A marginal zone B-cell lymphoma is a type of B-cell lymphoma which is normally located at the margins of the secondary lymph node follicles. According to 2008 World Health Organization (WHO) classification, there are three main types classified according to the location of invasion: nodal lymphoma in the lymph nodes, splenic lymphoma in the spleen, and extranodal lymphoma in other locations. Recently, we have experienced a rare case of primary nodal marginal zone lymphoma that arose in the lower eyelid. Therefore, we report this case with a review of literature.

BACKGROUND: Obesity has been generally diagnosed by 'Body Mass Index (BMI)' in primary care. Recently the use of Bioelectrical Impedance Analyzer' has become popular in Korea to evaluate body fat rate (BFR), as cost is inexpensive and the method to use is simple. As a result, the opposed finding of normal BMI and elevated BFR vice versa in same individuals are being encountered frequently. We designed this study to find out the characteristics and cardiovascular risk of people in these groups. METHODS: The medical records of health promotion center were obtained and 22,704 applicants visitor who undeerwent health risk questionnaire, screening tests and physical examination for cardiovascular disease were reviewed. RESULTS: After adjusting for age, sex, exercise and education level, cardiovascular risk such as hypertension, DM, and hypercholesterolemia, LDL tended to increase linearly and HDL tended to decrease linearly with increase of BFR or BMI. In comparison with normal BMI and BFR group, the odds ratios of normal BMI and elevated BFR group or vice versa were increased. CONCLUSION: If either one of BMI or BFR of a person was elevated, even though the other was within normal range, the cardiovascular risk of that person was shown to be high.
Adipose Tissue* ; Body Mass Index* ; Cardiovascular Diseases ; Education ; Electric Impedance ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Mass Screening ; Medical Records ; Obesity ; Odds Ratio ; Physical Examination ; Primary Health Care ; Reference Values ; Risk Factors* ; Surveys and Questionnaires

PURPOSE: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. METHODS: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. RESULTS: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2–5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. CONCLUSION: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.
Adolescent* ; Ambulatory Care Facilities ; Bruxism ; Child* ; Female ; Gyeonggi-do ; Humans ; Incidence ; Korea ; Male ; Night Terrors ; Parents ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Initiation and Maintenance Disorders ; Snoring ; Somnambulism

BACKGROUND: In spite of its high prevalence and social impact, pain in the elderly has not been managed appropriately. Understanding the multidimensional aspect of pain is crucial in its effective management. Patients with chronic pain are known to be more profoundly affected by psychological and social factors. We, therefore, classified chronic pain patients and especially focused on the relationship between pain and stress. METHODS: The subjects were 149 persons older than 60 years attending a certain geriatric college. A survey was peformed employing the Korean version of Geriatric Pain Measure (GPM-K), the Korean Version of Brief Pain Inventory (BPI-K), the Elderly Life Stress Inventory (ELSI), the Perceived Stress Scale (PSS), the Geriatric Depression Scale Short Form-Korea Version (GDSSF-K), and the Revised Chalder's Fatigue Scale (Fatigue). RESULTS: A total of 103 people, who completed both the questionnaires on pain and stress were enrolled. There was a significant correlation between GPM-K and ELSI (ELSI: r=.38, P<0.01). In chronic pain patients, not only ELSI, but also PSS was correlated with GPM-K (ELSI: r=.37, P<0.01, PSS: r=.25, P=0.04). CONCLUSION: There was a significant correlation between GPM-K and ELSI in the elderly. In chronic pain patients, it was more closely associated with GPM-K. We, therefore, believe that stress management can be useful in the management of pain, especially in the management of chronic pain patients.
Aged ; Chronic Pain ; Depression ; Fatigue ; Humans ; Prevalence ; Social Change ; Stress, Psychological ; Surveys and Questionnaires

The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

Background: Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. Methods: This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. Results: CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. Conclusion Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.

Background: Nasal bone fractures are frequently encountered in clinical practice. Although fracture reduction is simple and correction requires a short operative time, low patient satisfaction and relatively high complication rates remain issues for many surgeons. These challenges may result from inaccuracies in fracture recognition and assessment or inappropriate surgical planning. Findings from immediate postoperative computed tomography (CT) scans and those performed at 4 to 6 weeks postoperatively were compared to evaluate the accuracy and outcomes of nasal fracture reduction. Methods: This retrospective study included patients diagnosed with nasal bone fractures at our department who underwent closed reduction surgery. Patients who did not undergo additional CT scans were excluded from the study. Clinical examinations, patient records, and radiographic images were evaluated in 20 patients with nasal bone fractures. Results: CT findings from immediately after surgery and a 1month follow-up were compared in 20 patients. Satisfactory nasal projection and aesthetically acceptable results were observed in patients with accurate correction or mild overcorrection, while undercorrection was associated with unfavorable results. Conclusion Closed reduction surgery for correcting nasal bone fractures usually provides acceptable outcomes with relatively few complications. If available, immediate postoperative CT scans are recommended to guide surgeons in the choice of whether to perform secondary adjustments if the initial results are unsatisfactory. Based on photogrammetric data, nasal bone reduction with accurate correction or mild overcorrection achieved acceptable and stable outcomes at 1 month postoperatively. Therefore, when upward dislocation is observed on postoperative CT, one can simply observe without a subsequent intervention.

BACKGROUND: This study was designed to compare the usual self-checked blood pressure measuring methods by hypertensive patients with standardized methods. METHODS: From May to August 2002, we surveyed 137 hypertensive patients who performed self blood pressure measurements with a self-administered questionnaire. We defined 14 standard methods from the six most frequently recommended guidelines. We asked patients how often they calibrated their sphygmomanometer, and how they learned to measure blood pressure. Also, their upper arm circumferences were measured. RESULTS: The percentage of correct preparations for BP measurement was over 80%, but that of correct technique was low. For example, 'reading from the arm with higher BP by more than 10 mmHg' (4.4%), 'placing midline of the bladder over the arterial pulsation' (21.5%), and 'waiting 2 or more minutes between readings' (21.9%). Only 11.2% of the patients have ever had calibrated their sphygmomanometers. In 20.2% of hypertensive subjects, upper arm circumferences were greater than 30 cm which made blood pressure measurement with a 24 cm-sized bladder incorrect. CONCLUSION: As shown in previous studies, the methods of blood pressure measurement were incorrect in many aspects. Therefore, systematically educating hypertensive patients to measure blood pressure by correct methods and recommending to use a proper-sized cuff are essential.
Arm ; Blood Pressure* ; Calibration ; Humans ; Hypertension ; Sphygmomanometers ; Urinary Bladder ; Surveys and Questionnaires

BACKGROUND: Ministry of Health and Welfare offered' Home Doctor Registration Program' to rein force primary care and to increase the efficiency of national health delivery system. But, it failed because it was not supported by doctors and nations. We designed this study to develope and evaluate apractical version of 'Home Doctor Registration Program'. METHODS: We invited primary care doctors who were concerned with 'Home Doctor Registration Program' via PC-communication and developed a practical version of this program. After 6 monte of this program, surveys on participated docters and patients were done. RESULTS: 8 primary care doctors and 285 patients have participated in this study. All the 8 doctors have offered the 4 obligatory services and 3 doctors have offered telephone counselling and no doctor has offered visiting examination. After 6 months of this program, CCPQ score was increased significantly and all the health risk factors of participated patients were decreased. Doctors have thought that Family Chart Service, Health Risk Appraisal, Vaccination and Screening Test are more necessary in this program. But Patients have thought that Telephone Counselling and Visiting Examination are more important in this program. CONCLUSION: Almost of participated doctors and patients have been satisfied with this practical version of 'Home Doctor Registration Program'. But, subjective feeling about which service was more necessary in this program was different between doctors and patients.
Health Services ; Humans ; Mass Screening ; Primary Health Care ; Risk Factors ; Telephone ; Vaccination

PURPOSE: The purpose of this study was to examine effects of smoking cessation program in large size company using motivational enhancement counseling. METHODS: A quasi-experimental design was conducted. 72 workers in intervention group and 65 workers in control group participated in 7 large size companies. Smoking cessation program consisted of a campaign, smoking cessation education, and 6 weeks motivational enhancement counseling. The motivational enhancement counseling was tailored to the individual's stage of change. Stages of smoking behavior, smoking cessation rate, nicotine dependence, and confidence of smoking cessation were assessed after intervention. RESULTS: The results showed that intervention had a significant impact on improving stages of smoking behavior and smoking cessation rate, and impact on decreasing nicotine dependence, compared to those of a control group. CONCLUSION: The effects and feasibility of smoking cessation program including motivational enhancement counseling were revealed in the large size company. These results might provide information that can be used in improving cultures of smoking cessation for workers.
Counseling ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Disorder