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

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.

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

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 safety and efficacy of the CO2laser as a replacement for the steel scalpel is well documented in plastic surgery, but the use of the laser blepharoplasty has been controversy. This study compares and contrasts the use of the CO2 laser with conventional method in cosmetic upper eyelid blepharoplasty. Thirteen Patients underwent blepharoplasty in a paired comparison study. Four patients(Group A) underwent blepharoplasty by laser, another four patients (Group B) underwent blepharoplasty by conventional method, and the other five patients(Group C) underwent upper eyelid blepharoplasty using the laser on one eye and a conventional method on the other side. Preoperative factor(set up time, equipment), intraoperative factor(actual operation time, bleeding, visibility), postoperative factor(swelling, ecchymosis, immediate & short term result) were evaluated. The advantage of using the CO2 laser rather than the steel scalpel in blepharoplasty are less bleeding and superior intraoperative visibility. The disadvantage of using the laser compared with steel scalpel include the cost of purchasing and maintaining the laser equipment, the need for additional and extensive laser training for surgeons and assistants, and the need for two assistants rather than the one needed for scalpel surgery There were no complications with either the scalpel or the laser.
Bleeding Time ; Blepharoplasty* ; Carbon Dioxide* ; Carbon* ; Ecchymosis ; Eyelids* ; Hemorrhage ; Humans ; Lasers, Gas* ; Matched-Pair Analysis ; Steel ; Surgery, Plastic

For many years the standard surgical treatment for carpal tunnel syndrome has been division of the transverse carpal ligament under direct vision through a palm incision. Although the effectiveness and Patient acceptability of the conventional open carpal tunnel release are good, disability from a painful palm cutaneous neuroma, and prolonged swelling are reported Endoscopic carpal tunnel release seems to result in less postoperative morbidity, and minimal serious complications. Because endoscopic carpal tunnel release leaves the overlying skin, the subcutaneous fat and the palmer fascia and its attachments to the thenar and hypothenar musculature intact its proponents maintain that their patient have less scar tenderness, quicker recovery of grip strength, and earlier to return activities of daily living and work The endoscopic approach(Agee single portal technique), which includes specific localization of the hook of hamate, flexor retinaculum and the superficial palmar arch utilizing topographical landmarks, avoids entry into Guyon's canal and common digital nerves. We experienced four cases of carpal tunnel syndrome. In four cases, patients with carpal tunnel syndrome have been performed endoscopic carpal tunnel release with minor complication.
Activities of Daily Living ; Carpal Tunnel Syndrome ; Cicatrix ; Fascia ; Hand Strength ; Humans ; Ligaments ; Neuroma ; Skin ; Subcutaneous Fat

No abstract available.
Spinal Fractures*

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