Eccrine angiomatous hamartoma (EAH) is a rare benign disease that is characterized by an abnormal proliferation of eccrine glands and vascular elements. It is generally congenital, but it can appear before puberty. It usually presents as a single plaque or nodule, but multiple patch-like lesions are also possible. EAH is mostly asymptomatic, but it is sometimes associated with pain or hyperhidrosis. It generally does not require aggressive treatment, but the lesion can be excised due to pain, enlargement and cosmetic reasons. A 3-week-old Korean female presented with a hemorrhagic skin lesion on the right foot since birth. There was no specific birth history. The lesion first appeared on the third toe of the right foot and quickly spread to almost half of the right foot. Histopathology examination revealed acanthosis in the epidermis and a proliferation of eccrine ducts, glands and capillaries. The eccrine glands were immunohistochemically-positive for carcinoembryonic antigen.
Capillaries ; Carcinoembryonic Antigen ; Cosmetics ; Eccrine Glands ; Epidermis ; Female ; Foot ; Hamartoma ; Hemorrhage ; Humans ; Hyperhidrosis ; Parturition ; Puberty ; Reproductive History ; Skin ; Toes

BACKGROUND: Pleural eosinophilia is rare and commonly considered to be an indicator of good prognosis. The diagnostic significance of eosinophilic pleural effusions remains controversial despite a century of observation and discussion. This study was conducted to assess the prevalence of eosinophilia in 446 consecutive samples of pleural fluid, to review the cause of eosinophilic pleural effusion and to determine whether the presence of eosinophils increases the likehood of benign conditions. METHOD: A retrospective analysis was performed upon patients that underwent first thoracentesis due to pleural effusion between January 1999 and December 1999. RESULTS: Eosinophilic pleural effusions were identified in 24 of the 446 patients (5.4%). Malignancy, parapneumonic effusion and tuberculosis were determined the major causes of pleural effusion (80.6%). Malignancy was diagnosed as frequently in eosinophilic effusions as in non-eosinophilic effusions (54.2% vs 50.5%, p=0.725). No difference was found in the prevalence of eosinophilic and non-eosinophilic effusion according to the etiology. The mean blood eosinophil ratio in patients with eosinophilic pleural effusion was 5.4% and no significant correlation existed between the blood and pleural eosinophilic count. CONCLUSION: Pleural eosinophilia is not helpful for differentiating benign and malignant etiology and is not related with blood eosinophilia or repeated tapping.
Eosinophilia ; Eosinophils* ; Humans ; Pleural Effusion* ; Prevalence ; Prognosis ; Retrospective Studies ; Tuberculosis

Bowen's disease is a squamous cell carcinoma in situ and has the potential to progress to a squamous cell carcinoma. The authors treated two female patients (a 39-year-old and a 41-year-old) with Bowen's disease in the vulva area using topical photodynamic therapy (PDT), involving the use of 5-aminolaevulinic acid and a light-emitting diode device. The light was administered at an intensity of 80 mW/cm2 for a dose of 120 J/cm2 biweekly for 6 cycles. The 39-year-old patient showed excellent clinical improvement, but the other patient achieved only a partial response. Even though one patient underwent a total excision 1 year later due to recurrence, both patients were satisfied with the cosmetic outcomes of this therapy and the partial improvement over time. The common side effect of PDT was a stinging sensation. PDT provides a relatively effective and useful alternative treatment for Bowen's disease in the vulva area.
Adult ; Bites and Stings ; Bowen's Disease* ; Carcinoma, Squamous Cell ; Female ; Humans ; Photochemotherapy* ; Recurrence ; Sensation ; Vulva*

Adenoid basal carcinoma and adenoid cystic carcinoma of the uterine cervix are rare tumors that have often been regarded as a single entity. But adenoid basal and adenoid cystic carcinomas of the cervix differ from each other in their histology, treatment, and prognosis. We experienced 2 cases of these neoplasms, with 1 case in each category. Whereas adenoid basal carcinoma is a slow-growing, locally invasive lesion amenable to simply hysterectomy, adenoid cystic carcinoma is an aggressive tumor associated with regional lymph node involvement and late distant metastases. This study reviews the literature and formulates a program for the management of these rare lesions.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Cervix Uteri* ; Female ; Hysterectomy ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

Pemphigus vegetans is a rare variant of pemphigus vulgaris and is characterized by vegetating lesions in the inguinal folds and mouth and by the presence of autoantibodies against desmoglein 3. Two clinical subtypes of pemphigus vegetans exist, which are initially characterized by flaccid bullae and erosions (the Neumann subtype) or pustules (the Hallopeau subtype). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery of the lesions. Oral administration of corticosteroids alone does not always induce disease remission in patients with pemphigus vegetans. We report here on a 63-year-old woman with pemphigs vegetans. She had a 2-year history of vegetating, papillomatous plaques on the inguinal folds and erosions of the oral mucosa. The enzyme-linked immunosorbent assay was positive for anti-desmoglein 3, but it was negative for anti-desmoglein 1. She was initially treated with systemic steroid, but no improvement was observed. The patient was then successfully treated with a combination of systemic steroid and dapsone with a good clinical response.
Administration, Oral ; Adrenal Cortex Hormones ; Autoantibodies ; Blister ; Dapsone ; Desmoglein 3 ; Enzyme-Linked Immunosorbent Assay ; Female ; Granulation Tissue ; Humans ; Middle Aged ; Mouth ; Mouth Mucosa ; Pemphigus

PURPOSE: This study investigates the current state of and future trends in the field of cataract surgery in Korea. METHODS: Since 1995, the members of the Korean Society of Cataract and Refractive Surgery (KSCRS) have made annual surveys on cataract and refractive surgery. The 2005 annual survey, consisting of 76 multiple-choice questions, was mailed in February 2005 to 300 KSCRS members. Sixty-six (22.0%) members answered the questions. Current data were compared with those of previous annual surveys and with those of surveys in the United States. RESULTS: Forty-six percent of the respondents were in the fifth decade. The duration of hospital stay has decreased annually and the use of topical anesthesia (44%) did not change. Self sealing wound construction was the main wound closure technique in phacoemulsification (63%). The implantation of phakic IOL was performed by 38% of the respondents and the most preferred intraocular lenses for small incision cataract surgery were acrylic (79%). Interest in the value added IOL has increased annually. CONCLUSIONS: This survey summarized current trends and changes in cataract surgery in Korea.
Anesthesia ; Cataract* ; Surveys and Questionnaires ; Korea* ; Length of Stay ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Refractive Surgical Procedures ; United States ; Wound Closure Techniques ; Wounds and Injuries

Reed syndrome is an autosomal dominantly inherited disease with incomplete penetrance that is characterized by uterine and cutaneous leiomyoma. While the skin tumors are relatively uncommon and benign, women of affected families often develop uterine leiomyoma with associated infertility, pain and bleeding. Here, we report a case of Reed syndrome in a family with multiple cutaneous and uterine leiomyomas. A 30-year-old woman had not only multiple cutaneous leiomyomatosis on cheek and neck, but also uterine multiple leiomyoma. Her mother had lesions that the multiple cutaneous leiomyomatosis on both shoulders and underwent myomectomy for a huge uterine leiomyoma at the age of 45. Her older sister also underwent myomectomy for uterine leiomyoma.
Adult ; Cheek ; Female ; Hemorrhage ; Humans ; Infertility ; Leiomyoma ; Leiomyomatosis ; Mothers ; Neck ; Penetrance ; Shoulder ; Siblings ; Skin

Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous infalmmation, which was compatible with tuberculosis. Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin. In patients with severe diarrhea receining anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.
Aged ; Anti-Bacterial Agents ; Biopsy ; Chest Pain ; Clostridium difficile ; Diarrhea ; Dyspnea ; Enterocolitis, Pseudomembranous* ; Ethambutol ; Gastrointestinal Tract ; Humans ; Isoniazid ; Lung ; Metronidazole ; Mucous Membrane ; Physical Examination ; Pleural Effusion ; Respiratory Sounds ; Rifampin* ; Sigmoidoscopy ; Sputum ; Thorax ; Tuberculosis ; Vancomycin

BACKGROUND: Takayasu's arteritis is a chronic non-specific inflammatory disease of arteries and it is known that aorta and its major branches are most commonly invoved. Its etiology is still unknown but the basic process is marked intimal proliferation, fibrosis and fibrous scarring with degeneration of the elastic fibers of the media. The proliferative and cicatrical process leads to luminal narrowing, stenosis, localized aneurysm, postsenotic dilatation and calcification in the involved arterial wall. Little attention has been paid to the diagnostic value of transesophageal echocardiography(TEE) in Takayasu's arteritis. METHODS: We evaluated transesophageal echocardiographic findings of aortic lesions in 3 cases of Takayasu's arteritis. RESULTS: The transesophageal echocardiographic findings of aortic lesions in Takayasu's arteritis characteristically showed relatively long sehmental luminal narrowing caused by marked intimal proliferation and contracture fo aortic wasll. The morphology of intimal thickening was characteristically circumferential, concentric and the size of the aorta itself was decreased by contracture as compared with atherosclerotic changes involving aorta. Besides these findings were consistent with angiographic findings. The common types of Takayasu's arteritis which we will meet clinically are known as type I or III. Indeed, 3 cases described in this paper are all type 3 patients. According to that fact, most of Takayasu's arterits may have aortic lesions that could be easily accessible by TEE and the degree of deformity of the aorta can be evaluated using TEE. CONCLUSION: The transesophageal echocardiography may be a valuable diagnostic tool for the evaluation of aortic wall and luminal status in the patients with Takayasu's arteritis.
Aneurysm ; Aorta ; Arteries ; Cicatrix ; Congenital Abnormalities ; Constriction, Pathologic ; Contracture ; Dilatation ; Echocardiography* ; Echocardiography, Transesophageal ; Elastic Tissue ; Fibrosis ; Humans ; Phenobarbital ; Takayasu Arteritis*

BACKGROUND: Patients undergoing ambulatory surgery under general anesthesia experience considerable levels of postoperative nausea and vomiting (N/V) after their discharge. However, those complications have not been thoroughly investigated in hand surgery patients yet. We investigated factors associated with postoperative N/V in patients undergoing an ambulatory hand surgery under general anesthesia and determined whether patients' satisfaction with this setting is associated with postoperative N/V levels. METHODS: We prospectively evaluated 200 consecutive patients who underwent ambulatory hand surgeries under general anesthesia to assess their postoperative N/V visual analogue scale (VAS) levels during the first 24 hours after surgery and their satisfaction with an ambulatory surgery setting. Potential predictors of postoperative N/V were; age, sex, body mass index, smoking behavior, a history of postoperative N/V after previous anesthesia or motion sickness, preoperative anxiety level and the duration time of anesthesia. We conducted multivariate analyses to identify factors associated with postoperative N/V levels. We also conducted multivariate logistic regression analyses to determine whether the N/V levels are associated with the patients' satisfaction with this setting. Here, potential predictors for satisfaction were sex, age, postoperative pain and N/V. RESULTS: Postoperative N/V were associated with a non-smoking history, a history of motion sickness and a high level of preoperative anxiety. Twenty-two patients (11%) were dissatisfied with the ambulatory setting and this dissatisfaction was independently associated with moderate (VAS 4-7) and high (VAS 8-10) levels of postoperative N/V and with a high level (VAS 8-10) of postoperative pain. CONCLUSIONS: Although most of the patients were satisfied with the ambulatory surgery setting, moderate to high levels of N/V were associated with dissatisfaction of patients with this setting, suggesting a need for better identifying and managing those patients at risk. The information regarding risk factors for N/V could help in preoperative patient consultation regarding an ambulatory hand surgery under general anesthesia.
Adolescent ; Adult ; Aged ; *Ambulatory Surgical Procedures ; Anesthesia, General ; Female ; Hand/*surgery ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Nausea and Vomiting/*diagnosis ; Young Adult