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

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

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

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/AIMS: The impact of Helicobacter pylori (H. pylori) eradication after endoscopic resection (ER) of early gastric cancer (EGC) has not been fully evaluated. We tried to find out the effect of H. pylori eradication therapy on the development of metachronous gastric cancers and changes in Cyclooxygenase-2 (COX-2) expression following attempts to eradicate H. pylori after ER of EGC. MATERIALS AND METHODS: We eradicated H. pylori in the patients with EGC after ER. Biopsy samples were taken according to the follow-up schedules for surveillance after ER. RESULTS: Fifty five patients were enrolled and finished the follow up schedules. Of the 55, 28 were successfully treated H. pylori infection, and the other 27 were failed eradication of H. pylori. The mean follow-up period was 60.8 months. Five in the H. pylori ongoing infection group developed metachronous gastric cancer, whereas no new gastric cancers were found in the 28 eradication group (P=0.023). COX-2 expression in the eradication group was significantly decreased (1.4+/-0.2, n=28), compared to that in H. pylori ongoing infection group (3.0+/-0.4, n=27, P=0.0001) after the follow-up. CONCLUSIONS: The eradication of H. pylori seems to have a preventative effect on the development of metachronous adenocarcinomas and a suppressive effect on COX-2 expression in the patients after ER for EGC.
Adenocarcinoma ; Appointments and Schedules ; Biopsy ; Cyclooxygenase 2 ; Follow-Up Studies ; Helicobacter ; Helicobacter pylori ; Humans ; Stomach Neoplasms

Endoscopic injection sclerotherapy is an effective and relatively safe modality for controlling bleeding esophageal varices. Injection of sclerosant causes acute mural thrombosis with a necroinflammatory response and subsequent sclerosis in the venous system of the distal esophagus. A few cases of mesenteric venous thrombosis with small bowel infarction after sclerotherapy have been reported, and most of which were fatal. The association between mesenteric venous thrombosis and sclerotherapy has been strongly suggested, but this still remains unproved. We report here on a case of mesenteric venous thrombosis with small bowel infarction that developed after endoscopic injection sclerotherapy.
Esophageal and Gastric Varices ; Esophagus ; Hemorrhage ; Infarction ; Sclerosis ; Sclerotherapy ; Thrombosis ; Venous Thrombosis

BACKGROUND/AIMS: Until recently, only indirect procedures were available to provide images of the small bowel. Double-balloon enteroscopy (DBE) has the ability to obtain tissue for diagnosis and endoscopic interventions. This study was designed to determine the usefulness of DBE in patients with small bowel diseases by evaluating diagnostic yields and the impact on treatment. METHODS: From November, 2004 to November, 2006 a total 81 patients with suspected small bowel disease were investigated by DBE. We analyzed the diagnostics and therapeutics rates according to the indications of DBE. RESULTS: A total of 114 DBE procedures were performed. Gastrointestinal bleeding (64.2%) was the most common indication, followed by chronic abdominal pain/diarrhea (29.6%). A diagnosis was obtained in 44 of 52 patients with gastrointestinal bleeding and 17 of 24 patients with chronic abdominal pain/diarrhea. DBE resulted in therapeutic intervention in 17 patients with gastrointestinal bleeding and 13 patients with chronic abdominal pain/ diarrhea. DBE was diagnostic in 75.3% of the patients and played a role in the subsequent treatment of 37.0% of the patients. CONCLUSIONS: DBE was a useful and safe method for diagnosis and treatments in patients with small bowel diseases.
Diarrhea ; Double-Balloon Enteroscopy ; Hemorrhage ; Humans