Two cases of cutaneous sporotrichosis, especially one of which was verrucous type in baby aged 4 months, were described. Throush the literatures the verrucous manifestation in baby was not yet reported. It is known that verrucous sporotrichosis is to be developed in individual who has had local and general resistance obtained by the previous cutaneous infection or by the infection of internal organ. But no such evidences were noticed in our case.
Sporotrichosis*

A case of 24 years old male with perifolliculitis capitis abscedens et suffodiens was reported This is, I presume the first case to be reparted in Korea. Clinically, the skin lesions were characterized by tbe multiple confluented indolent abscesses and hypertrophic scars which were developed on the vertex. On these lesions, there were also noticed complete alopecia and several dilated hair follicle orifices plugged by keratinous materials. The regional lymphnodes were not enlarged and the abscesses were proved bacteriologically sterile.
Abscess ; Alopecia ; Cicatrix, Hypertrophic ; Hair Follicle ; Humans ; Korea ; Male ; Skin ; Young Adult

Disfiguring hyperpigmentation of the exposed areas may have impartant and lasting effects on the emotional well-being of the patient. And many attempts to treat areas of hyperpigmentation have been earried out, but all of them are not very successful. Recently 4-isopropylcatechol has been known to inhibit melanin pigmentation with a selective action on melanocytes either destroying or inactivating the melanocytes experimentally. There is no report on its clinical trial till now. In this study, 1% 4-isopropylcatechol cream was topieally applied to the hyperpigmented lesions of 29 patieots of melasma, freckle, and cafe-au-lait spot. The bleaching effect on meiasmas was very satisfactory in all patients but coantact dermatltis in 3 patients and reticular hyperpigmentation with areas of depigmented spots in one patient were developed as the side effects of the drug. Freckle and cafe-au-Iait spots were not bleached.
Cafe-au-Lait Spots ; Humans ; Hyperpigmentation ; Melanins ; Melanocytes ; Melanosis ; Pigmentation

BACKGROUND: Burden of acute stroke management is increasing according to aging population and advances in the therapeutic time window. However, reduction of resident numbers by the national policy in addition to the underlying low medical charge and reward gradually leaded to a lower rate of application to neurology department. METHODS: We conducted a nationwide survey from May 29, 2017 through July 11, 2017 to evaluate the real-world working conditions and issues of acute stroke management by stroke neurologists in Korea. Of 100 candidates of stroke professors/specialists, a total of 81 physicians participated the survey comprising 40 questionnaires. RESULTS: Stroke care physicians were suffering from heavy work load of inpatient care, outpatient clinic due to shortage of manpower for caring acute stroke. There were only three hospitals (3.7%) where neurologists independently take lead an endovascular therapy. About 43% of the participants were involving in primary duty for acute stroke management stroke, majority of whom (65.7%) were on by themselves. Participants pointed out that the biggest drawbacks were manpower shortage due to lack of residents, and numerous frequencies of primary duty. Approximately 80% of the participants forecasted a dismal future for stroke field. CONCLUSIONS: With the growing incidence of stroke, there is an emerging need for increasing number of neurologists due to contemporary grave shortage of stroke neurologists. It is necessary to investigate the effective demand forecasting for stroke neurologists for the strategy to improve an unmet quality of stroke care with the awareness and help of government.
Aging ; Ambulatory Care ; Brain Infarction ; Forecasting ; Humans ; Incidence ; Inpatients ; Korea ; Neurology ; Reward ; Stroke

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.
Adult ; Ascites ; Biopsy ; Collagen ; Follow-Up Studies ; Humans ; Immunosuppression ; Korea ; Lymphocytes ; Outpatients ; Parenteral Nutrition, Total ; Peritoneal Dialysis ; Peritoneum ; Peritonitis* ; Renal Dialysis ; Tomography, X-Ray Computed

Systemic sclerosis (SS) is a connective tissue disease and cardiac involvement is common. Primary cardiac involvement such as conduction system disturbances and arrhythmias can also occur. However, reports of sustained ventricular tachycardia (VT) are rare. We report a case of catheter ablation of sustained ventricular tachycardia in a patient with systemic sclerosis using a conventional mapping system. A 64-yr-old woman with a 10-yr history of SS was referred for management of her ventricular tachycardia. There was no structural abnormality in cardiac chambers. However, electrophysiologic study revealed electrical substrate of ventricular tachycardia which could be ablated with pacemapping and substrate mapping. This case demonstrated successful conventional mapping and catheter ablation in a hemodynamically unstable patient with SS.
*Catheter Ablation ; Electrocardiography ; Female ; Humans ; Middle Aged ; Scleroderma, Systemic/*complications/*diagnosis ; Tachycardia, Ventricular/*etiology/physiopathology/*surgery

Recent clinical trials demonstrated the clinical benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion. These trials confirmed that good outcome after EVT depends on the time interval from symptom onset to reperfusion and that in-hospital delay leads to poor clinical outcome. However, there has been no universally accepted in-hospital workflow and performance benchmark for rapid reperfusion. Additionally, wide variety in workflow for EVT is present between each stroke centers. In this consensus statement, Korean Society of Interventional Neuroradiology and Korean Stroke Society Joint Task Force Team propose a standard workflow to reduce door-to-reperfusion time for stroke patients eligible for EVT. This includes early stroke identification and pre-hospital notification to stroke team of receiving hospital in pre-hospital phase, the transfer of stroke patients from door of the emergency department to computed tomography (CT) room, warming call to neurointervention (NI) team for EVT candidate prior to imaging, NI team preparation in parallel with thrombolysis, direct transportation from CT room to angiography suite following immediate decision of EVT and standardized procedure for rapid reperfusion. Implementation of optimized workflow will improve stroke time process metrics and clinical outcome of the patient treated with EVT.
Advisory Committees ; Angiography ; Benchmarking ; Consensus* ; Emergency Service, Hospital ; Humans ; Joints ; Reperfusion ; Stroke* ; Transportation

Recent clinical trials demonstrated the clinical benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion. These trials confirmed that good outcome after EVT depends on the time interval from symptom onset to reperfusion and that in-hospital delay leads to poor clinical outcome. However, there has been no universally accepted in-hospital workflow and performance benchmark for rapid reperfusion. Additionally, wide variety in workflow for EVT is present between each stroke centers. In this consensus statement, Korean Society of Interventional Neuroradiology and Korean Stroke Society Joint Task Force Team propose a standard workflow to reduce door-to-reperfusion time for stroke patients eligible for EVT. This includes early stroke identification and pre-hospital notification to stroke team of receiving hospital in pre-hospital phase, the transfer of stroke patients from door of the emergency department to computed tomography (CT) room, warming call to neurointervention team for EVT candidate prior to imaging, neurointervention team preparation in parallel with thrombolysis, direct transportation from CT room to angiography suite following immediate decision of EVT and standardized procedure for rapid reperfusion. Implementation of optimized workflow will improve stroke time process metrics and clinical outcome of the patient treated with EVT.
Advisory Committees ; Angiography ; Benchmarking ; Consensus* ; Emergency Service, Hospital ; Humans ; Joints ; Reperfusion ; Stroke* ; Transportation

Antithrombotic therapy is a cornerstone of acute ischemic stroke (AIS) management and secondary stroke prevention. Since the first version of the Korean Clinical Practice Guideline (CPG) for stroke was issued in 2009, significant progress has been made in antithrombotic therapy for patients with AIS, including dual antiplatelet therapy in acute minor ischemic stroke or high-risk transient ischemic stroke and early oral anticoagulation in AIS with atrial fibrillation. The evidence is widely accepted by stroke experts and has changed clinical practice. Accordingly, the CPG Committee of the Korean Stroke Society (KSS) decided to update the Korean Stroke CPG for antithrombotic therapy for AIS. The writing members of the CPG committee of the KSS reviewed recent evidence, including clinical trials and relevant literature, and revised recommendations. A total of 35 experts were invited from the KSS to reach a consensus on the revised recommendations. The current guideline update aims to assist healthcare providers in making well-informed decisions and improving the quality of acute stroke care. However, the ultimate treatment decision should be made using a holistic approach, considering the specific medical conditions of individual patients.

PURPOSE: To investigate the biochemical change in serum and 24-hour urine after therapy with Urocitra(R) in patients affected by urolithiasis, who had hypocitraturia alone or associated with other metabolic disorder. MATERIALS AND METHODS: One hundred eighteen patients with evidence of 1 or more stone attacks within the last 3 years participated in the present study. They were 78 men and 40 women (6 to 78 years old, with a mean age of 47.01 12.95 years). All of the patients received 15 to 20ml of Urocitra(R)-solution or 5 g of Urocitra(R)-C powder, three or four times daily for 3 months. Before treatment, 24-hour urine and venous blood samples were obtained, while patients were maintained on a random diet, and analyzed for various stone risk factors. After 1 week, 1 month and 3 months of treatment, samples were again obtained and analyzed in the same manner. Thereafter, we compared the biochemical values before and after treatment. RESULTS: In all three follow-up periods Urocitra(R) induced a significant increase in urinary citrate (p<0.001) level. Urinary potassium (p<0.001), pH (p<0.001) and total volume (p<0.05) also increased significantly after 1 and 3 months of therapy, as did urinary citrate excretion in patients with hypocitraturia and normocitraturia. Urocitra(R) did not alter calcium, sodium or phosphorus urinary excretion. There was no significant change of serum chemistry after administration. CONCLUSIONS: Urocitra(R) was effective in increasing urinary pH and citrate. Furthermore, it was relatively free of side effects, except for minor gastrointestinal distress. Thus, our study provides physiological and clinical validation for the use of Urocitra(R) in patients affected by urolithiasis, who have hypocitraturia alone or associated with another metabolic disorder.
Aged ; Calcium ; Chemistry ; Citric Acid ; Diet ; Female ; Follow-Up Studies ; Humans ; Hydrogen-Ion Concentration ; Male ; Phosphorus ; Potassium ; Risk Factors ; Sodium ; Urolithiasis*