Inverted Papilloma arising from mucous membrane of the nasal cavity and paranasal sinuses is rare benign neoplasm, and usually unilateral arise from lateral wall of nasal cavity. This tumor is histologically benign neoplasm but clinically malignant, because of frequent recurrence and extensive bone destruction. And occasionally, this tumor can be transformed to squamous cell carcinoma or verrucous carcinoma. Recently, we have experienced a case of the inverted papilloma with verrucous carcinoma of the nose and paranasal sinuses and patient expired due to extension of intracranial cavity. We report out case with review of current literatures.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Humans ; Mucous Membrane ; Nasal Cavity ; Nose* ; Papilloma, Inverted* ; Paranasal Sinuses* ; Recurrence

STATEMENT OF PROBLEM: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition. Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. PURPOSE: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface- modified titanium. MATERIALS AND METHODS: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the d iscs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. RESULTS AND CONCLUSION: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from ach other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).
Alkaline Phosphatase ; Animals ; Bone and Bones ; Cell Adhesion ; Cell Count ; Cell Movement ; Edible Grain ; Crystallins ; Osseointegration ; Osteoblasts ; Rats ; Skull ; Surface Properties ; Titanium*

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.

In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Aging ; Aircraft* ; Airports ; Blood Pressure* ; Female ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Male ; Military Personnel ; Noise* ; Presbycusis ; Psychological Tests ; Stress, Psychological*

The purpose of this study was to determine the factors which were responsible for delaying early diagnosis and optimal management of rheumatoid arthritis (RA) in Korea. We interviewed 109 outpatients diagnosed as RA being treated by rheumatologists, and we eventually analyzed 98 patients' data. The median length of time from symptom onset to the first visit to a medical doctor, to diagnosis, and visiting a rheumatologist were 8 weeks, 23 weeks, and 42 months respectively. The subspecialist with whom the patients consulted with for the longest time before visiting a rheumatologist were an orthopaedic surgeon for 51 patients, a Chinese herbal doctor for 19 patients, and a pharmacist for 16 patients. For early diagnosis and optimal management of RA in Korea, we believe that it is necessary to reduce the use of unconventional medical services such as Chinese herbal medicine and nonprescribed medication, and to emphasize rheumatologic and rehabilitative care in the early stage.
Adult ; Alternative Medicine/utilization ; Arthritis, Rheumatoid/therapy* ; Arthritis, Rheumatoid/rehabilitation ; Female ; Health Services/utilization* ; Human ; Korea ; Male ; Middle Age ; Rheumatology/methods

In order to evaluate the accuracy of endoscopic findings in the diagnosis of gastric can the endoscopic findings of gastric lesion were compared with the macroscopic and pathologic findings of excised identical lesion. 105 operated gastric cancer paitients (advanced cancer 95 cases, early cancer 10 cases) who were diagnosed endoscopically at Pusan National University Hospital from January 1983 to August 1987 were studied. The results were as follows; 1) The accuracy of endoscopic findings were 94.7% in the advanced gastric cancer, and 45.5% in the early gastric cancer. 2) The accuracy of gross findings endoscopic and pathologic in advanced gastric cancer were 50.0% in Borrmann type I, 45.0% in Borrmann type II, 73.2% in Borrmann type III, and 66.7% in Borrmann tyye IV. 3) The accuracy of the endoscopy ia morphologic classification of advanced gastric cancer according to pathologic tumor location were 60.0% in C (upper 1/3), 43.9% in M(middle 1/3),76.3% in A (lower 1/3), 55.6% in the anterior wall, 50.0% in the posterior wall, 66.7% in the greater curavature, and 67.2% in the lesser curvature. 4) The accuracy of endoacopy in morphologic classification of gastric cancer to tumor size ware 54.5% in below 2 cm, 54.5% in from 2.1 cm to 4 cm, 65.4% in from 4.1 cm to 6.0 cm, 80% in from 6.1 cm to 8 cm, 75.0% in above 8.1 cm. 5) The accuracy of endoscopy in the morphologic classification according to the pathologic tumor stage in advanced gastric cancer were 55.6% in TNM stage I, 52.0% in TNM stage II, 65.4% in TNM stage III, and 73,7% in TNM stage IV.
Busan ; Classification ; Diagnosis ; Endoscopy ; Stomach Neoplasms*

Purpose: To report a case of successful treatment of bilateral infectious keratitis combined with endophthalmitis caused by Pseudomonas aeruginosa in an immunocompromised patient.Case summary: A 66-year-old male with colon cancer and lung metastasis was referred to our clinic with ocular pain and reduced visual acuity in both eyes for 3 days. Visual acuity was “light perception” in both eyes at the first visit. On slit lamp examination, he presented with corneal central necrosis with mucopurulent discharge and anterior chamber hypopyon in both eyes. The left eye especially had vitreous haziness using a B-scan. Pseudomonas aeruginosa was detected in the corneal scrape culture and percutaneous transhepatic biliary drainage culture. After administration of topical eye drops, intravitreal injection, and systemic antibiotics, visual acuity improved from “light perception” to 20/63 in the right eye and to 20/125 in the left eye. Conclusions Although bilateral corneal ulcers combined with endophthalmitis induced by Pseudomonas aeruginosa are rare it can occur in immunocompromised patients. In the case of corneal ulcers combined with endophthalmitis, thorough ocular examinations and active treatments with intravitreal injections and systemic administration of antibiotics can help to recover vision.

PURPOSE: To compare the in vitro toxicity of commercial olopatadine anti-allergic ophthalmic agents on cultured rabbit's conjunctival cells according to concentrations and exposure times. METHODS: Rabbit conjunctival cells were exposed to anti-allergic olopatadine ophthalmic agents, (Patanol® [0.1% olopatadine hydrochloride; Alcon, Fort Worth, TX, USA], Pataday® [0.2% olopatadine hydrochloride; Alcon], and Pazeo® [0.7% olopatadine hydrochloride; Alcon]) at concentrations of 5%, 10%, and 15% for periods of 30 minutes, 1, 2, 3, and 6 hours, respectively. Cell proliferation and injury assays were performed using the methylthiazoltetrazolium and lactate dehydrogenase (LDH) leakage assays. We checked the composition of the three anti-allergic agents, and performed light and transmission electron microscopy to compare the morphological changes in cells. RESULTS: The conjunctival cell proliferation was inhibited after 1 hour exposure to each olopatadine ophthalmic agent, with significant cell proliferation inhibited using 15% of each drug. The proliferation of conjunctival cells was inhibited during 6 hours of drug exposure at all concentrations of Pataday® and Pazeo®. The titer of LDH increased from 3 hours after drug exposure, but 15% Pazeo® significantly increased the LDH titer at 2 hours after drug exposure. As the concentration of the drug increased, the LDH titer also significantly increased. The cellular morphological changes of conjunctival cells were in the increasing order of Pazeo®, Pataday®, and Patanol® with a high concentration of olopatadine hydrochloride. CONCLUSIONS Among the anti-allergic olopatidine ophthalmic agents, higher olopatadine concentrations in the increasing order of Pazeo®, Pataday®, and Patanol® resulted in cytoplasmic damage of conjunctival cells, but there was no severe damage to the cytoplasmic or the nuclear membranes.

BACKGROUND: Thus far, research studies on community-acquired pneumonia (CAP) have focused on its clinical severity. Recently, it has been determined that procalcitonin (PCT) level is correlated with severity of CAP. A retrospective study conducted at our hospital used risk predictability and PCT to determine whether or no PCT is useful in assessing the severity of CAP. METHODS: This study covered 92 CAP cases that were admitted to the respiratory department at Changwon Fatima Hospital between July 1, 2008 and June 30, 2009. All enrolled subjects were measured for infection markers and risk predictability. RESULTS: Based on hospital admission data, enrolled subjects had Pneumonia Severity Index (PSI) scores serving as risk predictors showed that both PCT and white blood cell (WBC) were statistically significant as infection markers (p=0.001, 0.037). Thus, this study used ROC curves in PSI for data analysis. As a result, it was determined that the area under curve (AUC) of PCT and WBC was 0.694 and 0.593 respectively, indicating that PCT has a higher test value for WBC, when PCT was higher than 0.745 ng/mL. In addition, it was found that PCT levels higher than 0.745 ng/mL had higher PSI scores than the group with PCT lower than 0.745 ng/mL (p=0.032). CONCLUSION: In order to predict risk of pneumonia cases admitted due to symptoms of CAP, it is important to consider PCT as well as PSI, and follow-up monitoring of PCT cases.
Area Under Curve ; Calcitonin ; Community-Acquired Infections ; Follow-Up Studies ; Humans ; Leukocytes ; Pneumonia ; Protein Precursors ; Retrospective Studies ; ROC Curve ; Statistics as Topic