Erythromelalgia is a rare neurovascular pain syndrome characterized by a triad of redness, increased temperature, and burning pain primarily in the extremities. Erythromelalgia can present as a primary or secondary form, and secondary erythromelalgia associated with a myeloproliferative disease such as essential thrombocythemia often responds dramatically to aspirin therapy, as in the present case. Herein, we describe a typical case of a 48-year-old woman with secondary erythromelalgia linked to essential thrombocythemia in the unilateral hand. As this case demonstrates, detecting and visualizing the hyperthermal area through infrared thermography of an erythromelalgic patient can assist in diagnosing the patient, assessing the therapeutic results, and understanding the disease course of erythromelalgia.
Aspirin ; Burns ; Erythromelalgia ; Extremities ; Female ; Hand ; Humans ; Neuralgia ; Thermography ; Thrombocythemia, Essential

A 73-year-old woman presented to the emergency department with submandibular pain and swelling. The patient was diagnosed to have Ludwig's angina, and she was planned to undergo urgent incision and drainage under general anesthesia. However, her physical examination revealed severe diffuse swelling extending from the bilateral submandibular spaces to the submental space and further down to the neck. As our view was blocked by the patient's neck swelling, we did not perform a regional anesthesia of the airway or a transtracheal block. Several non-invasive alternatives were considered. The “spray-as-you-go” technique was chosen, and it was performed using the OptiScope®. However, the OptiScope did not have a working channel or syringe adaptor for the administration of the local anesthetic solution. To solve this problem, we combined the OptiScope with a 27-G tunneled epidural catheter (100 cm) for the administration of lidocaine and this combination made the awake intubation successful.
Aged ; Anesthesia, Conduction ; Anesthesia, General ; Catheters* ; Drainage ; Emergency Service, Hospital ; Female ; Humans ; Intubation* ; Lidocaine ; Ludwig's Angina* ; Neck ; Physical Examination ; Syringes

BACKGROUND: Herpetic disorders cause pain and skin lesion. So, asymmetric temperature of both sides of the involving dermatome has been reported in thermogram. This study examined the usefulness of infrared thermography for a predictor of post-herpetic neuralgia (PHN). METHODS: Patients with acute herpes zoster who underwent nerve block were randomly selected. Biographic data, including age, gender and times of onset of the skin lesions, development of PHN, combined diseases were recorded. Infrared thermography was performed and subjective pain severity, dysesthesia and allodynia, skin lesion size were assessed. RESULTS: The temperature differences between the lesion site and the contralateral site at lateral and posterior were significantly correlated with lesion size (P < 0.01) and the temperature differences at anterior and lateral site were correlated with duration of disease (ant: P < 0.01, lat: P < 0.05). The temperature differences were not correlated with the pain severity, dysesthesia and allodynia (P > 0.05). PHN was correlated with skin lesion size and infrared thermal imaging (P < 0.01). CONCLUSIONS: Infrared thermal imaging cannot demonstrate subjective pain objectively in herpes zoster. Short duration showed high temperature on the lesion sites compared to the contralateral sites. The patients with big skin lesions developed PHN more. The PHN can be predicted by the infrared thermal imaging as low temperature on the lesion site compared to the contralateral site.
Herpes Zoster* ; Humans ; Hyperalgesia ; Nerve Block ; Neuralgia ; Paresthesia ; Skin ; Thermography

Cephalosporins are commonly used antibiotics in treatment of clinical infection. They frequently cause a positive direct antiglobulin test, but rarely cause hemolysis. The authors report a case of immune hemolytic anemia due to a second-generation cephalosporin, cefuroxime, by the drug adsorption mechanism.
Adsorption ; Anemia, Hemolytic* ; Anti-Bacterial Agents ; Cefuroxime* ; Cephalosporins ; Coombs Test ; Hemolysis

Syphilis is re-emerging worldwide due to the HIV epidemic. Prior to the introduction of penicillin, syphilis was the second most common primary cause of all cases of uveitis. Today, ocular syphilis is a rare disease, especially in an immunocompetent patient. Variable manifestation without pathognomonic signs of ocular syphilis often lead to delayed diagnosis, resulted in irreversibile loss of vision. In Korea, syphilitic uveitis has not been reported in an immunocompetent patient since 1984. We experienced a case of syphilitic uveitis in an immunocompetent man with visual deterioration. As the incidence of syphilis is increasing in these days, a high degree of clinical suspicion should be considered in patients with unexplained ocular inflammation and visual disturbances.
Delayed Diagnosis ; HIV ; Humans ; Incidence ; Inflammation ; Korea ; Penicillins ; Rare Diseases ; Syphilis ; Uveitis ; Vision, Ocular

Actinomyces normally colonizes the mouth, colon, and vagina. Although disruption of mucosa may lead to infection at virtually any site, central nervous system actinomycosis is rare. A 45-year-old man presented with seizure and magnetic resonance imaging showed brain abscess. He was diagnosed with actinomycotic and streptococcal infection of brain by histologic and microbiologic examination. After stereotactic aspiration and biopsy, he was treated successfully by prolonged antibiotic therapy using intravenous penicillin-G and oral amoxicillin.
Actinomyces ; Actinomycosis ; Amoxicillin ; Biopsy ; Brain ; Brain Abscess ; Central Nervous System ; Colon ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mouth ; Mucous Membrane ; Seizures ; Streptococcal Infections ; Vagina

Syphilis is re-emerging worldwide due to the HIV epidemic. Prior to the introduction of penicillin, syphilis was the second most common primary cause of all cases of uveitis. Today, ocular syphilis is a rare disease, especially in an immunocompetent patient. Variable manifestation without pathognomonic signs of ocular syphilis often lead to delayed diagnosis, resulted in irreversibile loss of vision. In Korea, syphilitic uveitis has not been reported in an immunocompetent patient since 1984. We experienced a case of syphilitic uveitis in an immunocompetent man with visual deterioration. As the incidence of syphilis is increasing in these days, a high degree of clinical suspicion should be considered in patients with unexplained ocular inflammation and visual disturbances.
Delayed Diagnosis ; HIV ; Humans ; Incidence ; Inflammation ; Korea ; Penicillins ; Rare Diseases ; Syphilis ; Uveitis ; Vision, Ocular

Actinomyces normally colonizes the mouth, colon, and vagina. Although disruption of mucosa may lead to infection at virtually any site, central nervous system actinomycosis is rare. A 45-year-old man presented with seizure and magnetic resonance imaging showed brain abscess. He was diagnosed with actinomycotic and streptococcal infection of brain by histologic and microbiologic examination. After stereotactic aspiration and biopsy, he was treated successfully by prolonged antibiotic therapy using intravenous penicillin-G and oral amoxicillin.
Actinomyces ; Actinomycosis ; Amoxicillin ; Biopsy ; Brain ; Brain Abscess ; Central Nervous System ; Colon ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mouth ; Mucous Membrane ; Seizures ; Streptococcal Infections ; Vagina

PURPOSE: The use of complementary and alternative medicine (CAM) is very common among patients with a urological malignancy. We assessed the prevalence and patterns of use of complementary therapies among patients with bladder, prostate and renal cancers. MATERIALS AND METHODS: Between May and July 2004, we conducted a survey to assess the use of CAM at 13 outpatient clinics in Korea. Seven hundred and eleven patients with bladder (269), prostate (300) or renal cancers (142) were selected to answer a self-administered questionnaire on CAM, which were then analyzed. RESULTS: Among 711 patients with urological malignancies, 279 (39.2%) had been treated with at least one type of CAM, in addition to conventional Western treatment. The cancer patients treated with radiation therapy or immunotherapy were more likely to employ CAM than those using other therapies. Age, gender, cancer type, occupations, religions, level of education and disease status (stable or progressive) were not associated with the prevalence of CAM. 44.3% of CAM users wanted to discuss CAM techniques with their doctors, but only 24.8% received an explanation of there use. CONCLUSIONS: CAM is used by a large number of patients with urological malignancies, particularly in those undergoing radiation therapy or immunotherapy. Urologists need to have an accurate knowledge and apprehension of CAM. The possible effects and side effects should be defined, with appropriate guidelines recommended for patients with a urological malignancy.
Ambulatory Care Facilities ; Complementary Therapies* ; Education ; Humans ; Immunotherapy ; Kidney Neoplasms ; Korea ; Occupations ; Prevalence ; Prostate ; Prostatic Neoplasms ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder Neoplasms

OBJECTIVE: Restless legs syndrome (RLS) is a highly heritable and common neurological sensorimotor disease disturbing sleep. The objective of study was to investigate significant gene for RLS by performing GWA and replication study in a Korean population. METHODS: We performed a GWA study for RLS symptom group (n=325) and non-RLS group (n=2,603) from the Korea Genome Epidemiology Study. We subsequently performed a replication study in RLS and normal controls (227 RLS and 229 controls) to confirm the present GWA study findings as well as previous GWA study results. RESULTS: In the initial GWA study of RLS, we observed an association of rs11645604 (OR=1.531, p=1.18×10−6) in MPHOSPH6 on chromosome 16q23.3, rs1918752 (OR=0.6582, p=1.93×10−6) and rs9390170 (OR=0.6778, p=7.67×10−6) in UTRN on chromosome 6q24. From the replication samples, we found rs9390170 in UTRN (p=0.036) and rs3923809 and rs9296249 in BTBD9 (p=0.045, p=0.046, respectively) were significantly associated with RLS. Moreover, we found the haplotype polymorphisms of rs9357271, rs3923809, and rs9296249 (overall p=5.69×10−18) in BTBD9 was associated with RLS. CONCLUSION: From our sequential GWA and replication study, we could hypothesize rs9390170 polymorphism in UTRN is a novel genetic marker for susceptibility to RLS. Regarding with utrophin, which is encoded by UTRN, is preferentially expressed in the neuromuscular synapse and myotendinous junctions, we speculate that utrophin is involved in RLS, particularly related to the neuromuscular aspects.
Epidemiology ; Genetic Markers ; Genome ; Genome-Wide Association Study* ; Haplotypes ; Korea ; Restless Legs Syndrome* ; Synapses ; Utrophin