Background: Longitudinal melanonychia (LM) can be caused by a variety of benign and malignant conditions. Nail matrix biopsy is necessary for the diagnosis of LM; however, physicians hesitate to perform the nail matrix biopsy due to the risk of postoperative complications like permanent matrix damage. Therefore, biopsy methods that minimize the risk of postoperative complications are necessary. Objective: To investigate the efficacy and safety of the nail matrix shave biopsy using a razor blade. Methods: We reviewed the medical records, clinical photographs, and histopathologic slides of patients who underwent shave biopsy for the diagnosis of LM from January 2018 to March 2020 at Wonkwang University Hospital. Results: The entire pigmented lesion was removed completely by shaving only a partial thickness of the superficial matrix in all patients. The histopathologic diagnosis was melanocyte activation with no atypia in all cases. Eight patients were followed up for 7∼19 months. Resting pain after the shave biopsy improved in most cases (75%) within 1 week. One patient experienced numbness lasting for 3 months. Abnormal sensations, such as tingling and itching, were temporarily reported by two patients. One patient (12.5%) had temporary postoperative nail plate dystrophy, and three patients (37.5%) had recurrence of pigmentation. Conclusion Our protocol of shave biopsy showed a lower rate of postoperative nail dystrophy than the conventional shave biopsy. We suggest that the shave biopsy using a flexible stainless steel razor blade is a favorable alternative to the conventional shave biopsy.

OBJECTIVE: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. METHODS: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. RESULTS: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). CONCLUSION: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.
Cystectomy ; Embryonic Development ; Endometriosis* ; Female ; Fertilization ; Humans ; Laparoscopy ; Oocytes ; Pregnancy ; Sclerotherapy

PURPOSE: The purpose of this study was to examine the experiences of Sanhujori facility use among the first time mothers in Korea. METHODS: A qualitative study was conducted, using focus group interview. Data were collected from the 24 first time mothers of 4 focus groups, who had given birth within 6 month and had used one of the Sanhujori facilities located in C province, Korea. After obtaining written informed consent from all participants, each session of the focus group was audio-taped and transcribed into verbatim. Data were analyzed using content analysis in order to identify significant themes. RESULTS: Four major themes that emerged from the data were as follows. 1) Promoting postpartum physical recovery through a enough time with only focusing on herself, 2) Promoting postpartum psychological recovery through emotional and informational support with peer mothers, 3) Experiencing breast feeding difficulties and disappointing with unsatisfied help from health professionals, and 4) Lack of the professional education programs regarding parenting. CONCLUSION: Based on these results, it will be suggested that the various support programs by not only the peer mothers co-resided in Sanhujori facilities but also the health care professionals in the Sanhujori facilities should be developed for helping a "becoming a mother" of the first time mother in the Sanhujori facilities. In addition, qualified education and counseling program, especially for the successful breast feeding, should be provided by the health care professionals for improving mothering ability of the first time mother in the Sanhujori facilities.
Breast Feeding ; Counseling ; Delivery of Health Care ; Education ; Education, Professional ; Focus Groups* ; Health Occupations ; Humans ; Informed Consent ; Korea ; Mothers* ; Parenting ; Parents ; Parturition ; Postpartum Period ; Qualitative Research

Necrotizing fasciitis is a rare, but life-threatening infection. Prompt diagnosis and early aggressive intervention is required for survival. However, there has been frequently occurred in delays of diagnosis and treatment due to its non-specific nature. Therefore, a high index of suspicion is needed to ensure timely intervention. We report a case of necrotizing fasciitis in a 7-day-old term healthy neonate.
Dietary Sucrose ; Fasciitis, Necrotizing ; Humans ; Infant, Newborn

No abstract available.
Breast* ; Mucinoses*

Although tumor necrosis factor (TNF)-alpha antagonist is a successful treatment modality for various autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis and psoriatic arthritis, many adverse effects have been reported. Cutaneous adverse reactions of TNF-alpha antagonist include skin rash, urticaria, lupus like rash, seborrheic dermatitis and different kinds of psoriasiform dermatitis. We report a case of psoriasiform dermatitis during TNF-alpha antagonist treatment in a 50-year-old woman with RA. The patient has been treated with adalimumab. After 2 months, she developed pruritic erythematous eruption and desquamative lesions on the head and limbs, which were defined as psoriasiform change by a skin biopsy. These skin lesions are successfully treated with combination therapy, including cessation of adalimumab, corticosteroid and phototherapy.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Dermatitis ; Dermatitis, Seborrheic ; Exanthema ; Extremities ; Female ; Head ; Humans ; Middle Aged ; Phototherapy ; Skin ; Tumor Necrosis Factor-alpha ; Urticaria ; Adalimumab

OBJECTIVE: The incidence rate of stroke as a result of intracranial arterial stenosis (ICAS) is higher in Asian countries than in the West. We aimed to analyze the regression, lack of change, or progression of asymptomatic ICAS after the administration of rosuvastatin and associated factors.METHODS: The patients who had undergone computed tomography angiography (CTA) at our hospital and had been diagnosed with ICAS with no ischemic event in the stenosed vascular territory were included in the study. They were administered 20mg of rosuvastatin per day. After a follow-up period of at least 6 months after treatment, the patients were examined using CTA again and the clinical information and imaging results were analyzed.RESULTS: In total, 48 patients were diagnosed with asymptomatic ICAS. During the final follow-up examination, it was found that the stenotic lesion regressed in 30 patients, whereas it remained unchanged or progressed without any adverse effects in 18 patients. In univariate analysis, the regressed group showed significantly higher differences in the levels of total cholesterol and low-density lipoprotein (LDL) between their initial and final values (both, p=0.031 for both). In the multivariate analysis, a significantly higher difference in the levels of LDL between its initial and final measurement was seen in the regressed group (p=0.035, odds ratio(OR) 3.9).CONCLUSIONS: Rosuvastatin was found to have better lipid-lowering effects for total cholesterol and particularly LDL in patients whose ICAS had regressed. We concluded that rosuvastatin administration can be recommended for the treatment of patients with asymptomatic ICAS.
Angiography ; Asian Continental Ancestry Group ; Atherosclerosis ; Cholesterol ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Incidence ; Lipoproteins ; Multivariate Analysis ; Rosuvastatin Calcium ; Stroke

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are developmental epithelial-lined lesions which are formed from fluid accumulation in the space between the reduced enamel epithelium and the surface of crown. This may occure due to the obstructin of venous return caused by tooth impaction. The most prevalent location of dentigerous cysts are the third molar of mandible. While the single dentigerous cysts are the second most common odontogenic cysts following the radicular cysts of jaw, multiple cysts are observed in patients with some conditions such as mucopolysaccharidosis type IV, basal cell nevus syndrome, and cleidocranial dysplasia. They occur in young patients in the second or third decades of life, but it is a rare occurrence for children. A sixteen-year-old girl with painful swelling in the right mandible visited to our department. All routine laboratory test results were within normal limits. However, we were able to diagnose that she had facial asymmetry. Computed tomography showed a well-defined soft tissue mass obliterating right mandible ramus with an impacted tooth. We performed total enucleation of cyst and molar tooth. The pathology revealed a non-keratinized squamous epithelial lined cyst associated with an undamaged tooth.
Basal Cell Nevus Syndrome ; Child ; Cleidocranial Dysplasia ; Crowns ; Dental Enamel ; Dentigerous Cyst* ; Epithelium ; Facial Asymmetry ; Female ; Humans ; Jaw ; Mandible* ; Molar ; Molar, Third ; Mucopolysaccharidoses ; Odontogenic Cysts ; Pathology ; Radicular Cyst ; Tooth ; Tooth, Impacted

BACKGROUND: It has been shown that severe asthmatic attacks are related to airway hyperresponsiveness (AHR). However, there has been no study on AHR measured just after control of acute severe asthma. OBJECTIVE: To determine the degree of AHR following acute severe asthma and to evaluate the safety of AHR measurement in patients just recovering from a severe attack. METHOD: In 23 consecutive asthma patients just recovering from a severe attack (10 severe, 13 near-fatal), all medications except inhaled or systemic steroids were withdrawn temporarily for more than each action time. Then a methacholine bronchoprovocation test was performed in patients with FEV1 > or = 75% of predicted or personal best value. RESULTS: Mean duration required to control asthma was 5.6+/-3.6 days, and methacholine provo- cation test was performed at 12.6+/-5.2 hospital days. The patients showed significantly lower methacholine-PC20 (geometric mean: 0.54 vs 1.64 mg/ml, p<0.05) and steeper slope of dose-response curve (p<0.01) compared to 62 outpatients. Initial FEV1 (r=0.470, p<0.05) and the duration required to control asthma (r=-0.623, p<0.01) were significantly related to methacholine-PC20. However, only 9 patients (39.1%) showed severe AHR, which was not significantly different from outpatients (25.8%). CONCLUSION: These results suggest that AHR is a risk factor of severe asthmatic attack and methacholine challenge just after control of acute asthma is relatively safe.
Asthma* ; Humans ; Methacholine Chloride* ; Outpatients ; Risk Factors ; Steroids

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation
Airway Obstruction ; Anesthesia* ; Anesthesia, General ; Humans ; Respiration ; Ventilation*