No abstract available.

system may include bending force in first and second orders and a torsional force in third order. Analytical and experimental studies on bending force have been introduced, but information about torsion is still lack. The purpose of this study was to estimate the torsional moment in the force system of rectangular arch wires through theoretical and experimental studies. Wires most frequently used for third order control were selected as study materials. Cross sections of 0.016X17.022, 0.0174.025, 0.0194.025 inch rectangular wires in four different materials such as stainless steel (O mco), TMA (Ormco), NiTi (Ormco), and braided stainless steel (DentaFlex, Dentaurum) were used. The torque/twist rate of each test material was calculated using the torsion fotiuula Torque/twist rate, yield torsional moment, and ultimate torsional moment were measured with a torque gauge. The torsion formula assesses that the torque,/twist rate (T/theta) is proportional to the characteristics of material(G) and cross section (J), and is inversely proportional to the length of wire (L). Most experimental results conesponded with the formula. The relative stiffness was calculated for reference to a logical sequence of wire changes.
Logic ; Orthodontic Wires* ; Stainless Steel ; Torque ; Torsion, Mechanical

The hem-o-lock is useful tools for the laparoscopic surgeon. We herein describe a simplified technique for suturing and knotting technique using hem-o-loc. After enucleation of the myoma, uterine parenchymal defect was closed laparoscopically using a 1-0 vicryl suture on a needle, also prepared with a hem-o-lock. Before suturing, the vicryl is tied up with hem-o-loc on the tail of continuous suture that is start point of suture site. Once the suture is passed, a hem-o-loc is used to cinch it down on the suture site and secure the knot tightly. All sutures can be completed with just one suture, continuously. We experienced no major surgical complication.
Myoma ; Needles ; Polyglactin 910 ; Sutures

STUDY DESIGN: A case report. OBJECTIVES: To report a case of indirect repair of cerebrospinal fluid (CSF) leakage after cervical anterior foraminotomy using Surgicel® and fibrin glue. SUMMARY OF LITERATURE REVIEW: There is no single modality that is best practice for this type of case because it is difficult to apply primary repair for a case of CSF leakage after cervical anterior decompression. MATERIALS AND METHODS: A 49-year-old female patient was diagnosed with CSF leakage on the second day after cervical anterior foraminotomy. We performed coverage with Surgicel® and fibrin glue at the CSF leak site. RESULTS: The patient was treated with indirect repair of CSF leakage without any complications. The clinical and radiological outcomes were excellent upon follow-up 1 year postoperatively. CONCLUSIONS: Indirect repair using Surgicel® and fibrin glue is an effective treatment for postoperative CSF leakage after cervical anterior foraminotomy.
Cerebrospinal Fluid Leak* ; Cerebrospinal Fluid* ; Decompression ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Follow-Up Studies ; Foraminotomy* ; Humans ; Middle Aged ; Practice Guidelines as Topic

OBJECTIVE: Paclitaxel, ifosfamide, and cisplatin have moderate single-agent activity in patients with metastatic or recurrent cancer of the uterine cervix. We administered a combination of these three agents (TIP) to patients with recurrent cervical carcinoma to evaluate its activity. METHODS: Forty-three patients were treated with ifosfamide (I) 1500 mg/m2 intravenously over 3 hours on Days 1-3, paclitaxel (T) 135 mg/m2 as a 3-hour intravenous infusion and cisplatin (P) 50 mg/m2 intravenously over 30 min on Day 1. The chemotherapy was repeated every 3 weeks. RESULTS: Thirty-five patients received at least three courses of treatment and were evaluable for response. Eighteen patients (51.4%) achieved an objective response, including 5.7% complete and 45.7% partial responses. The median time to progression and overall survival for all patients were 8.0 and 16.0 months, respectively. The site of recurrence relative to prior radiation field and histopathology (squamous vs other pathology) did not affect the response rate and survival. Patients treated with another chemotherapy regimen before the initiation of TIP regimen showed lower response rate (28.6% vs 66.6%, p=0.027) and shorter survival (14 month vs 25 month, p=0.028). Grade 3 or 4 toxicity included granulocytopenia in 13% of patients, anemia in 8%, thrombocytopenia in 5%. CONCLUSION: The TIP regimen is relatively well tolerated and moderately active in patients with recurrent carcinoma of the uterine cervix. Patients more likely to benefit are those who received TIP regimen for the first time after recurrence.
Agranulocytosis ; Anemia ; Cervix Uteri* ; Cisplatin* ; Drug Therapy ; Female ; Humans ; Ifosfamide* ; Infusions, Intravenous ; Paclitaxel* ; Recurrence ; Thrombocytopenia ; Uterine Cervical Neoplasms

OBJECTIVE: To compare the efficacy of a pulmonary recruitment maneuver using lower airway pressure (30 cm H2O) and intraperitoneal bupivacaine, alone or in combination, for reducing shoulder pain after gynecologic laparoscopy.METHODS: A prospective controlled study was performed in a teaching hospital with patients who underwent elective gynecologic laparoscopic surgery. Two hundred eighty-seven patients were randomized into 1 of 4 groups: group A, placebo; group B, intraperitoneal instillation of bupivacaine; group C, CO2 removal by a pulmonary recruitment maneuver; group D, combination of intraperitoneal bupivacaine and pulmonary recruitment maneuver. The interventions were performed at the end of surgery. Shoulder pain was recorded on a visual analog scale (VAS) at 1, 6, 12, and 24 hours postoperatively.RESULTS: The overall incidence of shoulder pain was 49.8% and the incidence tended to gradually decrease from group A to group D (59.0% in group A, 54.8% in group B, 44.4% in group C, and 41.5% in group D; P=0.026). In addition, the VAS scores gradually decreased from group A to D, although a statistically significant difference was only found at 6 hours postoperatively (P=0.03). There were no complications related to the interventions.CONCLUSION: The combination of a pulmonary recruitment maneuver with intraperitoneal bupivacaine significantly reduced shoulder pain after gynecologic laparoscopy.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01039441

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasms in the same individual. Due to the development of new diagnostic techniques and the rise in long-term survival of cancer, reports of multiple primary cancers have gradually increased. Herein, we describe the case of a 68-year-old female patient with quadruple primary cancer of the breast, rectum, ovary, and endometrium. For its great rarity, we report this case with a review of the literature.
Aged ; Breast ; Breast Neoplasms ; Endometrium ; Female ; Humans ; Ovary ; Rectum

Multiple primary cancer is defined as the multiple occurrence of malignant neoplasms in the same individual. Due to the development of new diagnostic techniques and the rise in long-term survival of cancer, reports of multiple primary cancers have gradually increased. Herein, we describe the case of a 68-year-old female patient with quadruple primary cancer of the breast, rectum, ovary, and endometrium. For its great rarity, we report this case with a review of the literature.
Aged ; Breast ; Breast Neoplasms ; Endometrium ; Female ; Humans ; Ovary ; Rectum

OBJECTIVE: This study was done to evaluate whether perioperative propranolol (ß-blocker) in ovarian cancer patients undergoing debulking surgery reduced perioperative tumor growth induced by surgical stress. METHODS: This was a prospective randomized single institution analysis. The primary objective was to compare the changes in CA 125 level (changes between preoperation day 2 and postoperative day 7). As a study arm, patients received a low dose of propranolol 40 mg/day (4×10 mg) starting two days before surgery and 40 mg twice daily for three days following surgery. RESULTS: Twenty-two patients were enrolled and 16 were evaluable for efficacy. The drug was well tolerated. The mean decrease of CA 125 during the seven perioperative days was 83.1±8.9% in the propranolol group and 72.4±14.7% in the placebo group. The difference was statistically significant (P=0.044). The change of C-reactive protein, cortisol, and anxiety score (State-Trait Anxiety Inventory-X1) were not different between the two groups. CONCLUSION: This preliminary result is the first to directly test the role of perioperative propranolol on tumor growth. Even with the small sample size and short term use of the drug, perioperative propranolol was effective in reducing tumor burden (as measured by CA 125) suggesting its potential benefits in decreasing perioperative tumor growth.
Anxiety ; Arm ; C-Reactive Protein ; Female ; Humans ; Hydrocortisone ; Ovarian Neoplasms* ; Pilot Projects* ; Propranolol* ; Prospective Studies ; Sample Size ; Tumor Burden

OBJECTIVE: To compare laparoscopic surgery with conventional abdominal surgery in patients with early stage endometrial cancer. METHODS: A retrospective review of 63 patients with early stage endometrial cancer managed between March 2003 and May 2005. Two groups were defined whether they had been treated by laparoscopy (case group: n=26) or by laparotomy (control group: n=37). We compared age, body mass index (BMI), hemoglobin change, operation time, number of pelvic lymph nodes, hospital stay, case with adjuvant treatment and recurrence between two groups. RESULTS: There was no statistical difference in characteristics (age, BMI, nulliparity, previous abdominal surgery, FIGO stage, histologic grade). between case and control group. In addition, there was no statistical difference in operation data and outcomes between two groups. Hemoglobin changes were 1.1 g/dL (case group) vs 1.7 g/dL (control group) (p=0.072). Operation time was 131 min vs. 115 min. The numbers of lymph nodes obtained were 8.7 vs 7.7 (right) 9.2 vs. 7.6 (left). Hospital stays were 8.4 vs. 9.2 days. Adjuvant treatment cases were 7 vs. 15. Recurrent case was one in each group. Two patients initially evaluated by laparoscopy were converted to laparotomy due to bleeding and adhesion. CONCLUSION: Laparoscopic surgery for treatment of early endometrial cancer is a safe and effective alternative to laparotomy . However, long-term survival and risk of recurrence have yet to be determined.
Body Mass Index ; Endometrial Neoplasms* ; Female ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Nodes ; Parity ; Recurrence ; Retrospective Studies