Trichophyton tonsurans is an anthropophilic dermatophyte that is not yet truly prevalent in Korea. Especially, cases of toe nail infection during childhood are very rare, and no cases have been reported prior to this report. We report a single case of tinea unguium due to T. tonsurans in a healthy child. A 7 year-old patient visited an outpatient clinic presenting with subungual hyperkeratosis of the 1st and 3rd Rt. toe nails, which had first presented at an age of 28 months, and no other symptoms. Numerous hyphae were evident on the KOH smear examination. A confirmative diagnosis of tinea unguium cased by T. tonsurans was made after culturing scales from the toe nail lesion. The patient is currently undergoing follow-up, after being treated with oral terbinafine hydrochloride, without a relapse in symptoms.
Ambulatory Care Facilities ; Arthrodermataceae ; Child ; Follow-Up Studies ; Humans ; Hyphae ; Korea ; Nails ; Naphthalenes ; Onychomycosis ; Polyenes ; Recurrence ; Toes ; Trichophyton ; Weights and Measures

Acquired idiopathic generalized anhidrosis (AIGA) is a very rare disease, and its pathogenesis is poorly understood. We here report on a 20-year-old man presenting with a history of inability to sweat, small wheals, and occasional heat intolerance since 3 months. On provocation test, there was no sweating over the entire surface of the body, excluding the palms and axillae. His medical history was unremarkable and laboratory examination findings were all normal. There was no familial history suggestive of neuroendocrine disease. Based on these findings, we diagnosed acquired idiopathic generalized anhidrosis. To our knowledge, this is the first case of AIGA in Korean dermatologic literature. Herein, we report a rare case of AIGA.
Axilla ; Hot Temperature ; Humans ; Hypohidrosis* ; Rare Diseases ; Sweat ; Sweating ; Young Adult

We intended to describe a case of cerebral coenurosis in a long-tailed goral, Naemorhedus caudatus, from Hwacheon-gun, Gangwon-do (Province), in the Korea. The goral, a 10-year-old male, was suffering from neurological symptoms, such as turning the circle to one side without lifting the head straight, and died at 30 days after admission to the wildlife medical rescue center in Chuncheon-si, Gangwon-do. A fluid-filled cyst was detected in the left cerebral hemisphere by computed tomography and magnetic resonance imaging. The cyst removed from the deceased goral was transparent, about 3×3 cm in size, contained a clear fluid and approximately 320 protoscolices invaginating from the internal germinal layer. The protoscolex had 4 suckers and a rostellum with 28 hooklets arranged in 2 rows. By the present study, a case of cerebral coenurosis was first confirmed in a long-tailed goral, N. caudatus, from Gangwon-do, in Korea. The residents frequently exposed in the sylvatic environment should be careful the accidental infections of zoonotic metacestode of Taenia multiceps, Coenurus cerebralis, in Korea.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. It is mainly found in the stomach and small intestine. Based on tumor size and mitotic index, it is classified into very low risk, low risk, intermediate risk and high risk. Generally, the recurrence of low risk GIST is extremely rare, but the recurrence rate can be different according to its location. Recently, it has been reported that the recurrence rate of low risk small bowel GIST is higher than the recurrence rate of low risk stomach GIST. We report a hepatic recurrence of low risk duodenal GIST that was removed completely through pancreaticoduodenectomy 11 years earlier. Regular long term follow-up must be considered, even for low risk GISTs.
Duodenum ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Intestine, Small ; Liver ; Mitotic Index ; Pancreaticoduodenectomy ; Recurrence* ; Stomach

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. It is mainly found in the stomach and small intestine. Based on tumor size and mitotic index, it is classified into very low risk, low risk, intermediate risk and high risk. Generally, the recurrence of low risk GIST is extremely rare, but the recurrence rate can be different according to its location. Recently, it has been reported that the recurrence rate of low risk small bowel GIST is higher than the recurrence rate of low risk stomach GIST. We report a hepatic recurrence of low risk duodenal GIST that was removed completely through pancreaticoduodenectomy 11 years earlier. Regular long term follow-up must be considered, even for low risk GISTs.
Duodenum ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Intestine, Small ; Liver ; Mitotic Index ; Pancreaticoduodenectomy ; Recurrence* ; Stomach

PURPOSE: Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus, which occurs frequently in liver transplant recipients with impaired cellular immunity. The purpose of this study was to evaluate the incidence and risk factors for HZ after adult liver transplantation (LT). METHODS: In our institution, 993 patients underwent adult LT from January 1997 to December 2013. We retrospectively analyzed the incidence rate of HZ and risk factors for HZ after LT. RESULTS: Of 993 LT recipients, 101 (10.2%) were diagnosed with HZ. The incidence of HZ at 1, 3, 5, and 10 years was 6.6%, 9.1%, 10.0%, and 11.9%, respectively. Therefore, we observed that the incidence of HZ after LT was 16.3 per 1,000 person-years. Older age (≥50 years) at LT and mycophenolate mofetil (MMF) exposure were independent risk factors of HZ infection after adult LT. CONCLUSION: Patients older than 50 years or with MMF exposure are considered to be at high risk for HZ. Therefore, adult liver recipients with such factors should not be given strong immunosuppression treatments.
Adult ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Immunosuppression ; Incidence ; Liver Transplantation ; Liver ; Retrospective Studies ; Risk Factors ; Transplant Recipients

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Colon cancer is very rarely accompanied by tumor thrombosis of the superior mesenteric vein (SMV). A 46-year-old patient had been diagnosed with SMV tumor thrombosis related to colon cancer without hepatic metastasis and underwent right hemicolectomy with SMV tumor thrombectomy. Tumor thrombosis was pathologically confirmed as metastatic colon cancer. There has been no recurrence for 12 months with 12 cycles of adjuvant-chemotherapy.
Colon, Ascending ; Colonic Neoplasms ; Humans ; Mesenteric Veins ; Middle Aged ; Neoplasm Metastasis ; Recurrence ; Thrombectomy ; Thrombosis