Verrucous carcinoma is a low-grade squamous cell carcinoma first described in 1948 by Ackerman. It is a slowly growing, fungating and verrucous tumor that may penetrate deep into the tissue. There are many causative agents such as HPV infection, chronic irritation, radiation, and etc. We report a case of verrucous carcinoma developed at the wrist joint, a relatively unusual site.

PURPOSE: To evaluate the efficacy and safety of pterygium excision using a large conjunctival autograft for the treatment of recurrent pterygium. METHODS: The medical records of 120 patients (126 eyes) with recurrent pterygium were reviewed. For each affected eye, pterygium excision with a large conjunctival autograft was performed. The graft was harvested from the superior bulbar area and measured more than 8 × 10 mm in size. Only patients who completed at least six months of follow-up were included. Postoperative clinical outcomes, recurrence rate, and complications were analyzed. Patients with any evidence of recurrence after surgery received a subconjunctival bevacizumab injection. RESULTS: The average patient age was 56.5 ± 10.2 years, and 45 out of 120 patients were male. The mean study follow-up period was 17.7 ± 17.6 months. Most patients were satisfied with the cosmetic outcome. Postoperative visual acuity improved from 0.69 to 0.75 (p < 0.05). Postoperative refractive astigmatism and corneal astigmatism decreased by 0.55 and 2.73 diopters, respectively (p < 0.05). The postoperative recurrence rate was 4.0%, and the average recurrence period was 7.4 ± 0.6 weeks. A subconjunctival injection of 5 mg bevacizumab was performed in cases of recurrence; no progression of the pterygium was observed following the injection. Postoperative complications included 2 cases of conjunctival graft edema in 2 eyes, 5 donor site scars in 5 eyes, 13 pyogenic granulomas in 13 eyes, and a conjunctival epithelial inclusion cyst in 7 eyes. CONCLUSIONS: Pterygium excision with a large conjunctival autograft for the treatment of recurrent pterygium produced an excellent cosmetic outcome, a low recurrence rate, and minimal complications. A subconjunctival bevacizumab injection given in cases of recurrence following surgery might be effective in preventing progression of the pterygium.
Astigmatism ; Autografts* ; Bevacizumab ; Cicatrix ; Edema ; Follow-Up Studies ; Granuloma, Pyogenic ; Humans ; Male ; Medical Records ; Postoperative Complications ; Pterygium* ; Recurrence ; Tissue Donors ; Transplants ; Visual Acuity

PURPOSE: The purpose of this study was to compare the diagnostic accuracies of chest radiographs and chest CTin the diagnosis of a solitary pulmonary nodule(SPN), and to determine the role of CT and CT findings which aid inthe differential diagnosis of nodules. MATERIALS AND METHODS: A retrospective study was done on 54 patients inwhom SPN was found on chest radiographs and chest CT was carried out. The study involved 25 benign and 29 malignant nodules, confirmed histopathologically and clinically. Chest radiographs and CT scans were reviewed separately in randomized order by two chest radiologists who for each film listed the three most likely diagnose sin descending order. The radiologists recorded the confidence value of the most probable diagnosis, and also the marginal and internal characteristics of nodules and their size, as nodules seen on chest CT scans. RESULTS: Diagnostic rates in the differential diagnosis of benign and malignant nodules were 65.7% by radiography and 77.8% by CT. Correct first-choice diagnosis was by radiography in 30.6 % of cases, and by CT in 41.7%. Using radiographs, and the correct diagnosis was among the top-three choices in 61.1% of cases ; with CT, the corresponding figure was 76.8%. Overall, a confident diagnosis was reached more often with the CT(41.7%) than with the chest radiograph(21.4%) ; diagnaotic accuracy was 60.0% and 52.2%, respectively. CT findings which imply abenign nodule include smooth margins and diffuse internal calcifications, whereas marginal lobulations, air-bronchograms, internal low density without cavitation, eccentric calcifications, and large size suggest malignancy. We faund that CT findings such as well-defined margins, spiculations, pleural tail or internal homogeneity did not contribute in the differentiation between benign and malignant nodules. CONCLUSION: CT issuperior to chest radiography in the differential diagnosis of the solitary pulmonary nodule. Using CT, diagnosis was accurate and made with a high level of confidence, especially with the application of CT findings which aid inthe differential diagnosis of nodules.
Diagnosis ; Diagnosis, Differential* ; Humans ; Radiography* ; Radiography, Thoracic ; Retrospective Studies ; Solitary Pulmonary Nodule* ; Thorax* ; Tomography, X-Ray Computed

PURPOSE: To evaluate and compare visual outcomes and optical quality after implantation of a bifocal (Acrysof ReSTOR® SN6AD1) or trifocal (AT LISA® tri 839MP) diffractive intraocular lens (IOL). METHODS: Fifty-one eyes of 43 patients undergoing cataract surgery were enrolled and assigned to one of two groups: the trifocal group, comprising 24 eyes implanted with the trifocal diffractive IOL (AT LISA® tri 839MP), and the bifocal group, comprising 27 eyes implanted with the bifocal diffractive IOL (Acrysof ReSTOR® SN6AD1). Visual acuity (distant, intermediate, and near vision) and refractive postoperative outcomes were evaluated at one and three months postoperatively. Measurements of optical quality (using OQAS II®), contrast sensitivity (using CGT-2000®), automated visual field examination, and evaluation of defocus curve were performed three months postoperatively. RESULTS: No statistically significant differences between the two groups were found in three-month postoperative distant and near (40 cm) visual acuities and optical quality. However, intermediate (63 cm, 80 cm, and 100 cm) visual acuities were significantly better in the trifocal group. Distant contrast sensitivity (5 m) under mesopic conditions was significantly better with the bifocal lens, whereas near contrast sensitivity (30 cm) under mesopic and scotopic conditions was significantly better with trifocal lens. There was no statistical difference between the groups under photopic conditions. In the defocus curve, the visual acuity was significantly better at intermediate distance in the trifocal group. CONCLUSIONS: Trifocal diffractive IOLs provide significantly better intermediate vision than bifocal IOLs, with equivalent postoperative levels of distant and near vision and ocular optical quality. Further, they provide better near contrast sensitivity under scotopic condition compared to diffractive bifocal IOLs.
Cataract* ; Contrast Sensitivity ; Humans ; Lenses, Intraocular* ; Visual Acuity ; Visual Fields

A patient with cutaneous sarcoidosis was treated with thalidomide for steroid unresponsive sarcoidal granulomas of the skin. The duration of the therapy was 16 weeks, during which time, the skin lesions showed clinically and histologically improvement. The initial dosage was 50mg a day, which was increased to 100mg a day after 5 weeks. No side effect was noted. The good response of sarcoidal granulomas of the skin to thalidomide observed in this patient demonstrates the usefulness of this drug as a possible long-term monotherapeutic or steroid-sparing agent in the treatment of cutaneous sarcoidosis.
Granuloma ; Humans ; Sarcoidosis* ; Skin ; Thalidomide*

OBJECTIVE: Infection is very common in the elderly, so there is a high prevalence of antibiotics use among this population. Especially, due to the emergence of resistant bacteria, the use of vancomycin is growing. The purpose of this study was to evaluate risk factors associated with vancomycin-induced nephrotoxicity in elderly patients. METHODS: The subjects of this study were patients over 18 years old who received intravenous vancomycin in a general hospital located in Gangneung-si, Korea between August 1, 2013 and July 31, 2015. Data collection regarding vancomycin use and baseline characteristics was conducted using computerized hospital database. Logistic regression analysis was used to identify risk factors associated with vancomycin-induced nephrotoxicity. RESULTS: A total of 290 patients were finally included, and 191(66%) out of these patients were age 65 or older. The incidence of vancomycin-induced nephrotoxicity was 11.0%, 12.6%, and 7.0% in the all adult patients, the elderly patients, and the non-elderly patients, respectively. There were significant differences in comorbidities between patients with nephrotoxicity and patients without nephrotoxicity in the all adult patients, and there were significant differences in vancomycin duration, comorbidities, and number of nephrotoxic agents between patients with nephrotoxicity and patients without nephrotoxicity in the elderly patients. However, according to the logistic regression analysis, there was no significant risk factor that increases the incidence of vancomycin-induced nephrotoxicity in all three age groups. CONCLUSION: There were no differences in risk factors that increase the incidence of vancomycin-induced nephrotoxicity between all adult patients, elderly patients, and non-elderly patients. Further studies with larger sample sizes to identify risk factors associated with vancomycin-induced nephrotoxicity in the elderly to improve the outcome of pharmacotherapy are required.
Acute Kidney Injury ; Adult ; Aged* ; Anti-Bacterial Agents ; Bacteria ; Comorbidity ; Data Collection ; Drug Therapy ; Hospitals, General ; Humans ; Incidence ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Sample Size ; Vancomycin

PURPOSE: HLA (human leukocyte antigen)-class I genes are highly polymorphic, play many roles in organ and bone marrow transplantation. HLA-B is the most polymorphic class I locus with 414 alleles. HLA-class I typing, which is based on serologic method, has been used until recently. The development of molecular biological techniques make it possible to define the genotypes of HLA genes. METHODS: Analyses of HLA-B genotyping on 1,000 UCB (Umbilical Cord Blood) samples which were considered to be HLA-B homozygote or blank were performed by ARMS-PCR (Amplification Refractory Mutation System-PCR) method and direct sequencing. RESULTS: We could identify HLA-B*5001 which was known to be absent in Koreans. CONCLUSION: It is strongly suggested that HLA-B homozygote should be confirmed to the DNA level especially in cases of donor selection for the unrelated bone marrow transplantation.
Alleles ; Bone Marrow Transplantation ; DNA ; Donor Selection ; Fetal Blood ; Genotype ; HLA-B Antigens ; Homozygote ; Leukocytes

OBJECTIVE: To determine the publication rate of abstracts presented by Korean investigators at national and international radiological meetings, and to identify predictive factors of publication. MATERIALS AND METHODS: Abstracts presented at the annual meetings of the Korean Radiological Society (KRS), and abstracts presented by Korean investigators at the annual meetings of the Radiological Society of North America (RSNA) and European Congress of Radiology (ECR) from 2001 to 2002 were searched for subsequent publication, using PubMed and the Korean Medical Database. The following variables were evaluated. 1) The overall publication rate; 2) the publication rates according to the radiological subspecialty, presentation type (oral or poster), sample size (< or = 20, 21-50, or > 50), study design (prospective or retrospective), statistical analysis (present or absent), and study outcome (positive or negative); 3) the time to publication; 4) the journal where the study was published; 5) consistency between the abstract and the final publication. RESULTS: Of 1,097 abstracts, 301 (27.4%) were subsequently published, at an average of 15.8 +/- 13.8 months after presentation in 48 journals. The publication rates for studies presented at the RSNA (35.4%) and ECR (50.5%) conferences were significantly higher than that for the KRS conference (23.6%, p < 0.05). Vascular/interventional radiology studies had the highest publication rate (33.1%), whereas musculoskeletal radiology studies had the lowest publication rate (17.1%). Other factors associated with subsequent publication were prospective design, use of statistical testing, and a positive study outcome. CONCLUSION: The publication rate is significantly lower for the KRS (23.6%) meeting abstracts as compared to those of the RSNA (35.4%) and ECR (50.5%). Prospective design, use of statistical testing, and positive study outcome have a statistically significant effect on the publication rate.
Congresses as Topic ; Europe ; Korea ; North America ; Publishing/*statistics & numerical data ; *Radiology ; Research Design ; Societies, Medical

Hepatic ischemia/reperfusion (I/R) injury leads to oxidative stress and acute inflammatory responses that cause liver damage and have a considerable impact on the postoperative outcome. Much research has been performed to develop possible protective techniques. We aimed to investigate the efficacy of SPA0355, a synthetic thiourea analog, in an animal model of hepatic I/R injury. Male C57BL/6 mice underwent normothermic partial liver ischemia for 45 min followed by varying periods of reperfusion. The animals were divided into three groups: sham operated, I/R and SPA0355 pretreated. Pretreatment with SPA0355 protected against hepatic I/R injury, as indicated by the decreased levels of serum aminotransferase and reduced parenchymal necrosis and apoptosis. Liver synthetic function was also restored by SPA0355 as reflected by the prolonged prothrombin time. To gain insight into the mechanism involved in this protection, we measured the activity of nuclear factor-kappaB (NF-kappaB), which revealed that SPA0355 suppressed the nuclear translocation and DNA binding of NF-kappaB subunits. Concomitantly, the expression of NF-kappaB target genes such as IL-1beta, IL-6, TNF-alpha and iNOS was significantly downregulated. Lastly, the liver antioxidant enzymes superoxide dismutase, catalase and glutathione were upregulated by SPA0355 treatment, which correlated with the reduction in serum malondialdehyde. Our results suggest that SPA0355 pretreatment prior to I/R injury could be an effective method to reduce liver damage.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Benzoxazines/*therapeutic use ; Liver/*drug effects/immunology/*injuries/pathology ; Male ; Mice, Inbred C57BL ; NF-kappa B/immunology ; Reperfusion Injury/*drug therapy/immunology/pathology ; Signal Transduction/drug effects ; Thiourea/*analogs & derivatives/therapeutic use

Background: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. Methods: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. Results: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively. Conclusion In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.