Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.
Calculi* ; Humans ; Methods* ; Mucous Membrane ; Needles* ; Pathology ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Glands ; Submandibular Gland

STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

OBJECTIVE: We examined a functional model of acquired capability for suicide, which was elaborated from the “Interpersonal-Psychological Theory of Suicide”. METHODS: A total of 6,027 Korean community subjects were recruited from The Korean Epidemiologic Catchment Area study conducted in 2011. The subjects were assessed systematically using the Korean version of the Composite International Diagnostic Interview version 2.1, the Korean version of the Barratt Impulsiveness Scale, and the Korean version of the Mood Disorder Questionnaire. We used structural equation modeling to identify potential factors contributing to a suicide attempt. RESULTS: Most aspects of the model were supported by the data and “the short-term enhancer for the acquired capability for suicide” had direct effects on suicide attempts. However, the suicidal planning effects of “the short-term enhancer for the acquired capability for suicide” were eliminated by the rule of parsimony. CONCLUSION: The main finding was that “the short-term enhancer for the acquired capability for suicide” is relevant to suicide attempts when it's direct, indirect, and reciprocal effects are tested within a more complete system of relationships than found in existing studies. The implications of these findings are discussed with regard to future conceptual work and empirical research.
Adult* ; Empirical Research ; Humans ; Mood Disorders ; Suicidal Ideation ; Suicide*

BACKGROUND/AIMS: In Korea, few studies have examined primary cardiac tumors, which have a reported incidence of 0.0017~0.19% in autopsy series. This study surveyed the status of primary cardiac tumors over the past 7 years in one region. METHODS: A retrospective review examined all patients with primary cardiac tumors, except for confirmed thrombus, using hospital medical records from 2000 to 2006 at six community hospitals. Identified cases undergoing biopsy and surgery were selected for the study. RESULTS: The operative mortality was 7.7%. Of the 71 patients (26 males) with identified primary cardiac tumors, 65 (91.5%) tumors were benign and 6 (8.5%) were malignant. The benign tumors were myxoma (78.9%), rhabdomyoma (4.2%), fibroelastoma (2.8%), fibroma (1.4%), and leiomyoma (1.4%). Two of the myxomas were present at multiple locations. The malignant tumors included sarcomas (67%) and lymphomas (33%). Most of the tumors were located in the left atrium (76%). The majority of patients presented with chest pain and dyspnea. During follow-up for an average of 26.8+/-21.3 months, all but one patient with benign tumors was alive; one myxoma patient died perioperatively (1.5%). Four of the patients with malignant tumors (67%) died. CONCLUSIONS: Cardiac myxomas and sarcomas were the most common primary benign and malignant tumors, respectively. Benign tumors had excellent postoperative survival rates, while malignant tumors had high mortality.
Autopsy ; Biopsy ; Chest Pain ; Dyspnea ; Fibroma ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Hospitals, Community ; Humans ; Incidence ; Korea ; Leiomyoma ; Lymphoma ; Medical Records ; Myxoma ; Retrospective Studies ; Rhabdomyoma ; Sarcoma ; Survival Rate ; Thrombosis

Acanthosis nigricans (AN) is characterized by symmetric, velvety, gray-brown hypertrophied plaques most commonly on the axillae and neck. Confluent and reticulated papillomatosis (CRP) is manifested by papules in the mid-chest that coalesce in the midline, and are arranged in a reticulated pattern peripherally. Both diseases are known to be related to endocrinopathies such as diabetes mellitus (DM), an insulin resistant state and obesity with unknown mechanisms. Herein, we presented three cases of concomitant acanthosis nigricans with confluent and reticulated papillomatosis in obese patients.
Acanthosis Nigricans ; Axilla ; Diabetes Mellitus ; Humans ; Insulin ; Neck ; Obesity ; Papilloma

Angioleiomyoma is a benign tumor arising from the muscle layer of the vein walls and mainly develops on the lower extremities of middle-aged women. We encountered a 31-year-old man who had a 3 year history of a painless but tender, 0.6 x 0.6 cm-sized nodule on the volar aspect of his left third finger. Histopathologically, a well-circumscribed nodular tumor was observed in the dermis, which comprised of numerous, various-sized, vessels and bundles of smooth muscle fibers. It is relatively rare for an angioleiomyoma to occur on the finger.
Adult ; Angiomyoma* ; Dermis ; Female ; Fingers ; Humans ; Lower Extremity ; Muscle, Smooth ; Veins

Cutaneous leiomyoma is a rare, benign tumor of smooth-muscle fibers. Five types of cutaneous leiomyoma include multiple piloleiomyomas, solitary piloleiomyoma, solitary genital leiomyoma, solitary angioleiomyoma and leiomyoma with additional mesenchymal elements. Genital leiomyoma is uncommon, and leiomyomas of the nipple is a rare type of genital leiomyoma. We report a case of cutaneous leiomyoma presenting as a large nipple in a middle-aged woman.
Angiomyoma ; Female ; Humans ; Leiomyoma* ; Nipples*

BACKGROUND: Palmoplantar dermatoses have frequently been encountered in the dermatologic field. Many previous studies have focused on the specific diseases of palmoplantar dermatoses; however, none of them have included a the comprehensive study of palmoplantar dermatoses. OBJECTIVE: The purpose of this study was to investigate the epidemiological aspects of palmoplantar dermatoses, with a brief review of the common palmoplantar dermatoses. METHODS: We retrospectively reviewed the data of 237 patients who had been biopsied for palmoplantar dermatoses between January 2000 and December 2004 at Our Lady of Mercy Hospital, The Catholic University of Korea. RESULTS: The results were as follows; Female to male ratio was 1 : 1.01. The mean age at diagnosis was 37.5+/-20.1 years. The mean duration of the disease was 35.9 months and ranged from 2 days to 50 years. Palmoplantar dermatoses appeared on the palms in 49 (20.6%) patients, the soles in 123 (51.9%) patients, and both the palms and soles in 65 (27.4%) patients. The most common five diseases of palmoplantar dermatoses were palmoplantar pustulosis (23.2%), verruca (11.4%), pompholyx (10.1%), palmoplantar keratoderma (8.9%), and contact dermatitis (8.0%). Of the 237 patients, 65 (27.4%) patients were accompanied with other dermatoses; fungal infection (13.9%), eczema (7.6%), onychodystrophy (3.4%), psoriasis (1.7%), erythema multiforme (1.3%), hyperhidrosis (1.3%), drug eruption (0.8%), or lichen simplex chronicus (0.4%). Of the 237 patients, 51 (21.5%) patients were accompanied with systemic diseases; Cardiovascular diseases (8.4%), endocrine diseases (6.6%), hepatobiliary diseases (4.6%), malignancy (3.4%), pulmonary diseases (2.5%), or gastrointestinal diseases (1.3%). CONCLUSION: Our study shows that the biopsy of palmoplantar dermatoses is gradually increasing. Further investigation with a wider and larger population is necessary to understand the epidermiology of palmoplantar dermatoses, and, based on the epidermiology of palmoplantar dermatoses, accurate diagnosis and proper treatment of palmoplantar dermatoses could then be achieved.
Biopsy ; Cardiovascular Diseases ; Dermatitis, Contact ; Diagnosis ; Drug Eruptions ; Eczema ; Eczema, Dyshidrotic ; Endocrine System Diseases ; Erythema Multiforme ; Female ; Gastrointestinal Diseases ; Humans ; Hyperhidrosis ; Keratoderma, Palmoplantar ; Korea ; Lung Diseases ; Male ; Neurodermatitis ; Psoriasis ; Retrospective Studies ; Skin Diseases* ; Warts

BACKGROUND: Lymphangioma is an uncommon, benign hamartomatous malformation that consists of dilated lymphatic channels lined by normal, single-cell lymphatic endothelia. The diagnosis of lymphangioma is usually made on the basis of clinical and histopathological characteristics. The lymphangiomas are divided into lymphangioma circumscriptum, cavernous lymphangioma, cystic higroma, acquired progressive lymphangioma and lymphangiectasis. OBJECTIVE: The purpose of this study was to investigate clinical and histopathological features of lymphangioma, especially focusing on the pathologic classification. METHODS: We retrospectively reviewed the medical records and 52 biopsy specimens of 51 patients who had been diagnosed with lymphangioma between January 1991 to September 2005 in 8 Hospitals under the charge of the Catholic Medical Center. RESULTS: We compiled clinical data and histologic information on the 52 cases of 51 patients of lymphangioma as follows: The mean age at development was 16.5 years, and 56.9% of the patients were under 10 years old. Lymphangioma developed predominantly in females, at a sex ratio of 1:1.55. The disease duration exceeded 10 years in 45.1% of patients. Most patients were asymptomatic, but 13.7%, 9.8% and 2.0% of patients complained of tenderness, pruritus and pain, respectively. The lesion was usually solitary. Lymphangioma occurred on the trunk, extremities, head and neck, and genitalia in 43.6%, 30.9%, 20.0% and 5.5% of 52 cases respectively. The legs, back, abdomen and lip were also found to be commonly involved. Histopathologically, lymphangiomas were divided into lymphangioma circumscriptum, cavernous lymphangioma, cystic higroma, acquired progressive lymphangioma and lymphangiectasis in 69.2%, 17.3%, 1.9%, 5.8% and 5.8% of the 52 cases respectively. CONCLUSION: Lymphangioma is un uncommon, benign hamartomatous malformation of lymphatic endothelial cells and occurs in several forms that differ in clinical and histological characteristics and prognosis. Therefore it is important to make a diagnosis on the basis of clinical and histopathologic findings and to understand the characteristics of the subtypes of lymphangioma.
Abdomen ; Biopsy ; Child ; Classification ; Diagnosis ; Endothelial Cells ; Extremities ; Female ; Genitalia ; Head ; Humans ; Leg ; Lip ; Lymphangiectasis ; Lymphangioma* ; Medical Records ; Neck ; Prognosis ; Pruritus ; Retrospective Studies ; Sex Ratio ; United Nations

PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.
Clinical Competence ; Humans ; Viperidae ; Surveys and Questionnaires