BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

BACKGROUND AND OBJECTIVES: One of problems for the management of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is the difficulty of determining the affected ear using Ewald's second law. The purpose of this study is to develop the new "Bow and Lean Test (BLT)" to determine easily the affected ear of HSC-BPPV and evaluate its efficiency. MATERIALS AND METHOD: We compared the efficiency between the classical method and BLT in 26 patients with HSC-BPPV. The classical method is based on Ewald??s second law comparing the intensity of nystagmus or symptoms in head roll test. BLT is based on the direction of both "bowing nystagmus" and "leaning nystagmus" at head's bowing and leaning state on sitting position. The affected ear is the same direction of bowing nystagmus in canalolithiasis and the same direction of leaning nystagmus in cupulolithiasis. RESULTS: In 26 patents (15 canalolithiasis, 11 cupulolithiasis), 3 (11.5%) patients did not show a prominent affected ear in the classical method, and 7 (26.9%) patients showed the different affected ear between two methods. All 10 patients were successfully treated with just one trial of barbecue rotation based on the affected ear in BLT. Three patients did not show any bowing or leaning nystagmus. The side with canal paresis in all 4 patients, who showed significant canal paresis in bithermal caloric tests, was equal to the affected ear based on BLT. CONCLUSION: "Bow and Lean Test" (also called "Choung's test") is a new method which can easily determine the affected ear of HC-BPPV.
Caloric Tests ; Ear ; Head ; Humans ; Jurisprudence ; Paresis ; Semicircular Canals ; Vertigo*

Radiological investigation in patients with clonorchiasis is very important as this is the only method of evaluating the severity of clonorchiasis. In order to correlate the radiologic and pathologic findings of clonorchiasis, fourteen rabbits infested with Clonorchis sinensis and five control rabbits were examined radiologically by ultrasonography, computed tomography and cholangiography and the results were correlated with pathologic findings. Dilatation of the intrahepatic small bile ducts of the liver was due to obstruction by flukes: oval or elliptical small filling defects or irregular margin of the bile ducts on cholangiogram or intraluminal echoes on sonogram represented flukes per se; periductal thickening on sonogram and periductal enhancement of bile ducts on CT were due to inflammatory cell infiltration, adenomatous hyperplasia and periductal fibrosis: band like enhancement at the periphery of the liver on CT represented proliferated bile ducts, destruction of liver cells and resultant fibrosis. The study confirmed the pathological bases for the radiological findings of clonorchiasis in liver and bile ducts and will, perhaps, serve as a basis for the future radiologic-pathological correlation of clonorchiasis and in further clinical and experimental researches in the biliary tract diseases.
Bile Ducts ; Biliary Tract Diseases ; Cholangiography ; Clonorchiasis* ; Clonorchis sinensis ; Dilatation ; Fibrosis ; Humans ; Hyperplasia ; Liver ; Methods ; Rabbits* ; Trematoda ; Ultrasonography

No abstract available.
Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa*

The pathogenesis of scleroderma has not been completely delineated, but it is suggested that increased collagen expression in fibroblast from sclerotic skin lesions may be an important factor contributing to collagen accumulation. PUVA therapy has been reported to be effective in the treatment of localized scleroderma. Its mechanism of action appears to be the stimulation of collagenase production by dermal fibroblasts. We report a case of localized scleroderma improved with systemic PUVA therapy.
Collagen ; Collagenases ; Fibroblasts ; PUVA Therapy* ; Scleroderma, Localized* ; Skin

Dermatofibrosarcoma protuberans(DFSP) is a cutaneous mesenchymal neoplasm originating in the dermis, which is diagnosed most in adulthood, with a range in age from birth to the ninth decade. Congenital DFSP is extremely rare and the diagnosis is difficult because of its resemblance to vascular birth mark of skin atrophy. We describe a case of congenital DFSP in a 19-year-old female on the left forearm, which was present as a vascular-appearing macule from birth with recent nodular change. Interestingly, the histopatholgy revealed Bednar tumor, a pigmented DFSP and it has not been reported in congenital case yet. The patient was treated with a wide and deep excision with surgical margin of 4cm and STSG, and no recurrence was noted for one year.
Atrophy ; Dermatofibrosarcoma* ; Dermis ; Diagnosis ; Female ; Forearm ; Humans ; Parturition ; Recurrence ; Skin ; Young Adult

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is one of the most common diseases in children and may be frequently related with dizziness. However, the association between OME and dizziness seems to be not clear and remains controversy. The purpose of this study was to determine the incidence of dizziness in children with long lasting OME, and to investigate the difference in vestibular functions between children with long lasting OME and the control group. MATERIALS AND METHOD: Thirty one children who had long-lasting OME over than 6 months (study group) and 28 normal hearing children without OME who were scheduled for adenotonsillectomy (control group), were given questionnaires and vestibular function tests (VFT) including electronystagmography (ENG) and rotation chair test (RCT). Statistical analysis was performed with chi-square test. RESULTS: Dizziness was found in 7 (22.6%) of 31 children in the study group and 2 (7.1%) of 28 children in the control group (p>0.05). The difference of abnormal findings in VFT between the study group and the control was not significant except visual vestibulo-ocular reflex (VVOR) in RCT. Most of the correlations in the study group, bilateral vs. unilateral OME, OME with dizziness vs. OME without dizziness, and preoperative vs. postoperative, were not significant. CONCLUSION: We did not find any evidences of significant difference of the incidence of dizziness and findings of VFT between children with long lasting OME and children without OME. However, there was a significant abnormal response in VVOR in RCT in children with long-lasting OME, suggesting the children with OME may be more dependent on the nonvestibular system including visual compensation to maintain balance.
Child* ; Compensation and Redress ; Dizziness ; Electronystagmography ; Hearing ; Humans ; Incidence ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Surveys and Questionnaires ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests

The most common cause of antibiotic-associated diarrhea is Clostridium difficile infection (CDI). Recurrent C. difficile infection (rCDI) often occurs after successful treatment of CDI. Due to the increased incidence and the difficulty in treating rCDI, it is becoming an important clinical issue. Identifying risk factors is helpful for early detection, treatment, and prevention of rCDI. Advanced age, use of antibiotics, gastric acid suppression, and infection with a hypervirulent strain are currently regarded as the major risk factors for rCDI. Several treatment modalities, including vancomycin, fidaxomicin, and fecal microbiota transplant (FMT), are suggested for rCDI treatment. However, there is currently no definitive treatment method with sufficient evidence for rCDI. Recent studies have focused on FMT and have shown positive results for rCDI. Prevention of rCDI by measures such as hand washing and isolation of patients is very important. However, these preventive measures are often overlooked in clinical practice. Here, we review the risk factors, treatment, and prevention of rCDI.
Anti-Bacterial Agents ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Gastric Acid ; Hand Disinfection ; Humans ; Incidence ; Methods ; Microbiota ; Recurrence ; Risk Factors* ; Vancomycin

Pachyonychia congenita (PC) is characterized by hypertrophic nail dystrophy, focal palmoplantar keratoderma and blistering, oral leukokeratosis, cyst formation, palmoplantar hyperhydrosis, and follicular keratoses on the trunk and extremities. PC is diagnosed by clinical findings and molecular genetic studies. A 26-year-old man presented with hypertrophic nail dystrophy and subungual debris of all 20 nails, hyperkeratotic plaques on the heels of both soles, and oral leukokeratosis. He had no family history of similar clinical findings. The patient's clinical presentation and history were consistent with PC. Herein we report on a rare case of pachyonychia congenita with a review of literature.
Adult ; Blister ; Extremities ; Heel ; Humans ; Keratoderma, Palmoplantar ; Keratosis ; Leukoplakia, Oral ; Molecular Biology ; Nails ; Pachyonychia Congenita

A 33-year old Korean man visited our department complaining of single mildly pruritic yellowish flat-topped papule on left upper eyelid. Lipid profile including low density lipoprotein-cholesterol and triglyceride level was above normal range. He remembered that the site was scalded by boiling oil about eight months ago. The patient was diagnosed with xanthelasma palpebrarum (XP) based on the clinical and histopathological findings, including diffuse infiltrate of large, pale-staining cells which have abundant foamy cytoplasm in the dermis. He was treated with CO2 laser ablation followed by application of 70% trichloroacetic acid with wooden stick. After a month, the skin lesion showed moderate improvement with disappearance of yellowish color and flat-topped elevation. So far, case of XP developed after minor trauma has not been reported. This case illustrates that minor trauma could be a trigger factor in the development of the disorder.
Cytoplasm ; Dermis ; Eyelids ; Humans ; Lasers, Gas ; Reference Values ; Skin ; Trichloroacetic Acid