No abstract available.
Biopsy, Fine-Needle* ; Humans ; Pathology, Surgical* ; Thyroid Gland* ; Thyroid Nodule*

We report two cases of vulvar syringorna in a 40-year-old women and a 28-year-old woman who had 2-3mm sized, brownish papules on both valvar areas an l-3rnm sized, yellow-brownish papules on both vulvar ares with yellowish milia-like lesion the surface, respectively. Microscopically the lesions revealed characteristic findings of syrinzoiza However the second case showed a small cystic duct in the papillary dermis, which is lineilly a stratified epithelium and filled with concenteric lamellae of keratin.
Adult ; Cystic Duct ; Dermis ; Epithelium ; Female ; Humans ; Syringoma* ; Vulva

Schilder’s disease is a rare sporadic demyelinating disease of the brain. We report a girl with Schilder’s disease who had undergone Kasai operation for biliary atresia. The patient presented with acute right hemiparesis. Brain magnetic resonance imaging (MRI) showed a single large tumefactive white matter lesion. A diagnosis of Schilder’s disease was based on clinical features and MRI findings. The patient showed dramatic clinical improvement and significant regression of the lesion in response to high-dose intravenous methyl prednisone, and remained free of relapse of other neurologic problems during the 3-year follow-up.

The main goal of the surgical treatment of maxillofacial deformity is improved esthetic appearance and masticatory function. Recently, the purpose of orthognathic surgery has been focused on esthetic improvement of the patients. The purpose of this study was to investigate the changes in gonial angle to orthognathic surgery. For this study 30 patients were randomly selected. All patients with mandibular prognathism were operated upon with bilateral sagittal split ramus osteotomy and mandibular setback. The patients were cephalmetric lateral radiographs for 1 hear. Lateral cephalmetric radiographs taken preoperatively, over 6-months and 1 year follow up were traced and analysed. The following conclusions were reached. : 1. During following up period for 1 year, the change of gonial angle after orthognathic surgery was decreased, except 3 cases. The mean gonial angle change was decreased from 128.6 degrees(+/-4.83) to 123.4 degrees(+/-5.52) in female(p<0.05). 2. During follow up period for 1 year, the mean gonial angle was decreased after orthognathic surgery from 129.7 degrees(+/-6.47) to 123.3 degrees(+/-7.52), in all male patients(p<0.05). 3. The mean gonial angle changes after orthognathic surgery was about 5.2 degrees in female and 5.4 degrees in male. There was less statistical significance between male and female. 4. The ratio of mandibular setback amount from 6mm to 15mm was 83.3%, and from 1mm to 5mm was 10%.
Congenital Abnormalities ; Female ; Follow-Up Studies ; Humans ; Male ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Prognathism

No abstract available.
Brain Abscess* ; Brain* ; Catheters*

We report a case of Kyrle's iisease occurring in a 60-year-old woman with chronic renal failure. The patient had multiple hyperkeratotic papules with a central plug on the back, and in the upper and lower extremities. Histopathological findings showed epidermal invagination filled with parakeratotic column and basophilic debris. Many dyskeratotic and vacuolated cells were present below the keratotic plug, and penetration of the parakeratotic column into the dermis was seen.
Basophils ; Dermis ; Female ; Humans ; Kidney Failure, Chronic ; Lower Extremity ; Middle Aged

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar’s test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

Purpose: The aim of this study was to investigate the optimal washout criteria of perfluorobutane-enhanced ultrasonography (PFB-US) for the diagnosis of hepatocellular carcinoma (HCC) in high-risk individuals. Methods: Participants at risk of HCC with treatment-naïve solid hepatic observations (≥1 cm) who underwent PFB-US from March 2019 to September 2020 were prospectively recruited. Arterial phase hyperenhancement (APHE), washout time, and washout degree were evaluated. The diagnosis of HCC was made by non-rim APHE with late and mild washout. The per-lesion diagnostic performance for diagnosing HCC using different cutoffs for late washout (50, 55, 60, 65, and 70 seconds postcontrast) and the different time windows for determining washout (until 2, 3, 4, 5, 6, 7, 8, 9, and 10 minutes postcontrast) were compared using the McNemar test. Results: In total, 101 participants with 113 observations (mean size, 33.5±2.8 mm; HCCs [n=82], non-HCC malignancies [n=16], benign [n=15]) were evaluated. Non-rim APHE was observed in 86.6% (71/82) of HCCs. As the cutoff time for late washout increased, the specificity increased to 100% (95% confidence interval [CI], 88.8% to 100%) at the 60-second cutoff with 62.2% sensitivity (95% CI, 50.8% to 72.7%). When the time window for determining washout became wider, the sensitivity and accuracy increased until 6 minutes, with 100% specificity at all times. Conclusion Determining washout within 6 minutes after contrast injection with a 60-second cutoff for late washout showed the highest sensitivity without losing specificity for diagnosing HCC using PFB-US in individuals at high risk.

PURPOSE: This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. METHODS: A 5-year retrospective study of pediatric hemato-oncologic patients with bacteremia in Seoul National University Children's Hospital, from 2006 to 2010 was conducted. RESULTS: A total of 246 pathogens were isolated, of which 63.4% (n=156) were gram-negative, bacteria 34.6% (n=85) were gram-positive bacteria, and 2.0% (n=5) were fungi. The most common pathogens were Klebsiella spp. (n=61, 24.8%) followed by Escherichia coli (n=31, 12.6%), coagulase-negative staphylococci (n=23, 9.3%), and Staphylococcus aureus (n=22, 8.9%). Resistance rates of gram-positive bacteria to penicillin, oxacillin, and vancomycin were 85.7%, 65.9%, and 9.5%, respectively. Resistance rates of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin were 37.2%, 17.1%, 6.2%, 32.2%, and 13.7%, respectively. Overall fatality rate was 12.7%. Gram-negative bacteremia was more often associated with shock (48.4% vs. 11.9%, P<0.01) and had higher fatality rate than gram-positive bacteremia (12.1% vs. 3.0%, P=0.03). Neutropenic patients were more often associated with shock than non-neutropenic patients (39.6% vs. 22.0%, P=0.04). CONCLUSION: This study revealed that gram-negative bacteria were still dominant organisms of bloodstream infections in children with hemato-oncologic diseases, and patients with gram-negative bacteremia showed fatal course more frequently than those with gram-positive bacteremia.
Amikacin ; Bacteremia ; Bacteria ; Cefotaxime ; Child ; Escherichia coli ; Fever ; Fungi ; Gentamicins ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Imipenem ; Klebsiella ; Neutropenia ; Oxacillin ; Penicillins ; Retrospective Studies ; Shock ; Staphylococcus aureus ; Vancomycin

BACKGROUND: Androgenetic alopecia (AGA) is one of the most common type of alopecia among all men and women after puberty. The number of patients with AGA appears to be gradually increasing. OBJECTIVES: The purpose of this study was to investigate the clinical status such as age, family history, and type of patients with AGA and to review recent Korean literature. METHODS: 1500 patients with AGA who had visited the Department of Dermatology, Busan Paik Hospital, Inje University School of Medicine during the last 7 years (from May 1997 through December 2003) were examined through the clinical records. RESULTS: 1) There were 1162 male and 338 female patients being most prevalent in the third decade in both sexes. 2) In males AGA, Norwood-Hamilton's type II was the most common. 3) In females AGA, Ludwig's type I was the most common. 4) There was a family history of baldness in 62.9% of relatives in male patients and 48.8% in female patients. 5) The largest number of patients with AGA first visited our department when they had had 1-5 year's history of AGA in both sexes. 6) In the management of male AGA, oral finasteride only or with topical medications was the most common (72.4%) treatment modality. 7) In the management of female AGA, topical minoxidil solution only or with other topical medications was the most common (78.7%) treatment modality. CONCLUSIONS: The proportion of young patients with mild types appears to be high among AGA patients. It might be largely due to psychological stress in social situations.
Adolescent ; Alopecia* ; Busan ; Dermatology ; Female ; Finasteride ; Humans ; Male ; Minoxidil ; Puberty ; Stress, Psychological