PURPOSE: To evaluate the US findings of soft tissue hemangiomas in extremities and to correlate the echo-pattern with MR signal characteristics of hemangiomas. MATERIALS AND METHODS: We retrospectively studied forty-two patients either with pathologically proven cases or with characteristic features of hemangiomas on MRI, US and plain film. Hemangiomas were divided into two types according to the locations;subcutaneous and intramuscular. Analytic points on US and MR findings were gross morphology of the mass, internal echo-pattern or signal characteristics. We correlated the echo-pattern with MR signal characteristics in hemangiomas. RESULTS: Subcutaneous hemangiomas revealed homogeneously anechoic mass on US, which were well correlated with MR signal characteristics' homogeneous low singnal intensity(SI) on Tl-weighted image(WI) and high SI on T2-WI. Intramuscular hemangiomas showed heterogeneously mixed echoic masses on US. An anechoic component on US corresponded to dilated vascular channels on MRI. The signal intensity of intramuscular hemangioma was less than that of subcutaneous fat on T1-WI and greater than that of fat on T2-WI. Both types of hemangiomas had tubular or lace-like appearance with interspersed fibrofatty septa. CONCLUSION: The echo-patterns in US were well associated with MR signal characteristics on MRI. Regarding US and MR features, intramuscular hemangiomas were different to subcutaneous hemangiomas.
Extremities* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Subcutaneous Fat

PURPOSE: To report the upper eyelid reconstruction with median forehead flap and Medpor(R) sheet implant following full-thickness eyelid defect resulting from tumor resection. CASE SUMMARY: A 65-year-old woman was examined at our hospital for a recurrent mass on the right upper eyelid. A wide tumor excision with a 3 mm margin and an eyelid reconstruction procedure were performed after a frozen section biopsy revealed a malignancy. The full-thickness eyelid defect was reconstructed with a median forehead flap as a substitute for skin and muscle and a Medpor(R) sheet substituted for tarsal plate was sutured with a lower conjunctiva flap for posterior lamella. The histopathology diagnosis of the lesion showed a well-differentiated squamous cell carcinoma. The lower conjunctiva was separated at 2 weeks after surgery, and then the median forehead flap detached from the upper eyelid skin at 8 weeks after surgery. One year postoperatively, there was no evidence of a wound infection and an exposure of the Medpor(R) sheet. The eyelid had a good cosmetic contour and the movement of the eyelid during blinking was natural. CONCLUSIONS: The use of a Medpor(R) sheet as a substitute for a tarsal plate in reconstructive procedures of the upper eyelid defect shows cosmetic and functional success.
Aged ; Biopsy ; Blinking ; Carcinoma, Squamous Cell ; Conjunctiva ; Cosmetics ; Eyelids ; Female ; Forehead ; Frozen Sections ; Humans ; Muscles ; Skin ; Wound Infection

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.
Aged, 80 and over ; Cornea/injuries/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Follow-Up Studies ; Humans ; *Tissue Donors ; Visual Acuity

OBJECTIVES: This study investigated the effects of Emotionally Focused Therapy (EFT) on distressed married couples. METHODS: We conducted 5 to 19 EFT sessions once a week with 10 couples from Yongin Mental Hospital who were experiencing marital conflict. We assessed participants before and after EFT, using the Beck Depression Inventory (BDI), Symptom Checklist 90-R (SCL-90R), and Korean Marital Satisfaction Inventory (K-MSI). The EFT consisted of 3 stages comprising 9 steps. Every couple followed this EFT structure. RESULTS: After completing the EFT sessions, the inventories showed the couples experiencing significant improvements in various psychological symptoms and marital satisfactions. CONCLUSION: These results indicate that EFT could be applied to distressed couples in a clinical setting and could effectively reduce psychological symptoms and improve marital satisfaction. Further study of the generalizability of these results and of the process variables are needed.
Checklist ; Depression ; Equipment and Supplies ; Family Characteristics ; Family Conflict ; Hospitals, Psychiatric ; Pilot Projects

PURPOSE: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. METHODS: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. RESULTS: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. CONCLUSION The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

No Abstract available.
Academic Medical Centers* ; Infection Control*

No abstract available.
Down Syndrome* ; Leukemia*

A 44-year-old man presented with a history of chronic epiphora, discharge from the right eye, and a palpable mass in the medial canthal area. Irrigation of the lacrimal system revealed bloody discharge. Orbital magnetic resonance imaging (MRI) showed a well-defined heterogeneous enhanced mass filling the lacrimal sac and upper nasolacrimal duct (NLD). A wide excision and surgical biopsy were performed. Histopathology showed the tumor to be an exophytic Schneiderian papilloma with moderate to severe dysplasia. Three months later, the mass was found to be invading the nasal cavity through the NLD. Endoscopic histopathological evaluation confirmed that it was identical to the originally identified papilloma.
Adult ; Biopsy ; Diagnosis, Differential ; Endoscopy ; Eye Neoplasms/*pathology/surgery ; Follow-Up Studies ; Humans ; Lacrimal Apparatus/*pathology ; Magnetic Resonance Imaging ; Male ; Nasal Mucosa/*pathology ; Neoplasm Invasiveness/*pathology ; Neoplasm Recurrence, Local/*pathology/surgery ; Nose Neoplasms/*pathology/surgery ; Papilloma/*pathology/surgery

PURPOSE: Using the spectral domain optical coherence tomography (SD-OCT), we studied the difference in the choroidal morphology between the choroidal neovascularization (CNV) area and the area surrounding CNV. METHODS: This retrospective study consisted of 19 patients with myopic CNV lesion in eye; fellow eyes were used as controls. All eyes were analyzed by measuring the choroidal thickness and large choroidal vessel size using SD-OCT. Eyes with CNV were divided into groups; the neovascular lesion was defined as group 1, the surrounding area as group 2. Subfovea of the fellow eye was defined as group 3. RESULTS: The choroidal thickness was 80.00 +/- 68.31 in group 1, 63.44 +/- 67.75 in group 2 and 71.11 +/- 65.69 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.038). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.365, p = 0.314). The large choroidal vessel size was 57.47 +/- 39.78 in group 1, 40.45 +/- 34.69 in group 2 and 45.63 +/- 37.00 microm in group 3. There was a significant difference between group 1 and group 2 (p = 0.025). There were no significant differences between group 1 and 3 or between group 2 and 3 (p = 0.123, p = 0.325). CONCLUSIONS: Choroidal thickness and large choroidal vessel size at the center of the CNV were greater than in the area surrounding CNV. The results suggest that although the CNVs were due to a thinned choroid caused by severe choroidal ischemia, the development of CNV requires maintenance of choriocapillaris and large choroid vessels.
Choroid* ; Choroidal Neovascularization* ; Humans ; Ischemia ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. METHODS: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. RESULTS: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. CONCLUSION: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.
Doxylamine ; Dyspnea ; Ephedrine ; Ethylene Glycol ; Ethylenes ; Humans ; Medical Records ; Oxygen ; Propofol ; Pulmonary Edema ; Thorax ; Transportation ; Vomiting