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

No abstract available.

In order to understand the role of mec regulator genes in the evolution of methicillin-resistant S. aureus (MRSA), the distribution of the mec regulator genes among the 66 clinical isolates of MRSA was analysed. And also the correlation between gene mutation and degree of phenotypic expression of resistance was studied. Fifty strains carried whole mec regulator region, while the mecI gene and nearly half of the 3'-end of the mecR#l gene were deleted in fifteen strains. The mecRl MS gene was detected among all of the mecA carried strains, but the mecRl PB gene was carried by 77% of the MRSA strains. At least a portion of the 5'-end region of the mecRl gene was carried by all MRSA strains tested. Forty-seven strains were finally confirmed to have mecI gene and each mecI gene of above strains was sequenced for identification of the relationship between repressor function of mecI gene on mecA transcription and MIC level of methicillin. Point mutations were detected in 11 strains of 47 strains. In 8 strains, there was one nucleotide substitution (C to T at position 202) that produced a new termination codon at position 201. In 3 strains, one nucleotide substitution from G to T at position 43 caused an amino acid substitution from Val to Phe. The MIC of methicillin of strains carrying mutated mecI genes ranged 256 ug/ ml to 1024 ug/ml. Transcription level of amplified cDNA corresponding to mecA was determined by the method of RT-PCR of extracted RNA. Total RNA was extracted from two strains with mutated mecI gene and a strain with intact mecI gene. Deletional loss or the mutational inactivation of the mecI gene did not affect the level of mecA transcription. Role of mecI gene as a strong repressor function on mecA gene seemed to be skeptical.
Amino Acid Substitution ; Codon, Terminator ; DNA, Complementary ; Genes, Regulator* ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Point Mutation ; RNA

A study of the volume and linear measurements of the breast to determine new nipple positions for 142 subjects was undertaken. Volume determination was done by using the Grossman-Roudner device. The size and shape of the female breast may differ significantly, and such size and linear measurements have to be measured accurately prior to breast aesthetic surgery. Statistical analysis of these results are closely related to physical constitution(height, weight, chest circumference). There have been increasing changes in linear measurement and decreasing changes in breast volume during the last 10 years, The results were as follows: 1) the mean distance from the midclavicular point to the nipple was 19.5cm, the distance from the sternal notch to the nipple was 19.4cm, the distance between nipples was 18.6cm, and the areolar diameter was 3.3cm, 2) the regression equation for the midclavicular point to the nipple was 7.236+ 0.00077x height(cm)+ 0.233 x weight(kg), for the sternal notch to the nipple was 8.845-0.0039 x height(cm)+ 0.214x weight(kg), for the distance between nipples was 11.192 - 0.0033xheight(cm)+ 0.151x weight(kg), and for the areolar diameter was 4.031+0.02xheight(cm)-0.048 x weight(kg),3) the mean value of breast volume of the left side was 209.6cc, and that of the right side was 211.8cc, 4) the regression equation for the mean breast volume was -137.673 + 6.668 x weight(kg), which was equal to -528.414 + 9.115x chest circumference under the axilla(cm) and -468.420 + 8.298 x chest circumference across the nipple (cm). In conclusion, these data could be useful for numerous aspects of breast surgery, including augmentation mammoplasty, mastopexy, reduction mammoplasty, and correction of asymmetrical breasts as the standard for Korean females, if we know the body constituents (weight, chest circumference) before surgery.
Breast* ; Female* ; Humans ; Mammaplasty ; Nipples ; Thorax

No abstract available.
Blepharoplasty*

By the human is getting older, the factors which can the reason of the aging process in the frontal region are divided, static factor and dynamic factor. the static factor is gravity, and the dynamic factor is repeatitive competition of depressosr muscles and elevator muscles. the depressor muscles are corrugator muscle, procerus muscle and orbicularis oculi muscle and the elevator muscle is frontalis muscle. Correction methods of this aging process are divided to non-surgical and surgical method. Non-surgical method are Atecoll and fat injection, and using botulinum toxin. But the effect of these method is temporary and limited, and if the skin laxity is great, this method cannot be used. Surgical methods are laser, chemical peeling, dermabrasion, classical forehead lift which is dissected superficial to galea aponeurosis or subperiosteal plane through coronal or hairline incision, and endoscopy method that the corrugator muscle and procerus muscle are transected by using endoscope, and then the posterior elevation of forehead flap is induced. the endoscopy method is the most popular method in recent years, which has the many advantages of minimal incision, less amount of bleeding and lower complication, but expensive equipment, adaptation and training period are needed. We present the result of 10 patients from May. 1996 to Jan. 1997. After the superior orbital rim exposed through upper eyelid incision, the corrugator muscle was resected while careful attention to the supraorbital n. which was located behind the orbicularis oculi muscle. A communication was made through both sided of medial canthal area, and after the procerus muscle was resected, the fat graft was inserted between them. Finally, we made periosteal incision superiorly, and subperiosteal forehead lift was done without using endoscope.
Aging ; Botulinum Toxins ; Dermabrasion ; Elevators and Escalators ; Endoscopes ; Endoscopy ; Eyelids ; Fibrinogen ; Forehead* ; Gravitation ; Hemorrhage ; Humans ; Muscles ; Orbit ; Skin ; Transplants

The cytolytic activity of CD4' T cells, both human and murine, has been clearly demonstrated in the immune response to mycobacterial infection and suggested to play a significant role in the protection and immunopathology. However, Uttle is known about the differentiation of CD4' CTL. In order to address this issue, we examined the influences of some factors on the generation of CD4' CTL specific to mycobacterial antigens. After 7 days' stimulation of PBMCs from healthy tuberculin reactors with mycobacterial antigens, the cytolytic activity of purised CD4' T cells toward autologous macrophages infected with mycobacteria was measured by Cr release assay. First, we found that both of live M. tubeiculosis and soluble antigens (ST-CF) induced the cytolytic activity of CD4' T cells, although the inducibility of the former was slightly greater than the latter. Second, the cytolytic activity was maximally induced at the relatively low antigen concentration (0.2:1 bacteria:monocyte ratio or 0.5 mg/ml of ST-CF). Finally, in the presence of increasing amounts of neutralizing anti-IL-12 or anti-IFN-r MoAb, the cytolytic activity of CD4+ T cells was decreased in a dose-dependent manner. These results suggest that low dose of antigen, its particulate type give mycobacteria), IL-12, and IFN-r give some positive signals for the generation of CD4+ CTL.
Humans ; Interleukin-12 ; Macrophages ; T-Lymphocytes* ; Tuberculin

Left ventricular hypertrophy is a compensatory response to hemodynamic overload secondary to an increased systemic resistance. This increase, however, is not the only cause of hypertrophy, and there are other factors which can have a significant effect on its incidence. To determine whether chronic antihypertensive therapy by enalapril modifies the cellular and subcellular changes of left ventricular hypertrophy observed in spontaneously hypertensive rats(SHR), 20-weeks-old SHR were treated for 22 weeks with enalapril(2mg/kg) and compared with normotensive Wister-Kyoto rats and not-treated SHR. Systolic blood pressure in enalapril-treated SHR was significantly lowered after 22 weeks compared with that of untreated control SHR group. Myocytes were reduced in size and fibrination seen in cardiac muscle fibers of control SHR was decreased in treated SHR group. Myofibrils appeared to be irregular in shape and myofilaments are decreased in control SHR but in enalapril-treated SHR the diameter and length of the myofilament became turned to regular forms. These results suggest that, enalapril, angiotensin converting enzyme inhibitor, may regress hypertrophy and some subcellular changes may be modified by enalapril.
Animals ; Blood Pressure ; Enalapril* ; Fibrin ; Hemodynamics ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Muscle Cells ; Myocardium ; Myofibrils ; Peptidyl-Dipeptidase A ; Rats ; Rats, Inbred SHR*

Craniofacial clefts are rare among facial anomalies with an incidence of 1.5 to 5 per 100,000 births, and 1 per 100 cases of cleft lip and palate. The Tessier No. 7 clefts are unusual lesions that result from failure of the embryonic mandibular and maxillary processes to properly fuse and form the corners of the mouth. We experienced a case of Tessier No. 7 craniofacial cleft in a 1 day-old female patient who presented with a macrostomia and auricular malformation. The diagnosis was established by clinical and radiographic findings. A brief review of literature was made.
Cleft Lip ; Diagnosis ; Female ; Humans ; Incidence ; Macrostomia ; Mouth ; Palate ; Parturition

PURPOSE: It has been believed that o-blocker affects the stromal component of BPH, while 5 alpha -reductase inhibitor affects the glandular component. Information on the tissue composition of BPH might be helpful to choose an appropriate medical therapeutic agent. We evaluated whether transrectal ultrasonographic findings could reflect the histologic composition of BPH and the correlation of the composition of BPH and the clinical parameters such as patient's age, peak flow rate, IPSS symptom score, and prostate volume. MATERIALS AND METHODS: Fifty five patients with BPH treated by transurethral resection were studied. The proportions of stromal and glandular area in the resected prostate were determined by image analyzer. "Stromal hyperplasia"was defined when more than 75% of the resected prostate was composed of stromal tissue and microscopically, abundant stromal tissue with normal or atrophic glands were dominant. "Glandular hyperplasia" was defined when more than 25% of the prostate was composed of glandular tissue and microscopically, hyperplastic glandular cells and dilated lumen with occasional cystic changes were dominant. Ultrasonographically, it is classified as stromal hyperplasia when the echo of central gland is fine and lower echogenic than that of peripheral gland, and classlfied as glandular hyperplasia when the echo of central gland Is coarse and isoechogenic or hyperechogenic with focal echopenic areas. Statistical significance was judged by Student t-test and linear regression analysis. Concordance of ultrasonographic findings and histopathologic findings of BPH was determined by Kappa index. RESULTS: Sixty nine percent of resected prostate tissue were composed of stromal tissue. The proportion of stromal tissue in stromal hyperplasia and glandular hyperplasia was 85.8+/- 1.6% and 64.8+/- 1.0%, respectively(p<0.001). Ultrasonography accurately reflect histopathologlc type in 50 of 55 BPH. Two of 12 stromal hyperplasia and 3 of 43 glandular hyperplasia were falsely interpreted on ultrasonography. Three of 5 falsely interpreted cases showed marginal stromal tissue composition(60.9%, 72.9%, 73.3%, 76.4%, and 84.2%). Kappa index of ultrasonogrhaphic finding and histopathologic classification was 0.74(fair to good). In the meantime, clinical parameters including patient's age, peak flow rate, IPSS symptom scores did not correlate with tissue composition. Only prostate volume and resected prostate weight showed negative correlation with proportion of stromal tissue(p=0.0953 and p=0.0794, respectively). CONCLUSIONS: Using our sonographic criteria, transrectal ultrasonography could reflect histologic type of BPH so that choice of medical therapeutic agent may be possible. Larger prostates had less stromal tissue, however, the histologic composition of the prostate was not related to the severity of symptoms or peak flow rate.
Classification ; Humans ; Hyperplasia ; Linear Models ; Prostate ; Prostatic Hyperplasia ; Ultrasonography