The skin over the nose is less mobile for primary closure of defects. In addition to skin graft and secondary intention healing, there are various local flap techniques and their modifications for the reconstruction of nasal defects. Imprecise engineering of wound repair methods and contracture can lead to twisting of the nose and distortion of surrounding anatomic structures such as the nasal ala and paranasal sulcus. The skin defects on the nasal dorsum were reconstructed with a modified bilateral rombic flap. In our case, there were no significant complications and the final result was satisfactory in both functional and cosmetic aspects. Through our experience, we can confirm that the modified bilateral rhombic flap can reconstruct defects on the center area of the nasal dorsum effectively and in a single stage.
Contracture ; Intention ; Nose ; Skin ; Transplants ; Wounds and Injuries

A 10-month-old male patient was seen with a nodular lesion on his left upper arm which developed several months after BCG vaccination. Physical examination revealed a bean sized, irregular surfaced, erythematous pustular nodule on the left upper arm at a place different from the vaccination site. Histopathologic examination of the nodule on the left upper arm showed tubercles composed of mononuclear cells, epithelioid cells and langhans type giant cells in the dermis. Caseation necrosis within the typical tubercles was noted. Prominent improvement of the lesion was observed 4 months after oral medication with isoniazid and rifampicin.
Arm ; Dermis ; Epithelioid Cells ; Giant Cells, Langhans ; Humans ; Hypogonadism ; Infant ; Isoniazid ; Male ; Mitochondrial Diseases ; Mycobacterium bovis ; Necrosis ; Ophthalmoplegia ; Physical Examination ; Rifampin ; Tuberculosis, Cutaneous ; Vaccination

Hyponatremia resulting from ingestion of large volumes of bowel preparation solution has been reported in patients with alternated renal water handling like renal failure or old age. Colonoscopy-induced hyponatremia was known to be related with an increase in serum arginine vasopressin concentration. Ingestion of bowel preparation solution can lead to diarrhea associated with nausea, vomiting and dehydration, often resulting in raised plasma concentrations of antidiuretic hormone. Besides, non- osmotic stimuli for arginine vasopressin concentrations can be provoked by nausea, vomiting, and intestinal hyperactivity during bowel preparation and colonoscopic procedure. We have experienced three cases of hyponatremia resulting from ingestion of bowel preparation solution for colonoscopy. The factors leading to increased arginine vasopressin secretion seem to be nausea, vomiting and intestinal hyperactivity during bowel preparation for colonoscopy.
Arginine Vasopressin ; Colonoscopy* ; Dehydration ; Diarrhea ; Eating* ; Humans ; Hyponatremia* ; Nausea ; Plasma ; Renal Insufficiency ; Vomiting

Hyperthyroidism has been associated with changes in muscle function such as thyrotoxic myopathy, thyrotoxic periodic paralysis and thyroid opthalomopathy, but rarely rhabdomyolysis. Usually serum creatinine kinase is either normal or low in hyperthyroidism. Only 3 reports described association between rhabdomyolysis and hyperthyroidism, no previous literatures have thyrotoxic periodic paralysis associated rhabdomyolysis. Patients with hypokalemic periodic paralysis sometimes elevated serum muscle protein during recovery from paralytic attack, but the mechanism was not well known. We report a patient who presented with clinical feature of thyrotoxic periodic paralysis and increasing serum CK, myoglobin during recovery from paralysis.
Creatinine ; Humans ; Hyperthyroidism ; Hypokalemic Periodic Paralysis ; Muscle Proteins ; Muscular Diseases ; Myoglobin ; Paralysis* ; Phosphotransferases ; Rhabdomyolysis* ; Thyroid Gland

No abstract available.

Since profound hyperkalemia induces fatal arrhythmias, the recognition of its electrocardiographic manifestations is very important. The changes on the ECG correlated roughly with the severity of hyperkalemia. It has been, however, less recognized that severe hyperkalemia is associated with bradycardia. We present 14 patients with chronic kidney disease manifesting marked bradycardia in the presence or absence of hyperkalemia. It is interesting that diabetes mellitus which was complicated in 10 of 14 patients in the present study might exaggerate bradycardia with or without hyperkalemia. 9 patients, who were taking drugs such as diltiazem, beta-blocker, alpha, beta-blocker, and digoxin, developed bradycardia even when their plasma potassium concentration were moderate (<6.5 mEq/L). Therefore, we suggest that synergistic action of these drugs, hyperkalemia, diabetes mellitus, and uremic toxin in patient with chronic kidney disease might play a role in inducing bradycardia.
Arrhythmias, Cardiac ; Bradycardia* ; Diabetes Mellitus ; Digoxin ; Diltiazem ; Electrocardiography ; Humans ; Hyperkalemia ; Plasma ; Potassium ; Renal Insufficiency, Chronic*

Skeletal remains collected from the archaeological fields must be maintained carefully, for being used in scientific studies on the physical characteristics, health status, and pathological disease of the ancient or medieval human populations. Even if Joseon Dynasty Human Sample Collection might be a good example for such studies, few of bone collections predated the Joseon Age (e.g. Goryeo Dynasty) have been established until now, possibly owing to poor preservation condition of archaeological sites in Korea. In this study, we performed anthropological studies on a few cases of Goryeo skeletons, which have been rarely reported by anthropologists in Korea. Judging from the preservation status of bones found in various types of Goryeo graves (e.g. earthen- or stone-chambered tombs), many cases seem to be cremated in accordance with Buddhist funeral rites. Goryeo bone collections must be constructed with the bones identified in the earthen tombs, which were preserved much perfectly than those of any other types of Goryeo tombs.
Anthropology, Physical ; Archaeology ; Funeral Rites ; Humans ; Korea ; Skeleton

The 55 years old male patient, undergoing maintenance hemodialysis, was admitted on our department because of painful swelling on left knee joint. At 19th hospital day, he complained of severe dyspnea. He had a large amount of pleural effusion of the left chest that was shown to be hemothorax by thoracentesis. After closed thoracostomy, about amount of 3,000 mL of blood was drained and bleeding was sustained from pleural cavity, and then emergency thoracotomy was done. We cannot find any bleeding focus in thoracic cavity, but oozing blood was seen on entire inner thoracic cavity. He had no previous invasive procedure or history of trauma before 6 months. We think that hemothorax may be developed because of defected coagulopathy and increased bleeding tendency due to platelet dysfunction in renal failure patient. Immediately thoracotomy and cryoprecipitate were helpful for this patient. We report a rare case of spontaneous hemothorax in a maintenance hemodialysis patient with literature review.
Blood Platelets ; Dyspnea ; Emergencies ; Hemorrhage ; Hemothorax* ; Humans ; Knee Joint ; Male ; Middle Aged ; Pleural Cavity ; Pleural Effusion ; Renal Dialysis* ; Renal Insufficiency ; Thoracic Cavity ; Thoracostomy ; Thoracotomy ; Thorax

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that's influenced by many genetic and environmental factors. Various treatment modalities are being applied for AD, including phototherapy, topical applicants and systemic agents. However, there has been no mass survey in Korea concerning the compliance of patients' to use their prescribed medication, which might influence the clinical efficacy of the physicians' treatment. OBJECTIVE: The purpose of the present study is to evaluate the efficacy, safety and patient compliance with using topical pimecrolimus to treat AD. METHODS: We reviewed the medical recordings, laboratory profiles, clinical severity scoring and photographs of AD patients at 9 general hospitals in Seoul and the local area of Korea. Interviews with the patients and a telephone survey were also done. Those patients who weren't perscribed topical applicants or those who did not use topical pimecrolimus or steroid within 6 months were excluded from this study. RESULTS: Topical pimecrolimus cream effectively controlled AD with a reduction of the EASI score from baseline 13.75 to 11.39 at 2 weeks and 4.46 at 10 weeks of topical pimecrolimus application. When topical pimecrolimus cream was applied for more than 12 months it significantly suppressed the recurrence and reactivation of AD (p<0.05). Although 22.6% of the patients complained of adverse effects, these were all transient and they did not evoke significant medical problems. Using topical pimecrolimus cream did not show significant adverse effects or complications. CONCLUSION: Topical pimecrolimus might well be an effective treatment modality for treating AD when patients show good compliance for applying the cream.
Compliance ; Dermatitis, Atopic ; Hospitals, General ; Humans ; Korea ; Medical Records ; Patient Compliance ; Phototherapy ; Recurrence ; Skin Diseases ; Tacrolimus ; Telephone