Microsportcm gypseum is a geophilic fungi abundant in soil throughout the world. The infections may occur either from animal to man(zoophilic) or from soil to man (geophilic). Patierit of 13-year-old Korean male sought medical attention with skin lesion on scalp which showed scaly patch with broken hairs and a round pilar cyst like nodule. Identification of Microsporum gypseum was made by culture on Sabouraud agar media and microscopic exarnination.
Adolescent ; Agar ; Animals ; Epidermal Cyst ; Fungi ; Hair ; Humans ; Male ; Microsporum* ; Scalp ; Skin ; Soil ; Tinea Capitis* ; Tinea*

PURPOSE: To report a case of a macular hole resulting from accidental exposure to tattoo removal by the Q-Switched Nd:YAG laser, which was treated successfully by vitrectomy and silicone oil infusion. CASE SUMMARY: A 33-year-old man presented with decreased visual acuity after accidental exposure to a Q-Switched Nd:YAG laser. According to fundus examination, vitreous hemorrhage and macular edema were observed. After 21 days, a macular hole had developed which was treated by standard pars plana vitrectomy and gas tamponade. Unfortunately, closure was not obtained on the first attempt. Therefore, a second attempt using silicone oil infusion was performed. Four months after the initial visit, BCVA had increased to 20/50, and anatomical occlusion was achieved. CONCLUSIONS: The authors of the present study experienced an unusual case of macular hole developed from the Q-Switched Nd:YAG laser used to remove a tattoo. A satisfactory visual acuity was achieved after silicone oil infusion despite failure in the first surgery.
Adult ; Humans ; Macular Edema ; Retinal Perforations ; Silicone Oils ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

The synovial cyst of the spine may be caused by degenerative changes or instability of the spine. The most common site of spinal synovial cyst is the lumbar spine. If conservative management is failed, the operation must be considered. So far, microscopic cyst removal has been considered a treatment of choice. Recently, biportal endoscopic surgery is now becoming increasingly common in spine surgery and has the advantage of minimizing damage to related structures such as muscle, bone, and nerve. There was a case in which the synovial cyst of the L4–5 level was successfully removed through a biportal endoscopic surgery, so we would like to report it with a literature review.

Extraadrenal pheochromocytomas developed from the paraganglia other than adrenal medulla are uncommon tumors. Such lesions have been reported that as much as 10% of retroperitoneal paragliomas arise outside the adrenal gland. But their incidence and prognosis are changing partly as a result of progression in developmental mechanism, diagnostic tools and concepts including ultrastructure, immunohistochemistry. The ultrastructure of chromaffine neoplasm from adrenal and extraadrenal tissues has been studied with chrarnaffine granule specificity and type of catecholamine content. With rare exceptions, extraadrenal chrornaffine tumor mainly has high concentration of norepinephrine which is suggested as dict relationship to numoruos electrone dense granular bodies in the cell cytoplasrn. High or intermediate level of epinephrine in tissue is associated with cytoplasmic granular bodies of much less density, Recently we experienced the exception, a case of norepinephrine secreting pheochrom-ocytoma in the organ of Zuckerkandl with epinephrine granules in cytoplasm and this discrepancy probably due to the plasticity
Adrenal Glands ; Adrenal Medulla ; Cytoplasm ; Epinephrine ; Immunohistochemistry ; Incidence ; Norepinephrine ; Para-Aortic Bodies ; Pheochromocytoma ; Plastics ; Prognosis ; Sensitivity and Specificity

Esophageal duplication cyst is a rare congenital gastrointestinal malformation. It is the second most common duplication cyst following small bowel duplication cyst in the gastrointestinal tract. Patients with an esophageal duplication cyst are generally asymptomatic; however, some patients may present the following symptoms: dysphagia, chest pain, stridor, unproductive cough, and epigastric discomfort by compression of the surrounding structures. Surgical removal is the treatment of choice in symptomatic cases and can be considered in asymptomatic cases if they are at risk for developing complications, such as ulceration or perforation. Herein, we report a case of hemorrhage of an esophageal duplication cyst, which was improved by endoscopic drainage.
Chest Pain ; Cough ; Deglutition Disorders ; Drainage* ; Endosonography ; Esophagus ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Respiratory Sounds ; Ulcer

OBJECTIVE: Unruptured intracranial aneurysms are now being detected with increasing frequency in clinical practice. Results of the largest studies, including those of the International Study of Unruptured Intracranial Aneurysms, indicate that surgical and endovascular treatments are rarely justified in small aneurysms. However, we have encountered several cases of rupture of small and very small aneurysms in our clinical practice. This retrospective study analyzed the incidence and clinical characteristics of very small ruptured aneurysms. MATERIALS AND METHODS: A total of 200 patients with aneurysmal subarachnoid hemorrhage between January 2012 and December 2014 were reviewed. Various factors were analyzed, including the aneurysm location and size as well as the associated risk factors. RESULTS: The mean age of patients was 56.31 +/- 13.78 (range, 25-89) years, and the male to female ratio was 1:2.1. There were 94 (47%) small-sized (< 5 mm), 91 (45.5%) medium-sized (5-9.9 mm), and 15 large-sized (> 10 mm) aneurysms. Of these, 30 (15%) aneurysms were very small-sized (< 3 mm). The most frequent site of aneurysms was the anterior communicating artery (ACoA). However, the proportion of aneurysms at the ACoA was significantly high in very small aneurysms (53.3%, p = 0.013). Hypertension was a significant risk factor for rupture of very small aneurysms (p < 0.001). CONCLUSION: About half of our cases of ruptured aneurysms involved the rupture of small and very small aneurysms. The most common site of rupture of very small aneurysm was the ACoA. Rupture of small and very small aneurysms is unpredictable, and treatment may be considered in selected high-risk patients according to factors such as young age, ACoA location, and hypertension.
Aneurysm ; Aneurysm, Ruptured ; Arteries ; Female ; Humans ; Hypertension ; Incidence* ; Intracranial Aneurysm* ; Male ; Retrospective Studies ; Risk Factors ; Rupture* ; Subarachnoid Hemorrhage

OBJECTIVES: To report upon a case of toxic hepatitis in a worker exposed to chloroform. METHODS: A 28-year-old female who had worked as chemical analysis engineer in a laboratory using chloroform was hospitalized due to nausea, vomiting and generalized weakness. The authors evaluated her using blood tests, abdominal CT scan and her occupational history. RESULTS: The blood tests revealed acute toxic hepatitis. Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis could be excluded. But autoimmune hepatitis couldn't be totally ruled out(ANA (++), IgG(serum) 1780 mg/dL). After admission, her symptoms improved and her liver enzyme levels(AST and ALT) were markedly reduced. She returned to her workplace after discharge. Afterwards, however, her liver enzyme levels increased again one week after returning to her workplace. Subsequent to a job change, her liver enzyme levels reduced and normalized after eight weeks. The airbone laboratory chloroform ranged from 3.155 to 9.037 ppm. CONCLUSIONS: The authors presume that this patient's liver injury was related to an interaction of chloroform toxicity and a predisposition to autoimmune hepatitis. The rapid improvement of the clinical symptoms and the progressive normalization of the liver function tests once the chloroform exposure eliminated supports the diagnosis.
Adult ; Chloroform ; Drug-Induced Liver Injury ; Female ; Hematologic Tests ; Hepatitis ; Hepatitis, Alcoholic ; Hepatitis, Autoimmune ; Humans ; Liver ; Liver Function Tests ; Nausea ; Vomiting

BACKGROUND: Hepatitis C virus(HCV), a family of Flaviviridae, has a host cell-derived envelope containing a positive-stranded RNA genome, and has been known as the maj or etiological agent for chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. There remains a need to dissect a molecular mechanism of pathogenesis for the development of therapeutic and effective preventive measure for HCV. Identification of cellular receptor is of central importance not only to understand the viral pathogenesis, but also to exploit strategies for prevention of HCV. This study was aimed at identifying peptide mimotopes inhibiting the binding of E2 protein of HCV to MOLT-4 cell . METHODS: In this study, phage peptide library displaying a random peptides consisting of 7 or 12 random peptides was employed in order to pan against E2 protein. Free HCV particles were separated from the immune complex forms by immunoprecipitation using anti-human IgG antibody, and used for HCV-capture ELISA. To identify the peptides inhibiting E2-binding to MOLT-4 cells, E2 protein was subj ect to bind to MOLT-4 cells under the competition with phage peptides. RESULTS: Several phage peptides were selected for their specific binding to E2 protein, which showed the conserved sequence of SHFWRAP from 3 different peptide sequences. They were also able to recognize the HCV particles in the sera of HCV patient s captured by monoclonal antibody against E2 protein. Two of them, showing peptide sequence of HLGPWMSHWFQR and WAPPLERSSLFY respectively, were revealed to inhibit the binding of E2 protein to MOLT-4 cell efficiently in dose dependent mode. However, few membrane-associated receptor candidates were seen using Fasta3 programe for homology search with these peptides. CONCLUSION: Phage peptides containing HLGPWMSHWFQR and WAPPLERSSLFY respectively, showed the inhibition of E2-binding to MOLT-4 cells. However, they did not reveal any homologues to cellular receptors from GenBank database. In further study, cellular receptor could be identified through the screening of cDNA library from MOLT-4 or hepatocytes using antibodies against these peptide mimotopes.
Antibodies ; Antigen-Antibody Complex ; Bacteriophages ; Carcinoma, Hepatocellular ; Conserved Sequence ; Databases, Nucleic Acid ; Enzyme-Linked Immunosorbent Assay ; Flaviviridae ; Gene Library ; Genome ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Hepatocytes ; Humans ; Immunoglobulin G ; Immunoprecipitation ; Liver Cirrhosis ; Mass Screening ; Peptide Library* ; Peptides ; RNA

BACKGROUND/AIMS: It has been recently reported that celiac ganglia can be identified by linear-array endoscopic ultrasonography (EUS). Still, there has been no report on the detection rate of celiac ganglia with radial scanning EUS. The aim of this study was to evaluate the detection rate of celiac ganglia by radial scanning echoendoscopy during a routine examination. METHODS: We prospectively enrolled 57 consecutive patients (23 men, 34 women; mean age 54 years, range 21-78 years) who were referred for EUS examination from September 2006 to December 2006. EUS was performed using a radial scanning echoendoscope. The size, location and EUS appearance of the celiac ganglia were recorded for each patient. RESULTS: Celiac ganglia were identified in 51 out of 57 patients (89.4%). They were identified at the left side of the celiac trunk and aorta and between the celiac artery and the left adrenal gland. They appeared as hypoechoic, oblong or lobulated structures, often with an irregular edge, and they often contained a hyperechoic focus or strand. The mean size was 18 mm by 4 mm. Structures corresponding to the visualized celiac ganglia were retrospectively identified on CT scans in 33 among the 37 patients (89.2%). CONCLUSIONS: The results of this study showed that celiac ganglia could be identified, with radial scanning EUS, in the majority of subjects.
Adult ; Aged ; Endosonography/*methods ; Female ; Ganglia, Sympathetic/radiography/*ultrasonography ; Humans ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Tomography, X-Ray Computed

An intravenous pyogenic granuloma is a rare, benign, intravascular tumor, which arises from the vein wall and protrudes into the lumen. This is characterized by a lobular proliferation of capillaries similar to the more common cutaneous pyogenic granulomas. We report a case of intravenous pyogenic granuloma which showed lobular capillary proliferation in the perivenous connective tissue.
Capillaries ; Connective Tissue ; Granuloma, Pyogenic* ; Veins