Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes

PURPOSE: To evaluate the clinical features of retinopathy in chronic hepatitis B patients treated with peginterferon. METHODS: Chronic hepatitis B patients treated with peginterferon were evaluated during regular routine ophthalmic examinations including fundus examination before and during the 1-year follow-up after treatment. A total of 88 patients were included in the study. RESULTS: Retinopathy developed in 11 (12.5%) out of 88 patients at a mean of 7 weeks after initiation of treatment. Peginterferon treatment was continued in all patients and retinal abnormalities including cotton wool spot, retinal hemorrhage and microaneurysm resolved without visual impairment. The incidence of hypertension between the retinopathy group and the group without retinopathy was significantly different (P = 0.020). CONCLUSIONS: The incidence of retinopathy with peginterferon in chronic hepatitis B patients was low and the prognosis was benign. Thus, routine screening for peginterferon retinopathy is not necessary.
Follow-Up Studies ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hypertension ; Incidence ; Mass Screening ; Prognosis ; Retinal Hemorrhage ; Retinaldehyde ; Vision Disorders ; Wool

We experienced a case of aeute cerebral infaretion after operation. A 74 year old female patient slipped down and received left femoral neck fracture. Preoperatively, orthopedist, internist and anesthesiologist visited and evaluated her but could not find any suspicious symptoms related to cerebral infarction. She have suffered from hypertension and diabetes mellitus for 1Q yrs. She underwent bipolar endoprosthesis under general anesthesia. Postoperatively, she became deep drowsy and revealed respiratory depression, abnormal neurological sign and was diagnosed as acute cerebral infartion on cranial computed tomography and ultimately expired.
Aged ; Anesthesia, General* ; Cerebral Infarction* ; Diabetes Mellitus ; Female ; Femoral Neck Fractures ; Humans ; Hypertension ; Respiratory Insufficiency

PURPOSE: To report a case of lacrimal gland stone initiated by an eyelash. CASE SUMMARY: A 31-year-old woman presented with foreign body sensation, pain, and conjunctival injection in the lateral palpebral conjunctiva of her right eye over 6 months in duration. The physical examination revealed a small, firm nodule at the lateral canthal area. The excisional biopsy was performed, and the mass was a concretion that contained an eyelash in the center. During one-year follow-up, the patient showed no signs of recurrence or complication after excision. CONCLUSIONS: Although rare in occurence, eyelashes may be the initial nidus for lacrimal gland stone formation.
Adult ; Biopsy ; Conjunctiva ; Eye ; Eyelashes ; Female ; Follow-Up Studies ; Foreign Bodies ; Humans ; Lacrimal Apparatus ; Physical Examination ; Recurrence ; Sensation

This report concerns an unusual case of acute postoperative pulmonary edema without any apparent causes in a 45-year-old man. The patient was subjected to the removal of a previously placed device on the left tibia, and the excision of a benign mass on the right forearm. Unexpected acute bilateral pulmonary edema occurred immediately after the completion of the procedures. The etiologies were reviewed in relation to the patient's condition and clinical manifestations. Fluid overloading was excluded as a cause in view of the patient's perioperative state and postoperative chest X-ray results. We could not find any symptoms of upper airway obstruction during emergence from general anesthesia. We had doubts about tourniquet or fentanyl-induced pulmonary edema, but these factors were not sufficient to bring about pulmonary edema in this case. To our knowledge, the cause of acute pulmonary edema in this case is indeterminate.
Airway Obstruction ; Anesthesia, General ; Forearm ; Humans ; Middle Aged ; Pulmonary Edema* ; Thorax ; Tibia ; Tourniquets

OBJECTIVE: To find the incidence of hip subluxation according to corrected chronologic age (CCA), neuromotor type, severity and motor quotient in cerebral palsy (CP). METHOD: We reviewed clinical records and radiological findings of CP visited our hospital between June 1999 and June 2003. One hundred ninety-six children with CP (mean CCA: 19.0+/-13.9 months) were evaluated by measurement of the migration index, acetabular index, central edge angle and neck shaft angle from pelvic X-ray. The hip subluxation was defined as above 33% on the migration index. RESULTS: Among the 311 hips, 35 hips (11.3%) were subluxated and none was dislocated. The incidence of hip subluxation in CP was not significantly different in neuromotor type, severity, type by involvement of extremity and motor quotient, but statistically different in 25~36 month old group in comparison with the other age groups (p<0.05). CONCLUSION: The hip subluxation in CP may occur irrespective of neuromotor type, severity, type by involvement of extremities and motor quotient. Therefore, it is recommended to perform routine screening and follow-up examination of pelvic x-ray in CP to find out hip subluxation.
Acetabulum ; Cerebral Palsy* ; Child ; Extremities ; Follow-Up Studies ; Hip* ; Humans ; Incidence ; Mass Screening ; Neck

PURPOSE: The aim of this study was to investigate the changing pattern in the use of intravenous pyelogram (IVP), conventional computed tomography (CT), and non-contrast-enhanced computed tomography (NECT) for evaluation of patients with acute flank pain. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,180 patients with acute flank pain who had visited Bundang Jesaeng General Hospital between January 2008 and December 2012 and analyzed the use of IVP, conventional CT, and NECT for these patients. RESULTS: During the study period there was a significant increase in NECT use (p<0.001) and a significant decrease in IVP use (p<0.001). Conventional CT use was also increased significantly (p=0.001). During this time the proportion of patients with acute flank pain who were diagnosed with urinary calculi did not change significantly (p=0.971). CONCLUSIONS: There was a great shift in the use of imaging study from IVP to NECT between 2008 and 2012 for patients with acute flank pain.
Flank Pain ; Hospitals, General ; Humans ; Medical Records ; Retrospective Studies ; Urinary Calculi*

Purpose: Current faculty development (FD) programs are mostly limited to medical education and often lack a comprehensive and systematic structure. Therefore, the present study aimed to explore the current status and needs of FD programs in medical schools to provide a basis for establishing FD strategies. Methods: We conducted an online survey of medical school FD staff and professors regarding FD. Frequency, regression, and qualitative content analyses were conducted. FD programs were categorized into the classification frameworks. Results: A total of 17 FD staff and 256 professors at 37 medical schools participated. There are gaps between the internal and external FD programs offered by medical schools and their needs, and there are gaps between the programs the professors participated in and their needs. Recent internal and external FD programs in medical schools have focused on educational methods, student assessment, and education in general. Medical schools have a high need for leadership and self-development, and student assessment. Furthermore, professors have a high need for leadership and self-development, and research. The number of participants, topics, and needs of FD programs varied depending on the characteristics of individual professors. Conclusion Medical schools should expand their FD programs to meet the needs of individuals and the changing demands of modern medical education. The focus should be on comprehensive and responsive programs that cover various topics, levels, and methods. Tailored programs that consider professors’ professional roles, career stages, and personal interests are essential for effective FD.

Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of early infancy, and is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Serum zinc levels are usually low in untreated patients and the oral administration of zinc sulfate can clear skin lesions and other symptoms. Although premature and cow`s milk-fed infants are at particular risk of developing AE, there have been a few reports about AE in term and breast-fed infants. We report a case of transient AE in a 4-month-old breast-fed infant. This patient suffered from diarrhea and dermatitis for more than a month. Her skin lesions were erythematous, scaly, crusted, psoriasiform, eczematous, with an eruption at the chin, and a periorificial disposition with involvement of the flexural areas of lower extremities. Her serum zinc level was almost normal at 129 microgram/dL (reference range: 60-121 microgram/dL), but the zinc level in her hair was low: 8 mg percent (reference range: 10-21 mg percent). Skin biopsy findings were consistent with AE. Seven days after zinc supplementation, the skin lesions and diarrhea improved. The authors recommend that a clinical trial of zinc supplementation be considered in cases where there are suspicious of AE, even when the serum zinc level is normal.
Acrodermatitis* ; Administration, Oral ; Alopecia ; Biopsy ; Chin ; Dermatitis ; Diarrhea ; Hair* ; Humans ; Infant ; Lower Extremity ; Skin ; Zinc Sulfate ; Zinc*

In children presenting to hospital with gastrointestinal symptoms, diseases such as intussusception and acute appendicitis require particular attention and careful examination. Early diagnosis and proper treatment are important because of possible severe complications such as peritonitis and death. Intussusception and appendicitis share similar clinical manifestations. More importantly, the presence of acute appendicitis together with intussusception in children is very rare. We describe an interesting case of a 38-month-old boy who presented with abdominal pain in the right lower quadrant. His vital signs were stable and laboratory test findings showed no specific alterations. We detected tenderness in the right lower quadrant. A computed tomography scan showed an ileocolic intussusception with no strangulation and diffuse wall thickening of the appendix trapped within the intussusception. The patient underwent an appendectomy and manual reduction.
Abdominal Pain ; Appendectomy ; Appendicitis* ; Appendix ; Child ; Child, Preschool ; Early Diagnosis ; Humans ; Intussusception* ; Male ; Peritonitis ; Vital Signs