Desmoplastic trichoepithelioma is a rare benign adnexal tumor with female preponderance, most commonly located on the face. Clinically, the tumor measures from 3 to 8mm in diameter, and has a raised, annular border and a depressed nonulcerated center. The three characteristic histologic features are narrow strands of tumor cells, horn cysts, and a desmoplastic stroma. We report herein a case of desmoplastic trichoepithelioma in a 25-year-old woman who had an asymptomatic hard annular nodule with a raised border and depressed center on the left cheek.
Adult ; Animals ; Cheek ; Female ; Horns ; Humans

PURPOSE: To report the clinical outcomes and utility of 23-gauge (G) transconjunctival sutureless vitrectomy (TSV) in patients with postoperative endophthalmitis following cataract surgery. METHODS: The medical records of 16 patients (17 eyes) who underwent 23-G TSV between January 2008 and December 2009 at Konyang University Hospital due to postoperative endophthalmitis following cataract surgery were retrospectively analyzed. The pre- and post-operative best-corrected visual acuities (BCVA), changes in intraocular pressure, the time from diagnosis to surgery, the intraoperative and postoperative complications, and the average duration of hospitalization were investigated. RESULTS: The mean BCVA significantly improved from log MAR 1.89 +/- 1.03 to log MAR 0.42 +/- 0.82 (p = 0.001), and the mean intraocular pressure changed from 16.1 +/- 4.1 mm Hg at baseline to 16.2 +/- 3.3 mm Hg on the first postoperative day without any significant difference (p = 0.955). In addition, none of the patients required sutures to treat wound leakage or showed hypotony on follow-up observation. The average operation time was 64.7 +/- 22.5 minutes, and the average duration of hospitalization was 5.4 +/- 4.5 days. CONCLUSIONS: The use of 23-G TSV in patients with postoperative endophthalmitis following cataract surgery may offer more convenience for the surgeon and more comfort for the patient. In addition, the patient may return to normal life earlier with a shortened duration of hospitalization.
Cataract ; Endophthalmitis ; Follow-Up Studies ; Hospitalization ; Humans ; Intraocular Pressure ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Sutures ; Visual Acuity ; Vitrectomy

Shiitake (Lentinus edodes) is nowadays the second most commonly produced edible mushroom in the world. Two patients complained of severe itching and showed widespread disseminated very small erythematous papule and characteristic linear grouped erythematous papules after scratching (Kobner phenomenon). Here we report two cases of mushroom intolerance which developed after ingestion of boiled or cooked shiitake mushrooms.
Agaricales* ; Eating ; Humans ; Pruritus ; Shiitake Mushrooms

Aspirin intolerance is defined as acute urticaria-angioedema, bronchospasm, severe rhinitis, or shock occuring within three hours of aspirin ingestion. Aspirin intolerance occurs most frequently in individuals with chronic urticaria, asthma, chronic rhinitis, and normal individual in order of decreasing frequency. NSAIDs frequently cross-react with aspirin in intolerant individuals. We report a case of aspirin intolerance, which cross-reacts with naproxen, in a 42-year-old male with chronic urticaria. He experienced angioedema within 20 minutes after ingesting aspirin (700mg) and within 2 hours after ingesting naproxen (125mg). He has also experienced itching, wheal, chest tightness, and nausea during oral challenge test with aspirin.
Adult ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Asthma ; Bronchial Spasm ; Eating ; Humans ; Male ; Naproxen ; Nausea ; Pruritus ; Rhinitis ; Shock ; Thorax ; Urticaria*

Repeated concussion is common among football players; however, these minor blunt head trauma rarely result in serious complications. We report a case of a young college football player who presented acute subdural hematoma, cerebral edema, and seizure due to pseudoaneurysm rupture. The pseudoaneurysm, located at the cortical branch of the middle cerebral artery, was speculated to be formed by dural calcification and adhesion with the underlying brain, possibly due to repeated concussions. Following successful excision of the pseudoaneurysm and control of brain swelling, the patient recovered without sequelae and was discharged after a short while.
Aneurysm, False* ; Athletic Injuries ; Brain ; Brain Edema ; Craniocerebral Trauma ; Dura Mater* ; Football* ; Hematoma, Subdural, Acute ; Humans ; Middle Cerebral Artery ; Rupture ; Seizures

We report a patient with an unusual manifestation of Trichophyton rubrum infection. A 75-year-old male presented an erythematous patch with painless crusted and non-crusted nodules on the left elbow which had persisted for 5 weeks. Histologic findings of the erythematous nodule showed epidermal hyperplasia and granulomatous change in the lower dermis. Trichophyton rubrum was isolated on the fungus culture of the biopsy specimen. The patient was treated with itraconazole (100mg/day) for 8 weeks, resulting in the clearing of the skin lesion and there has been no recurrence of any skin lesion over a 3-month' follow-up period.
Aged ; Biopsy ; Dermis ; Elbow ; Follow-Up Studies ; Fungi ; Granuloma* ; Humans ; Hyperplasia ; Itraconazole ; Male ; Recurrence ; Skin ; Trichophyton*

PURPOSE: To report 2 young female patients with bilateral posterior scleritis and serous retinal detachment. CASE SUMMARY: An 11-year-old girl (Case 1) and a 16-year-old girl (Case 2) visited our clinic with bilateral ocular pain, redness, and blurred vision. Slit lamp examinations revealed severe bilateral scleral injection and mild anterior chamber reactions. Fundus examinations showed bilateral serous retinal detachments in the macular area. In both patients, diffuse multifocal leaking and pooling were found at the macula in the early and late phase fluorescein angiography, respectively. On the B-mode ultrasounds and orbital images (MRI or CT), scleral thickening with retention of subtenons fluid were found. There were no systemic diseases associated with the conditions. We diagnosed the patients with bilateral posterior scleritis and administered systemic steroids. After systemic steroid treatment, all of the symptoms were alleviated. Three months after the regression, bilateral posterior scleritis recurred in patient 2. Oral cyclosporine 100 mg was additionally prescribed in addition to the previous medications that she had taken during her first treatment. CONCLUSIONS: Two young patients diagnosed with posterior scleritis and serous retinal detachment was treated with systemic steroids. With proper examination and treatment, posterior scleritis can be treated with no complications.
Adolescent ; Anterior Chamber ; Child ; Cyclosporine ; Female ; Fluorescein Angiography ; Humans ; Orbit ; Retention (Psychology) ; Retinal Detachment ; Retinaldehyde ; Scleritis ; Steroids ; Vision, Ocular

BACKGROUND: As a result of the extensive changes in burn care over the last few decades, including prevention of infection, burn survival has greatly increased. However, infection is still one of the main causes of death in severe burn cases, despite the progression in intensive care. But no recent comprehensive survey of infection has been carried out. OBJECTIVES: This retrospective study of bacteriological profile and antibiotic sensitivity patterns of isolates from a burn unit was carried out to provide burn care to plan future steps to reduce further the incidence of sepsis. METHODS: A retrospective review of burn wound infection in 623 patients treated in the burn center at the Hangang Sacred Heart Hospital, over a 2-year period (1998 - 2000) was carried out. RESULTS AND CONCLUSIONS: From wound cultures, Pseudomonas aeruginosa was most commonly isolated (24.7%) followed by Staphylococcus aureus (15.8%), Acinetobacter baumannii (14.5%), Enterococcus faecium (10.4%), Enterococcus faecalis (9.1%), coagulase negative staphylococcus (7.7%), Escherichia coli (6.6%), alpha-hemolytic streptococcus (5.3%), Klebsiella spp. (3.9%), Candida (3.2%), Serratia marcescens (2.9%), and Proteus spp. (2.1%). The most common isolate from blood cultures was Staphylococcus aureus (39.9%) followed by Enterococcus faecium (17.2%), coagulase negative staphylococcus (8.7%), Pseudomonas aeruginosa (7.5%), Enterococcus faecalis (4.7%), Candida (3.7%), Acinetobacter baumannii (3.7%), Serratia marcescens (3.5%), Enterobacter aerogens (2.8%), and Enterobacter cloaca (2.8%). The concordance rate of the results of the wound culture and blood culture was 96.0% in the Pseudomonas aeruginosa, 51.3% in the Staphylococcus aureus, 16.7% in the Enterococcus faecalis, 10.5% in the coagulase negative staphylococcus. Vancomycin and teicoplanin were effective in 100% of gram-positive organism. The drugs effective in gram-negative organism were cefepime, aztreonam, imipenem, piperacillin+tazobactam, ticarcillin+clavulanic acid, and amikacin.
Acinetobacter baumannii ; Amikacin ; Aztreonam ; Burn Units ; Burns* ; Candida ; Cause of Death ; Cloaca ; Coagulase ; Enterobacter ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Heart ; Humans ; Imipenem ; Incidence ; Critical Care ; Klebsiella ; Proteus ; Pseudomonas aeruginosa ; Retrospective Studies ; Sepsis ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Vancomycin ; Wound Infection ; Wounds and Injuries

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

BACKGROUND: Early reperfusion therapy with thrombolytic agents or primary PTCA is most important to salvage ischemic myocardium in acute myocardial infarction(AMI). Timely reperfusion of jeopardized myocardium clearly improves hemodynamics, decreases infarct size and improves survival. The extent of protection appears to be directly related to the rapidity of reperfusion after onset of coronary occlusion. Although the intravenous thrombolysis is a feasible therapy in the patients with evolving AMI, the benifit of thrombolytic therapy decreases because of the time delay after onset of symptom. This study was perfomed to analyze the factors time delay between onset of symptom and the thrombolytic therapy with retrospective and prospective questionaire in the patients with AMI. METHOD: Eighty one patients with AMI were included in this study who came to the emergency room(ER) of Chungnam National University Hospital(CNUH) from Feburary 1995 to October 1996. Delay between door and thrombolytic therapy was defined as hospital time delay. RESULTS: Thrombolytic therapy(rt-PA or urokinase iv) was done in 60 patients(74.1%) and mean prehopital time delay was significantly decreased in the patients with thrombolytic therpapy when compared with those without thormbolytic threapy(462+/-90 vs 1375+/-473 minutes, p=0.005). There were no singificant factors for prehospital time delay such as age, sex, redsidence, ER near residence, transfer time to ER near residence, family status, family history of AMI, severity of chest pain, presence of risk factors of cardiovascular disease(CVD), previous CVD, degree of education, history of other disease and routine check, transfer methods. The only 8 patients(9.8%) knew about AMI and 7 patients among these patient came to ER earlier and received thrombolytic therapy. From 57 referred patients, 40 patients(70.2%) received reperfusion therapy and only 30 patients(52.6%) had recored EKG in the referred hospital. In the analysis of hospital delay from patient's arrival to the thrombolytic therapy, the arrival time at weekdays and weekend had no differences, but hospital delay were significantly prolonged when patients arrived at ER in the night. CONCLUSION: Since prehospital time delay is a most important factor of time delay for the effective thrombolytic therapy in AMI, the pubic education program and effective transport system are needed. And routine record of EKG in patient with chest pain in the local hospital is very helpful to start effective thromolytic therapy at ER. The well designed prospective study with more patinets in our local region is essential to get more accurate information about transport system and to improve survival rate in patients with AMI.
Chest Pain ; Chungcheongnam-do ; Coronary Occlusion ; Education ; Electrocardiography ; Emergencies ; Fibrinolytic Agents ; Hemodynamics ; Humans ; Myocardial Infarction* ; Myocardium ; Prospective Studies ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survival Rate ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator