Kimura's disease is an uncommon, chronic inflammatory disorder of unknown etiology that is seen in an endemic form in the Orient. It usually presents as a mass in the subcutaneous tissue of the head and neck region or the major salivary glands, and is often associated with a regional lymphadenopathy. The patients have peripheral blood eosinophilia and elevated IgE levels but are otherwise usually healthy. We encountered the case of a 33-year-old man who had a soft tissue mass in his left distal arm which was diagnosed as being Kimura's disease.
Adult ; Arm* ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Lymphatic Diseases ; Neck ; Salivary Glands ; Subcutaneous Tissue

No abstract available.
Intellectual Disability ; Muscle Weakness ; Muscular Dystrophy, Duchenne*

We review 66 patients with lower caliceal stones treated with extracorporeal shock wave lithotipsy. One of the major problems involved with extracorporeal shock wave lithotripsy is the high rate of residual stone fragments in the lower calices. We observed the influence of the presence of lower caliceal dilatation, hydronephrosis, and the size of alone on the passage of stone. Thirty-nine of the 66 patients with a lower caliceal stone and no stone fragments. The success rate was only 59 per cent. The stone was completely fragmented in 59 of 66 (89%) patients. Thirty-nine of 59 patients who had completely fragmented stones. had no residual fragments. The patients who had no lower caliceal dilatation and a relativgly small size stone (less than 1.5 x 1.0 cm). such as in group 4. had a high success rate of 70%. The patients with a large stone or the presence of caliceal dilatation. were expected to low success rate, therefore there was a need for repeated treatment with extracorporeal shock wave lithotripsy and combined treatment with percutaneous nephrostomy.
Dilatation ; Humans ; Hydronephrosis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

No abstract available.
Humans ; Infant, Newborn* ; Osmolar Concentration* ; Specific Gravity*

No abstract available.
Animals ; Brain* ; Pineal Gland* ; Rats*

Purpose: We present a case of internal astigmatism correction using a toric scleral contact lens in a patient with high myopia after implantable collamer lens (ICL) surgery.Case summary: A 45-year-old man presented with a significant decrease in visual acuity despite previous ICL surgery. Initial attempts to fit a corneal rigid gas permeable contact lens to the left eye were unsuccessful due to fitting challenges. Subsequently, the use of a spherical scleral contact lens effectively corrected corneal astigmatism but failed to address internal astigmatism, thereby limiting improvement in visual acuity. Postoperative corneal ectasia and ICL rotation were suspected to be the underlying causes of this astigmatism. The introduction of a front toric scleral lens resulted in a significant improvement in visual acuity and sustained comfort throughout the 3-month follow-up period. Conclusions The use of toric scleral lenses can significantly improve visual acuity and provide exceptional comfort in cases where corneal morphology and lens position change after ICL surgery. This modality presents a promising alternative for future consideration.

Pityriasis lichenoides Chronica is a cutaneous disorder of unknown etiology and characterized pathologically by vasculitis and clinically by its marked chronicity and lack of specific treatment. Emollient-phototherapy is a recently introduced effective treatment for psoriasis. The authors treated 3 patients with pityriasis lichenoides chronica by the emollient-phototherapy technic with quite satisfactory results.

Purpose: We report a case of probable posterior ischemic optic neuropathy in a patient with acute fungal sinusitis.Case Summary: An 81-year-old male patient presented with sudden-onset visual loss in his left eye 3 weeks prior to presentation. His best corrected visual acuity was 0.6 in his right eye and light perception in his left eye. Pupillary size was 3 mm in both eyes, and a relative afferent pupillary defect was detected in his left eye. In fundus examination, diabetic retinopathy was found, and cup/disc ratios were increased in both eyes, but disc swelling and hemorrhage were not observed. Fluorescein angiography did not indicate filling delay, defects, or leakage of discs in either eye. Magnetic resonance imaging of the brain revealed multi-sinusitis in the sphenoid, ethmoid, and frontal sinuses. No bony defects or erosion were found around the optic canal or orbital apex during endoscopic surgery; however, histological examination revealed aspergillosis. The patient was diagnosed with posterior ischemic optic neuropathy caused by acute fungal sinusitis. Conclusions When elderly patients with uncontrolled diabetes experience sudden visual disturbances without ocular pain, posterior ischemic optic neuropathy with fungal sinusitis should be considered as a differential diagnosis. Immediate imaging studies and appropriate treatment should be performed.

PURPOSE: This survey was intended to investigate the awareness and application of the asthma guideline among pediatricians. Insight into the feasibility in the guidelines can guide implementation strategies in the future and, if necessary, support the revision of the previous guideline. METHODS: This self-administered survey study was conducted with the data on 10 items of questionnaire about knowledge and implementation of Korean childhood asthma guideline. The data was analyzed using SPSS WINDOW 8.0. RESULTS: A total of 141 doctors out of 500 participants in the pediatric refresh course responded the questionnaire. Ninety-five percent of the responders were aware of guideline, but differences were found between the asthma management policies in the guideline and their habitual practice patterns. As far as the prescription of inhaled corticosteroid, approximately half of the responders followed the guideline. For peak flowmeter use, 57% of the responders never prescribed peak flowmeter and only 5% of the responders used peak flowmeter frequently. The barriers pediatricians face when applying the guideline in the practice were habitual management pattern, time limitation, low compliance, lack of knowledge and economic burden. CONCLUSION: The guideline for diagnosis and management of childhood asthma seemed to be recognized widely, however, the role of the guideline to change pediatricians habitual practice was limited. These data clearly indicate a need for further educational programs directed to both physicians and patients. Finally the development of more practical evidence- based guideline is needed
Asthma* ; Compliance ; Diagnosis* ; Flowmeters ; Humans ; Prescriptions ; Surveys and Questionnaires