PURPOSE: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.
Abscess ; Aged ; Anti-Bacterial Agents ; Dacryocystitis ; Dacryocystorhinostomy ; Delayed Diagnosis ; Drainage ; Edema ; Eyelids ; Female ; Fistula ; Humans ; Hyperemia ; Magnetic Resonance Imaging ; Nasolacrimal Duct ; Orbit ; Orbital Cellulitis ; Pseudomonas aeruginosa ; Rupture ; Tears ; Tomography, X-Ray Computed

BACKGROUND: Hormone replacement therapy(HRT) has an established role in reducing cardiovascular risk and In preventing osteoporosis. But compliance with HRT is not good as expected. There fore, So we assessed perimenopausal womens knowledge and attitude fowards menopause and HRT to. METHOD: Questionnaires were provided to the students mothers of a high school located in Seoul from June 10th, to 15th, 1996. General characteristics and routine breast examination routine Pap smear, the knowledge and practice of high calcuim diet for preventing osteoporosis, their menstural pattern, the in formation source of HRT, in attitude for HRT, and the reasons for refusing. RESULT: Among 560 women, 362 women(64.6%) responded, and the mean age was 45.5 years. For osteoporosis prevention they knew milk(74.7%) were, anchovy(27.4%), calcium(23.6%), HRT(7.4%) were beneficial. And almost(91.8%) all sublets answered that menopause was a natural course and 40.5% of women answered that physical change after menopause could not prevent. Among 34 postmenopause, 5(14.2%) received HRT and 48(20.3%) answered that they would receive HRT, and 57 (24.1%) answered that they would not receive HRT. The reasons for refusing HRT were that menopause was a natural course, there fore deciding the need for artificial hormone therapy(22.4%), increased incidence of brew cancer(21.8%), and that lack of information for HRT(13.9%).The association was not proven between the attitude for HRT and regular Pap smear, regular breast examination, exercise, oral intake for osteoprosis prevention. CONCLUSION: Almost all of the respondents recognized that menopause was a natural course. And the effectiveness of diet and exercise in preventing osteoporosis was more well known compared to HRT.
Breast ; Compliance ; Surveys and Questionnaires ; Diet ; Female ; Hormone Replacement Therapy* ; Humans ; Incidence ; Menopause* ; Middle Aged* ; Mothers ; Osteoporosis ; Postmenopause ; Seoul

This study was conducted to investigate the effects of residence types ( parent house, dormitory or boarding home, boarding home w/o food) on the dietary habits and health status of college women (20-23 y). Overall, 46.1% of college women reported that they were economically middle class and spent 200,000-390,000 won. Additionally, 17.4% of college women considered themselves healthy, while 33.8% reported that they were not healthy. Furthermore, 32.0% of college women had experience to control their weight and 39.8% reported that they exercised to control their weight. There were no significant differences in the height and weight of the subjects according to residential type, but the amount of skeletal muscles mass (21.0 +/- 2.6 kg) of the subjects that lived in dormitory or boarding home was significantly higher (p < 0.05) than that of women who lived at home. Additionally, 30.8% of students that lived in private residences, 25.0% of students that dwelled in dormitory or boarding homes and 27.7% of students that boarding home w/o food had three regular meals every day (p < 0.05). It has been reported that 18.3% of college students eat processed and instant foods due to their convenience. In the present study, intakes of energy, protein, fat, vitamin A, vitamin B1, vitamin B2, vitamin B6, niacin, vitamin C, vitamin E and folic acid for the subjects who lived in dormitory or boarding homes was significantly higher than those of students who lived in private residences (p < 0.05). Additionally, intakes of iron, calcium, and zinc were lower in the subjects that boarding home w/o food (p < 0.05). Finally, the blood glucose level was 84.7 +/- 13.0 mg/dL, and differed significantly by residential types (p < 0.05); however, the average glucose levels of all subjects were within the normal range (90-110 mg/dL).
Ascorbic Acid ; Blood Glucose ; Calcium ; Female ; Folic Acid ; Food Habits ; Glucose ; Humans ; Iron ; Meals ; Muscle, Skeletal ; Niacin ; Parents ; Reference Values ; Riboflavin ; Thiamine ; Vitamin A ; Vitamin B 6 ; Vitamin E ; Vitamins ; Zinc

BACKGROUND: For cancer patients, pain is the most common symptom and the most important factor that seriously affects their treatment and quality of life. The purpose of the research was to determine the controllable factors for pain management in order to increase patients' satisfaction for pain management. METHOD: This study was based on the survey answers and medical records of 464 cancer patients, in 8 hospitals in Korea from March until September 2000. RESULTS: As shown by Chi-square test, according to the degree of satisfaction for cancer pain management, those patients who were "satisfied" with pain treatment showed better activity rate (P=0.007) than the "unsatisfied" group. Additionally, the frequency of using painkillers according to WHO step-ladder, Pain Management Index (PMI), or patients own knowledge and attitude toward cancer pain control was not found to be relevant to patients satisfaction (P=0.106, P=0.382, P>0.05). But, in the "satisfaction" group, more patients were informed of the importance of pain management (P=0.004) and reported less pain (P<0.05). A close relationship between higher satisfaction and lower pain interference rate was discovered, but no correlation was found for activity, mood, or gate. The average of interference rate was lower in the "satisfaction" group (P<0.05). CONCLUSION: For higher satisfaction rate for pain management among cancer patients, high activity rate, patient education of importance of pain management, less severity of pain, and low interference rate in life are found to be the determinants.
Humans ; Korea ; Medical Records ; Pain Management* ; Patient Education as Topic ; Patient Satisfaction* ; Quality of Life

PURPOSE: The purpose of this study was to evaluate the effect of the kV on fractal dimension of trabecular bone in digital radiographs. MATERIALS AND METHODS: 16 bone cores were obtained from patients who had taken partial resection of tibia due to accidents. Each bone core along with an aluminum step wedge was radiographed with an occlusal film at 0.08 sec and with the constant film-focus distance (32 cm). All radiographs were acquired at 60, 75, and 90 kV. A rectangular ROI was drawn at medial part, distal part, and the bone defect area of each bone core image according to each kV. The directional fractal dimension was measured using Fourier Transform spectrum, and the anisotropy was obtained using directional fractal dimension. The values were compared by the repeated measures ANOVA. RESULTS: The fractal dimensions increased along with kV increase (p<0.05). The anisotropy measurements did not show statistically significant difference according to kV change. The fractal dimensions of the bone defect areas of the bone cores have low values contrast to the non-defect areas of the bone cores. The anisotropy measurements of the bone defect areas were lower than those of the non-defect areas of the bone cores, but not statistically significant. CONCLUSION: Fractal analysis can notice a difference of a change of voltage of x-ray tube and bone defect or not. And anisotropy of a trabecular bone is coherent even with change of the voltage of x-ray tube or defecting off a part of bone.
Aluminum ; Anisotropy* ; Fourier Analysis ; Fractals* ; Humans ; Tibia

BACKGROUND: Two representative groups of family physicians and oncologists were surveyed concerning their knowledge and attitudes toward cancer pain management (CPM). METHODS: A questionnaire, designed to assess knowledge (13 items) and attitudes (6 items) toward CPM, was sent to 2,200 members of Korean Association of Family Medicine and 800 members of Korean Cancer Association. RESULTS: Three hundreds and eighty eight family physicians (17.6%) and one hundred and forty seven oncologists (18.4%) responded and completed the questionnaire. They had inadequate knowledge toward CPM, especially, chance of respiratory depression, tolerance to adverse effect, ceiling effect, risk of addiction, and use of adjuvants. Most of the physicians had positive attitude toward importance of CPM, best judge of pain severity, and priority of CPM but had negative attitude toward concerns about potential problem of addiction and earlier prescription of maximum dose of opioid. Family physicians displayed more lack of knowledge about CPM in 9 of 13 items and more negative attitudes toward 4 of 6 items. Adjustment for demographic characteristics and experiences in cancer patients with pain showed that while family physicians had poor knowledge of tolerance to confusion, they had more adequate knowledge on the effect of antidepressant and had positive attitude towards best judge of pain severity and priority of CPM. Poor knowledge about CPM was rated by 66.3% of physicians as the most important barrier to adequate CPM. CONCLUSION: These findings that most of the physicians had poor knowledge and negative view toward CPM suggest a continuous need for comprehensive education program focused on CPM for physicians.
Education ; Humans ; Korea* ; Pain Management* ; Physicians, Family* ; Prescriptions ; Respiratory Insufficiency ; Surveys and Questionnaires

Periorbital edema is a rare manifestation of systemic lupus erythematosus (SLE). We describe here a patient with bilateral periorbital edema as a presenting symptom of SLE. A 23-year-old woman was admitted for a sudden onset of severe periorbital edema that developed 7 days previously. On the basis of the malar rash, arthritis of the right hand and left wrist, leukopenia, proteinuria and the positive anti-nuclear and anti-dsDNA antibodies, she was diagnosed with SLE. Kidney biopsy revealed lupus nephritis (WHO class IV). After treatment with high dose of steroids, intravenous cyclophosphamide and daily hydroxychloroquine, her symptoms resolved, including the periorbital edema. She was discharged with prescriptions for prednisolone and hydroxychloroquine and she remains well.
Antibodies ; Arthritis ; Biopsy ; Cyclophosphamide ; Edema ; Exanthema ; Female ; Hand ; Humans ; Hydroxychloroquine ; Kidney ; Leukopenia ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Prednisolone ; Prescriptions ; Proteinuria ; Steroids ; Wrist ; Young Adult

Pulmonary aspergilloma usually arises in preexisting lung cavities characterized by recurrent hemoptysis. Although surgical resection of the aspergilloma is the best treatment, most patients are poor candidates for surgery because of far-advanced underlying pulmonary disease. On the other hand, pulmonary actinomycosis is a chronic, indolent bacterial infection and follows aspiration of oropharyngeal material. Bronchiectasis and obstructive lung disease are often associated underlying conditions. We report a case of pulmonary aspergilloma in bronchogenic cyst associated with an actinomycosis in 21-year-old woman treated by thoracoscopic surgery with a review of literature.
Actinomycosis* ; Bacterial Infections ; Bronchiectasis ; Bronchogenic Cyst* ; Female ; Hand ; Hemoptysis ; Humans ; Lung ; Lung Diseases ; Lung Diseases, Obstructive ; Thoracoscopy ; Young Adult

Pulmonary toxicity is one of the most serious adverse effects associated with a quick course of vincristine, bleomycin, and cisplatin neoadjuvant chemotherapy (NAC-VBP). The aim of this study was to evaluate pulmonary toxicity related to a quick course NAC-VBP. A total of consecutive 61 patients, who underwent at most 3 cycles of NAC-VBP every 10 days in the International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIB cervical cancer from 1995 to 2007, were retrospectively analyzed. Of the 61 study subjects, 7 (11.5%) were identified to have pulmonary toxicity and 2 (3.3%) died of pulmonary fibrosis progression despite aggressive treatment and the use of a multidisciplinary approach. No factor predisposing pulmonary toxicity was identified. Initial symptoms were non-specific, but bronchiolitis obliterans organizing pneumonia and interstitial pneumonitis were characteristic findings by high-resolution computed tomography of the chest. The benefit of steroid therapy was uncertain and was associated with steroid-induced diabetes mellitus requiring insulin therapy in two patients. Fatal pulmonary toxicity is a major concern of a quick course NAC-VBP. In conclusion, these patients require special monitoring for bleomycin-induced pulmonary toxicity.
Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects/therapeutic use ; Bleomycin/administration & dosage/*adverse effects/therapeutic use ; Cisplatin/administration & dosage/*adverse effects/therapeutic use ; Female ; Humans ; Lung Diseases/*chemically induced/pathology ; Middle Aged ; *Neoadjuvant Therapy ; Pulmonary Fibrosis/chemically induced/mortality/pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Uterine Cervical Neoplasms/complications/*drug therapy ; Vincristine/administration & dosage/*adverse effects/therapeutic use

OBJECTIVE: To define the molecular basis of TGF-beta1 function in cervical carcinogenesis, we explored the expression and mutational status of TGF-beta1, TGF-beta1 receptors, and Smads, the regulators of the TGF-beta1 signaling pathway, in human cervical cancers. METHODS: Expression of TGF-beta1, TGF-beta1 receptors, and Smads transcripts were determined by quantitative reverse transcription-polymerase chain reaction (RT-PCR), and sequence alteration was analyzed using RT-PCR-single-strand conformation polymorphism (SSCP) analysis. Genomic levels of TGF-beta1, TGF-beta1 receptors and Smads was also measured by quantitative genomic PCR. RESULTS: Abnormal overexpression of TGF-beta1 and abnormal reduction of type II TGF-beta1 receptor were identified in 36% (18 of 50) and 20% (10 of 50) of cervical cancer tissues, respectively. 22% (11 of 50) in Smad2 and 14% (7 of 50) in Smad4 revealed tumor specific mRNA reduction less than a half of normal means. In addition, no evidence for sequence alterations of the gene was found by RT-PCR-SSCP analysis. CONCLUSION: Our study demonstrates that disruption of TGF-beta/Smad signaling pathway exist in human cervical cancer, suggesting that abnormal expressions of the member of TGF-beta/Smad signaling pathway might contribute to the malignant progression of human cervical tumors via suppressing the tumor suppression function of TGF-beta1 1's tumor suppression function.
Humans ; Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta1 ; Uterine Cervical Neoplasms