As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.
Adolescent ; Adult ; Central Nervous System ; Charcot-Marie-Tooth Disease* ; Connexins ; Demyelinating Diseases ; Exome ; Humans ; Leg ; Lower Extremity ; Muscle Weakness ; Mutation, Missense* ; Neural Conduction ; Paresis ; Polyneuropathies ; Quadriplegia ; Rare Diseases

The widely accepted method for coronary artery bypass grafting(CABG) is performing the distal coronary artery anastomoses on the flaccid and nonbeating heart with the aid of cardiopulmonary bypass(CPB) and cardioplegic arrest. However, current cardioplegic techniques are not consistent in avoiding myocardial ischemic damages especially in high risk patients undergoing CABG. In this regard, "Off-Pump" seems to be an ideal method for preventing myocardial ischemic damage and adverse effects during CPB. However, "Off-pump" CABG is not always technically feasible. We report 2 cases of "On-pump" CABG performed on the beating heart in high risk patients; The first patient had left ventricular dysfunction(Ejection Fraction=25%), and the second patient had cardiogenic shock after percutaneous transluminal coronary angioplasty.
Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Coronary Vessels ; Heart* ; Humans ; Shock, Cardiogenic

Background: Nodular hidradenoma is a relatively common benign cutaneous neoplasm, which usually presents as solitary intradermal nodule. In Korea, an extensive study on tumors with eccrine differentiation was performed in 2006; however, the study considered all eccrine tumors and detailed analysis of its differentiation was not performed. In addition, although most skin pathology textbooks classify it as a tumor showing eccrine differentiation, its differentiation remains controversial. Objective: This study investigated clinicopathological features of nodular hidradenoma in Koreans at a tertiary referral center. Methods: We retrospectively investigated 22 patients who presented with nodular hidradenoma at Yeungnam University Hospital between 2000 and 2021. Diagnosis was confirmed by histopathological examination in all the patients. Results: About half of the lesions were located on the head and neck area (45.5%), followed by the trunk (31.8%). Histopathological examination revealed that tumor cells in most of the cases consisted of cuboidal and clear cells; however, in some cases there were several specific modified cells such as clear cells (9.1%), squamoid cells (4.5%), and poroid cells (22.7%). Considering the morphological characteristic of tubular structures, most cases (90.9%) showed apocrine differentiation, and only 2 cases (9.1%) showed eccrine differentiation. Conclusion Considering the characteristics of cells and tubular structures constituting tumors, it is reasonable to consider nodular hidradenoma as a tumor with apocrine differentiation rather than with eccrine differentiation, which had previously been the predominant classification. Furthermore, there still is no distinct marker for determining whether cells differentiate into eccrine or apocrine tissues and further studies are therefore needed.

Coronary arteriovenous fistula is relatively rare disease and originates more commonly in the right than in the left cononary artery. We report one case of cononary arteriovrnous fistula which we have experienced recently in 22 years old female, who has complained of dyspnea on exertion and intermittent anterior chest pain radiating to the left shoulder for several years. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. In this case, the fistula was originated from the right coronary artery and drained into the posterior wall of the right ventricle, the coronary artery was dilated(diameter=1.5cm) and tortuous and significant shunt was measured(Qp/Qs=2.31). The opening of the fistula draining into right ventricle was obliterated with sutures.
Arteries ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dyspnea ; Echocardiography* ; Echocardiography, Transesophageal ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Shoulder ; Sutures ; Young Adult

Nonstructural valvular dysfunction of the mechanical valve is one of the serious complications after valve replacement. It may be caused by various factors; 1) entrapment by pannus, tissue or suture material 2) paravalvular leakage 3) inappropriate sizing or positioning. We have experienced the rare case of nonstructural valvular dysfunction caused by abnormal subaortic pannus ingrowth associated with malposition of mechanical valve. We removed the pannus and successfully performed valve replacement after annulus enlargement procedure(Nicks procedure).
Heart Valve Prosthesis ; Sutures

Benign schwannoma of the esophagus is very rare. Diagnosis requires histology and immunohistochemical staining. We are reporting a case of benign schwannoma of the esophagus, incidentally diagnosed as a submucosal tumor of the esophagus in 66 year-old woman during the regular check-up. The tumor was enucleated through right thoracotomy, and was diagnosed as a benign schwannoma by immunohistochemical pathologic test. There has been no evidence of recurrence during 1 year follow-up.
Aged ; Diagnosis ; Esophageal Neoplasms ; Esophagus* ; Female ; Follow-Up Studies ; Humans ; Neurilemmoma* ; Recurrence ; Thoracotomy

PURPOSE: To evaluate the histopathological prognostic factors, relapse pattern and survival in patients with endometrial carcinoma who were treated with surgery and postoperative adjuvant radiotherapy (RT). METHODS AND MATERIALS: From September 1991 to December 1997, 27 patients with endometrial carcinoma treated with surgery and postoperative adjuvant RT at Asan Medical Center were entered in this study. Surgery was performed with total abdominal hysterectomy in six, total abdominal hysterectomy with pelvic lymph node dissection in eight and radical hysterectomy in 13 patients. External RT of 50.4 Gy was done to all patients and among these, additional high dose rate vaginal vault irradiation of 20-25 Gy with fractional dose of 4-5 Gy was boosted in 16 patients. The patients were followed for 6-95 months (median 30). RESULTS: The number of patients according to FIGO stage were I 18 (67%), II 1 (4%) and III 7 (26%). Patients with poor histologic grade, deep myometrial invasion, adnexal involvement, lymphovascular invasion showed more pelvic lymph node involvement, but no statistical significance was indicated. The 5year overall and disease free survival were 100% and 76.8%, respectively. Relapse sites were pelvic, para-aortic lymph node, and multiple metastases including lung, and no vaginal relapse was developed. Factors that were associated with disease free survival were FIGO stage (p=0.01), lymphovascular invasion (p=0.03), pelvic lymph node involvement (p=0.000 1). There was only one Grade 1 rectal bleeding without moderate to severe complications. CONCLUSION: Postoperative adjuvant RT is considered to reduce the loco-regional failure, resulting the improvement of survival. The group of patients with the risk of vaginal failure without vaginal vault irradiation should be investigated according to stage and grade.
Chungcheongnam-do ; Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Lung ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Radiotherapy, Adjuvant ; Recurrence

Syphilis is a highly contagious sexually transmitted disease, and early diagnosis and prompt treatment significantly affect the prognosis. Syphilis usually presents with genital lesions in the early stages; therefore, extragenital syphilitic lesions can easily be misdiagnosed. A 20-year-old man presented with a 1-month history of a worsening hyperkeratotic black crusted ulcerative plaque on the right 4 th finger, with distorted periungual structures.Histopathological examination showed epidermal hyperplasia, mild endothelial swelling, and numerous plasma cells in the dermis. Excessive dermal infiltration of plasma cells suggested primary syphilis, which necessitated additional serological tests; the patient showed positive results on Venereal Disease Research Laboratory and Treponema pallidum hemagglutination testing. The lesion significantly improved after an intramuscular injection of 2.4 million units of benzathine penicillin G. We report a rare case of primary syphilis involving the finger in a patient with clinical features of ulcerative paronychia.