Impetigo herpetiformis is a rare pustular eruption that may be seen in late pregnancy. It is associated with severe maternal and fetal complications in case of misdiagnosis and delayed treatment. The patient was a 25-years-old multigravida with psoriasis in her past history. At 20weeks gestation, she had been developed erythematous scaly annular patchs with papules and pustules on inner thigh. At 37weeks' gestation, the patient was suffered from a severely pruritic pustular rash with fever and leukocytosis. The skin of the affected areas was biopsied and showed intraepidermal pustular abscess with a neutrophilic infiltrate. Treatment commenced with intravenous fluids, antibiotics, systemic prednisone, steroid creams, and phototherapy(UVB) under the careful fetal well being monitoring. Cesarean section was done due to fetal distress, and a normal healthy male infant was delivered, following which the patient's condition improved rapidly.
Abscess ; Anti-Bacterial Agents ; Cesarean Section ; Diagnostic Errors ; Exanthema ; Female ; Fetal Distress ; Fever ; Humans ; Impetigo* ; Infant ; Leukocytosis ; Male ; Neutrophils ; Prednisone ; Pregnancy* ; Psoriasis ; Skin ; Thigh

PURPOSE: Pelvic actinomycosis is a rare infection which presents difficulty in establishing a correct preoperative diagnosis. The aim of this study is to find diagnostic clues for pelvic actinomycosis preoperatively. METHODS: A retrospective analysis performed at Chonbuk National University Hospital identified 9 patients with a diagnosis of pelvic actinomycosis from 1998 to 2006. RESULTS: All patients were women with a history of intrauterine device (IUD) use. Abdominal pain (7 cases), palpable mass (3 cases), defecation difficulty (3 cases) and leucorrhea (2 cases) were the main presenting complaints. The median duration of presenting symptoms was 78 days (range: 10~365 days). The median duration of using an IUD unchanged was 11 years (range: 4~30 years). A correct diagnosis was made in 3 patients (33%) without exploration. All patients were treated with antibiotics after pathologic diagnosis. There was no recurrence. CONCLUSIONS: It is very difficult to diagnose pelvic actinomycosis preoperatively. Howere, if a mass or a pelvic abscess is found in women with an IUD that has been unchanged for a long time, pelvic actinomycosis should be suspected to avoid unnecessary exploration.
Abdominal Pain ; Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Defecation ; Diagnosis ; Female ; Humans ; Intrauterine Devices ; Jeollabuk-do ; Recurrence ; Retrospective Studies

Ovarian remnant syndrome is a rare condition which develops when functional ovarian tissue is left in situ after intended bilateral oophorectomy. It produces clinically significant syndrome, namely chronic pelvic pain and dysmenorrhea. Although the true incidence of this syndrome is unknown, an apprant increase in incidence has been reported. We have experienced a case of ovarian remnant syndrome showing chronic pelvic pain and palpable abdominal mass after difficult gynecologic operation. So, we report this case with a brief review of literatures.
Dysmenorrhea ; Female ; Incidence ; Ovariectomy ; Pelvic Pain

PURPOSE: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. MATERIALS AND METHODS: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour, 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. RESULTS: The results were obtained as follows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05), but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs, the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. CONCLUSIONS: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.
Alloys ; Anti-Bacterial Agents ; Cell Proliferation ; Ceramics ; Dental Implants ; Fibroblasts* ; Humans* ; Microscopy, Electron, Scanning ; Osseointegration ; Titanium ; Tooth

PURPOSE: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. MATERIALS AND METHODS: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour, 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. RESULTS: The results were obtained as follows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05), but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs, the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. CONCLUSIONS: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.
Alloys ; Anti-Bacterial Agents ; Cell Proliferation ; Ceramics ; Dental Implants ; Fibroblasts* ; Humans* ; Microscopy, Electron, Scanning ; Osseointegration ; Titanium ; Tooth

Primary tumors of the heart are uncommon lesions that can mimic almost any type of cardiac disease. Over 90 per cent of myxoma which are the most common cardiac tumor occur in the atria, with 3 to 4 times as many occuring on the left as on the right. The development of nonivasive echocardiographic technique has made it possible to screen large numbers of patients with atrial myxoma with ease and safe. A 28 year old housewife was admitted because of dyspnea for 5 months. Clinical diagnosis of right atrial myxoma was made by echocardiography and right atrial angiocardiogram. Surgical resection was performed successfully. We presented a case of right atrial myxoma with a review of literatures.
Adult ; Diagnosis ; Dyspnea ; Echocardiography ; Heart ; Heart Diseases ; Heart Neoplasms ; Humans ; Myxoma*

STATEMENT OF PROBLEM: The screws of dental implant, having various thread types, can be categorized into different classes by their geometrical form, and each type transmits dissimilar amount and form of stress to alveolar bone. PURPOSE: The purpose of this study was to find an inclination angle of the screw thread that is favorable in distributing the stresses to alveolar bone. MATERIAL AND METHODS: In this study, We used three dimensional finite element analysis with modeling having three types of thread inclination angles and fixed pitch-0.8 mm (single thread type with 3.8 degrees inclination, double thread type with 7.7 degrees inclination, triple thread type with 11.5 degrees inclination). RESULTS: The results obtained from this study were as follows; 1. When the number of thread increased, the amount of Von-Mises stress was reduced since the generated stress was effectively distributed. 2. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants when comparing the magnitude of the maximum principal stress double thread had least amount of stress. This shows that the double thread screw gave best result. CONCLUSION: In conclusion, double, and triple thread screws were found to be more effective on distribution of the stress than the single thread screws. But, increasing in the thread inclination angle such as triple thread screw relate on the magnitude of the maximum principal stress affecting on the alveolar bone can become problematic. Thus, effective combination of thread number and thread inclination angle can help prolonging the longevity of implant.
Dental Implants ; Finite Element Analysis* ; Longevity

PURPOSE: To evaluate the clinical features of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy and the effect of Ahmed valve implantation. METHODS: The medical records of 217 eyes of 178 patients who had undergone pars plana vitrectomy for proliferative diabetic retinopathy were reviewed. The clinical data on preoperative, intraoperative, and postoperative factors of these patients were compared with that of those who developed neovascular glaucoma (20 eyes of 18 patients) after vitrectomy. The effect and complications of Ahmed valve implantation were also reviewed. RESULTS: The type 1 diabetes, the presence of NVD, grade of NVE, grade of preoperative PRP, presence of postoperative vitreous hemorrhage, and postoperative tractional retinal detachment were significantly correlated with the development of neovascular glaucoma. Ahmed valve implantation in these patients was effective in controlling intraocular pressure and improving visual acuity. Complications of the Ahmed valve implantation were hyphema, tube exposure, recurrent vitreous hemorrhage, hypotony, and choroidal effusion. CONCLUSIONS: The risk factors for the development of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy were evaluated. Ahmed valve implantation in these patients is considered an effective treatment for controlling intraocular pressure.
Choroid ; Diabetic Retinopathy* ; Glaucoma, Neovascular* ; Humans ; Hyphema ; Intraocular Pressure ; Medical Records ; Retinal Detachment ; Risk Factors ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Primary mediastinal leiomyosarcoma is an extremely rare neoplasm that arises from smooth muscle, usually in the esophagus or main vessels, but rarely from small vessels in the soft tissues of the mediastinum. The clinical findings depend mostly on its size and the subsequent compression of neighboring structures. The treatment of choice is surgical removal. We report the case of a 78-year-old female who presented with esophageal compression symptoms due to a 9-cm inhomogeneous mass in the posterior mediastinum. A computed tomography (CT)-guided gun biopsy and immunohistochemistry established the pathological diagnosis of leiomyosarcoma with a high grade of malignancy. Surgery was performed because of local invasion involving the aorta and diaphragm. The literature is reviewed and the pathology discussed
Aged ; Aorta ; Biopsy ; Diaphragm ; Esophagus ; Female ; Humans ; Immunohistochemistry ; Leiomyosarcoma ; Mediastinum ; Muscle, Smooth

PURPOSE: Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years. METHODS: From January 2009 to December 2013, 30 patients diagnosed with necrotizing fasciitis or Fournier's gangrene in Pusan National University Hospital were enrolled for this study. The following parameters were analyzed retrospectively: demographics, infection site, initial laboratory finding, initial antibiotics, isolated microorganisms, number of surgeries, time to first operation, length of intensive care unit, and total hospital stays. RESULTS: The overall mortality rate was 23.3%. Mean body mass index (BMI) of the survival group (24.7 ± 5.0 kg/m2) was significantly higher than the nonsurvival group (22.0 ± 1.4 kg/m2, P = 0.029). When BMI was less than 23 kg/m2, the mortality rate was significantly higher (P = 0.025). Two patients (6.7%) with chronic kidney disease requiring hemodialysis died (P = 0.048). Initial WBC count (>13×103/µL), CRP (>26.5 mg/dL), and platelet (PLT) count (<148×103/µL) were found to have negative impact on the prognosis of necrotizing soft tissue infection. Factors such as potassium level, blood urea nitrogen (>27.6 mg/dL), serum creatinine (>1.2 mg/dL) that reflected kidney function were significant mortality factors. CONCLUSION: Patients with low BMI or abnormal values of WBC count, CRP, and PLT count reflecting the degree of infection or abnormal renal function will need more intensive care.
Anti-Bacterial Agents ; Blood Platelets ; Blood Urea Nitrogen ; Body Mass Index ; Busan ; Creatinine ; Critical Care ; Demography ; Fasciitis, Necrotizing ; Fournier Gangrene ; Humans ; Intensive Care Units ; Kidney ; Length of Stay ; Mortality* ; Potassium ; Prognosis ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Soft Tissue Infections*