Infectious disease consultation contributes to optimal antibiotic use as well as improved treatment outcomes in many infectious diseases, especially severe infections like bacteremia. However, communication and language matter in consultations between clinicians. Communication barriers are even more complex among professionals who speak Korean, since there are significant challenges for practicing medicine while relying on language translations. This review aims to address some of the components that should be included in infectious diseases consultations for Korean-speaking specialists.
Bacteremia ; Communicable Diseases* ; Communication Barriers ; Consultants* ; Humans ; Referral and Consultation ; Specialization ; Translations

BACKGROUND: The CD34(human progenitor cell antigen) is a monomeric, 115 kD glycoprotein which is expressed on hemitopoietic progenitor cells. It is also now known as an immunohistochemical marker of endothelial cell like UEA-I and factor VIII R Ag and its function is thought to be related to endot.helial adhesion, migration, and angiogenesis. OBJECTIVE: This study was aimed to investigate the patterns of CD34 expression during the early and late stages of vascular formation in pyogenic granuloma. METHOD: We performed immuinoperoxidase staining(ABC technique) by using a monoclonal anti-CD34 antibody(QBEND10, IgG1) on the formalin fixed, paraffin embedded sections of 19 cases of pyogenic granulomas. Result : 1. In all cases of pyogenic grinulomas, CD34 was strongly expressed in the endothelial cells of normal vessels in the perilobular stroma and in the endothelial cells of the mature vessels within the lobules of hemangioma. 2. In the foci of immature vessels, most of the endothelial cells located near the small vascular lumina and endothelial cells with intracellular lumen formations expressed CD34, while the endothelial cells far from the vascular lumina and endothelial cells without intracellular lumen formations mostly did not express CD:4. CONCLUSION: The above result. suggested that the expression of CD34 of the endothelial cells vary with the stage of maturation of the vessels.
Endothelial Cells ; Factor VIII ; Formaldehyde ; Glycoproteins ; Granuloma, Pyogenic* ; Hemangioma ; Paraffin ; Stem Cells

Trichoadenoma is a rare tumor with differentiation towards the infundibular portion of the pilosebaceous canal. Clinically, it is a nodular growth, usually on the face and buttock. Histologically, it is characterized by numerous horn cysts lined with squamous epithelium in the dermis. In this report, we describe a 44-year-old man who developed trichoadenoma on his right shin. Anti-CD34 antibody stained spindle-shaped cells in the stroma just adjacent to the peripheral layers of keratinous cysts and solid masses of squamous epithelial cells. To our knowledge, this is the first description of an occurrence of trichoadenoma in the lower leg and the first to use immunohistochemical staining to know the CD34 staining pattern.
Adult ; Animals ; Buttocks ; Dermis ; Epithelial Cells ; Epithelium ; Horns ; Humans ; Leg

Fibrofolliculoma is a benign follicular neoplasm which usually occurs in multiple and rarely solitarily. We have found only seven cases of previous reports of solitary fibrofolliculomas worldwide and only two in Korean literature. Herein we report on a 40-year-old female patient with a solitary flesh-colored bean sized mass on the scalp which histopathologically proved to be a fibrofolliculoma.
Adult ; Female ; Humans ; Scalp

Cutaneous metastasis from visceral malignancies shows diverse manifestations. Very rarely, cutaneous metastasis mimicks benign mesenchymal tumors. We describe a case in which metastasis from gastric adenocarcinoma mimicked fibrohistiocytic tumors. The diagnosis of cutaneous metastasis was confirmed by the presence of atypical cells and signet-ring cells, positive staining for mucin and positive immunohistochemical stainings for keratins, carcinoembryonic antigen(CEA), and lysozyme within the tumor cells infiltrated in the irregular, intertwining bundles of collagen in the reticular dermis.
Adenocarcinoma* ; Collagen ; Dermis ; Diagnosis ; Mucins ; Muramidase ; Neoplasm Metastasis

BACKGROUND: Norwegian scabies is a highly infectious disease characterized by crust formation, different from ordinary scabies, and is caused by Sarcoptes scabiei. After the patient in our case was diagnosed with Norwegian scabies, active measures were taken to prevent its transmission within the hospital. Methods: A 66-year-old female patient was admitted to the general ward of a university hospital on January 23rd, 2008 and 6 days later, she was found to have been infected with Norwegian scabies all over the body. For epidemiological investigation, those who had been in contact with the patient were identified and interviewed. The patient was advised to follow the contact precaution, and linen the patient used was cleaned thoroughly. The surrounding environment was decontaminated by applying surface disinfectant. Preventive cream against the Norwegian scabies was distributed to staff members and patients who had been exposed to the patient, and appointed a dermatologist to educate them on how to use of medicine, what the mechanism of the disease is, what cautions must be taken, and how to write an ex post facto report. RESULTS: After the confirmation of the 1st case, no additional cases have been reported in the hospital during the ensuing 2 months. Therefore, prompt prevention and infection control activities against Norwegian scabies can be thought to have been successful. CONCLUSION: Whena patient with an uncertain skin disease is admitted, pertinent measures must be taken from the moment the patient is admitted and contact precaution should be applied both to the patients and the staff members. When a scabies patient is detected in an institution, the medical staff must enforce as much active preventive measures as possible, and by doing so, there will be a better chance to prevent the outbreak of scabies in the hospital.
Aged ; Bedding and Linens ; Communicable Diseases ; Cross Infection ; Female ; Humans ; Infection Control ; Medical Staff ; Patients' Rooms ; Sarcoptes scabiei ; Scabies ; Skin Diseases

Intussusception can develop at any age but about 95% of patients are children under 2 years-old. Adult intussusception is a rare condition. Unlike children, nearly all adults with intussusception have a lead point such as benign or malignant small bowel tumors, intestinal tuberculosis, or Meckel's diverticulum. First case is a 48-year-old male who was admitted with 2 days of diffuse abdominal cramping pain and no other associated gastrointestinal symptoms. Barium enema revealed ileocolic intussusception with a round cecal mass after barium reduction. An ileocecectomy was performed electively. The pathologic report was cecal cyst, which was an intraluminal structure with an epithelial lining of colonic mucosa. The second case, a 53-year-old male, was admitted with 1 week of diffuse abdominal cramping pain and watery diarrhea. Barium enema revealed ileocecal intussusception. Emergency surgery (ileocecectomy), revealed a polypoid small bowel mass. The pathologic report was lipoma. Recently, we experienced two cases of adult intussusception and report these cases with a brief review of the literature.
Adult* ; Barium ; Child ; Child, Preschool ; Colic ; Colon ; Diarrhea ; Emergencies ; Enema ; Humans ; Intussusception* ; Lipoma ; Male ; Meckel Diverticulum ; Middle Aged ; Mucous Membrane ; Tuberculosis

The neuropeptide substance P(SP) has been implicated in the mediation of inflammation and immune-mediated disease such as arthritis. Recently, it was reported that SP was markedly increased around the blood vessels in inflamed gingiva as well as in close association with the inflammatory cell infiltrate. These results support that SP may contribute to the pathophysiology of neuronal inflammation in human periodontal tissues. SP may regulate inflammatory/immune responses by stimulating the proliferation of human T cells, differentiation and antibody-secreting potential of B cells, macrophage respiratory burst, connective tissue proliferation, and the secretion of cytokines from monocytes and T cells. Here, I studied potential role of SP as a costimulatory chemical signal in inflammatory/immune responses, by determining the released proinflammatory cytokines such as MIP-1alpha, IL-1beta, and IL-6 from culture supernatants of homogeneous immune cell lines. Serum free cell supernatants were concentrated with TCA precipitation, fractionated with SDS-PAGE, and subjected into western blot analysis. Among 15 cell lines tested, macrophage/monocyte cell line RAW264.7 and WR19m.1 showed the highest level of induction of MIP-1alphawhen stimulated with LPS. Discrete IL-6 bands with multiple forms of molecular mass were detected from supernatants of B cell lines A20(32kDa), Daudi(32, 35kDa), and SKW6.4(29kDa), which were expressed constitutively. IL-1beta could not be detected by the method of western blot analysis from supernatants of all cell lines tested except RAW264.7, WR19m.1, and erythroid cell line K562 which showed the least amount of IL-1betasecretion. SP 10(-9)M with suboptimal dose of LPS treatment showed synergistic induction of MIP-1alpharelease from RAW264.7 or WR19m.1, and also IL-6 release from A20, but this synergism is not the case in costimulation of RAW264.7 or WR19m.1 with SP 10(-9)M and TPA. Although treatment of T cell line CTLL-R8 with SP 10(-7)M or PHA+TPA induced modest level of MIP-1alpha secretion, synergism was not observed when they are applied together. These findings all together suggest the possibility of a regulatory role of SP in inflammatory/immune reaction through differential modulation of bioactivities of other chemical cosignals.
Arthritis ; B-Lymphocytes ; Blood Vessels ; Blotting, Western ; Cell Line* ; Chemokine CCL3 ; Connective Tissue ; Cytokines* ; Electrophoresis, Polyacrylamide Gel ; Erythroid Cells ; Gingiva ; Humans ; Inflammation ; Interleukin-6 ; Macrophages ; Monocytes ; Negotiating ; Neurons ; Neuropeptides ; Respiratory Burst ; Substance P* ; T-Lymphocytes

A quadriparetic 62-year-old male patient completely cured from small cell lung cancer was admitted to the hospital. The patient complained of dizziness and spontaneous horizontal nystagmus was present in both eyes. He was tolerable during the cancer treatment, but 4 months later he became bed ridden status and totally dependent on all of the daily living activities. Brain metastasis of primary cancer and paraneoplastic syndrome were suspected first, however the brain MRI and paraneoplastic antibody study revealed negative result. With reviewing his medical history, he took chemotherapy including carboplatin. We suspected the ototoxicity induced by carboplatin, as carboplatin has a unique side effect including ototoxicity affecting the balance function while preserving the hearing function. Clinicians should keep in mind this adverse effect in any patient with chemotherapy including carboplatin and who subsequently develops nystagmus and functional level impairment. In such, we present this case with the related literatures.
Activities of Daily Living ; Brain ; Carboplatin ; Dizziness ; Eye ; Hearing ; Humans ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Nystagmus, Pathologic ; Paraneoplastic Syndromes ; Small Cell Lung Carcinoma

For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter.
Humans ; Pulmonary Embolism ; Thrombectomy* ; Thrombosis* ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Thrombosis