells showed no change in KCNJ2 and KCNJ6 expression, but an increase in KCNJ14 expression. Furthermore, KCNQ1 and KCNA2 showed decreased expression. We found that the expression levels of both inward and delayed rectifi er potassium channel genes in patient cells differ from those in normal cells. Altered potassium channel gene expression in patient cells may suggest a possible mechanism for hypokalemia in familial hypokalemic periodic paralysis.

BACKGROUND: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. METHODS: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels − the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. RESULTS: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). CONCLUSIONS: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Body Mass Index ; Bone-Patellar Tendon-Bone Grafts ; Female ; Humans ; Knee ; Linear Models ; Male ; Outcome Assessment (Health Care) ; Patellar Ligament ; Retrospective Studies ; Tears ; Transplants*

PURPOSE: We investigated the statistical methods to compose the functional brain map of human working memory and the principal factors that have an effect on the methods for localization. MATERIALS AND METHODS: Repeated PET scans with successive four tasks, which consist of one control and three different activation tasks, were performed on six right-handed normal volunteers for 2 minutes after bolus injections of 925 MBq H0 at the intervals of 30 minutes. Irnage data were analyzed using SPM96 (Statistical Parametric Mapping) imple-mented with Matlab (Mathworks Inc., U.S.A.). Images from the same subject were spatially registered and were normalized using linear and nonlinear transformation methods. Significant difference between control and each activation state was estimated at every voxel based on the general linear model. Differences of global counts were removed using analysis of covariance (ANCOVA) with global activity as covariate. Using the mean and variance for each condition which was adjusted using ANCOVA, t-statistics was performed on every voxel To interpret the results more easily, t-values were transformed to the standard (saussian distri-bution (Z-score). RESULTS: All the subjects carried out the activation and control tests successfully. Average rate of correct answers was 95%. The numbers of activated blobs were 4 for verbal memory I, 9 for verbal memory II, 9 for visual memory, and 6 for canjunctive activation of these three tasks. The verbal working memory activates predominantly left-sided slruetures, and the visual memory activates the right hernisphere. CONCLUSION: We conclude that rCBF PET imaging and statistical parametric mapping method were useful in the localization of the brain regions for verbal and visual working memory.
Brain Mapping* ; Brain* ; Electrons* ; Healthy Volunteers ; Humans ; Linear Models ; Memory ; Memory, Short-Term ; Positron-Emission Tomography*