PURPOSE: To evaluate the role of MRI in the management of cervical cancer treated by conventional four-field whole pelvic irradiation. METHOD AND MATERIAL: Between 1993-march and 1994-february, 20 patients(4 Stage I B, 3 Stage U A, 13 Stage U B) with invasive cervical cancer were eligible for evaluation of accuracy of conventionally designed lateral treatment field without MRI determination. RESULTS: 5 out of 20 Patients had inadequate margin without MRI. The position of uterine fundus was more important than cervix in correction of field size and the center of treatment field. CONCLUSION: This Preliminary date show MRI determination of uterine position prior to radiotherapy planning is essential in the case of four-field whole pelvic irradiation technique.
Cervix Uteri ; Female ; Humans ; Magnetic Resonance Imaging* ; Radiotherapy* ; Uterine Cervical Neoplasms*

All authors would like to withdraw the article because they have found a mistake in selecting subjects for this study.

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

PURPOSE: To determine the magnetic resonance (MR) imaging findings of tuberculous arthritis, and the frequency-in such cases-with which tuberculoma occurs. MATERIALS AND METHODS: MR images of 26 patients (M:F, 14:12; mean age, 46.2 years) with pathologically proven tuberculous arthritis were retrospectively reviewed. The presence of joint effusion, subchondral erosion, synovial proliferation and soft tissue abscess, and whether the inner wall of this abscess was smooth, were assessed. In particular, we determined whether a nodular lesion which showed low SI on T1WI, central low SI with peripheral high SI on T2WI, and rim enhancement on contrast study, was a tuberculoma. RESULTS: The joints involved were those of the knee (n=7), hip (n=7), shoulder (n=4), sacroiliac region (n=3), elbow (n=3), and ankle (n=2). Joint effusion was noted in 15 cases (58%), and subchondral erosion in 24(92%). synovial proliferation was found in 23 cases (88%), and soft tissue abscess in 24 (92%). The inner wall of this abscess was irregular in 17 cases (71%). A tuberculoma was present in intra- or extra-articular soft tissue in 18 cases (69%). CONCLUSION: The MR findings of tuberculous arthritis were subchondral erosion, synovial proliferation, and soft tissue abscess. The presence of a tuberculoma in intra- or extra-articular soft tissue, a specific finding in tuberculous arthritis, was noted in 69% of our cases.
Abscess ; Ankle ; Arthritis* ; Elbow ; Hip ; Humans ; Joints ; Knee ; Retrospective Studies ; Shoulder ; Tuberculoma*

No abstract available.

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

BACKGROUND: The afferent and efferent pathways of fentanyl cough response (FCR) and central organization are poorly understood at present. The aim of this study was to investigate the pretreatment effects of morphine, propofol, atropine, and midazolam on FCR. METHOD: The 120 healthy patients were randomly assigned to six equal pretreatment groups. They received 2ug/kg fentanyl rapidly through a peripheral venous catheter. The patients in each group were pretreated before the time necessary for peak plasma levels with different drugs as follows: group 1, no premedication; group 2, morphine 0.05 mg/kg iv; group 3, morphine 0.05 mg/kg iv naloxone 0.01mg/kg iv; group 4, propofol 0.5 mg/kg iv; group 5, atropine 0.01 mg/kg iv; group 6, midazolam 0.05 mg/kg iv. The patients were observed for any coughing or side effects, including oxygen desaturation, bronchoconstriction, chest wall rigidity and seizure. RESULT: 40% of patients in group 1 (control) had a cough response to fentanyl. Group 2 (morphine) and group 3 (morphine naloxone) showed a reduced FCR of 10%. The incidence of coughing was 60% of the patients in group 4 (propofol), 30% in group 5 (atropine), and 40% in group 6 (midazolam). These were not statistically significant. CONCLUSION: FCR is not altered by pretreatment with propofol, atropine, or midazolam, but morphine inhibits cough response and this antitussive effect was not antagonized by naloxone.
Atropine* ; Bronchoconstriction ; Catheters ; Cough* ; Efferent Pathways ; Fentanyl* ; Humans ; Incidence ; Midazolam* ; Morphine* ; Naloxone ; Oxygen ; Plasma ; Premedication ; Propofol* ; Seizures ; Thoracic Wall

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

No abstract available.
Humans ; Prognosis* ; Respiratory Insufficiency*

PURPOSE: To define and correlate characteristic sonographic and pathologic findings in men with gynecomastia. MATERIALS AND METHODS: We reviewed medical records and sonographic findings of 26 patients with pathologically proven gynecomastia. All of the chief symptoms, physical findings and causes were categorized. Characteristic sonographic patterns of gynecomastia were analyzed and compared with pathologic findings. RESULTS: Gynecomastia was most common in the 20- to 40-year-old age group (50%) 6;palpable mass was found in 62% of all those cases. Gynecomastia was unilateral or asymmetrical in 22 men (85%), and was caused idiopathically in 21 (81%). The characteristic sonographic patterns correlated with pathologic findings were as follows : (1) focal subareolar smooth oval (or triangular) indistinct margined homogeneous hypoechoic(or isoechoic) patterns were found in 14cases (54%). Eight of these (57%) were of the florid type of gynecomastia (67%) ; (2) diffuse homogeneous hyperechoic (or isoechoic) patterns were found in five cases (19%) ; four of these (80%) were of the intermediate or fibrotic type : (3) involuting female breast parenchymal patterns were found in seven cases (27%), of which six(86%) were of the intermediate or fibrotic type. CONCLUSION: The characteristic sonographic patterns of gynecomastia correlate closely with pathologic types related to the duration of the condition. Ultrasonography isa useful primary diagnostic modality for the evaluation of gynecomastia.
Adult ; Breast ; Female ; Gynecomastia* ; Humans ; Male ; Medical Records ; Ultrasonography