Since Mikulicz's description of symptomless hypertrophy of the salivary gland and lacrimal gland, the term, Mikulicz syndrome, has been used to describe enlargement of the salivary gland with or without lacrimal gland involvement occurring in leukemia, lymphosarcoma, sarcoidosis, tuberculosis syphilis, etc. However, there are still a tremendous amount of confusion in the application of the term, Mikulicz syndrome. In Korea, there has been no reported case of Mikulicz syndrome to date. Internationally, it is also extremely rare to spot a reported case of the disease originating primarily from submandibular glands. We would like to report a case in which a 56 year old female patient was reported to have the disease ; she was diagnosed initially as benign lymphoepithelial lesion (BLL) by submandibular biopsy, but later confirmed by lacrimal gland biopsy to have mucosa associated lymphoid tissue (MALT).
Biopsy ; Female ; Humans ; Hypertrophy ; Korea ; Lacrimal Apparatus ; Leukemia ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Mucous Membrane ; Salivary Glands ; Sarcoidosis ; Submandibular Gland ; Syphilis ; Tuberculosis

Keloids are fibrous overgrowth resulting from abnormal wound healing processes at the site of cutaneous injury. It extends beyond the confines of the original wound, begins later after injury, and does not regress with time contrary to hypertrophic scar. The gold standard has not been established in the treatment of keloids, yet. Excision of keloid alone showed a high rate of recurrence (45-100%). Recently, we have experienced two keloidal masses in the auricle (one on helix, the other on lobule), which were treated with surgery and adjuvant steroid injection. We developed an anteriorly-based skin flap from the skin covering of the keloidal mass and used it for several reasons. We also used triamcinolone injection after the surgery. In this paper, we are presenting the result of these cases with a review of literature.
Cicatrix, Hypertrophic ; Keloid* ; Recurrence ; Skin ; Triamcinolone ; Wound Healing ; Wounds and Injuries

Mumps virus infections usually involve the parotid glands. It usually spreads from a human reservoir by airborne droplet of infected saliva. Therefore, early proper diagnosis and isolation of patients can help to inhibit dissemination of the disease. Diagnosis of mumps virus infection is mainly dependent on clinical inspection, palpation of the parotid and laboratory tests, because most mumps virus infections involve the parotid gland. Isolated submandibular gland involvement in mumps is rare and presents diagnostic challenge. We report unusual consecutive cases of mumps virus infections in two patients who were brothers, for whom bilateral submandibular glands were found to be involved paring parotid glands. These cases instruct us not to exclude mumps virus infection even in isolated uni/bilateral submandibular gland swelling.
Diagnosis ; Humans ; Mumps virus ; Mumps* ; Palpation ; Parotid Gland ; Saliva ; Siblings ; Submandibular Gland*

BACKGROUND AND OBJECTIVES: Peritonsillar abscess (PTA) is a collection of pus lateral to tonsil and is located between the fibrous capsule of the palatine tonsil, usually at its upper pole, and the superior to the pharyngeal constrictor muscle. It frequently occurs as a complication of acute tonsillitis. Bacteriology including clinical characteristics in PTA were evaluated. SUBJECTS AND METHOD: Sixty-one patients with peritonsillar abscess, who visited National Medical Center from January 1997 through August 2001 were entered into the study. Each patient was asked to answer a questionnaire for clinical aspects of PTA. Needle aspirations were performed and pus was drained in all cases. Bacterial susceptibility to ampicillin, cephazoline, ciprofloxacin, erythromycin, tetracyclin, and vancomycin was tested on the ioslated bacteria. RESULTS: Among 61 cases, aerobes were isolated in 15 cases (24.6%) and anaerobes in 16 cases (26.2%). There was no significant difference in the culture positive rate of aerobes (p=0.767) and anaerobes (p=1.0) between antibiotics-medicated patients and nonmedicated patients. Among the cultured organisms, peptostreptococcus was the most common and the second most common was beta-hemolytic streptococcus. However, alpha-hemolytic streptococcus, an important pathogen considered in the previous study, was detected at 1.6%. CONCLUSION: Antibiotics medication was not a significant factor in culture positive rate in our study. Peptostreptococcus as an anaerobe and beta-hemolytic streptococcus as an aerobe were the major causes that contributed to the decreased state of peritonsillar abscess and culture positive rate of alpha-hemolytic streptococcus.
Ampicillin ; Anti-Bacterial Agents ; Aspirations (Psychology) ; Bacteria ; Bacteriology ; Cefazolin ; Ciprofloxacin ; Erythromycin ; Humans ; Needles ; Palatine Tonsil ; Peptostreptococcus ; Peritonsillar Abscess* ; Surveys and Questionnaires ; Streptococcus ; Suppuration ; Tonsillitis ; Vancomycin

OBJECTIVES: This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. METHODS: This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chi-squared test and student's t-test were used as statistical analysis methods. RESULTS: There were differences in education level between two groups divided according to FGID status (χ²=10.139, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (χ²=11.408, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=−3.106, p=0.002), depressive symptom (t=−2.105, p=0.037), somatic symptom (t=−3.565, p < 0.001), trait anger (t=−3.683, p < 0.001), anger-in (t=−2.463, p=0.015), and anger-out (t=− 2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=−4.893, p < 0.001), depressive symptom (t=−3.459, p < 0.001), somatic symptom (t=−7.906, p < 0.001), trait-anger (t=−4.148, p < 0.001), state-anger (t=−2.181, p=0.031), anger-in (t=−2.684, p=0.008), and anger-out (t=−3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=−4.286, p < 0.001), depressive symptom (t=−3.402, p < 0.001), somatic symptom (t=−7.162, p < 0.001), trait anger (t=−2.994, p=0.003), state anger (t=−2.259, p=0.025), anger-in (t=−2.772, p=0.006), and anger-out (t=−2.958, p=0.004). CONCLUSIONS: Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.
Anger ; Anxiety ; Demography ; Depression ; Dyspepsia ; Education ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Prevalence ; Psychology

BACKGROUND AND OBJECTIVES: Caudal septal deformities are surgically challenging disorders. A number of corrective programs have been described with variable success. Causes of frequent failure in correction of the caudal deformities have been conservatism and unrealistic dependence on incisional method such as cross hatching, and limited comprehension of the extrinsic and intrinsic forces causing caudal deformities. We reviewed and evaluated the surgical techniques for correction of the caudal septal deformities performed at our institution. SUBJECTS AND METHOD: A retrospective study was performed on 24 patients who underwent septal surgeries for severe caudal septal deformities between Feb 2001 to May 2004. With open approach, all deforming forces around the caudal septum were released and definite intraoperative correction was possible. RESULTS: All 24 patients showed definite improvement in terms of functional and anesthetic outcomes. Potential complications related with structural instability as well as other inherent complications of nasal surgery have not been encountered. CONCLUSION: For successful correction of the caudal septal deformities, completed exposure and releasing all the extrinsic forces around the caudal deformities via open rhinoplasty approach is desirable to avoid frequent recurrences.
Comprehension ; Congenital Abnormalities* ; Humans ; Nasal Surgical Procedures ; Politics ; Recurrence ; Retrospective Studies ; Rhinoplasty

BACKGROUND: A 15-item GDS form is now widely used to screen for depressive symptoms in elderly patients, but even the 15-item version seems fairly long for routine use in busy outpatient settings. This study was conducted to determine which of the three short-form GDS tools with four or five questions extracted from the 15-item GDS tool could be a valid alternative to the 15-item GDS. METHODS: This study was performed using a questionnaire survey of 102 elderly patients over sixty-five, who had either visited or had been admitted in either one of the two universities hospitals in Seoul or ChungCheong district from October 1999 to June 2004. Questionnaire contained demographic and statistical characteristics, items related to health behavior, 15-item GDS, Mini-Mental State Examination Korean (MMSE-K) and activities of daily living. Three scales, namely, D'Ath GDS-4, Van Marwijk GDS-4, and Hoyl GDS-5 were compared to the 15-item GDS. Sensitivity, specificity, positive predictive value and the area under the ROC curves were calculated for each short-form GDS scales. RESULTS: The mean 15-item GDS score was 7.4+/-3.3 and 69.6% of the subjects were to have suggested depression. Hoyl GDS-5 instrument had the highest sensitivity of 87.3%, specificity of 80.6%, and positive predictive value of 91.1% among the three short-form alternatives. The 5-item Hoyl GDS version had the highest area under the curve (0.84), compared to 0.76 for the 4-item Van Marwijk and 0.66 for the 4-item D'Ath GDS version. CONCLUSION: The 5-item Hoyl GDS had superior validity over the D'Ath GDS-4 and Van Marwijk GDS-4. The GDS5/15 may be an effective alternative screening tool.
Activities of Daily Living ; Aged* ; Depression* ; Health Behavior ; Humans ; Mass Screening ; Outpatients ; ROC Curve ; Sensitivity and Specificity ; Seoul ; Weights and Measures* ; Surveys and Questionnaires