A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

Purpose: The purpose of the study was to identify degrees of symptoms, self-efficacy, fear of cancer recurrence, anti-hormone therapy beliefs, and medication adherence, and to pinpoint factors influencing medication adherence among patients with breast cancer who were undergoing hormone therapy. Methods: The data of 144 breast cancer patients who had breast cancer surgery and were undergoing anti-hormone therapy were collected from July to August 2022. The collected data were analyzed using the descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and hierarchy multiple regression analysis. Results: Medication adherence significantly differed according to the breast cancer stage (F=3.35, p=.38) and presence of comorbidities other than breast cancer (t=-2.26, p=.025). Medication adherence was explained by breast cancer stage (β=.15), the presence of comorbidities other than breast cancer (β=.16), symptom (β=.17), and Anti-Hormone Therapy Beliefs (β=-.44)(F=11.47, p<.001). The model explained 34% of the variance. Conclusion The results of the study suggest that share the patient’s symptom experiences among medical staff, and educate about the importance of anti-hormone therapy beliefs and prior methods. The findings of this study highlight the need to develop and implement education or interventions to enhance medication adherence among breast cancer patients who are undergoing anti-hormone therapy.

No abstract available.
Prevalence* ; Ulsan*

BACKGROUND: Since the herniorrhaphy was performed by Bassini, that method has been the standard for herniorrhaphy for over a hundred year, although it has been modified by other surgeons. During recent decades, biomaterials were introduced to the medical field, and polypropylene mesh was applied to reconstruct the defective abdominal wall of an inguinal hernia in an adult. The Lichtenstein Hernia Institute is regarded as the leading group for the tension-free herniorrhaphy using Marlex mesh under local anesthesia. METHODS: We designed this study prospectively to investigate the characteristics of groin hernias and the results, including complications and recurrence after surgery. The primary method of surgery was a Lichtenstein's tension-free herniorrhaphy using Prolene mesh. We performed 196 hernioplasties in 180 patients having a groin hernia, which included 16 bilateral hernias. RESULTS: 139 indirect hernias, 51 direct hernias, and 3 femoral hernias were included; there were 15 recurrent hernias. A Lichtenstein's tension-free herniorrhaphy was performed in 84.2% of the cases, a preperitoneal mesh graft in 10.2%, and a Bassini's method in 4.6%. There were four recurrences; three were through the femoral canal after the repair of a direct hernia in a female, and one was a recurrent direct hernia in a male patient. CONCLUSIONS: With the use of a mesh prosthesis, a tension-free herniorrhaphy is possible with neither distortion of the normal anatomy nor suture-line tension. However, it should be carefully applied to a direct hernia only after thorough exploration of the groin through the retroinguinal space of Bogros to rule out coexisting intraparietal or femoral hernias. It is necessary to provide enough laxity for the mesh because prolene mesh can shrink up to 20%, and recurrence might be caused by the tension in the applied mesh.
Abdominal Wall ; Adult* ; Anesthesia, Local ; Biocompatible Materials ; Female ; Groin ; Hernia ; Hernia, Femoral ; Hernia, Inguinal* ; Herniorrhaphy* ; Humans ; Male ; Polypropylenes ; Prospective Studies ; Prostheses and Implants ; Recurrence ; Transplants

No abstract available.

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

This study analyzed various aspects of what glaucoma patients think about their quality of life(QOL), knowledge of glaucoma, and compliance to treatment. For the study, survey and multifactorial analysis were performed in 165 patients in 10 subject with 60 questions. After the diagnosis of glaucoma, 25.5% of patients were not satisfied with their life compared with 7.3% of them before the diagnosis. Life satisfaction could be decreased from 3.76 point in Likert scale before the diagnosis to 3.07 point after the diagnosis. Life satisfaction decreased significantly in the highly educated group, in the upper or lower income group, and in those who thought as though they were generally healthy. Beside these results, 87.3% of patients were afraid of losing their vision, 78.2% of the patients who had not been operated preferred medical treatment to surgery.
Compliance ; Diagnosis ; Glaucoma* ; Humans ; Quality of Life*

Ground-glass opacity is a frequent but nonspecific finding seen on high-resolution CT scans of lung parenchyma. Histologically, this appearance is observed when thickening of the alveolar wall and septal interstitium is minimal or the alveolar lumen is partially filled with fluid, macrophage, neutrophils, or amorphous material. It has been shown that ground-glass opacity may be caused not only by an active inflammatory process but also by fibrotic processes. When a focal area of ground-glass opacity persists or increases in size, the possibility of neoplasm-bronchioloalveolar carcinoma or adenoma, or lymphoma, for example- should be considered. Diffuse nonsegmental ground-glass opacity in both lung fields was incidentally found on follow up abdominal CT in a stomach cancer patient and signet-ring cell-type metastatic lung cancer was confirmed by transbronchial lung biopsy. We report a case of diffuse ground-glass opacity seen in metastatic lung cancer from adenocarcinoma of the stomach.
Adenocarcinoma* ; Adenoma ; Biopsy ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung* ; Lymphoma ; Macrophages ; Neoplasm Metastasis* ; Neutrophils ; Stomach Neoplasms ; Stomach* ; Tomography, X-Ray Computed

Spinal cord infarction as a complication of spine surgery occurs rarely. Herein, a case of spinal cord infarction, which developed in a 69 year old woman following posterior decompression and internal fixation for a T11 bursting fracture, is descirbed. The anesthetic induction and intraoperative course were uneventful, except at the end of the procedure, where her blood pressure suddenly dropped from 130/90 to 90/60 mmHg. The patient was aggressively treated with a transfusion and vasopressor, the blood pressure then returned to its usual value within 10 minutes. However, during a physical examination in the recovery room, the patient was found to have flaccid lower limbs, with impaired sensory function below the T8 level. Her cord diameter had increased, and a high signal lesion was observed within the thoracic spinal cord, from T9 to T12 level on T2-weighted MR images, which was diagnosing as a spinal cord infarction, was and showed no improvement despite the immediate and aggressive treatment.
Aged ; Blood Pressure ; Decompression ; Female ; Humans ; Infarction* ; Lower Extremity ; Physical Examination ; Recovery Room ; Sensation ; Spinal Cord* ; Spine*