Neonatal lupus erytematosus is a distinct subset of lupus erythematosus. It is characterized by cutaneous findings exhibiting the morphology of subacute cutaneous lupus erythematosus, congenital heart block, and anti-Ro/SSA and/or anti-La/SSB autoantibodies which result from the transplacental passage of maternal autoantibodies. We report a case of a 12-week-old female infant who presented with characteristic clinical and histopathological features of cutaneous neonatal lupus erythematosus but without evidence of congenital heart block. Initial serological studies reveled the presence of anti-La/SSB anti-bodies and antinuclear antibodies. 5 months later, follow-up serology was negative in accordance with a clinical remission.
Antibodies, Antinuclear ; Autoantibodies ; Female ; Follow-Up Studies ; Heart Block ; Humans ; Infant ; Lupus Erythematosus, Cutaneous

BACKGROUND: Anesthesiologists should understand the physiology of intraocular pressure and the implications of anesthetic drugs and maneuvers on intraocular pressure(IOP). Although most anesthetics reduce IOP, succinylcholine causes a transient but significant increase in IOP. And thiopental by itself does not prevent to increase blood pressure, IOP. This study was designed to evaluate the preventive effect of propofol on IOP changes during tracheal intubation. METHODS: IOP was measured with a hand-held applanation tonometer in the eye. Baseline(control) IOP was measured before the induction of anesthesia(stage 1) and serial measurements of IOP were made after administration of the induction agent before intubation(stage 2), immediately after intubation(stage 3) and 10 minutes after intubation(stage 4). Heart rate and systolic blood pressure were recorded simultaneously. According to induction agent and neuromuscular blocker, the 60 patients were divided into control group(C; thiopental, succinylcholine), pretreatment group(T) using defasciculation dose of vecuronium bromide, propofol group(P; propofol, succinylcholine) and vecuronium group(V; propofol, vecuronium bromide). RESULTS: Administration of either propofol or thiopenal resulted in a significant reduction in IOP(P<0.01). At stage 2, IOP of gpoup P and V were significantly lower than that of group C(P<0.05). At stage 3, IOP increased significantly compared to the values of stage 1 in all group(P<0.01). At stage 4, IOP decreased significantly compared to the values of stage 1 in all group(P<0.01), but there was no significant difference between groups in IOP at stage 4. CONCLUSIONS: Propofol may be a useful induction agent of general anesthesia for opthalmic surgery, but cannot prevent to increase IOP during endotracheal intubation.
Anesthesia, General ; Anesthetics ; Blood Pressure ; Heart Rate ; Humans ; Intraocular Pressure* ; Intubation* ; Intubation, Intratracheal ; Neuromuscular Blockade ; Physiology ; Propofol* ; Succinylcholine ; Thiopental ; Vecuronium Bromide

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Epithelium ; Female ; Humans ; Mucous Membrane ; Papilloma* ; Vulva* ; Young Adult

Purpose: We report on the 10-year clinical hip function and radiologic outcomes of patients who underwent hip arthroplasty using a COREN stem. Materials and Methods: A consecutive series of 224 primary cementless hip arthroplasty implantations were performed using a COREN stem between 2009 and 2011; among these, evaluation of 128 hips was performed during a minimum follow-up period of 10 years. The mean age of patients was 65.4 years (range, 40-82 years) and the mean duration of follow-up was 10.8 years (range, 10-12 years). Evaluation of clinical hip function and radiologic implant outcomes was performed according to clinical score, thigh pain, and radiologic analysis. Results: Dramatic improvement of the mean Harris hip score (HHS) from 59.4 preoperatively to 93.5 was observed at the final follow-up (P≤0.01). Stable fixation was demonstrated for all implants with no change in position except for one case of Vancouver type B2 periprosthetic femur fracture. A radiolucent line (RLL) was observed in 16 hips (12.5%). Thigh pain was observed in only two hips (1.6%) at the final follow-up. There were no cases of osteolysis around the stem. The survival rate for the COREN stem was 97.7%. Conclusion Good long-term survival with excellent clinical and radiological outcomes can be achieved using the COREN femoral stem regardless of Dorr type.

Negative pressure wound therapy (NPWT) has emerged as a valuable tool for managing complex wounds within the foot and ankle field.This review article discusses the expanding applications of NPWT in this specialized field. Specifically, it discusses the efficacy of NPWT for various wound types, including diabetic foot wounds, traumatic wounds, surgical wounds, and wounds involving exposed bone or soft tissue defects. NPWT demonstrates versatile utility for foot and ankle wound management by promoting healing, potentially reducing the need for secondary surgery, improving diabetic and neuropathic ulcer healing times and outcomes, and optimizing the healing of high-risk incisions. In addition, this review explores the underlying mechanisms through which NPWT might enhance wound healing. By synthesizing current evidence, this review provides a comprehensive overview of the role of NPWT in foot and ankle surgery and offers valuable insights to clinicians navigating the complexities of wound care in this challenging anatomical area.

OBJECTIVE: We report a case with a long-standing history of the ankylosing spondylitis(AS) who showed multiple cerebellar infarctions with bulbar symptom owing to vertebral artery obstruction, due to anterior and vertical subluxation of atlanto-axial and atlanto-occipital joint. CLINICAL PRESENTARION: An 51-year-old male patient with swallowing difficulty, tongue deviation to the left side and severe nuchal pain and rigidity is presented. INTERVENTION: After removal of posterior portion of foramen magnum, posterior portion of left transverse foramen of axis was decompressed. CONCLUSIONS: Spontaneous anterior atlanto-axial subluxation occurs in patients with AS about 2% of presents with or without signs of spinal cord compression. Vertical subluxation occurs in 3-8% of patient with rheumatoid arthritis but it is an exceedingly rare complication of AS. Close observation and follow-up are needed in patients with AS and if subluxation occurs, good prognosis is anticipated using an early operative treatment.
Arthritis, Rheumatoid ; Atlanto-Occipital Joint* ; Axis, Cervical Vertebra ; Deglutition ; Follow-Up Studies ; Foramen Magnum ; Humans ; Infarction ; Male ; Middle Aged ; Prognosis ; Spinal Cord Compression ; Spondylitis, Ankylosing* ; Tongue ; Vertebral Artery*

Age-related rotator cuff tendon degeneration is related to tenofibroblast apoptosis. Anthocyanins reduce oxidative stress-induced apoptotic cell death in tenofibroblasts. The current study investigated the presence of cell protective effects in cyanidin and delphinidin, the most common aglycon forms of anthocyanins. We determined whether these anthocyanidins have antiapoptotic and antinecrotic effects in tenofibroblasts exposed to H₂O₂, and evaluated their biomolecular mechanisms. Both cyanidin and delphinidin inhibited H₂O₂-induced apoptosis in a dose-dependent manner. However, at concentrations of 100 μg/ml or greater, delphinidin showed cytotoxicity against tenofibroblasts and a decreased antinecrotic effect. Cyanidin and delphinidin both showed inhibitory effects on the H₂O₂-induced increase in intracellular ROS formation and the activation of ERK1/2 and JNK. In conclusion, both cyanidin and delphinidin have cytoprotective effects on cultured tenofibroblasts exposed to H₂O₂. These results suggest that cyanidin and delphinidin are both beneficial for the treatment of oxidative stress-mediated tenofibroblast cell death, but their working concentrations are different.
Anthocyanins ; Apoptosis ; Cell Death ; Rotator Cuff ; Tendons

A spontaneous spinal epidural hematoma (SSEH) of the thoracic spine is a rare space-occupying disease that accompanied with severe axial pain in the spine. Because there is the possibility of a significant neurological injury such as paraplegia, SSEH requires careful diagnosis and management. A SSEH is mainly caused by a coagulating disorder or anticoagulant medication, while certain cases have shown that this disease is related with spinal inflammatory conditions. A SSEH tends to occur in patients who have risk factors for hemorrhage. However, the incidence of SSEH is quite low, and there are few domestic reports of a SSEH in young adults who are without the risk factors for hemorrhage. We encountered a 25 years old young male without a prior significant medical history and he was suffering from severe back pain and paraplegia due to a SSEH at the thoracic spine. The early diagnosis was made via MRI. We report here on a favorable clinical outcome that was achieved with immediate operative treatment, and we include a review of the relevant literature.
Back Pain ; Early Diagnosis ; Hematoma, Epidural, Spinal ; Hemorrhage ; Humans ; Incidence ; Male ; Paraplegia ; Risk Factors ; Spine ; Stress, Psychological ; Young Adult

Eclampsia is defined as the occurrence of convulsions, not caused by any coincidental neurologic disease such as epilepsy, in a woman whose condition also meets the criteria for preeclampsia. Intracerebral hemorrhage with eclampsia is rare but maternal mortality is 30-40%. Fetal outcome parallels that of the mother and reflects the maternal condition as well as gestational age at delivery. With noninvasive imaging technique of CT, the early diagnosis and proper management of intracerebral hemorrhage in a patient can be achieved. The syndrome of Hemolysis, Elevated Liver enzyme, Low Platelets (HELLP) is considered to be complication of severe preeclampsia-eclampsia. We report a case of intracerebral hemorrhage and HELLP syndrome in a patient with eclampsia.
Cerebral Hemorrhage* ; Early Diagnosis ; Eclampsia* ; Epilepsy ; Female ; Gestational Age ; HELLP Syndrome* ; Hemolysis ; Humans ; Liver ; Maternal Mortality ; Mothers ; Pre-Eclampsia ; Pregnancy ; Seizures

The incidence of recurrence and anal stricture after surgical hemorrhoidectomy were reported in about 5% and 2.5~13%, respectively Generally, complete and adequate surgery for hemorrhoids was not infrequently neglected because the treatment of hemorrhoids was based on symptoms rather than pathogenesis. This study was performed to analyze the clinical features of recurrent hemorrhoids and to assess the adequate surgical management for the prevention of recurrence. From June 1989 to December 1997, we reviewed 222 (10.6%) recurrent hemorrhoids of surgically treated at Asan Medical Center. Median follow-up period was 38 months (range, 4 months~8 years 9 months). The most common symptom was prolapse (37%). Previous treatment for hemorrhoids was surgical hemouhoidectorny in 99 cases (45%) and sclerotherapy in 111 cases (50%). The most common location and associated complication of recurrent hemorrhoids were sites of major piles (83%) and anal stricture (37%), respectively. Anal stricture was more prevalent in patients with previous sclerotherapy (P<0.05). In respect to the numbers of combined surgical procedures, one procedure was more frequently performed in the non-complicated recurrent hemorrhoids group (P<0.05) whereas over four in the complicated group (P<0.05). Internal sphincterotomy and anoplasty were frequently needed in the complicated recurrent hemorrhoids (P<0.05). Mean hospital stay and healing time were 5 days (range, 2~26 days) and 21 days (range, 6~180 days), respectively. We had excellent or satisfactory results in 175 of 197 patients (89%). Conclusively, multiple combined surgical procedures in accordance with individual status might be useful in treating the recurrent hemorrhoids. An adequate and complete surgical procedure must be applied during the initial operation of hemorrhoids, especially on major piles.
Chungcheongnam-do ; Constriction, Pathologic ; Follow-Up Studies ; Hemorrhoidectomy ; Hemorrhoids* ; Humans ; Incidence ; Length of Stay ; Prolapse ; Recurrence ; Sclerotherapy