Diffuse alopecia due to occult syringoma of the scalp has rarely been reported but the authors of the cases presented different opinions about which one is the primary event between the two conditions and if the syringoma is true or a reactive ductal proliferation. We have found a case whose diffuse alopecia is believed to be due to true syringoma of the scalp. A 43-year old woman showed simultaneous and gradual development of diffuse alopecia and multiple papular elevations on the face and neck adjoining the frontal and temporal hair lines. Histopathology of the scalp and the facial papular elevations all revealed typical syringomatous infiltrations with epithelial comma-tails and sclerotic stroma. All of the clinicopathological findings supported that the diffuse alopecia of the patient was due to the occult syringoma of the scalp.
Adult ; Alopecia* ; Female ; Hair ; Humans ; Neck ; Scalp ; Syringoma*

A nine year old boy presented asymptomatic multiple papular lesions for 6 months. Biopsy revealed typical features of xanthogranuloma with Touton type giant cells. Authors observed natural course of the lesions for about 2 years thereafter, which showed shrinkage of the existing papules in general in spite of newly appearing lesions. Review of the previous cases reported by the name of juvenile xanthogranuloma showed that the age of the onset of the most of the cases with multiple lesions was before one year after birth, but adolescent cases were rare. It was also noted that previous cases with such multiple lesions had a course of spontaneous regression regardless of the onset of its age.
Adolescent* ; Biopsy ; Giant Cells ; Humans ; Male ; Parturition ; Xanthogranuloma, Juvenile

STUDY DESIGN: Retrospective cohort study. PURPOSE: To evaluate the incidence and risk factors for early adjacent vertebral fractures following balloon kyphoplasty (KP). OVERVIEW OF LITERATURE: KP is a safe and effective treatment for pain alleviation in patients with osteoporotic vertebral compression fractures (OVCF). However, some studies have reported that the risk of newly developed fractures increases at the adjacent vertebra after KP. METHODS: Total 123 consecutive patients with painful OVCF who underwent KP were enrolled from January 2009 to June 2016. Early adjacent vertebral fractures were defined as new fractures that had developed within 3 months after surgery. Sex, age, body mass index (BMI), bone mineral density (BMD), vertebral height, kyphotic angle, Visual Analog Scale score, cement amount, and leakage were evaluated as risk factors for adjacent vertebral fractures. Only cement leakage into the disc space was included in this study. RESULTS: Early adjacent vertebral fractures were identified in 20 (16.2%) of the 123 patients. The mean time to diagnosis of fractures was 1.7±0.7 months after KP. The average patient age was 78.0±0.7 years, average BMI was 23.06±3.83 kg/m², and mean BMD was −3.61±1.22 g/m². Cement leakage was present in 16 patients, and fractures developed in 11 (68.7%). In contrast, fractures developed in nine patients (8.2%) without cement leakage. There were no significant differences in terms of age, BMI, BMD, kyphotic angle, or vertebral body height ratio between the fracture and control groups. CONCLUSIONS: Cement leakage into the disc increased the risk of early adjacent vertebral fractures after balloon KP.
Body Height ; Body Mass Index ; Bone Density ; Cohort Studies ; Diagnosis ; Fractures, Compression ; Humans ; Incidence ; Kyphoplasty ; Retrospective Studies ; Risk Factors ; Spine ; Visual Analog Scale

Sebaceous trichofolliculoma, which is a variant of trichofolliculoma, is a rare disease that clinically show a centrally depressed lesion usually singly on the nose, and histologically a centrally located cavity, lined by squamous epithelium, with numerous sebaceous lobules connected to them. We describe a case of sebaceous trichofolliculoma in a 27-year-old woman who had several brown papules on the nose. We think that this is the first report of sebaceous trichofolliculloma in Korean literature.
Adult ; Epithelium ; Female ; Humans ; Nose ; Rare Diseases

BACKGROUND: The authors hypothesized that the continuous infusion of ramosetron 0.15 mg following a 0.15 mg bolus administration would maintain higher 5-hydroxytryptamine type 3 receptor occupancy levels and be more effective in preventing postoperative nausea and vomiting (PONV) than a 0.3 mg single bolus administration. We conducted a study to compare the efficacy of single bolus ramosetron administration with the combination of continuous infusion following intravenous bolus administration for PONV prophylaxis. METHODS: One hundred and fifty female patients undergoing thyroidectomy were allocated randomly to one of three groups to receive a placebo (Group 1, n = 49), 0.3 mg of IV ramosetron (Group 2, n = 53), or the continuous infusion of 0.15 mg ramosetron following a bolus administration of 0.15 mg of ramosetron (Group 3, n = 48). Anesthesia was maintained with sevoflurane and N2O. The incidence of PONV, nausea severity, and use of rescue antiemetics during the postoperative 24 hours were recorded. RESULTS: Group 1 showed higher incidences of PONV during the postoperative 24 hour than Group 2 (81% vs. 58%, P = 0.02) and Group 3 (81% vs. 48%, P < 0.01), but there was no difference between Groups 2 and 3 (P = 0.39). The use of rescue antiemetics was significantly lower in Groups 2 and 3 than Group 1 during the postoperative 6 to 24 hours. CONCLUSIONS: There were no significant differences of incidence and severity of PONV between ramosetron 0.3 mg single bolus administration and the combination of ramosetron infusion after 0.15 mg bolus administration.
Analgesia, Patient-Controlled ; Anesthesia ; Antiemetics* ; Female ; Humans ; Incidence ; Morphine ; Nausea ; Postoperative Nausea and Vomiting ; Serotonin ; Thyroidectomy

Purpose: Following the outbreak and global spread of the coronavirus disease 2019 (COVID-19), an increasing number of people have turned to cycling. This study aims to investigate the epidemiology of bicycle-related injuries before and after the emergence of the COVID-19. Methods: In this retrospective study, we collected medical records of those patients who visited the emergency room for orthopedic injuries related to bicycle accidents. The “COVID-19 period” consisted of the patients identified from April 1 to November 31 in the year 2020, while the “pre-COVID-19 period” consisted of those identified during the same months of the year 2019. Results: A total of 519 patients were identified. The bicycle-related injuries increased by 5.1% during the COVID-19, in comparison to the pre-COVID-19 period. Among these, 76.3% were men. The highest incidence of the injuries was seen for 10– 19 years of age during the pre-COVID-19, and for 50– 59 years of age during the COVID-19 period. Overall, upper limb injuries were the commonest, consisting of 32.2% of all injuries. The shoulder injuries were the commonest in the pre-COVID-19, while the knee injuries were the commonest in the COVID-19 period. Assessing the severity of the injuries, contusion (81.8%) was the commonest. Of the injuries requiring hospital admissions, hip injuries had the highest incidence at 76.5%. Conclusion During the COVID-19, the total number of bicycle-related injuries did not increase significantly. In the bicycle-related injuries, the middle-age group had the highest proportion during the COVID-19 period. More efficient prevention strategies for middle-aged riders are necessary.

Purpose: Following the outbreak and global spread of the coronavirus disease 2019 (COVID-19), an increasing number of people have turned to cycling. This study aims to investigate the epidemiology of bicycle-related injuries before and after the emergence of the COVID-19. Methods: In this retrospective study, we collected medical records of those patients who visited the emergency room for orthopedic injuries related to bicycle accidents. The “COVID-19 period” consisted of the patients identified from April 1 to November 31 in the year 2020, while the “pre-COVID-19 period” consisted of those identified during the same months of the year 2019. Results: A total of 519 patients were identified. The bicycle-related injuries increased by 5.1% during the COVID-19, in comparison to the pre-COVID-19 period. Among these, 76.3% were men. The highest incidence of the injuries was seen for 10– 19 years of age during the pre-COVID-19, and for 50– 59 years of age during the COVID-19 period. Overall, upper limb injuries were the commonest, consisting of 32.2% of all injuries. The shoulder injuries were the commonest in the pre-COVID-19, while the knee injuries were the commonest in the COVID-19 period. Assessing the severity of the injuries, contusion (81.8%) was the commonest. Of the injuries requiring hospital admissions, hip injuries had the highest incidence at 76.5%. Conclusion During the COVID-19, the total number of bicycle-related injuries did not increase significantly. In the bicycle-related injuries, the middle-age group had the highest proportion during the COVID-19 period. More efficient prevention strategies for middle-aged riders are necessary.

BACKGROUND: Hepatocellular carcinoma remains a highly chemoresistant neoplasm and is a common malignancy with poor prognosis in Korea. We performed a phase II study to evaluate the efficacy and toxicities of topotecan and cisplatin combination chemotherapy for advanced hepatocellular carcinoma. METHODS: Between November 1999 and May 2001, ten patients with histologically proven hepatocellular carcinoma were enrolled in this study. The median age was 54 (range: 53~74) years and all were male. Six patients demonstrated stage IV, 1 stage IIIC, 2 stage IIIB and 1 stage IIIA. Six patients showed a ECOG performance status of 1. The treatment regimen consisted of topotecan 1.25 mg/m2 and cisplatin 20 mg/m2 for 5 days. The treatment was repeated every 4 weeks. Toxicities were evaluated according to WHO toxicity criteria. RESULTS: All ten patients were evaluable for response and toxicity. There was only one patient who achieved partial response. The overall response rate was 10% (95% C.I.) and the response duration was 46 weeks. The median survival of all patients was 21 (range: 17~54+) weeks. During a total of 24 cycles, neutropenia of WHO grade 3 and 4 occurred in 33%, thrombocytopenia in 33% and anemia in 21%. In non-hematologic toxicity, diarrhea and hepatoxicity of grade 3 occurred in 1 and 2 patients, respectively. But there was no treatment-related death. CONCLUSION: When used in this dose and schedule, topotecan and cisplatin combination chemotherapy does not seem to be effective for patients with advanced hepatocellular carcinoma.
Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Hepatocellular/*drug therapy ; Cisplatin/*administration & dosage ; Human ; Liver Neoplasms/*drug therapy ; Male ; Middle Aged ; Topotecan/*administration & dosage ; Treatment Outcome

Klinefelter's syndrome (KFS) is a gonosomal aberration disease that occurs in males, and is characterized by 47, XXY karyotype, hypogonadism and a lack of secondary sexual characteristics. A potential link between this hormonally deficient syndrome and autoimmune disease, particularly systemic lupus erythematosus (SLE), has been reported. On the other hand, KFS is rarely reported to be accompanied by rheumatoid arthritis (RA), and there are no Korean cases reported. We report the first Korean case of a KFS patient with sero-positive RA and discuss the role of the pathogenesis of RA with KFS.
Aluminum Hydroxide ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Carbonates ; Hand ; Humans ; Hypogonadism ; Karyotype ; Klinefelter Syndrome ; Lupus Erythematosus, Systemic ; Male ; X Chromosome

College of Medicine, Ulsan University, Seoul, Korea The vascular rings comprise less than 1% of congenital cardiovascular malformations and can be overlooked because they are rare diseases and show nonspecific respiratory symptoms such as wheezing or airway obstruction or apnea. This case is a 2-months old infant who had been repaired patch closure due to ventricular septal defect, but failed to wean from ventilator. Chest CT showed right main stem bronchus lying between right pulmonary arery and right descending aorta, bronchoscopy showed right main bronchus was compressed by extrinsic pulsating mass which were descending aorta and Kommerell's diverticulum . After aortopexy and transfer of subclavian artery, this patient was able to be extubated and is now free of respiratory symptoms. When there is failure to weaning of ventilator and persistent bronchial obstruction and emphysema, we should have more vigorous effort to seek the cause of bronchial obstruction, using bronchoscope and chest CT.
Airway Obstruction ; Aorta, Thoracic* ; Apnea ; Bronchi ; Bronchoscopes ; Bronchoscopy ; Deception ; Diverticulum* ; Emphysema ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Korea ; Rare Diseases ; Respiratory Sounds ; Seoul ; Subclavian Artery ; Tomography, X-Ray Computed ; Ulsan ; Ventilators, Mechanical ; Weaning