The appendiceal mucocele is very rare disease of 0.2% incidence. About 24% of patients are asymptomatic and symptomatic patients present with pain in the right lower quadrant of abdomen in 64%, plapable maas in the right lower quadrant of abdomen in 50%, and rarely, melena, hematochezia, anemia, diarrhea, malaise, and abdominal distension. The gastrointestinal bleeding may be presented in the patient with intussusception, but the massive bleeding is generally absent. We report a case of appendiceal mucocele accompanying with gastrointestinal bleeding and review of literature.
Abdomen ; Anemia ; Diarrhea ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Incidence ; Intussusception ; Melena ; Mucocele* ; Rare Diseases

Primary gastrointestinal lymphoma primarily confined to gastrointestinal tract is relatively rare diaease. Although the lymphoma primarily involved colorectum or small bowel was commonly reported than primary gastric lymphoma in Korea, the concurrent primary lymphoma of colon and small bowel is very rare in reported cases. We report a case of combined primary malignant lymphoma of the jejunum and cecum, who was admitted due to melena and anemia. She had right hemicolectomy and end-to-side ileotransverse colostomy at 2 months ago, due to primary colon lymphoma. The laparotomy was performed and identified hard, 2 x 3 cm sized masses on distal 25 cm, 80 cm and 150 cm from the Treitz ligament. The histology of these small ma showed histiocytic lymphoma as same as cecal specimen. In general, the small bowel lymphoma shaws poor prognosis than gastric or colorectal lymphoma due to diffieulty in diagnosis and late symptoms, but this problem could be resolved through the knowledge about primary gastrointestinal lymphoma and the development of diagnostic methods.
Anemia ; Cecum ; Colon* ; Colostomy ; Diagnosis ; Gastrointestinal Tract ; Jejunum ; Korea ; Laparotomy ; Ligaments ; Lymphoma* ; Lymphoma, Large B-Cell, Diffuse ; Melena ; Prognosis

Of several possible configurations of pin fixation of a displaced supracondylar fracture of the humerus in children, the medial and lateral crossed pinning technique has been known to provide the greatest resistance to gross rotational displacement. A new technique with ipsilateral two lateral crossed pins was devised so as to avoid the ulnar nerve injury with good stability for fracture site. During the period from 1992 to 1994, 18 children with displaced supracondylar fracture of the humerus were treated by closed reduction and ipsilateral two lateral crossed pinning. Eighty nine percents of the final results were satisfactory. There were no ulnar nerve injuries and fixation loss in all cases from the treatment. This is a safe, simple and reliable technique for providing the good stability of fracture site as well as avoiding the ulnar nerve injury.
Child ; Humans ; Humerus ; Ulnar Nerve ; Ulnar Neuropathies ; United Nations

PURPOSE: The purpose of this study was to examine the effects of an empowerment program on self-esteem and depression provided through home visits to low-income elderly women who live alone. METHODS: The research design was a control group pre-post test design. The participants were 49 low-income women over age 65 living alone, 24 in the experimental group and 25 in the control group. The independent variable was the empowerment program, and the dependent variables were self-esteem and depression. The empowerment program was provided for 60 minutes, once a week for 8 weeks. Data were analyzed using the SPSS/WIN 18.0 program. RESULTS: The experimental group reported significant improvement in self-esteem compared to the control group (t=12.50, p<.001). The experimental group also reported significant improvement in depression scores compared to the control group (t=-9.59, p<.001). CONCLUSION: The results indicate that the empowerment program has the potential to improve the mental health of low-income elderly women.
Aged ; Depression ; Evaluation Studies as Topic ; Female ; House Calls ; Humans ; Mental Health ; Power (Psychology) ; Research Design

The examination of the optic nerve is an important part of every examination of the fundus. In attempting to determine weather or not a pathologic process is present, it is essential that the normal disk and its varitions, as well as the congenital anomalies, be thoroughly understood. For this reason the major portion of this study will be devoted to the normal disk shape and its congenital variations.
Optic Nerve ; Weather

Central 30-2 threshold tests were performed in 124 eyes of 62 normal subjects with Humphrey Field Analyzer. The average value of foveal threshold, mean deviation(MD), pattern standard deviation(PSD), shor-term fluctuation(SF) and corrected pattern standard deviation(CPSD) were 34.3+/-2.6dB, -1.96+/-1.31dB, 2.25+/-0.88dB, 1.38+/-0.52dB and 1.41+/-1.10dB, respectively. The frequency of abnormal value on automated perimetry(p<5%) was 25.5% in foveal threshold and 19.1% in MD, which was higher than fundamental data of perimetry. As the age increased, foveal threshold decreased (r=-0.729), PSD and CPSD increased (r=0.422) and 0.385, respectively) ; these are statistically significant correlations(p<0.05). This study has the limitation that test was performed on single session and had small study group. Therefore, further study is needed with comparative analysis following repeated test and larger group of visual field examination.
Visual Field Tests ; Visual Fields*

It has been thought the histological features of rheumatoid arthritis do not reliably indicate the degree of activity or prognosis of the disease and that they are not specific for that condition (Hemerman, 1963). Recently, however, Muirden and Mills (1971) found in rheumatoid joints submitted for synovectomy a direct correlation between the degree of lymphocytic infiltration and joind damage. Lymphocytes might play a helpful role in protection of the rheumatoid joint. Muirden (1970) has also reported a significant relationship between histological estimates of the extent of the iron deposits nd the grades of roentgenographic changes in biopsied joints. The present study directed to confirm and analyze the changes in the clinical and pathological aspects, with the cases synovectomized at Korea and Severance Hospital, Seoul, Korea. Resuits: Clinical and histological studies were made on 21 cases of “classical” and “definite” rheumatoid arthritis submitted to the Department of Orthopaedic, Korea General Horsital and the Department of Pathology, Yonsei University College of Medicine, during the period from 1966 to 1975, and results were as follows. 1 In age distribution, 16 cases (76.2%) were in the interval between 21 and 51 years old: the mean age was 33.5 years old. The sex distribution showed approximately a three fold female predominance with 16 females (76.2%) to 5 male cases (23.8%). 2. The most common chief complaint recorded were morning stiffness and multiple joint pain. Other symptoms, in descending order of occurrence were tenderness, synovial swelling, flexion deformity, joint swelling and subcutaneous nodules. The interval from initial complaint to admission varied from 7 months to 15 years, with a mean interval of 5.9 years. 3. Serological studies for rheumatoid factor were done on 15 cases and eight (53.3%) were found to be positive while seven cases (46.7%) were negative. The positive cases had longer histories and were in older age groups than the negatives. 4. Histologic findings were characterized by proliferation of suface lining cells of synovium, infiltration of lymphocytes, proliferation and thickeness of the vessels, and synovial villi, deposition of fibrins and hemosiderins and infiltration of acute inflammtory celIs. Each of the characteristics studied was ratect on a scaled score ranging from 0 to 3 from 1 to 3. For each patient the scaled scores were totaled and the totals ranged between 6 and 18 with a mean score of 10.5 5. Roentgenographic findings were characterized by swelling of the soft tissues swelling of the joints,. narrowed space of the joint cavity, and destruction of bone. Each of the characteristics studied was rated. on a scaled score ranging from 0 to 3 or from 1 to 3. For each patient the scaled scores were totaled and the totals ranged between 3 and 11 with a mean score of 7.1. 6. There was no significant correlation between histologic findings such as synovial hyperplasia or infiltration of lymphocytes, and clinical findings such as age, duration of histories, presence of rheumatoid factor, roentgenographic findings or surgicaI findings.
Age Distribution ; Arthralgia ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Female ; Fibrin ; Hemosiderin ; Humans ; Hyperplasia ; Iron ; Joints ; Korea ; Lymphocytes ; Male ; Pathology ; Prognosis ; Rheumatoid Factor ; Seoul ; Sex Distribution ; Synovial Membrane

Approximately 60% of all hemangiomas occur in the head and neck region, but hypopharyngeal hemangiomas are very rare. The diagnoses were classified depending on histopathologic findings into cavernous hemangioma, capillary hemangioma and mixed hemangioma. The treatments are sclero theraphy, surgical excision, vascular ligation, cryotheraphy, electrical cautery, ND Yag laser excision, and CO2 laser excision. We have experienced a case of hemangioma in the medial wall of the left pyriform sinus. In our case, we removed it "en bloc" without difficulty with the endoscopic CO2 laser. The histologic diagnosis was a cavernous hemangioma with no evidence of malignancy. One year after surgery, there was no evidence of residual tumors or recurrence. We report this case of cavernous hemangioma in the hypopharynx.
Cautery ; Diagnosis ; Head ; Hemangioma ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Hypopharynx ; Lasers, Gas ; Lasers, Solid-State ; Ligation ; Neck ; Neoplasm, Residual ; Pyriform Sinus* ; Recurrence

BACKGROUND: Coronary artery bypass grafts obtained from internal mammary artery(IMA) have a greater patency rate than do saphenous vein grafts(SVG). The release or production of endothelium-derived relaxing factor(EDRF), which regulates blood flow and inhibits platelets function, may contribute to the higher patency rate of IMA. In order to evaluate the difference between endothelium dependent relaxation in IMA and in grafted saphenous veins, we observed acetylcholine responses of IMAs and SVGs in humans. METHOD: Incremental dose if acetylcholine(Ach:A1-20, A2-50, A3-100microg) or single dose if acetylcholine(A3) were infused into the non-grafted IMA in 16 patients with different clinical presentation of coronary artery disease(3 with stable angina, 2 with acute myocardial infarction 4 with variant angina and atypical chest pain syndrome in 7). After the dose-response to Ach was completed nitroglycerine 200microg was injected into the IMA. Graded dose of Ach (A1, A2, A3) was also infused in 13 grafted saphenous veins(SVG). RESULTS: The overall vascular effects of Ach into the IMA were dilatory responses regardless of different clinical presentation. Two or 3 minutes after Ach injection, the diameter of IMA increased by 9.2%(A1) and 16. 7%(A3) respectively(p<0.01). Maximal dilatory response after A3 was comparable to that after nitroglycerin injection. Angiographically normal segements of SVGs also increased its diameter 2 minutes after Ach injection (7.2% with A1, 6.9% with A2 and 8.5% with A3). Thus the degree of relaxation of IMA was more prominent than that of SVGs. Angiographically dicreased segments of SVGs had no response after Ach injection. The overall responses of native coronary artery to Ach was dose dependant constriction. CONCLUSION: Injection of Ach to IMA and angiographically normal segments of SVGs caused vascular dilatation probably due to EDRF response. However the degree of relaxation was more prominent in IMA than in SVG. Angiographically diseased segments of SVGs had no response to Ach injection, suggesting that diseased SVG does not produce EDRF. However the finding of a consistent Ach-induced EDRF relaxation in the SVGs despite of constrictive response in the majority of native coronary arteries might suggest that the regenerated endothelial cell in the SVGs were probably of saphenous vein origin rather than derived from the coronary arterial endothelium.
Acetylcholine ; Angina, Stable ; Chest Pain ; Constriction ; Coronary Artery Bypass ; Coronary Vessels ; Dilatation ; Endothelial Cells ; Endothelium ; Humans ; Mammary Arteries* ; Myocardial Infarction ; Nitroglycerin ; Relaxation ; Saphenous Vein* ; Transplants*

Twenty cases who had underwent extracapsular cataract extraction with pupilloplasty followed by implantation of posterior chamber intraocular lens (PCL) were followed up more than 3 months from May 1989 to April 1991. Postoperative uncorrected visual acuity was improved in all cases. Corrected visual acuity was 20/40 or better in 13 cases (65% of all cases) and refractive state was myotic (-1.1D in average) at 2 months after operation. Postoperative astigmatism was -1.3D in average at 2 months after operation, which became -0.8D in average at 1 year after operation. Postoperatively vitreous prolapse occured in 1 case and increased intraocular pressure due to posterior synechiae was observed in 1 case. After-catract developed in 1 case. We obtained good clinical results after ECCE and PCL implantation in leprosy patients for whom wearing the contact lens and glasses were impractical due to hand and finger deformities.
Astigmatism ; Cataract Extraction ; Cataract* ; Congenital Abnormalities ; Eyeglasses ; Fingers ; Glass ; Hand ; Humans ; Intraocular Pressure ; Lenses, Intraocular* ; Leprosy ; Prolapse ; Visual Acuity