PURPOSE: This survey was performed to gather information about the guardians of pediatric oculoplastic patients undergoing certain medical care services in order to recommend improvements in these services. METHODS: Questionnaires were distributed to guardians of pediatric oculoplastic patients who were admitted for operations to correct epiblepharon and ptosis. Completed questionnaires, which numberd 100, were then analyzed. RESULTS: The results of this survey show that most guardians were the parents of the patient; most had a level of education higher than or equal to junior college graduation; and most were middle-class. The parents themselves had discovered their children's disease and had a great influence on the decision to operate. Most parents took an optimistic view of the results of the operation. The higher the guardians' economic status, the more likely he or she believed that both an ophthalmic and a plastic surgeon could perform oculoplastic operations. Many guardians chose an ophthalmic clinic over a plastic surgery clinic because the likelihood of a satisfactory result is higher and because these diseases are related to visual acuity. Half of the guardians knew that there is an oculoplastic clinic at the department of ophthalmology, and many of them gathered information about oculoplastic surgery from the internet. CONCLUSIONS: Better explanations about oculoplastic diseases and more education about these diseases should be available to the guardians of patients with these diseases. Systematic publicity for the field of oculoplastic surgery is needed urgently, and the availability of accurate information and specialized medical counseling about these diseases on the internet should be increased.
Counseling ; Education ; Humans ; Internet ; Ophthalmology ; Parents ; Surveys and Questionnaires ; Surgery, Plastic ; Visual Acuity

Lupus vulgaris is most prevalent on exposed parts, especially the face but can also develop on exetremities. Lupus vulgaris originates from tuberculosis elsewhere in the body by hematogenous, lymphatic, or contiguous spread. A 19-year-old male patient came to our department. The patient had had many recurrent oozing and verrucous plaques and crusts on the left foot for one year. A skin biopsy from the lesion on the left dorsum of the foot showed scattered well defined granulomas consisting of the epithelioid cell clusters with Langerhans and foreign body type giant cells in the mid dermis. Caseation necrosis was slight. There were no bacilli on AFB staining. The multi test CMI for tuberculin was highly positive. A chest X-ray did not show any abnormal findings. The presence of Mycobacterium tuberculosis DNA was demonstrated by polymerase chain reactions (PCR) for detection of mycobacterial DNA from a routinely prepared paraffin-embedded skin specimen. Herein we report a very atypical case of lupus vulgaris confirmed by PCR.
Biopsy ; Dermis ; DNA ; Epithelioid Cells ; Foot ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Lupus Vulgaris* ; Male ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Skin* ; Thorax ; Transplants* ; Tuberculin ; Tuberculosis ; Young Adult

This study was designed to investigate the stress distribution of alveolar bone in case of en masse retraction with lingual K-loop archwire using the 3-dimensional photoelastic stress analysis followed by stress freezing process. Lingual K-loop archwire which had loop in 15mm height was used and activated by retraction force of 350gm per each side. The results were as follows: 1. Central incisor: As the closer side to crown, the larger tensile stress was distributed at both mesial and labial surfaces and the larger compressive stress was distributed at distal surface. As the closer side to root apex, the larger compressive stress was distributed at lingual surface. The compressive stress was distributed at root apex. 2. Lateral incisor: The tensile stress was distributed at the coronal side of mesial surface. The compressive stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at labial surface. The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of lingual surface. The compressive stress was distributed at root apex. 3. Canine: The tensile stress was distributed at coronal side and the compressive stress was distributed at apical side of mesial surface. The tensile stress was distributed at distal surface. As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. The compressive stress was distributed at root apex. 4. Second premolar: The tensile stress was distributed at mesial surface. The compressive stress was distributed at coronal side and the tensile stress was distributed at apical side of distal surface. The compressive stress was distributed at coronal side of buccal surface. As the closer side to crown, the larger tensile stress was distributed at lingual surface. The compressive stress was distributed at root apex. 5. First molar: As the closer side to crown, the larger tensile stress was distributed at both mesial and distal surfaces. No stress was distributed at buccal surface and palatal root apex. As the closer side to crown, the larger tensile stress was distributed at both lingual surfaces. The compressive stress was distributed at buccal root apexes. 6. Second molar: The compressive stress was distributed at all root apexes. As the closer side to crown, the larger compressive stress was distributed at both mesial and lingual surfaces, and the larger tensile stress at both distal and buccal surfaces. Transverse bowing effect was observed in en-masse retraction with lingual K-loop archwire, however vertical bowing effect was not. Rather, reverse vertical bowing effect was developed.
Bicuspid ; Crowns ; Freezing ; Incisor ; Molar

BACKGROUND: Dermatologic emergency patients who visit the emergency room increase in number every year. But there is no report about the statistical analysis of such visits. OBJECTIVES & METHODS: We reviewed 326 new dermatologic emergency patients who uisited the emergency room of Dongsan Medical Center in Taegu from 1986 to 1995 to study the age, sex, monthly and yearly distributior, arrival time, length of visit, prevalence of common dermatoses, admission rate and death rate. RESULTS: The results are summarized as follows: 1. Of 326 patients, there were 151 males and 175 females. The sex ratio of male to female was 1: 1.15. The number of patients increased with each year. 2. In age distribution, there were 23(7%) under 10;46(14%) between 11-20,55(17%) between 21-30;49(15% ) between 31-40;33(10%) between 41 50; 62(19% ) between 51-60 years,39(12% ) between 61-70 and 19(6%) between 71-80 years. 3. In monthly and arrival time distribution, the peak month incidence occurred in August(24 %), and the lowest incidence in December(1%). The peak incidence of arrival time occurred PM 6-12 hours and the lowest incidence AM 0-6 hour. 4. In the distribution about length nf visit, 73% of patients stayed more than 10 hours, 23% 5-10 hours and 4% less than 5 hours. 5. Of the most common derrnatoses, acute urticaria was seen in 124 cases(38%), and herpes zoster. in 94 cases (29%). In age distribution, acute urticaria was most preualent between the age of 0-30 and herpes zoster between 50-70. 6. The admission rate was 43%(140 cases). The death rate was 1.2%(3 cases). CONCLUSION: Our study of e nergency patients revealed that dermatologic emergency patients who visited the emergency room had increased in number every year and the distribution of patients is quite different from that of outpatients.
Age Distribution ; Daegu ; Emergencies* ; Emergency Service, Hospital* ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Mortality ; Outpatients ; Prevalence ; Sex Ratio ; Skin Diseases ; Urticaria

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

PURPOSE: Heart rate variability (HRV) is a tool used to measure autonomic nervous function; however, there is no evidence that it can be used to define sympathetic hyperactivity in men with lower urinary tract symptoms (LUTS). We suspected that LUTS would differ between sympathetic hyperactive and hypoactive patients. Therefore, we measured HRV and divided the LUTS patients into two groups, a sympathetic hyperactive group and a sympathetic hypoactive group according to the low frequency/high frequency (LF/HF) ratio and made clinical comparisons between the groups. METHODS: A total of 43 patients with symptomatic LUTS (International Prostate Symptom Score [IPSS] over 8) and 49 healthy volunteers were enrolled. No subjects had diseases that could affect the autonomic nervous system, such as diabetes or hypertension. Electrocardiographic signals were obtained from subjects in the resting state and HRV indexes were calculated with spectral analyses. We divided the LUTS patients into two groups by an LF/HF ratio of 1.9, which was the median value in the healthy volunteers, and compared the differences in clinical characteristics, IPSS, prostate-specific antigen (PSA), and transrectal ultrasound (TRUS) results. The parameters were compared by independent sample t-test by use of SPSS ver. 19. RESULTS: There were no significant differences in age, serum PSA, or volume of the prostate between the 2 LUTS groups. However, analyzing IPSS questionnaires between two groups showed that there were significant differences in mean of Q2 score (frequency) and storage symptom score ([Q2+Q4+Q7]/3) (P<0.05). CONCLUSIONS: We suggest that an imbalance of autonomic nervous system activity may be a factor that evokes varieties of symptoms in men with LUTS. LUTS patients with hypoactive sympathetic tone may suffer from frequency and storage symptoms.
Autonomic Nervous System ; Electrocardiography ; Heart Rate ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia

PURPOSE: To describe MR findings and differential points of supratentorial cystic intracranial lesions. MATERIALS AND METHODS: We retrospectively reviewed and analyzed the MR findings of 59 patients with supratentorial cystic intracranial lesions, and classified them as follows: tumor-associated cyst, infectious cyst, ex-vacuo type cyst, and congenital/developmental cyst. RESULTS: Among 59 patients, 47 tumor-associated cysts were seen in 17, 42 infectious cysts in 13, 17 ex-vacuo type cysts in 10, and 19 congenital/developmental cysts in 19. In 44 of 47 tumor-associated cysts, increased or inhomogeneous internal signal intensity was seen on T1-weighted image, 37 of 47 showed thick uneven walls ; 35 of 47 had enhancing solid components and there was variable perifocal edema and mass effect. Infectious cysts were multiple (11 of 13). In cases of brain abscess, increased internal signal intensity on T1-weighted image, low signal intensity of abscess wall on T2-weighted image, thick even enhancing wall, and marked perifocal edema(4 of 4) were seen in all four cases. Cysts in cysticercosis were variable in appearance depending on the stage, but were smaller than other cystic lesions. Ex vacuo type cysts were of uniform CSF signal intensity in all pulse sequences and there was no identifiable wall or enhancement associated with enlarged adjacent ventricle and encephalomalacia(17 of 17). Congenital/developmental cysts showed a single lesion(19 of 19), a signal intensity similar to CSF in all pulse sequences(15 of 19), no identifiable wall(16 of 19), no enhancement(17 of 19), and no perifocal edema(19 of 19). CONCLUSION: MR was used to categorize supratentorial cystic intracranial lesions into four groups on the basis of their number, size, internal homogeneity of signal intensity on T1-weighted image, enhancing pattern, perifocal edema and mass effect, thereby improving diagnostic specificity and patient management.
Abscess ; Brain Abscess ; Cysticercosis ; Edema ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND: Sorbitol fermenting Escherichia coli O157 were reported. And E. coli O157:H7 produce various Shiga toxin (Stx) such as Stx1, Stx2, or variants of Stx2. In this study, we tried to establish laboratory methods that detect E. coli O157:H7 quickly and precisely by analyzing sensitivity of colony hybridization test and PCR technique. METHODS: Stx1-producing E. coli ATCC 43890, Stx2-producing E. coli ATCC 43889, and Stx2vha- producing E. coli ATCC 51435 were tested. Three strains of E. coli were diluted with 0.1 g of diarrheal stools from 107 CFU to 101 CFU respectively. The stool samples were incubated overnight in MacConkey agar plates. A mean of 63 colonies were hybridized by stx1- and stx2-specific oligonucleotide probes. PCR for stx1 gene and stx2 gene was done after overnight- incubation of stool samples in the LB broth with vancomycin (6 ug/mL). Positive colonies by colony hybridization were confirmed by PCR for stx1 gene and stx2 gene. RESULTS: Colony hybridization test could detect Stx1-producing E. coli at 103 CFU per 0.1 g of stool, Stx2-producing E. coli at 105 CFU per 0.1 g of stool, and Stx2vha-producing E. coli at 104 CFU per 0.1 g of stool. PCR technique after enrichment in LB broth with vancomycin (6 ug/mL) could detect stx1-, stx2-, and stx2vha-containing E. coli at 10 CFU per 0.1 g of stool respectively. CONCLUSOIN: A combination of colony hybridization and PCR after enrichment in broth with vancomycin (6 ug/mL) is useful for the rapid and precise diagnosis of infections of Shiga toxin-producing E. coli O157:H7.
Agar ; Diagnosis ; Escherichia coli O157 ; Escherichia coli* ; Escherichia* ; Oligonucleotide Probes ; Polymerase Chain Reaction ; Shiga Toxin ; Sorbitol ; Vancomycin

Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.
Breast ; Hematologic Neoplasms ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Magnetic Resonance Imaging ; Skin ; Subcutaneous Tissue

PURPOSE: Thallim-201 (201Tl) brain SPECT and proton (1H) magnetic resonance spectroscopy (MRS) have been used to evaluate tumor grade and viability of glioma. We assessed the correlations between 201Tl brain index or spectrum of metabolites of 1H MRS and grade of glioma or histopathologic findings. MATERIALS AND METHODS: We studied 17 patients (4 astrocytoma, 7 anaplastic astrocytoma and 6 glioblastoma). On 201Tl Brain SPECT, 201Tl index was measured as the ratio of average counts for region of interest to those for the contralateral normal brain. On 1H MRS, we calculated choline (Cho) /creatine (Cr) ratio and N-acetylaspartate (NAA)/Cr ratio in ROI defined as tumor center. Histopathologic findings were graded by Ki-67 index, cellularity, mitosis, pleomorphism, necrosis and endothelial proliferation. An unpaired t test and statistical correlations were performed to evaluate these data. RESULTS: Tl-index showed the best correlation with Ki-67 index (p<0.01), less correlations with cellularity, mitosis, and endothelial proliferation, but no correlation with results of MRS, pleomorphism, or necrosis. The findings of MRS did not correlate with all of the above. The cases of glioblastoma demonstrated a higher Tl-index, Cho/Cr ratio, Ki-67 index and lower NAA/Cr ratio, albeit without statistical significance. CONCLUSION: Even though 201Tl brain SPECT did not correlate directly with grade of malignancy, it may still be useful in determining biological aggressiveness of tumor and prognosis of patients because it correlated well with Ki-67 index, a growth fraction of glioma, cellularity, mitosis and endothelial proliferation.
Astrocytoma ; Brain* ; Choline ; Glioblastoma ; Glioma* ; Humans ; Magnetic Resonance Spectroscopy* ; Mitosis ; Necrosis ; Pathology* ; Prognosis ; Protons ; Tomography, Emission-Computed, Single-Photon*