No abstract available.
Lasers, Dye* ; Melanosis*

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on medline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Adolescent ; Adult ; Autopsy ; Chlorpheniramine ; Death, Sudden* ; Diverticulum ; Female ; Hashimoto Disease ; Hepatitis, Chronic ; Humans ; Hypothyroidism* ; Korea ; Spleen ; Thyroid Gland ; Thyroiditis

BACKGROUND/AIMS: Achalasia is a primary motility disorder of esophagus. Many parameters represent esophageal function and morphologic changes, but their interrelationship is not yet established. We hypothesized that esophageal body would need to generate unusual pressure to empty the food bolus through the non-relaxing lower esophageal sphincter in patients with achalasia; therefore, higher is the residual lower esophageal sphincter pressure, greater would be the contraction pressure in the esophageal body in these patients. To verify the hypothesis, correlations among parameters from esophageal manometry, esophagography and esophageal transit study had been investigated. METHODS: A retrospective review of 34 patients was conducted. Resting lower esophageal sphincter pressure and contraction pressure of esophageal body were obtained from conventional esophageal manometry. Diameter of esophageal body was measured from barium column under esophagography. Radionuclide imaging was performed to assess the esophageal transit, designated as R30, which was the residual radioactivity at 30 seconds after ingesting radioactive isotope. RESULTS: In vigorous achalasia group, contraction pressure of esophageal body was negatively correlated to dilated diameter of esophageal body (P = 0.025, correlation coefficient = -0.596). Esophageal transit was more delayed as dimensions of esophageal body increased in classic achalasia group (P = 0.039, correlation coefficient = 0.627). CONCLUSIONS: Diameter of esophageal body in classic achalasia was relatively wider than that of vigorous achalasia group and the degree of delayed esophageal transit was proportionate to the luminal widening. Patients with vigorous achalasia had narrower esophageal lumen and relatively shorter transit time than that of classic achalasia group. Proper peristalsis is not present in achalasia patients but remaining neuromuscular activity in vigorous achalasia patients might have caused the luminal narrowing and shorter transit time.
Barium ; Contracts ; Esophageal Achalasia ; Esophageal Sphincter, Lower ; Esophagus ; Humans ; Manometry ; Peristalsis ; Phenobarbital ; Radioactivity ; Retrospective Studies

Oral focal mucinosis (OFM) is an uncommon clinicopathologic entity which is considered to be the oral counterpart of cutaneous focal mucinosis. It is comprised of a clinically-elevated mass with a histological feature of localized areas of myxomatous connective tissue. We herein report a case of oral focal mucinosis in a child, plus a review of the literature.
Child ; Connective Tissue ; Humans ; Mucinoses*

Oral focal mucinosis (OFM) is an uncommon clinicopathologic entity which is considered to be the oral counterpart of cutaneous focal mucinosis. It is comprised of a clinically-elevated mass with a histological feature of localized areas of myxomatous connective tissue. We herein report a case of oral focal mucinosis in a child, plus a review of the literature.
Child ; Connective Tissue ; Humans ; Mucinoses*

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma. Mohs micrographic surgery is considered the standard treatment. Other treatment modalities such as surgical excision, radiotherapy, topical chemotherapy, and photodynamic therapy are associated with varying degrees of effectiveness, and possible loss of tissue function and disease recurrence are seen. The search for an effective, safe treatment with minimal side effects proves to be challenging. Imiquimod is the first representative of a new class of immunomodulating drugs demonstrating potent antiviral and antitumor activity, and has been approved by the FDA for treating anogenital warts, actinic keratosis and basal cell carcinoma. Recent research has demonstrated its effective usage as a 5% cream in the management of EMPD. We report a case of EMPD of the scrotum successfully treated with topical 5% imiquimod cream. This has never been published in the Korea dermatologic literature.
Adenocarcinoma ; Carcinoma, Basal Cell ; Drug Therapy ; Keratosis, Actinic ; Korea ; Mohs Surgery ; Paget Disease, Extramammary* ; Photochemotherapy ; Radiotherapy ; Recurrence ; Scrotum ; Warts

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma. Mohs micrographic surgery is considered the standard treatment. Other treatment modalities such as surgical excision, radiotherapy, topical chemotherapy, and photodynamic therapy are associated with varying degrees of effectiveness, and possible loss of tissue function and disease recurrence are seen. The search for an effective, safe treatment with minimal side effects proves to be challenging. Imiquimod is the first representative of a new class of immunomodulating drugs demonstrating potent antiviral and antitumor activity, and has been approved by the FDA for treating anogenital warts, actinic keratosis and basal cell carcinoma. Recent research has demonstrated its effective usage as a 5% cream in the management of EMPD. We report a case of EMPD of the scrotum successfully treated with topical 5% imiquimod cream. This has never been published in the Korea dermatologic literature.
Adenocarcinoma ; Carcinoma, Basal Cell ; Drug Therapy ; Keratosis, Actinic ; Korea ; Mohs Surgery ; Paget Disease, Extramammary* ; Photochemotherapy ; Radiotherapy ; Recurrence ; Scrotum ; Warts

A human tail is a rare congenital anomaly, and is characterised by a prominent lesion from the lumbosacrococcygeal region. Human tails are classified into 'true tails' and 'pseudotails'. True tails are comprised of only mesenchymal tissue. They are presumed to be remnants of the embryologic tail. All other lumbosacrococcygeal protrusions are summarized as pseudotails. Congenital smooth muscle hamartoma usually presents as a well-circumscribed, hypertrichotic, hyperpigmented or skin-colored patch or plaque on the trunk or an extremity at birth. Histologically, numerous thick, long, well-defined bundles of smooth muscle fibers are scattered throughout the dermis in various directions. We report a case of congenital smooth muscle hamartoma in a 15-year-old male patient who presented with a tail-like protruding mass accompanied by hypertrichosis and underlying soft tissue deviation.
Adolescent ; Dermis ; Extremities ; Hamartoma* ; Humans* ; Hypertrichosis ; Male ; Muscle, Smooth* ; Parturition

The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.
Contracture ; Intention ; Nose ; Skin ; Transplants ; Wounds and Injuries