The anterior maxillary sinus walls are the most frequently injured sites in midfacial fractures. The maxillary sinus is a difficult surgical site for reduction and fixation due to its narrow surgical field, and has a chance of developing sinusitis when sufficient treatment is not given. In this study, the methods developed by the authors for managing such are introduced. Two small openings were made on both sides of the fracture line, then a suture knot was tied instead of wiring for reduction and fixation. Then an absorbable mesh was applied on top of the fracture site, with a suture knot for additional fixation. This method was applied on an actual patient, and it was a convenient method despite the narrow surgical field that was provided. The authors believe that using suture knots to fixate fractured segments and absorbable mesh is relatively convenient and economically efficient when it comes to the reduction and fixation of the maxillary sinus wall fracture with several fragments.
Humans ; Maxillary Sinus* ; Sinusitis ; Sutures*

Norwegian scabies is a crusted rash that's caused by a massive infestation with the mite Sarcoptes scabiei. The characteristic skin lesions of this form are gross scaling and hyperkeratotic plaques, and especially on the hands, feet, face, nails and scalp with varying degrees of pruritus. It is often seen in the individuals with human immunodeficiency virus infection, the elderly, immunocompromised patients and institutionalized persons. We report here on a case of Norwegian scabies on an 86-year-old patient who was living in an eldercare hospital, and the patient presented with localized, pruritic, erythematous patches with thick yelolwish crusts on the scalp.
Aged ; Aged, 80 and over ; Exanthema ; Foot ; Hand ; HIV ; Humans ; Immunocompromised Host ; Institutionalization ; Mites ; Nails ; Pruritus ; Sarcoptes scabiei ; Scabies ; Scalp ; Skin

Background: It is necessary to perform antifungal susceptibility testing of dermatophytes. Etest (AB Biodisk, Sweden) is a rapid, easy-to-perform in-vitro antifungal susceptibility test. Objective: The purpose of this study was to investigate the minimal inhibitory concentration (MICs) of dermatophytes isolated from skin using Etest. Methods: 21 species of dermatophytes (12 strains of T. rubrum, 7 strains of T. mentagrophytes, M. canis and M. gypseum) and two standard strains (Aspergillus flavus KCTC 6905, Aspergillus fumigatus KCTC 6145) were tested MIC endpoints of Etest for itraconazole (ITZ) and amphotericin B (AMB) were read after 72, 96, and 120 hours incubation for each strains on RPMI 1640 agar. Results: MIC of ITZ was 0.12~0.47 microg/mL on T. rubrum, 0.012~1.0 microg/mL on T. mentagrophytes, 0.012 microg/mL on M. canis, and 0.023 microg/mL on M. gypseum. MIC of AMB was 0.094~0.5 microg/mL on T. rubrum, 0.032~1.0 microg/mL on T. mentagrophytes, 0.19 microg/mL on M. canis, and 0.032 microg/mL on M. gypseum. One strain of T. mentagrophytes isolated from patient with tinea pedis showed ITZ-resistant. Conclusion: This study showed that Etest represented a simple and efficacious method for antifungal susceptibility testing of dermatophytes.
Agar ; Amphotericin B ; Arthrodermataceae ; Aspergillus fumigatus ; Humans ; Itraconazole ; Skin ; Sprains and Strains ; Tinea Pedis

We report a case of rosacea-like tinea faciei in a 62-year-old female. The lesions were manifested by 2.0x2.0 cm and 2.0x2.0 cm-sized, two, pruritic, well-demarcated, erythematous macules on the nose and left ala nasi. Histopathologic examination of the skin lesion showed chronic dermal inflammation with presence of fungal hyphae in the honey layer of the epidermis. Fungal culture of the biopsy specimen grew out typical white cottony colonies of Trichophyton rubrum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Skin lesions improved one month after the treatment, and recurrence has not been observed.
Biopsy ; Epidermis ; European Continental Ancestry Group ; Female ; Honey ; Humans ; Hyphae ; Imidazoles ; Inflammation ; Middle Aged ; Naphthalenes ; Nose ; Recurrence ; Skin ; Tinea ; Trichophyton

Mycobacterium (M.) fortuitum is a rapidly growing mycobacterium. It is classified as Runyon's group IV with M. abcessus and M. chelonae that are mostly found in water and soil. M. fortuitum infection usually occurs after trauma, surgery or procedures such as acupuncture that cause cutaneous or soft tissue manifestations. We report a case of cutaneous infection due to M. fortuitum in a 72-year-old woman with erythematous deep-seated nodules on her left hand. She inflicted a minor injury to her left hand in a farm. Culture from skin biopsy specimens on 3% Ogawa medium yielded bacterial colonies after 5 days. The microorganism was subsequently identified as M. fortuitum by PCR-restriction fragment length polymorphism analysis. The skin lesions were improved by antibiotic therapy with clarithromycin for 6 months.
Acupuncture ; Aged ; Biopsy ; Clarithromycin ; Female ; Hand ; Humans ; Mycobacterium ; Mycobacterium fortuitum ; Skin ; Soil

We report a case of tinea corporis caused by Microsporum(M.) gypseum and keloid while applying tinea corporis with glacial acetic acid improperly in a 59 year-old female. The lesions were manifested by 7.0x4.5 cm-sized, localized pruritic fine scaly erythematous annular patch and keloid on left antecubital fossa. Culture from the annular skin lesion of patient on Sabouraud's dextrose agar showed typical colony of M. gypseum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Keloid was improved by intralesional steroid injection.
Acetic Acid ; Agar ; Female ; Glucose ; Humans ; Imidazoles ; Keloid ; Microsporum ; Naphthalenes ; Skin ; Tinea

We report a case of tinea corporis caused by Microsporum(M.) gypseum and keloid while applying tinea corporis with glacial acetic acid improperly in a 59 year-old female. The lesions were manifested by 7.0x4.5 cm-sized, localized pruritic fine scaly erythematous annular patch and keloid on left antecubital fossa. Culture from the annular skin lesion of patient on Sabouraud's dextrose agar showed typical colony of M. gypseum. The patient was treated with 250 mg of terbinafine daily for 1 month and topical lanoconazole application. Keloid was improved by intralesional steroid injection.
Acetic Acid ; Agar ; Female ; Glucose ; Humans ; Imidazoles ; Keloid ; Microsporum ; Naphthalenes ; Skin ; Tinea

BACKGROUND: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. METHODS: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. RESULTS: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. CONCLUSION: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.
Confounding Factors (Epidemiology) ; Diagnosis ; Diagnosis-Related Groups ; Humans ; Inpatients ; Korea

BACKGROUND: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. METHODS: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. RESULTS: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. CONCLUSION: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.
Confounding Factors (Epidemiology) ; Diagnosis ; Diagnosis-Related Groups ; Humans ; Inpatients ; Korea

We report a case of tinea corporis arising in previous burn area which shows tinea imbricata-like clinical appearance in a 69-year-old male. He showed round, 5.0x5.0 cm sized, fine scaly, well-defined erythematous patch with concentrically arranged rings of scales on the right forearm. Histopathologically, PAS staining revealed fungal hyphae in the horney layer of the epidermis. Fungal culture of scales of the lesions on Sabouraud's dextrose agar showed typical Trichophyton verrucosum. He was treated with oral terbinafine (250 mg/day) and topical lanoconazole for 1 month. Skin lesions improved one month after the treatment, and recurrence has not been observed
Agar ; Aged ; Burns ; Epidermis ; Forearm ; Glucose ; Humans ; Hyphae ; Imidazoles ; Male ; Naphthalenes ; Recurrence ; Skin ; Tinea ; Trichophyton ; Weights and Measures