Axis, Cervical Vertebra ; Dentofacial Deformities ; Malocclusion ; Mandible ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Temporomandibular Joint

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Histiocytosis, Langerhans-Cell* ; Myelodysplastic Syndromes* ; Skin

PURPOSE: lntra-arterial cisplatin infusion chemotherapy delivers higher concentration of this therapeutic agent to the limited area of cervical carcinoma. We evaluated the role of endorectal ultrasonography (ERUS) in the analysis of the tumor response to this chemotherapy. MATERIALS AND METHODS: ERUS was done in 20 patients of cervical carcinomas limited to the pelvis by rotating the 5 UHz linear arraytransducer along the reference sagittal plane in the middle of uterine cervix and vagina. We examined and compared the change of tumor size and morphology on ER US, before, during and after intra-arterial cisplatin (50 mg/m2) chemotherapy through internal lilac artery near uterine arterial branching. Colposcopy and radical hysterectomy with pelvic lymphadenectomy were performed in all patients, and ERUS findingswere compared with those findings. RESULTS: ERUS correlated well with surgery in the estimation of preoperative tumor size and morphology. Tumor reduction rate on ERUS (100-the largest area of the preoperative tumor/the largest area of the initial tumor) was as follows: more than 75% decrease of the original size in 3 patients, 75% -50% in 6 patients, 50%-25% in 8 patients, and less than 25% in 3 patients. Hyperechoic reflecting areas were noted in 4 patients, which corresponded to gaseous necrosis on postoperative pathology. CONCLUSION: ERUS is helpful to evaluate the morphologic change of cervical carcinoma limited tothe pelvis in intra-arterial cisplatin chemotherapy.
Arteries ; Cervix Uteri ; Cisplatin* ; Colposcopy ; Drug Therapy* ; Female ; Follow-Up Studies* ; Humans ; Hysterectomy ; Lymph Node Excision ; Necrosis ; Pathology ; Pelvis ; Ultrasonography* ; Vagina

In the present study, tap water iontophoresis as a method of treatment of palmoplantar hyperhidrosis was evaluated. Eighteen patients, twelve males and six females, with singnificant palmoplantar hyperhidrosis were treated on every weekday for 2 weeks. The hand and foot of the same side were randomly selected for the treatment by tap water iontophoresis according to the the method described by Levit. The selected hand and foot were immersed in a pair of pans containing tap water and exposed to 30V and 3 to 14mA of direct current for 20 minutes. The results obtained were as follows . Among 18 patients treated, 14(77.8%) accomplishei3 sufficient control of hyperhidrosis after 6 12(average 9.1) treatments. Two patients showed a moderate response and one weak response. One patient showed no response. Several patients experienced untoward effects such as mild itching, erythema, tingling sensation, exfoliation, compensatory hyperhidrosis, but the discomfort was not so severe as to stop the treatment
Erythema ; Female ; Foot ; Hand ; Humans ; Hyperhidrosis* ; Iontophoresis* ; Male ; Pruritus ; Sensation ; Water

Hypereosinophilir. dermatitis, which was first described in 1981, is a clinically distinet disease within the spectrum of the hypereosinophilic syndrome. It is characterized by a generalized polymorphous pruritic eruptions and blood eosinophilia with minimal or no extracutaneous involvement known cause hypereosinophilia, namely parasites, allergies and drug association are absent in these patients. We present a patient with hypereosinophilic dermatitis who did not show evidence of systemic disease. The patient was a 18-year old male who had pruritic erythematous brownish elevated plaque on both lower extremities for 5 months. A)though the patients skin lesions improved after treatment with steroids and dapsone, after discontinuing medication, hypereosinophilia recurred.
Adolescent ; Dapsone ; Dermatitis* ; Eosinophilia ; Humans ; Hypereosinophilic Syndrome ; Hypersensitivity ; Lower Extremity ; Male ; Parasites ; Skin ; Steroids

No abstract available.
Child* ; Humans ; Korea*

No abstract available.
Parkinsonian Disorders*

No abstract available.
Adenomatous Polyposis Coli*

Basement membrane zone gene expression by fibroblast cultures was examined by molecular hybridizations with human sequence specific cDNAs corresponding to type 1V procollagen and laminin subunit polypeptides. Northern transfer analysis with total RNA revealed the presence of specific mRNA transcripts for al (IV) and a2 (1V) chains of type 1V procollagen as well as Bl and B2 chains of laminin. Laminin A chain mRNAs were not detected using the same RNA preparations. The molecular size of al (1V) and a2 (1V) procollagen mRNA revealed 6.8kb and 6.7kb, respectively. The molecular size of Bl chain of laminin revealed 5.6kb, and B2 chain revealed 8.2 and 5.5kb polymorphic transcripts. In slotblot analysis using densitometer, steady-state levels of type IV procollagen and laminin mRNAs indicated that they were in relatively low abunclance, as compaired with type I procollagen mRNA. Quantitative levels of al (IV) and laminin Bl chaii mRNAs were more abundant than those of a2 (IV) and laminin B2 mRNAs. The mRNA ratio of al (IV)/a2 (lV) and laminin Bl/B2 were 1.9 and 1.5, respectively. These results demonstrate evidence for differential regulation of the expression of different basement membrane zone molecules during the formation of basement membrane.
Basement Membrane ; Collagen Type I ; Collagen Type IV* ; DNA, Complementary ; Fibroblasts* ; Gene Expression ; Humans ; Laminin* ; Peptides ; Procollagen ; RNA ; RNA, Messenger ; Skin*