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

BACKGROUND: Onychomycosis is one of the most common diseases of nails, accounting for 50% of all nail problems and a recent rise in the prevalence of onychomycosis has been noted. It has been known that the growth rate of nails is influenced by age, sex, seasonal factor, individual health and familial tendency. Several drugs, also, have been known to influence the growth rate of nails. OBJECTIVE: We want to know the influence of antifungal drug, itraconazole and terbinafine that used widespread recently, to the growth rate of nail. METHODS: This study was performed the 41 patients with distal subungal onychomycosis affecting only one sided great toenail and affected area more than 50%. The growth rate of the affected and the unaffected toenails in the same patients according to the medication of itraconazole or terbinafine was measured. Also, the growth rate of nails in 36 people with normal toenail was measured. RESULTS: No growth rate differences were seen in comparing the great toenails affected to onychomycosis in itraconazole and terbinafine group (p> 0.05). Also no growth rate differences were seen in great toenails not affected to onychomycosis in itraconazole and terbinafine group and no growth rate differences with the toenails of normal control (p> 0.05). CONCLUSION: There was no difference of itraconazole or terbinafine to the growth rate of nail. Even though there was no statistical significance, the possibility of the drug effect as normal nail growth became faster with the antifungal medication can not be excluded. So study with comparison of nail growth rate before and after antifungal medication will be needed in the future.
Humans ; Itraconazole ; Nails* ; Onychomycosis* ; Prevalence ; Seasons

Myxedema coma is a severe life-threatening form of hypothyroidism that is associated with a high mortality rate. It is known to be common in the elderly, and is mainly accompanied with cardiogenic shock, respiratory failure, central nervous system dysfunction, and body temperature regulation defects. Thus, immediate management is required in order to prevent fatal complications in myxedema coma. However, early detection is difficult and further, it is easily misdiagnosed due to its low incidence rate and nonspecific symptoms. We report a case of myxedema coma which was misdiagnosed for heart failure. The patient was successfully treated with intensive care and oral low dose levothyroxine.
Aged ; Body Temperature Regulation ; Central Nervous System ; Coma* ; Heart Failure ; Humans ; Hypothyroidism ; Hypoventilation ; Incidence ; Critical Care ; Mortality ; Myxedema* ; Respiratory Insufficiency ; Shock, Cardiogenic ; Thyroxine*

Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is an autosomal dominant disorder of the fibrovascular tissue. It is characterized by the classic triad of mucocutaneous telangiectasias, recurrent hemorrhages, and familial occurrence. The cutaneous manifestation appear clinically as punctuate, linear, or splinter-like telangiectasias of the upper body, oral, and nasal mucous membranes, and nail beds. A 73-year-old woman presented with purpuric, punctuate, and tiny macules on the finger tips of both hands and the tongue. The skin lesions were discovered about 50 years previously. She had a family history of cutaneous telangiectasia. Also, she had episodes of recurrent epistaxis, gastrointestinal bleeding, and anemia. The gastroendoscopy revealed gastric angiodysplasia of the fundus and body of the stomach. The histopathologic study showed dilated capillaries lined by flat endothelial cells in the papillary dermis. From these findings, we diagnosed this case as hereditary hemorrhagic telangiectasia, which has rarely been reported in the dermatologic literature.
Aged ; Anemia ; Angiodysplasia ; Capillaries ; Dermis ; Endothelial Cells ; Epistaxis ; Female ; Fingers ; Hand ; Hemorrhage ; Humans ; Mucous Membrane ; Nails ; Skin ; Stomach ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis ; Tongue

Pigmented Bowen`s disease is characterized by increased melanin pigment in the epidermis or papillary dermis, in addition to the typical findings of Bowen`s disease. This disorder has been infrequently reported and it represents less than 2% of all cases of Bowen`s disease. Thus far, there has been only 1 case of pigmented Bowen`s disease on the umbilicus in the medical literature, and no such case has been reported in Korea. Pigmented Bowen`s disease develops on sun-exposed areas of the face and neck, as well as sun-unexposed areas like the trunk, extremities, perianal area and umbilcus. A 36-year-old man presented with a 9-month history of solitary dark brown slithery or wavy plaque with a verrucous surface on the umbilicus, and the lesion measured 1 x 2 cm in size. The histopathologic findings showed hyperkeratosis, parakeratosis and atypical keratinocytes disorderly arranged throughout the epidermis. Increased melanin pigment was noted in the basal layer of the epidermis. From these findings, we diagnosed this lesion as pigmented Bowen`s disease.
Adult ; Dermis ; Epidermis ; Extremities ; Humans ; Keratinocytes ; Korea ; Melanins ; Neck ; Parakeratosis ; Umbilicus

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