No abstract available.
Follow-Up Studies* ; Intermittent Urethral Catheterization*

This study is comprised of data obtained from the files of 346 patients with temporomandibular disorders. All patients were diagnosed, treated and followed in the Department of Dentistry at the Inha university hospital, Incheon, Korea. The patients had treated with medications, physical therapy, occlusal splint and arthrocentesis. The study data were obtained from the medical records and telephone interviews that were conducted by research assistants. The results were as follows 1. The patient's main complaint was pain(77%), and mouth opening limitation was 17%. 2. An analysis of the medical records of the 346 patients disclosed that 82% were improved and 17% had no improvement when they were dismissed. 1% of the patients had become worse during therapy. 3. A success rate of 82% was achieved when medication assisted physical therapy was included. In the current status at the telephone interview, 270 patients(89%) reported that they were doing well with 56% describing themselves as asymtomatic and 32% experiencing only minor residual or recurrent symptoms. 11% regarded themselves as unimproved and worse. 4. In the current status of the unsuccessfully treated patients by medications and physical therapy, 64% of patients were doing well(3% as asymptomatic and 56% as only minor residual or recurrent symptom). But 36% of patients was reported as unimproved and worse. 5. TMJ has a remarkable adaptive potential and TMJ disorder has a natural history of spontaneous fluctuations and favorable prognosis during the subsequent natural course. 6. In the treatment of the temporomandibular disorders, there is a treatment ladder, starting with the simplest and least expensive treatment, that is ascended until resolution of the patient's symptoms occur. These findings suggest that conservative reversible therapies are both sufficient and appropriate for management of temporomandibular disorder in most patients. Major alterations of mandibular position or dentoalveolar relationships do not appear to be necessary for obtaining either short term or long term success and therefore they can be generally regards as inappropriate treatment for this disorder. The fact that physical therapy is non-invasive and does not appear to be fraught with irreversible changes, makes it a very applicable vehicle in the area of clinical TMJ disorder management.
Dentistry ; Humans ; Incheon ; Interviews as Topic ; Korea ; Medical Records ; Mouth ; Natural History ; Occlusal Splints ; Prognosis* ; Temporomandibular Joint ; Temporomandibular Joint Disorders*

The recorded cases of ileovesical fistula are surprisingly few. However, when encountered, they present an interesting problem which commands the attention of urologist. Ileovesical fistula due to malignant lymphoma is a rare disease and usually first manifested by a long period of urinary symptom. We report a case of ileovesical fistula due to malignant lymphoma, diffuse, poorly differentiated, lymphocytic type, in sixty-four-year-old male patient with the brief review of literature.
Fistula* ; Humans ; Lymphoma* ; Male ; Rare Diseases

Since early gastric cancer (EGC) patients show an excellent surgical outcome and a long-term survival rate, the purpose and methods of postoperative follow-up need to be reconsidered. The recurrence rate after surgery is less than 2% in EGC. The mode of recurrence is diverse, of which hematogeous metastasis being most frequently encountered. Post-gastrectomy patients have a risk of nutritional deficiency and more chances to develop remnant gastric tumor or secondary tumor than normal population. Based on the pattern and developmental time span of recurrence, postoperative follow-up program for EGC should not be different from that for advanced gastric cancer. Most Korean doctors' post-operative follow-up with the patients range up to 5 years with an interval of 4 to 6 months. Gastroscopy, CT, and tumor markers are used for follow-up by more than 50% of doctors. Due to the increased rate of long-term survival, follow-up program should include assessment of functional aspect and nutritional well-being of the patients. Epidemiological studies for the long-term survivors and specialized strategies need to be developed for management of postgastrectomy cancer patients. Although early detection of recurrence is the primary goal of post-operative follow-up, postgastrectomy patients should be recognized as a risk group in terms of nutritional and medical problems on a life-long basis, and long-term management strategy should be developed.
Biomarkers, Tumor ; Follow-Up Studies ; Gastroscopy ; Humans ; Malnutrition ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms ; Survival Rate ; Survivors

Transsexuals are those who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. For this reason, they wish to be reassigned to their psychological sex by means of endocrinological and surgical treatment. Although its etiology is unknown, the majority of modern psychiatrists and behavioral scientists agree that the transsexualism is a disease entity belonging to gender identity disorder or gender dysphoria but not to be confused with the transversite, honosexualism or psychiatric problem. Three kinds of hermaphroditism have been defined according to the histology of the gonad : female pseudohermaphroditism, male pseudohermaphroditism and true hermaphroditism. It is very difficult, if not possible to assign sex especially in neonate and young children. Once sex assignment has been decided and accepted by the patient, surgical intervention should be undertaken as soon as possible. For adults there are many kinds of operative techniques. We have operated 28 cases of transexualism patients by using the penile and scrotal skin flap. This technique is superb for improving sexual appearance and function, and finally for a good opportunity for social activity. We report the results of surgery.
46, XX Disorders of Sex Development ; 46, XY Disorders of Sex Development ; Adult ; Child ; Disorders of Sex Development ; Female* ; Gender Identity ; Gonads ; Humans ; Infant, Newborn ; Male* ; Ovotesticular Disorders of Sex Development ; Phenotype ; Psychiatry ; Skin* ; Transsexualism*

OBJECTIVE: The accuracy of analytical results of blood and urine heavy metals came out to the main issue on occupational health from late eighties. The discrepancy of the results for same samples from different laboratories made the diagnosis for occupational diseases be unreliable. Therefore, a quality control program for analysis of samples taken from workplace had been introduced in Korea since 1992. This study aims to show the quality control program f'or analysis of blood and urine samples and its proficient rates from 1992 to 1999 and to know how they have been being used in occupational health. METHODS: The quality control program runs twice a year with mandatory items of blood lead and urine hippuvic acid and voluntary items of blood cadmium and manganese and urine mandellic acid and methyl hippuric acid. Participant laboratories are receiving three levels for each items and two out of three samples have to be qualified for being a proficient laboratory for the item. The acceptable range of blood lead and urine hippuric acid is +/-15% and that of the others is within 3 SD(standard deviation) from the reference values. RESULTS: The proficient rates of blood lead and urine hippuric acid was 89%, 90%, repectively, however those of the other voluntary items have been from 51% to 62%. The proficient rates of urine mercury and urine N-methylformamide(NMF), which are introduced since 1999, were very poor. Urine hippuric acid and blood lead were analyzed frequently for the purpose of biological monitoring conducting by special health examination organizations. Urine and blood manganese and urine metabolites of trichloroethylene, urine phenol, methylhippuric acid and cadmium were followed. CONCLUSIONS: In conclusion, the quality control program for biological monitoring has dramatically improve the ability of analysing blood and urine samples and eventually contributes to diagnose occupational diseases and to prevent occupational poisoning. However, some biological monitoring data, such as urine manganese, mercury and NMF, have been still reported from laboratories that were not accepted as a proficient laboratory.
Cadmium ; Diagnosis ; Environmental Monitoring ; Korea ; Manganese ; Metals, Heavy ; Occupational Diseases ; Occupational Health ; Phenol ; Poisoning ; Quality Control ; Reference Values ; Trichloroethylene

We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

No abstract available.

Together, the cheek and neck can be considered as a single anatomic location because skin vascularity, texture and thickness are similar. The cervicofacial flap has been described as the treatment of choice for the cheek defect because of its good mobility and excellent cosmetic result. However, if the defects on the cheek are wider than the length of palpebral fissure of extended to the lower two thirds of the cheek, the conventional cervicofacial flaps would be inadequate in size without the benefit of expansion. Tissue expansion of the cheek and neck is distinguished by a particuarly high rate of complication. Prevention of various complications require careful planning and certain modifications in technique. We have used the following modifications and measures to prevent the complications and to maximize the expansion. 1) Whenever possible, expanders were placed over the rigid foundation such as mandible or posterior neck area after wide undermining. 2) Expanders were placed deep to platysma in the neck area. 3) Following optimal expansion, the further dissection extending to the clavicle and the posterior neck area was performed for optimal mobilization and draping of the expanded skin. 4) The expanded skin was advanced upward on the cervical portion and rotated forward on the cheek portion. 5) The flap should not be draped above the inferior orbital rim and postoperatively the pressure garments were applied to prevent drooping of the expanded skin. We experienced 21 cases of the expanded cervicofacial flaps with above surgical modifications and the expanded cervicofacial flaps can resurface the 95% of cheek defects with minimal complications and excellent cosmetic results.
Cheek* ; Clavicle ; Mandible ; Neck ; Orbit ; Skin ; Tissue Expansion

Objective: To present new classification methods of knee osteoarthritis (KOA) using machine learning and compare its performance with conventional statistical methods as classification techniques using machine learning have recently been developed. Methods: A total of 84 KOA patients and 97 normal participants were recruited. KOA patients were clustered into three groups according to the Kellgren-Lawrence (K-L) grading system. All subjects completed gait trials under the same experimental conditions. Machine learning-based classification using the support vector machine (SVM) classifier was performed to classify KOA patients and the severity of KOA. Logistic regression analysis was also performed to compare the results in classifying KOA patients with machine learning method. Results: In the classification between KOA patients and normal subjects, the accuracy of classification was higher in machine learning method than in logistic regression analysis. In the classification of KOA severity, accuracy was enhanced through the feature selection process in the machine learning method. The most significant gait feature for classification was flexion and extension of the knee in the swing phase in the machine learning method. Conclusion The machine learning method is thought to be a new approach to complement conventional logistic regression analysis in the classification of KOA patients. It can be clinically used for diagnosis and gait correction of KOA patients.