Minimal cleft lip has been defined as a cleft which does not extend over the vermilion. Minimal cleft lip has no specific classification and few methods for its correction. Based on our operative experience with secondary cleft lipnose deformities, we have developed principles of operation for minimal cleft lip: minimal incision, nostril and alar reconstruction, philtrum reconstruction. alignment of cupid's bow, and vermilial notching correction. Nine patients of minimal cleft lip were operated on from March 1992 to June 1998 in our department. Each partients was evaluated for lip and nose deformities presurgically: the nasal tip, columella, ala, scar, cupid's bow, lip pout and lip length. Every patients required a different technique for repair. Satisfactory results were obtained by treating the cleft following the principles.
Cicatrix ; Classification ; Cleft Lip* ; Congenital Abnormalities ; Humans ; Lip ; Nose

OBJECTIVES: The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.
Adult ; Aged ; Alcohol Drinking/*adverse effects ; Cohort Studies ; Educational Status ; Female ; Humans ; Korea/epidemiology ; Lung Neoplasms/epidemiology/*etiology ; Male ; Middle Aged ; Proportional Hazards Models ; Smoking/*adverse effects ; Tuberculosis, Pulmonary/*complications

Blood-borne metastatic involvement of the gastric mucosa as a result of cancer is a rare occurrence. The tumors which were most commonly reported to metastasize to the stomach include melanoma, breast carcinoma, and lung carcinoma. Some reports document that large cell carcinoma and squamous cell carcinoma of the lungs have a higher pre- dilection for gastrointestinal tract metastases. Upper gastrointestinal endoscopic findings of metastatic lesions may vary but often produce a characteristic single or multiple bulls eye or target lesion. Therefore, whenever single or multiple target lesions are seen in the stomach on upper gastrointestinal endoscopy or barium study, the examination should include careful radiographic evaluation of the chest. Moreover, when the patient is known to have lung cancer, metastatic disease should be suspected. With a correct diagnosis and proper treatment, relief of symptoms and prolongation of life can sometimes be achieved, A case in reported involving squamous cell lung cancer with stomach metastasis in a 73 year-old woman. The patient was diagnosed by bronchoscopy, upper gastrointestinal endoscopy, chest CT, and abdominal CT. The chest and abdominal CT revealed a poorly marginated, lobulated, and 4 x 3 cm sized mass lesion in the right lower lobe causing obstruction of right lower lobe bronchus with invasion to the left atrium. right inferior pulmonary vein, and superior vena cava. Mediastimal lymph node enlargement and liver metastasis was also detected. Upper gastrointestinal endoscopy showed two "bulls eye" lesions with different sizes and two nodules without tip ulceration.
Aged ; Barium ; Breast Neoplasms ; Bronchi ; Bronchoscopy ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Heart Atria ; Humans ; Life Support Care ; Liver ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis* ; Pulmonary Veins ; Stomach* ; Thorax ; Tomography, X-Ray Computed ; Ulcer ; Vena Cava, Superior

Progressive muscular dystrophy (PMD) is an X-linked recessive primary muscular disease characterized by progressive muscular weakness. It causes gait disturbance and complications such as pneumonia, heart failure, and aspiration, so lead to death. Becker muscular dystrophy (BMD) is a milder type of PMD, of which incidence is 5 cases per 100,000 populations. It begins later and evolves more slowly than Duchenne muscular dystrophy (DMD). In PMD patients without heart failure symptom, there may be ECG abnormality or ventricular dilatation, impaired ventricular function which is consistent with dilated cardiomyopathy, especially in DMD. In BMD, heart failure is rare but ECG or echocardiographic abnormality is often found. With the advance of molecular genetics, mutations of the dystrophin gene is proved to be related to the pathogenesis of PMD and dilated cardiomyopathy. We confirmed the deletion of exon 43-51 in the dystrophin gene a case of BMD with asymptomatic dilated cardiomyopathy, diagnosed by echocardiography.
Cardiomyopathy, Dilated ; Dilatation ; Dystrophin* ; Echocardiography ; Electrocardiography ; Exons* ; Gait ; Heart Failure ; Humans ; Incidence ; Molecular Biology ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne* ; Pneumonia ; Ventricular Function

Progressive muscular dystrophy (PMD) is an X-linked recessive primary muscular disease characterized by progressive muscular weakness. It causes gait disturbance and complications such as pneumonia, heart failure, and aspiration, so lead to death. Becker muscular dystrophy (BMD) is a milder type of PMD, of which incidence is 5 cases per 100,000 populations. It begins later and evolves more slowly than Duchenne muscular dystrophy (DMD). In PMD patients without heart failure symptom, there may be ECG abnormality or ventricular dilatation, impaired ventricular function which is consistent with dilated cardiomyopathy, especially in DMD. In BMD, heart failure is rare but ECG or echocardiographic abnormality is often found. With the advance of molecular genetics, mutations of the dystrophin gene is proved to be related to the pathogenesis of PMD and dilated cardiomyopathy. We confirmed the deletion of exon 43-51 in the dystrophin gene a case of BMD with asymptomatic dilated cardiomyopathy, diagnosed by echocardiography.
Cardiomyopathy, Dilated ; Dilatation ; Dystrophin* ; Echocardiography ; Electrocardiography ; Exons* ; Gait ; Heart Failure ; Humans ; Incidence ; Molecular Biology ; Muscle Weakness ; Muscular Diseases ; Muscular Dystrophies ; Muscular Dystrophy, Duchenne* ; Pneumonia ; Ventricular Function

Fitz-Hugh-Curtis syndrome is an extrapelvic manifestation of PID. It is associated with right upper quadrant pain that likely results from the inflammation of liver capsule and diaphragm. The liver capsule becomes involved with inflammatory exudates that later forms violin string adhesion between two liver capsule and adjacent diaphragm or peritoneum. Previously, Neisseria gonorrhea was thought to be the only etiological agent, but recent studies have reported cases of Fitz-Hugh-Curtis syndrome due to Chlamydia trachomatis infection. 15 to 30 percents of women with PID develop symptom of Fitz-Hugh-Curtis syndrome. It is often mistakenly diagnosed as either pneumonia or acute cholecystitis. Laparoscopy may be the definitive method in diagnosis of Fitz-Hugh-Curtis syndrome. However, we have experienced one cases of Fitz-Hugh-Curtis syndrome, which was diagnosed preoperative by pelvic CT imaging and report with the brief review of the literatures.
Chlamydia trachomatis ; Cholecystitis, Acute ; Diagnosis ; Diaphragm ; Exudates and Transudates ; Female ; Gonorrhea ; Humans ; Inflammation ; Laparoscopy* ; Liver ; Neisseria ; Peritoneum ; Pneumonia

PURPOSE: The purpose of this study was to investigate the effects of emotional labor, emotional intelligence and social support on job stress in clinical nurses. METHODS: Participants were 123 clinical nurses and data were collected from October to December, 2011 and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with SPSS 18.0. RESULTS: A positive correlation was found between job stress and emotional labor. Emotional labor showed a significant negative correlation with emotional intelligence and social support, whereas a positive correlation was found between emotional intelligence and social support. The strongest predictor of job stress was emotional labor. In addition, institution satisfaction (dissatisfaction) and the reason for selecting the job (opportunities for service) accounted for 21% of variance in job stress. CONCLUSION: The results of this study suggest that it is important to manage emotional labor as well as to improve job satisfaction in order to reduce job stress in clinical nurses.
Emotional Intelligence ; Job Satisfaction

This paper presents a case of an early malignant transformation of untreated ulcers in a patient with diabetes. This case shows that Marjolin's ulcer can occur not only after chronic injury, but can also develop in the early stages after the onset. Hence, an early biopsy for diabetic foot ulcers that fail to heal with acute treatment can enable an earlier diagnosis and treatment without amputation, resulting in a better quality of life for the patient.
Amputation ; Biopsy ; Diabetic Foot* ; Diagnosis ; Humans ; Quality of Life ; Ulcer*

OBJECTIVES: This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. MATERIALS AND METHODS: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. RESULTS: The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. CONCLUSIONS: The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.
Adult ; Aged ; Cohort Studies ; Female ; Humans ; Korea ; Middle Aged ; *Questionnaires ; Reproducibility of Results ; *Reproductive Medicine

Breast cancer is the second leading cancer for Korean women and its incidence rate has been increasing annually. If early diagnosis were implemented with epidemiologic data, the women could easily assess breast cancer risk using internet. National Cancer Institute in the United States has released a Web-based Breast Cancer Risk Assessment Tool based on Gail model. However, it is inapplicable directly to Korean women since breast cancer risk is dependent on race. Also, it shows low accuracy (58%-59%). In this study, breast cancer discrimination models for Korean women are developed using only epidemiological case-control data (n = 4,574). The models are configured by different classification techniques: support vector machine, artificial neural network, and Bayesian network. A 1,000-time repeated random sub-sampling validation is performed for diverse parameter conditions, respectively. The performance is evaluated and compared as an area under the receiver operating characteristic curve (AUC). According to age group and classification techniques, AUC, accuracy, sensitivity, specificity, and calculation time of all models were calculated and compared. Although the support vector machine took the longest calculation time, the highest classification performance has been achieved in the case of women older than 50 yr (AUC = 64%). The proposed model is dependent on demographic characteristics, reproductive factors, and lifestyle habits without using any clinical or genetic test. It is expected that the model could be implemented as a web-based discrimination tool for breast cancer. This tool can encourage potential breast cancer prone women to go the hospital for diagnostic tests.
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/*diagnosis/*epidemiology ; Diagnosis, Computer-Assisted/*methods ; Early Detection of Cancer/*methods ; Female ; Humans ; *Machine Learning ; Middle Aged ; Pattern Recognition, Automated/methods ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/methods ; Risk Factors ; Sensitivity and Specificity ; Women's Health/*statistics & numerical data