Background: A patient’s overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods: Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results: The bacterial study had 29 positive results. Based on these results and the patient’s status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

Background: Eye measurements in Koreans have been studied extensively, but researchers have reported widely differing values, even for the same parameters. These discrepancies are likely due to inconsistencies in the proportions of subjects with double eyelids included in their studies. We retrospectively studied eye measurements according to the presence or absence of double eyelids, and compared the results to those of previous studies. Methods: We conducted anthropometric measurements of eyes in young (20–29 years) Korean women with no congenital malformation, trauma, or surgery of the eyelids. The participants were dichotomized according to the presence of double eyelids, resulting in 116 eyes with single eyelids and 124 with double eyelids. We measured the palpebral fissure length (PFL), palpebral fissure height (PFH), margin reflex distance 1 (MRD1), intercanthal distance (ICD), interpupillary distance (IPD), outer canthal distance (OCD), and inclination of the palpebral fissure in each eye. Results: The mean PFL was 24.1 mm in the single-eyelid group and 25.5 mm in the double-eyelid group. The other mean values for the two groups were as follows: PFH, 8.0 mm and 9.9 mm, respectively; MRD1, 2.8 mm and 4.1 mm, respectively; IPD, 61.6 mm and 62.8 mm, respectively; and OCD, 85.3 mm and 87.9 mm, respectively. Conclusions In the double-eyelid group, the horizontal and vertical length of the eye was greater than in the single-eyelid group, and the mean values of IPD, OCD, PFL, PFH, and MRD1 were statistically significantly higher.

The presented case is a 43-year-old male with a painless mass in the right neck for two weeks. Excisional biopsy was performed under the clinical impression of malignant lymphoma, because he experienced lymphoma 32 months ago. Histopathologically, it shows hyperplasia of small blood vessels and lymphoid cells with eosinophilic infiltration, so it was diagnosed as Kimura's disease. This seems to be the first reported case of Kimura's disease developed during follow up period after remission of lymphoma.
Adult ; Biopsy ; Blood Vessels ; Eosinophils ; Follow-Up Studies* ; Humans ; Hyperplasia ; Lymphocytes ; Lymphoma* ; Male ; Neck ; T-Lymphocytes

PURPOSE: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. MATERIALS AND METHODS: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. RESULTS: As the animals were anesthetized, the baseline temperature at the start of each session decreased by 1.3degrees C to 2.8degrees C (median, 2.1degrees C). The mean increases in temperature measured by the intrahepatic sensors were 2.42degrees C (95% confidence interval [CI], 1.70-3.13) and 2.67degrees C (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were 2.10degrees C (95% CI, 0.71-3.49) and 2.87degrees C (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. CONCLUSION: We observed mean 2.67degrees C and 2.87degrees C increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.
Anesthesia, General ; Animals ; Fever* ; Glass ; Liver* ; Peritoneal Cavity ; Skin ; Skin Temperature ; Swine ; Thermometry ; Ultrasonography

Staphylococcal scalded skin syndrome is a systemic disease with a clinical spectrum ranging from subcorneal pustules, patterned exfoliation to extensive erosion and peeling of skin by the exfoliative toxin of group II Staphylococcus aureus. This disease occurs mainly in infancy and children below five years and it isn't easy to differentiate from other vesicular diseases clinically, but skin biopsy shows an epidermal split at the granular layer. The form and severity of staphylococcal scalded skin syndrome will vary according to defense system and toxic factors. Treatment is effective antibiotics, and the mortality rate increases to 5% in children. In our four cases, symptoms were erythema and fever, followed by formation of large bullae and denuded skin. On laboratory findings, leukocytosis was noted in three cases, and S. aureus was confirmed by culture of eye discharge in all cases. Our cases improved with antibiotic therapy. We experienced four cases of staphylococcal scalded skin syndrome which were presented with vesicle and exfoliative skin lesion and treated successfully.
Anti-Bacterial Agents ; Biopsy ; Child ; Erythema ; Fever ; Humans ; Leukocytosis ; Mortality ; Skin ; Staphylococcal Scalded Skin Syndrome* ; Staphylococcus aureus

This article provides an annual update of Korean breast cancer statistics, including the incidence, tumor stage, type of surgical treatment, and mortality. The data was collected from the Korean Breast Cancer Society registry system and Korean Central Cancer Registry.In 2019, 29,729 women were newly diagnosed with breast cancer. Breast cancer has continued to increase in incidence since 2002 and been the most common cancer in Korean women since 2019. Of the newly diagnosed cases in 2019, 24,820 (83.5%) were of invasive carcinomas, and 4,909 (16.5%) were of carcinoma in situ. The median age of women with breast cancer was 52.8 years, and breast cancer was most commonly diagnosed in the age group of 40–49 years. The number of patients who have undergone breast conserving surgery has continued to increase since 2016, with 68.6% of patients undergoing breast conserving surgery in 2019. The incidence of early-stage breast cancer continues to increase, with stage 0 or I breast cancer accounting for 61.6% of cases. The most common subtype of breast cancer is the hormone receptor-positive human epidermal growth factor receptor 2-negative subtype (63.1%). The 5-year relative survival rate of patients with breast cancer from 2015 to 2019 was 93.6%, with an increase of 14.3% compared to that from 1993 to 1995. This report improves our understanding of breast cancer characteristics in South Korea.

PURPOSE: Allergic disease and its comorbidities significantly influence the quality of life. Although the comorbidities of allergic diseases are well described in adult populations, little is known about them in preschool children. In the present study, we aimed to assess the prevalence and comorbidity of allergic diseases in Korean preschool children. METHODS: We conducted a cross-sectional study comprising 615 Korean children (age, 3 to 6 years). Symptoms of allergic diseases were assessed using the Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire that was modified for preschool children. Comorbidities of allergic diseases were assessed by 'In the last 12 months, has your child had symptoms?'. RESULTS: The prevalence of symptoms of asthma, allergic rhinitis, and atopic dermatitis as recorded using the ISAAC questionnaire, within the last 12 months was 13.8%, 40.7%, and 20.8%, respectively. The symptom rates of allergic conjunctivitis, food allergy, and drug allergy were 14.8%, 10.4%, and 0.8%, respectively. The prevalence of allergic rhinitis in children with asthma was 64.3% and that of asthma in children with allergic rhinitis was 21.6%. The prevalence of rhinitis in children with conjunctivitis was 64.8% and that of conjunctivitis in children with rhinitis was 23.6%. CONCLUSION: The prevalence of current rhinitis in our preschool children is shown to be higher than that previously reported. Allergic conjunctivitis is closely associated with asthma and allergic rhinitis. However, further studies are warranted to determine the prevalence and effects of these comorbidities on health outcomes in preschool children.
Adult ; Asthma ; Child ; Child, Preschool ; Comorbidity ; Conjunctivitis ; Conjunctivitis, Allergic ; Cross-Sectional Studies ; Dermatitis, Atopic ; Drug Hypersensitivity ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Prevalence ; Quality of Life ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial

Goltz syndrome(focal dermal hypoplasia) is a rare disorder characterized by ectodermal and mesodermal dysplasia described in 1962 by Goltz. In Korea, one case of Goltz syndrome was reported in 1994. The inheritance mode is mostly X-linked dominant. Skin abnormality is the most common manifestation including hypoplasia of the dermis. Skeletal involvement such as syndactyly, polydactyly, scoliosis, kyphosis and spina bifida occulta may be present, also ocular and dental abnormalities are reported. Radiologic findings are the osteopathy and striation of the long bone. We experienced a case of Goltz syndrome in a 9-year old female who was presented with right side hypotrophy, focal dermal hypoplasia, ocular(anidria, microcornea), dental(oligodontia, amelogenesis) and skeletal(syndactyly) abnormalities. Skin biopsy was performed and showed decreased expression of type I collagen gene with Northern blotting.
Biopsy ; Blotting, Northern ; Child ; Collagen Type I ; Dermis ; Ectoderm ; Female ; Focal Dermal Hypoplasia* ; Humans ; Korea ; Kyphosis ; Mesoderm ; Polydactyly ; Scoliosis ; Skin ; Skin Abnormalities ; Spina Bifida Occulta ; Syndactyly ; Wills

OBJECTIVE: To evaluate the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the management of cervical dystonia (CD) with botulinum toxin type A (BoNT-A) injection. METHOD: Thirty two subjects with CD were included. A BoNT-A injection was provided either by clinically targeting method (group 1) or by 18F-FDG PET/CT-assisted, clinically targeting method (group 2). In group 2, selection of target muscles and dosage of BoNT-A were determined according to the increased 18F-FDG uptake, in addition to physical examination and functional anatomy. The outcomes of BoNT-A injection was compared between the two groups, in terms of the number of subjects who had reinjection before and after 6 months, the number of reinjections, the interval of reinjections, the duration to the minimal Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), the number of adverse events, the reduction rate of TWSTRS at 1-3 months and 3-6 months after injection, and the probability of reinjection-free living. RESULTS: The number of subjects who had reinjection within 6 months was significantly lower in group 2 than in group 1 (10 in group 1 vs. 3 in group 2). The reduction rate of TWSTRS after 3-6 months (37.8+/-15.7% of group 1 vs. 63.3+/-28.0% of group 2) and the probability of reinjection-free living were significantly higher in group 2 than in group 1. CONCLUSION: These findings suggest that 18F-FDG PET/CT study could be useful in management of CD in terms of the identification of dystonic muscles if there is an increase in the 18F-FDG uptake in the cervical muscle of the images.
Botulinum Toxins ; Botulinum Toxins, Type A ; Electrons ; Fluorodeoxyglucose F18 ; Muscles ; Physical Examination ; Positron-Emission Tomography ; Torticollis

PURPOSE: We aimed to determine the prevalence of allergic rhinitis and nonallergic rhinitis, difference in symptoms between allergic rhinitis and nonallergic rhinitis, and the association between lung function and the degree of asthma control in children with asthma. METHODS: One hundred seventy patients who were followed-up for asthma treatment at the department of pediatrics of CHA Bundang Medical Center were enrolled in this study. We conducted the questionnaire regarding coexistence of rhinitis, childhood asthma control test (C-ACT), and the basic lung function test. The patients were classified as allergic rhinitis group and nonallergic rhinitis group according to the response to 11 common inhalation and food allergens, and assessed the degree of asthma control and the severity of rhinitis. RESULTS: One hundred thirty patients (73%) were found to have rhinitis. Of these, 79 patients (53%) had allergic rhinitis and 34 patients (20%) had nonallergic rhinitis. The allergic rhinitis group was older than the nonallergic rhinitis group or the nonrhinitis group (7.73+/-2.85 vs. 5.97+/-2.48 vs. 6.12+/-2.70, P<0.001). Nasal itching sense was more prevalent in the allergic-rhinitis group than in the nonallergic rhinitis group (3.23+/-1.90 vs. 2.44+/-1.56, P=0.036). There was an inverse correlation between the rhinitis and C-ACT (r= -0.329, P<0.05). Of note, nasal obstruction symptom was highly correlated with C-ACT (r=-0.334, P<0.001). CONCLUSION: Allergic rhinitis and nonallergic rhinitis were highly prevalent in the pediatric patients with asthma and both of them had a significantly adverse impact on asthma control by rhinitis-itself. Therefore, regardless of atopic status, clinicians should focus on relieving rhinitis symptoms.
Allergens ; Asthma ; Child ; Humans ; Inhalation ; Lung ; Nasal Obstruction ; Pediatrics ; Prevalence ; Pruritus ; Respiratory Function Tests ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires