Castleman's disease is a rare disorder that's characterized by the proliferation of lymphoid tissue. It is very rare to find this disease arising from the sigmoid mesocolon. We report here on a case of localized Castleman's disease involving the sigmoid mesocolon, and we discuss the findings of the gray-scale ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging.
Colon, Sigmoid ; Giant Lymph Node Hyperplasia ; Lymphoid Tissue ; Magnetic Resonance Spectroscopy ; Mesocolon

Diabetic macular edema is one of the most common causes of visual acuity impairment in adults. Various treatment modalities are currently used. They include laser therapy, intravitreal or periocular injection of steroid, intravitreal injection of anti-vascular endothelial growth factor, and pars plana vitrectomy. Introduction of newer therapeutic agents, such as ranibizumab and aflibercept has changed the paradigm of treatment approaches for diabetic macular edema. However, traditional treatment methods, such as laser photocoagulation and vitrectomy, are still being used effectively in certain situations. Each treatment modality has its own unique mode of action, and has advantages and disadvantages at the same time. Given multiple mechanisms are involved in the development of diabetic macular edema, a combination treatment approach is often employed rather than using only one of the treatment modalities. In this review, treatment outcomes of each approach are summarized and combination approaches are discussed.
Adult ; Bevacizumab ; Dexamethasone ; Endothelial Growth Factors ; Humans ; Injections, Intraocular ; Intravitreal Injections ; Laser Therapy ; Light Coagulation ; Macular Edema* ; Ranibizumab ; Visual Acuity ; Vitrectomy

No abstract available.
Carcinoma, Squamous Cell* ; Poroma*

Nevus sebaceus of Jadassohn is a hamartoma of the skin with the potential to develop benign and malignant neoplasms. This case was characterixed by multiple basal cell epitheliomas, clinically one reddish nodule and multiple pigmented papules, arising in the nevus sebaceus. Histologically, epithelial papillomatous hyperplasia and high-positioned hyperplastic sebaceous glands were found, and tumor nests consisting of basaloid cells with peripheral palisading arrangements were mainly situated in the upper dermis without significant infiltrative growth. We report a rare case of nevus sebaceus with multiple basal cell epitheliomas in the right cheek of a 49-year-old woman.
Carcinoma, Basal Cell* ; Cheek ; Dermis ; Female ; Hamartoma ; Humans ; Hyperplasia ; Middle Aged ; Nevus* ; Nevus, Sebaceous of Jadassohn* ; Sebaceous Glands ; Skin

Transcutaneous electrical nerve stimulation (TENS) has widely been employed as a method of obtaining analgesia in medical practice. The mechanisms of pain relief by TENS are known to be associated with the spinal gate control mechanism or descending pain inhibitory system. However, most of the studies concerning the analgesic effects and their mechanisms for TENS have dealt with somatic pain. Thus, in this experiment, we investigated the analgesic effects of TENS on renal pain as a model of visceral pain, and the characteristics of the dorsal horn cells with renal inputs. The renal pain was induced by acute occlusion of the ureter or renal artery. The main results are summarized as follows: 1) The renal nerve was composed of A beta, A delta and C fiber groups; the thresholds for each group were 400-800 mV, 1.1-1.5 V, and 2.1-5.8 V, respectively. 2) The dorsal horn cells tested received A and/or C afferent fibers from the kidney, and the more C inputs the dorsal horn cells had, the greater was the response to the stimuli that elicited the renal pain. 3) 94.9% of cells with renal input had the concomitant somatic receptive fields on the skin; the high threshold (HT) and wide dynamic range (WDR) cells exhibited a greater responses than low threshold (LT) cells to the renal pain-producing stimuli. 4) TENS reduced the C-responses of dorsal horn cells to 38.9 +/- 8.4% of the control value and the effect lasted for 10 min after the cessation of TENS. 5) By TENS, the responses evoked by acute occlusion of the ureter or renal artery were reduced to 37.5 +/- 9.7% and 46.3 +/- 8.9% of the control value, respectively. This analgesic effects lasted 10 min after TENS. 6) The responses elicited by squeezing the receptive fields of the skin were reduced to 40.7 +/- 7.9% of the control value and the effects lasted 15 min after TENS. These results suggest that most of dorsal horn cells with renal inputs have the concomitant somatic inputs and TENS can alleviate the renal pain as well as somatic pain.
Animal ; Cats ; Female ; Kidney/innervation/*physiopathology ; Male ; Pain/physiopathology/*therapy ; Support, Non-U.S. Gov't ; *Transcutaneous Electric Nerve Stimulation

PURPOSE: To report one case which has been showed successful results after prosthokeratoplasty using `Cardona Bolt and Nut' model. Even though prosthokeratoplasty has a high rate of failure within 5 years after surgery because of many complications, But there was no complications over a 16-year period in this case since surgery by one of the authors (J-H K). METHODS: This patient had an alkali burn on both his eyes due to the accidental explosion of carbamate in 1979 when he was 26 years old. His corneas were densely pacified with neo-vascularization despite undergoing keratoplasty once on his right eye, and twice on his left eye. To improve his vision, we performed ultimately a successful Cardona Bolt and Nut prosthokeratoplasty on his right eye in 1988. RESULTS: During the period of to 16-year follow-up the visual acuity of his right eye was maintained at 0.1 without correction, and 0.15 with correction (+7.0 D.), even though his visual field narrowed(within 10 degree) due to the long and narrow optical cylinder.
Adult ; Alkalies* ; Burns* ; Cornea ; Corneal Transplantation ; Explosions ; Follow-Up Studies ; Humans ; Nuts ; Visual Acuity ; Visual Fields

BACKGROUND: ChromID Clostridium difficile agar (IDCd; bioMerieux SA, France) is a recently developed chromogenic medium for rapid and specific isolation of C. difficile. We compared the performance of IDCd with that of Clostridium difficile Selective Agar (CDSA). METHODS: A total of 530 fresh stool specimens were collected from patients with clinical signs compatible with C. difficile infection, and cultures for C. difficile were performed on IDCd and CDSA. C. difficile colonies were identified by spore staining, odor, use of an ANI identification test kit (bioMerieux SA), and multiplex PCR for tcdA, tcdB, and tpi. RESULTS: The concordance rate between IDCd and CDSA was 90.6% (480/530). The positivity rates on IDCd on days 1 and 2 (55.6% and 85.0%, respectively) were significantly higher than those on CDSA (19.4% and 75.6%, respectively) (P<0.001 for day 1 and P=0.02 for day 2), but the detection rates on IDCd and CDSA on day 3 were not different (89.4% vs. 82.8%, P=0.0914). On day 3, the recovery rates for non-C. difficile isolates on IDCd and CDSA were 30.2% (160/530) and 22.1% (117/530), respectively (P=0.0075). Clostridium spp. other than C. difficile were the most prevalent non-C. difficile isolates on both media. CONCLUSIONS: The culture positivity rates on IDCd and CDSA were not different on day 3 but IDCd may allow for rapid and sensitive detection of C. difficile within 2 days of cultivation.
Agar/*chemistry ; Bacterial Proteins/genetics ; Bacterial Toxins/genetics ; Clostridium difficile/genetics/*isolation & purification ; DNA, Bacterial/analysis ; Enterocolitis, Pseudomembranous/diagnosis/microbiology ; Enterotoxins/genetics ; Feces/*microbiology ; Humans ; Multiplex Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Triose-Phosphate Isomerase/genetics

The aim of this study was to investigate behavioral and psychological symptoms of dementia (BPSD) measured by caregiver-administered neuropsychiatric inventory (CGA-NPI) as a function of dementia severity in early onset (EOAD) versus late onset Alzheimer's disease (LOAD). A total of 113 patients with AD consisting of 49 patients with EOAD and 64 patients with LOAD were enrolled consecutively. General cognitive function and severity of dementia were assessed by the Korean version of mini-mental status examination and clinical dementia rating (CDR), respectively. In the mild stage (CDR 0.5-1), LOAD patients had a significantly higher total CGA-NPI score than EOAD patients. Subgroup analysis demonstrated that disinhibition and night-time behavior were more common and severe in the LOAD group than the EOAD group. However, in the moderate to severe stage (CDR 2-3), EOAD patients had a significantly higher total CGA-NPI score with higher subscores in hallucination, agitation/aggression, irritability/lability, aberrant motor behavior, and appetite/eating change. This study suggested that the heterogeneity of BPSD in AD might be accounted for by dementia severity as well as age at symptoms onset.
Alzheimer Disease* ; Dementia* ; Hallucinations ; Humans ; Population Characteristics

BACKGROUND: Clostidium difficile is one of the most important pathogens responsible for nosocomial diarrhea; therefore, we compared the efficacy of laboratory tests for diagnosing C. difficile diarrhea. METHODS: We evaluated 107 stool specimens using a latex agglutination test (LA) (BD CDT, Culturette CDT, Becton, Dickison and Company, USA) and an enzyme linked fluorescent immunoassay (ELFA) (VIDAS C. difficile Toxin A II, Bio-Merieux sa, Marcy-l'Etoile, France). Stool specimens were cultured using cycloserine cefoxitine fructose agar in anaerobic condition. For identification of C. difficile, spore stain and Vitek ANA identification card (Bio-Merieux sa) were used. Toxin A and toxin B genes were analysed by PCRs using primers NK3-NK2 and NK104N-K105 respectively. RESULTS: The concordance rate between LA and ELFA was 68.2%. Based on the culture results, the sensitivity/specificity of LA and ELFA were 54.8%/100% and 17.8%/100%, respectively. The positive rates of toxin A and B genes were both 90.4%(66/73). Based on the results of PCR assays for toxin A and B genes, the sensitivity/specificity of LA and ELFA were 37.9%/85.7% and 19.7%/100%, respectively. CONCLUSION: Based on C. difficile culture and toxin A and B gene PCR results, the sensitivity of LA was apparently higher than that of ELFA. However, it should not be simply estimated that ELFA has lower capability for detecting toxin A of C. difficile because the possibility of emerging variant strains of C. difficile could not be ruled out. The prevalence of toxigenic strains of C. difficile including variant strains should be studied in Korea.
Agar ; Agglutination* ; Cefoxitin ; Clostridium difficile* ; Clostridium* ; Cycloserine ; Diarrhea ; Fluorescence* ; Fructose ; Immunoassay ; Immunoenzyme Techniques ; Korea ; Latex Fixation Tests ; Latex* ; Polymerase Chain Reaction* ; Prevalence ; Spores

Malignant transformation of mature cystic teratoma of the ovary can develop with an incidence of 1-2%. Squamous cell carcinoma is the most common malignant tumor arising in benign cystic teratoma. The authors have recently experienced a case of combined microcystic adnexal carcinoma and squamous cell carcinoma arising in a benign cystic teratoma of the ovary in a 72-year-old Korean woman. The right ovarian cystic mass had been ruptured and firmly adhered with salpinx and omental fat tissue on operation. Thickened cystic wall with yellowish white solid infiltrative lesion was noted grossly, and two different malignant tumors of microcystic adnexal carcinoma exhibiting both eccrine and hair follicular differentiation and squamous cell carcinoma were observed microscopically. PAS and CEA positivities suggested eccrine differentiation in areas of microcystic adnexal carcinoma.
Aged ; Carcinoma, Skin Appendage/*pathology ; Carcinoma, Squamous Cell/*pathology ; Case Report ; Female ; Human ; Neoplasms, Multiple Primary/*pathology ; Ovarian Neoplasms/*pathology ; Skin Diseases/*pathology ; Skin Neoplasms/*pathology ; Teratoma/*pathology