摘要
No abstract available.
Subject(s)
Humans , Dasatinib , Drug Therapy , Hypopigmentation , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Protein-Tyrosine Kinases摘要
Apocrine hidrocystoma is a benign tumor arising from apocrine sweat gland. It presents as a solitary translucent nodule, usually on the face, head, and neck. However it is extremely rare for the apocrine hidrocystoma to arise on the extremities, and no case of apocrine hidrocystoma on lower extremity has been reported in Korean dermatologic literature. Herein, we report a case of 63-year-old male apocrine hidrocystoma that developed in ankle area with a review of the literature.
Subject(s)
Humans , Male , Middle Aged , Ankle , Extremities , Head , Hidrocystoma , Lower Extremity , Neck , Sweat Glands摘要
No abstract available.
Subject(s)
Pulmonary Aspergillosis , Tomography, X-Ray Computed , Foreign Bodies摘要
No abstract available.
摘要
A 46-year-old male presented with skin lesion on the tip of penis, occurring a month ago. Erythematous macules and grouped vesicles on the glans penis and upper side of prepuce area were noticed. In addition, scales were noticed on the tip of glans penis. The lesion was first diagnosed as herpes genitalis based on the clinical manifestation, but had failed to improve with systemic and topical antiviral and topical antibiotics. KOH examinations were performed on his upper glans penis, and we detected pseudo hyphae and spores. Fungal culture and polymerase chain reaction (PCR) study were revealed as Candida albicans. He was successfully treated with topical isoconazole cream twice a day. Candida balanitis refers to candida infections of glans penis. Infectious balanitis presented various clinical presentations, it is not easy to diagnose with clinical presentation only. Therefore, it is essential to include other examination such as KOH examination, microorganism exam, and/or biopsy in the differential diagnosis when cutaneous lesions are noticed in patients. Herein, we present a candida balanitis with atypical features that clinically mimicked herpes genitalis.
Subject(s)
Humans , Male , Middle Aged , Anti-Bacterial Agents , Balanitis , Biopsy , Candida albicans , Candida , Diagnosis, Differential , Herpes Genitalis , Hyphae , Penis , Polymerase Chain Reaction , Skin , Spores , Weights and Measures摘要
No abstract available.
Subject(s)
Aneurysm , Coronary Aneurysm , Coronary Vessels , Drug-Eluting Stents , Stents , Ultrasonography, Interventional摘要
Antiphospholipid syndrome (APS), the most common acquired hypercoagulable condition, is diagnosed by persistent presence of antiphospholipid antibodies and episodes of vascular thrombosis. It may be an important predisposing factor for stent thrombosis, resulting in poor outcomes. Also, anti-platelet therapy non-responsiveness is associated with stent thrombosis. We report a case of a 39-year-old man who after undergoing successful percutaneous coronary intervention for significant coronary artery disease suffered repeated stent thrombosis events leading to ST-segment elevation myocardial infarction. Eventually, he underwent coronary artery bypass surgery because of uncontrolled thrombosis and was diagnosed as having APS and dual antiplatelet therapy non-responsiveness.
Subject(s)
Adult , Humans , Antibodies, Antiphospholipid , Antiphospholipid Syndrome , Causality , Coronary Artery Bypass , Coronary Artery Disease , Myocardial Infarction , Percutaneous Coronary Intervention , Stents , Thrombosis摘要
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Alcoholism/complications , Endoscopy, Digestive System , Pancreatic Pseudocyst/diagnosis , Pancreatitis/diagnosis , Tomography, X-Ray Computed摘要
BACKGROUND/AIMS: Data regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in nonagenarians are very limited. The aim of the present study was to evaluate the temporal trends and in-hospital outcomes of primary PCI in nonagenarian STEMI patients. METHODS: We retrospectively reviewed data from the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to January 2008, and from the Korea Working Group on Myocardial Infarction (KorMI) from February 2008 to May 2010. RESULTS: During this period, the proportion of nonagenarians among STEMI patients more than doubled (0.59% in KAMIR vs. 1.35% in KorMI), and the rate of use of primary PCI also increased (from 62.5% in KAMIR to 81.0% in KorMI). We identified 84 eligible study patients for which the overall in-hospital mortality rate was 21.4% (25.0% in KAMIR vs. 20.3% in KorMI, p = 0.919). Multivariate analysis identified two independent predictors of in-hospital mortality, namely a final Thrombolysis in Myocardial Infarction (TIMI) flow < 3 (odds ratio [OR], 13.7; 95% confidence interval [CI], 3.2 to 59.0; p < 0.001) and cardiogenic shock during hospitalization (OR, 6.7; 95% CI, 1.5 to 30.3; p = 0.013). CONCLUSIONS: The number of nonagenarian STEMI patients who have undergone primary PCI has increased. Although a final TIMI flow < 3 and cardiogenic shock are independent predictors of in-hospital mortality, primary PCI can be performed with a high success rate and an acceptable in-hospital mortality rate.
Subject(s)
Aged, 80 and over , Female , Humans , Male , Age Factors , Chi-Square Distribution , Hospital Mortality/trends , Logistic Models , Multivariate Analysis , Myocardial Infarction/diagnosis , Odds Ratio , Percutaneous Coronary Intervention/adverse effects , Registries , Republic of Korea , Retrospective Studies , Risk Factors , Shock, Cardiogenic/etiology , Time Factors , Treatment Outcome摘要
BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is the most frequent cause of noncardiac chest pain (NCCP) in Western countries. Gastroduodenal disease has a high prevalence in Korea; thus, it is important to evaluate the stomach/duodenum. We retrospectively reviewed the findings in patients with chest pain who were diagnosed by coronary angiography (CAG) to be normal or who had minimal coronary lesions to evaluate the necessity of performing esophagogastroduodenoscopy (EGD) in patients with NCCP. METHODS: A total of 565 patients with chest pain underwent CAG followed by EGD from February 2000 to March 2011 at Konyang University Hospital. We excluded patients who underwent EGD more than 3 days after CAG or had significant coronary lesions. We retrospectively reviewed the EGD findings of the remaining 349 patients. RESULTS: Of the 349 patients, 151 were male, and the average age of the patients was 57.7+/-11.44 years. After performing EGD, GERD was diagnosed in 35 patients (10.0%; LA [Los Angeles classification]-A, 30; LA-B, three; LA-C, two) and peptic ulcer was diagnosed in 48 patients (13.8%; gastric ulcer, 34; duodenal ulcer, 10; gastric and duodenal ulcer, four). Gastritis was diagnosed in 253 patients (72.5%; erosive, 89; erythematous, 90; hemorrhagic, 10; mixed, 64). Duodenitis, esophagitis, Barrett's esophagus, hiatus hernia, and gastric cancer was diagnosed in 36 (10.3%), three (0.9%), two (0.6%), three (0.9%), and one patient, respectively. CONCLUSIONS: Unlike the situation in the west, stomach/duodenal lesions other than GERD are common causes of NCCP in Korea, Therefore, prior to proton pump inhibitor testing or empirical therapy, EGD is necessary to evaluate NCCP and to rule out gastroduodenal lesions.
Subject(s)
Humans , Male , Barrett Esophagus , Chest Pain , Coronary Angiography , Duodenal Ulcer , Duodenitis , Endoscopy , Endoscopy, Digestive System , Endoscopy, Gastrointestinal , Esophagitis , Gastritis , Gastroesophageal Reflux , Hernia, Hiatal , Korea , Peptic Ulcer , Prevalence , Proton Pumps , Retrospective Studies , Stomach Neoplasms , Stomach Ulcer , Thorax摘要
Systemic lupus erythematosus (SLE) is an autoimmune disease with various manifestations, while its autoantibodies and immune reactions involve multiple organs. Neuropsychiatric involvement in SLE is known to be common, however, peripheral neuropathy is relatively rare. Guillain-Barre syndrome is clinically defined as an acute demyelinating peripheral neuropathy causing weakness and numbness in the legs and arms. We describe a case of Guillain-Barre syndrome with antiphospholipid syndrome and lupus nephritis. The patient was admitted with fever and diarrhea. He developed progressive weakness of the upper and lower extremities and dysarthria with characteristic nerve conduction patterns compatible with Guillain-Barre syndrome. He also had proteinuria and gangrene of the hand and toe with antiphospholipid antibody. He received intravenous immunoglobulin and plasmapheresis for progressive neuropathy, intravenous high dose steroid to control activity of SLE, and anticoagulation for antiphospholipid syndrome. Neuropsychiatric manifestation of SLE is related to lupus activity closely, so it is important to control lupus activity.
Subject(s)
Humans , Antibodies, Antiphospholipid , Antiphospholipid Syndrome , Arm , Autoantibodies , Autoimmune Diseases , Diarrhea , Dysarthria , Fever , Gangrene , Guillain-Barre Syndrome , Hand , Hypesthesia , Immunoglobulins , Leg , Lower Extremity , Lupus Erythematosus, Systemic , Lupus Nephritis , Neural Conduction , Peripheral Nervous System Diseases , Plasmapheresis , Proteinuria , Toes摘要
BACKGROUND: Three-dimensional (3D) echocardiography has been reported to be valuable for evaluating the geometry of cardiac chambers. We validated the accuracy of 3D transthoracic echocardiography for quantifying aortic root geometry in comparison with cardiac multi-detector computed tomography (MDCT). METHODS: Twenty-three patients who underwent cardiac MDCT and showed normal left ventricular ejection fraction (> 55%), as assessed by 2-dimensional transthoracic echocardiography, were enrolled (12 male, mean 53 +/- 9 years). We defined the aortic root volume as the volume from the aortic annulus to the sinotubular junction. The aortic root volume at end-diastole measured by both cardiac MDCT and 3D echocardiography was assessed. RESULTS: The cross-sectional area of the aortic root was asymmetric. At the annulus level, the cross-sectional area showed asymmetric triangle. From the aortic annulus to the most dilated point of the sinus of Valsalva, the asymmetric triangular shape was maintained. From the most dilated point of the sinus of Valsalva to the sinotubular junction, the cross-sectional shape of the aortic root changed to oval. The average aortic root volumes measured by 3D echocardiography (ARV-3DE) were 13.6 +/- 4.8 mL at end-diastole and 14.1 +/- 5.3 mL at end-systole, respectively. The average aortic root volume measured by MDCT at end-diastole (ARV-CT) was 14.1 +/- 5.7 mL. At end-diastole, the ARV-3DE correlated well with the ARV-CT (R2 = 0.926, difference = 0.5 +/- 1.7 mL), and the two methods were in excellent agreement (the percent difference was 0%). CONCLUSION: Our results demonstrate both the feasibility and accuracy of 3D echocardiography for the clinical assessment of the geometry of the aortic root.
Subject(s)
Humans , Male , Echocardiography , Echocardiography, Three-Dimensional , Sinus of Valsalva , Stroke Volume摘要
Relapsing polychondritis (RP) is a rare autoimmune connective tissue disease of unclear pathogenesis and may present with the multisystem involvements and varied presentations, courses and responses to the therapy. The respiratory complaints or history such as dyspnea or snoring deserve to be in consideration, especially in the cases of no specific causes and must be ruled out the rare autoimmune airway diseases such as relapsing polychondritis, Wegener's granulomatosis, rhinoscleroma, or amyloidosis resulting in serious airway obstruction without adequate management. In this report we described a case of 15-year-old young male with the delayed diagnosis of relapsing polychondritis with intractable subglottic stenosis during the course of the management for several months despite of tonsillectomy for the relief of the airway obstruction.
Subject(s)
Adolescent , Humans , Male , Airway Obstruction , Amyloidosis , Connective Tissue Diseases , Constriction, Pathologic , Delayed Diagnosis , Dyspnea , Polychondritis, Relapsing , Rhinoscleroma , Snoring , Tonsillectomy , Granulomatosis with Polyangiitis摘要
Spastic airway disease including bronchospasm is a common perioperative event. Despite pharmacologic and mechanical approaches for prevention, we could not avoid unexpected attacks on occasion in anesthetic management, especially during airway manipulation. We report an experience of bronchospasm during transportation to the operating room in a 63-year-old female with Ambu bagging through a tracheostomy tube. We also review the potential effect of anticholinergics and airway irritation during transportation in tracheotomized or intubated patients by bagging for ventilatory support.
Subject(s)
Female , Humans , Middle Aged , Bronchial Spasm , Cholinergic Antagonists , Muscle Spasticity , Operating Rooms , Tracheostomy , Transportation摘要
Transient global amnesia is characterized by a sudden memory loss of recent and/or remote events and transient inability to acquire new knowledge. Although mostly followed by complete recovery within a day, this rare and unexpected event in recovery phase after general anesthesia should be embarrassing and confusing, so we must proceed with prompt differential diagnosis for other organic intracranial pathology including transient ischemic attack and go on close observation. We describe a case of transient global amnesia of a 66-year-old woman after general anesthesia for excision and biopsy of left neck mass.
Subject(s)
Aged , Female , Humans , Amnesia , Amnesia, Transient Global , Anesthesia, General , Biopsy , Diagnosis, Differential , Ischemic Attack, Transient , Memory Disorders , Neck摘要
Postobstructive pulmonary edema is a recognized complication of acute airway obstruction, especially after endotracheal extubation. It usually follows relief of the obstruction and is likely to be of non- cardiogenic origin. The mechanism by which an upper airway obstruction results in pulmonary edema is likely by the combination of the increased reduction of intrapulmonary pressure, increased capillary permeability and hypoxia. The application of moderate continuous positive airway pressure in conjunction with the administration of diuretics usually clears pulmonary edema in these clinical settings within 24 hours. We encountered a rare case of a 47-years-old female with a postobstructive pulmonary edema that occurred in a patient after relief of upper airway obstruction following intubation of the trachea