Thirty-two dacryocystorhinostomies were performed in the chronic dacryocystitis and obstruction of the nasolacrimal duct between 1971 and 1976. A routine dacryocystography was performed prior to operation in all cases. A modified Toti's method was applied as a surgical technique; vaseline gauze was used as a plugging agent and both posterior flaps of sac ans nasal mucous membrane was not sutured because of technical difficuty and for prevention of granulation tissue due to suture materials Ranging in age from 22 to 66 years of age; 3 were men and 29 were women. Success was achieved in 29 of 32 cases initially. One of three initial failured cases, which was due to formation of obstructing granulation tissue by suture materials in posterior flap, was turn into succes by secondary operation. We attempted to make this method in 3 cases of shrunken sac: Two were failed. In these cases, if vaseline gauze should removed after more than 10 days, it will be possible to expansion of shrunken sac and to obtained successful result. We also attempted to make this method in 3 cases of macerted sac, and gained successful result. In such a case, it is possible by suturing of anterior flaps of sac and nasal mucous mem brane only. In conclusion, this operation is simple to do and within the range of any ophthalmic surgeon. It is possible in case of macerated sac and shrunken sac.
Dacryocystitis ; Dacryocystorhinostomy* ; Female ; Granulation Tissue ; Humans ; Male ; Mucous Membrane ; Nasolacrimal Duct ; Petrolatum ; Sutures

This paper reports a case of a 21-year-old male patient who complained of intermittent pain and snapping at 110° of flexion in his left elbow joint. Magnetic resonance imaging revealed a band-like low signal intensity in front of the radiohumeral joint. An ultrasound was conducted to check its association with the symptoms. Observations of a high echo escaping from the radiohumeral joint at the point when snapping occurred indicated noted that the hypertrophic plica was a cause of the snapping. The hypertrophic plica removed arthroscopically, and the results were good for up to 6 months after surgery. If snapping is observed in the elbow joint, it will be necessary to consider the symptoms from the hypertrophic plica, although rare, and ultrasound might be an effective tool for a differential diagnosis.
Diagnosis* ; Diagnosis, Differential ; Elbow Joint ; Elbow* ; Humans ; Joints ; Magnetic Resonance Imaging ; Male ; Ultrasonography* ; United Nations ; Young Adult

The treatment approach for proximal humeral fractures is determined by various factors, including patient age, sex, dominant arm, fracture pattern, presence of osteoporosis, preexisting arthritis, rotator cuff status, and medical comorbidities. However, there is a lack of consensus in the literature regarding the optimal treatment for displaced proximal humeral fractures. This study aimed to assess and quantify the decision-making process for either conservative or surgical treatment and the choice of surgical method among shoulder surgeons when treating proximal humeral fractures. Methods: Forty sets of true anteroposterior view, scapular Y projection view, and three-dimensional computed tomography of proximal humeral fractures were provided to 12 shoulder surgeons along with clinical information. Surveys regarding Neer classification, decisions between conservative and surgical treatments, and chosen methods were conducted twice with an interval of 2 months. The factors affecting the treatment plans were also assessed. Results: The inter-rater agreement was fair for Neer classification (kappa=0.395), moderate for the decision between conservative and surgical treatments (kappa=0.528), and substantial for the chosen method of surgical treatment (kappa=0.740). The percentage of agreement was 71.1% for Neer classification, 84.6% for the decision between conservative and surgical treatment, and 96.4% for the chosen method of surgical treatment. The fracture pattern was the most crucial factor in deciding between conservative and surgical treatments, followed by age and physical activity. Conclusions: The decision between conservative and surgical treatment for proximal humeral fractures showed good agreement, while the chosen method between osteosynthesis and arthroplasty showed substantial agreement among shoulder surgeons.

BACKGROUND: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. METHODS: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. RESULTS: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], −0.255 [p=0.077], 0.068 [p=0.642], and −0.188 [p=0.196], respectively). CONCLUSIONS: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.
Education ; Exercise ; Humans ; Immobilization ; Pamphlets ; Range of Motion, Articular ; Rehabilitation ; Rotator Cuff ; Shoulder

PURPOSE: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. METHODS: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. RESULTS: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. CONCLUSION: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.
Biopsy ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Liposarcoma ; Liposarcoma, Myxoid ; Neck ; Neoplasm Metastasis ; Rare Diseases ; Retroperitoneal Space ; Sarcoma ; Thigh ; Young Adult

PURPOSE: The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital. METHODS: The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC). RESULTS: Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74. CONCLUSION: Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.
Aged ; Aged, 80 and over ; Area Under Curve ; Behavior ; Communication ; Confusion ; Delirium/diagnosis/*nursing ; Female ; Hallucinations ; Hospitals, General ; Humans ; Illusions ; Male ; Pilot Projects ; *Program Development ; Psychomotor Performance ; Questionnaires ; ROC Curve ; Republic of Korea ; Translating

The effects of retrograded rice on body weight gain, gut functions, and hypolipidemic actions in rats were examined. When the retrograded rice was produced by repetitive heating and cooling cycles, it contained significantly higher amounts of resistant starch (13.9 +/- 0.98%) than is found in common rice (9.1 +/- 1.02%) (P < 0.05). Sprague-Dawley rats were fed either common rice powder or retrograded rice powder, and mean body weight gain was significantly lower in the retrograded rice group (P < 0.05). The liver weight of the retrograded rice group (14.5 +/- 0.5 g) was significantly lower than that of the common rice group (17.1 +/- 0.3 g, P < 0.05). However, the weights of other organs, such as the kidney, spleen, thymus, and epididymal fat pad were not significantly affected by rice feeding. Intestinal transit time tended to be lower in rats fed retrograded rice when compared to rats fed the common rice, but the difference was not significant. The retrograded rice diet significantly increased stool output when compared to that in the common rice powder diet (P < 0.05), whereas fecal moisture content (%) was significantly higher in the retrograded rice group (23.3 +/- 1.2) than that in the common rice group (19.1 +/- 1.2) (P < 0.05). The retrograded rice group had significantly lower plasma cholesterol (P < 0.05), liver cholesterol (P < 0.05), and triacylglycerol contents in adipose tissue (P < 0.05) when compared to those in the common rice group. In conclusion, retrograded rice had higher resistant starch levels compared with those of common rice powder, and it lowered body weight gain and improved lipid profiles and gut function in rats.
Adipose Tissue ; Animals ; Body Weight ; Cholesterol ; Diet ; Heating ; Hot Temperature ; Kidney ; Lipid Metabolism ; Liver ; Plasma ; Rats ; Rats, Sprague-Dawley ; Spleen ; Starch ; Thymus Gland ; Triglycerides ; Weights and Measures

Purpose: Differentiating between glioblastoma and solitary metastasis is very important for the planning of further workup and treatment. We assessed the ability of various morphological parameters using conventional MRI and diffusion-based techniques to distinguish between glioblastomas and solitary metastases in tumoral and peritumoral regions. Materials and Methods: We included 38 patients with solitary brain tumors (21 glioblastomas, 17 solitary metastases). To find out if there were differences in the morphologic parameters of enhancing tumors, we analyzed their shape, margins, and enhancement patterns on postcontrast T1-weighted images. During analyses of peritumoral regions, we assessed the extent of peritumoral non-enhancing lesion on T2- and postcontrast T1-weighted images. We also aimed to detect peritumoral neoplastic cell infiltration by visual assessment of T2-weighted and diffusionbased images, including DWI, ADC maps, and exponential DWI, and evaluated which sequence depicted peritumoral neoplastic cell infiltration most clearly. Results: The shapes, margins, and enhancement patterns of tumors all significantly differentiated glioblastomas from metastases. Glioblastomas had an irregular shape, ill-defined margins, and a heterogeneous enhancement pattern; on the other hand, metastases had an ovoid or round shape, well-defined margins, and homogeneous enhancement. Metastases had significantly more extensive peritumoral T2 high signal intensity than glioblastomas had. In visual assessment of peritumoral neoplastic cell infiltration using T2-weighted and diffusion-based images, all sequences differed significantly between the two groups. Exponential DWI had the highest sensitivity for the diagnosis of both glioblastoma (100%) and metastasis (70.6%). A combination of exponential DWI and ADC maps was optimal for the depiction of peritumoral neoplastic cell infiltration in glioblastoma. Conclusion In the differentiation of glioblastoma from solitary metastatic lesions, visual morphologic assessment of tumoral and peritumoral regions using conventional MRI and diffusion-based techniques can also offer diagnostic information.

Purpose: Differentiating between glioblastoma and solitary metastasis is very important for the planning of further workup and treatment. We assessed the ability of various morphological parameters using conventional MRI and diffusion-based techniques to distinguish between glioblastomas and solitary metastases in tumoral and peritumoral regions. Materials and Methods: We included 38 patients with solitary brain tumors (21 glioblastomas, 17 solitary metastases). To find out if there were differences in the morphologic parameters of enhancing tumors, we analyzed their shape, margins, and enhancement patterns on postcontrast T1-weighted images. During analyses of peritumoral regions, we assessed the extent of peritumoral non-enhancing lesion on T2- and postcontrast T1-weighted images. We also aimed to detect peritumoral neoplastic cell infiltration by visual assessment of T2-weighted and diffusionbased images, including DWI, ADC maps, and exponential DWI, and evaluated which sequence depicted peritumoral neoplastic cell infiltration most clearly. Results: The shapes, margins, and enhancement patterns of tumors all significantly differentiated glioblastomas from metastases. Glioblastomas had an irregular shape, ill-defined margins, and a heterogeneous enhancement pattern; on the other hand, metastases had an ovoid or round shape, well-defined margins, and homogeneous enhancement. Metastases had significantly more extensive peritumoral T2 high signal intensity than glioblastomas had. In visual assessment of peritumoral neoplastic cell infiltration using T2-weighted and diffusion-based images, all sequences differed significantly between the two groups. Exponential DWI had the highest sensitivity for the diagnosis of both glioblastoma (100%) and metastasis (70.6%). A combination of exponential DWI and ADC maps was optimal for the depiction of peritumoral neoplastic cell infiltration in glioblastoma. Conclusion In the differentiation of glioblastoma from solitary metastatic lesions, visual morphologic assessment of tumoral and peritumoral regions using conventional MRI and diffusion-based techniques can also offer diagnostic information.

OBJECTIVE: This study is designed to evaluate the relationship between bone mineral density (BMD) and life-style factors such as physical activity, smoking, and alcohol consumption and to offer the information for the modification of life-style. METHOD: Eight hundred and sixty nine inhabitants (354 males and 515 females whose age was 55.0+/-13.9 years- old) were participated in this study. BMD was measured in the right calcaneus by quantitative ultrasound (Mark 6000(R), Medison). Amount of physical activity, smoking, and alcohol consumption were got through the closely designed interview. Independent sample T-test and simple regression were used for data analysis. RESULTS: Amount of physical activities were 2656.8+/-732.3 cal/day, smokers were 329 persons (37.9% of inhabitants), and amount of alcohol consumption were 26.2+/-53.3 g/day. Increasing the amount of physical activity, BMD showed significantly higher T-score (p<0.01). Increasing the amount of alcohol consumption, BMD showed significantly lower T-score (p<0.01). BMD in smokers appeared significantly lower T-score than non-smokers (p<0.01). CONCLUSION: Life-style factors significantly effect on bone mineral density. Therefore prevention of osteoporosis through maintenance or augmentation of BMD needs proper physical activity, cessation of smoking, and no heavy drinking.
Alcohol Drinking ; Bone Density* ; Calcaneus ; Drinking ; Female ; Humans ; Male ; Motor Activity ; Osteoporosis ; Smoke ; Smoking ; Statistics as Topic ; Ultrasonography