BACKGROUND: Pusan is geographically far away from the indigenous area of malaria. It is the area where the tourists and foreigners travel through frequently because of the port. We investigated the situation in Pusan concerning malaria through the examination of malaria patients who contracted it recently. We found the ways to decrease erroneous diagnosis presuming malaria on the basis of these studies. METHODS: We retrospectively analyzed the medical records of 28 confirmed cases of malaria with the chief complaint of repeated high fever, who were admitted and treated in the Pusan Adventist Hospital and Pusan Samsun Hospital from June 1997 to August 2000. RESULTS: 25 cases were indigenous and 3 patients were imported cases contracted overseas. Peripheral blood smears revealed Plasmodium vivax in all indigenous cases, whereas 2 were P. falciparum and 1 case was P. vivax in the imported cases. Yeonchon-goon(9 cases) was the most prevalent area in the indigenous cases. Africa and Southeast Asia(3 cases) were the contracted areas in the imported cases. 27 cases were men and 1 case was a woman among the 28 cases, and the incidence was high peak in 8-10 month. Most of the patients(72.1%) were in the their 20's, and most of all had worked in the military bases near the demilitarized zone(DMZ). Thrombocytopenia and leukopenia were found more frequently by the laboratory findings. 23 of the cases(82%) were suspected to be malaria, before we confirmed it by peripheral blood smears. CONCLUSION: The number of patients with indigenous malaria from the other areas in Korea and patients with malaria from foreign countries will be expected to increase. Before we confirmed the malaria by peripheral blood smears, the cases suspected of malaria were 82.1%. This is a high diagnostic rate due to careful history taking and physical examination. The doctors decreased the rate of erroneous diagnosis of malaria and should be careful in the choice of the proper drugs.
Africa ; Busan* ; Diagnosis ; Emigrants and Immigrants ; Female ; Fever ; Humans ; Incidence ; Korea ; Leukopenia ; Malaria* ; Male ; Medical Records ; Military Facilities ; Physical Examination ; Plasmodium vivax ; Retrospective Studies ; Thrombocytopenia

Perforation of the interventricular septum complicating acute myocardial infarction is uncommon. The condition was first described anatomically by Latham in 1845 and the first antemortem diagnosis was made by Brunn in 1923. In both cases, bedside catheterization utilizing a flow directed catheter detected a step up of O2 saturation at the ventricular level, compatible with ventricular septal defect, and two dimensional echocardiogram allowed direct visualization and localization of the postmyocardial infarction VSD. Finally cineventriculogram confirmed them.
Catheterization ; Catheters ; Diagnosis ; Heart Septal Defects, Ventricular ; Infarction* ; Myocardial Infarction

Angioedema is a well-demarcated localized edema involving the deeper layers of the skin, including the subcutaneous tissue. Angioedema occurs with Cl esterase inhibitor (Cl INH) deficiency that may be inborn as an autosomal dominant characteristic or may be acquired. Acquired angioedema (AAE) is a rare disorder characterized by adult onset and lack of evidence of inheritance of the disease. Two types of AAE are known today: type I in which there are lowering of functional Cl INH, an underlying disease such as a B-cell disease, and no detectable autoantibodies to Cl INH, type II with anti Cl INH autoantibodies in the circulation without detectable underlying disease and with depressed functional Cl INH levels. We experienced a case of angioedema in a 29-year old man. He had no family history of angioedema and laboratory data showed depressed Cl-INH levels. We diagnosed the case as acquired type of angioedema. Even though we could not measure anti-Cl INH auto-antibodies, we identified the case as type II because there was no evidence of underlying disease.
Adult ; Angioedema* ; Angioedemas, Hereditary* ; Autoantibodies ; B-Lymphocytes ; Complement C1 Inhibitor Protein* ; Complement C1s* ; Edema ; Humans ; Skin ; Subcutaneous Tissue ; Wills

PURPOSE: Warthin's tumor is a slow growing tumor found exclusively either in the parotid gland or the periparotid lymph nodes. Although surgical resection is the treatment of choice, the extent of surgery which is most beneficial has remained contraversial. We performed a comparative study of the results between enucleation and parotidectomy groups to evaluate the effectiveness of the enucleation procedure for the surgical management of parotid Warthins tumor. METHODS: Between January 1981 and July 2001, 74 patients underwent surgical resection of parotid Warthin's tumor. We reviewed the clinicopathological characteristics retrospectively and compared the operation time, postoperative complication rate, duration of postoperative hospital stay and recurrence between the enucleation group and the parotidectomy group. RESULTS: The mean age was 57.0 years (19~86 years) and the male to female ratio was 5.7: 1. The majority of the tumors were situated in the lower region of the superficial lobe (89.2%). Bilateral simultaneous involvements of the parotid gland was found in 5 patients (6.8%) and therefore a total of 79 parotid glands were involved. Four (5.4%) of the 79 parotid glands featured multifocal tumors of two or three lumps. Tumor sizes varied from 0.5 to 13.0 cm with a mean diameter of 3.5 cm. Of the 74 patients, 51 (68.9%) were diagnosed preoperatively or perioperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 79 glands, 46 underwent a superficial (n=39), partial (n=2) or total (n=5) parotidectomy, while enucleation was performed for the remaining 33 cases with single Warthin's tumor. Only one case of recurrence was identified during the follow up period. However the operation time, the postoperative complication rate, and the duration of postoperative hospital stay were all significantly reduced in the enucleation group (P<0.05). CONCLUSION: The enucleation procedure may represent a safe and appropriate surgical method for patients with single Warthin's tumor that is diagnosed preoperatively.
Biopsy ; Biopsy, Fine-Needle ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Length of Stay ; Lymph Nodes ; Male ; Parotid Gland ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor.However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a ‘string of pearls’ vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment.After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.

Acne vulgaris is a universal skin disease with multifactorial pathogenesis. Although an extensive range of treatment options exist for acne, a substantial number of patients are still struggling for an optimal treatment option due to the side effects or contraindications to the conventional acne treatment. Negative air ions (NAIs) are electrically charged molecules that naturally exist in the atmosphere. Since they are natural component of air, there are no known side effects and contraindications to their application. Furthermore, among the identified benefits of NAIs, certain mechanisms are related to acne pathogenesis, allowing them to be attractive candidates for acne treatment. Here, we describe three patients with acne who showed considerable clinical improvement after NAI therapy. All of the patients had failed to tolerate traditional acne treatment options. In all three cases, considerable improvement was observed in acne severity and the number of total lesions. Based on the three cases and a review of literature underlying the effects of NAIs, we suggest that NAIs may be a safe and effective alternative therapeutic option for acne vulgaris.

Clear cell acanthoma (CCA) is an uncommon, benign epithelial tumor presenting as a well-defined, slow-growing solitary nodule. The diagnosis of CCA is usually based on clinical and histopathological evaluation of the tumor.However, when such type of benign tumor occurs on an exposed area, a biopsy is not always the best diagnostic option since it may leave scar. The recent advent of dermoscopy has offered an accurate and non-invasive method to diagnose CCA without resorting to skin biopsy. A 40-year-old male presented with a shiny, erythematous-to-brown, flattened nodule on the left cheek. Dermoscopic examination revealed a ‘string of pearls’ vascular pattern, a characteristic dermoscopic feature of CCA. Under the clinical and dermoscopic impression of CCA, a 595 nm pulsed dye laser (PDL) therapy targeting the vascular tissue in the superficial dermis of the lesion was chosen for a minimally invasive treatment.After repeated sessions of PDL, an optimal cosmetic outcome was achieved and no recurrence was recorded during the follow-up period. Herein, we report a case of presumed CCA which was successfully diagnosed and treated by utilizing non-invasive modalities.

An attempt has been made to discriminate synaptic diversity in the neostriatum of the cat with emphasis on the characteristic structures of axon terminals and postsynaptic profiles. The differentiation of the axon terminals was based on the size and shape of synaptic vesicles in the axoplasm. Three types of axon terminals could be differentiated: Type I, the terminals contained small round (45 nm in diameter) vesicles; type II, the terminals with large pleomorphic (50 nm) vesicles; and type III, the terminals contained flattened (45 x 25 nm) vesicles. The type I terminals were making asymmetrical or symmetrical synapses in contact with the somata, dendrites and dendritic spines of neurons in the neostriatum, and a few type I terminals making asymmetrical or symmetrical contact with axons were also observed. The type II and III terminals were making symmetrical contact with the somata and dendrites of neostriatal neurons. A few type II terminals formed at the node of Ranvier of myelinated nerve fibers were making symmetrical contact with large dendrites. Additionally, dendro-dendritic and serial syanpses were rarely found in the neostriatum. In the serial synapses composed of axo-dendritic and dendro-dendritic synapses, the type I terminals making asymmetrical contact and the type II making symmetrical contact were identified.
Animals ; Axons ; Cats* ; Dendrites ; Dendritic Spines ; Neostriatum* ; Nerve Fibers, Myelinated ; Neurons ; Presynaptic Terminals ; Synapses ; Synaptic Vesicles

Objective: The aim of the present study was to evaluate cortical hypometabolism of the F-18- fluorodeoxyglucose positron emission tomography (FDG-PET) based on a diagnostic cutoff point of the mini-mental state examination (MMSE) in de novo PD.Methods: We recruited 24 PD patients and 15 healthy controls to analyze FDG-PET. We divided the patients into two groups by the diagnostic cutoff point of MMSE for diagnosing dementia, with scores of>25 vs. < 25. FDG-PET was processed using statistical parametric mapping (SPM) 8 running on Matlab 11. Results: Patients with a MMSE < 25 presented lower score in time orientation, serial sevens, language and pentagon copying of MMSE compared to patients with a MMSE >25. Compared to healthy controls, patients with a MMSE> 25 and < 25 showed a fronto-temporo-parietal hypometabolism, which was more extended in patients with a MMSE < 25. Difference in cortical hypometabolism between patients with a MMSE >25 and < 25 was found in the right inferior parietal lobule. Conclusions: In the comparison by cutoff point of MMSE (25/24), hypometabolism in the right inferior parietal lobule suggests that the posterior cortical deficit is the main region ofde novo PD with cognitive impairment. Hypometabolism of right inferior parietal lobule is related to the damage of cerebral networkin de novo PD.
Parkinson Disease

A stercoral perforation of the colon is a very rare condition, which results from stercoral ulcers due to severe, prolonged constipation, and has a very high mortality rate. Herein is presented four cases of stercoral perforation of the sigmoid colon. All the patients were female. They had long standing and severe constipation, with peritonitis, prior to admission. Plain chest or abdominal X-rays revealed the presence of abdominal free air in all cases, and so emergent operations were undertaken. Fecalomas were found in the colon or abdominal cavity, with round and spherical shaped perforated sites. Microscopically, the edges of the ulcers were compressed with the accumulation of lymphocytes. A resection of the perforated colon with a proximal colostomy was performed in one case, a primary closure of the perforated colon and a proximal colostomy in another and a Hartmann's colostomy in the remaining two cases.
Abdominal Cavity ; Colon* ; Colon, Sigmoid ; Colostomy ; Constipation ; Female ; Humans ; Lymphocytes ; Mortality ; Peritonitis ; Thorax ; Ulcer