No abstract available.
Arthritis, Rheumatoid* ; Humans ; Hyperplasia* ; NF-kappa B*

No abstract available.
Dermoid Cyst* ; Female ; Ovary* ; Pregnancy ; Pregnancy, Tubal*

BACKGROUND: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. METHODS: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range: 3-67). RESULTS: 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). CONCLUSION: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment.
Biopsy ; Diagnosis ; Female ; Hospitals, Veterans ; Humans ; Korea ; Liver ; Male ; Medical Records ; Molluscum Contagiosum ; Skin ; Virus Diseases

Recently, we have encountered an increasing number of patients who have obtained topical steroids to self-treat various dermatosis. Tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often atypical appearing and the diagnosis can be delayed or missed. We report a case of tinea incognito with ill-defined erythematous patch and nodules on the right upper eyelid and taken intermittently application with corticosteroid ointment over a period of l year. Mycologic studies including KOH mount and fungus culture were positive for hyphae and colonies of Trichophyton mentagrophytes. The lesion was treated with of itraconazole and cured 3 weeks later.
Arthrodermataceae ; Diagnosis ; Eyelids ; Fungi ; Humans ; Hyphae ; Itraconazole ; Skin Diseases ; Steroids ; Tinea* ; Trichophyton*

Hidroacanthoma simplex is a rare skin tumor which most often develops on the lower extremity of an elderly person. Clinically, the lesion appears as a well-demarcated brownish flat or verrucous plaque, resembling seborrheic keratosis or Bowen's disease. Histologically, it is characterized by intraepidermal nests of basaloid cells within an acanthotic epidermis. there is some controversy over the histogenesis of hidroacanthoma simplex, many consider it an epidermal tumor differentiation into intraepidermal eccrine duct cells. We report a case of hidroacanthoma simplex presented a small verrucous papule on the left foot with the results of an immunohistochemical study.
Aged ; Bowen's Disease ; Epidermis ; Foot ; Humans ; Keratosis, Seborrheic ; Lower Extremity ; Skin

BACKGROUND: The purpose of this study was to find additional effects of intrathecal nalbuphine 1 mg to morphine 0.1 mg for pain relief during a cesarean section. METHODS: Sixty healthy patients at full term who were scheduled for an elective cesarean delivery with spinal anesthesia were enrolled in the study. They received 0.5% bupivacaine 10 mg with either morphine 0.1 mg (group M), or nalbuphine 1 mg (group N), or morphine 0.1 mg nalbuphine 1 mg (group M + N). Analgesic effects were evaluated by a verbal rating scale on the duration of complete analgesia (time from the intrathecal injection to the first pain report), effective analgesia (time from the intrathecal injection to the first analgesic request), and cumulative doses of additional analgesics. Hemodynamic changes and adverse effects were also observed. RESULTS: The duration of complete analgesia increased significantly in group M, compared with group N and group M + N. Effective analgesia was longer in group M and group M + N, compared with group N. The incidence of pruritus was significantly lower in group N, compared with group M and M + N. The incidence of nausea and vomiting was the same among all groups. CONCLUSIONS: We concluded that intrathecal addition of nalbuphine 1mg to morphine 0.1 mg during spinal anesthesia for a cesarean delivery reinforced intraoperaitive analgesia compared with intrathecal morphine 0.1 mg. However, it reduced the duration of complete analgesia and had no effect on the incidence of pruritus.
Analgesia ; Analgesics ; Anesthesia, Spinal ; Bupivacaine ; Cesarean Section* ; Female ; Hemodynamics ; Humans ; Incidence ; Injections, Spinal ; Morphine* ; Nalbuphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

Desmoplastic melanoma is a rare variant of the spindle cell melanoma that first was recognized and described in 1971 as an invasive fibrosarcoma-like tumor that exhibits an abundant collagenous stroma. These tumors usually arise in sun-damaged skin of the head and neck in older persons, in association with lentigo maligna or de novo. The clinical presentation is often not characteristic, and they may clinically simulate other tumors of the skin. Hence they are often diagnosed late. Histologically, desmoplastic melanoma appears as a nodule of fibrous tissue containing hyperchromatic pleomorphic spindle cells that either are scattered singly, lie in fascicles, or aggregate in nests, and collagenous tissue replacing the reticular dermis. Immunohistochemistry is usually quite helpful as the tumors are almost always immunoreactive with S-100 protein and negative for HMB-45. We report a case of desmoplastic melanoma in a 67-year old male who had a walnut sized tumor upon large indurated plaque on the left thigh. A biopsy specimen of the tumor showed that fascicles of spindle cells are interspersed throughout collagenous tissue and most tumor cells are immunoreactive with S-100 protein. To our knowledge, this is the first case report in Korea.
Aged ; Biopsy ; Collagen ; Dermis ; Head ; Humans ; Hutchinson's Melanotic Freckle ; Immunohistochemistry ; Juglans ; Korea ; Male ; Melanoma* ; Neck ; S100 Proteins ; Skin ; Thigh

The papillary eccrine adenoma is a rare benign sweat gland neoplasm, first described by Rulon and Helwig in 1977. It is usually present as a solitary dermal nodule on the distal extremities. Histological examination revealed a well circumscribed, non capsulated dermal nodule consisting of multiple ducts with various size. These ducts were composed of double layered epithelial cells mostly and intraluminal papillation with eosinophilic luminal materials was seen. We report a case of papillary eccrine adenoma in 52-year-old male who presented single nodule on the right midback, uncommon area.
Adenoma* ; Eosinophils ; Epithelial Cells ; Extremities ; Humans ; Male ; Middle Aged ; Phenobarbital ; Sweat Gland Neoplasms

Purpose: This qualitative study examined the inner response of medical students who participated in a transgender healthcare education program. The factors that effected the inner response were investigated in order to suggest strategies for improving the effectiveness of the transgender healthcare education program. Methods: The transgender healthcare education program consisted of 2 hours of lectures and 2 hours of clinical role-play over 3 weeks. Eight 4-year medical students in Seoul, South Korea, were selected considering gender, the route of admission to medical school, and religion. Each student was interviewed individually for approximately 30 minutes 3 times before, during, and after the educational program, and interviews were analyzed using thematic analysis. Results: By attending the transgender healthcare education program, students have shown three types of inner response—confusion, acceptance, and negotiation. The students’ personal identities and professional identities influenced these responses. In particular, students’ existing professional identities motivated them to learn about transgender healthcare and played a key role in resolving the discomfort that occurred during the educational program. Through the transgender healthcare education, students were able to reduce prejudice against transgender people, understand the unique medical needs of the transgender population and increase their self-efficacy related to transgender health care. Conclusion The transgender healthcare education program allowed medical school students to acquire medical knowledge related to transgender patients and increase their cultural competence as future medical professionals. In addition, as the professional identity is critical in educating transgender healthcare, it should be considered thoroughly in order to effectively educate the medical students.

BACKGROUND: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. METHODS: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. RESULTS: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. CONCLUSION: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.
Dalteparin* ; Factor Xa ; Hemorrhage* ; Heparin, Low-Molecular-Weight ; Humans ; International Normalized Ratio ; Medical Records ; Odds Ratio ; Platelet Count ; Retrospective Studies ; Rivaroxaban* ; Venous Thromboembolism*