OBJECTIVES: No evidence has been found on various types of dental erosion, except for occupational dental erosion. This study aimed to evaluate the distribution of four types of dental erosion (occupational, dietary, systemic, and gastric) and its associated factors among workers in factories that use acids. METHODS: Of 89,034 workers from 4,625 factories that use acids, 716 workers from 38 factories were selected for this cross-sectional epidemiological study by using three-stage stratified cluster sampling. Evaluation for dental erosion was performed by a trained dentist by using Kim's criteria, and a saliva sample was collected directly from each participant. Data on acid sources and associated factors were collected by using questionnaires. By using a complex sample analysis, the T test and Rao-Scott chi-square test were applied to analyze the distribution of four acid factors and to evaluate the associated factors. RESULTS: The prevalence of overall dental erosion was 37.7% for occupational dental erosion, 23.1% for dietary dental erosion, 3.1% for systemic dental erosion, and 3.2% for gastric dental erosion. The prevalence of severe dental erosion was 10.5% for occupational dental erosion, 7.1% for dietary dental erosion, 1.8% for systemic dental erosion, and 1.7% for gastric dental erosion. The factors associated with dental erosion were age, sex, acid exposure, dental cervical abrasion, and dental attrition. CONCLUSIONS: Our data showed that the prevalence of dental erosion was high, moderate, and low in occupational, dietary, and gastric and systemic dental erosions, respectively, among workers exposed to acids. The related factors differed according to the types of dental erosion. Our data suggested that different types of promotion programs for dental erosion should be considered according to acid source.
Dentists ; Epidemiologic Studies ; Epidemiology ; Humans ; Prevalence ; Saliva ; Tooth Attrition

PURPOSE: The aim of this study was to investigate clinicopathologic differences between prostate cancer (PCa) detected at initial and repeat transrectal ultrasound-guided prostate biopsy in a large Korean cohort. MATERIALS AND METHODS: From 2000 through 2012, a total of 7,001 patients underwent transrectal ultrasound-guided prostate biopsy at 6 centers in Daegu and Gyeongbuk provinces. Of these 7,001 patients, the initial biopsy was positive for PCa in 2,118 patients. Repeat biopsy was performed in 374 of the 4,883 patients with an initial negative finding and a persistently elevated prostate-specific antigen (PSA) level, nodules or asymmetry by digital rectal examination (DRE), high-grade prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Numbers of biopsy cores varied from 6 to 12 according to center and biopsy date. RESULTS: Cancer was diagnosed in 2,118 of the 7,001 patients (30.3%) at initial biopsy and in 86 of the 374 patients (23.0%) at repeat biopsy. The repeat biopsy rate was 5.3%. Mean PSA values were 68.7+/-289.5 ng/mL at initial biopsy and 18.0+/-55.4 ng/mL at repeat biopsy (p<0.001). The mean number of cancer-positive cores per biopsy was 5.5+/-3.5 for initial biopsy and 3.0+/-2.9 for repeat biopsy (p<0.001). Mean Gleason score was 7.5+/-1.4 at initial biopsy and 6.6+/-1.3 at repeat biopsy (p<0.001). For detected cancers, the low-stage rate was higher for repeat biopsy than for initial biopsy (p=0.001). CONCLUSIONS: Cancers detected at repeat biopsy tend to have lower Gleason scores and stages than cancers detected at initial biopsy. The present study shows that repeat biopsy is needed in patients with a persistently high PSA or abnormal DRE findings.
Adult ; Aged ; Aged, 80 and over ; Endosonography/*methods ; Follow-Up Studies ; Humans ; Image-Guided Biopsy/*methods ; Incidence ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostatic Neoplasms/epidemiology/*pathology ; Rectum ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies

PURPOSE: This study was conducted to generate theoretical constructs on depression from the study data by examining and interpreting Korean housewives' experience with depression to elicit its meaning, understand it better, and develop empirical knowledge on it. METHODS: The data were collected in a community public mental health center between April 1, 2012 and September 30, 2012 using in-depth interviews and theoretical sampling. The participants were 12 women aged 40-64 years who scored 7 or higher in the Korean version of the 21-item Hamilton Rating Scale for Depression (Kim, 1980). Collected data were analyzed by grounded theory methodology using open, axial, selective coding process. RESULTS: It was found that the basic socio-psychological process of Korean housewives' living through depression could be summarized into the following four phases: (1) the vanishing of the self into thin air, (2) becoming an empty shell, and (3) searching for the meaning of life, (4) fulfilling of an empty shell. CONCLUSION: This study may enhance the culturally elusive understanding of Korean housewives' experience with depression. As they are living through a hollow empty shell which looks normal on the outside, so can't get support from their families. It's important to educate their families about depressive phases.
Clinical Coding ; Depression* ; Female ; Humans ; Mental Health ; Qualitative Research

BACKGROUND/AIMS: Because preoperative diagnosis of xanthogranulomatous pyelonephritis (XGP) is difficult, due to its similarities to other renal diseases, the diagnosis is made postoperatively in most cases. The purpose of this study was to describe the clinical findings in 11 patients with histologically documented XGP. METHODS: We retrospectively reviewed the characteristics, laboratory and radiological findings, preoperative diagnoses and operative methods of 11 patients with XGP, who underwent a surgical procedure or percutaneous renal biopsy. RESULTS: Among eleven patients, nine had flank pain and six had anemia. Preoperatively, three patients were diagnosed as XGP, two with renal cell carcinoma, two with renal tuberculosis, one with renal abscess, one with perirenal abscess, one with renal staghorn calculi with non-functioning kidney, and one with pyelonephrosis. On the basis of the computed tomography (CT) features, the diffuse or global forms (70.0%) were more common than the localized or focal forms (30.0%). One patient diagnosed with renal cell carcinoma preoperatively was diagnosed as XGP through an intraoperative frozen section renal tissue biopsy and underwent partial nephrectomy. One patient diagnosed as focal XGP underwent percutaneous biopsy of the renal mass, which confirmed the diagnosis. This patient received treatment with only antibiotic therapy. CONCLUSIONS: CT can be considered the preferred diagnostic tool for the evaluation of XGP; however, percutaneous renal biopsy seems to be valuable in selected cases for differential diagnosis of renal malignancy.
Abscess ; Anemia ; Anti-Bacterial Agents ; Biopsy ; Calculi ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Flank Pain ; Frozen Sections ; Humans ; Kidney ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous ; Retrospective Studies ; Tuberculosis, Renal

Ewing's sarcoma is rarely found occurs in the bones of the hands and feet. We report a case of Ewing's sarcoma of the left calcaneus in a 15-year-old girl who complained of left heel pain and swelling. An open biopsy was performed and histological examination showed the proliferation of uniform small round cells. Immunohistochemical staining for CD99 showed diffuse strong positivity in the cytoplasmic membrane of the tumor cells. After preoperative chemotherapy, a below knee amputation was performed.
Adolescent ; Amputation ; Biopsy ; Calcaneus* ; Cell Membrane ; Drug Therapy ; Female ; Foot ; Hand ; Heel ; Humans ; Knee ; Sarcoma, Ewing*

PURPOSE: Childhood acute immune thrombocytopenic purpura (ITP) is a benign hematologic disease. Therapy does not affect the natural history of the illness. We evaluated the clinical and laboratory findings, treatment and prognosis of childhood acute ITP in Korea through a retrospective multicenter study. METHODS: We analyzed retrospectively the data of 1, 829 children with acute ITP through survey of 33 hospitals among 43 hospitals in Korea from Sep. 1992 to Aug. 2001. RESULTS: Male to female ratio was 1.3: 1 and the median age at the diagnosis of ITP was 2.9 (0.1 17) years. Median duration of follow up was 6 months. One hundred and forty nine cases of the total 1, 829 patients (8.1%) received no treatment. The initial median platelet count of the non-treated group was 42, 500/mm3. Among the 861 cases who were followed up over 6 months, 315 cases (36.6%) progressed into chronic ITP. Associated with this high rate of chronicity of childhood acute ITP patients in Korea, we must consider the fact that acute ITP patients with fast improvement in the first episode tend not to follow up. Considering that fact, the rate of chronicity becomes 17.2% of the 1, 829 acute ITP patients. The treated group used many kinds of treatment methods. Intravenous immunoglobulins (IVIG) with or without prednisolone (PD) (67.5%) were the most commonly used regimens. In the group treated with IVIG alone, the platelet count began to rise above 50, 000/mm3 at 2.6 days, 100, 000/mm3 at 3.7 days and 150, 000/mm3 at 4.9 days. Four hundred and twenty two cases of the 1, 686 (25.0%) cases followed up after first episode of ITP relapsed. The relapse rate was significantly higher in older patients and in girls than in younger patients and in boys (P< 0.05). The chronicity of ITP statistically increased with age (P< 0.05) and that was the only valuable factor. CONCLUSION: Despite the fact that childhood acute ITP is a pretty common disaese, there is no agreement on the best treatment method for this disease. The establishment of Korean treatment guideline of childhood acute ITP, based on an analysis of multicenters, seems to be needed.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Immunoglobulins, Intravenous ; Korea* ; Male ; Natural History ; Platelet Count ; Prednisolone ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies

BACKGROUND: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. MATERIALS AND METHODS: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. RESULTS: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
Classification ; Humans ; Knee Joint ; Soft Tissue Injuries ; Tibia

PURPOSE: We performed this study to evaluate the value as early markers predicting the acute rejection and differential diagnosis with other causes of renal dysfunction. METHODS: Immunohistochemical stains for HLA-DR, ICAM-1, IL-2 and IL-4 were performed on 44 cases of implantation biopsies which were divided into cases with acute rejection (R group, 14 cases) and cases without rejection episode (N group, 30 cases), and 45 gun biopsies for renal dysfunction which divided into cases diagnosed as rejection (A group, 28 cases) and cases diagnosed as other causes rather than rejection (B group, 17 cases). We analysed immunohistochemical results, various clinical datas such as age and sex of donor, living or cadaveric status of donor, the mean number of HLA-DR mismatch, age and sex of patient, serum creatinine level at post op 2 day for implantation biopsy and at the day on biopsy for renal dysfunction between above groups. RESULTS: 1) In 44 cases of implantation biopsies, positive immunohistochemical stains for HLA-DR were more frequent in R goup (71.43%) than in N group (26.66%). There was no significant difference of clinical datas and immunohistochemical stains for ICAM-1, IL-2 and IL-4. 2) In 45 cases of gun biopsies for renal dysfunction, immunohistochemical stains for HLA-DR were all positive in A group (100%) with higher rate of 3 stains (39.28%) than B group (positive; 70.58%, 3 ; 5.88%). Immunohistochmical stains for ICAM-1 were more frequently expressed in A group (100%) than B group (76.47%). Both stains revealed no significant difference according to the grades of rejection, disease other than rejection. There was no significant diffrence of immunohistochemical stains for IL-2 and IL-4, and clinical datas between two groups. CONCLUSION: We can conclude that the immunohistochemical stains for HLA-DR on implantation biopsies may predict the devepoment of the acute rejection and the immunohistochemical stains for HLA-DR and ICAM-1 on gun biopsies at the time of renal dysfunction may differentiate the reje.
Biopsy* ; Cadaver ; Coloring Agents ; Creatinine ; Diagnosis, Differential ; HLA-DR Antigens* ; Humans ; Intercellular Adhesion Molecule-1* ; Interleukin-2* ; Interleukin-4* ; Kidney Transplantation ; Living Donors ; Tissue Donors

BACKGROUND: If started with segmental block, epidural anesthesia appears to have an inadequate sacral block in the early part of cesarean deliveries. A dural puncture using the combined spinal-epidural technique making an early sacral blockade might be a solution. METHODS: A prospective, randomized, double-blinded study was performed on forty patients who were divided into two groups (C, DP; n = 20, each). An epidural infusion of 25 ml of 2% lidocaine with epinephrine was given to the group C. A dural puncture with a 27G Whitacre needle was done before the epidural infusion in the group DP. Two-way sensory levels were checked for 15 min, just before the operation. The side effects and recovery variables were also compared between the groups. RESULTS: Initial wider cephalic block (P = 0.038, 0 min) followed by more caudal block (P = 0.023, 0.013; 5, 10 min after the completion of the epidural infusion, respectively) occurred in the DP group. After 10 min, there were no differences in both block levels. The number of dermatomes blocked was bigger in the DP group at 10 min after. Fewer patients in the DP group had nausea and/or vomiting (P = 0.044). CONCLUSIONS: Early spread of the sensory blockade, initial cephalic and then caudal, was due to the dural puncture by a 27G needle. This fast onset could make the parturients more comfortable in the early part of cesarean sections.
Anesthesia, Epidural* ; Cesarean Section* ; Epinephrine ; Female ; Humans ; Lidocaine ; Nausea ; Needles* ; Pregnancy ; Prospective Studies ; Punctures* ; Vomiting

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of: 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.
Disease Management ; House Calls ; Interviews as Topic ; Life Style ; Nursing ; Qualitative Research ; Self Care