OBJECTIVE: To establish a supraorbital nerve sensory conduction recording method and assess its usefulness. METHODS: Thirty-one healthy subjects without a history of trauma or neurological disease were recruited. For the orthodromic procedure, the recording electrode was attached immediately superior to the supraorbital notch. The stimulation electrode was placed on points along the hairline which evoked the largest sensory nerve action potentials (SNAPs). The antidromic sensory response was recorded after switching the recording and stimulating electrodes. The measured parameters were onset latency, peak latency, and baseline to peak amplitude of the SNAPs. The electrophysiological parameters of the bilateral supraorbital nerves were compared. We also recruited two patients who had sensory deficits on one side of their foreheads because of laceration injuries. RESULTS: The parameters of orthodromically recorded SNAPs were as follows: onset latency 1.21±0.22 ms (range, 0.9-1.6 ms), peak latency 1.54±0.23 ms (range, 1.2-2.2 ms), and baseline to peak amplitude 4.16±1.92 µV (range, 1.4-10 µV). Those of antidromically recorded SNAPs were onset latency 1.31±0.27 ms (range, 0.8-1.7 ms), peak latency 1.62±0.29 ms (range, 1.3-2.2 ms), and baseline to peak amplitude 4.00±1.89 µV (range, 1.5-9.0 µV). There was no statistical difference in onset latency, peak latency, or baseline to peak amplitude between the responses obtained using the orthodromic and antidromic methods, and the parameters also revealed no statistical difference between the supraorbital nerves on both sides. CONCLUSION: We have successfully recorded supraorbital SNAPs. This conduction technique could be quite useful in evaluating patients with supraorbital nerve lesions.
Action Potentials ; Electrodes ; Electromyography ; Forehead ; Humans ; Lacerations ; Neural Conduction*

The purpose of this study was to compare radiopacity and radiographic discriminability of various FRC-Posts. Six FRC-Posts were investigated ; 1) FRC Postec Plus (Ivoclar Vivadent AG, Schaan, Liechtenstein), 2) Snowlight (Carbotech, Lewis center, OH, USA), 3) Dentin Post (Komet Brasseler, Lamgo, Germany), 4) Rely-X Fiber Post (3M ESPE, St.paul, MN, USA), 5) D.T.-Light Post (BISCO, Schaumburg, IL,USA), 6) Luxapost (DMG, Hamburg, Germany) The radiographs of each post with a reference 1 mm / 2 mm aluminum step-wedge was taken using digital sensor. The optical density were calculated by gray value of 10 x 10 pixel and compared in mm Al equivalent at five points. Six maxillary incisors of similar radiopacity were used. Radiographs of posts in Mx. incisors of lingual side of dry mandible were taken. We showed radiographs and asked the questionnaire to 3 radiologists, 3 endodontists, 3 general practitioners. The questionnaire was comprised of choices of the highest, lowest radiopaque individual post and the choices of best discriminable post at apical, coronal area. The following results were obtained. 1. Each post system showed various radiopacity. 2. There was change of discriminability between each post and simulated specimens regardless of examiner. Although each post showed various radiopacity, the difference of radiopacity did not affect on discriminability.
Acrylic Resins ; Aluminum ; Composite Resins ; Dentin ; General Practitioners ; Humans ; Incisor ; Mandible ; Polyurethanes ; Resin Cements ; Surveys and Questionnaires

A thymic carcinoma is a rare malignant neoplasm of the thymus epithelium, which can be distinguished from a benign or invasive thymoma. Contrary to a thymoma, the association of a thymic carcinoma and autoimmune disease is rare, with only a few cases having been reported. Herein, a case of thymic carcinoma diagnosed concurrently with systemic lupus erythematosus (SLE) is reported. A 49 year-old man presented at our clinic with myalgia. He was diagnosed with SLE, based on an oral ulcer, lymphopenia, and positive ANA and anti-Sm antibodies. Incidentally, a routine chest X-ray showed a large mediastinal mass. Pathological examination of the mediastinal mass revealed an undifferentiated thymic carcinoma, of WHO classification type C. Further work-up for staging showed multiple bone and lung metastases. With a palliative aim, he received systemic chemotherapy, but refused further chemotherapy after the 2nd course. Currently, the patient has not been followed up since the chemotherapy.
Antibodies ; Autoimmune Diseases ; Classification ; Drug Therapy ; Epithelium ; Humans ; Lung ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Middle Aged ; Myalgia ; Neoplasm Metastasis ; Oral Ulcer ; Thorax ; Thymoma* ; Thymus Gland

OBJECTIVE: We have developed an instant messenger system that supports transmitting 3D medical image objects for telediagnostic use. METHODS: We used thresholding and down-scaling technique to build down-scaled 3D object with 80 sliced Digital Imaging and Communication in Medicine(DICOM) images. And, we also construct instant messenger for medical data transfer and general communication. We measured total image size and transmission time which were decreased when applied peer to peer connection using instant messenger for medicine. RESULTS: Our study showed that total DICOM image size was decreased around 1% and transmission time was also decreased by 1.59% when we use proposed system. CONCLUSION: Proposed methods have a potential to be a useful tool in ubiquitous health network system. Also, we expect the synergy effect is increased by developing 3D object technique and security solutions.

PURPOSE: We prospectively conducted a multi-center, open-label, randomized phase II trial to compare the efficacy and safety of docetaxel plus cisplatin (DC) and etoposide plus cisplatin (EC) for treating advanced stage non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Seventy-eight previously untreated patients with locally advanced, recurrent or metastatic NSCLC were enrolled in this study. The patients received cisplatin 75 mg/m2 on day 1 and either docetaxel 75 mg/m2 on day 1 or etoposide 100 mg/m2 on days 1 to 3 in the DC or EC arm, respectively, every 3 weeks. RESULTS: The objective response rate was 39.4% (15/38) and 18.4% (7/38) (p=0.023) in the DC and EC arms, respectively. The median time to progression (TTP) was 5.9 and 2.7 months (p=0.119), and the overall survival was 12.1 and 8.7 months (p=0.168) in the DC and EC arms, respectively. The prognostic factors for longer survival were an earlier disease stage (stage III, p=0.0095), the responders to DC (p=0.0174) and the adenocarcinoma histology (p=0.0454). The grades 3 and 4 toxicities were similar in both arms, with more febrile neutropenia (7.9% vs. 0%) and fatigue (7.9% vs. 0%) being noted in the DC arm. CONCLUSION: DC offered a superior overall response rate than does EC, along with tolerable toxicity profiles, although the DC drug combination did not show significantly improved survival and TTP.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Etoposide* ; Fatigue ; Febrile Neutropenia ; Humans ; Prospective Studies

BACKGROUND: To define the final outcome of large cell carcinomas (LCC) after surgical treatment, the histopathology, clinical features and follow-up results of 28 cases were reviewed. METHODS: Twenty eight patients, with LCC that underwent a surgical resection between 1986 and 2001, at the Severance Hospital, were retrospectively reviewed. We analyzed clinical data, radiological findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected primary lung cancer cases (1003 cases) during the 15 year period of the study. The mean age of the patients was 59 years old, with 25 male cases. There were 23 smokers, smoking an average of 33 pack years. A cough was the most frequent symptom. There were 15 cases located in the peripheral part of the lung and 26 consisted of a lobulated mass. From a chest CT scan, 26 cases had necrotic portions, which appeared to be low density. The postoperative stages were IA, IB, IIB, IIIA and IV in 1 (3.6%), 11 (39.3%) 8 (28.5%), 7 (25%), 1 case (3.6%), respectively. The concordance rate of the pre- and postoperative stage was 43%. The median survival time and 5 year-survival rate were 54.5 months and 45%, respectively. CONCLUSION: Our results suggested that a LCC in the lung was predominant in males, and equally located at the center and periphery of the lung in the surgically resected cases. To define the treatment outcome and risk factors of a LCC of the lung, further multicenter studies are needed.
Adenocarcinoma/diagnosis/epidemiology/surgery ; Adolescent ; Adult ; Age Distribution ; Aged ; Carcinoma, Large Cell/*diagnosis/epidemiology/*surgery ; Female ; Human ; Lung Neoplasms/*diagnosis/epidemiology/*surgery ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Sex Distribution ; Support, Non-U.S. Gov't ; Survival Analysis

BACKGROUND: To define the final outcome of large cell carcinoma (LCC) after surgical treatment, we reviewed the histopathology, clinical features and follow-up results of 28 cases. METHODS: We retrospectively reviewed 28 patients with LCC who underwent surgical resection during the last 15 years from 1986 to 2001 in Severance Hospital. We evaluated clinical data, radiologic findings, pathologic findings, treatment modalities, and survival. RESULTS: The prevalence of LCC was 2.9% (29 cases) among the surgically resected cases in primary lung cancer (1003 cases) during 15 years. The mean age was 59 years old and twenty five cases were male. There were 23 smokers and the average pack year was 33. The cough was the most frequent symptom. Fifteen cases were located in the peripheral part of the lung. Twenty cases consisted of lobulated mass. In chest CT scan, twenty six cases had necrotic portions which appeared to be lower density. Postoperative stage was IA in 1 case (3.6%), IB in 11 cases (39.3%), IIB in 8 cases (28.5%), IIIA in 7 cases (25%), and IV in 1 case (3.6%). Preoperative and postoperative stage concordance rate was 43%. Median survival time was 54.5 months and 5 year-survival rate was 45%. CONCLUSION: Our results suggest that LCC in the lung is predominant in male and is equally located in the central and peripheral parts of the surgically resected cases. To define the treatment outcome and risk factors of LCC of the lung, further multicenter studies are needed.
Carcinoma, Large Cell* ; Cough ; Diagnosis ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.
Disease-Free Survival ; Doxycycline* ; Fever ; Humans ; Lung Neoplasms* ; Lung* ; Picibanil* ; Pleural Effusion, Malignant* ; Pleurodesis* ; Radiography, Thoracic ; Retrospective Studies ; Sclerosis ; Sclerotherapy ; Thoracostomy

BACKGROUND: Lung cancer is the leading cause of malignant pleural effusions, which is currently most commonly treated using pleurodesis via bedside thoracostomy. Several agents had been used for the treatment of pleural sclerosis, but with differing efficacies and associated side effects. Our purpose with this study was to compare the efficacy, side effects and disease free survival times of patients being treated with OK-432 and doxycycline sclerotherapy in lung cancer induced malignant pleural effusions. PATIENTS AND METHODS: 79 patients who underwent pleurodesis with OK-432 and doxycycline, between Jan. 1994 and Aug. 2001, were retrospectively reviewed. Resopnses 30 days following pleurodesis were determined from chest radiographs, with the disease free survival time being evaluated according to the response. RESULTS: The success rates, 30 day followint pleurodesis, with OK-432 and doxycycline 83 and 87%, respectively (p=0.677). With regard to the side effects, fever was more common when OK-432 was used (59%, p=0.001), and pain was more common with doxycycline use (73%, p=0.008). There was no significant difference in disease free survival times between OK-432 (13.6 Months) and doxycycline (11.6 Months) (p=0.532). CONCLUSION: with the use of OK-432, for pleurodesis, was as effective as doxycycline, can be considered as an alternative treatment for malignant effusion in patients with lung cancer.
Disease-Free Survival ; Doxycycline* ; Fever ; Humans ; Lung Neoplasms* ; Lung* ; Picibanil* ; Pleural Effusion, Malignant* ; Pleurodesis* ; Radiography, Thoracic ; Retrospective Studies ; Sclerosis ; Sclerotherapy ; Thoracostomy

Cryptococcosis is a relatively common mycosis of human caused by a worldwide Cryptococcus neoformans. Cryptococcosis occurs more frequently in immuno-compromised hosts such as patients with lymphoma, AIDS, leukemia and other debilitating diseases which manifest a condition of altered cell mediated immunity. Also cancer patients with anticancer chemotherapy are at high risk. Cryptococcosis is primarily a pulmonary disease that remains asymptomatic and unrecognised in most cases. Meningitic and meningoencephalitc forms are more frequently diagnosed because of their striking clinical symptoms.Meningoencephalitis is an uncommon form of cryptoccocosis that often leads to coma and death within a short time, if it is not quickly diagnosed and treated properly. The treatment of choice for the cryptococcosis consists of intravenous amphotericin B and 5-fluorocytocine. We report a case of cryptococcal meningitis in 47-year-old female breast cancer patient with liver metastasis after systemic chemotherapy. She complained headach, fever and diagnosed as cryptococcal meningitis after the India ink smear and culture of CSF. After treated with amphotericin B, her conditions were improved.
Amphotericin B ; Breast Neoplasms ; Coma ; Cryptococcosis ; Cryptococcus neoformans ; Drug Therapy ; Female ; Fever ; Herpes Zoster* ; Humans ; Immunity, Cellular ; India ; Ink ; Leukemia ; Liver* ; Lung Diseases ; Lymphoma ; Meningitis, Cryptococcal* ; Middle Aged ; Neoplasm Metastasis* ; Strikes, Employee