Secondary cutaneous cryptococcosis may occur earlier than other manifestations of disseminated cryptococcosis. A 68-year-old woman presented with multiple ulcerative lesions on the right calf of 2 weeks duration. She had been treated with antibiotics, but the lesions spread rapidly. The initial clinical impression was necrotizing fasciitis, but routine KOH mounting from the ulcerative lesions showed numerous budding yeast cells with peripheral clear zones and further investigations including a skin biopsy, tissue cultures and India ink preparations allowed a rapid and definitive diagnosis of cutaneous cryptococcosis. Studies for other evidence of infection elsewhere revealed an asymptomatic pulmonary lesion. We report a case of secondary cutaneous cryptococcosis clinically mimicking necrotizing fasciitis that occured before other manifestations of disseminated cryptococcosis.
Aged ; Anti-Bacterial Agents ; Biopsy ; Cryptococcosis* ; Diagnosis ; Fasciitis, Necrotizing* ; Female ; Humans ; India ; Ink ; Saccharomycetales ; Skin ; Ulcer

We report herein a gigantic case of verrucous hemangioma occuring in a 15 year-old school- boy. The lesion was a dark red colored, 10.0 x 6.0 x 0.8cm sized, verrucous surfaced, hemangiomatous tumor affecting the posterior aspect of the right thigh. At birth an erythematous macule appeared and insidious]y increased or extended with age. In the last 6 months, it had grown rapidly to the size of the present lesion with a smaller satellite one, assumably ascribing to the repeated minor trauma or pressure. Histological findings from the totally excised lesion showed epidermal hyperplasia with irregular acanthosis and papillomatosis and diffuse marked proliferation and dilatation of blood vessels from the upper dermis to subcutaneous fatty tissue. Wide excision was done. There was no relapse after about one years postoperative follow up.
Adipose Tissue ; Adolescent ; Blood Vessels ; Dermis ; Dilatation ; Follow-Up Studies ; Hemangioma* ; Humans ; Hyperplasia ; Male ; Papilloma ; Parturition ; Recurrence ; Thigh

A 28-year-old man presented with a 6.0 * 5.0 cm sized ulcer on the anterior chest and widespread copper-red colored maculopapular eruptions. There was no past or family history of syphilis sign or STS. He had been taken imposition of hands twice to treat chronic hepatitis about 4 months prior to presentation. Thereby, the ulcerative lesion on the anterior chest developed as a result of erosive trauma through contact with infected fingernails. The clinical features and serologic tests as well as biopsy findings were consistent with syphilis. Spirochetes were observed under the dark field examination of the anterior chest lesion. On Warthin-Starry staining, spirochetes were identified in the epidermal area of the papular lesion. We report a case of unusual transmission of syphilis.
Adult ; Biopsy ; Hand* ; Hepatitis, Chronic ; Humans ; Nails ; Serologic Tests ; Spirochaetales ; Syphilis* ; Thorax ; Ulcer

Nevus sebaceus is a common hamartoma that has a variety of appendage tumors. We report a case of nevus sebaceus with multiple appendage tumors on the scalp of a 43-year-old male. The exudative inflamed patches were admixed with darkly pigmented small nodules which had developed secondarily within a 4.0 × 1.5cm lesion 2 years previously. Histologically, on serial sectioning, there were various types of basal cell carcinoma, syringocystadenoma papilliferum, tubular apocrine adenoma and sebaceous adenoma. Some parts of a biopsy specimen, showed a tumor of the follicular infundibulum-like epidermal changes. There were also calcium depositions in the stroma and apocrine tumors, There was no relapse at 1-year follow-up after surgical treatment.
Adenoma ; Adult ; Biopsy ; Calcium ; Carcinoma, Basal Cell ; Follow-Up Studies ; Hamartoma ; Humans ; Male ; Nevus* ; Recurrence ; Scalp

BACKGROUND: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. METHODS: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. RESULTS: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. CONCLUSION: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.
Angina Pectoris ; Coronary Disease ; Emergency Service, Hospital ; Health Policy ; Hospitals, High-Volume ; Hospitals, Low-Volume ; Humans ; Mortality ; Myocardial Infarction ; National Health Programs ; Percutaneous Coronary Intervention ; Proportional Hazards Models

Verrucous carcinoma is simply very well differentiated malignant neoplasm. It is unique only in that the diagnosis is difficult to make histologically and locally invasive but metastasis is rare. Clinically, verrucous carcinoma is often warty and usually exophytic. It can be multicentric. It looks uniquely epithelial. When biopsy is done, the pathologist uses words such as "hyperplasia", "keratosis" or "fibrosis", however is reluctant to use the word "carcinoma". Verrrucous carcinoma can be present in three forms: oral or mucosal, genital, and plantar. Base of tongue is uncommon site in it. Authors are reporting a case of huge verrucous carcinoma of base of tongue with a view of the related articles.
Biopsy ; Carcinoma, Verrucous* ; Diagnosis ; Neoplasm Metastasis ; Tongue*

PURPOSE: The aim of the present study was to evaluate the different features of such instruments and how they cause ocular fatigability. METHODS: Under the same settings and circumstances, 75 participants were asked to read the novel, "You without me?" in different formats including paper book, E-book (biscuit(R), Interpark Inc., LG INNOTECK LTD, Korea) and LCD reader (iPad(R), Apple Inc., United States). For every 10 minutes of reading, 10 minutes of rest was provided. After finishing the novel, the participants were asked to complete a questionnaire, and the data obtained were statistically analyzed using univariate analysis. RESULTS: Compared to paper book readers (1.93), LCD readers (2.40) complained of insufficient lubrication in the eye (p = 0.038), and experience more letter-floating illusions (1.92) than did paper book readers (1.49) (p = 0.043). Moreover, compared to the other formats including the E-book (20%) and paper book (8%), LCD readers (72%) experienced more significant glare symptoms (n = 23) and could read at a faster rate than the other groups of readers (n = 26). CONCLUSIONS: In the present study, the I-Pad caused ocular fatigability more easily than the other formats examined. No statistical significance of ocular discomfort or fatigability was observed among the different format groups. Further investigation with a greater number of age-controlled participants should be conducted prior to designing a study to determine the best format for reading.
Dry Eye Syndromes ; Eye ; Glare ; Illusions ; Lubrication ; Multimedia ; Surveys and Questionnaires

Atypical polypoid dermatofibroma(APDF) represents a distinctive clinicopathologic variant of dermatofibroma. We describe an unusual case of APDF occuring on the right buttoack in a 27-year-old female. The lesion was a reddish-hued, rounded, hard protuberant tumor with short pedicle, measuring 2,7 x 2.7 x 1.5cm. Excised tumor showed a well circumscribed dermal lesion localized in the protruded ar~ea, and dense proliferation of fibroblasts and capillaries reminiseent of fibrous or scle~rosing hemangioma type, with prominent focal cellular atypia. The tumor cells were vimentin-positive, but did not express CD34. There was no evidence of recurrence after 18 months postoperative follow-up.
Adult ; Capillaries ; Female ; Fibroblasts ; Follow-Up Studies ; Hemangioma ; Histiocytoma, Benign Fibrous* ; Humans ; Recurrence

Periorbital swelling is a rather common symptom. Of the causes, the associated lymphoproliferative diseases rarely involve, and, if any, pseudolymphoma and B-cell type of lymphoma are mostly implicated. We report herein a case of unspecified peripheral T-cell lymphoma presenting as only manifestation of bilateral orbital swelling. A 32-year-old woman had a fluctuant course of bilateral mild erythematous swelling without ocular or lymph node involvement for about 2 years. Biopsy specimens from the left upper eyelid showed infiltration of medium-sized atypical cells with pleomorphism, convoluted nuclei, scant cytoplasm and less prominent nuclei. The cell was LCA, UCHL-1 and CD3 positive, but negative for L26. She received six cycles of CHOP combined therapy, with a marked improvement. No relapse was noted during a period of about a 6-month follow-up.
Adult ; B-Lymphocytes ; Biopsy ; Cytoplasm ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell, Peripheral* ; Orbit ; Pseudolymphoma ; Recurrence

Analyses and studies have been made on 34 cases of the combined ICH, showing mass effect among 305 male and female ruptured intracranial aneurysmal patients who were admitted to Kyungpook National University Hospital from Mar. 1984, through Feb. 1990. The incidence of the large ICH was 11.1% with 2.1 to 1 ratio of male to female. The highest age incidence of the hematoma was in the 40 to 60 years bracket. The most frequent site of the aneurysm combined with the large ICH was at MCA aneurysm, 38.6%, followed by at A-com artery aneurysm, 4.8%. The most frequent location of the hematoma was in temporal lobe, 88.2%. The rate of combined large ICH was 20.3% in multiple aneurysmal bleeding patients who revealed higher incidence of the hematoma than the single bleeding patients. In amount of the hematoma, 30-40ml bracket ranked top occupying 32.4% of all cases. After surgical treatment, 29.4% patient was improved to the good and fair on discharge. The rate of mortality was 61.8%, which was mainly due to direct effect of hematoma and cerebral infarction caused by vasospasm.
Aneurysm ; Arteries ; Cerebral Infarction ; Female ; Gyeongsangbuk-do ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Temporal Lobe