Fine needle biopsy of nodules on the thyroid is simple diagnostic method and it is generally a safe procedure. The main side effect is pain and hematoma. Secondary hemangioma development after biopsy is extremely rare. A 63-year-old woman presented with a 5-year history of solitary erythematous papule on neck. Spontaneous bleeding recorded six times within 5 years. There is not vascular anastomosis in ultrasonographic imaging. A histopathologic study showed vessel-like arteriole around small veins in dermis. No arteriovenous hemangioma case has been previously reported to be related to fine needle biopsy. Our case showed possibilities of arteriovenous hemangioma developments after fine needle biopsy.
Arterioles ; Biopsy ; Biopsy, Fine-Needle ; Dermis ; Female ; Hemangioma ; Hematoma ; Hemorrhage ; Humans ; Neck ; Thyroid Gland ; Veins

Neutrophilic eccrine hidradenitis (NEH) usually occurs in patients receiving chemotherapy for acute myelogenous leukemia or other malignant diseases. We experienced a case of NEH occurring in an HIV (human immunodeficiency virus)-positive 35-year-old male patient. The patient presented with a 1-year history of recurrent erythematous papule on his upper extremity. Laboratory studies showed that Anti-HIV is positive and HIV RNA PCR is 1.02x106. Histopathologic study showed neutrophilic infiltration within and around the eccrine glands and degeneration of the eccrine glands.
Acquired Immunodeficiency Syndrome ; Adult ; Eccrine Glands ; Hidradenitis ; HIV ; Humans ; Leukemia, Myeloid, Acute ; Male ; Neutrophils ; Polymerase Chain Reaction ; RNA ; Upper Extremity

BACKGROUND: With increase in the prevalence of obesity in recent years, much inferest has focused on obesity nowdays. Inerease in abdominal fatness raises mortality and morbidity of cardiovascular disease and there is some possibility that smoking has effect on obesity. We evaluated the influence of smoking on abdominal fatness. METHOD: This study was carried out on 475 individuals who visited the Health Promotion Center in Youngnam University Hospital in May, 1999. The subjects were checked on age, sex, life style (smoking, drinking, physical activity, exercise, etc.), past medical history, blood pressure, height, weight, waist circumference, hip circumference, body fat percent and other obesity indexes. RESULTS: In men, waist circumference (P<0.01), body fat percent (P<0.05), waist hip ratio (p<0.01) were significantly increased according to the amount of smoking after adjustment for BMI, age, alcohol intake, exercise and physical activity. But, the waist circumference, waist to hip ratio and percent body fat of mild smoker were rather shorter than that of the non-smoker or one who abstained from smoking. CONCLUSION: In men, it seems that obesity index of abdominal fatness may be significantly high in moderate to heavy smokers and low in mild smokers.
Abdominal Fat* ; Adipose Tissue ; Blood Pressure ; Body Fat Distribution ; Cardiovascular Diseases ; Drinking ; Health Promotion ; Hip ; Humans ; Life Style ; Male ; Mortality ; Motor Activity ; Obesity ; Prevalence ; Smoke ; Smoking* ; Tobacco Products* ; Waist Circumference ; Waist-Hip Ratio

Wilson's disease is an autosomal recessive disorder of abnormal copper metabolism. Although dysphagia is a common complaint of patients with Wilson's disease and pneumonia is an important cause of death in these patients, management of swallowing function has rarely been reported in the context of Wilson's disease. Hence, we report a case of Wilson's disease presenting with dysphagia. A 33-year-old man visited our hospital with a complaint of difficulty in swallowing, since about last 7 years and which had worsened since the last 2-3 months. He was diagnosed with Wilson's disease about 13 years ago. On the initial VFSS, reduced hyoid bone movement, impaired epiglottic movement and moderate amount of residue in the valleculae during the pharyngeal phase were noted. After 10 sessions of neuromuscular electrical stimulation for 1 hour per day, decreased amount of residue was observed in the valleculae during the pharyngeal phase on the follow-up VFSS.
Adult ; Cause of Death ; Copper ; Deglutition ; Deglutition Disorders ; Electric Stimulation ; Electric Stimulation Therapy ; Follow-Up Studies ; Hepatolenticular Degeneration ; Humans ; Hyoid Bone ; Pneumonia

Wilson's disease is an autosomal recessive disorder of abnormal copper metabolism. Although dysphagia is a common complaint of patients with Wilson's disease and pneumonia is an important cause of death in these patients, management of swallowing function has rarely been reported in the context of Wilson's disease. Hence, we report a case of Wilson's disease presenting with dysphagia. A 33-year-old man visited our hospital with a complaint of difficulty in swallowing, since about last 7 years and which had worsened since the last 2-3 months. He was diagnosed with Wilson's disease about 13 years ago. On the initial VFSS, reduced hyoid bone movement, impaired epiglottic movement and moderate amount of residue in the valleculae during the pharyngeal phase were noted. After 10 sessions of neuromuscular electrical stimulation for 1 hour per day, decreased amount of residue was observed in the valleculae during the pharyngeal phase on the follow-up VFSS.
Adult ; Cause of Death ; Copper ; Deglutition ; Deglutition Disorders ; Electric Stimulation ; Electric Stimulation Therapy ; Follow-Up Studies ; Hepatolenticular Degeneration ; Humans ; Hyoid Bone ; Pneumonia

PURPOSE: The aim of our study was to evaluate the usefulness of high-resolution CT scans in addition tohelical CT for characterizing a solitary pulmonary nodule. MATERIALS AND METHODS: Our study included 49 patientswith a solitary pulmonary nodule ; in each patient this was evaluated by both additional high-resolution CT andhelical scanning. Images were evaluated by three independent observers, each of whom read them twice : initiallywith helical CT images only and then with helical images plus high-resolution CT images. After analysis, theobservers recorded the following : histologic diagnosis, benignancy or malignancy of a nodule, and confidence intheir diagnosis (three scales). RESULTS: In differentiating benign and malignant nodules, the accuracy of helicalscans only was 75% (110/147 readings) whereas that of helical plus high-resolution CT scans was 82% (121/147readings) (p=0.001). Correct histologic diagnosis was made in 47% of cases (69/147 readings) when helical scansonly had been evaluated and in 48% of cases (71/147 readings) for which both helical and high-resolotion CT scanswere available (p=0.815). Diagnosis was more often highly confident on the basis of additional high-resolution CTscans (25%) than helical scans only (5%) (p=0.001) . CONCLUSION: By enhancing differential diagnosticaccuracy between benign and malignant nodules and by increasing confidence in the histologic diagnosis of apulmonary nodule, additional high-resolution CT scans are valuable for the evaluation of a solitary pulmonarynodule.
Diagnosis ; Humans ; Solitary Pulmonary Nodule* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

PURPOSE: To determine optimal scan time for the early phase of two-phase spiral CT and to evaluate its usefulness in the detection and assessment of extension of urinary bladder lesions. MATERIALS AND METHODS: In four normal adults, we performed dynamic scanning and obtained time-density curves for internal and external iliac arteries and veins, and the wall of the urinary bladder. Sixty patients with 68 lesions of the urinary bladder or prostate underwent precontrast and two-phase spiral CT scanning. After injection of 100ml of noninonic contrast material, images for the early and delayed phases were obtained at 60 seconds and 5 minutes, respectively. We measured CT H.U. of the wall, the lesion, and lumen of urinary bladder as seen on axial scanning, in each image in which the lesion was best shown. For the detection of bladder lesions and assessment of their extension, precontrast, early-, and delayed phase images were compared. RESULTS: Dynamic study of normal adults showed maximum enhancement of bladder wall between 60 and 100 seconds. The difference of CT H.U. between bladder wall and the lesion was greatest in the early phase. The best detection rate (98.5%) was seen during this phase, and for the detection of bladder lesion, this same phase was superior or equal (66/68,97.1%) to the delayed phase. The precontrast image was also superior or equal (31/68,45.6%) to that of the delayed phase. For the assessment of extension of bladder lesion, the early phase was superior (36/68,52.9%) to the delayed phase, and precontrast image was superior (1/68, 1.5%) to that of the delayed phase. For determining the stage of bladder cancer, the early phase was most accurate if the stages was below B2 or D, while for stage C, the delayed phase was most accurate. CONCLUSION: In two-phase spiral CT scanning, we consider the optimal time for the early phase to be between 60 and 100 seconds after injection of contrast material. For the detection and assessment of extension of urinary bladder lesion, the early phase was superior to the late phase, and for evaluation of the ureter, the delayed phase was useful. The precontrast image was inferior to that of the delayed phase. We suggest that for the detection and assessment of extension of urinary bladder lesion without scanning of the precontrast image, two-phase spiral CT is reliable.
Adult ; Humans ; Iliac Artery ; Prostate ; Tomography, Spiral Computed* ; Ureter ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Veins

PURPOSE: To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. MATERIALS AND METHODS: This study was conducted using the 2003–2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. RESULTS: Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861–$895] and $257 (95% CI: $251–$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253–$260) and $26 (95% CI: $26–$27) per person per year, respectively. CONCLUSION: Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma.
Adult ; Asthma/*economics/epidemiology/therapy ; *Cost of Illness ; *Efficiency ; *Employment ; Female ; *Health Care Costs ; Health Expenditures ; Humans ; Male ; Middle Aged ; Obesity/*economics/epidemiology/therapy ; Overweight/economics/epidemiology/therapy ; United States/epidemiology ; Young Adult

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*

Tracheoesophageal fistula (TEF) is a rare disease which develops as a result of congenital or acquired causes. We report on two TEF female stroke patients with associated endotracheal intubation. Endotracheal intubation was kept for 13-14 days because of decreased mentality by intracranial hemorrhage. Recurrent pneumonia was a predominant symptom. Computed tomography and bronchoscopy were used to diagnose TEF. Both patients expired by sepsis and recurrent pneumonia before definite TEF treatment. The excessive dilatation of the cuff balloon of the endotracheal tube was considered one of the main causes of TEF. Prevention is most important and early treatment is required in this fatal disease.
Bronchoscopy ; Dilatation ; Female ; Humans ; Intracranial Hemorrhages ; Intubation, Intratracheal* ; Pneumonia ; Rare Diseases ; Sepsis ; Stroke ; Tracheoesophageal Fistula*