PURPOSE: We evaluated the clinical characteristics of respiratory viruses that were frequently found in children during spring/summer, namely, human bocavirus (hBoV), human metapneumovirus (hMPV), parainfluenza virus (PIV), and human rhinovirus (hRV). METHODS: This study enrolled patients with acute lower respiratory infection in whom respiratory virus reverse transcriptase polymerase chain reaction was performed between March 2013 and August of 2013. We retrospectively reviewed the medical records to collect the patients' data. RESULTS: A total of 96 patients were enrolled and divided into 5 categories: hBoV in 19 patients (19.8%), hMPV in 18 patients (18.8%), PIV in 16 patients (16.7%), hRV in 20 patients (20.8%), and negative result in 23 patients (24.0%). The mean age of the patients was 8.2+/-5.9 months (median, 7.5 months; range, 1-24 months), and the male-to-female ratio was 1.1:1. The most common diagnoses were acute bronchiolitis (62.5%) and pneumonia (30.2%). Compared to other patients, those with hBoV were older (12.3+/-4.9 months, P=0.001) and more frequently diagnosed with acute bronchiolitis (P=0.005). In addition, they showed higher incidences of tachypnea and rales (P=0.039 and P=0.035, respectively), and were more frequently treated with oxygen and systemic steroids (P=0.044 and P=0.001, respectively) than the other patients. CONCLUSION: We compared respiratory viruses in children during spring/summer and found that hBoV may have more severe clinical manifestations than other viruses.
Bronchiolitis ; Child* ; Diagnosis ; Human bocavirus* ; Humans ; Humans* ; Incidence ; Medical Records ; Metapneumovirus ; Oxygen ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus ; Steroids ; Tachypnea

Intracranial Hemorrhage due to Moya-moya disease in the pregnancy women is rarely documented. We present a 31-years old woman who had intracranial hemorrhage at 34 weeks of gestation. She had stuporous state(Glouscow coma scale 2-3-5) with normal blood pressure at emergency room. Computed tomography revealed intraventricular hemorrhage and scanty intracerebral hemorrhage at left paraventricular area. External ventricular drainage enabled her symptoms to improve gradually. Additional MRI and angiography revealed finding of Moya-moya disease at left middle cerebral artery. Generally, intracranial hemorrhage during pregnancy, caused by aneurysmal rupture and AVM, is treated extensively regardless of pregnancy. In Moya-moya disease intracranial hemorrhage should be removed with a simple and safe procedure as soon as possible. And cesarean section should be considered in selected cases who has hypertension during labor.
Adult ; Aneurysm ; Angiography ; Blood Pressure ; Cerebral Hemorrhage ; Cesarean Section ; Coma ; Drainage ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Moyamoya Disease* ; Pregnancy* ; Rupture ; Stupor

PURPOSE: Many doctors have difficulty in deciding the treatment duration in trauma patients to write in the casualty medical certificate. We tried to find a solution for this problem by using abbreviated injury scale (AIS). METHODS: A total of 39 patients treated in our regional trauma center who requested an author to write treatment duration on casualty medical certificate from January 2014 to April 2017 were included. And the treatment duration was decided based on the PARK Formula (AIS). PARK Formula (AIS)=(AIS×2) ~ ([AIS×2]+2) RESULTS: Among 39 patients included and 36 (92.3%) had treatment duration on casualty medical certificate within the range of treatment duration calculated by PARK Formula (AIS). Compared to the PARK Formula (AIS), the mean value was 0.13 week (0.90 day) smaller. Comparing the treatment duration between Korean Medical Association (KMA) guideline and PARK Formula (AIS), only 22 patients (56.4%) showed agreement. The mean value was 1.02 week (7.18 days) smaller in KMA guideline. CONCLUSIONS For the decision of the treatment duration in trauma patients, utilizing worldwide used AIS scoring system is very efficient. Using PARK Formula (AIS), doctors can document the treatment duration in the casualty medical certificate with ease. KMA should provide more practical ‘treatment duration of each diagnosis in writing casualty medial certificate’ for the doctors. We recommend PARK Formula (AIS) as a good alternative for KMA guide.

An ischemia-reperfusion injury of the intestine due to blunt trauma is very rare. Low blood flow can result in an incarceration and an ischemia-reperfusion injury of the small intestine. A 63-year-old woman fell, producing a splenic rupture. Despite the successful angio-embolization of the splenic rupture, the patient continued to suffer from hypotension. During laparotomy to identify the bowel injury, no intestinal perforation was found. However, we found a hemorrhagic infarction of the small intestine with congestion of the submucosal blood vessels. The part of bowel with the hemorrhagic infarction was resected and reconstructed with a jejuno-colic anastomosis. After surgery, she recovered from the trauma and was discharged without complications. We present this ischemia-reperfusion injury of the intestine due to blunt trauma. Meticulous examination and computed tomography scan is mandatory for diagnosis and assessment of treatment outcome.
Blood Vessels ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Humans ; Hypotension ; Infarction ; Intestinal Perforation ; Intestine, Small* ; Intestines ; Laparotomy ; Middle Aged ; Reperfusion Injury ; Splenic Rupture ; Treatment Outcome

PURPOSE: There are various lymph node-based staging systems. Nevertheless, there is debate over the use of parameters such as the number of involved lymph nodes and the lymph node ratio. As a possible option, the distribution of metastatic lymph nodes may have a prognostic significance in rectal cancer. This study is designed to evaluate the impact of distribution-weighted nodal staging on oncologic outcome in rectal cancer. MATERIALS AND METHODS: From a prospectively maintained colorectal cancer database of our institution, a total of 435 patients who underwent a curative low anterior resection for mid and upper rectal cancer between 1995 and 2004 were enrolled. Patients were divided into 3 groups according to the location of apical metastatic nodes. A location-weighted prognostic score was calculated by a scoring model using a logistic regression test for location based-statistical weight to number of lymph nodes. All cases were categorized in quartiles from lymph node I to lymph node IV using this protocol. RESULTS: The location of lymph node metastasis was an independent factor that was associated with a poor prognostic outcome (p<0.001). Based on this result, the location-weighted-nodal prognostic scoring model did not show lesser significant results (p<0.0001) in both overall survival and cancer-free survival analyses. CONCLUSION: The location of apical nodes among the metastatic nodes does not have a lesser significant impact on oncologic result in patients with advanced rectal cancer. A location-weighted prognostic scoring model, which considered the numbers of involved lymph nodes as the rate of significance according to the location, may more precisely predict the survival outcome in patients with lymph node metastasis.
Colorectal Neoplasms ; Humans ; Logistic Models ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms*

Kimura's disease is a rare inflammatory disorder of unknown etiology primarily seen in young Asian males. It is characterized by painless subcutaneous masses, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin E (IgE) levels. Clinically, the subcutaneous nodules occur predominantly in the head and neck. However, we report the case of a five-year-old boy presenting with an asymptomatic solitary brown pigmented nodule on the left buttock diagnosed with Kimura's disease. Here we describe the diagnosis and treatment of this unusual case.
Asian Continental Ancestry Group ; Buttocks ; Child, Preschool ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Immunoglobulins ; Male ; Neck

Lichen planus (LP) commonly involves the flexor aspects of the wrists, legs, and oral and genital mucous membranes. But it rarely occurs on the palms and/or soles. It mainly affects people in the age range 30~60 years. Childhood LP is reported to constitute only 1~4% of total cases of LP. In the literature, a few cases of LP on the palms and soles of pediatric patients have been reported. Here we report an interesting case of childhood LP with palmoplantar involvement. The patient was a 7-year-old boy who for 6 months had variously sized and shaped, pruritic, violaceous, polygonal papules and plaques on the whole body. The skin biopsy specimens taken from four sites of the patient (dorsum of the hand and foot, sole and chest) showed typical features of LP on histopathology. A diagnosis of generalized LP with palmoplantar involvement was made.
Biopsy ; Child ; Foot ; Hand ; Humans ; Leg ; Lichen Planus ; Lichens ; Mucous Membrane ; Skin ; Wrist

A digital mucous cyst (DMC) is clinically characterized by a round to oval, translucent, smooth nodule localized to the dorsal aspect of the distal digits near the distal interphalangeal joint. It usually presents as a solitary lesion, and multiple lesions are uncommon. An 88-year-old man presented with herpetiform translucent papules on the right thumb. We first diagnosed the lesion as molluscum contagiosum or herpetic whitlow. Histopathology showed a cystic space containing mucinous material and numerous fibroblasts surrounded by mucinous stroma in the upper dermis. The lining of the cyst wall was not apparent and mucinous material was stained with Alcian blue, indicating a diagnosis of DMC.
Aged, 80 and over ; Alcian Blue ; Chlorobenzenes ; Dermis ; Fibroblasts ; Humans ; Joints ; Molluscum Contagiosum ; Mucins ; Thumb

BACKGROUND: Acute and persistent pain are the most significant clinical manifestations of herpes zoster. It has been suggested that the demographic and clinical characteristics of patients with herpes zoster at the time of presentation predict the duration and severity of pain on long-term follow-up. However, the association between pain in herpes zoster and emotional factors such as depression and anxiety has been less well investigated. OBJECTIVE: The purpose of this study was to correlate the characteristics of pain with clinical, demographic, and emotional factors in herpes zoster patients. METHODS: Ninety-seven patients with herpes zoster and 105 healthy controls were recruited from the department of dermatology at a university-affiliated hospital. Depression and anxiety levels were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. We compared severity of initial pain and duration of pain by age, depression, and anxiety. RESULTS: The levels of depression and anxiety were higher in herpes zoster patients compared to controls (p <0.05). There were no significant differences by age, depression, or anxiety. The duration of pain increased with increasing age, depression, and anxiety (p <0.05). Stratified analyses showed that the association between pain duration and increasing depression and anxiety was significant in the young age group (p <0.05), but not significant in the old age group. CONCLUSION: This study suggests that age, depression, and anxiety are the main correlates of pain duration in patients with herpes zoster. Therefore, depression and anxiety should not be ignored in the management of herpes zoster patients.
Anxiety ; Depression ; Dermatology ; Follow-Up Studies ; Herpes Zoster ; Humans

Becker's nevus is a cutaneous hamartoma characterized by unilateral hairy hyperpigmentation and can be associated with subjacent and distant soft tissue and bony abnormalities. Ipsilateral breast hypoplasia is a rare abnormality in Becker's nevus, suggesting that increased androgenic receptors or early postzygotic mutation may play a role in the pathogenesis of Becker's nevus. We report a case of Becker's nevus associated with ipsilateral breast hypoplasia in a 24-year-old female.
Breast ; Female ; Hamartoma ; Humans ; Hyperpigmentation ; Nevus* ; Young Adult