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

No Abstract Available.
Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy*

A mediastinal mass was aspirated by fluoroscope-guided fine needle aspiration biopsy in a 47 years old female patient. The first aspiration smears were not diagnostic, because of hemorrhagic background and cell paucity. On the second aspiration, the smears were composed of some clusters of benign epithelial cells in hemorrhagic background. Cells were arranged in mostly solid sheets and tended to form glandular lumina in part. Their nuclei were round and vesicular. Nucleoli were not prominent. These findings were suggestive of benign glandular tissue, which was finally confirmed as mediastinal thyroid gland by open thoracotomy specimen.
Biopsy ; Biopsy, Fine-Needle ; Epithelial Cells ; Female ; Humans ; Middle Aged ; Necrosis* ; Nephritis* ; Risk Factors* ; Thoracotomy ; Thyroid Gland

OBJETIVE: The aim of this study was to evaluate the outcome the GnRH antagonist (Cetrotide) short protocol in controlled ovarian hyperstimulation comparing with GnRH agonist long protocol. MATERIALS AND METHOD: From July 2000 to November 2001, 26 patients, 28 cycles were performed in controlled ovarian hyperstimulation by GnRH antagonist and GnRH agonist. GnRH antagonist (Cetrotide) was administered in 12 patients (14 cycles, Group 1) and GnRH agonist (Lucrin, Sub Q, Group 2) in 14 patients (14 cycles). Ovulation induction was performed by hMG (Pergonal) in group 1, and by Combo (Metrodine HP + Pergonal) in group 2. We compared the fertilization rate, good quality embryo, and clinical pregnancy rate between the two groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. RESULTS: Ovarian hyperstimulation syndrome did not occurred in which estradiol (E2) level was 3874+/-809 pg/ml and the number of retrieved oocytes was 18.4+/-2.4. The number of used gonadotropin ampules was significantly decreased in Group 1 (26.0 vs. 33.1, p<0.04). There were no significant difference in the number of preovulatory oocyte (10.6+/-6.9 vs. 10.0+/-6.1), fertilization rate (74.8+/-23.4 vs. 72.2+/-21.8), good quality embryo (58.7+/-23.6 vs. 38.7+/-36.6), and embryo transfer (4.3+/-1.6 vs. 4.4+/-1.6). Although the age of the group 1 was older than the group 2 (34.4 vs. 30.8), there was no significant difference in clinical pregnancy rate (50.0% vs. 57.1%). CONCLUSIONS: We suggest that GnRH antagonist was a safe, effective, and alternative method in the controlled ovarian hyperstimulation, especially in PCOD patients who will be develop the ovarian hyperstimulation syndrome.
Embryo Transfer ; Embryonic Structures ; Estradiol ; Female ; Fertilization ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Pregnancy Rate

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

No abstract available.

No abstract available.
Status Epilepticus*

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*