Familial lichen planus is an uncommon disease, and there are 104 cases reported in the English literature. Several theories regarding the etiopathogenesis of lichen planus have been proposed. However, immunological mechanisms and genetic susceptibility have been emphasized the most. Several reports showed HLA analysis in lichen planus patients, and recently 2 cases have revealed an increased frequency of DR1 antigen in patients with lichen planus compared to a control group. We observed two brothers with typical skin lesions of lichen planus of almost simultaneous onset. We confirmed lichen planus by skin biopsies in both brothers and analyzed HLA typing. We also observed the occurrence of DR1 antigen in both of them.
Biopsy ; Genetic Predisposition to Disease ; Histocompatibility Testing ; Humans ; Lichen Planus* ; Lichens* ; Siblings ; Skin

BACKGROUND: Fine Needle Aspiration Cytology (FNAC) is widely accepted as the most accurate procedure to differentiate malignant from benign thyroid nodules. It is a simple, safe, and inexpensive procedure, and the accuracy of FNAC is relatively high; however, its success usually depends upon the skill in using the aspiration technique and the experience and skill of the cytologist. The authors confirmed the diagnostic value of preoperative FNAC in differential diagnosis of thyroid nodules treated by the surgical resection. METHODS: Three hundred fifty specimens were taken in the Department of Surgery, Inje University College of Medicine, from July 1990 to June 1996. Fifty-one males and 299 females with ages ranging from 11 to 73 years were enrolled. The cytology of FNAC was compared to the final histologic diagnosis. RESULTS: The number of inadequate smears (or sampling error) was 15.7%. Preoperative cytologic diagnoses was consisted of 198 cases of benign disease (92 cases of nodular goiters, 96 cases of follicular lesion types III, and 10 cases of thyroiditis), 12 cases of highly suspicious malignant lesions (follicular lesions type II), and 85 cases of malignant disease (71 cases of papillary carcinomas and 14 cases of follicular lesions type I). Histologic diagnoses consisted of nodular goiters in 116 cases, adenomas in 66 cases, thyroiditis in 9 cases, papillary carcinomas in 84 cases, and follicular carcinomas in 20 cases. These results has an 84.6% sensitivity, a 95.2% specificity, a 15.3% false negative rate, and a 4.7% false positive rate. In the fifty-five cases of inadequate sampling, 13 cases (23.6%) were malignant lesions histologically. In the 16 cases proven as false negative, nine cases were papillary carcinomas, and 7 cases were follicular carcinomas histologically. Thirteen cases (16.1% of 27 cases of cystic lesions) of cystic nodules revealed malignant neoplasms histologically. CONCLUSION: FNAC is a single, useful diagnostic procedure for the initial screening for malignancy in thyroid nodules. Performing repeated aspiration in cystic nodules and clinically suspicious cases could reduce inadeguate sampling and the false negative rate.
Adenoma ; Biopsy, Fine-Needle* ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential* ; Female ; Goiter, Nodular ; Humans ; Male ; Mass Screening ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroiditis

PURPOSE: Asthma has been known as a chronic inflammatory disease to cause airway obstruction by allergens, viral infections and other factors. Nowdays infantile asthma is increasing markedly. However, to date the enough study for predicting its long term prognosis was not performed. This study aimed to estimate the long term prognosis of infantile asthma. METHODS: In pediatric allergy clinic of Hanyang University Hospital, 84 asmatics younger than 24 months of age were included from January 1986 to December 1992, who had no abnormality in the airway. Infantile asthma was diagnosed on the basis of chronic cough, episodic wheezing more than three times and reversibility of clinical symptoms by using inhaled bronchodilators. Forty four asthmatics could have been followed and divided into two groups, symptomatic and resolved by analyzinng their medical records and performing follow- up examination with blood and skin prick tests to common allergens. RESULTS: 1) The two study groups included resolved 28 children (63.6%) and symptomatic 16 children (36.4%) with the ratio of male 3.9 to female 1. 2) There were no significant differences the age of first wheezing episode (9.6+/-5.6 mo. vs. 9.9+/-3.5 mo.) as well as diagnosis (14.3+/-5.7 mo. vs. 16.2+/-5.1 mo.) between two study groups, respectively (P>0.05). 3) For history of atopic dermatitis, there was significant difference between the resolved group 6 of 28 children and the symptomatic group 12 of 16 (P<0.05). 4) For laboratory examination, no significant difference was observed, between the levels of PB eosinophil count (310.4+/-282.2/mm3 vs. 368.1+/-465.9/mm3 at diagnosis; 294.3+/-205.3/mm3 vs. 457.7+/-511.2/mm3 at follow-up) and serum IgE (107.2+/-126.5 IU/ml vs. 157.6+/-246.3IU/ml at diagnosis; 267.3+/-700.5IU/ml vs. 442.6+/-546.0IU/ml at follow-up). 5) The frequency of asthmatic attack per year was 3.3+/-1.6 vs. 3.7+/-1.7; the duration of clinical symptom was 2.6+/-1.4 vs. 5.7+/-2.0 years, respectively. 6) The results of skin prick test showed that more frequent positivity to common inhalants in symptomatic group than in resolved was observed. CONCLUSIONS: In the long term follow-up for infantile asthma, the resolved 28 of 44 asthmatics were observed. The positive history of atopic dermatitis might be one of the important predictors for their persistent clinical symptoms.
Airway Obstruction ; Allergens ; Asthma* ; Bronchodilator Agents ; Child ; Cough ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Female ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Male ; Medical Records ; Prognosis ; Respiratory Sounds ; Skin

A nephrocolic fistula is uncommon complication resulting from chronic inflammatory processes in the kidney. We report here a case of nephrocolic fistula associated with staghorn calculi. A 61-year-old female with known renal stones for three years was admitted to our hospital because of left flank pain and gross hematuria. Abdominal CT scan showed pyonephrosis with staghorn calculi in the left kidney. We performed percutaneous nephrostomy because of pelvocaliceal dilatation and high fever. Leakage of contrast dye was also detected in antegrade pyelogram, and drainage of fecal contents from nephrostomy was noted, suggesting fistulous formation between left kidney and colon. Clinical and laboratory findings of the patient deteriorated rapidly in spite of conservative management including antibiotics administration, so we performed nephrectomy with excision of the fistulous tract and partial colectomy. However, she showed delirium and had several attacks of generalized seizure, and she died of sepsis and multiple organ failure on the 33rd hospital day. In conclusion, when a nephrocolic fistula develops in patient with renal stone, prompt investigation and appropriate surgical treatment should be considered to improve the clinical outcome.
Anti-Bacterial Agents ; Calculi* ; Colectomy ; Colon ; Delirium ; Dilatation ; Drainage ; Female ; Fever ; Fistula* ; Flank Pain ; Hematuria ; Humans ; Kidney ; Middle Aged ; Multiple Organ Failure ; Nephrectomy ; Nephrostomy, Percutaneous ; Pyonephrosis ; Seizures ; Sepsis ; Tomography, X-Ray Computed

Objectives: The objective of this study was to analyze dental caries incidence in the permanent teeth of 12-year-old children. Methods: This study used the raw data from the 2015 Korean children’s oral health survey. Participants of the research were 12-year-old children in their first year of middle school. A total of 27,291 people participated in the questionnaire and oral examination. Statistical analysis was performed using complex samples frequency analysis and contingency coefficient phi (φ). Results: Dental caries predominately developed symmetrically with a higher tendency for left-right symmetry than for maxillary-mandibular symmetry in the mouth. The incidence of dental caries between adjacent teeth had a statistically significant correlation and was highest in the first and second premolars. Conclusions Information on symmetry in the development of dental caries and the association of dental caries incidence between adjacent teeth of 12-year-old children should be actively utilized when establishing evidence-based dental caries management plans.

Objectives: This study aimed to investigate the association between school loss due to dental disease and oral health status in adolescents. Methods: The study participants were 881 adolescents (453 middle and 428 high school students).Data were collected through a self-administered survey and oral examination. Chi-square test and t-test were used to analyze the association between school loss due to dental disease and oral health status, and multiple logistic regression was used to analyze the factors influencing school loss. Results: Dental caries was the leading cause of school loss. School loss due to dental disease was more prevalent in the group with a higher number of carious teeth than in the group without dental caries. According to bivariate analysis, school loss due to dental disease was associated with toothache, gingival bleeding, maxillofacial trauma, and caries. When controlling demographic variables, gingival bleeding, maxillofacial trauma, and dental caries were associated with school absence.Moreover, maxillofacial trauma was associated with school absence period up to 1 year. Conclusions Therefore, oral health status and school loss of adolescents are associated, and the importance of oral health in adolescents should be emphasized.

Despite the increasing use of alternative analgesic agents, salicylate overdose remains a not-uncommon problem. Severe poisoning is life threatening, so prompt treatment and supportive measures are required to reduce mortality. Generally, salicylate intoxication results in the development of high-anion-gap metabolic acidosis. However, outside of Korea, normal-anion-gap or negative-anion-gap metabolic acidosis with hyperchloremia is rarely reported. We report herein the case of an 83-year-old female patient with chronic aspirin intake who presented with hyperchloremia and a negative anion gap. The patient's symptoms improved with conservative treatment and hemodialysis; notably, her chloride levels decreased as her blood salicylate concentrations decreased. Salicylate may cause hyperchloremia, demonstrating the importance of careful documentation of patient medication histories.
Acid-Base Equilibrium ; Acidosis ; Aged, 80 and over ; Analgesics ; Aspirin ; Female ; Humans ; Korea ; Mortality ; Poisoning ; Renal Dialysis

We report a case of intrathyroidal and ectopic parathyroid hyperplasia in a 47-year-old female patient with secondary hyperparathyroidism. During evaluation for end stage renal disease, hypercalcemia and hyperparathyroidism were detected in laboratory exam and thyroid nodules were found in computed tomography, and thyroid ultrasonography. In subsequent dual-phase technetium-99m methoxyisobutrlisonitrile (Tc-99m MIBI) scan, delayed focal uptakes were found in thyroid gland and the upper mediastinum. I-123 scan showed photon defects in thyroid gland and no uptake in the upper mediastinum. The imaging findings indicate intrathyroidal and mediastinal ectopic parathyroid hyperplasia. The intrathyroidal and ectopic parathyroid hyperplasia were confirmed by surgical approach. Tc-99m MIBI scan was useful for detecting ectopic parathyroid hyperplasia concomitant intrathyroidal parathyroid lesion.
Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperplasia* ; Incidental Findings* ; Kidney Failure, Chronic ; Mediastinum ; Middle Aged ; Parathyroid Neoplasms ; Technetium Tc 99m Sestamibi ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography

The first case report of granular cell tumor was by Abrikossoff in 1926, the tumor has been named with more than 20 different synonyms. It is found usually in the tongue, oral cavity, and the skin. It occurs rarely in the esophagus. Esophageal granular cell tumor is a benign lesion which can be diagnosed by endoscopic biopsy. Large symptomatic lesion can be removed by polypectomy. A 29-year-old female visited our hospital for intermittent epigastric pain and anterior chest discomfort. Endoscopy showed a 0.6 *0.4 cm whitish yellow nodule in the mid-esophagus, 25 cm from the incisor teeth. Endoscopic polypectomy was performed with "O"-type rubber band for endoscopic variceal ligation(EVL). A case of esophageal granular cell tumor conformed by S-100 protein stain is reported with the review of literature.
Adult ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Granular Cell Tumor* ; Humans ; Incisor ; Mouth ; Rubber ; S100 Proteins ; Skin ; Thorax ; Tongue ; Tooth

17 cases of acute myocardial infarction with no or insignificant narrowing of major coronary arteries on angiogram and without any-other types of heart disease were found in a series of 133 consecutively studied patients with acute myocardial infarction(12,7%). There were no differences in risk factors between groups. Although the infarction site were similar in both groups, the patients with normal coronary arteries had fewer complications during hospitalization(p<0.05) and lesser ST segment change during the exercise test before discharge(p<0.05). In the hemodynamic fingings, cardiac index, left ventricualr and diastolic pressure and resional wall motion were similar in both groups of the patients, but ejection fraction was higher(p<0.05) in the patients with the normal coronary arteries. In conclusion, it could be predicted that the acute myocardial infarction with the normal coronary arteries would have the better prognosis. And a transient coronary occlusion, as the most likely pathogenic mechanism of the acute mtocardial infarction with normal coronary arteries, might be studied in the aspect of the thrombosis following lysis, the coronary artery spasm and the platelet aggregation.
Angiography* ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels ; Exercise Test ; Heart Diseases ; Hemodynamics ; Humans ; Infarction ; Myocardial Infarction* ; Platelet Aggregation ; Prognosis ; Risk Factors ; Spasm ; Thrombosis