Lupus vulgaris is most prevalent on exposed parts, especially the face but can also develop on exetremities. Lupus vulgaris originates from tuberculosis elsewhere in the body by hematogenous, lymphatic, or contiguous spread. A 19-year-old male patient came to our department. The patient had had many recurrent oozing and verrucous plaques and crusts on the left foot for one year. A skin biopsy from the lesion on the left dorsum of the foot showed scattered well defined granulomas consisting of the epithelioid cell clusters with Langerhans and foreign body type giant cells in the mid dermis. Caseation necrosis was slight. There were no bacilli on AFB staining. The multi test CMI for tuberculin was highly positive. A chest X-ray did not show any abnormal findings. The presence of Mycobacterium tuberculosis DNA was demonstrated by polymerase chain reactions (PCR) for detection of mycobacterial DNA from a routinely prepared paraffin-embedded skin specimen. Herein we report a very atypical case of lupus vulgaris confirmed by PCR.
Biopsy ; Dermis ; DNA ; Epithelioid Cells ; Foot ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Lupus Vulgaris* ; Male ; Mycobacterium tuberculosis ; Necrosis ; Polymerase Chain Reaction ; Skin* ; Thorax ; Transplants* ; Tuberculin ; Tuberculosis ; Young Adult

BACKGROUND: Dermatologic emergency patients who visit the emergency room increase in number every year. But there is no report about the statistical analysis of such visits. OBJECTIVES & METHODS: We reviewed 326 new dermatologic emergency patients who uisited the emergency room of Dongsan Medical Center in Taegu from 1986 to 1995 to study the age, sex, monthly and yearly distributior, arrival time, length of visit, prevalence of common dermatoses, admission rate and death rate. RESULTS: The results are summarized as follows: 1. Of 326 patients, there were 151 males and 175 females. The sex ratio of male to female was 1: 1.15. The number of patients increased with each year. 2. In age distribution, there were 23(7%) under 10;46(14%) between 11-20,55(17%) between 21-30;49(15% ) between 31-40;33(10%) between 41 50; 62(19% ) between 51-60 years,39(12% ) between 61-70 and 19(6%) between 71-80 years. 3. In monthly and arrival time distribution, the peak month incidence occurred in August(24 %), and the lowest incidence in December(1%). The peak incidence of arrival time occurred PM 6-12 hours and the lowest incidence AM 0-6 hour. 4. In the distribution about length nf visit, 73% of patients stayed more than 10 hours, 23% 5-10 hours and 4% less than 5 hours. 5. Of the most common derrnatoses, acute urticaria was seen in 124 cases(38%), and herpes zoster. in 94 cases (29%). In age distribution, acute urticaria was most preualent between the age of 0-30 and herpes zoster between 50-70. 6. The admission rate was 43%(140 cases). The death rate was 1.2%(3 cases). CONCLUSION: Our study of e nergency patients revealed that dermatologic emergency patients who visited the emergency room had increased in number every year and the distribution of patients is quite different from that of outpatients.
Age Distribution ; Daegu ; Emergencies* ; Emergency Service, Hospital* ; Female ; Herpes Zoster ; Humans ; Incidence ; Male ; Mortality ; Outpatients ; Prevalence ; Sex Ratio ; Skin Diseases ; Urticaria

Alveolar Bone Grafting ; Cicatrix ; Congenital Abnormalities ; Dentition, Mixed ; Fistula ; Humans ; Inlays ; Oral Hygiene ; Rehabilitation ; Ribs ; Tooth, Deciduous ; Transplants

We describe a 75-year-old man with a cervico-thoraco-lumbar spinal epidural abscess was extended to the psoas muscle. The patient complained high fever and back pain, followed by weakness of the lower extremities. He had received multiple epidural injections in a local pain clinic just few days before the onset of fever. The multi-segmental epidural abscess which was demonstrated by MRI compressed dural sac and cord. The best way to recommend him was to undergo a surgical decompression, but he refused the surgery. Next, we chose nonsurgical treatment such as longstanding parenteral antibiotic therapy and percutaneous drainage of psoas abscess. We could cultivate a causative organism and chose appropriate antibiotics. The patient experienced immediate relief of fever and the improvement of laboratory findings, gradual relief of back pain and full neurological recovery.
Aged ; Anti-Bacterial Agents ; Back Pain ; Decompression, Surgical ; Drainage ; Epidural Abscess ; Fever ; Humans ; Injections, Epidural ; Lower Extremity ; Pain Clinics ; Psoas Abscess ; Psoas Muscles

The case of a cyanotic infant with a rare combination of atypical pulmonary artery sling, imperforate anus, absence of the left kidney, interruption of the inferior vena cava, left side hemihypertrophy and diffuse-type pulmonary arteriovenous fistula is described. The clinical features were confusing, because of compounding abnormalities involving the respiratory tract and pulmonary circulation. The diagnostic approach to the etiology of cyanosis is discussed and the embryonic origin of pulmonary artery sling is reviewed.
Arteriovenous Fistula/ultrasonography ; Arteriovenous Fistula/pathology* ; Case Report ; Human ; Infant ; Male ; Pulmonary Artery/pathology*

Adult ; Animals ; Dogs ; Electric Stimulation ; Humans ; Latency Period (Psychology) ; Osteogenesis ; Osteogenesis, Distraction ; Osteopontin ; Osteotomy

OBJECTIVES: Because effective decolonization options are not available, and treatment options are limited, carbapenem-resistant Enterobacterales (CRE) constitute increasingly threatening nosocomial pathogens. To prevent CRE-associated transmission and ensure patient safety, healthcare personnel and everyone in contact with CRE-infected patients must implement stringent infection control practices. This report describes a CRE outbreak, possibly related to a caregiver at a long-term care facility (LTCF), and presents a new surveillance model to improve the infection control of CRE in Seoul, Korea. METHODS: The Seoul Metropolitan Government surveillance system identified an outbreak of CRE in an LTCF in 2022. We obtained data on the demographic characteristics and contact histories of the inpatients, medical staff, and caregivers. To isolate the inpatients and employees exposed to CRE, we used rectal swab samples and environmental sampling during the study period (May-December 2022). RESULTS: We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE, and conducted a complete 197-day follow-up of all cases in the LTCF’s isolation wards. CONCLUSIONS This investigation demonstrated that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

PURPOSE: Biological parameters can be quantified using dynamic PET data with compartment modeling and Nonlinear Least Square (NLS) estimation. However, the generation of parametric images using the NLS is not appropriate because of the initial value problem and excessive computation time. In irreversible model, Patlak graphical analysis (PGA) has been commonly used as an alternative to the NLS method. In PGA, however, the start time (t*, time where linear phase starts) has to be determined. In this study, we suggest a new Multiple Linear Analysis for irreversible radiotracer (MLAIR) to estimate fluoride bone influx rate (Ki). METHODS: [18F]Fluoride dynamic PET scans was acquired for 60 min in three normal mini-pigs. The plasma input curve was derived using blood sampling from the femoral artery. Tissue time-activity curves were measured by drawing region of interests (ROIs) on the femur head, vertebra, and muscle. Parametric images of Ki were generated using MLAIR and PGA methods. RESULT: In ROI analysis, estimated Ki values using MLAIR and PGA method was slightly higher than those of NLS, but the results of MLAIR and PGA were equivalent. Patlak slopes (Ki) were changed with different t* in low uptake region. Compared with PGA, the quality of parametric image was considerably improved using new method. CONCLUSION: The results showed that the MLAIR was efficient and robust method for the generation of Ki parametric image from [18F]Fluoride PET. It will be also a good alternative to PGA for the radiotracers with irreversible three compartment model.
Femoral Artery ; Femur Head ; Fluorides ; Plasma ; Positron-Emission Tomography ; Spine

Background/Aims: Endoscopic biliary drainage (EBD) using a plastic stent has been proposed for the management of choledocholithiasis when there is difficulty with stone extraction. We investigated the long-term effects and complications of EBD with using a plastic stent in the elderly or high risk patients with common bile duct (CBD) stones. METHODS: From January 2000 to June 2004, thirty-one patients with CBD stones underwent EBD with using plastic stents (17 women and 14 men, mean age: 75.2 years). RESULTS: Biliary drainage was successful in all patients. As for the early complications, only minor hemorrhage with no requirement of transfusion occurred in 2 patients. Twelve patients (38.7%) had late complications of EBD. Six of them had cholangitis, five had biliary colics and one had nausea. Of the six patients with cholangitis, three were managed with stent exchange and one was managed by removal of the stent. The remaining two patients died from stent-related sepsis. The mean symptom-free duration was 39.9 months. CONCLUSIONS: For the elderly or high risk patients who undergo an operation, EBD proved to be a safe and effective alternative for the treatment of patients with irretrievable bile duct stones.
Aged ; Bile Ducts ; Cholangitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Drainage* ; Female ; Gallstones ; Hemorrhage ; Humans ; Male ; Nausea ; Plastics* ; Sepsis ; Stents*

PURPOSE: The objective of this study was to achieve a linguistic adaptation of the original version of the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale into Korean. MATERIALS AND METHODS: Between June 2008 and December 2008, a linguistic adaptation was carried out by 2 native Korean speakers who were also fluent in English. First, the original English version of the PUF was translated into Korean. A panel, which included the 2 translators, reviewed the translations to form a single reconciled forward translation of the Korean version. Then, another bilingual translator, having never seen the original version, back-translated the first draft of the Korean version of the PUF into English, and this back-translation was subsequently assessed for equivalence to the original. The panel discussed all discrepancies and produced a second version. After revising the 2nd version, 10 participants [5 interstitial cystitis (IC) patients and 5 persons from the general population], stratified variously by age, sex, and educational level, answered the PUF and were systematically debriefed afterwards. A summary of the changes from the patient interviews were incorporated into the third version. After the spelling, grammar, layout, and formatting were checked, the third version was verified as the final Korean version of the PUF, without modifications. RESULTS: The multi-step process of forward translation, reconciliation, back-translation, cognitive debriefing, and proofreading of the Korean version of the PUF was completed. CONCLUSIONS: The Korean version of the PUF scale may be helpful for screening IC patients in the Korean population and can now be used in Korea.
Cystitis, Interstitial ; Humans ; Korea ; Linguistics ; Mass Screening ; Pelvic Pain ; Translations ; Weights and Measures