We report two cases of recurrent extramarnmary Pagets disease after wide local excision. Both cases involved the scrotum and the penoserotal junction, respectively. On histopathological examination, we could observed many Paget cells confined to the epidermis and the hair follicle, but not invading the underlying dermis in both cases. There was no evidence of internal malignancy. Both cases were treated with wide local reexcision.
Dermis ; Epidermis ; Hair Follicle ; Paget Disease, Extramammary* ; Scrotum

Cystic lymphangioma are rare benign tumors that originate as a congenital anomaly of the lymphatic system. Their common presentation is in neck and axillary area at the birth, during infancy or early pediatric age group. Author reports an unusual case of cystic lymphangioma of breast which was diagnosed in a 32-year-old woman. The findings were very dense, sharply defined, and multilobulated masses on mammography, and mu-Itiloculated echo free lesions on ultrasonogram.
Adult ; Breast* ; Female ; Humans ; Lymphangioma, Cystic* ; Lymphatic System ; Mammography ; Neck ; Parturition ; Ultrasonography

Congenital Abnormalities ; Female ; Humans ; Jaw ; Jeollabuk-do ; Male ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Rehabilitation ; Surgery, Oral

No abstract available.

Malignant neoplasm associated with chronic empyema is rare. Most squamous cell carcinomas of the pleura may occur in association with chronic persistent empyema, with or without pleurocutaneous fistula. We report a case of squamous cell carcinoma associated with chronic empyema caused by a metallic foreign body.
Carcinoma, Squamous Cell* ; Empyema* ; Fistula ; Foreign Bodies ; Pleura

PURPOSE: The purpose of this study was to investigate the status of infection control in long-term care facilities in Korea and educational needs of nurses in charge of infection control. METHODS: This was a descriptive study. A self-reported questionnaire was provided to the nurses in charge of infection control in 250 hospitals with long-term care. 209 nurses answered to the questionnaire. Data were collected from September 30 to November 7, 2016. Data were analyzed using SPSS/WIN 18.0, and the educational needs were analyzed by applying the Borich Needs Assessment Model. RESULTS: Only 17.4% of the hospitals had infection control departments, and only 1.0% of the hospitals had nurses who were fully-in-charge of infection control. Regarding the educational needs on infection control, level of knowledge was statistically significantly lower in all 50 items compared to the importance. Specifically, educational demand on air and water quality management, construction and infection control, indicator management, and infectious disease management were also high. CONCLUSION: The results of this study showed that organization and manpower were needed for effective infection control of long-term care facilities in Korea. In addition, it was deemed necessary to develop and applicate infection control education programs as reflected on the scores obtained in the educational needs on infection control.
Communicable Diseases ; Education ; Infection Control* ; Korea* ; Long-Term Care* ; Needs Assessment ; Water Quality

OBJECTIVE: To compare the reliability of the Greulich-Pyle (GP) method, Tanner-Whitehouse 3 (TW3) method and Korean standard bone age chart (KS) in the evaluation of bone age of prepubertal healthy Korean children. MATERIALS AND METHODS: Left hand-wrist radiographs of 212 prepubertal healthy Korean children aged 7 to 12 years, obtained for the evaluation of the traumatic injury in emergency department, were analyzed by two observers. Bone age was estimated using the GP method, TW3 method and KS, and was calculated in months. The correlation between bone age measured by each method and chronological age of each child was analyzed using Pearson correlation coefficient, scatterplot. The three methods were compared using one-way analysis of variance. RESULTS: Significant correlations were found between chronological age and bone age estimated by all three methods in whole group and in each gender (R2 ranged from 0.87 to 0.9, p < 0.01). Although bone age estimated by KS was slightly closer to chronological age than those estimated by the GP and TW3 methods, the difference between three methods was not statistically significant (p > 0.01). CONCLUSION: The KS, GP, and TW3 methods show good reliability in the evaluation of bone age of prepubertal healthy Korean children without significant difference between them. Any are useful for evaluation of bone age in prepubertal healthy Korean children.
Age Determination by Skeleton/*methods ; Asian Continental Ancestry Group ; Child ; Emergency Service, Hospital ; Female ; Hand/*radiography ; Humans ; Male ; Republic of Korea ; Wounds and Injuries

Purpose: There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric GHD and to identify risk factors that may predict pituitary or intracranial abnormalities. Methods: A total of 95 pediatric GHD patients were included. Their medical records and brain magnetic resonance (MR) images were reviewed retrospectively. Results: Abnormal pathogenic MR images were found in 14 patients (14.7%), including 10 (10.5%) with pituitary hypoplasia and 4 (4.2%) with pituitary stalk interruption syndrome. Serum levels of insulin-like growth factor-I (IGF-I), IGF-I standard deviation score (SDS), insulin-like growth factor binding protein 3 (IGFBP3), and growth hormone (GH) peak level of GH stimulation test were statistically significantly lower in the group with abnormal brain MRI. The frequency of abnormal MRI was statistically significantly higher in the complete GHD group. IGF-1 SDS showed the highest area under the curve which can predict the presence of brain abnormality with a sensitivity of 85% and a specificity of 71.4%, if IGF-1 SDS was less than -1.365. IGF-1, IGFBP3, and GH peak levels also showed good sensitivity of over 80% for predicting brain abnormalities with cutoff values of 70.285 ng/mL, 1,604 ng/mL, and 4.205 ng/mL, respectively. Conclusion The sensitivity and specificity of each cutoff value of IGF-1, IGF-1 SDS, IGFBP3, and GH peak levels were good and statistically significant in predicting brain MRI abnormalities. However, it was insufficient to predict all brain abnormalities with these variables. Therefore, we would like to recommend performing a brain MRI if a child is diagnosed with GHD.

Purpose: There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric GHD and to identify risk factors that may predict pituitary or intracranial abnormalities. Methods: A total of 95 pediatric GHD patients were included. Their medical records and brain magnetic resonance (MR) images were reviewed retrospectively. Results: Abnormal pathogenic MR images were found in 14 patients (14.7%), including 10 (10.5%) with pituitary hypoplasia and 4 (4.2%) with pituitary stalk interruption syndrome. Serum levels of insulin-like growth factor-I (IGF-I), IGF-I standard deviation score (SDS), insulin-like growth factor binding protein 3 (IGFBP3), and growth hormone (GH) peak level of GH stimulation test were statistically significantly lower in the group with abnormal brain MRI. The frequency of abnormal MRI was statistically significantly higher in the complete GHD group. IGF-1 SDS showed the highest area under the curve which can predict the presence of brain abnormality with a sensitivity of 85% and a specificity of 71.4%, if IGF-1 SDS was less than -1.365. IGF-1, IGFBP3, and GH peak levels also showed good sensitivity of over 80% for predicting brain abnormalities with cutoff values of 70.285 ng/mL, 1,604 ng/mL, and 4.205 ng/mL, respectively. Conclusion The sensitivity and specificity of each cutoff value of IGF-1, IGF-1 SDS, IGFBP3, and GH peak levels were good and statistically significant in predicting brain MRI abnormalities. However, it was insufficient to predict all brain abnormalities with these variables. Therefore, we would like to recommend performing a brain MRI if a child is diagnosed with GHD.

Purpose: There is controversy as to whether brain magnetic resonance imaging (MRI) should be performed on all children with growth hormone deficiency (GHD) including those judged to have mild GHD. This study was aimed to determine the frequency of pituitary or intracranial abnormalities in pediatric GHD and to identify risk factors that may predict pituitary or intracranial abnormalities. Methods: A total of 95 pediatric GHD patients were included. Their medical records and brain magnetic resonance (MR) images were reviewed retrospectively. Results: Abnormal pathogenic MR images were found in 14 patients (14.7%), including 10 (10.5%) with pituitary hypoplasia and 4 (4.2%) with pituitary stalk interruption syndrome. Serum levels of insulin-like growth factor-I (IGF-I), IGF-I standard deviation score (SDS), insulin-like growth factor binding protein 3 (IGFBP3), and growth hormone (GH) peak level of GH stimulation test were statistically significantly lower in the group with abnormal brain MRI. The frequency of abnormal MRI was statistically significantly higher in the complete GHD group. IGF-1 SDS showed the highest area under the curve which can predict the presence of brain abnormality with a sensitivity of 85% and a specificity of 71.4%, if IGF-1 SDS was less than -1.365. IGF-1, IGFBP3, and GH peak levels also showed good sensitivity of over 80% for predicting brain abnormalities with cutoff values of 70.285 ng/mL, 1,604 ng/mL, and 4.205 ng/mL, respectively. Conclusion The sensitivity and specificity of each cutoff value of IGF-1, IGF-1 SDS, IGFBP3, and GH peak levels were good and statistically significant in predicting brain MRI abnormalities. However, it was insufficient to predict all brain abnormalities with these variables. Therefore, we would like to recommend performing a brain MRI if a child is diagnosed with GHD.