No abstract available.

PURPOSE: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. METHODS: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. RESULTS: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. CONCLUSION: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.
Cause of Death ; Classification ; Clinical Protocols ; Humans* ; Mortality ; Organophosphates* ; Pesticides ; Phosphamidon* ; Pneumonia ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Shock ; World Health Organization

PURPOSE: To evaluate the classification of punctal stenosis based on the shape of the external punctum, clinical characteristics and histopathologic features. METHODS: Patients who experienced tearing and were diagnosed with punctal stenosis were evaluated in this study. Punctal stenosis was classified according to the shape of the lower external punctum, which included membranous type, slit type, horseshoe type, and pinpoint type. Tear meniscus height, 2% fluorescein dye disappearance test and lacrimal pathway irrigation were measured or performed. For treatment, a punctal snip operation and silicone tube placement were performed, and the peripunctal histopathological findings were evaluated. RESULTS: Punctal stenosis was classified into four types: membranous type (17 eyes, 21.5%), slit type (11 eyes, 13.9%), horseshoe type (25 eyes, 31.6%), and pinpoint type (26 eyes, 32.9%). The tear meniscus was significantly higher, and the 2% fluorescein dye disappeared significantly more slowly in the punctal stenosis group. However, correlation of the tear meniscus height and 2% fluorescein dye disappearance test with the punctum shape was not statistically significant. A history of previous chemotherapy was significantly associated with the occurrence of punctal stenosis, especially the membranous type (p < 0.05). Histopathologic evaluation of the punctum showed differences between the punctum types. Pinpoint puncta exhibited a high density of muscle fibers, while they were faintly visible in the membranous type. CONCLUSIONS: Acquired punctal stenosis has various shapes, and the major types of stenotic puncta exhibited unique histopathologic features. Punctal stenosis and its pathophysiology may be related to multiple factors, such as age and systemic 5-fluorouracil chemotherapy history.
Classification* ; Constriction, Pathologic* ; Drug Therapy ; Fluorescein ; Fluorouracil ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Silicon ; Silicones ; Tears

OBJECTIVE: To determine the prevalence of osteoporosis based on the measurement of bone mineral density (BMD) and to examine the effect of menopausal status on BMD in Korean women. METHODS: Ultra-distal and distal radius BMD was measured by dual energy X ray absorptiometry (osteoplan p-DXA) in 296 women. The result was analysed, retrospectively. We diagnosed osteopenia and osteoporosis according to the WHO criteria. RESULTS: The ultra-distal and distal radius BMD and T score decreased significantly with increase of age. Of women in their thirties, the prevalence of ultra-distal and distal radial osteoporosis were 0%, 6.2%, and in their forties, they were 7.6%, 3.4% and in their fifties, they were 26.6%, 27.9% and of women in their sixties, they were 81.7%, 87.8%. Of women in their forties and fifties, premenopausal women had a higher BMD result than postmenopausal women in the same age group. Of premenopausal women in their forties, the prevalence of osteoporosis were 4.6%, 2.3% and of postmenopausal women in that age, they were 15.6%, 6.3%. Of premenopausal women in their fifties, the prevalence of osteoporosis were 8.3%, 8.3% and of postmenopausal women in that age, they were 29.9%, 31.3%. CONCLUSION: With increasing age, the prevalence of osteoporosis increased and the BMD decreased. In the postmenopausal state, this difference became larger.
Absorptiometry, Photon ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Menopause* ; Osteoporosis* ; Prevalence* ; Radius* ; Retrospective Studies

PURPOSE: To determine the correlation of the clinical characteristics and histopathologic findings of lacrimal sac after external dacyrocystorhinostomy (DCR). METHODS: From March 2008 to June 2009, 49 lacrimal sac tissues of 47 patients were obtained after external DCR and divided according to fibrosis and inflammatory findings. The correlation of preoperative duration of symptoms with NLD obstruction, symptoms of recurrence and outcomes of the operation to the histopathologic findings were retrospectively evaluated. RESULTS: The mean age of the patients was 58.83 +/- 11.49 years and the mean duration of preoperative symptoms was 65.2 +/- 69.05 months. Forty-three cases (88%) maintained good openings and 30 cases (61%) had no recurring symptoms over 6 months after the operation. Among the significant symptoms, severe subepithelial inflammations were observed more frequently at shorter duration. However, the fibrosis showed a positive relation with the preoperative duration of symptoms (Spearman correlation test, p<0.05). Most failures were found in the severe inflammation and fibrosis groups and were recovered with anti-inflammatory treatment. CONCLUSIONS: Inflammation and fibrosis of the lacrimal sac could be an important prognostic and predictive factor of outcomes of DCR.
Dacryocystorhinostomy ; Fibrosis ; Humans ; Inflammation ; Recurrence ; Retrospective Studies

PURPOSE: This study validated the musculoskeletal model of the human lower extremity by comparative study between calculated muscle parameters through simulation using modified hill-type model and measured muscle parameters through isokinetic exercise. The relationship between muscle forces and moments participated in motion was quantified from the results of simulation. MATERIALS AND METHODS: For simulation of isokinetic motion, a three-dimensional anatomical knee model was constructed using gait analysis. The EMG-force model was used to determine muscle activation level exciting muscles. The modified Hill-type model was used to calculate individual muscle force and moment in dynamic analysis. This method was validated by comparing analytical data with experimental data. RESULTS: The results showed that there was a significant correlation between calculated torques from simulation and measured torque from isokinetic motion experiments (R=0.97). We also found that muscle forces and moments during knee flexion and extension have nonlinearly proportional or inversely proportional relationship, since lower extremity muscles were simultaneously involved in flexion/extension motion and inner/outer rotation. CONCLUSION: We concluded that the simulation by using musculoskeletal model may be a useful mean to predict and recover musculoskeletal-related diseases, and analyze complicated experiment such as clash condition.
Gait ; Humans ; Knee Joint* ; Knee* ; Lower Extremity ; Muscles ; Torque

PURPOSE: The purpose of this study is to illustrate MR patterns of signal intensity of proximal femur in normal subjects according to the age distribution. METHOD AND MATERIAL: Tl-weighted MR images of the proximal femur in 125 subjects, aged 13 days to 25 years, were retrospectively analyzed. Age distribution was classified to 4 groups;below 4 months, 5 months to 4 years, 5 years to 14 years, and 15 years to 25 years. RESULTS: By the age of 4 months, the non-ossified femoral epiphysis was seen as intermediate-signal-intensity cartilage. At 5 months-4 years, the ossified fernoral capital epiphysis was seen within intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow surrounded by a rim of low-signal-intensity cortical bone. At 5-14 years, the ossified femoral capital and greater trochanteric epiphysis were seen within the intermediate-signal-intensity cartilage and appeared as decreased or increased signal-intensity red or yellow marrow. At 15-25 years, the proximal metaphyseal marrow showed increased signal intensity. Four patterns of the metaphyseal marrow were recognized by Ricci et al. The frequency of pattern la progressively decreased with age. Pattern 2 and 3 were visible in the 15-25 years age group. CONCLUSION: An understanding of the spectrum of normal age-related change of the proximal femoral cartilage and marrow patterns serves as the foundation for interpretation of proximal femur pathologies.
Age Distribution ; Bone Marrow ; Cartilage ; Epiphyses ; Femur* ; Humans ; Magnetic Resonance Imaging* ; Pathology ; Retrospective Studies

OBJECTIVES: This study is intended to evaluate the effects of promotion of periodontal health in the elderly, through professional toothbrushing and education on the use of the interdental brush, using the Gingival Bleeding Index and the Patient Hygiene Performance Index (PHP index). METHODS: The study was conducted on 87 participants, who had given the informed consent to participate in the study at a general hospital 'B' in Busan from June to August, 2011. After assessing the general health condition and the medical history of the participants, the Watanabe toothbrushing method was used for professional toothbrushing on four different visits, along with imparting of education on the use of the interdental brush for self-management. The periodontal health of the participants was assessed based on the extent of gingival bleeding, by using the Gingival Bleeding Index, and the degree of plaque accumulation, by using the Patient Hygiene Performance Index. The data thus obtained was analyzed using Statistical Analysis Systems (SAS) (ver 9.13), followed by frequency analysis, analysis of variance (ANOVA), and the mixed effect model. RESULTS: The average gingival bleeding index was 1.65 at the commencement of the study and 1.25, 0.88, and 0.65, after the first, second and third trial, respectively. The PHP index of dental plaque was 2.90 prior to commencement of the study, 2.79, 2.77, and 2.76 after the first, second, and third trials, respectively, thus significantly improving with every successive visit. Gingival bleeding index and PHP index significantly reduced with every visit, regardless of age, smoking habits, or systemic chronic diseases such as diabetes, hypertension, central nervous system or cardiovascular diseases. CONCLUSIONS: Education on the use of the interdental brush and professional tooth brushing promotes periodontal health, regardless of the chronic diseases seen in the elderly. Education on self-management of oral health, along with professional care at regular intervals should be recommended to effectively maintain periodontal health in the elderly.
Aged ; Central Nervous System ; Chronic Disease ; Dental Plaque ; Hemorrhage ; Hospitals, General ; Humans ; Hygiene ; Hypertension ; Informed Consent ; Oral Health ; Self Care ; Smoke ; Smoking ; Tooth ; Toothbrushing

PURPOSE: Helicobacter pylori infection induces phenotype-stabilizing methylation and promotes gastric mucosal atrophy that can inhibit CpG-island methylation. Relationship between the progression of gastric mucosal atrophy and the initiation of CpG-island methylation was analyzed to delineate epigenetic period for neoplastic transformation. MATERIALS AND METHODS: Normal-appearing gastric mucosa was biopsied from 110 H. pylori–positive controls, 95 H. pylori–negative controls, 99 gastric cancer patients, and 118 gastric dysplasia patients. Gastric atrophy was assessed using endoscopic-atrophic-border score. Methylation-variable sites of eight CpG-island genes adjacent to Alu (CDH1, ARRDC4, PPARG, and TRAPPC2L) or LTR (MMP2, CDKN2A, RUNX2, and RUNX3) retroelements and stomach-specific TFF3 gene were analyzed using radioisotope-labeled methylation-specific polymerase chain reaction. RESULTS: Mean ages of H. pylori–positive controls with mild, moderate, and severe atrophy were 51, 54, and 65 years and those of H. pylori–associated TFF3 overmethylation at the three atrophic levels (51, 58, and 63 years) tended to be periodic. Alu-adjacent overmethylation (50 years) was earlier than TFF3 overmethylation (58 years) in H. pylori–positive controls with moderate atrophy. Cancer patients with moderate atrophy showed late Alu-adjacent (58 years) overmethylation and frequent LTR-adjacent overmethylation. LTR-adjacent overmethylation was frequent in cancer (66 years) and dysplasia (68 years) patients with severe atrophy. CONCLUSION: Atrophic progression is associated with gastric cancer at moderate level by impeding the initiation of Alu-adjacent methylation. LTR-adjacent methylation is increased in cancer patients and subsequently in dysplasia patients.
Atrophy* ; DNA Methylation ; Epigenomics ; Gastric Mucosa ; Gastritis, Atrophic ; Genes, Essential* ; Helicobacter pylori ; Housekeeping* ; Humans ; Methylation* ; Polymerase Chain Reaction ; Retroelements ; Stomach Neoplasms*

Myoepithelial carcinoma is a rare malignant tumor of the salivary glands with an incidence of less than 1%. Most cases arise in the parotid gland but have also been described in the submandibular gland and in the minor salivary glands. Myoepithelial carcinoma shows almost exclusively tumor cells with myoepithelial differentiation, although epithelial-myoepithelial carcinoma is characterized by a biphasic cell population represented by myoepithelial and ductal epithelial cells. Although myoepithelial carcinoma arising in the maxillary sinus has been reported, there is no report of myoepithelial carcinoma that has originated from inferior turbinate. We report, with a review of literature, a 72-year-old female patient diagnosed as myoepithelial carcinoma that has originated from the inferior turbinate of left nasal cavity.
Aged ; Epithelial Cells ; Female ; Humans ; Incidence ; Maxillary Sinus ; Myoepithelioma ; Nasal Cavity ; Parotid Gland ; Salivary Glands ; Salivary Glands, Minor ; Submandibular Gland ; Turbinates