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

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

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

To establish management protocol for delayed ischemic deficits(DID), the authors designed a prospective study involving patients with aneurysmal subarachnoid hemorrhage, Fisher group 2 or 3, who had been admitted within 72 hours of the first rupture. The study group consisted of 100 consecutive surgical cases who underwent prophylactic hyperdynamic therapy during the period May 1995 to December 1996. The historical control group was a series of 117 patients, treated between January 1993 and April 1995, who did not undergo the same therapy. DID occurred in seven of 51 patients(13.7%) in the study group who underwent surgery within 72 hours of the first rupture, and in ten of 38 patients(26.3%) in the control group who similarly under surgery. Patients who postoperatively showed evidence of DID were managed as follows ; 1) in those developing DID without increased velocity on transcranial Doppler(TCD) study, hypertension was induced ; 2) in those who on TCD study showed increased flow velocity, cerebral angiography was performed ; 3) those with significant arteriographic vasospasm or delayed cerebral circulation, were intra-arterially infused with papaverine. In conclusion, prophylactic hyperdynamic therapy is an effective tool for the prevention of DID, especially following early surgery. TCD study may not effectively detect DID, but is a useful guide to the selection of management modalities. Intra-arterial papaverine infusion is an effective therapy for angiographic vasospasm and the prevention of DID.
Cerebral Angiography ; Humans ; Hypertension ; Intracranial Aneurysm* ; Papaverine ; Prospective Studies* ; Rupture* ; Subarachnoid Hemorrhage ; Ultrasonography, Doppler, Transcranial

Coronoid impingement can cause limitation of mouth opening. In many cases, it appears to be related to the coronoid hyperplasia. We present a case of mouth opening limitation caused by coronoid impingement on the posterior surface of the zygomatic bone without coronoid hyperplasia. The bony changes in coronoid and zygoma including surface irregularity and discontinuity of the cortex and sclerotic change of inner medullary space were noted on computed tomography (CT) scans in different level of axial planes. Through another CT scans in open mouth position could demonstrate that those bony changes were caused by the contact of both surfaces against each other. In case coronoid impingement is suspected of the many possible causes, the open mouth CT scans will be needed to reveal the direct impingement of coronoid on zygoma even without coronoid hyperplasia.
Diagnosis* ; Hyperplasia ; Mouth ; Tomography, X-Ray Computed ; Trismus ; Zygoma

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

BACKGROUND/AIMS: Techniques for endoscopic evaluation of gastrointestinal subepithelial lesions include conventional endoscopy, jumbo biopsy, endoscopic ultrasonogrphy (EUS), EUS-guided fine needle aspiration, and endoscopic submucosal resection. However, these procedures have many limitations, such as low diagnostic yields and high complication rates. We therefore evaluated the diagnostic yield for tissue sampling of incidental subepithelial lesions using the bite-on-bite technique. METHODS: One hundred and forty subepithelial lesions were found in 129 patients during conventional diagnostic esophagogastroduodenoscopy by one examiner from October 2003 to November 2004. Bite-on-bite biopsies with conventional-sized forceps were taken from 36 patients having 37 lesions that did not appear to be hypervascular or to have a thick overlying epithelium. Two to eight bites were performed to obtain submucosal tissue for one lesion. RESULTS: The bite-on-bite technique was diagnostic in 14 of the 37 lesions (38%). Blood oozing for more than 30 seconds occurred in five cases, but was easily controlled by epinephrine injection (2 cases) or hemoclip (3 cases). The diagnostic yield tended to be higher in the esophagus than in the stomach and duodenum (54% vs. 28%, p=0.109). CONCLUSIONS: The bite-on-bite technique for subepithelial lesions is an effective and safe method in selected cases. This technique may be useful for incidental subepithelial lesions, especially those of the esophagus, except for ones with a high risk of bleeding or thick overlying epithelium.
Adult ; Aged ; Biopsy/adverse effects/instrumentation/*methods ; Duodenum/*pathology ; *Endoscopy, Digestive System/adverse effects ; Esophagus/*pathology ; Female ; Gastric Mucosa/pathology ; Hemorrhage/etiology/prevention & control ; Hemostatic Techniques ; Humans ; *Incidental Findings ; Intestinal Mucosa/pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Stomach/*pathology ; Surgical Instruments

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