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

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

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

Traditionally, preeclamptic women who meet established criteria for severe disease aredelivered expeditiously. Although delivery is always appropriate thrapy for the mother, itmay not be for the fetus remote from term. The purpose of this investigation was to evaluatethe differences of pregnancy and neonatal outcome of severe preeclampsia and normalpregnancy, especially before 34 weeks gestational age, and to determine whether aggressiveor expectant management of severe preeclampsia before 34 weeks is more beneficial tomaternal and fetal outcome. A hundred and twenty consecutive pregnancies complicated bysevere preeclampsia and a hundred and twenty normal pregnancies were stuided.The results were as follows:1. The incidence of severe preeclampsia was 3.9%(130 of 3328). The 26~30 year oldage group was most common, 43%(52 patients).2. In case of study between severe preeclamptic patients and normal pregnant patient,there was no differences regarding gestational age at delivery, birth weight, cesarean sectionrate, incidence of RDS, perinatal death. The 1min/5 min Apgar scores of severe preeclampsiais significantly lower than control group(6/7 vs 7/8, p < 0.05). Neonates with SGA(small for gestational age) were found in 29% neonates of patients with severe preeclampsia,which is significantly higher than normal pregnancy group(6%, p < 0.05).3. There was no significant difference between expectant(n=10) and aggressive(n=21)management group less than 34 weeks gestation regarding the gestational age of admissionand delivery, blood pressure, proteinuria, serum creatinine, hemoglobin, hematocrit, pletelets,liver enzymes, and LDH. Only the prolongation of gestational age in the expectant managementgroup is significantly higher than in the aggressive management group(7 vs 2 days,p < 0.05).4. The neonatal and pregnancy outcome of expectant(n=10) and aggressive managementgroup(n=15) were as follow: The birth weight in the expectant management groupis lower than in the aggressive management group(1316.7+/-668.8g vs 1576.2+/-428.7 g, p < 0. 05). The incidence of SGA in the expectant management group is higher than in theaggressive management gorup(50% vs 27%, p=not significant). There was no significant differencebetween expectant and aggressive management group regarding the 1 min/ 5 minApgar score, the cesarean section rate, and the frequency of respiratory distress syndrome,cerebral hemorrhage, renal failure, sepsis, DIC of neonates.
Birth Weight ; Blood Pressure ; Cesarean Section ; Creatinine ; Dacarbazine ; Female ; Fetus ; Gestational Age ; Hematocrit ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Mothers ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Proteinuria ; Renal Insufficiency ; Sepsis

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

Recently, new trials for the treatment of the vesicoureteral reflux have been proposed. These trials convince us of the need to reevaluate the ureterovesical junction and to reinvestigate the role of the detrusor muscle and the ureteral sheath. We studied forty adult and five infant human bladders and distal ureters. Microscopic sections were studied, taken serially from the ureterovesical junction and adjacent urinary bladder with the hematoxylin-eosin and the Gomori trichrome staining method. The slit shaped ureteral orifice was most commonly observed ( 57.0 %). The approximate ratio of the submucosal length to the intramural ureter was 2:3. Ureteral sheath consists of smooth muscle fibers (bundles) arranged in a helical fashion and loose connective tissues which envelope the distal ureter over a 3 cm distance to the juxtavesical portion. These structures are independent from the ureter proper. The muscle bundles of ureteral sheath are of 4 types: 1. Those which extend from the outer bladder wall to the juxtavesical ureters (JVU) and, 2. continuing from JVU, these become the detrusor muscle after entering the bladder. 3. Bundles run from the JVU to the trigone, and 4. bundles run to the trigone from the mid-circular layer of the detrusor muscle. In the bladder, most roof muscle bundles of ureteral sheath run to the upper portion of the trigone after crossing the intramural ureter ventrally. Most floor bundles run to the inferolateral portion of the bladder. In infants, the deep trigone and basal detrusor muscle are relatively thicker and not compactly organized. We conclude that ureteral sheath is of detrusor muscle origin. We suggest that ureteral sheath functions as a part of a preventive mechanism with compressing the intravesical ureter by contraction in voiding and filling phase independently against vesicoureteral reflux.
Adult ; Connective Tissue ; Humans ; Infant ; Muscle, Smooth ; Ureter ; Urinary Bladder ; Vesico-Ureteral Reflux

No abstract available.
Drug Therapy* ; Humans ; Neutropenia*

No abstract available.
Pregnancy*

OBJECTIVE: To investigate the early trauma history between young/middle adulthood patients and earlier/later older adulthood patients with panic disorder (PD). METHODS: 216 patients with PD and 76 healthy controls (HCs) were included for analysis. Patients with PD were operationally dichotomized into two groups of young/middle adulthood (age below 50 years) and earlier/later older adulthood (age 50 years or over) to compare the early trauma history between two groups. Data of sociodemographic factors, self-reported shortened form of the Early Trauma Inventory (ETI), and the Albany Panic and Phobia Questionnaire (APPQ) were analyzed. RESULTS: Patients with PD showed higher scores of ETI than HCs. Young/middle adulthood PD showed statistically significantly higher levels of general trauma (t=-2.088, p=0.041), physical abuse (t=-2.456, p=0.014), emotional abuse (t=-3.690, p=0.000), and total scores of trauma (t=-3.534, p=0.001) except sexual abuse. In the young/middle adulthood PD group, ETI scores were significantly correlated with APPQ scores while no significant correlation with ETI was found in earlier/later older adulthood PD. CONCLUSION: These results show that PD is statistically associated with early trauma history and that early trauma history is more significantly related with PD in young/middle adulthood than earlier/later older adulthood. These findings suggest that the age factor should be considered in clinical practice for patients with PD.
Age Factors ; Humans ; Panic Disorder* ; Panic* ; Phobic Disorders ; Physical Abuse ; Sex Offenses