Lipoma is a common benign tumor found at various sites in the body, but it is rarely encountered in the middle ear. We report a case of a 5-month-old girl who presented a middle ear lipoma, which was successfully removed by canal wall up mastoidectomy. To the best our knowledge, this is the youngest case of rare middle ear lipoma, which has ever been reported in the literature.
Ear, Middle ; Female ; Humans ; Infant ; Lipoma ; Otitis Media

Lipoma is a common benign tumor found at various sites in the body, but it is rarely encountered in the middle ear. We report a case of a 5-month-old girl who presented a middle ear lipoma, which was successfully removed by canal wall up mastoidectomy. To the best our knowledge, this is the youngest case of rare middle ear lipoma, which has ever been reported in the literature.

PURPOSE: Rotavirus is the main cause of infantile diarrheal disease worldwide, especially in patients 3-24 months of age. Infants younger than 3 months of age are relatively protected by transplacental antibody. So the purpose of this study is to evaluate the clinical features and severity of neonatal rotaviral gastroenteritis less than 1 month of age. METHODS: A retrospective chart review was established of 62 neonates less than 1 month of age and with a diagnosis of rotaviral gastroenteritis who had been admitted to Pochon CHA University between June 2002 through July 2004. The rotavirus was examined by stool latex agglutination. RESULTS: During 2 years, the total number of admitted patients for rotaviral gastroenteritis was 688 and among these, less than 1 month of age accounted for 9% (62). The occurrence was generally even distribution from January to July (7.14+/-1.0) but since then decreased (2.4+/-1.8). The most common chief complaint was mild fever (46%) when admitted which subsided within 1 hospital day in most patients. 4 patients had seizure and cyanosis with no typical symptoms of rotaviral gastroenteritis. During admission, all the patients had diarrhea. 17% of the patients had leukocytosis and positive C-reactive protein. In one patient, stool occult blood test was positive but there was no necrotizing gastroenteritis evidence. The mean period of hospital day was 5.8+/-2.5 and breast-milk feeding was 62.9%. CONCLUSION: Neonatal rotaviral gastroenteritis is not a rare disease. Most patients have fever and diarrhea and improve through conservative therapy but a few patients may have severe complications so we must be more cautious about the hygiene for prevention.
Agglutination ; C-Reactive Protein ; Cyanosis ; Diagnosis ; Diarrhea ; Fever ; Gastroenteritis* ; Humans ; Hygiene ; Infant ; Infant, Newborn* ; Latex ; Leukocytosis ; Occult Blood ; Rare Diseases ; Retrospective Studies ; Rotavirus ; Seizures

BACKGROUND: Cell culture is the golden standard method for Herpes simplex virus (HSV) isolation. However, some specimens require many days to develop any cytopathic effect (CPE). We developeda rapid sensitive culture technique for HSV isolations. METHODS: This study included a total of 133 patients with suspected HSV infection. Specimens were centrifuged onto a Vero cell monolayer in a shell vial. The CPE was observed daily during the5-day incubation by inverted-phase microscope. The direct immunofluorescence (DIF) stain with aHSV specific antibody was performed 2 days after sample inoculation. The negative samples in theDIF stain were reinoculated in the new shell vials after extraction of the monolayer. Polymerase chainreaction for HSV detection was performed using the original samples. RESULTS: The CPE was observed 30 (64%), 39 (83%), 43 (92%), 44 (94%), and 46 (98%) cases at1, 2, 3, 4, and 5 days incubation, respectively. The DIF stain detected 46 cases (98%) at 2 days incubation. The CPE was observed in another 7 cases at 1-day incubation after the reinoculation of negative samples. The PCR detected 47 (100%) of 133 cases. CONCLUSIONS: The reinoculation of negative sample in a shell vial culture is a rapid sensitive methodfor HSV isolation.
Cell Culture Techniques ; Culture Techniques ; Fluorescent Antibody Technique, Direct ; Humans ; Polymerase Chain Reaction ; Simplexvirus* ; Vero Cells

BACKGROUND: Accurate recognition of stroke victims by ambulance paramedics is necessary to ensure the rapid transfer of these patients to the hospital. We carried out a prospective study to characterize the cause of prehospital delays after stroke by the emergency medical service (EMS) and to determine the accuracy of identifying acute stroke by paramedics. METHODS: All paramedics in the Busan Metropolitan 119 EMS were asked to record the clinical presentations and time intervals from symptom onset to various points along the patients' prehospital course on the ambulance admission sheets for suspected stroke patients during a month (February 1, 2010 to February 28, 2010). Neurologists in twenty four hospitals reviewed the hospital records for the patients who were given a diagnosis of stroke or transient ischemic attack by the paramedics. RESULTS: Of the EMS on-scene evaluations, the diagnosis of stroke by ambulance paramedics was correct for 79 of the 186 (43%) patients. Positive predictive values for main suspected stroke symptoms were 95% in hemiparesis, 88% in speech disturbance and 44% in impaired consciousness. The prehospital personnel transferred the suspected stroke patients to each hospital at a mean of 25 minutes after the emergency 119 call. However, only 62% of the stroke patients called EMS within the first 2 hours of stroke. CONCLUSIONS: Public education for the need to seek EMS promptly after stroke as a medical emergency, and strokespecific training for EMS personnel are essential so that stroke patients receive effective acute treatment.
Allied Health Personnel ; Ambulances ; Consciousness ; Dietary Sucrose ; Emergencies ; Emergency Medical Services ; Hospital Records ; Humans ; Ischemic Attack, Transient ; Paresis ; Prospective Studies ; Stroke

Behcet's disease is a chronie inflammatory symptom complex consisting of recurrent oral ulcer, genital ulcer, ocular lesion or skin lesion. Intestinal involvement in Behcet's disease most commonly affects the ileocecal region in the patient with gestrointestinal symptoms, But esophageal involvement in Behcet's disease is very uncommon, most commonly affects the midesophagus with localized ulcerative lesion. A 38-Year-old woman with refractory and recurrent oral and genital ulcer was admitted because of aggravation of pharyngodynia and dysphagia. Gastrofiberscopic examination showed multiple, small sized ulcers on oral cavity and mid-to-distal esophagus. She was treated with steroid.
Adult ; Deglutition Disorders ; Esophagus ; Female ; Humans ; Mouth ; Oral Ulcer ; Skin ; Ulcer

BACKGROUND: There are many causes for the failure of aspirin therapy in patients with acute ischemic stroke. Laboratory aspirin resistance (AR) might be involved in clinical aspirin non-response. The PFA-100 is a laboratory method to evaluate AR in the clinical setting. However, there has been limited data regarding concordance with optical platelet aggregometry, which is considered the gold standard for detecting AR. We retrospectively analyzed platelet function tests using the PFA-100 and an optical platelet aggregometer in 86 patients with acute ischemic stroke. METHODS: Eighty six patients were enrolled in the study and were evaluated the platelet function test by optical aggregometer and a PFA-100. We determined the variability in the prevalence of AR and the kappa value between the two tests in patients with acute ischemic stroke. RESULTS: Among 86 patients, 27 (31.4%) were detected as AR by the optical aggregometer and 31 (36.0%) by the PFA-100. There were 13 cases of AR (15.1%) in both laboratory methods. The optical platelet aggregometer results showed that female gender (P=0.03), aspirin monotherapy (P =0.05), and NIHSS at baseline (P=0.04) were related with AR in acute ischemic stroke. Multiple logistic regression analysis showed that NIHSS was independently associated with AR of the optical platelet aggregometer (OR=1.12 95%, CI: 1.00-1.25, P=0.05). CONCLUSION: The prevalence of AR was similar between the PFA-100 and the optical platelet aggregometer in patients with acute ischemic stroke. However, the concordance rate of these two tools is low.
Aspirin ; Blood Platelets ; Female ; Humans ; Logistic Models ; Platelet Aggregation ; Platelet Function Tests ; Prevalence ; Retrospective Studies ; Stroke

Lidocaine is a commonly used local anesthetic for dental treatment. Urticaria caused by lidocaine has seldom been reported. Generally, urticaria immediately develops after exposure to a causative agent and is considered a manifestation of IgE-mediated hypersensitivity. However, delayed urticaria caused by local anesthetics was reported to be related to cell mediated hypersenstivity. A 3-year old girl visited our allergy clinic due to delayed urticaria after local administration of lidocaine. Both skin prick and intradermal tests with lidocaine revealed negative reactions. However, the provocation test with subcutaneous injection of lidocaine showed urticaria 7 hours after test. In order to identify alternative local anesthetic for the subsequent dental procedure, we performed skin prick, intradermal and provocation tests with procaine, a local anesthetic of the other class, all of which showed negative results. Therefore, we recommended procaine as an alternative local anesthetic, and the patient was successfully treated with procaine. To the best of our knowledge, this is the first case of delayed urticaria caused by lidocaine in Korea.
Anesthetics, Local ; Child* ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Injections, Subcutaneous ; Intradermal Tests ; Korea ; Lidocaine* ; Procaine ; Skin ; Urticaria*

OBJECTIVES: Diffusion tensor imaging (DTI) is a new technique that can be used to visualize and measure the diffusion of water in brain tissue. It is particularly useful for evaluating white matter abnormalities. In this paper, we investigated the neuropathology of the corpus callosum in patients with schizophrenia through the new methods, diffusion tensor imaging. METHODS: Diffuse tensor imaging was performed in 19 schizophrenic patients and 26 healthy controls. One complementary measure, fractional anisotropy (FA), which is considered to be sensitive indices of axonal integrity, was obtained from regions of interest in the five areas of the corpus callosum. Neuropsychological measurement also underwent for measurement of frontal lobe function in two groups. RESULTS: There were no significant differences of FA in the DTI measures for either the schizophrenic patients compared with controls. FA was significantly decreased in women compared with men. Neuropsychological measurements such as Wisconsin card sorting test were correlated with FA of patients with schizophrenia. CONCLUSION: FA measures revealed no differences between schizophrenia and controls. The findings suggest that the structural integrity of white matter in patient with schizophrenia was not disrupted. The results are discussed in relation to previous studies reporting positive and negative findings. It is concluded that further studies using DTI in larger samples, improved and standardized methods of data acquisition and analysis are needed.
Anisotropy ; Axons ; Brain ; Corpus Callosum* ; Diffusion Tensor Imaging* ; Diffusion* ; Female ; Frontal Lobe ; Humans ; Male ; Schizophrenia* ; Water ; Wisconsin

Dermatomyositis (DM) is rare systemic inflammatory disease with typical skin manifestations and muscular involvement. Various skin lesions can accompany this disease, such as Gottron's sign, Heliotrope rash, mechanic's hands, V sign and shawl sign. Scleredema is a very rare skin manifestation in DM. We report a case of DM in a 63-year-old woman, who had scleredema on her thighs. A diagnosis of DM was established by clinical manifestation, elevated muscle enzyme levels, electromyogram measures, and muscle biopsy findings. She was successfully treated with the immunosuppressants methotrexate, cyclosporine, and steroids (low dose).
Biopsy ; Cyclosporine ; Dermatomyositis ; Exanthema ; Female ; Hand ; Humans ; Immunosuppressive Agents ; Methotrexate ; Middle Aged ; Muscles ; Scleredema Adultorum ; Skin ; Skin Manifestations ; Steroids ; Thigh