OBJECTIVES: To determine the health behavior practices and needs for health promotion in shift work pattern in subway workers. METHODS: Among 789 male subway workers divided into four groups, 191 day time workers, 187 station service men (3 groups, 2 turns), 204 rolling stock inspectors (3 groups, 2 turns) and 207 train operators (8 groups, 5 turns), we surveyed the health behavior and needs for health promotion by questionnaire. RESULTS: For obesity, blood pressure and total cholesterol, day time workers had the highest levels, while train operators had higher diseases of the liver and stomach than others. The station service men had the highest smoking rate and daily smoking amount. More than 80% of the respondents consumed alcohol, and the drinking amount was highest among the day time workers and the 8/5 shift train operators. Eighty-two percent of the station service men had irregular eating habits and 17.7% did not have any breakfast. In health promotion activities, exercise and restriction of one's favorite(smoking or drinking) were most preferred in the four groups of respondents. The priority of needs and participation for health promotion program was exercise programs, followed by stress management, cancer prevention program, weight control program, anti-smoking campaign, high blood pressure control program, and abstinence/moderation in drinking. CONCLUSION: As the health behavior practices differed relative to shift work patterns, it was suggested that a comprehensive health promotion program according to shift work pattern should be planned and implemented among subway workers.
Blood Pressure ; Breakfast ; Cholesterol ; Data Collection ; Drinking ; Eating ; Health Behavior* ; Health Promotion* ; Humans ; Hypertension ; Liver ; Male ; Obesity ; Questionnaires ; Railroads* ; Smoke ; Smoking ; Stomach

PURPOSE: Endometriosis is the heterotropic occurrence of island of endometrial glands and stroma outside of uterus. It common occurs in pelvic cavity, but rarely at the ectopic area of extra-pelvic cavity. The aim of this study was to evaluate the clinical characteristics of extrapelvic endometriosis in order to help diagnosis and treatment. METHODS: Between January 2001 and June 2007, 22 patients who underwent surgery and was diagnosed as ectopic endometriosis of extra-pelvic cavity at Bundang CHA hospital were retrospectively reviewed with medical records and a telephone interview. RESULTS: All cases were women in their reproductive age, with a median age of 33 years (range 24~49 years). 17 of 22 cases were endometriosis in the scarring tissue of prior caesarean section wound on abdomen. 1 case in vaginal orifice on episiotomy wound of perineum, 1 case in femoral ring area and 3 cases in appendix. All patients except endometriosis of appendix, were presented with mass, pain and symptoms almost associated with menstruation. 18 of 22 cases were suspected of having extra-pelvic endometriosis due to their specific clinical features, 4 cases were suspected of hernia and acute appendicitis. All patients were treated with surgery. None has revisited to clinics due to recurrence. CONCLUSION: Women who have mass or lump in surgical scar and symptoms associated with menstruation period should be suspected of having endometriosis. Endometriosis of surgical scaring tissue should be treated by wide local excision to prevent local recurrence.
Abdomen ; Appendicitis ; Appendix ; Cesarean Section ; Cicatrix ; Endometriosis ; Episiotomy ; Female ; Hernia ; Humans ; Medical Records ; Menstruation ; Perineum ; Pregnancy ; Retrospective Studies ; Telephone ; Uterus

Although injectable soft-tissue augmentation materials are extremely well-tolerated, undesirable effects sometimes occur. Whereas minor adverse events such as erythema, edema or bruising are generally reversible, the formation of foreign body granuloma, atypical mycobacterial infections or tissue necrosis may cause serious irreversible damages and disfigurement. We present here the case of a 50-year-old woman with an indurated painful nodule and patch on the right cheek, and this occurred after an unlicensed nonspecialist injected filler of unknown ingredients. The histopathologic findings showed granulomatous inflammation composed of lymphocytes, histiocytes and multinucleated giant cells with a Swiss cheese appearance. Although any acid-fast bacilli were not observed on Ziehl-Neelsen staining, the mycobacterial culture demonstrated an ivory-colored wet colony that was identified as M. chelonae by polymerase chain reaction-restriction fragment length polymorphism. The patient was treated with 1 g of clarithromycin for seven weeks, and the lesion improved considerably.
Cheek ; Cheese ; Clarithromycin ; Edema ; Erythema ; Female ; Foreign Bodies ; Giant Cells ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Inflammation ; Lymphocytes ; Middle Aged ; Mycobacterium ; Mycobacterium chelonae ; Necrosis

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are associated with cutaneous adverse events, including papulopustular eruption, xerosis, paronychia, hair abnormality and mucositis. In particular, acneiform eruptions might serve as the visible markers of anti-tumor activity and the therapeutic efficacy of EGFR inhibitors. OBJECTIVE: Our aims are to investigate the common cutaneous adverse events induced by cetuximab, which is one of the EGFR inhibitors approved by the US Food and Drug Administration, and to analyze whether the presence and severity of papulopustular eruptions have a correlation with the tumor response. METHODS: We retrospectively reviewed the medical records and clinical photographs of 114 Korean patients who had been treated with cetuximab at Asan Medical Center from September 2004 to March 2007. Results: Papulopustular eruptions occurred in 100 patients (87.7%) and this usually happened 10 days after starting chemotherapy. There was a tendency that the better the tumor responded to the chemotherapeutic agents including cetuximab, the more severe were the papulopustular eruptions. The papulopustular eruptions prominently improved after the treatment with topical agents such as benzoyl peroxide, metronidazole, clindamycin and retinoid, and with systemic agents such as minocycline and tetracycline, and there was no adverse event induced by this treatment for papulopustular eruptions. Xerosis appeared in 67 patients (58.8%), and there was a tendency that the more severe papulopustular eruptions were, the more frequently xerosis occurred. Paronychia occurred in 8 patients (7.0%). CONCLUSION: Although the cutaneous adverse events are burdensome to the patients, they might serve as visible markers of the anti-tumor activity and therapeutic efficacy of cetuximab and they can be easily and safely controlled with many topical and systemic agents. Therefore, it is important for dermatologists to properly treat these cutaneous adverse events and to reassure the patient to continue with the cetuximab treatment.
Acneiform Eruptions ; Antibodies, Monoclonal, Humanized ; Benzoyl Peroxide ; Clindamycin ; Drug Therapy, Combination ; Hair ; Humans ; Medical Records ; Metronidazole ; Minocycline ; Mucositis ; Paronychia ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Tetracycline ; United States Food and Drug Administration ; Cetuximab

Incontinentia pigmenti is a systemic disorder affecting the skin, teeth, eyes, nervous tissue, hair, nails, musculoskeletal system, and heart. We describe an 11-month-old girl with incontinentia pigmenti associated with a ventricular septal defect, left hemiatrophy, hemangiomas, an abnormal labial frenum, and spastic cerebral palsy manifested as left hemiplegia and developmental delay. We believe this patient illustrates that incontinentia pigmenti is a systemic disorder necessitating a multidisciplinary approach to management.
Cerebral Palsy ; Eye ; Hair ; Heart ; Heart Septal Defects, Ventricular ; Hemangioma ; Hemiplegia ; Humans ; Incontinentia Pigmenti ; Infant ; Labial Frenum ; Musculoskeletal System ; Nails ; Skin ; Tooth

Cutaneous metastasis from renal cell carcinoma is rare. Once metastatic cutaneous involvement of a renal cell carcinoma has occurred, the disease is already widespread and therefore has a very poor prognosis. Herein we report a case of a 59-year-old man who presented with a renal cell carcinoma metastatic to the scalp, lung, brain and contralateral kidney.
Brain ; Carcinoma, Renal Cell ; Humans ; Kidney ; Lung ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Scalp

Proliferative fasciitis is a rare, rapidly growing, pseudosarcomatous nodule of subcutaneous tissue. It commonly occurs on the extremities. Lesions on the head and neck are exceedingly rare. Histopathologically, it is characterized by several large basophilic ganglion-like cells deposited in a myxoid stroma with spindled cells. Herein, we report a case of a 54-year-old man who noticed a nodule on his right cheek about six months before examination. At first, its size abruptly increased, and then remained without any change in size. Microscopically, many basophilic ganglion-like cells and spindled cells were deposited in a myxoid stroma. Immunohistochemically, ganglion-like cells and spindled cells were strongly positive for vimentin and weakly positive for smooth muscle actin and CD68. Although it was not radically excised, the lesion has not been found for 3 months.
Actins ; Basophils ; Cheek ; Extremities ; Fasciitis ; Head ; Humans ; Middle Aged ; Muscle, Smooth ; Neck ; Subcutaneous Tissue ; Vimentin

PURPOSE: Defecography is a dynamic investigation which can influence clinical decision making in patients with pelvic outlet obstructive disease (POOD). The current study was designed to establish defecographic findings in patients with POOD. Specifically, we sought to assess the physiologic characteristics of categorized types by using anorectal physiologic tests. METHODS: One hundred seven patients (disease group; 45 men, 62 women) with POOD were retrospectively categorized as type I [non-relaxation of puborectalis (NRPR) only, n=19], type II [NRPR and rectocele, n=20], type III [NRPR, rectocele, and dynamic perineal descent (PD), n=17], type IV [deformed rectocele, mild-to-moderate fixed PD, and absence of NRPR, n=29], and type V [rectocele, severe fixed PD, and absence of NRPR, n=20] on the bases of defecographic findings. The ability to evacuate, the frequency/degree of intarectal intussusception (IRI), and the size of the rectocele were evaulated in these defecographic types of POOD. Age, duration of symptoms, and the physiologic findings of anal manometry and EMG/PNTML were compared for the five types. Eighteen healthy volunteers who had no defecation difficulty were used to estimate the normal findings of defecography. RESULTS: The age and the sex showed no significant differences among the types. The duration of symptoms was gradually lengthened from type I to V (P<0.01). The ability to evacuate in patients with POOD was significantly worse (failed to effectively evacuate) compared to that in the healthy volunteers (P<0.01). The frequency of IRI was increased more and more from type I to V (P<0.01). The size of the rectocele was significantly increased in types V compared to the other types (P<0.01). Manometric and neurologic findings, including EMG/PNTML, revealed no significant differences among the types. CONCLUSIONS: Even though there were no specific differences in the findings of the anal manometric and neurologic tests, the evacuation dynamics; were different in the five defecographic categories of patients with POOD. Specifically, these differences were relevants to the presence of NRPR, rectoceles, IRI, and perineal descent.
Decision Making ; Defecation ; Defecography ; Healthy Volunteers ; Humans ; Intussusception ; Male ; Manometry ; Neurologic Manifestations ; Rectocele ; Retrospective Studies

Although a basal cell carcinoma usually results from chronic irradiation of solar ultraviolet, some reports have mentioned that non-solar ultraviolet and trauma also could be etiologic factors of basal cell carcinoma. Herein, we report a case of a 64-year-old man who had worked as a welder for more than thirty years. Four years ago, he was burnt on his right upper eyelid during welding. After that, the lesion had been darkened and indurated, and finally was diagnosed as basal cell carcinoma. The significance of non-solar ultraviolet irradiation and thermal burn during welding in the pathogenesis of basal cell carcinoma is discussed.
Burns ; Carcinoma, Basal Cell ; Eyelids ; Humans ; Middle Aged ; Welding

Mucoepidermoid carcinoma is the most common primary salivary gland malignancy. About 60% of mucoepidermoid carcinomas occur in the major salivary glands and 35% in the minor glands, in which the palate and buccal mucosa are the most frequent sites. Histologically, tumor cells, composed of intermediate, mucous, epidermoid, and clear cells in widely varying proportions, form numerous sheets, islands, duct-like structures and cysts. Many foci of mucin production are prominent. Herein, we report a case of a 37-year-old man who presented a nodule on left buccal mucosa. After the diagnosis, he was referred to a dental surgeon, by whom the tumor was radically excised. But, tumor cells were observed at one of the resection margins. As a result, he received radiation therapies (6 weeks, 60 Gy). He is now undergoing regular follow ups without any signs of recurrence.
Adult ; Carcinoma, Mucoepidermoid ; Follow-Up Studies ; Humans ; Islands ; Mouth Mucosa ; Mucins ; Palate ; Recurrence ; Salivary Glands ; Salivary Glands, Minor