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

The purpose of the present study lied in examining the incidence, treatment and failure causes of peri-implantitis by analyzing medical charts of those patients who underwent implant placement for the past 2 years. The subjects included those patients who underwent implant placement at the present hospital from January 2001 to December 2002. 3i implants were used for the analysis for the comparison of significance. A total of 301 patients were examined, among whom 102 were females and 199, males. Implants were placed in a total of 578 cases. The number of peri-implantitis was present in a total of 29 cases (21 males and 8 females), giving the incidence at 9.6%. The evidence of peri-implantitis was seen in 60 cases, which was in 10.4% of the patients. Among those cases with peri-implantitis, 28 cases (47%) underwent bone graft and 22 cases (43%) underwent maxillary sinus lift. Furthermore, 4 of these patients had systemic diseases such as diabetes or hypertension. Regular management is important for the preven ion of peri-implantitis. In other words, early prevention through regular follow-ups to check the status of surrounding soft tissue would be needed to maintain implants.
Female ; Humans ; Hypertension ; Incidence ; Male ; Maxillary Sinus ; Peri-Implantitis* ; Retrospective Studies* ; Transplants

Continuous bladder irrigation with 1% alum solution was performed in 10 patients with various lesions in whom massive bladder hemorrhage persisted despite evacuation of clots and normal saline irrigation. Hematuria ceased promptly in all patients without any complication. So, we report them with the literature review.
Hematuria ; Hemorrhage* ; Humans ; Urinary Bladder*

Pseudothrombocytopenia is usually associated with anticoagulant ethylene diaminetetraacetic acid (EDTA). The platelet clumping that occurs in EDTA-dependent pseudothrombocytopenia (EDPT) can sometimes be prevented by the use of other anticoagulants such as heparin or sodium citrate. As an alternative, we used kanamycin before or after the withdrawal of EDTA-anticoagulated blood in a 6-year-old boy with EDPT. Kanamycin used supplementarily during the differentiation of EDPT effectively prevented platelet clumping.
Anticoagulants ; Blood Platelets* ; Child ; Citric Acid ; Edetic Acid ; Heparin ; Humans ; Kanamycin* ; Male ; Platelet Aggregation* ; Sodium

No abstract available.
Drug Therapy* ; Extremities* ; Osteosarcoma*

From Sept. 1987 to Mar. 1993, 14 cases of pelvic bone tumors took surgical treatment. Male to female ratio was 7:7, with an average age of 31.9 years. Pathological diagnosis were chondrosarcoma 7(1 ; secondary), metastatic thyroid cancer 2, and each one case of giant cell tumor, desmoplastic fibroma, metastatic synovial sarcoma, malignant fibrous histiocytoma(MFH), and enchondroma. According to the Enneking's classification for the type of surgical resection, we performed 4 cases of type II+III resection, 4 type IA, 2 type I+II, 2 type III, and each one of II and IIA+III. Types of reconstruction were hip fusion(3 cases), heat treated autogenous bone graft combined with total hip replacement arthroplasty(4), bone graft(2), cement spacer(1) or saddle prothesis(1). Simple resection was done for 3 cases. Wide surgical margin was achieved in 12 cases, marginal margin in 1 and intralesional magin in 1. Complications occurred in 3 cases(21.4%) : 1 graft failure ; 1 lymphedema ; and 1 delayed union. The average follow-up period was 27.4(8-60) months. During follow up, lung metastasis developed in MFH case but no local recurrence was noted in all. By the criteria of American Musculoskeletal Tumor Society(MSTS), the average score for functional activities was 21(70% of normal). The function of the extremity with reconstructed or undestroyed pelvic ring was better than that with disrupted pelvic ring(functional scores ; 24.6 vs 12.3 respectively). Due to the Korean life style using hypocaust, fused hip was not good for indoor activity. For the malignant pelvic bone tumor not involving femoral neurovascular bundle, limb-salvage using internal pelvectomy and reconstruction of pelvic ring can be indicated as a surgical procedure, instead of the hindquarter amputation.
Amputation ; Arthroplasty, Replacement, Hip ; Chondroma ; Chondrosarcoma ; Classification ; Diagnosis ; Extremities ; Female ; Fibroma, Desmoplastic ; Follow-Up Studies ; Giant Cell Tumors ; Hip ; Hot Temperature ; Humans ; Life Style ; Lung ; Lymphedema ; Male ; Neoplasm Metastasis ; Pelvic Bones ; Recurrence ; Sarcoma, Synovial ; Thyroid Neoplasms ; Transplants

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

The chest X-ray findings of 20 cases of pulmonary opportunistic infections were analyzed according tocausative agents. The results we as follows; 1. Final diagnoses of 20 cases of opportunistic infections weretuberculosis in 6 cases, pneumocystis carinii pneumonia in 5 cases, bacterial infection in 7 cases, and fungalinfection in 2 cases. 2. The underlying diseases were leukemia in 6 cases, kidney transplantation in 6 cases,lymphoma in 3 cases, nephrotic syndrome in 1 case, nasopharyngeal cancer in 1 case, multiple myeloma in 1 case,agranulocytosis in 1 case, and hypogammaglobulinemia in 1 case. 3. In tuberculosis, all the 6 cases showed severemanifestations such as miliary tuberculosis, tuberculous pneumonia, moderately advanced tuberculosis andtuberculous pericarditis. 4. In pneumocystis carinii pneumonia, the most frequent findings were bilateral alveolardensities and peripheral field of the lung was saved in most cases. 5. In 2 cases of fungal infections bilatarealmultiple cavitary nodules were noted. 6. In cases of bacterial infection there were more cases of gram negativeinfection than gram positive and 2 cases of pseudomonas revealed bilateral multiple cavitary nodules.
Agammaglobulinemia ; Bacterial Infections ; Diagnosis ; Kidney Transplantation ; Leukemia ; Lung ; Multiple Myeloma ; Nasopharyngeal Neoplasms ; Nephrotic Syndrome ; Opportunistic Infections ; Pericarditis ; Pneumonia ; Pneumonia, Pneumocystis ; Pseudomonas ; Thorax ; Tuberculosis ; Tuberculosis, Miliary

Since the introduction of surgical microscope in microvesael surgery by Jacobson and Suarez in 1960, many surgeons have succeeded replantation, transplantation of composite segment of tissues so called free fiap-free bone graft and toe to hand transfer. McCraw & Furlow reported successfully transfered dorsal foot flap using dorsalis pedis artery in 1975 and Cobett transfered great toe to band for reconstruction of the amputated thunb. The authors experienced six cases of microsurgery using dorsalis pedis artery durig the recent two years in the department of Orthopaedic surgery of Soon Chun Hyang College and results in this paper. 1. Four cases out of six were dorsalis pedis free flap, one case was second toe to thumb and tbe other one was reconstruction of an amputated thumb in one stage using iliac bone graft and dorsalis pedis flap. 2. One case out of four cases of dorsalis pedis free flap was performed for reconstruction of contracted first web and the other cases were performed for foot. 3. Five cases out of six were successfully transfeed, one case which was toe to thumb was failed. The cause. of fail was probably due to post-operative hematoma. 4. Composite tissue using dorsalis pedis artery is one of the good donor site for composite tissue transfer for not only skin defect and scar contracture of the hand and foot but also reconstruction of the amputated fingers because it has several advantages; an acceptable thickness, a constant arterial supply, venous drainage through the saphenous system, and constant innervation through the terminal branches of the superficial and deep peroneal nerve.
Arteries ; Cicatrix ; Contracture ; Drainage ; Fingers ; Foot ; Free Tissue Flaps ; Hand ; Hematoma ; Humans ; Microsurgery ; Peroneal Nerve ; Replantation ; Skin ; Surgeons ; Thumb ; Tissue Donors ; Toes ; Transplants

OBJECTIVE: The purpose of this study was to determine the knee extension force of healthy Korean adults by using a hand-held dynamometer and evaulate the relationship of knee extension force between each decade. METHOD: One hundred and twenty healthy subjects (60 males, 60 females) between the ages of 20 and 79 years were tested for knee extension force by using Nicholas Manual Muscle Tester (MMT). Data were analyzed for means, standard deviations, test-retest reliability and correlation with variables by using the SPSS(R) software package. RESULTS: The mean value of the knee extension force was 25.9 +/- 5.8 kg in the males and 16.5 +/- 4.1 kg in the females. Significant difference between each decade was found in the males but not in the females. The knee extension force of the males was stastically correlated with all of variables, i.e., age, weight and height, but the knee extension force of the females, was correlated only with weight. Intratester correlation coefficients were high for the Nicholas MMT to measure the knee extension force for healthy adults. Also the difference between the dominant and nondominant side for the knee extensor force was not significant, stastically. CONCLUSION: This MMT may be useful to quickly and objectively evaluate force in the clinical setting.
Adult* ; Female ; Humans ; Knee* ; Male