We report a case of Mycobacterium fortuitum infection of the face and abdomen in a 25 years old man following cosmetic autologous fat injection. The goal of this manuscript is to increase awareness and suspicion of such as atypical mycobacterial infections complicating liposuction and fat injection. The clinical presentation, laboratory studies utilizing acid-fast stains and cultures, prevention and treatment including surgical debridement, and pharmacologic regimens in the ultimate diagnosis for Mycobacterium fortuitum infections are discussed.
Abdomen ; Coloring Agents ; Cosmetics ; Debridement ; Lipectomy ; Mycobacterium ; Mycobacterium fortuitum

PURPOSE: This study aimed to investigate the respiratory morbidities in term neonates, as well as their relationship with mode of delivery and gestational age. METHODS: Medical records of term infants with respiratory symptoms, who were admitted to the neonatal intensive care unit (NICU) of Dong-A University Hospital from Jan 2008 to Dec 2013, were retrospectively reviewed. Term neonates with respiratory diseases, such as transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), neonatal pneumonia, meconium aspiration syndrome (MAS), pneumothorax, and persistent pulmonary hypertension of the newborn (PPHN), were included. The respiratory morbidities were investigated according to the gestational age (<39 weeks vs. > or =39 weeks) and/or mode of delivery (with labor vs. without labor). RESULTS: A total of 260 term neonates were enrolled in the study. The average gestational age was 38(+6)+/-1.3 weeks, while the birth weight was 3,233.7+/-462.0 g. The most common respiratory disease encountered in term neonates was TTN (n=98, 37.7%), followed by MAS (n=76, 29.2%), spontaneous pneumothorax (n=27, 10.4%), PPHN (n=24, 9.2%), neonatal pneumonia (n=19, 7.3%), and RDS (n=16, 6.2%). Incidence of TTN and RDS was higher in neonates aged <39 weeks than in those aged > or =39 weeks. Higher incidence of spontaneous pneumothorax and RDS was observed in neonates delivered before the onset of labor. The incidences of TTN, spontaneous pneumothorax, and RDS were higher in the elective cesarean section group before 39 weeks of gestation. CONCLUSION: Respiratory morbidities in term neonates are affected by the gestational age (<39 weeks vs. > or =39 weeks) and/or mode of delivery (with labor vs. without labor).
Birth Weight ; Cesarean Section ; Female ; Gestational Age ; Humans ; Hypertension, Pulmonary ; Incidence ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Medical Records ; Pneumonia ; Pneumothorax ; Pregnancy ; Retrospective Studies ; Transient Tachypnea of the Newborn

BACKGROUND: Three isoforms of the neuronal acetylcholine receptors (AChRs) have been described in muscle epsilonAChRs, gammaAChRs and alpha7AChRs. The adult neuromuscular junctions are composed of epsilonAChRs. During immobilization, new AChRs with subunit compositions of gammaAChRs and alpha7AChRs appear in the perijunctional and extrajunctional area. This study evaluated the contribution of these isoforms to neurotransmission during immobilization, by using waglerin-1 which selectively blocks the epsilonAChRs. METHODS: Male mice (n = 20) were used and each group was divided into sham operated or immobilized. A leg was immobilized in mice for 14 days by pinning, after which nerve-evoked twitch tension was examined under anesthesia in tibialis muscle of both legs, with the contralateral leg serving as control. Neuromuscular transmission was monitored by using a peripheral nerve stimulator with the tibialis muscle and sciatic nerve. Electrical stimuli of 0.2 msec duration were applied to sciatic nerve 2 Hz for 2 sec every 30 sec. After administration of waglerin-1, the evoked twitch was recorded. The percent depression of T1 relative to baseline was transformed to probit scale to determine the effective dose of waglerin-1 for 5%, 50%, and 95% twitch depression. RESULTS: The twitch tension in the control group was higher than immobilized group, confirming the efficacy of immobilization. Waglerin-1 produced 99% twitch suppression on the control group. But on the immobilized group, waglerin-1 produced only 70% twitch suppression even at 37 pg. CONCLUSIONS: The functional role of epsilonAChRs in neurotransmission decreases during immobilization while that of gammaAChRs and alpha7AChRs increases.
Adult ; Anesthesia ; Animals ; Depression ; Hindlimb ; Humans ; Immobilization ; Leg ; Male ; Mice ; Muscles ; Neuromuscular Junction ; Neurons ; Peripheral Nerves ; Protein Isoforms ; Receptors, Cholinergic ; Salicylamides ; Sciatic Nerve ; Synaptic Transmission

Chondroid syringoma is referred as mixed tumor because it has epithelial structure and mesenchymal elements. Mixed tumors could be divided into two distinct types, eccrine and apocrine. Mixed tumor with follicular, sebaceous and apocrine differentiation is considered as an expression of the common embryologic origin of elements of the folliculosebaceous-apocrine unit. A 32-year old manpresented with an asymptomatic firm erythematous nodule on the left cheek. Histologically, it showed typical features of chondroid syringoma with tubules exhibiting branching and cystic dilatation in the myxoid and chondroid stroma. Our case is unique in that the tumor arose from follicular infundibulum with follicular, sebacesous and apocrine differentiation.
Adenoma, Pleomorphic* ; Adult ; Cheek ; Dilatation ; Humans

BACKGROUND: The precise measurement of body temperature during anesthesia is important to prevent hypothermia.The aim of this study was to compare the urinary bladder temperature to the esophageal, nasopharyngeal, rectal and skin temperatures, and to compare three heating methods during spine surgery. METHODS: Forty-two patients with ASA physical status I-II, who were scheduled to undergo spine surgery in the prone position, were included in this study.The patients were randomly divided into 4 groups:Group I was treated without any heating methods; group 2, with fluid-warmers; group 3, with forced air-warmers; and group 4, with a combination of both heating methods.After the induction of anesthesia, the esophageal, nasopharyngeal, rectal, urinary bladder and skin temperature was monitored every 15 minute for 3 hours.The urinary bladder temperature was compared to the esophageal, nasopharyngeal, rectal and skin temperatures. RESULTS: The urinary bladder temperature was found to be higher than the esophageal and the nasopharyngeal temperatures (P < 0.01).The urinary bladder temperature of group 3 was higher than that of group 1 at 180 minutes after induction of anesthesia (P < 0.05).The urinary bladder temperature of group 4 was higher than that of group 1 at 150 minutes (P < 0.05), as well as at 165 and 180 minutes (P < 0.05).The skin temperatures of groups 3 and 4 were higher than group 1 (P < 0.001). CONCLUSIONS: The urinary bladder temperature was higher than the esophageal temperature and correlated with the esophageal, nasopharyngeal and rectal temperatures.During spine surgery in the prone position, a forced air-warmer was found to be the most effective but a combination of all the methods tested was found to be even more effective.
Anesthesia ; Body Temperature ; Heating ; Hot Temperature ; Humans ; Prone Position ; Skin ; Skin Temperature ; Spine ; Urinary Bladder

PURPOSE: This study evaluated the effect of first nocturnal ejaculation timing on risk and sexual behaviors of Korean male adolescents. METHODS: We analyzed data from the 10th edition of the Korea Youth Risk Behavior Web-based survey that was conducted with male high school adolescents in grades 10–12. The survey included 17,907 adolescents, and 10,326 responded their experience of first nocturnal ejaculation. Of these, 595 had their first nocturnal ejaculation in ≤grade 4 (“early puberty”) and 9,731 had their first nocturnal ejaculation in ≥grade 5 (“normal puberty”). We analyzed differences between these 2 groups in risk and sexual behaviors. RESULTS: Early first nocturnal ejaculation showed a positive association with sexual intercourse (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.56–4.17), sexual debut at elementary school age (OR, 7.45; 95% CI, 5.00–11.10), and having had a sexually transmitted disease (OR, 6.60; 95% CI, 3.94–11.08). After a multiple logistic regression to adjust for socio-demographic variables, early first nocturnal ejaculation was still positively associated with sexual intercourse (OR, 2.73; 95% CI, 2.03–3.69), sexual debut at elementary school age (OR, 5.96; 95% CI, 3.47–10.22), and having had a sexually transmitted disease (OR, 5.17; 95% CI, 2.52–10.20). Early first nocturnal ejaculation was positively associated with alcohol consumption, smoking, and substance use. However, this was not statistically significant after adjusting for several socio-demographic variables. CONCLUSION: There is a positive association between early nocturnal ejaculation and sexual behaviors in male adolescents. Proactive education about sexual behaviors is required for adolescents who reach sexual maturity early.
Adolescent* ; Alcohol Drinking ; Coitus ; Education ; Ejaculation* ; Humans ; Korea ; Logistic Models ; Male ; Male* ; Puberty ; Risk-Taking ; Sexual Behavior* ; Sexually Transmitted Diseases ; Smoke ; Smoking

The ethical statement was omitted unintentionally.

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting low platelet count in peripheral blood without any other abnormalities in other blood cell lineage. There were many studies that investigated the mechanism of ITP and the factors related to its chronicity, but much remains controversial. Neutrophil to lymphocyte ratio (NLR) is considered an indicator representing the severity of acute or chronic inflammation. The aim of this study was to assess whether NLR can predict the outcome of ITP and its chronicity.METHODS: Patients who were diagnosed as ITP at Dong-A University Hospital between March 2000 and March 2016 were analyzed retrospectively. NLR results and other medical records at diagnosis and after treatment were analyzed and compared between two groups; patients with single episode and chronic ITP group.RESULTS: Of a total of 67 patients, 39 patients (58.21%) were chronic ITP. Patients with single episode showed low NLR at diagnosis than patients with chronic ITP (1.23±1.38 vs. 1.54±1.15, P=0.42), but NLR after recovery were significantly high (1.58±1.71 vs. 1.31±0.76, P=0.21). However, patients with chronic ITP showed a trend of high NLR at the time of relapse.CONCLUSION: Chronic ITP patients showed higher NLR at the time of diagnosis compared with the patients with single episode. Also, the NLR at the time of relapse showed higher level compared to those at diagnosis. Relationship between NLR and chronic ITP need to be further studied.
Blood Cells ; Diagnosis ; Humans ; Inflammation ; Lymphocytes ; Medical Records ; Neutrophils ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies

PURPOSE: To compare initial CT findings of non-tuberculous mycobacteria (NTM) pulmonary infection between stable and progressed groups and determine whether they could be used to predict disease prognosis and treatment response. MATERIALS AND METHODS: From July 2006 to October 2013, 71 patients with NTM infection were retrospectively reviewed. Lung lesion pattern of CT finding, specific species, disease duration, and follow-up period were analyzed. These patients were classified into NTM stable (n = 46) and progressed (n = 25) groups. RESULTS: The most common CT findings of NTM infection were small nodules (n = 71, 100%) and bronchiectasis (n = 67, 94%). Large consolidation (> 2 cm, n = 34, 48%) and involvement of more than four lobes (n = 49, 69%) were also commonly observed. According to disease prognosis, large consolidation (n = 18, 72%, p = 0.003), cavitary lesion (n = 17, p = 0.002), and involvement of four or more lobes (n = 21, p = 0.044) on CT were significantly more frequent in disease progressed group than that in the stable group. CONCLUSION Among common CT findings of NTM disease, some CT findings such as large consolidation, cavitary lesion, and disease extent are good predictors of response to treatment in NTM pulmonary disease.

Purpose: To investigate the efficacy and safety of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) after > 10 years of follow-up. Materials and Methods: This study included five patients who underwent RFA to treat PTMCs (five lesions, mean diameter 0.5 cm, range 0.4–0.7 cm) between November 2006 and December 2009. The inclusion criteria were histopathologically confirmed PTMCs, a single PTMC lesion without extrathyroidal extension, no metastasis, and ineligibility or refusal to undergo surgery. RFA was performed by a single radiologist using a radiofrequency generator and an internally cooled electrode. We retrospectively analyzed the procedure-induced complications, serial changes in ablated tumors, recurrence, and local as well as lymph node metastasis based on data obtained from medical records and radiological images. Results: The mean follow-up period was 130.6 months (range 121–159 months). Three patients underwent a single RFA session, and two patients underwent two RFA sessions. We observed no procedure-induced complications. Three tumors completely disappeared after ablation, and ablation of the other two tumors resulted in the formation of a small scar that showed long-term stability (mean duration 16.8 months, range 12–27 months). At the last follow-up, no patient showed recurrence or lymph node metastasis, and serum thyroglobulin levels were within normal limits in all patients. Conclusion RFA may be effective and safe to treat low-risk PTMC in patients who refuse or are ineligible for surgery.