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.
Anterior Temporal Lobectomy* ; Seizures*

PURPOSE: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation. METHODS: Medical records of 80 patients who had undergone cataract extraction with primary intraocular lens implantation between 6 months and 21 years of age from March 1993 to March 2008 were reviewed. Nine patients (11 eyes) with strabismus before cataract surgery were excluded. Patients were divided into 2 groups; patients with congenital bilateral cataracts (43 patients, 86 eyes) or patients with unilateral cataracts (28 patients, 28 eyes). Data were collected on age at cataract surgery, pre and post-cataract extraction visual acuity, interocular visual acuity differences, nystagmus, operation method, and the existence of associated other ocular diseases to evaluate the association of the onset of strabismus and after cataract. RESULTS: Factors statistically significantly associated with the development of strabismus include presence of nystagmus in bilateral cataracts and postoperative visual acuity differences > 0.3 in unilateral cataracts. A post-cataract extraction mean visual acuity < or = 0.2 and preservation of posterior capsule were significant factors in both groups. CONCLUSIONS: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus especially when they have poor postoperative visual acuity, nystagmus, large postoperative interocular visual acuity differences, or preservation of posterior capsule.
Cataract ; Cataract Extraction ; Child ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Medical Records ; Strabismus ; Visual Acuity

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

STATEMENT OF PROBLEM: Proper proximal contact is important for maintaining and stabilizing the dental arch. However, the proximal contact strength (PCS) is not a constant value and can be affected by a variety of factors. PURPOSE: This study examined the influences of postural changes on the posterior PCS. MATERIAL AND METHODS: Twelve adults with a normal occlusion and had not undergone prosthetic treatment or proximal restoration were participated in this study. A metal strip was inserted into the proximal surface and removed at a constant velocity. The contact strength was measured in every contact point between canine to second molar in both arches. The PCSs were obtained initially in the upright position, secondly in the supine position and finally in the upright position again. All measurements were repeated after a 2 hour period. Statistical analysis was carried out using the Friedman test (P < .05). RESULTS: Generally, a decrease in PCS occurred when the posture was changed from the initial upright to supine position, while it increased when the posture was changed from the supine to upright position. A significant change was observed in all areas except for between the canine-first premolar in the maxilla and between the first molarsecond molar in the mandible areas. CONCLUSION: The posterior PCS, which dentists generally believe to be a static feature of occlusion, is affected significantly by posture.
Adult ; Bicuspid ; Dental Arch ; Dentists ; Humans ; Mandible ; Maxilla ; Molar ; Posture ; Supine Position

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fibronectins* ; Staphylococcus aureus* ; Staphylococcus*

Hearing loss is a very common health problem throughout the world, although the number of hearing impaired individuals varies greatly in the countries. It is generally accepted that hearing impairment inevitably leads to a breakdown in communication and physical and mental health problems consequently. Nevertheless, few community based studies have been undertaken to examine both the mental and more general physical state of the hearing impaired patients. This study was conducted to evaluate the anxiety and depression in hearing impaired patients. Self-administered questionnaires including sociodemographic data were given to 336 subjects over the age of 18 years who visited the Health Management Center, Uijongbu St. Mary's Hospital for the routine health check up from January 1996 to April 1996 and three hundred seventeen samples (male: 197, female: 120) were selected. For the assessment of anxiety and depression we used Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) devised by Zung. And hearing impairment was evaluated using a Beltone Model 110 Audiometer. The results were statistically analyzed by ANOVA test and x(2) test. The results obtained were as follow: 1. The mean anxiety scores counted by SAS of 0-15dB HL (hearing loss) group (classified by the average loss in the better ear at 500, 1,000, 2,000Hz frequencies), 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 33.1+/-6.6 32.2+/-5.9, 41. +/-8.4, 42.8+/-6.0 respectively. And the mean depression Scores counted by SDS of 0-15dB HL group, 16-29dB HL group, 30-44dB HL group, more than 45dB HL group were 37.4+/-7.7, 37.2+/-7.2, 46.2+/-8.4, 48.6+/-8.6, respectively. The more than 30dB HL group showed significant high scores in SAS and SDS than the less than 30dB HL group (p<0.001). 2. The frequency of clinically significant anxiety disorder (SAS > or = 50) was 3.4% in less than 30dB HL group and 11. 1% in more than 30dB HL group. The difference between two groups was statistically significant (p<0.05). 3. The frequency of clinically significant depression disorder (SDS > or = 50) was 5.1% in less than 30dB HL group and 39.5% in more than 30dB HL group. The difference between two groups was statistically significant (p<0.05). 4. When several important interaction variables related to anxiety: and depression (such as age, sex, marital status, education level, economic status, occupation, religion) were stratified and we compared the groups between the more than 30dB HL and less than 30dB HL, most factors about anxiety and depression showed the significant differences in two groups. 5. Multiple logistic regression analysis revealed that hearing loss(p<0.05) predicted anxiety disorder (SAS> or = 50) and hearing loss(p<0.01), age(p<0.05) predicted depression disorder (SDS> or = 50). In conclusion, there was significant difference in anxiety and depression scores, between more than 30dB HL(in the better hearing ear) group and less than 30dB HL group. This study suggested that anxiety and depression should be considered as adverse effects of hearing impairment.
Anxiety Disorders ; Anxiety* ; Depression* ; Ear ; Education ; Female ; Hearing Loss* ; Hearing* ; Humans ; Logistic Models ; Marital Status ; Mental Health ; Occupations ; Questionnaires

No abstract available.
Adenoma* ; Cervix Uteri* ; Female