A 62-year-old farmer was admitted to our department because of second degree chemical burns of both buttocks ten days following accidental contact with Gramoxone, a weed killer. He was treated with oral antibiotics and cold compresses and discharged after the burned area were reepithelialized. Laboratory findings were within normal limits for three weeks. Although lung fibrosis, hepatic and renal failure can be caused by repeated absorption of paraquat (Gramoxone) through injuried skin, systemic absorption through normal skin has not been reported. During the four month follow up period there were no systemic problems nor recurrence of skin lesions. We report herein a case of chemical burns induced by Gramoxone, which is probably an occupational dermatosis of farmers handling weed killers.
Absorption ; Anti-Bacterial Agents ; Burns ; Burns, Chemical* ; Buttocks ; Fibrosis ; Follow-Up Studies ; Humans ; Lung ; Middle Aged ; Paraquat ; Recurrence ; Renal Insufficiency ; Skin ; Skin Diseases

No abstract available.
Adrenocortical Carcinoma*

There are many controversies concerning therapeutic guidelines for the treatment of Kienbock's disease. We experienced 17 cases of stage II or III Kienbock's disease(Lichtman's classification), which were treated with triscaphe fusion from March 1983 to March 1992. The mean Follow-up peri- od was 25 months. The purpose of this study is to evaluate the clinical and radiological result of triscaphe fusion of 17 cases of Kienbock's disease. 1. The pain was relieved in all cases, but range of motion was not improved after operation. 2. The postoperative results of triscaphe fusion were evaluated by Licthman's method. 9 cases (53%) were rated as satisfactory and 8 cases as unsatisfactory. 75%(3 cases of 4) were rated sat isfactory in IIIA a group and 22%(2 casaes of 9) were rated satisfactory in IIIB group. 3. The psudoarthrosis was noted in 2 cases of 17.
Follow-Up Studies ; Methods ; Osteonecrosis ; Range of Motion, Articular

PURPOSE: To evaluate the differences in dry eye and meibomian gland dysfunction (MGD) by comparing ocular surface status before and after wearing an orthokeratologic (OK) lens and rigid gas permeable (RGP) lens made of the same material. METHODS: The ocular surface and meibomian gland statuses of 12 eyes of 12 OK lens wearers (OK lens group) and 16 eyes of 16 RGP wearers (RGP lens group) were evaluated before and 1 and 3 months after lens wearing. Ocular surface disease index (OSDI), tear film break-up time (TBUT), Schirmer's test I, and ocular surface staining score were evaluated for ocular surface parameters. Meibomian gland function was evaluated by assessing lid margin abnormality, meibomian gland expressibility, and meibum quality. RESULTS: TBUT and ocular surface staining score after 1 and 3 months of wearing an OK lens were significantly aggravated (p= 0.004, p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an OK lens (p < 0.001, p < 0.001, p < 0.001, p= 0.002). After 1 and 3 months of wearing an RGP lens, OSDI, TBUT, and ocular surface staining score were aggravated (all p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an RGP lens (all p < 0.001). MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were significantly more aggravated in the RGP lens group than in the OK lens group after 3 months (p < 0.001, p < 0.001, p= 0.001, p < 0.001). CONCLUSIONS: Use of OK and RGP lenses affects ocular surface status. Especially, meibomian gland parameters and OSDI showed greater changes in RGP lens wearers than OK lens wearers.
Meibomian Glands ; Tears

PURPOSE: To evaluate the differences in dry eye and meibomian gland dysfunction (MGD) by comparing ocular surface status before and after wearing an orthokeratologic (OK) lens and rigid gas permeable (RGP) lens made of the same material. METHODS: The ocular surface and meibomian gland statuses of 12 eyes of 12 OK lens wearers (OK lens group) and 16 eyes of 16 RGP wearers (RGP lens group) were evaluated before and 1 and 3 months after lens wearing. Ocular surface disease index (OSDI), tear film break-up time (TBUT), Schirmer's test I, and ocular surface staining score were evaluated for ocular surface parameters. Meibomian gland function was evaluated by assessing lid margin abnormality, meibomian gland expressibility, and meibum quality. RESULTS: TBUT and ocular surface staining score after 1 and 3 months of wearing an OK lens were significantly aggravated (p= 0.004, p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an OK lens (p < 0.001, p < 0.001, p < 0.001, p= 0.002). After 1 and 3 months of wearing an RGP lens, OSDI, TBUT, and ocular surface staining score were aggravated (all p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an RGP lens (all p < 0.001). MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were significantly more aggravated in the RGP lens group than in the OK lens group after 3 months (p < 0.001, p < 0.001, p= 0.001, p < 0.001). CONCLUSIONS: Use of OK and RGP lenses affects ocular surface status. Especially, meibomian gland parameters and OSDI showed greater changes in RGP lens wearers than OK lens wearers.
Meibomian Glands ; Tears

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

Although many methods have been developed to correct the aging process of the head and neck, the correction of nasolabial folds still remains a difficult area. The difficulty of correcting nasolabial fold is due to the anatomical location and the difference of aging process. From March 2000 to February 2001, the authors operated on 10 aging face patients using face lift with SMAS and FAME(Finger-assisted malar fat pad elevation) technique. The authors repositioned the SMAS-platysma flap posterosuperiorly and used finger dissection of the malar fat pad enabling a 3-dimensional correction and repositioning of the fat pad without detachment of the zygomatic ligament. The finger dissection of the malar fat pad attached to the skin enables a more anatomical correction of the malar fat pad with a more natural looking layer and longer lasting results in addition to decreased hematoma, edema and postoperative pain compared to previous methods.
Adipose Tissue ; Aging ; Edema ; Fingers ; Head ; Hematoma ; Humans ; Ligaments ; Nasolabial Fold ; Neck ; Pain, Postoperative ; Rhytidoplasty* ; Skin

Few cases of ichthyosis bullosa of Siemens(IBS) have been reported since 1939, as a distinct entity from bullous congenital ichthyosiform erythroderma(BCIE). IBS can be differentiated from BCIE by the absence of congenital erythroderma and a different distribution of involved skin area. It's characteristic features include blistering, superficial erosion or moulting of the outer skin. Histological features are tonofilaments aggregation confined to the granular and upper spinous layer of the epidermis. However, in BCIE these findings are present in the whole suprabasal compartment. The original reports of Siemens and cases from other authors showed an autosomal dominant inheritance. Our patient developed IBS sporadically without a familial background.
Blister ; Dermatitis, Exfoliative ; Epidermis ; Humans ; Ichthyosis Bullosa of Siemens* ; Ichthyosis* ; Intermediate Filaments ; Molting ; Skin ; Wills

BACKGROUND: The efficacy of palonosetron in preventing postoperative nausea and vomiting (PONV), as well as chemotherapy-induced nausea and vomiting, has already been demonstrated in multiple clinical studies. The purpose of this study was to determine whether continuous infusion of palonosetron following single injection could reduce PONV to a greater extent than single injection only of palonosetron. METHODS: In total, 132 women were enrolled in the study. All subjects were over the age of 20 years and were scheduled to undergo gynecologic laparoscopic surgery. Patients were randomly allocated into two groups. In both groups, patients received 0.075 mg of palonosetron intravenously, immediately before induction of anesthesia. In the continuous palonosetron infusion group, 0.075 mg (1.5 ml) of palonosetron was added to the patient-controlled analgesia device. In the single-injection palonosetron group, 1.5 ml of normal saline was added. RESULTS: The incidence of PONV 24 hours postoperatively was significantly lower in the continuous palonosetron infusion group than the single-injection palonosetron group (31.8 vs. 56.1%, P = 0.009). CONCLUSIONS: Continuous palonosetron infusion, following single injection, reduces the incidence of PONV compared with single injection only.
Analgesia, Patient-Controlled* ; Anesthesia ; Female ; Humans ; Incidence ; Laparoscopy ; Nausea ; Postoperative Nausea and Vomiting* ; Vomiting

OBJECTIVES: To investigate the factors associated with symptoms from job stress among Korean dental laboratory technicians. METHODS: We collected the data of 786 technicians for life-style, job stressor, social support, self-esteem, personality, and various dimension of stress symptoms included roomatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility by self-administerd questionnaire. Global severity index of dental technician (GSID) was calculated by total sum of sub-dimension. RESULTS: We used 80 percentile as a cut-off point, and got the 81.5 % of sensitivity, 86.1 % of specificity by receiver operating characteristic curve. The odds ratios of various factors in high group of GSID compared with low group were 1,49(95 % Cl 1.00-2.00) for smoker, 1,53 (1.06-2.21) for unhealthy group, 6,69 (4.74-9.44) for work overload, 8.34(5.82-11.97) for work demand, 9.89 (6.76-74.94) for work process, 8.27 (5.80-11,79) for work environment, 5.82 (4.04-8.39) for interpersonal relationship, 8.34 (5.82-11.97) for occupational conflict, 5.70 (4.04-8.04) for labor remuneration, 7.58 (5.37-10.71) for role conflict, but 0.39 (0.27-0.57) for social support, 0.41 (0.29-0.60) for self-esteem. By multiple logistic regression, factors were significantly associated with GSID were age, working area, role overload, work demand, work procedure, physical environment, occupational conflict, role conflict, social support, personality traits. CONCLUSIONS: Factors associated with symptoms from stress were role overload, work demand, work procedure, occupational conflict, interpersonal relationship, labor remuneration and role conflict in Korean dental laboratory technicians. It is suggested that health promotion program to reduce job stress and to enforce social support and self-esteem should be developed.
Anxiety ; Dental Technicians ; Depression ; Health Promotion ; Hostility ; Humans ; Laboratories, Dental* ; Logistic Models ; Odds Ratio ; Questionnaires ; Remuneration ; ROC Curve ; Sensitivity and Specificity