Tumors of the parotid gland are the most frequently encountered salivary gland tumors. Knowledge of the histology and anatomy of the salivary gland is important when considering the histiogenesis of salivary gland tumors, requiring close cooperation between the pathologist and the surgeon. Most tumors are benign epithelial formations. Pleomorphic adenomas predominate. Superficial lobectomy is adequate treatment. When the tumor involves a deep lobe, total parotidectomy is indicated. Treatment of malignant tumors depends on the histology, its TNM stage and other factors. Total parotidectomy with lymph adectomy and radiotherapy are needed in case of high grade malignancy. In children, vascular neoplasias are the most frequent, followed by malignant tumors. Their histological features and treatment are the same as for adults. We reviewed 64 cases of the parotid tumors at Department of surgery, Dong-A University Hospital from July. 1990 to Jan. 1999 for the purpose of apprehension of parotid gland tumor by the clinical study and review. Over all sex ratio was 1: 1.13 (M: F), mean age was 38.9 years, mean size was 3.53cm. According to histologic findings of 64 cases, pleomorphic adenoma was 55 (85.9%), Warthin's tumor was 3 (4.7%), mucoepidermoid carcinoma was 3 (4.7%), squamous cell carcinoma was 2 (3.1%), acinic cell carcinoma was 1 (1,6%). Post op. facial nerve palsy 16 (25%), Frey's syndrome 11 (17.2%) cases were happened. Hence, the clinical manifestation of pain, tenderness, facial N. palsy suggest malignant tumors.
Adenoma, Pleomorphic ; Adult ; Carcinoma, Acinar Cell ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Child ; Facial Nerve ; Humans ; Paralysis ; Parotid Gland* ; Radiotherapy ; Salivary Glands ; Sex Ratio ; Sweating, Gustatory

Fibroblasts ; Hemorrhage ; Lip ; Mouth Mucosa ; Neurofibroma ; Neurofibromatoses ; Palate ; Plastics ; Recurrence ; Tongue

BACKGROUND: Mental stress prebably leads to disease by the effect on autonomic nervous system, especially on cardiovascular nervous system it leads deleterious effects ranging from the apperarence or worsenig of ischemia to lethal arrhythmia or sudden death. Especially after myocardial infarction this risks were increased. PURPOSE & METHODS: In order to assess the effect of postural change and arithmetic test on the state of autonomic nervous system in patients with AMI(acute myocardial infarction) autoregressive power spectral analyses were applied to 21 healthy subjects(51.9+/-6.5 years) and 20 AMI patients(55.3+/-7.4 years) during supine, standing and arithmetic test. RESULTS: R-R interval and systolic blood pressure decreased during standing compared with during supine position but there were no remarkable changes during arithmetic test compared with during supine position. In two groups, both during standing and during arithmetic test, compared with during supine position, the remarkable increase of LF(low frequency) spectral parameters(Nu, p<0.001) and decrease of HF(high frequency) spectral parameter(Nu, p<0.001) were observed. And during arithmetic test, compared with during standing, the remarkable increase of LF spectral parameter(Nu, p<0.01) and decrease of HF spectral parameter(Nu, p<0.01) were observed. LF/HF ratio and LFCCV/HFCCV ratio, so an index of sympatho-vagal balance, significantly increased during standing and during arithmetic test compared with during supine position and the increase was more prominent during arithmetic test(p<0.05). There was no significant difference of spectral parameters beteen two groups. CONCLUSION: In conclusion, sympathetic activity increased during standing and during arithmetic test. Especially, during arithmetic test it induced only sympathetic activity to increase remarkably without significant hemodynamic changes. The state of autonomic nervous system 7-10 days after AMI was not different from that of healthy subjects. Among the spectral parameters, Nu was more useful than either PSD or CCV in assessing autonomic nervous activity.
Arrhythmias, Cardiac ; Autonomic Nervous System ; Autonomic Pathways ; Blood Pressure ; Death, Sudden ; Hemodynamics ; Humans ; Ischemia ; Myocardial Infarction* ; Nervous System ; Supine Position

No abstract available.
Adenocarcinoma*

Many risk factors for atherosclerosis have been proposed to identify high risk individuals. We conducted a retrospective study to determine the risk factors for development of carotid stenosis (CS) in Koreans. Database of 2,805 subjects who underwent a check up of carotid artery for health examination were analyzed. Stenosis (%) of common carotid artery or proximal internal carotid artery was examined with ultrasonography. Subjects were divided into 2 groups (Group I; CS <10%, Group II; CS > or =30%). We compared demographic, laboratory and clinical data between 2 groups to determine the risk factors of CS. One hundred ninety seven subjects (7.0%) were categorized as Group II. At age- and sex-adjusted multivariate analysis, diabetes mellitus, hypertension, cerebrovascular disease, ischemic heart disease, hyperlipidemia, aspirin medication, current smoking, fasting glucose, total cholesterol, low density lipoprotein-cholesterol (LDL-C) and leukocyte count were significant risk factors of CS. At stepwise logistic regression analysis, age, hypertension, hyperlipidemia, LDL-C and leukocyte count were independent risk factors. At subgroup analysis by smoking, age and leukocyte count were independent risk factors in smoker and age and hypertension in nonsmoker.
Adult ; Age Factors ; Aged ; Carotid Stenosis/blood/*epidemiology/etiology ; Cholesterol/blood ; Comparative Study ; Female ; Humans ; Korea/epidemiology ; Lipoproteins, LDL Cholesterol/blood ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoking/adverse effects

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

Background: In Korea, the health gap widens due to the number of medical resources and access to medical services between metropolitan and rural. The purpose of this study is to identify the impact of residential migration on medical utilization and accessibility. Methods: This study extracted 528,516 claimed cases in the National Health Insurance Service-Cohort Sample Database from 2006 to 2015. Subjects were classified into two groups by the magnitude of the region, the metropolitan and the rural. The inversed probability weights were calculated for each group. And coefficients of the two-part model were estimated by generalized estimation equation. Results: Those who moved region from metropolitan to rural tend to increase the length of stay and inpatients with ambulatory care sensitive conditions (ACSC) disease. Contrariwise, those who moved areas from rural to metropolitan tend to decrease the total medical cost, the adjusted patient days, the number of outpatients and the number of outpatients and inpatients with ACSC disease. Conclusion This study identified that between the residents who continued to reside in the region and the migrants, there were significant differences in the medical accessibility, quality of primary care, and unmet medical need.

Fifteen percent of patients with Cushing's syndrome could be accompanied with nonpituitary tumors that secrets ACTH-the ectopic ACTH syndrome. Among them, bronchial carcinoid is one of the rare causes of the ectopic ACTH syndrome. We experienced a 60-year-old woman who showed conditions of weight gain, generalized edema, hypokalemia, diabetes mellitus, and right middle lung mass. Histologically, the tumor was diagnosed with bronchial carcinoid and was confirmed as an ectopic ACTH syndrome through immunohistochemical staining of ACTH. After resection of the lung mass, blood sugar, electrolytes, generalized weakness, and blood pressure improved.
ACTH Syndrome, Ectopic* ; Adrenocorticotropic Hormone ; Blood Glucose ; Blood Pressure ; Carcinoid Tumor* ; Cushing Syndrome ; Diabetes Mellitus ; Edema ; Electrolytes ; Female ; Humans ; Hypokalemia ; Lung ; Middle Aged ; Weight Gain

PURPOSE: To evaluate imaging findings and lung density changes after 95% oxygen inhalation in rat. MATERIALS AND METHODS: A total of 18 rats were divided into three groups on the basis of inhalation time: group I(n=6) inhaled 95 % oxygen for 24 hours, and group II(n=6) for 48 hours, group III(n=6) for 60 hours. A control group(n=6) inhaled room air(21% oxygen). Chest radiograph and high resolution computed tomography were performed, and pathologic and imaging findings were compared. RESULTS: Chest radiograph showed abnormality only in group III. High resolution CT, however, revealed abnormal findings in all three groups : diffuse ground glass opacity in groups I, II and III, additional focal patchy consolidation at the peripheral portion in group II, and diffuse consolidation in group III. Lung density was sig-nificantly higher in group I than in controls(p <0.05), while density in group II was not significantly different from that in group I(p >0.05). In group III, density was significantly higher than in group II. The lung density changes seen in all groups showed a bilateral diffuse increased pattern. but, in group III, changes were more severe in the central, peripheral and posterior portion of the lower lung. Ground glass opacity and focal patchy consolidaton seen on HRCT were found on pathologic examination to be due to alveolar cell hyperplasia and septal thickening. Consolidation was caused by alveolar edema and hemorrage. Pathologic lesions were randomly distributed in both lungs. CONCLUSION: One HRCT images, rat exposed to hyperoxia showed ground glass opacity, patchy consolidation and diffuse consolidation. Depending on exposure time, the pathologic findings also indicated increased lung density and a bilateral, diffuse distribution pattern, as well as alveolar cell hyperplasia and septal thickening, alveolar edema and hemorrage. HRCT may be more helpful than simple X-rays for the early detection of pulmonary oxygen toxicity.
Animals ; Edema ; Glass ; Hyperoxia ; Hyperplasia ; Inhalation ; Lung* ; Oxygen* ; Radiography, Thoracic ; Rats*

PURPOSE: There are limited population-based data regarding herpes zoster in children. Thus we conducted a multi-institutional epidemiological analysis of herpes zoster in children and comparative analysis according to their immune status. MATERIALS AND METHODS: The study included 126 children under the age of 18 years who were hospitalized for herpes zoster at 8 hospitals in South Korea, between July 2009 and June 2015. The subjects were divided into 2 groups according to their immune status, and medical records were reviewed. RESULTS: There were 61 cases (48.4%) in the immunocompetent group and 65 cases (51.6%) in the immunocompromised group. Median age was older in immunocompromised group (11.4 vs. 8.6) (p<0.001). The mean duration of hospitalization was longer in immunocompromised group (11.0 vs. 6.6) (p<0.001). Patients were treated with oral or intravenous antiviral agents. A total of 12 in immunocompetent group were cured only by oral acyclovir. No treatment failure was found in both groups. Six immunocompromised patients had postherpetic neuralgia and 1 case was in immunocompetent group. In immunocompetent children, herpes zoster was likely caused by early varicella infection. There was no increase in progression of severity in both groups due to appropriate treatment. CONCLUSION: Early initiation of therapy is necessary for those in immunocompromised conditions. And inactivated herpes zoster vaccination may be considered in immunocompromised adolescents in the future.
Acyclovir ; Adolescent ; Antiviral Agents ; Chickenpox ; Child ; Child, Hospitalized ; Herpes Zoster ; Hospitalization ; Humans ; Immunocompromised Host ; Korea ; Medical Records ; Neuralgia, Postherpetic ; Treatment Failure ; Vaccination