We reported a case of cutaneous focal mucinosis in a 19 year-old male, which occured by multiple nodules on the both dorsa of hands, extensor surface of elbows, intergluteal folds and shins, and responded well to intralesional injection of triamcinolon acetonide. Histopathologically, most of the collagen in the dermis is replaced to homogeneous mucinous material which was confirmed as hyaluronic acid.
Collagen ; Dermis ; Elbow ; Hand ; Humans ; Hyaluronic Acid ; Injections, Intralesional ; Male ; Mucinoses* ; Mucins ; Young Adult

PURPOSE: This survey was performed to gather information about the guardians of pediatric oculoplastic patients undergoing certain medical care services in order to recommend improvements in these services. METHODS: Questionnaires were distributed to guardians of pediatric oculoplastic patients who were admitted for operations to correct epiblepharon and ptosis. Completed questionnaires, which numberd 100, were then analyzed. RESULTS: The results of this survey show that most guardians were the parents of the patient; most had a level of education higher than or equal to junior college graduation; and most were middle-class. The parents themselves had discovered their children's disease and had a great influence on the decision to operate. Most parents took an optimistic view of the results of the operation. The higher the guardians' economic status, the more likely he or she believed that both an ophthalmic and a plastic surgeon could perform oculoplastic operations. Many guardians chose an ophthalmic clinic over a plastic surgery clinic because the likelihood of a satisfactory result is higher and because these diseases are related to visual acuity. Half of the guardians knew that there is an oculoplastic clinic at the department of ophthalmology, and many of them gathered information about oculoplastic surgery from the internet. CONCLUSIONS: Better explanations about oculoplastic diseases and more education about these diseases should be available to the guardians of patients with these diseases. Systematic publicity for the field of oculoplastic surgery is needed urgently, and the availability of accurate information and specialized medical counseling about these diseases on the internet should be increased.
Counseling ; Education ; Humans ; Internet ; Ophthalmology ; Parents ; Surveys and Questionnaires ; Surgery, Plastic ; Visual Acuity

PURPOSE: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. METHODS: This study used Walker and Avant's process of concept analysis. RESULTS: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. CONCLUSION: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.
Adaptation, Psychological ; Caregivers ; Concept Formation ; Humans ; *Intensive Care Units ; *Patient Transfer ; Patients' Rooms ; *Stress, Psychological

The aim of this study was to evaluate the morphology of the mandibular symphysis and anterior alveolar and skeletal d relationship under the influence of the rotational growth pattern of mandible in skeletal Class III malocclusion. A total of 86 untreated adult subjects were divided into two groups-forward rotational growth pattern group, backward rotational growth pattern group-according to the suggestion of Skieller et al. The antero-posterior position, vertical relationship, mandibular symphysis and anterior alveolar and skeletal relationship were assessed on lateral cephalometric radiographs. Mandibular symphysis and anterior alveolar and skeletal relationship in each subject were studied and the following conclusions were drawn: 1. Concerning the antero-posterior position, forward rotational growth pattern group showed significantly larger SNA, SNB. Concerning the vertical relationship, all measurements showed statistically significant differences. 2. Forward rotational growth pattern group showed significantly larger IMPA MnAD, backward rotational growth pattern group showed significantly larger MxABH. 3. There was no statistically significant difference in symphysis ratio to mandibular plane between forward and backward rotational growth pattern group. 4. In the correlative analysis of rotational growth pattern of mandible and mandibular symphysis, anterior alveolar of and skeletal relationship, statistically significant correlations in overbite, IMPA, MnAD, symphysis width were showed.
Adult ; Humans ; Malocclusion* ; Mandible* ; Overbite

At the finishing stage, the use of asymmetric elastics to treat mild skeletal and dental midline discrepancies often creates several side effects such as canted occlusal plane, tipped incisors and anesthetic results. This report presents the clinical cases with midline discrepancies, following a differential diagnosis, optimal mechanics, and considerations in treatment. Differential diagnosis and treatment mechanics with three-piece basal archwire can obtain predictable midline correction with minimal side effects.
Dental Occlusion ; Diagnosis, Differential ; Humans ; Incisor ; Mechanics

PURPOSE: Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. PlGF is implicated in several pathologic processes, including the growth and spread of cancer and tumor angiogenesis. The aim of this study was to evaluate the expression and the clinical implications of PlGF in colorectal cancer. METHODS: In order to ascertain the clinical significance of PlGF expression in colorectal cancer, the researcher analyzed the expression pattern of PlGF by using an immunohistochemical method and attempted to establish if a relationship existed between PlGF expression and microvessel density (MVD), and subsequently between PlGF expression and the predicted prognosis. A total of 83 patients with colorectal cancer were included for immunohistochemical staining. Clinicopathological characteristics were defined according to the tumor-node-metastasis (TNM) criteria of the Union for International Cancer Control. Clinicopathologic factors, such as age, sex, histological types of tumors, tumor cell grade, TNM stage, lymphovascular invasion, and lymph-node metastasis, were reviewed. RESULTS: In this study, the PlGF protein expression level was significantly correlated with MVD, patient survival, and clinicopathological factors such as lymph-node metastasis, TNM staging, lymphatic invasion and vascular invasion. CONCLUSION: PlGF may be an important angiogenic factor in human colorectal cancer, and in this study, PlGF expression level was significantly correlated with positive lymph-node metastases, tumor stage, and patient survival. These findings suggest that PlGF expression correlates with disease progression and may be used as a prognostic marker for colorectal cancer.
Angiogenesis Inducing Agents ; Colorectal Neoplasms ; Disease Progression ; Humans ; Microvessels ; Neoplasm Metastasis ; Neoplasm Staging ; Pathologic Processes ; Placenta ; Pregnancy Proteins ; Prognosis ; Vascular Endothelial Growth Factor A

BACKGROUND: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. METHODS: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. RESULTS: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. CONCLUSION: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.
Adult ; Animals ; Bias (Epidemiology) ; Blood Gas Analysis ; Blood Viscosity ; Cardiopulmonary Bypass ; Dogs ; Elasticity ; Erythrocytes* ; Extracorporeal Circulation* ; Hematocrit ; Hematology ; Humans ; Lactic Acid ; Plasma ; Pulsatile Flow ; Viscosity

PURPOSE: To evaluate the clinical aspects of severe endogenous endophthalmitis requiring evisceration,particularly underlying disease, causative microorganisms, and infection focus, and to assess the outcome of evisceration. METHODS: The records of 13 patients who were diagnosed with endogenous endophthalmitis requiring evisceration and treated at Yeungnam University Hospital from July 1994 to April 2007 were retrospectively reviewed. RESULTS: Of the 13 patients, all patients had diabetes mellitus, five had advanced liver disease, and one had aplastic anemia. Infection foci were pyelonephritis, pneumonia, and liver abscess. Five cases were confirmed with positive culture of lebsiella pneumoniae. Ten cases underwent evisceration with hydroxyapatite implantation, and three cases were treated conservatively because the patient was in poor systemic condition. Of the 10 patients who underwent evisceration, ocular implants were exposed in five cases. CONCLUSIONS: This study suggests that evisceration with primary orbital implant insertion for endogenous endophthalmitis involves the risk of implant exposure, but after secondary repair, all patients have stable clinical courses.
Anemia, Aplastic ; Diabetes Mellitus ; Durapatite ; Endophthalmitis ; Humans ; Liver Abscess ; Liver Diseases ; Orbital Implants ; Pneumonia ; Pyelonephritis ; Retrospective Studies

PURPOSE: To analyze postoperative results of intermittent exotropia as a function of the difference in strabismic angles measured immediately and another time prior to the surgery. METHODS: We reviewed the clinical records of intermittent exotropia patients who received surgery and had differences greater than or equal to 10 prism diopters (PD) between the last preoperative measurement of strabismic angle and another previous measurement. After applying various exclusion criteria, 66 patients were entered into our study. At the last follow-up visit after surgery, we divided postoperative results into 3 categories: (1) poor; with greater than 10 PD of esotropia or angle of exodeviation of 20 PD or more (2) moderate; with 6-10 PD of esophoria/tropia or 10-19 PD exodeviation, or (3) good; with 1-5 PD of esophoria/tropia or an angle of exodeviation less than 10 PD, or orthophoria. RESULTS: Good results were higher in patients where the difference in strabismic angle was 10 PD or greater between the last measurement and any other earlier measurement. CONCLUSIONS: In cases of Intermittent exotropia where the last preoperative value of strabismic angle was greater than any previous preoperative measurement, surgical dosage based on the last preoperative measurement yielded better results.
Treatment Outcome ; Severity of Illness Index ; Retrospective Studies ; Ophthalmologic Surgical Procedures/*methods ; Oculomotor Muscles/*physiopathology/surgery ; Male ; Infant ; Humans ; Follow-Up Studies ; Female ; Eye Movements/*physiology ; Exotropia/physiopathology/*surgery ; Child, Preschool

OBJECTIVE: Our purpose was to compare the pregnancy outcomes of nulliparous women aged 40 years and older with those of nulliparous women under 35 years of age. METHODS: From January 1989 to December 1998 total 57,563 deliveries were seen in Gachon Gil Medical Center. Among them we experienced 59 cases of nulliparas at 40 years and older. These women were compared with 188 young nulliparas under 35 years of age as the control group. The statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence rate of elderly nulliparas aged 40 years and older was increased from 0.04% in 1989 to 0.30% in 1998. The age distribution was from 40 years to 45 years. The gravidity of eldery nulliparas was 2.2 in comparison with 1.6 in control group. The incidence of uterine myoma, gestational DM, IUGR and oligohydramnios was significantly high rate in elderly nulliparas. There was significantly high rate of cesarean section in elderly nulliparas(88.1%) in comparison with control group(40.4%). The reasons of cesarean section were her demand(39.0%), CPD(15.3%) and breech presentation(13.6%) in decreasing order. The preterm delivery rate was 10.2% in elderly nulliparas in comparison with 4.3% in the control group. Placenta accreta and uterine atony were significantly high in elderly nulliparas and mean estimated blood loss was also high. There was no difference in 5-minute Apgar score between both group, but there were more cases of neonatal intensive care unit admission in neonates of elderly nulliparas(6.8% vs 0%). CONCLUSION: The incidence of elderly nulliparas is continuously increasing. The elderly nulliparas and their babies are at greater risk than young women. Therefore all elderly nulliparas aged 40 years and older can be regarded as high risk patients and they must be managed with careful attention.
Age Distribution ; Aged ; Apgar Score ; Cesarean Section ; Female ; Fetal Growth Retardation ; Gravidity ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Leiomyoma ; Oligohydramnios ; Placenta Accreta ; Pregnancy ; Pregnancy Outcome ; Uterine Inertia