PURPOSE: The purpose of this study was to examine obstacles and supportive behaviors perceived or experienced by clinical nurses providing care for terminally ill cancer patients. METHODS: Beckstrand's survey questionnaire was translated into Korean and verified by an expert committee and through a preliminary study. A survey that used 26 questionnaire items on obstacles and 24 on supportive behaviors, was conducted among 228 registered nurses with more than one year of experience at medical-surgical general wards in a hospital. RESULTS: The highly-perceived and frequently-experienced obstacles in providing care for terminally-ill cancer patients were related to patients' uncontrollable pain or psychologically unstable family members. The highly-perceived and frequently-experienced supportive behaviors were related to caring family members or having supportive family members. However, nurses' perceptions or experiences of multiple obstacles and supportive behaviors differed by hospital type, career length, and department. CONCLUSION: Nurses seem to be in need of training for pain management for terminal cancer patients and of family care in general. Highlyperceived and highly-experienced obstacles or highly-perceived but rarely-experienced supportive behaviors should be intervened without delay considering a hospital type or nurses' career length.
Humans ; Nurses ; Pain Management ; Patients' Rooms ; Surveys and Questionnaires ; Terminal Care ; Terminally Ill*

Recurrent parotitis, which is also known as juvenile recurrent parotitis, is characterized by a cyclic swelling of parotid glands associated with discomfort and/or pain in the absence of external inflammatory changes or progression to frank suppuration. It is usually accompanied by fever and malaise. Recurrent parotitis, following mumps, is the most common inflammatory salivary gland disease during childhood. Its etiology remains an enigma, but various etiologies have been suggested as causes, including infection, allergy, localized manifestations of systemic immunologic disorders, autoimmune diseases and hereditary or congenital abnormalities of salivary duct. Sialolithiasis may occur at any age. Its higher frequency is found between the 4th and 6th decade, but it is rare in the first decade. We currently experienced a 14-year-old boy with recurrent parotitis associated with sialolithiasis. One and a half year earlier this boy experienced right-sided parotid swelling, which subsided spontaneously over a few days. During the following year and a half period, he experienced three more short bouts of parotid swelling with mild pain, fever and malaise. The symptoms including swelling lasted from several days to 2 weeks and resolved spontaneously, independent of any treatment. Forty days ago diffuse swelling of his right parotid gland developed with pain and fever, which were more exacerbated during or after meals. Meanwhile, his left parotid gland also became swollen. Diagnosis for sialolithiasis was confirmed by sialographic findings showing the filling defect in the right parotid duct. We present a case of parotid parotitis with sialolithiasis in a child with a brief review of related literatures.
Adolescent* ; Autoimmune Diseases ; Child ; Congenital Abnormalities ; Diagnosis ; Fever ; Humans ; Hypersensitivity ; Male* ; Meals ; Mumps ; Parotid Gland ; Parotitis* ; Salivary Ducts ; Salivary Gland Calculi* ; Salivary Gland Diseases ; Suppuration

PURPOSE: The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. MATERIALS AND METHODS: We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. RESULTS: The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59+/-0.30 mm in pre-surgical group and 2.69+/-2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). CONCLUSION: Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible.
Congenital Abnormalities ; Displacement (Psychology) ; Humans ; Incisor ; Mandible ; Maxilla ; Splints ; Temporomandibular Joint ; Track and Field

No abstract available.
Drug Therapy* ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Stomach Neoplasms*

PURPOSE: To evaluate the clinical characteristics and treatment result of Coats' disease in children. METHODS: Data on demographics, clinical presentation, and ocular findings were analyzed for 67 eyes of 67 patients with Coats' disease by retrospective chart review. Among these, treatment results were analyzed from 56 eyes which had received local treatment or subretinal fluid drainage (SRFD). Treatment was considered successful when telangiectatic vessels or exudates had regressed after local treatment or when pupillary block glaucoma was treated or prevented after SRFD. RESULTS: Mean age at diagnosis was 5.0 years (5 months-15 years) and 90% were males. 67% of retinal telangiectasias were located in the temporal. There were exudative retinal detachments in 46 (69%) eyes. Among them, SRFD was performed in 19 (28%) to treat or prevent pupillary block glaucoma. The mean age at diagnosis of patients that underwent treatment was 5.1 years. In 37 of 56 patients, 95% of retinal telangiectasias were regressed after primary local treatment, and 21 eyes (31%) underwent SRFD. Management of glaucoma was achieved after SRFD in 16 patients, and one more SRFD was needed after primary SRFD in 5 patients. CONCLUSIONS: In Coats' disease, it is necessary to eradicate retinal telangiectasia with local treatment and to follow up carefully for secondary glaucoma, which can be treated with SRFD in cases of severe exudative retinal detachment.
Child* ; Cryotherapy ; Demography ; Diagnosis ; Drainage ; Exudates and Transudates ; Follow-Up Studies ; Glaucoma ; Humans ; Male ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Telangiectasis

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensitiy in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.
Adult ; Biopsy ; Diagnostic Imaging ; Histiocytoma, Malignant Fibrous* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Mandible ; Maxillary Sinus ; Molar ; Sarcoma

PURPOSE : To investigate the incidence and prevalence of C-shaped root canal using computed tomographic images of head and neck in Korean population. MATERIALS AND METHODS : Regardless of each examination purpose, randomly selected 268 examples which have serial axial computed tomographic images with 8 normal molars in maxilla and mandible were selected and investigated. Defined C-shaped root canal and we could get 82 proper image examples in view of this definition. These were detected and investigated of incidence and prevalence of C-shaped root canal. RESULTS : C-shaped root canals were found in 82 examples among 268 (30.6%) and 147 teeth. They were only found on molar area, and the highest incidence was 37.41% of left mandibular second molars, and the lowest was 2.04% of right maxillary second molars. On prevalence of tooth position, mandibular second molar was the highest, 65% of C-shaped root canal teeth and maxillary second molar was 6% the lowest. CONCLUSION : 31% of randomly selected CT images no considering check-up reason have C-shaped root canals. The C-shaped root canals of mandibular second molar are found most frequently and they are also detectable on maxilla. On Korean population, C-shaped root canals are one of conditions that have to concern with dental treatment for it appears at a high prevalence relatively.
Dental Pulp Cavity ; Head ; Incidence ; Mandible ; Maxilla ; Molar ; Neck ; Prevalence ; Tooth

A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse permeative bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansile lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Squamous Cell ; Diagnosis* ; Diagnosis, Differential ; Diagnostic Imaging ; Drug Therapy* ; Female ; Humans ; Middle Aged ; Molar ; Neoplasm Metastasis ; Osteonecrosis ; Radiography ; Radiotherapy* ; Water

There has been a dramatic increase in the number and type of procedures performed in the field of cardiac intervention in the past decade. Percutaneous intervention is becoming an increasingly recognized modality for the management of prosthetic paravalvular leakages (PVLs) in severely symptomatic non-surgical candidates. Herein, we report our experience of percutaneous closure using the Amplatzer duct occluder for a PVL in a patient who underwent tricuspid valve replacement.
Heart Valve Prosthesis ; Humans ; Septal Occluder Device ; Tricuspid Valve ; Tricuspid Valve Insufficiency

Primitive neuroectodermal tumor (PNET), which belongs to the Ewing's sarcoma (ES) family of tumors, is mainly seen in children and young adults. PNETs are extremely rare in the maxilla. Here, we report a case of PNET of the left maxillary sinus in an elderly male. Magnetic resonance imaging (MRI) revealed a slightly enhanced solid mass occupying the left maxillary sinus and infiltrating into the retroantral space. A partial maxillectomy was performed. Despite postoperative chemotherapy, follow-up computed tomography (CT) and MRI revealed a nodal metastasis in the submandibular space. Neck dissection was performed. However, the patient died 10 months after the second surgery because of distant metastasis to the liver. MRI and CT were particularly useful in detecting the extent of the tumor, recurrence, and metastasis. Further, a literature review of the previously reported PNET cases of the maxilla was carried out. In this paper, we also discuss the current approach for the diagnosis and management of these tumors.
Aged* ; Child ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Liver ; Magnetic Resonance Imaging ; Male ; Maxilla ; Maxillary Sinus* ; Neck Dissection ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive* ; Recurrence ; Sarcoma, Ewing ; Young Adult