PURPOSE: To describe a case of exercise-induced anaphylaxis presenting with lower lid angioedema. CASE SUMMARY: A 35-year-old female patient for the past 3 years experienced lower lid edema in her left eye after exercising. In the treadmill exercise test, sneezing, coughing, and lower lid edema in her left eye appeared 13 minutes after initiating exercise. Additionally, contrast-enhanced computed tomography scan revealed minimal soft tissue thickening of the left inferior periorbital subcutaneous area with subtle enhancement after exercise. The serum immunoglobulin E (IgE) test showed elevated total IgE levels. The patient was diagnosed with exercise-induced anaphylaxis based on the above results. We informed the patient on her trigger factors and possible symptoms and prescribed an oral antihistamine and steroid. CONCLUSIONS: In patients presenting with facial edema or eyelid edema after exercise, the possibility of exercise-induced anaphylaxis should be considered. In addition, we have to aware of possibility of complication such as airway obstruction or a life-threatening condition, and it is needed to prevent a recurrence of anaphylaxis by cooperating with other department.
Adult ; Airway Obstruction ; Anaphylaxis* ; Angioedema* ; Cough ; Edema ; Exercise Test ; Eyelids ; Female ; Humans ; Immunoglobulin E ; Immunoglobulins ; Recurrence ; Sneezing

Central serous chorioretinopathy (CSCR) is potential ophthalmologic sequelae of steroid use characterized by an idiopathic serous detachment of neurosensory retina within the macula. Its etiology and pathophysiology are still unknown, but what has been implicated to cause CSCR is the the use of corticosteroid via multiple administration routes including oral, intravenous, inhaled, intranasal, epidural and intraarticular as well as topical forms. We report, with a review of the literature, an additional case of CSCR, which developed during systemic corticosteroid treatment in a Bell's palsy patient.
Bell Palsy ; Central Serous Chorioretinopathy ; Humans ; Retina ; Steroids

It is known that neutropenia caused by combination pegylated interferon plus ribavirin therapy for hepatitis C virus (HCV) infection is well tolerated and carries a negligible risk of infection. Neutropenic enterocolitis is encountered most frequently in patients with hemato-oncologic diseases who are undergoing intensive chemotherapy. However, little information exists regarding this life-threatening event in the setting of HCV therapy. We present here an unusual case of fatal neutropenic enterocolitis in a cirrhotic patient receiving combination therapy for HCV infection. This is the first report of a death from neutropenic enterocolitis associated with treatment for chronic HCV infection. The present case suggests that caution should be exercised when continuing HCV therapy in neutropenic patients with advanced fibrosis, and the decision to maintain such therapy should be balanced against the potential for serious adverse events.
Enterocolitis, Neutropenic ; Fibrosis ; Hepacivirus ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Interferons ; Neutropenia ; Ribavirin

No abstract available.
Eyelids ; Tinea* ; Trichophyton*

PURPOSE: This study was conducted to explore the influence of academic institutional interest, open parent-adolescent communication, social (friend) support, and existential spiritual well-being on suicidal ideation of college students. METHODS: The research design was descriptive survey research involving 285 college students in city G. Data was collected from May 18, 2011 to November 2, 2011 and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. RESULTS: The findings reveal that suicidal ideation of college students was low, i.e., average score was 9.2+/-3.65 (possible range 5~25). This study determined that suicidal ideation is negatively correlated with interest on the part of the academic institution, open parent-adolescent communication, social support from friends, and existential spiritual well-being. The extent of existential spiritual well-being was a significant predictor of suicidal ideation, controlling for general characteristics variables (gender, number of close friends, first supporter) and institutional interest, open parent-adolescent communication, and social support. Existential spiritual well-being accounted for 50% of the explanation of suicidal ideation of college students. CONCLUSION: Based on the outcomes of this study, designing an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation of tertiary education students is strongly recommended.
Education ; Friends ; Humans ; Research Design ; Suicidal Ideation*

We experienced one case of epidermoid cyst. This tumor occurs usually in early adult life. So simple excision and testicular preservation are desirable when frozen section reveals the presence of an unequivocally benign lesion.
Adult ; Epidermal Cyst* ; Frozen Sections ; Humans ; Testis

PURPOSE: Knowledge of nutritional support and attitudes of medical staff both affect patient care. We identified attitudes regarding nutritional support among medical staff as well as changes in attitudes when a nutritional support team is present. METHODS: Data were collected from 172 medical staff members who served at a university hospital located in Gyeongju by self-administered questionnaire from June 12~August 30, 2013. The questionnaire inquired about importance of nutritional support, self-confidence about nutritional support, consideration of nutritional support for patient care, consideration of nutritional support when a nutritional support team is present, and nutritional knowledge training during the past year. RESULTS: A total of 169 subjects (98.3%) thought that nutritional support is important for patient care. Only 19 subjects (11.0%) were highly self-confident about nutritional support. In total, 147 subjects (85.5%) considered nutritional support for some or all patients, whereas 169 (98.3%) considered nutritional support for patient care when a nutritional support team is present. Thirty-eight subjects (22.1%) received nutritional knowledge training during the past year. High self-confidence for nutritional support was related to nutritional knowledge training and service part. Positive changes regarding nutritional support when a nutritional support team is present were associated with nutritional knowledge training and high self-confidence for nutritional support. CONCLUSION: No differences in nutritional support attitudes for patient care were observed among the medical staff. Nutritional knowledge training and service part affected self-confidence of nutritional support and induced positive changes in attitudes for nutritional support.
Gyeongsangbuk-do ; Humans ; Inpatients ; Medical Staff* ; Nutritional Status ; Nutritional Support* ; Patient Care* ; Surveys and Questionnaires

BACKGROUND/AIMS: Obstructive sleep apnea is becoming more important in gastroesophageal reflux disease (GERD) patients. This study investigated the prevalence of high risk for obstructive sleep apnea in GERD patients in comparison with that in healthy controls using the Berlin Questionnaire. We also investigated the risk factors for obstructive sleep apnea in GERD patients. METHODS: We enrolled 1,007 subjects: 776 healthy controls, 115 individuals with erosive reflux disease, and 116 with non-erosive reflux disease. GERD was diagnosed and classified using endoscopy and a reflux questionnaire. The Berlin Questionnaire was used to evaluate obstructive sleep apnea. RESULTS: More patients in the GERD group (28.2%) had higher risk for obstructive sleep apnea than healthy controls (20.4%, P = 0.036). More patients with non-erosive disease (32.8%) had higher risk for obstructive sleep apnea (OSA) than patients with erosive disease (20.9%) and controls (20.4%, P = 0.010). On multivariate analysis, non-erosive disease was a high risk factor for obstructive sleep apnea (odds ratio [OR], 1.82; P = 0.011). Age > or = 55 years (OR, 1.83; P < 0.001) and a high body mass index (> or = 25 kg/m2) (OR, 2.76; P < 0.001) were also identified as risk factors. Nocturnal GERD was related to high risk for OSA in non-erosive disease patients (OR, 2.97; P = 0.019), but not in erosive disease patients. CONCLUSIONS: High risk for OSA is more prevalent in GERD patients than in controls. Non-erosive reflux disease, age > or = 55, and a high BMI are associated with high risk for OSA.
Berlin ; Body Mass Index ; Endoscopy ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Multivariate Analysis ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Sleep Apnea, Obstructive*

Epithelioid hemangioendothelioma is a neoplasm of vascular origin with a low-to-intermediate malignant potential and is one of the rare sarcomas arising from the liver. Its etiology is unknown and its clinical outcome is unpredictable. There is no generally accepted therapeutic strategy because of its rarity and the variable natural course between hemangioma and angiosarcoma. We report a case of a 64-year old woman who underwent hepatic resection due to epithelioid hemangioendothelioma in the right lobe that progressed to extrahepatic metastases of the bone, pleura, and peritoneum 22 months later. However, after resection there was no primary hepatic recurrence.
Bone Neoplasms/diagnosis/pathology/secondary ; Female ; Hemangioendothelioma, Epithelioid/*diagnosis/pathology/*secondary ; Hepatectomy ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Lung Neoplasms/diagnosis/pathology/secondary ; Middle Aged ; Tomography, X-Ray Computed

Although continuous low-dose (metronomic [MET]) therapy exerts anti-cancer efficacy in various cancer models, the effect of long-term MET therapy for hepatocellular carcinoma (HCC) remains unknown. This study assessed the long-term efficacy of MET on suppression of tumor growth and spontaneous metastasis in a rat model of HCC induced by administration of diethylnitrosamine for 16 wk. The rats were divided into 3 groups: MTD group received intraperitoneal (i.p.) injections of 40 mg/kg cyclophosphamide on days 1, 3, and 5 of a 21-day cycle; Control and MET groups received i.p. injections of saline and 20 mg/kg cyclophosphamide twice a week, respectively. Anti-tumor and anti-angiogenic effects and anti-metastatic mechanisms including matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) were evaluated. Twelve wk of MET therapy resulted in a significant reduction in intrahepatic tumors than control or MTD therapy. The MET group had fewer proliferating cell nuclear antigen-positive cells and decreased hypoxia-inducible factor-1alpha levels and microvessel density. Lung metastases were detected in 100%, 80%, and 42.9% in the control, MTD, and MET groups, respectively. MET therapy significantly decreased expression of TIMP-1, MMP-2 and -9. For mediators of pro-MMP-2 activation, MET therapy induced significant suppression in the TIMP-2 and MMP-14 level. The survival in the MET group was significantly prolonged compared to the control and MTD groups. Long-term MET scheduling suppresses tumor growth and metastasis via its potent anti-angiogenic properties and a decrease in MMPs and TIMPs activities. These results provide a rationale for long-term MET dosing in future clinical trials of HCC treatment.
Animals ; Antineoplastic Agents/*administration & dosage/*pharmacology ; Carcinoma, Hepatocellular/chemically induced/*drug therapy/mortality/pathology ; Cell Proliferation/drug effects ; Cyclophosphamide/*administration & dosage/*pharmacology ; Diethylnitrosamine ; Disease Models, Animal ; Gene Expression Regulation, Neoplastic/*drug effects ; Liver Cirrhosis/chemically induced ; Liver Neoplasms/chemically induced/*drug therapy/mortality/pathology ; Lung Neoplasms/drug therapy/pathology/secondary ; Male ; Matrix Metalloproteinases/metabolism ; Neovascularization, Pathologic/enzymology/physiopathology ; Rats ; Rats, Sprague-Dawley ; Survival Analysis ; Tissue Inhibitor of Metalloproteinases/metabolism ; Tumor Burden/drug effects