Takotsubo syndrome, also known as stress-induced cardiomyopathy, is a transient cardiac syndrome that mimics acute coronary syndrome. This condition should be suspected if the patient presents with chest pain after intense emotional stress, accompanied by an abnormal electrocardiogram, elevated levels of myocardial enzymes, and left ventricular apical akinesia on echocardiography. Coronary angiography should be performed for prompt differentiation from ischemic heart disease. A 77-year-old female presented with traumatic multiple fractures of the left sixth and seventh ribs resulting from a violent strike. Clinical findings of physical examination, laboratory tests, electrocardiogram, and coronary angiography provided the diagnosis of Takotsubo syndrome. We performed conservative management including pain control, and the patient was uneventfully discharged seven days after admission.
Acute Coronary Syndrome ; Aged ; Cardiomyopathies ; Chest Pain ; Coronary Angiography ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Fractures, Multiple ; Humans ; Myocardial Ischemia ; Physical Examination ; Rib Fractures* ; Ribs* ; Stress, Psychological ; Strikes, Employee ; Takotsubo Cardiomyopathy*

BACKGROUND: There have been few clinical and mycological studies of superficial cutaneous candidiasis in Korea. OBJECTIVE: The purpose of the study was to investigate the recent clinical and mycological features of superficial cutaneous candidiasis and correlation between underlying diseases and candidiasis. METHODS: Among 233 patients, 233 strains of Candida(C.) species were isolated and identified by Sabouraud's dextrose agar culture, germ tube test and sugar assimilation test using API 20C kit. RESULTS AND CONCLUSION: 1. The incidence of superficial cutaneous candidiasis was 4.0% out of a total of 5,809 out-patients. 2. The ratio of male to female patients was 1.1:1. 3. Among the age groups, the incidence rate was high in the first decade and above sixth decade. 4. Candidal intertrigo was the most common type of infection(56.7%). 5. Among 233 Candida species C. albicans(90.6%), C. parapsilosis(4.7%), C. guilliermondii(2.1%), C. tropicalis(1.7%), C. glabrata(0.9%) were identified. 6. Neurological disease was the most common underlying disease(56.4%).
Agar ; Candida* ; Candidiasis ; Candidiasis, Cutaneous* ; Female ; Glucose ; Humans ; Incidence ; Intertrigo ; Korea ; Male ; Outpatients

Pheniramine maleate(avil(R)) is a H1-antagonist that is derived from alkylamine. Skin reactions with parenteral administration of avil(R) are uncommon. A 29-year-old woman visited our department with a 3-year history of relapsing generalized multiple pruritic evanescent erythematous wheals after antihistamine and steroid injection. Intradermal skin test with Avil(R) was positive. We treated with 5 mg of mequitazine administration three times a day for 2 years.
Adult ; Female ; Humans ; Pheniramine* ; Skin ; Skin Tests ; Urticaria*

OBJECTIVES: To investigate the nature of emotional responsiveness in normal adults, we exam the emotional responses to emotional pictures in an evaluative space defined by arousal and valence. METHODS: Subjects were instructed to rate the arousal and valence that they experienced from the presentation of one of two sets of 60 emotional pictures. These two picture sets were comprised of 107 pictures: 101 selected from International Affective Pictures System and six pictures from our own collection. According to "evaluative space model", the authors set an evaluative space defined by the arousal scores as independent variable and the valence scores as dependent variable. In this evaluative space, one-hundred-and-seven pairs of coordinates representing respective emotional pictures were plotted. With regression analyses, the steepness of the regression lines on the plots with positive emotional responsiveness (n=51) and those with negative emotional responsiveness (n=56) were compared. RESULTS: In the evaluative space, the regression line of negative emotional responsiveness was significantly different from that of positive responsiveness. The slope of negative responsiviveness was significantly steeper than that of positive responsiveness. At a low arousal level, the absolute valence of a positive stimuli was larger than that of a negative picture. CONCLUSION: This finding indicates that the function of the negative affective responsiveness might be different from that of the positive responsitiveness. IAPS also seems applicable to Korean subjects.
Adult ; Arousal ; Humans

Tuberculosis generally affects the respiratory tract. In developing nations, the pericardium is the most common location of extrapulmonary tuberculosis; however, tuberculous pericarditis rarely appears as a localized mass or tuberculoma. We present here a case of a 62-year-old woman with pericardial tuberculoma. She had a history of effusive tuberculous pericarditis and drainage. Because she had taken regular medication over a period of six months, the pericardial mass with an adjacent lung nodule newly detected on the chest radiogram was initially suspected of being invasive lung cancer. Prior to pathologic confirmation, precise information from imaging tests, including computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are helpful when making decisions regarding which methods should be used for surgical approach and treatment. Through imaging, our case showed typical features of pericardial tuberculoma and a favorable clinical course after two months with a change in antituberculous therapy.
Developing Countries ; Drainage ; Electrons ; Female ; Humans ; Lung ; Lung Neoplasms ; Magnetic Resonance Imaging ; Middle Aged ; Pericarditis, Tuberculous ; Pericardium ; Respiratory System ; Thorax ; Tuberculoma ; Tuberculosis

PURPOSE: The prevalence and treatment patterns of abdominal aortic aneurysm (AAA) vary according to ethnicity and region. This study analyzed nationwide data on the epidemiology, practice patterns, and mortality rates of AAA in Korea.MATERIALS AND METHODS: Data from patients treated for AAA from 2012 to 2016 were extracted from the Korean Health Insurance Review and Assessment (HIRA) database.RESULTS: A total of 30,766 patients in Korea had treatment codes for AAA and 2,618 patients were treated for ruptured AAA. Of the 6,356 patients treated surgically, 1,849 and 4,507 underwent open surgical aneurysmal repairs (OSAR) or endovascular aneurysmal repairs (EVAR), respectively. The number of surgical treatments performed annually for AAA increased from 1,129 cases in 2012 to 1,501 cases in 2016. The number of EVAR cases increased from 753 to 1,109 during these five years, while the number of OSAR cases remained similar, at 376 and 392, respectively. The 30-day mortality rates after EVAR and OSAR were 4.2% and 10.6%, respectively. The mortality rates were significantly higher in patients with hypertension, dyslipidemia, chronic renal disease, diabetes mellitus, and congestive heart failure. There were significant differences in the prevalence, proportion of EVAR, and mortality rates according to the regional area.CONCLUSION: The prevalence of AAA and the proportion of EVAR in Korea increased in the past 5 years, while the rupture rate and the proportion of OSAR remained similar. To minimize mortality and regional discrepancies, nationwide registry and treatment standardization are needed.
Aneurysm ; Aortic Aneurysm, Abdominal ; Cross-Sectional Studies ; Diabetes Mellitus ; Dyslipidemias ; Epidemiologic Studies ; Epidemiology ; Heart Failure ; Humans ; Hypertension ; Insurance, Health ; Korea ; Mortality ; National Health Programs ; Prevalence ; Renal Insufficiency, Chronic ; Rupture

Silica contaminates frequently accidental wounds, but most silica-contaminated wounds heal uneventfully with normal scarring. In exceptional cases, a delayed hypersensitivity granulomatous reaction occurs at the site of the old scar. We report a case of silica granuloma in a 30-year-old female. She had presented four discrete asymptomatic, mildly erythematous to skin colored papules or deep-seated nodules on upper extremity and trunk for 3 months. Histopathology of right upper arm lesion showed a well-demarcated conglomerate nodule in subcutaneous tissue, composed of numerous non-caseating granulomas without central necrotic or hyalinized foci. Small polarizable birefractile fibrous particles are found within the nodule. Scanning electron microscopy(SEM) revealed thin needle shaped fibers with fracture ends and energy dispersive X-ray analysis(EDXA) of the fiber showed major peak for a silica component.
Adult ; Arm ; Cicatrix ; Female ; Granuloma* ; Humans ; Hyalin ; Hypersensitivity, Delayed ; Needles ; Silicon Dioxide* ; Skin ; Subcutaneous Tissue ; Upper Extremity ; Wounds and Injuries

Isotopic response is the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. Various diseases have been reported in terms of isotopic response associated with herpes zoster, but the development of comedones is uncommon. We report a case of comedones that had developed on the site previously affected by herpes zoster in a 59-year-old male, which is thought to be an isotopic response. Eight months ago, he visited with herpes zoster lesions on the left upper eyelid, forehead and scalp(dermatome cranial nerve V1). He had grouped and discrete, slightly elevated, skin colored papules with dark, firm hyperkeratotic plug on the healed site of herpes zoster.
Cranial Nerves ; Eyelids ; Forehead ; Herpes Zoster* ; Humans ; Male ; Middle Aged ; Skin ; Skin Diseases

Hamster is mammal which belongs to the rodent family, usually small in size and frequently nocturnal in their habits and small pet kept in many countries today. We report a case of Trichophyton(T.) mentagrophytes infection probably transmitted from hamster. A 11-year-old girl was presented with a 1 month history of pruritic 3x2cm-sized erythematous scaly papular patch on the left posterior thigh. Culture from a thigh lesion of patient on Sabouraud dextrose agar showed T. mentagrophytes. One hundred mg of itraconazole per day for 15 days was tried and skin lesion was improved without recurrence.
Agar ; Animals ; Child ; Cricetinae* ; Female ; Glucose ; Humans ; Itraconazole ; Mammals ; Recurrence ; Rodentia ; Skin ; Thigh

Perifollicular granuloma of the leg is a variant of Majocchi's granuloma. We report a case of perifollicular granuloma of the leg caused by Trichophyton(T.) rubrum in a 31-year-old female, who showed mild pruritic, erythematous indurated plaque with central ulcerations on the right shin for 8 months. Fungal culture of the biopsy specimen grew out typical white cottony colonies of T. rubrum. Histopathologic examination of the skin lesions showed chronic granulomatous inflammation and fungal elements in the dermis. After one month of terbinafine therapy (250 mg/day), lesions were completely cleared. No recurrence has been observed to date.
Adult ; Biopsy ; Dermis ; Female ; Granuloma* ; Humans ; Inflammation ; Leg* ; Recurrence ; Skin ; Trichophyton* ; Ulcer