A case of 17 years old male with KPP of Tbost-Unna Type is reported. The akin lesions were characterized by the presence of confluent, sharply demarcated hyperk eratotic plaques on the palmar and plantar surfaces. Hypercontraction of palms and soles and hyperhidro is of scalp, face, palms and soles were also noted. Roentogenologic study revealed secondary changes of osteoporosis, flexion deformity and osteoarthritis due to soft tissue contracture and phalangeal and metatarsal bones of hands and feet showed bony resorption with tapering appearance. Histalogic findings of palmar lesion showed excessive hyperkeratosis, parakeratosis and acantosis in the epidermis and no pathology was noted in the dermis and skin appendages, He was treated with hot water compress, 5% Salicylic acid ointment and vit. A and D for 2 months and favorable effect was noted. Authors reviewed relevant literature and made discussions also.
Adolescent ; Betazole ; Congenital Abnormalities ; Contracture ; Dermis ; Epidermis ; Foot ; Hand ; Humans ; Keratoderma, Palmoplantar* ; Keratosis* ; Male ; Metatarsal Bones ; Osteoarthritis ; Osteoporosis ; Parakeratosis ; Pathology ; Salicylic Acid ; Scalp ; Skin ; Water

No abstract available.
Takayasu Arteritis*

No abstract available.
Rhabdomyosarcoma*

Intra-abdominal pregnancy is uncommon occurrence, constituting only 1% of all ectopic pregnancy. It is usually the result of a tubal or ovarian pregnancy that has aborted or ruptured into the peritoneal cavity. However, the complications of abdominal pregnancy can be devastating. Premature placental separation with massive hemorrhage, hypofibrinogenemia following fetal demise, and suppuration and abscess formation lead to producing maternal health risk. A perinatal mortality and maternal mortality were 85-95% and 0.5-6% respect-ively, from the world literature. Optimal obstetrical care requires early diagnosis and prompt surgical intervention. Recently, a patient presented to the St.Francisco general Hospital with a retained abdominal pregnancy of 6 years duration without complications, as discussed below.
Abscess ; Early Diagnosis ; Female ; Hemorrhage ; Hospitals, General ; Humans ; Maternal Mortality ; Maternal Health ; Perinatal Mortality ; Peritoneal Cavity ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Suppuration

PURPOSE: Knowing the optimal length of central venous catheterization is important in order to prevent complications provoked by inappropriate placement of the tip of central venous catheter. We evaluated the optimal lengths of central venous catheterization using 3-Dimensional Multi- Detector Row Computed Tomography (MDCT). METHODS: Between May 2005 and September 2005, we prospectively enrolled 122 consecutive patients who underwent elective chest MDCT. We reconstructed 3-dimensional MDCT images of the right internal jugular vein, right subclavian vein, left internal jugular vein, left subclavian vein and the superior vena cava/right atrium (SVC/RA) junction. In 3-dimensional images, we measured the distance from the puncture site of catheterization to the SVC/RA junction. In addition, we analyzed the correlation of the length of central vein to demographic findings, including patients' height, weight, body mass index, and body surface area (BSA). By regression modeling, we derived formulas to calculate the optimal lengths for central venous catheterization. RESULTS: The optimal lengths of central venous catheterization via the right internal jugular vein, right subclavian vein, left internal jugular vein, and left subclavian vein were 12.9+/-1.5 cm, 14.0+/-1.5 cm, 15.9+/-1.9 cm, and 17.9+/-1.4 cm, respectively. The optimal length of right subclavian catheterization correlated significantly with body weight and BSA (p<0.01). The optimal length of left internal jugular approach correlated well with height (p<0.01), body weight, BMI, and BSA (p<0.005). CONCLUSION: The optimal lengths of central venous catheter were measured by 3-dimensional MDCT and correlated with demographic findings. By regression modeling, we developed formulas to predict the optimal length of central venous catheterization using based on demographic findings.
Body Surface Area ; Body Weight ; Catheterization ; Catheterization, Central Venous* ; Catheters ; Central Venous Catheters* ; Humans ; Jugular Veins ; Prospective Studies ; Punctures ; Subclavian Vein ; Thorax ; Veins

No abstract available.
Neuroblastoma*

No abstract available.
Flushing* ; Liver Transplantation* ; Liver*

Purpose: The aim of this study was to compare surgical outcomes after liver resection for hepatocellular carcinoma (HCC) according to tumor size using a large, nationwide cancer registry-based cohort and propensity score matching. Methods: From 2008 to 2015, a total of 12,139 patients were diagnosed with liver cancer and registered in the Korean Primary Liver Cancer Registry. Patients without distant metastasis who underwent hepatectomy as a primary treatment were selected. We performed 1:1 propensity score matching between the small (<5 cm), large (≥5 cm and <10 cm), and huge (≥10 cm) groups. Results: Overall, 265 patients in the small and large groups were compared, and 64 patients each in the large and huge groups were compared. The overall and progression-free survival rates were significantly lower in the large group than in the small group (P < 0.001 and P < 0.001, respectively). Overall survival tended to be poorer in the huge group than in the large group (P = 0.051). The progression-free survival rate was significantly lower in the huge group than in the large group (P = 0.002). Conclusion Although primary liver resection can be considered even in patients with huge HCC, greater caution with careful screening for recurrence is needed.

BACKGROUND: Although amphotericin B (AMB) has a wide spectrum of activity that encompasses the majority of yeast isolates, there have been recent reports suggesting that some yeast isolates exhibit decreased susceptibility to AMB. However, in vitro AMB susceptibility of yeast species isolates from blood cultures in Korea has not been fully surveyed. METHODS: A total of 92 bloodstream yeast isolates from four Korean hospitals, representing 10 Candida species (69 isolates) and 4 non-Candida yeast species (23 isolates) were evaluated. AMB minimum inhibitory concentrations (MICs) were determined by two methods: the CLSI method and Etest. AMB minimum fungicidal concentrations (MFCs) were also determined. RESULTS: For all 92 yeast isolates, the CLSI method generated a restricted range of MICs (0.125 to 4 microgram/mL) with 3.3% exhibiting MICs > or =2 microgram/mL, and the corresponding MFC values ranged from 0.25 to 8 microgram/mL with 26.1% showing MFCs > or =2 microgram/mL. Etest produced the widest distribution of MICs, ranging from 0.03 to 32 microgram/mL. High AMB MICs (> or =0.38 microgram/mL) by Etest was observed in 34.8% of the isolates: Candida krusei (100%), Candida rugosa (100%), Trichosporon asashii (100%), Candida glabrata (82%), and Yarrowia lipolytica (75%). Etest disclosed that all isolates of Candida guilliermondii, Candida lusitaniae, Candida pelliculosa and Kodamaea ohmeri were highly susceptible to AMB (MIC < or =0.19 microgram/mL). CONCLUSIONS: Our study showed that Etest may be more useful to discriminate yeast isolates with reduced susceptibility to AMB, and some isolates of less common yeast species from Korea may have decreased AMB susceptibilities.
Amphotericin B/*pharmacology ; Antifungal Agents/*pharmacology ; Candida/drug effects/isolation & purification ; Candidiasis/microbiology ; Culture Media ; Humans ; Korea ; Microbial Sensitivity Tests ; Reagent Kits, Diagnostic ; Yeasts/*drug effects/isolation & purification

PURPOSE: The aim of this study was to evaluate the time delays in reperfusion of patients with ST elevation myocardial infarction (STEMI) according to the mode of transportation and patient arrival time. METHODS: An observational study of patients with STEMI treated with primary percutaneous coronary intervention (PCI) was performed from January 2004 to May 2009. The patients were classified into several subgroups according to the transportation method (self-transportation, EMS, and transfer) and patient arrival time (regular hours: weekdays, 7 AM~6 PM, off-hours: weekdays, 6 PM~7 AM, weekend and holiday). The symptom-to-door time (STDT), door-to-balloon time (DTBT), and the timeline to reperfusion were compared in each group. RESULTS: The median STDTs, DTBTs and the percent of the timeline to reperfusion (DTBT < or =90 min) differed significantly according to the transportation mode (p<0.001, respectively). Especially, the transfer group had longer median STDT (200 min, IQR 120~330), shorter median DTBT (80 min, IQR 66~102) and a significantly higher rate of achieving a timely DTBT (64.8%), compared to the other groups (self-transport and EMS use). Compared to the regular hour group, the offhour group had a shorter STDT (129 min vs. 180 min, p=0.016) and longer DTBT (99 min vs. 81 min, p<0.001). The percent of patients achieving a timely DTBT was much lower during off-hours (41.1% vs. 61.5%, p<0.001). CONCLUSION: The results of this study showed that the transfer group and regular hour group had a significantly shorter median DTBT, and the timeline for reperfusion was longer in the transfer group compared to the regular hour group in this study.
Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Reperfusion ; Sodium Fluoride ; Transportation ; Urethane