A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.
Acupuncture ; Adult ; Cardiopulmonary Bypass ; Chest Pain ; Dyspepsia ; Female ; Foreign Bodies* ; Heart Ventricles* ; Humans ; Needles* ; Radiography, Thoracic ; Substance-Related Disorders

Neuroblastoma stage IV-S patients have frequent spontaneous remission and high survival rate. Many investigators have recommended minimal or no therapeutic intervention ; however, some patient do experience progressive disease and ultimately die of neuroblastoma. We experienced a case of stage IVS neuroblastoma with N-myc amplification and coagulopathy. This patient has treated with combination chemotherapy and radiation therapy, then remained disease free for 1 year on the follow up till March, 1997.
Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Neuroblastoma* ; Remission, Spontaneous ; Research Personnel ; Survival Rate

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.
Aged* ; Dental Care ; Dentures* ; Education ; Health Surveys ; Humans ; National Health Programs* ; Oral Health ; Quality of Life ; Social Class

PURPOSE: To analyze the outcome and therapeutic effectiveness of dacryocystography in patients with epiphora. METHODS: A retrospective study was carried out on 270 patients (385 eyes) who had undergone dacryocystography for epiphora from 1998 to 2002. The factors assessed were age, sex, duration of epiphora, incidence rate of obstruction site of lacrimal system, reliability of dacryocystography as a diagnostic method, correlation of syringing with dacryocystography, correlation of probing with dacryocystography. RESULTS: The incidence rate of lacrimal system obstruction on dacryocystography was 74% (285 eyes). The most common site was nasolacrimal duct (138 eyes, 48.4%), followed by sac (78 eyes, 27.4%), common canaliculus (51 eyes, 17.9%), and superior and inferior canaliculus (18 eyes, 6.3%). Dacryocystography showed 74% sensitivity and 87% specificity (p<0.01). The results of syringing and probing correlates poorly with the results of dacryocystography. CONCLUSIONS: Dacryocystography is a useful method to assess the lacrimal passage system, and the obstruction site so that therapy can be accurately planned, particularly in patients with epiphora.
Classification* ; Humans ; Incidence ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Drug Eruptions*

PURPOSE: To determine the side effects of short-term high-dose methylprednisolone therapy (pulse methylprednisolone therapy), which was used to treat patients with optic neuritis, traumatic optic neuropathy, orbital pseudotumor, and orbital myositis. METHODS: All 27 patients treated with pulse methylprednisolone therapy from June 2005 to June 2006 were included in this study. Each patient was injected with 1 g per day of methylprednisolone intravenously, administered in 250 mg doses every 6 hours, for 3 days. We measured body mass index (BMI), fasting glucose, HbA1c, blood pressure, and intraocular pressure. In addition, we performed slit lamp examination and chest X-ray. RESULTS: The average age of the 27 patients was 35.8 years, including 16 males and 11 females. Thirteen patients had optic neuritis, 10 patients had traumatic optic neuropathy, 3 patients had orbital pseudotumors, and 1 patient had orbital myositis. Before treatment, the average of body mass index (BMI) was 23.09 (kg/m2), but at 3 months after treatment it was 23.73 (kg/m2). All patients had fasting glucose levels higher than the normal range during the treatment. However, all fasting glucose levels returned to within the normal range at 3 months after treatment, except in 1 patient. In addition, a major complaint among patients was an increase in body weight. CONCLUSIONS: We performed a close observation of controlled diet and exercise on patients who were treated with pulse methylprednisolone therapy because we knew it would have a hyperglycemic effect. An increase in body weight is the most common complaint of steroid therapy. Even after treatment is completed, it is important to monitor glucose level and weight.
Blood Pressure ; Body Mass Index ; Body Weight ; Diet ; Eye ; Eye Diseases ; Fasting ; Female ; Glucose ; Humans ; Intraocular Pressure ; Male ; Methylprednisolone ; Optic Nerve Injuries ; Optic Neuritis ; Orbit ; Orbital Myositis ; Orbital Pseudotumor ; Organothiophosphorus Compounds ; Reference Values ; Thorax

PURPOSE: This study was conducted to identify job experiences of male hospital nurses. METHODS: Data were collected from 20 male nurses working at general hospitals, through semi-structured in-depth interviews. The interviews were recorded and subsequently transcribed verbatim. Using content analysis, data were coded and categorized. RESULTS: The analyzed domains were motivations for choosing nursing, occupational experiences (3 subdomains), and attitudes toward the future. A total of 85 significant statements were selected from the data and classified into 32 categories. The nurses' motivations for choosing nursing were advantages of employment, their aptitude, scarcity value of men, professionalism and job security, good promotion, stable income, and family influence. In occupational experiences, they were assigned to special fields and dissatisfied with vertical relationship, promotion system, their salary, and gaps in military service time; they had difficulties in adapting to female-dominated groups and encountered gender role stereotype and preconception; they were satisfied with their distinguished performance, but had damaged self-esteem, and were stressed and disappointed in their work. In their attitudes toward the future, they considered their career changes, but tried to make professional and personal advancement. CONCLUSION: These findings have implications for recruiting and retaining male nurses in clinical settings.
Aptitude ; Employment ; Gender Identity ; Hospitals, General ; Humans ; Male ; Military Personnel ; Motivation ; Nurses, Male ; Salaries and Fringe Benefits ; Statistics as Topic

PURPOSE: Autogenous fascia lata of distal thigh is the best material for repairing ptosis with poor levator function. The purpose of this study is to evaluate the complications associated with autogenous fascia lata harvesting on the distal thigh for frontalis suspension surgery. METHODS: We reviewed the medical charts of ptosis patients who underwent frontalis suspension surgery with autogenous fascia lata from March 2001 to March 2003. Fifteen patients, with at least 1-year follow-up, were included. RESULTS: Postoperative functional complications related with walking were pain on walking in 10 patients (67%), limping in 6 (40%), muscle weakness in 2 (12%), and limitation of knee motion in 1 (7%). Complications related- with the wound were tenderness in 8 patients (53%), an unsightly scar on harvesting site in 8 (53%), inflammation in 1 (7%), muscle herniation in 1 (7%), and hypoesthesia around the wound in 1 (7%). CONCLUSIONS: Except for the scar, most of postoperative complications were resolved during the early follow-up period. The only long-term complication was the cosmetic problem of an unsightly scar on the harvesting site. For which careful suture on the wound site and fascia lata harvesting on the proximal thigh are recommended.
Cicatrix ; Fascia Lata* ; Fascia* ; Follow-Up Studies ; Humans ; Hypesthesia ; Inflammation ; Knee ; Muscle Weakness ; Postoperative Complications ; Sutures ; Thigh* ; Walking ; Wounds and Injuries

BACKGROUND: This study aimed to investigate the effects of critical thinking and good communication skills on the problem-solving abilities of dental hygiene students. METHODS: A total of 508 dental hygiene students were convenience-sampled from 3 universities. RESULTS: The results revealed that critical thinking had the highest intellectual fairness score of 3.60, and systematicity was the lowest at 3.19. The values for communication skills were high in reaction, social adequacy, and concentration, with an average of 3.65. Problem-solving abilities were in the following order: clarification of the problem, seeking solutions, and decision making. According to general characteristics, more extroverted personalities possessed higher levels of critical thinking, communication skills, and problem-solving abilities (p<0.01). Critical thinking scores were high (p=0.016) in students who responded that peer relationship was difficult; however, their communication skills were the lowest (p<0.001). Additionally, problem-solving abilities were highest among students who reported a difficult peer relationship (p=0.001). The higher the satisfaction with dental hygiene academics, the higher the critical thinking, communication skill, and problem-solving ability (p<0.001). Critical thinking showed a high positive correlation with variables in the following order: clarification of the problem, performing the solutions, seeking solutions, decision making, and evaluation and reflection. The communication skills were also related to these variables listed above (p<0.01). With critical thinking, confidence, watchfulness, intellectual passion/curiosity, sound skepticism, objectivity, and systematicity all influenced the problem-solving ability. CONCLUSION: Communication skills were influenced by noise control, putting on the other's shoe, social tensions, and efficiency, which affected the problem-solving ability. Dental clinics require dental hygienists to have critical thinking to make analytical judgments and effective communication skills to solve human relation problems with patients and care-givers. Therefore, these skills should be developed in dental hygiene students to improve their problem-solving abilities.
Decision Making ; Dental Clinics ; Dental Hygienists ; Humans ; Judgment ; Noise ; Oral Hygiene ; Shoes ; Thinking

PURPOSE: To evaluate the clinical effectiveness of topical diquafosol tetrasodium (DQS) after laser epithelial keratomileusis (LASEK). METHODS: This randomized prospective study included 97 eyes of 49 patients who were scheduled for LASEK. Patients in the DQS group used both 0.3% sodium hyaluronate and 3% DQS for 3 months after surgery while patients in the control group used only 0.3% sodium hyaluronate. Corneal staining score, tear film break-up time (TF-BUT), Schirmer test and ocular surface disease index (OSDI) were evaluated before surgery and 2, 4, 8, 12 and 16 weeks after surgery. RESULTS: There was no significant difference in visual acuity, spherical equivalent and corneal haziness between the 2 groups after surgery. Corneal staining score was significantly lower in the DQS group than in the control group 2 weeks after LASEK (p < 0.01) and increased in the control group after LASEK compared with the preoperative value (2 weeks after LASEK, p < 0.01), but decreased in the DQS group (12 and 16 weeks after LASEK, p < 0.05). TF-BUT was significantly higher in the DQS group than in the control group 2 to 16 weeks after LASEK (p < 0.01) and increased values were observed in the DQS group after LASEK compared with the preoperative value (4 to 16 weeks after LASEK, p < 0.05). The mean OSDI was significantly higher 4 to 16 weeks after LASEK in the control group than in the DQS group (p < 0.01). CONCLUSIONS: Subjective dry eye symptoms and objective markers were worse for 4 weeks after LASEK. The use of 3% DQS for 12 weeks after surgery improved these symptoms and markers with the effect lasting 16 weeks after LASEK.
Dry Eye Syndromes ; Humans ; Hyaluronic Acid ; Keratectomy, Subepithelial, Laser-Assisted ; Prospective Studies ; Refractive Surgical Procedures ; Tears ; Visual Acuity