Nevus lipomatosus cutaneous superficialis(NLCS) is a rare nevoiri anomaly characterized by ectopic adipose tissue in the dermis without predilection. In this disease two clinical types are distinguished: The classic type consists of asymptomatic linear or zosteriform coliection of soft, flesh colored to yellowish, papules or nodules that often coalesce into plaque. It is usually located in the pelvic girdle and lumbar area but has been repeted on the abdomen, thorax, thigh, and scalp. The solitary form usually appears later in life and can occur at any site. There is no sexurl irredilection or hereditary trend. There are no assoeiated abnor malities. The authors experienced three cases of typical NLCS including thia silitary type that had several solitary nodules irregularly. The first case was a 24-year-old female which has had multiple, flesh to dark brown-colored, confluent nodules over the left upper thigh for 5-years. The second case is the solitary type that a 56-year-old female has had discrete bean sized to what sized nodules on the right buttock for 13-years. The third case was a 23-year-old female who had soft, yellowish skin colored, cerebriform tumor on the right buttock for 10-yesrs. Diagnos was confirmed by clinical and histopathologic findings.
Abdomen ; Adipose Tissue ; Buttocks ; Dermis ; Female ; Humans ; Middle Aged ; Nevus* ; Scalp ; Skin ; Thigh ; Thorax ; Young Adult

Langerhans cell histiocytosis is a rare disease entity in which various tissue are infiltrated by proliferating histiocytes. Involvement of alimentary tract is rare (<5%), especially in the stomach. Only seven cases of gastric Langerhans cell histiocytosis have been reported in Enlglish literature. Diabetes insipidus is the most common endocrinologic complication. We report a case of Langerhans cell histiocytosis involving stomach and pituitary stalk. The diagnosis of gastric Langerhans cell histiocytosis and diabetes insipidus was based on gastric mucosal biopsy specimen from a Korean man with suspicious hypertrophic gastric folds of gastric body, water deprivation test and sella MRI.
Biopsy ; Diabetes Insipidus ; Diagnosis ; Histiocytes ; Histiocytosis, Langerhans-Cell* ; Magnetic Resonance Imaging ; Pituitary Gland ; Rare Diseases ; Stomach ; Water Deprivation

This paper presented a case of athyrotic cretinism in a 4 months old female infant. Durring neonatal 7 period she suffered from prolonged jaundice for about 50 days On admission, elinical manifestations suggesting of hypothyroidism were umbilical hernia, feeding problems due to large tongue, respiratory difficulty, lethargy and skin changes Roengenogram of the long bone series revealed the absence of epiphyseal centers of capitates and hamates in the hands, and cuboids in the feet. Thyroid function test also showed 6.5% and 4.1% at 6 hours and 24 hours after I131 uptake respectively, and T 3 value of 25.1ug/dl and T4 of 3.0ug/dl. On thyroid scan, no evidence of activity of thyroid gland was noted. Complete absence of thyroid tissues on autopsy of this baby confirmed the diagnosis of athyrotic cretinism. The review of the literature Concerning the Congenital hypothyroidism were made briefly.
Autopsy ; Congenital Hypothyroidism* ; Diagnosis ; Female ; Foot ; Hand ; Hernia, Umbilical ; Humans ; Hypothyroidism ; Infant ; Jaundice ; Lethargy ; Skin ; Thyroid Function Tests ; Thyroid Gland ; Tongue

OBJECTIVE: To investigate diagnostic usefulness of dermatomal somatosensory evoked potentials (DSEP) in the evaluation of lumbar radiculopathy using stimulation intensity lower than conventional stimulation intensity. METHOD: Fifty-seven patients with low back pain were studied with DSEP and needle electromyography (EMG). The radiculopathy was diagnosed by lumbar MRI or operative findings. The DSEP study was performed with stimulation intensity of 1.0x, 1.5x, 2.5x sensory threshold, respectively. We compared the sensitivity and specificity of DSEP and needle EMG in the evaluation of L5 radiculopathy. RESULTS: Radiological and operative findings revealed unilateral herniated disc and L5 root compression in 38 patients (66.7%). Nineteen patients had no significant L5 root compression. The sensitivity and specificity of abnormality were 68.4% and 78.9% in 1.0x sensory threshold stimulation; 71.1%, 78.9% in 1.5x sensory threshold stimulation; and 44.7%, 84.2% in 2.5x sensory threshold stimulation, respectively. Whereas they were 55.2% and 100% in needle EMG. CONCLUSION: DSEP using low stimulus intensity showed higher sensitivity in the diagnosis of L5 radilculopathy, and DSEP might provide additional diagnostic usefulness in the evaluation of patients with suspected L5 radiculopathy.
Diagnosis ; Electromyography ; Evoked Potentials, Somatosensory* ; Humans ; Intervertebral Disc Displacement ; Low Back Pain ; Magnetic Resonance Imaging ; Needles ; Radiculopathy* ; Sensitivity and Specificity ; Sensory Thresholds

Toxoplasmic encephalitis (TE) is the most common cause of opportunistic central nervous system infection in advanced acquired immunodeficiency syndrome (AIDS) patients. The incidence of TE has fallen markedly after the availability of highly active antiretroviral therapy and cotrimoxazole chemoprophylaxis. TE linked to AIDS is a rare entity in Korea, but we must consider TE in the differential diagnosis of the opportunistic infections in AIDS patients. We report a case of toxoplasmic encephalitis in an advanced AIDS patient presenting as progressive right facial palsy.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Central Nervous System Infections ; Chemoprevention ; Diagnosis, Differential ; Encephalitis* ; Facial Paralysis ; Humans ; Incidence ; Korea ; Opportunistic Infections ; Trimethoprim, Sulfamethoxazole Drug Combination

Tuberculosis mainly develops in the lung, but may also rarely invade other parts of the abdominal region. Abdominal tuberculosis is associated with pulmonary tuberculosis in approximately 15% of cases, and abdominal tuberculosis primarily develops in the terminal ileum and lymphatic gland. Moreover, hepatic tuberculosis is uncommon and is usually accompanied with active pulmonary or miliary tuberculosis. Hence, the development of primary hepatic tuberculoma as a single liver mass is very unusual. In the present report, we describe the case of a 63-year-old man with a solitary hepatic tuberculoma; the 6.4 cm mass was incidentally detected during abdominal computed tomography in the asymptomatic patient, and the diagnosis was confirmed by liver biopsy through ultrasonography-guided fine-needle aspiration.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Humans ; Ileum ; Liver ; Lung ; Middle Aged ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Hepatic ; Tuberculosis, Miliary ; Tuberculosis, Pulmonary

PURPOSE: Emergency department (ED) overcrowding results in loss in timely, effective medical care, as well as in social and economical efficiency. This paper proposes a new overcrowding index to reduce and to prevent these losses. METHODS: We investigated the real-time situation of the emergency department in a major Korean hospital, compared to existing indices and to extracted factors to develop a new, customized overcrowding index based on the flow of patients, a reflection of emergency room conditions. We developed 3 indices, FFOI (Front Flow Overcrowding Index), BFOI (Back Flow Overcrowding Index), and TFOI (Total Flow Overcrowding Index). Each index was applied to test the period from 10 September 2007 to 16September 2007. We extracted values of each index at 3- hour intervals and estimated how they reflected the overcrowding situation compared with basic overcrowdingindices. We used the correlation coefficient and Kullback- Leiblur (KL) distance as the basis for measurement. RESULTS: Existing indices are emergency department work index (EDWIN), national emergency department overcrowding scale (NEDOCS), and real-time emergency analysis of demand indicator (READI) work score (WS). EDWIN and READI did not reflect accurately the overcrowding situation. Some factors extracted from NEDOCS and WS were not suited to the emergency department. We solved these problems by develop in new indices. CONCLUSION: In conclusion, the new indices are more effective and descriptive than the existing indices with respect to correlation to crowdedness in the emergency department. In the future, the new, customized overcrowding index will become more descriptive if the necessary data is gathered in real time and more effectively verified by the medical staffs and patients.
Crowding ; Emergencies ; Emergency Medical Services ; Humans ; Medical Staff

OBJECTIVE: To document our experience of the vascular anomalies or variants in paraaortic region and intend to increase vigilance among the gynecological surgeons for presence of variable vascular anomalies or variants. METHODS: We conducted a retrospective chart review of 280 patients with various gynecologic malignancies who had undergone systemic laparotomic or laparoscopic paraaortic lymphadenectomy between November 2003 and July 2011. RESULTS: We discovered total nine patients of vascular anomalies during the surgery. Seven patients had an accessory polar renal artery. One patient had a duplicated inferior vena cava and the other had a right paravertebral vein. There were no vascular complications such as tearing, ligation or transection. CONCLUSION: It is not uncommon to encounter vascular anomalies in paraaortic region during the lymphadenectomy. Hence, the gynecological surgeons must be cognizant of various vascular anomalies occurring within this area to reduce the vascular accidents.
Humans ; Ligation ; Lymph Node Excision ; Renal Artery ; Retrospective Studies ; Veins ; Vena Cava, Inferior

OBJECTIVE: To establish reference data for dermatomal somatosensory evoked potentials (DSEP) using a stimulation intensity lower than what is conventionally utilized. METHOD: Fifty subjects (25 older adults>48 years old; 25 younger adults<32 years old) without history of neck pain or cervical spine surgery were enrolled. The DSEP study was performed with stimulation intensities of 1.0, 1.5, and 2.5 times sensory threshold (ST) on right arms for C5, C6, C7, and C8 dermatomes. RESULTS: The mean latencies of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 17.6+/-1.7 ms, 22.2+/-2.1 ms, 22.8+/-1.4 ms, and 22.6+/-1.8 ms, respectively. The mean amplitude (N1P1) of DSEP stimulating C5, C6, C7, and C8 dermatomes with 1.5 times ST intensity were 0.9+/-0.4 microV, 0.9+/-0.5 microV, 1.0+/-0.6 microV, and 1.1+/-0.8 microV, respectively. The C5, C6, C7, and C8 DSEP were evoked in 84%, 98%, 100%, and 96% of cases with 2.5 times ST compared to 64%, 56%, 60%, and 62% with 1.5 times ST, respectively. When one DSEP was not evoked, the DSEP of the opposite side was evoked only in 2 subjects. CONCLUSION: This study provides the reference data of DSEP with lower stimulation intensities than are conventionally utilized. Additionally, two cases of clinical significance were reported.
Arm ; Evoked Potentials, Somatosensory ; Neck Pain ; Radiculopathy ; Sensory Thresholds ; Spine

Despite nation-wide immunization with O, A, and Asia 1 type vaccines in Republic of Korea, foot-and-mouth disease type O occurred again in July 2014 after three years and three months. This virus was a Mya-98 strain of the Southeast Asian topotype and was most similar to the identified type that circulated in East Asia in 2014. This was new virus with the deletion of 23 amino acids in 3A/3B1 region and low pathogenic property.
Amino Acids ; Animals ; Asia ; Asian Continental Ancestry Group ; Far East ; Foot-and-Mouth Disease Virus* ; Foot-and-Mouth Disease* ; Humans ; Immunization ; Korea* ; Republic of Korea ; Sequence Deletion ; Vaccination ; Vaccines