Median raphe canal is an uncommon disease and represents a defect abnormality of the male genitalia. It occurs along the ventral median raphe from the glans penis to the anus. Histologically the canal is lined by stratified squamous epithelium which dose not communicate with the urethra. Surgical excision is the treatment of choice. Recently we observed a 25-year-old male patient who had had a median raphe canal located in the ventral aspect of penis.
Adult ; Anal Canal ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis* ; Urethra

BACKGROUND: The 2004 World Health Organization classification introduced atypical pituitary adenoma (aPA), which was equivocally defined as invasion with increased mitotic activity that had a Ki-67 labeling index (LI) greater than 3%, and extensive p53 immunoreactivity. However, aPAs that exhibit all of these features are rare and the predictive value for recurrence in pituitary adenomas (PAs) remains uncertain. Thus, we sought to characterize pathological features of PAs that correlated with recurrence. METHODS: One hundred and sixty-seven cases of surgically resected PA or aPA were retrieved from 2011 to 2013 in Seoul St. Mary’s Hospital. Among them, 28 cases were confirmed to be recurrent, based on pathologic or radiologic examination. The pathologic characteristics including mitosis, invasion, Ki-67 LI and p53 immunoreactivity were analyzed in relation to recurrence. RESULTS: Analysis of the pathologic features indicated that only Ki-67 LI over 3% was significantly associated with tumor recurrence (p = .02). The cases with at least one pathologic feature showed significantly higher recurrence rates (p < .01). Analysis indicated that cases with two pathologic features, Ki-67 LI over 3% and extensive p53 immunoreactivity 20% or more, were significantly associated with tumor recurrence (p < .01). CONCLUSIONS: Based on these results, PA tumor recurrence can be predicted by using mitosis, invasion, Ki-67 LI (3%), or extensive p53 immunoreactivity (≥ 20%). Assessment of these features is recommended for PA diagnosis for more accurate prediction of recurrence.
Classification ; Diagnosis ; Ki-67 Antigen ; Mitosis ; Pituitary Neoplasms* ; Recurrence* ; Seoul ; Tumor Suppressor Protein p53 ; World Health Organization

PURPOSE: Patients with chronic gastrointestinal disease are at risk for trace element deficiency due to impaired absorption and gastrointestinal loss. The aim of this study was to evaluate the trace element status of patients with gastrointestinal disease by blood and hair analysis, and to determine the usefulness of hair mineral analysis for diagnosing trace element deficiency not detected by a blood test. METHODS: An analysis of hair minerals was performed and compared with blood mineral analysis in 13 patients with chronic gastrointestinal disease. The concentration of each element in the hair and blood was compared in the subgroups based on parenteral nutritional support or clinical symptoms. RESULTS: Almost all patients had trace element deficiency. The trace elements deficient in the blood or hair analysis included zinc, selenium and copper. The hair zinc concentration was significantly lower in the group receiving parenteral nutritional support. The hair selenium concentration was statistically associated with the clinical symptoms of hair loss, brittle hair and loss of hair pigmentation. CONCLUSION: The results of this study suggest that patients with chronic gastrointestinal disease should receive adequate zinc and selenium replacement to avoid trace element deficiency especially when treated with long-term parenteral nutrition. Hair mineral analysis is useful as a complementary tool for the detection of a trace element deficiency.
Absorption ; Child ; Copper ; Gastrointestinal Diseases ; Hair ; Humans ; Minerals ; Nutritional Support ; Parenteral Nutrition ; Selenium ; Trace Elements ; Zinc

BACKGROUND: Woods are capable of causing allergic or irritant contact dermatitis which typically occurs on exposed areas. Because Bolivian rosewood exclusively contains the strong sensitizer R-3,4-dimethoxydalbergione, an increasing number of cases of irritant and allergic contact dermatitis has been reported. CASE REPORT: A 49-year-old, male, wood worker, who handled a variety of woods, developed allergic contact dermatitis. A patch test confirmed a positive reaction to one of the exotic woods, Bolivian rosewood. Allergens found in Bolivian rosewood caused this patient's dermatitis, which cleared when he avoided this wood. CONCLUSION: Exotic woods such as Bolivian rosewood can induce occupational contact dermatitis. Measures to lower the incidence of work-related dermatitis are needed in the workplace. Especially, when cutting or sanding woods, workers should wear proper personal protection.
Allergens ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Erythema Multiforme* ; Erythema* ; Humans ; Incidence ; Male ; Middle Aged ; Patch Tests ; Silicon Dioxide ; Wood

No abstract available.
Angiomyoma*

No abstract available.
Aged ; Cysticercosis/*diagnosis/radiography ; Humans ; Immunocompetence ; Incidental Findings ; Male ; Neurocysticercosis/diagnosis/radiography

Nocardiosis is an acute, subacute, or chronic infection, most often beginning in the lung, and usually affects the immunocompromised host. Nocardial infections are not rare in the United States, 500 to 1000 cases are recognized each year, but rarely reported in Korea. Disorders associated with cellular immune dysfunction are the major risk factors for nocardiosis. We report one case of brain and retroperitoneal abscess caused by Nocardia asteroides in patient who has had a chronic lymphocytic leukemia and diabetes mellitus, with a review of the relevant literature.
Abscess ; Brain ; Diabetes Mellitus ; Humans ; Immunocompromised Host ; Korea ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Lung ; Nocardia asteroides ; Nocardia Infections* ; Risk Factors ; United States

BACKGROUND/AIMS: The aim of this study was to ascertain the effects of two week treatment of omeprazole (O) and clarithromycin (C) with and without metronidazole (M), and one week treatment of omeprazole, clarithromycin and metronidazole, for the eradieation of Helicobacter pylori (H. pylori) in patients with peptic ulcer disease in double-blind, randomly controlled groups. METHODS: The H. pylori infection determined in patients whose results were positive in a rapid urease test or in those who exhibited histology in antrum and body, The OC14 group received O 40 mg qd and C 500 mg t.i.d. for 2 weeks; the OCM14 group received O, C, and M 250 mg t.i.d for 2 weeks, and the OCM7 group received O, C, M for 1 week, respectively. H. pylori eradication was assessed 4 weeks after the end of treatment. The H. pylori eradication was determined as all negative for the rapid urease test and histology on both the antrum and body.
Clarithromycin* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metronidazole* ; Omeprazole* ; Peptic Ulcer* ; Urease

Among various dermatological entities, toxic epidermal necrolysis (TEN) is a rare but potentially fatal delayed hypersensitivity reaction to numerous medications. A 38-year-old male presented with systemic hypersensitivity reaction, such as high fever, pain in the eyes, and diffuse pruritic erythematous maculopapular eruptions with multiple targetoid plaques that became vesicular and bullous. Oral mucosa and conjunctivae were involved. The first sign appeared about 1 week after taking methazolamide (50 mg twice a day) for the management of glaucomatous eyes. Although methazolamide was discontinued, blistering and skin denudation progressed to affect up to 80% of the body surface area and a positive Nikolsky sign was noted. High fever also persisted. Skin lesions started to improve after 2 weeks of management and fever subsided. Cutaneous lesions improved with minimal permanent sequele 2 months later. HLA-B*5901 was found by high-resolution genotyping. The lymphocyte activation test performed 6 months after remission showed a positive response to methazolamide challenge. This is the first case of methazolamide-induced TEN in which methazolamide was confirmed as a culprit drug by the lymphocyte activation test.
Adult ; Blister ; Body Surface Area ; Conjunctiva ; Fever ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Lymphocyte Activation* ; Lymphocytes* ; Male ; Methazolamide ; Mouth Mucosa ; Skin ; Stevens-Johnson Syndrome*

BACKGROUND/AIMS: The prevalence and clinical characteristics of entecavir (ETV) resistance is not well known. The aim of this study was to determine the frequency of genotypic resistance in nonresponders and virologic breakthrough (VBT) patients. METHODS: The medical records of 76 chronic hepatitis B patients treated for a least 6 months from October 2006 to October 2008 were reviewed retrospectively. We divided patients into two groups: nucleoside analogue (NA)-naive patients (n=38) and LAM experienced patients (n=38). NA-naive and LAM experienced patients received ETV at 0.5 and 1.0 mg/day, respectively. The virologic response and VBT were investigated in both groups. We used the multiplex restriction fragment mass polymorphism (RFMP) method to test genotypic resistance at the rtI169, rtT184, rtS202, rtM204, and rtM250 sites. RESULTS: Age, gender, serum ALT, and HBV DNA level before treatment did not differ between the groups. Neither VBT nor nonresponse was observed in the NA-naive group, whereas VBT and nonresponse were observed in three patients each in the lamivudine (LAM)-experienced group; all six patients had YMDD mutation at study enrollment, all three patients with VBT had genotypic resistance to ETV, but the three nonresponse patients did not have genotypic resistance to ETV. CONCLUSIONS: We suspect that VBT is mostly associated with genotypic resistance to ETV. However, nonresponse might be associated with the continuance or reselection of the YMDD mutant in LAM-experienced patients.
Adult ; Antiviral Agents/*therapeutic use ; Drug Resistance, Viral/genetics ; Female ; Genotype ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B/genetics ; Hepatitis B, Chronic/*drug therapy/virology ; Humans ; Lamivudine/therapeutic use ; Male ; Middle Aged ; Mutation ; Polymorphism, Restriction Fragment Length ; RNA-Directed DNA Polymerase/genetics ; Retrospective Studies