Targetoid hemosiderotic hemangioma is a benign vascular tumor with a peculiar clinical presentation and histologic features sometimes difficult to differentiate from the patch stage of Kaposi's sarcoma, progressive lymphangioma, eosinophilic hemangioma, retiform hemangioendothelioma. We report a case of targetoid hemosiderotic hemangioma on upper back and right upper arm of a 28-year-old male. He has a 5mm × 5mm sized slightly raised violaceous papule surrounded by an ecchymotic halo on upper back and right upper arm. We took a biopsy of the lesion and identified it as targetoid hemosiderotic hemangioma. This is a case of targetoid hemosiderotic hemangioma with typical clinical and histopathological findings.
Adult ; Arm ; Biopsy ; Eosinophils ; Hemangioendothelioma ; Hemangioma* ; Humans ; Lymphangioma ; Male ; Sarcoma, Kaposi

We clinically reviewed four patients who were suffering from aseptic meningitis combined with polio-like paralysis and performed radiological. neurological and virological studies on them. Three patients were admitted to the department of Pediatrics. Asan Medical Center from March to August 1990, and one patient was admitted to the department of Pediatrics. Kangnam General Hospital. The results were as follows; 1) During the period of study, 18 patients (10.1%)out of 178 aseptic meningitis patients also suffered from hand, foot and mouth disease, and three patients (1.69%) out of 178 patients also suffered from polio-like paralysis. 2) The age of the patients who also suffered from polio-like paralysis were eight months, 22 months, 23 months and four years old respectively. Three patients were male and one patient was female. 3) Paralysis developed three to five days after aseptic meningitis infection. 4) In two cases, Magnetic Resonance Imaging (MR) showed two small cavitary lesions that means anterior horn cell necrosis in concordant with residual paralysis. Axial T1-weighted image showed decreased signal intensity and axial T2-weighted image showed increased signal intensity. In another case 20 days after onset of illness MR was performed, the transverse myelitis showed mild swelling of cornus medullaris. Follow up MR in 2 months revealed atropic change in lower thoracic spinal cord. 5) The electromyography and nerve conduction velocity test revealed acute polyradiculoneuropathy. 6) Serologic virus study were carried out in three cases for Coxsackievirus A16 and Enterovirus 71. The Enterovirus 71 antibody titer were 1:128 in two cases and 1:64 in one case. The Coxsackievirus A16 antibody titer were less than 1:4. This study showed that the causative agents for polio-like paralysis during this period seemed to be the Enterovirus 71 infection.
Anterior Horn Cells ; Chungcheongnam-do ; Cornus ; Electromyography ; Enterovirus ; Female ; Follow-Up Studies ; Hand, Foot and Mouth Disease ; Hospitals, General ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Aseptic* ; Myelitis, Transverse ; Necrosis ; Neural Conduction ; Paralysis* ; Pediatrics ; Polyradiculoneuropathy ; Spinal Cord

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

Purpose: Surgery is prioritized for a splenic injury when the patient is hemodynamically unstable or the injury is severe and there is an increased risk of bleeding. This study aimed to examine the outcomes of splenectomies where a surgical stapling device was used to reduce operation time and rapidly control bleeding. Methods: This retrospective study included 53 patients who underwent a splenectomy for traumatic splenic injury at Chosun University Hospital between 2012 and 2017. Clinical outcomes including operation time (duration), blood transfusion amount (number of units), length of hospital stay, length of intensive care unit stay, and mortality rate were compared between patients who received conventional ligation [conventional group (CG)] and patients who received a splenectomy where a surgical stapling device was used [stapling group (SG)]. Results: The SG showed an average operation time of 17 minutes less than the CG, although the reduction was not statistically significant. No significant differences in estimated blood loss and blood transfusion amount were determined between the 2 groups, although the SG received 1 more unit of red blood cells for transfusion in the 48-hour post-operative period compared with the CG. One case of pancreatic fistula as a postoperative complication was reported in the SG. Conclusion The use of a surgical stapling device in a splenectomy may be considered for a hemodynamically unstable patient with splenic injury which caused severe anatomical damage.

BACKGROUND: The aim of this study was to investigate the effect of a botulinum toxin type A (BTX-A) injection in the masseter muscle using electromyography (EMG) in an animal model. METHODS: Ten male adult (>3 months of age) New Zealand white rabbits were used. Muscle activity was continuously recorded from 8 hours before to 8 hours after BTX-A injection. The rabbits received unilateral BTX-A injections of either 5 units (group 1, n = 5) or 20 units (group 2, n = 5). RESULTS: The masseter muscle activity of the rabbits was significantly reduced immediately after BTX-A injection (P < 0.05 for both groups). When the results from group 1 were compared with those from group 2, only the peak voltage was significantly decreased in group 2 (P = 0.013). CONCLUSION: Masseter muscle activity measured by EMG was immediately decreased after a BTX-A injection.
Adult ; Botulinum Toxins, Type A* ; Electromyography ; Humans ; Male ; Masseter Muscle* ; Models, Animal* ; Rabbits

OBJECTIVE: The purpose of this study is to compare the surgical and anesthetic complications of the local and general anesthesia in chronic subdural hematoma (CSDH) patients. METHODS: We retrospectively analyzed the medical record and brain CT of CSDH patients over 60-years-old, who were treated surgically in our institution between January 2005 and December 2012. RESULTS: One hundred six patients with CSDH were enrolled for this study and 61 patients had a burr hole craniostomy under the local anesthesia. In local anesthesia group, surgical complication was not increased than general anesthesia group. But in general anesthesia group, heart disease such as arrhythmia, acute myocardial infarction was relatively increased than local anesthesia group (p=0.04). And the hospitalization period of local anesthesia group was shorter than that of general anesthesia group (p=0.001). CONCLUSION: In this present study, there was no significant difference of surgical complications between the local and general anesthesia group. But the general anesthesia group had more cardiovascular complications and longer hospitalization periods. In conclusion, when we planned the burr hole craniostomy for the elderly patients with CSDH, local anesthesia should be considered more actively for postoperative prognosis.
Aged* ; Anesthesia, General* ; Anesthesia, Local ; Arrhythmias, Cardiac ; Brain ; Heart Diseases ; Hematoma, Subdural, Chronic* ; Hospitalization ; Humans ; Medical Records ; Myocardial Infarction ; Postoperative Complications ; Prognosis ; Retrospective Studies

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

Central nervous system toxicity is the most commonly recognized problem during treatment with carbamazepine (CBZ). The most common side effects of CBZ are drowsiness, incoordination, and vertigo. However, unusual conditions such as movement disorders, seizure aggravation, and encephalopathy have also been attributed to CBZ therapy. In case 1, cognitive dysfunction and exacerbation of preexisting gait disturbance were observed in a 63-year-old female who had frontal lobe epilepsy, schizencephaly, and lissencephaly treated with CBZ. The neurological symptoms were resolved 24 hours after the withdrawal of CBZ and induced with the reintroduction of CBZ. In case 2, myoclonic jerks occurred in a 37-year-old female when CBZ was readministered after a 4-day-withdrawal period of CBZ. The myoclonic jerks disappeared 12 days after CBZ was discontinued. In both cases, plasma CBZ levels were within the therapeutic range. We report two cases with encephalopathy and myoclonic jerks as unusual side effects of CBZ, with the plasma levels of CBZ being within the therapeutic range.
Adult ; Ataxia ; Carbamazepine ; Central Nervous System ; Epilepsy, Frontal Lobe ; Female ; Gait ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Middle Aged ; Movement Disorders ; Myoclonus* ; Plasma ; Seizures ; Sleep Stages ; Vertigo

OBJECTIVE: Chronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hemorrhages usually associated with trauma. Surgical treatment is the treatment of choice and burr hole trephination (BHT) is widely performed. The recurrence rate in the patients with CSDH is 3.7-30%. This study investigated the risk factors associated with the recurrence of patients with CSDH who underwent BHT. METHODS: One hundred twenty-five patients with CSDH underwent BHT. Eight of 125 patients (6.4%) underwent reoperation for recurrent CSDH. We retrospectively analyzed demographic, clinical and radiological findings, catheter tip location and drainage duration as the risk factors for the recurrence of CSDH. RESULTS: Recurrence of CSDH in the high- or mixed-density groups was significantly higher than those in the low- or iso-density groups (p<0.001). Placement of catheter tip at the temporoparietal area was associated with a significantly higher recurrence rate of CSDH than placement at the frontal area (p=0.006) and the brain re-expansion rate (BRR) was much lower than placement at the frontal area (p<0.001). CONCLUSION: The operation may be delayed in high- and mixed-density groups, unless severe symptoms or signs are present. In addition, placing the catheter tip at the frontal area helps to reduce the incidence of postoperative recurrence of CSDH and to increase the BRR.
Brain ; Butylated Hydroxytoluene ; Catheters ; Drainage ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Incidence ; Recurrence* ; Reoperation ; Retrospective Studies ; Risk Factors* ; Trephining*

PURPOSE: To investigate the accuracy and reproducibility of Optical Low Coherence Reflectometry (OLCR) corneal thickness measurements compared with the Orbscan system and ultrasound pachymeter (IOPac, Mentor). METHODS: Two examiners measured corneal thicknesses of 78 normal eyes and in 36 eyes that had undergone LASIK, and five sequential measurements of corneal thickness with OLCR, Orbscan system, Mentor, and IOPac were performed. Remeasurements of corneal thickness in 24 normal eyes were performed after two days to investigate intra-examiner reproducibility. RESULTS: The average corneal thickness measured in normal subjects was 536.3+/-23.8 micrometer in OLCR, 542.4+/-25.3 micrometer in the Orbscan system, 535.4+/-23.7 micrometer in Mentor, and 534.2+/-24.1 micrometer in IOPac. The average corneal thickness measured in patients who had undergone LASIK was 487.3+/-30.8 micrometer in OLCR, 492.5+/-36.5 micrometer in the Orbscan system, 487.5+/-30.8 micrometer in Mentor, and 485.3+/-30.8 micrometer in IOPac. There was no statistically significant difference between the four pachymeters. The inter-examiner and intra-examiner reproducibilities were shown to be highly reliable. CONCLUSIONS: The OLCR showed similar measurments of corneal thickness with the Orbscan system and ultrasound pachymeter, and showed no difference in reproducibility with different examiners.
Corneal Pachymetry* ; Humans ; Keratomileusis, Laser In Situ ; Mentors ; Ultrasonography*