No abstract available.

Atrial flutter occurs most often in patients with organic heart disease. It appears that chronic atrial flutter is associated with a remarkably high risk of clinically apparent thromboembolism and effective anticoagulation appears to reduce this risk, but acute or recent onset, postoperative atrial flutter may have a lower risk of thromboembolism than those with chronic atrial flutter. In chronic atrial flutter or fibrillation with organic heart disease, anticoagulation is generally justified but there is some debate about anticoagulation in paroxysmal atrial flutter. The spontaneous echo contrast is generally accepted one of the major risk factor of thromboembolism and usually occurred in mitral stenosis, dilated cardiomyopathy, and enlarged left atrium, but rarely observed in apical hypertrophic cardiomyopathy. We experienced a patient with apical hypertrophic cardiomyopathy, who visited to emergency medical center due to dizziness and suffered from cerebral thromboembolism after restoration of sinus rhythm. In transesophageal echocardiography, there was moderate to severe spontaneous echo contrast in left atrium. This patient showed that transesophageal echocardiography evaluation of left atrium might be mandatory in patients with paroxysmal atrial flutter and organic heart disease.
Atrial Flutter* ; Cardiomyopathies* ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; Dizziness ; Echocardiography, Transesophageal ; Emergencies ; Heart Atria ; Heart Diseases ; Humans ; Mitral Valve Stenosis ; Risk Factors ; Thromboembolism*

BACKGROUND: Although skin cancer incidence has recently increased, there has been little research into the incidence, clinical manifestations, and prognosis of skin cancers in Korea, especially in Daegu City and the Kyungpook Province. OBJECTIVE: To analyze changes over the recent two decades in incidence and clinical patterns, including recurrence of skin cancers diagnosed at a university hospital in Daegu City. METHODS: We reviewed 1,566 skin cancer cases from 1994 to 2013 at the Department of Dermatology in Kyungpook National University Hospital (KNUH). We also divided them into first (1994~2003) and second group (2004~2013) to examine changes over the years. RESULTS: The average incidence of skin cancers among the total number of outpatients was 1.39% through whole study period including 0.38% in the first and 2.10% in the second decade. Basal cell carcinoma (BCC) was the most commonly diagnosed skin cancer (total:1st:2nd=0.60%:0.16%:0.91%), followed by squamous cell carcinoma (SCC) (0.43%:0.12%:0.65%) and malignant melanoma (MM) (0.22%:0.05%:0.34%). The most common skin cancer site was the face in each decade. The recurrence of three major skin cancers (BCC, SCC and MM) was diagnosed in 49 of the 1,402 patients (3.50%). In each disease, the recurrence rate (1st:2nd) was 1.64% (BCC, 4.11%:1.34%), 3.51% (SCC, 11.11%:2.55%), and 8.57% (MM, 4.35%:9.01%). CONCLUSION: This epidemiological study provided useful information about the incidence and prognosis of skin tumors in Korea, especially in Daegu City and Kyungpook Province.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Daegu* ; Dermatology ; Epidemiologic Studies ; Gyeongsangbuk-do* ; Humans ; Incidence ; Korea ; Melanoma ; Outpatients ; Prognosis ; Recurrence ; Skin ; Skin Neoplasms

Epidermal nevi (EN) are hamartomatous lesions derived from epidermal components originating from pluripotent cell mutations. They have been categorized according to their predominant component. The existence of >2 types of EN concurrently within a single area or within contiguous areas has been rarely reported. This report describes the case of simultaneous presence of a yellowish plaque on the left medial canthus and an aggregation of closed comedo-like papules on the right side of the cheek of a 15-year-old girl.
Adolescent ; Cheek ; Female ; Humans ; Nevus*

No abstract available.
Keloid

No abstract available.
Keloid

Active sensitization of contact allergen is an uncommon complication of patch test. Para-tertiary-butylphenol (PTBP) is a component of neoprene-based adhesives used in glued leather goods such as shoes, handbags, belts and watchstraps. Contact allergy to PTBP is frequently seen when the patch test is performed. However, active sensitization to PTBP after the patch test is rare. A 23-year-old female patient came to our clinic with a brownish hyperpigmented patch on the belt position of her belly. Pruritic erythematous papules and vesicles developed on the abdomen when she wore new pants 4 months ago. Under the clinical diagnosis of allergic contact dermatitis, the patient was patch tested with the Thin-layer Rapid Use Epicutaneous Test (TRUE Test(R)). The result showed strong positive reaction to nickel sulphate and thiomersal both on day 2 and 3 after application. Twenty-nine days after the test, the patient noticed pruritus on the TRUE Test(R) area. Thirty-four days after the test, an erythematous square-shaped plaque studded with tiny vesicles developed at the PTBP patch test site. This strongly suggests that the reaction to PTBP is occurred. She was diagnosed with an active sensitization to PTBP. We report a rare and interesting case of active sensitization to PTBP after TRUE Test(R).
Abdomen ; Adhesives ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Female ; Humans ; Hypersensitivity ; Nickel ; Patch Tests ; Phenols ; Porphyrins ; Pruritus ; Shoes ; Thimerosal

BACKGROUND AND PURPOSE: Carotid artery stenting (CAS) is emerging as an alternative to carotid endarterectomy for the treatment of carotid artery stenosis (CS), but the effect of CAS on the cognitive function of patients with severe CS has not been fully investigated. The aim of this study was to use comprehensive neuropsychological tests to determine the effect of CAS on cognitive function from baseline to 3 months postprocedure in patients with severe CS. METHODS: Thirty-one patients due to undergo CAS due to high-grade CS (> or =70%) and 11 control subjects who were diagnosed with CS, but who did not undergo CAS, and who visited the clinic or emergency room between February 2009 and February 2012 were recruited consecutively at baseline (i.e., pre-CAS). Follow-up neuropsychological evaluations after 3 months were completed by 23 of the 31 patients who underwent CAS, and by 10 of the 11 control subjects. The primary cognitive outcome was assessed using a neuropsychological test containing subcategories designed to test general cognitive function, attention, visuospatial function, language and related functions, memory, and frontal lobe/executive function. RESULTS: Of the 23 patients undergoing CAS who completed the 3-month follow-up tests, 12 had asymptomatic CS. During the 3-month follow-up period, the patients who underwent CAS and those with asymptomatic CS achieved similar results to the control group on all cognitive tests. However, symptomatic CS patients (n=11) who underwent CAS exhibited improvements in visuospatial function (p=0.046) and total Seoul Neuropsychological Screening Battery-Dementia Version scores (p=0.010) in comparison with both the asymptomatic CS patients and the control group. CONCLUSIONS: The findings of this study suggest that CAS has a positive effect on cognitive function in patients with symptomatic CS over a 3-month follow-up period. A long-term, multicenter, prospective case-control study would be helpful to predict quality of life and prognoses for patients undergoing CAS.
Carotid Arteries* ; Carotid Stenosis* ; Case-Control Studies ; Cognition ; Constriction, Pathologic ; Emergency Service, Hospital ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Mass Screening ; Memory ; Neuropsychological Tests ; Prognosis ; Prospective Studies* ; Quality of Life ; Seoul ; Stents*

No abstract available.

Background: Because Korea is the fastest aging country, the stroke incidence is increasing rapidly. We investigate the trend of the number of patients with acute stroke in recent years and estimate the burden of the neurologist to treat the acute stroke patient visited the emergency department. Methods: We requested a questionnaire survey to all teaching hospitals on the number of hospital beds, the number of stroke patients who visited the emergency department, the number of stroke patients in charge of the neurologist, and the number of days on duty of residents from 2016 to 2019. Results: Of 69 teaching hospitals, 41 hospitals answered the survey. The average hospital beds per hospital were increased annually from 909 to 916. The average patients who visited the emergency department with stroke and were in charged to neurologists were rapidly increased from 799 to 867 per hospital. In particular, the number of patients with hyperacute cerebral infarction requiring the thrombolytic administration or mechanical thrombectomy were rapidly increased from 105 to 131. On the other hand, the average number of residents per hospital was decreased from 5.1 to 4.8. Therefore, the days on duty per resident were increased from 74 to 77. Conclusions The number of acute stroke patients, especially, hyperacute stroke required the rapid cooperation and high labor were increasing rapidly in recent years. However, because the number of residents were decreased, the burden was increasing. To improve the quality of acute stroke treatment, it is necessary to increase the number of residents.