A 48-year-old man has felt discomfort and fullness of left eye for 4 months. He noticed left infraorbital mass 2 months ago and visited our clinic. The corrected visual acuity was 1.0 in both eyes. Exophthalmometry showed 12mm in the right eye and 14mm in the left eye (bar:100mm). A hard, non tender, immobile mass was palpable in the infraorbital area of the left eye. Computed axial tomography showed low density cystic mass with rim enhancement which extended from the anterior wall of the maxillary sinus to the infraocular area. At operation, the cystic mass had yellowish mucopurulent material and eroded the anterior wall of maxillary sinus and the orbital floor. The mass was not connected with the maxillary sinus. On the light microscopic examination, the cystic mass was lined with pseudostratified ciliated columnar epithelium and diagnosed as mucopyocele. Occasionally the sinus is congenitally divided by bony septa into two more or less separate cavities. In this case, the mucopyocele was thought to be originated from congenitally septated maxillary sinus presenting as infraorbital mass.
Cytochrome P-450 CYP1A1 ; Epithelium ; Humans ; Maxillary Sinus* ; Middle Aged ; Orbit ; Visual Acuity

BACKGROUND: If started with segmental block, epidural anesthesia appears to have an inadequate sacral block in the early part of cesarean deliveries. A dural puncture using the combined spinal-epidural technique making an early sacral blockade might be a solution. METHODS: A prospective, randomized, double-blinded study was performed on forty patients who were divided into two groups (C, DP; n = 20, each). An epidural infusion of 25 ml of 2% lidocaine with epinephrine was given to the group C. A dural puncture with a 27G Whitacre needle was done before the epidural infusion in the group DP. Two-way sensory levels were checked for 15 min, just before the operation. The side effects and recovery variables were also compared between the groups. RESULTS: Initial wider cephalic block (P = 0.038, 0 min) followed by more caudal block (P = 0.023, 0.013; 5, 10 min after the completion of the epidural infusion, respectively) occurred in the DP group. After 10 min, there were no differences in both block levels. The number of dermatomes blocked was bigger in the DP group at 10 min after. Fewer patients in the DP group had nausea and/or vomiting (P = 0.044). CONCLUSIONS: Early spread of the sensory blockade, initial cephalic and then caudal, was due to the dural puncture by a 27G needle. This fast onset could make the parturients more comfortable in the early part of cesarean sections.
Anesthesia, Epidural* ; Cesarean Section* ; Epinephrine ; Female ; Humans ; Lidocaine ; Nausea ; Needles* ; Pregnancy ; Prospective Studies ; Punctures* ; Vomiting

BACKGROUND: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
Classification ; Humans ; Knee Joint ; Soft Tissue Injuries ; Tibia

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of: 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.
Disease Management ; House Calls ; Interviews as Topic ; Life Style ; Nursing ; Qualitative Research ; Self Care

PURPOSE: This study was conducted to generate theoretical constructs on depression from the study data by examining and interpreting Korean housewives' experience with depression to elicit its meaning, understand it better, and develop empirical knowledge on it. METHODS: The data were collected in a community public mental health center between April 1, 2012 and September 30, 2012 using in-depth interviews and theoretical sampling. The participants were 12 women aged 40-64 years who scored 7 or higher in the Korean version of the 21-item Hamilton Rating Scale for Depression (Kim, 1980). Collected data were analyzed by grounded theory methodology using open, axial, selective coding process. RESULTS: It was found that the basic socio-psychological process of Korean housewives' living through depression could be summarized into the following four phases: (1) the vanishing of the self into thin air, (2) becoming an empty shell, and (3) searching for the meaning of life, (4) fulfilling of an empty shell. CONCLUSION: This study may enhance the culturally elusive understanding of Korean housewives' experience with depression. As they are living through a hollow empty shell which looks normal on the outside, so can't get support from their families. It's important to educate their families about depressive phases.
Clinical Coding ; Depression* ; Female ; Humans ; Mental Health ; Qualitative Research

OBJECTIVES: No evidence has been found on various types of dental erosion, except for occupational dental erosion. This study aimed to evaluate the distribution of four types of dental erosion (occupational, dietary, systemic, and gastric) and its associated factors among workers in factories that use acids. METHODS: Of 89,034 workers from 4,625 factories that use acids, 716 workers from 38 factories were selected for this cross-sectional epidemiological study by using three-stage stratified cluster sampling. Evaluation for dental erosion was performed by a trained dentist by using Kim's criteria, and a saliva sample was collected directly from each participant. Data on acid sources and associated factors were collected by using questionnaires. By using a complex sample analysis, the T test and Rao-Scott chi-square test were applied to analyze the distribution of four acid factors and to evaluate the associated factors. RESULTS: The prevalence of overall dental erosion was 37.7% for occupational dental erosion, 23.1% for dietary dental erosion, 3.1% for systemic dental erosion, and 3.2% for gastric dental erosion. The prevalence of severe dental erosion was 10.5% for occupational dental erosion, 7.1% for dietary dental erosion, 1.8% for systemic dental erosion, and 1.7% for gastric dental erosion. The factors associated with dental erosion were age, sex, acid exposure, dental cervical abrasion, and dental attrition. CONCLUSIONS: Our data showed that the prevalence of dental erosion was high, moderate, and low in occupational, dietary, and gastric and systemic dental erosions, respectively, among workers exposed to acids. The related factors differed according to the types of dental erosion. Our data suggested that different types of promotion programs for dental erosion should be considered according to acid source.
Dentists ; Epidemiologic Studies ; Epidemiology ; Humans ; Prevalence ; Saliva ; Tooth Attrition

Ewing's sarcoma is rarely found occurs in the bones of the hands and feet. We report a case of Ewing's sarcoma of the left calcaneus in a 15-year-old girl who complained of left heel pain and swelling. An open biopsy was performed and histological examination showed the proliferation of uniform small round cells. Immunohistochemical staining for CD99 showed diffuse strong positivity in the cytoplasmic membrane of the tumor cells. After preoperative chemotherapy, a below knee amputation was performed.
Adolescent ; Amputation ; Biopsy ; Calcaneus* ; Cell Membrane ; Drug Therapy ; Female ; Foot ; Hand ; Heel ; Humans ; Knee ; Sarcoma, Ewing*

BACKGROUND: Selective 2-agonists cause decrease in serum K+ concentration. Midazolam is an anxiolytic, sedative, and amnestic drug. Premedication of midazolam prevents increase of catecholamine with anxiety. Clonidine, alpha 2-adrenergic receptor agonist, supresses sympathetic outflow from central nervous system. So we can expect that premedication of clonidine or midazolam will prevent hypokalemia before induction of anesthesia. METHODS: Twenty two patients received 300 mcg clonidine per oral, 22 patients 0.05 mg/kg midazolan IM and 22 patients had no premedication. We measured serum K+ level at out-patient Department (T1), at 11:00 P.M. of the day before surgery (T2) and immediately before induction of anesthesia (T3). RESULTS: Serum K+ levels at T2 decreased compared to serum K+ level at T1 in all groups. Serum K+ levels T3 decreased compared to serum K+ level at T2 in control and midazolam groups but clonidine group did not decrease in serum K+ level. CONCLUSIONS: We can not prevent decrease of serum K+ level with premedication of midazolam but we can prevent decrease of serum K+ level with premedication of clonidine. So premedication of clonidine is more effective than midazolam in prevention of hypokalemia before induction of anesthesia.
Anesthesia* ; Anxiety ; Central Nervous System ; Clonidine* ; Humans ; Hypokalemia* ; Midazolam* ; Outpatients ; Premedication

Kimura's disease is a rare chronic inflammatory and proliferative condition of unknown etiology. It has been thought to be a part of large spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). However, recently the difference is emphasized between the two entities by some authors. It usually presents subcutaneous or dermal mass in the head and neck region. This condition can be mistaken for a malignant tumor. It is defined pathologically as hyperplastic lymphoid follicles, eosinophilic infiltration and vascular proliferation. Authors have experienced three cases of Kimura's disease occurring in the submandibular, axillary and inguinal regions since 1993. There were two males and one female. Two patients presented peripheral eosinophilia. All patients underwent surgical excision. Two patients were managed with oral prednisone postoperatively.
Angiolymphoid Hyperplasia with Eosinophilia ; Eosinophilia ; Eosinophils ; Female ; Head ; Humans ; Male ; Neck ; Prednisone

PURPOSE: The aim of this study was to investigate clinicopathologic differences between prostate cancer (PCa) detected at initial and repeat transrectal ultrasound-guided prostate biopsy in a large Korean cohort. MATERIALS AND METHODS: From 2000 through 2012, a total of 7,001 patients underwent transrectal ultrasound-guided prostate biopsy at 6 centers in Daegu and Gyeongbuk provinces. Of these 7,001 patients, the initial biopsy was positive for PCa in 2,118 patients. Repeat biopsy was performed in 374 of the 4,883 patients with an initial negative finding and a persistently elevated prostate-specific antigen (PSA) level, nodules or asymmetry by digital rectal examination (DRE), high-grade prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Numbers of biopsy cores varied from 6 to 12 according to center and biopsy date. RESULTS: Cancer was diagnosed in 2,118 of the 7,001 patients (30.3%) at initial biopsy and in 86 of the 374 patients (23.0%) at repeat biopsy. The repeat biopsy rate was 5.3%. Mean PSA values were 68.7+/-289.5 ng/mL at initial biopsy and 18.0+/-55.4 ng/mL at repeat biopsy (p<0.001). The mean number of cancer-positive cores per biopsy was 5.5+/-3.5 for initial biopsy and 3.0+/-2.9 for repeat biopsy (p<0.001). Mean Gleason score was 7.5+/-1.4 at initial biopsy and 6.6+/-1.3 at repeat biopsy (p<0.001). For detected cancers, the low-stage rate was higher for repeat biopsy than for initial biopsy (p=0.001). CONCLUSIONS: Cancers detected at repeat biopsy tend to have lower Gleason scores and stages than cancers detected at initial biopsy. The present study shows that repeat biopsy is needed in patients with a persistently high PSA or abnormal DRE findings.
Adult ; Aged ; Aged, 80 and over ; Endosonography/*methods ; Follow-Up Studies ; Humans ; Image-Guided Biopsy/*methods ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostatic Neoplasms/epidemiology/*pathology ; Rectum ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies