Basal cell carcinoma (BCC) comprising several lesions is not uncommon, but nonsyndromic multiple BCCs with parotid invasion are rare entities. We present two cases of multiple sporadic, nonsyndromic BCCs, and one of these cases is a unique case of parotid invasion associated purely with actinic keratosis. In Case 1, a 79-year-old female presented with multiple skin lesions on the face and left hand. All lesions were completely removed by surgery. The pathologic results showed lesions consistent with BCC and some lesions consistent with actinic keratosis. After 8 months, the patient presented with skin lesions in bilateral temporal areas and left cheek area. Surgical excision of the lesions was performed, and the biopsy results were squamous cell carcinoma in situ and actinic keratosis. In Case 2, a 43-year-old woman presented with multiple skin lesions on the face, scalp, right chest, abdomen and right leg. All lesions were completely removed by surgery. Pathologic evaluation confirmed the diagnosis of BCC. BCC is rarely metastatic, but it can lead to severe disfiguration or destruction. It is important to diagnose and treat BCC at an early stage.
Abdomen ; Adult ; Aged ; Biopsy ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell ; Cheek ; Diagnosis ; Female ; Hand ; Humans ; Keratosis, Actinic ; Leg ; Scalp ; Skin ; Skin Neoplasms ; Thorax

Keloid scars are commonly found on the ears. Treatment modalities include compression, intralesional steroid injection, and surgical excision with or without radiotherapy, depending on the size and location of the keloid scar. Excision may be a curative solution, but it always requires the immediate reconstruction of the excised defect. Herein, we report the case of a keloid scar located at the helical base of the auriculotemporal sulcus that was treated by excision and a V-Y temporal advancement flap.
Cicatrix ; Ear ; Ear Auricle ; Keloid* ; Radiotherapy ; Surgical Flaps

OBJECTIVES: The aim of this study was to estimate the prevalences of electroencephalographic (EEG) abnormalities and epilepsy in children and adolescents with autism spectrum disorder (ASD). In addition, we intended to identify demographic and clinical correlates of epilepsy in ASD. METHODS: A total of 140 children and adolescents (age 7.3+/-4.8 yrs, 106 boys) with ASD underwent EEG from January 2010 to December 2013 at Asan Medical Center. Medical records were reviewed for demographic information, clinical characteristics, psychiatric diagnoses and comorbidities, EEG findings and neurological diagnoses. RESULTS: The prevalences of EEG abnormalities and epilepsy in children and adolescents with ASD was 62.1% and 38.6%, respectively. In subjects with seizure-like movements, EEG abnormalities and epilepsy were more frequent than those without seizure-like movements (EEG abnormalities : 92.5% vs. 43.7%, p<.001 ; epilepsy : 90.6% vs. 5.7%, p<.001). ASD subjects who had epilepsy were older (p=.001), had lower full scale intelligence quotient (p<.001) and took more antipsychotics (p=.006) than those who did not. CONCLUSION: The prevalences of EEG abnormalities and epilepsy in our sample were similar to those from Western countries. Our results suggested a possible association of older age, lower intelligence quotient, and antipsychotics use with epilepsy in ASD. Conduct of further prospective study in a larger sample is needed.
Adolescent* ; Antipsychotic Agents ; Autism Spectrum Disorder* ; Child* ; Chungcheongnam-do ; Comorbidity ; Diagnosis ; Electroencephalography ; Epilepsy ; Humans ; Intelligence ; Medical Records ; Prevalence

Although ganglion cyst is a relatively common benign mass in soft tissues, there have been very few reports of intramuscular ganglion cyst. We encountered such a case located in the antecubital fossa originating from the supinator muscle. A 61-year-old woman presented with a painless mass in the antecubital fossa. However, the patient complained of a significant sensory deficit in the radial side of the thumb, index, and middle finger. She also had extensor weakness at the metacarpophalangeal joint. The mass was excised completely, with no post-surgical complications. Pathologic results revealed the ganglion cyst. The patient showed improvements in sensory dysfunction and extensor weakness. Intramuscular ganglion cyst can be misdiagnosed. This report might be useful for making an accurate diagnosis and rapidly initiating treatment for an intramuscular mass.
Diagnosis ; Elbow Joint ; Elbow* ; Female ; Fingers ; Ganglion Cysts* ; Humans ; Metacarpophalangeal Joint ; Middle Aged ; Radial Nerve* ; Thumb

Adult ; Female ; Hemangioma ; Humans ; Mouth ; Mouth Floor ; Neurilemmoma ; Peripheral Nerves ; Schwann Cells ; Tongue

Objective: The objective of this study was to assess the effectiveness and safety of atomoxetine in Korean children and adolescents with epilepsy. Methods: We retrospectively reviewed the electronic medical records of 105 children and adolescents with epilepsy treated with atomoxetine. Effectiveness was measured with the Clinical Global Impressions-Severity (CGI-S) and/or Clinical Global Impressions-Improvement (CGI-I) scales at baseline, and after 4 and 12 weeks. We defined response to atomoxetine as a CGI-I score less than three at week 12. Safety was evaluated at each visit, based on clinical assessment by a child and adolescent psychiatrist and reports from participants or their caregivers. Results: In total participants (n=105), 33 (31.4%) showed a response to treatment: a significant decrease in CGI-S scale score was observed over 12 weeks of atomoxetine treatment. The most common adverse event (AE) was decreased appetite (n=16, 15.2%), and life-threatening AEs were not observed. Seizure aggravation due to atomoxetine was observed in 7.6% (n=8) of total participants, and one of them discontinued atomoxetine. Conclusion Our results provide preliminary evidence of the effectiveness and safety of atomoxetine in children and adolescents with epilepsy.

OBJECTIVES: In this study, the cognitive characteristics, especially priming effect, of above 50 years old age group who had less than 25 points in K-MMSE were investigated. METHODS: In this study, an implicit memory test measuring priming effect was made and adminis-tered to old age people who had less than 25 points in K-MMSE in screening session. To control the effect of age, educational level and intelligence, demographic variables were measured, and the subtests of KWIS, vocabulary and block design were administered. Descriptive statistical analysis of the two priming measures and correlational analysis between variables were done. To test the effect of cognitive functioning on priming effect multiple regression analysis was done. RESULTS: Correlational analysis revealed priming score obtained from correct identification response was positively correlated with K-MMSE and ADAS-Cog. And priming score obtained from mean reaction time was positively correlated with age and negatively correlated with vocabulary substest of KWIS. The regression analysis results indicated general cognitive functioning measured by ADAS-Cog has significant effect on priming score obtained from correct identification response, whereas age has significant effect on priming score obtained from mean reaction time. CONCLUSIONS: The results revealed that as cognitive deterioration progresses priming effect which identify primed stimulus correctly diminish, and as one grow older within age 50 to 70, priming effect which identifies primed stimulus quickly increase.
Humans ; Intelligence ; Mass Screening ; Memory ; Middle Aged ; Mild Cognitive Impairment* ; Reaction Time ; Vocabulary

Recent advances in childhood cancer treatment have increased survival rates to 80%. Two out of three survivors experience late effects (LEs). From a group of 241 survivors previously described, 193 were followed at the long-term follow-up clinic (LTFC) of Severance Hospital in Korea; the presence of LEs was confirmed by oncologists. We reported the change in LEs during 3 yr of follow-up. The median follow-up from diagnosis was 10.4 yr (5.1-26.2 yr). Among 193 survivors, the percentage of patients with at least one LE increased from 63.2% at the initial visit to 75.1% at the most recent visit (P = 0.011). The proportion of patients having multiple LEs and grade 2 or higher LEs increased from the initial visit (P = 0.001 respectively). Forty-eight non-responders to the LTFC were older and had less frequent and severe LEs than responders at initial visit (all P < 0.05). In multivariate analysis, younger age at diagnosis, older age at initial visit, a diagnosis of a brain tumor or lymphoma, and use of radiotherapy were significant risk factors for LEs (all P < 0.05). Adverse changes in LEs were seen among the survivors, regardless of most clinical risk factors. They need to receive comprehensive, long-term follow up.
Adolescent ; Age Factors ; Brain Neoplasms/mortality/pathology/radiotherapy ; Child ; Child, Preschool ; Disease Progression ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells/cytology ; Humans ; Infant ; Infant, Newborn ; Lymphoma/mortality/pathology/radiotherapy ; Male ; Multivariate Analysis ; Neoplasms/mortality/*pathology/radiotherapy ; Risk Factors ; Severity of Illness Index ; Survival Rate

BACKGROUND AND PURPOSE: 22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome. Epilepsy and other neuropsychiatric (NP) manifestations of this genetic syndrome are not uncommon, but they are also not well-understood. We sought to identify the characteristics of epilepsy and other associated NP manifestations in patients with 22q11.2DS. METHODS: We retrospectively analyzed the medical records of 145 child and adolescent patients (72 males and 73 females) with genetically diagnosed 22q11.2DS. The clinical data included seizures, growth chart, psychological reports, development characteristics, school performance, other clinical manifestations, and laboratory findings. RESULTS: Of the 145 patients with 22q11.2DS, 22 (15.2%) had epileptic seizures, 15 (10.3%) had developmental delay, and 5 (3.4%) had a psychiatric illness. Twelve patients with epilepsy were classified as genetic epilepsy whereas the remaining were classified as structural, including three with malformations of cortical development. Patients with epilepsy were more likely to display developmental delay (odds ratio=3.98; 95% confidence interval=1.5-10.5; p=0.005), and developmental delay was more common in patients with structural epilepsy than in those with genetic epilepsy. CONCLUSIONS: Patients with 22q11.2DS have a high risk of epilepsy, which in these cases is closely related to other NP manifestations. This implies that this specific genetic locus is critically linked to neurodevelopment and epileptogenesis.
Adolescent* ; Child* ; DiGeorge Syndrome* ; Epilepsy* ; Genetic Loci ; Growth Charts ; Humans ; Male ; Malformations of Cortical Development ; Medical Records ; Mental Disorders ; Neurologic Manifestations ; Retrospective Studies ; Seizures

BACKGROUND AND PURPOSE: To determine how cognitive function is related to epilepsy classification and comorbid attention deficit hyperactivity disorder (ADHD) in children with newly diagnosed epilepsy of genetic or unknown etiology. METHODS: The medical records of children aged 6-16 years with newly diagnosed epilepsy of genetic or unknown etiology were reviewed retrospectively. The Korean Education Development Institute-Wechsler Intelligence Scale for Children and the Comprehensive Attention Test were used to evaluate intelligence and attention/executive function, respectively. RESULTS: The data of a total of 149 children, 103 with focal seizures and 46 with generalized seizures, were reviewed. The prevalence of ADHD was 49.2% (59 out of 120 examined patients), and ADHD patients exhibited significantly worse auditory selective attention, flanker test results, and spatial working memory. Patients with generalized seizures exhibited significantly worse auditory selective and sustained attention than patients with focal seizures. In patients with generalized seizures, sustained attention, flanker test findings, and spatial working memory were found to be affected by ADHD, and auditory selective and sustained attention were significantly worse in patients with benign childhood epilepsy with centrotemporal spikes and ADHD than in their counterparts without ADHD. CONCLUSIONS: Cognitive processes are affected by seizure type and comorbid ADHD. Proper characterization of these neuropsychiatric impairments may allow earlier intervention during the disease course.
Attention Deficit Disorder with Hyperactivity* ; Child ; Classification ; Cognition ; Education ; Epilepsy* ; Humans ; Intelligence ; Medical Records ; Memory, Short-Term ; Prevalence ; Retrospective Studies ; Seizures