Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

Leukocytoclastic vasculitis is a small vessel inflammatory disease, mediated mostly by deposition of immune complexes. Medications cause 10~24% of cases of leukocytoclastic vasculitic skin lesions, but warfarin has rarely been implicated. We report a case of warfarin-induced leukocytoclastic vasculitis in a 72-year-old woman which developed 45 days after warfarin medication. Palpable purpura, hemorrhagic vesicles, and ulcers developed on both lower legs. A skin biopsy showed characteristic features of leukocytoclastic vasculitis. Warfarin was replaced by clopidogrel, and the skin lesions gradually disappeared after 3 weeks.
Aged ; Antigen-Antibody Complex ; Biopsy ; Female ; Glycosaminoglycans ; Humans ; Leg ; Purpura ; Skin ; Ticlopidine ; Ulcer ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Warfarin

Decubitus ulcer is a pressure-induced ischemia-reperfusion injury overlying a bony prominence. Various dressing methods have been developed to treat it, but clinical management is still a challenging practice. A patient presented with stage IV decubitus ulcer on the left lateral side of the buttock, which was caused by compulsively lying down on the left side due to schizophrenia. The ulcer was resistant to occlusive dressing method for five weeks. However, the patient successfully recovered in three weeks by our applying a negative pressure dressing with the portable vacuum-assisted closure (VAC) system. Our experience shows negative pressure dressing can be effectively used to treat intractable decubitus ulcer in outpatient settings.
Bandages ; Buttocks ; Deception ; Humans ; Negative-Pressure Wound Therapy ; Occlusive Dressings ; Outpatients ; Pressure Ulcer ; Reperfusion Injury ; Schizophrenia ; Ulcer

PURPOSE: Each ethnic group has a unique life style, including diets. Life style affects bowel movement. The aim of this study is to describe the results of colon transit time (CTT) tests in Korean children who had chronic functional constipation based on highly refined data. METHODS: One hundred ninety (86 males) out of 415 children who performed a CTT test under the diagnosis of chronic constipation according to Rome III criteria at Konkuk University Medical Center from January 2006 through March 2015 were enrolled in this study. Two hundreds twenty-five children were excluded on the basis of CTT test result, defecation diary, and clinical setting. Shapiro-Wilk and Mann-Whitney U, and chi-square tests were used for statistical analysis. RESULTS: The median value and interquartile range (IQR) of CTT was 54 (37.5) hours in Encopresis group, and those in non-encopresis group was 40.2 (27.9) hours (p<0.001). The frequency of subtype between non-encopresis group and encopresis was statistically significant (p=0.002). The non-encopresis group (n=154, 81.1%) was divided into normal transit subgroup (n=84, 54.5%; median value and IQR of CTT=26.4 [9.6] hours), outlet obstruction subgroup (n=18, 11.7%; 62.4 [15.6] hours), and slow transit subgroup (n=52, 33.8%; 54.6 [21.0] hours]. The encopresis group (n=36, 18.9%) was divided into normal transit subgroup (n=8, 22.2%; median value and IQR of CTT=32.4 [9.9] hours), outlet obstruction subgroup (n=8, 22.2%; 67.8 [34.8] hours), and slow transit subgroup (n=20, 55.6%; 59.4 [62.7]hours). CONCLUSION: This study provided the basic pattern and value of the CTT test in Korean children with chronic constipation.
Academic Medical Centers ; Child* ; Colon* ; Constipation* ; Defecation ; Diagnosis ; Diet ; Encopresis ; Ethnic Groups ; Humans ; Korea ; Life Style

BACKGROUND: Xanthelasma palpebrarum is the most common type of xanthoma. Due to its delicate location near the eye, treatment of xanthelasma palpebrarum is rather difficult. The treatment includes surgical excision, local treatment with chemicals, and various laser therapies. OBJECTIVE: This study was designed to review the various therapeutic modalities and to evaluate the efficacy and safety of bichloroacetic acid (BCA) for the treatment of xanthelasma palpebrarum. METHODS: Nine patients, with a total of 19 xanthelasma lesions, were treated with BCA. The efficacy and safety were assessed over a follow-up period of 6 to 24 months (average, 16 months). RESULTS: All lesions were grossly removed completely with a single treatment and the treatment was well-tolerated by patients. Erythema and oozing were observed in six patients but improved after two weeks' dressing. Xanthelasma palpebrarum recurred in three patients, but the mean size of the recurred lesions was smaller in comparison to the primary lesion. CONCLUSION: BCA is an effective and safe therapeutic modality for xanthelasma palpebrarum. Advantages include simplicity, cost-effectiveness, speed, safety and efficacy.
Bandages ; Dichloroacetic Acid* ; Erythema ; Follow-Up Studies ; Humans ; Laser Therapy ; Xanthomatosis

Dermatofibrosarcoma protuberance is a relatively rare malignant soft tissue tumor which is locally invasive and looks like a protruded hardened plaque composed of multiple nodules. It seldom occurs on the scalp and the occurrence rate is less than 5%. Nowadays there is a tendency to choose Mohs surgery as a primary treatment instead of a wide excision, because Mohs surgery can reduce cases of recurrence. We report a case of multiple dermatofibrosarcoma protuberans on the scalp of a 32-year-old man. We planned a delayed operation using tissue expanders. We inserted two skin expanders and successfully expanded scalp tissue more than 150% after 7 months. Mohs surgery was performed with a 4 cm distance from borderline of lesions and then the large scalp skin defect was covered by the expanded skin which had been prepared by tissue expanders. It has been 9 months since the operation was performed and there have been no signs of recurrence.
Adult ; Dermatofibrosarcoma* ; Humans ; Mohs Surgery* ; Recurrence ; Scalp* ; Skin ; Tissue Expansion Devices ; Tissue Expansion*

OBJECTIVES: The purposes of this study were to identify the factors that affect the health-related quality of life (HRQoL) of the elderly with chronic diseases and to subsequently develop from such factors a prediction model to help identify HRQoL risk groups that require intervention. METHODS: We analyzed a set of secondary data regarding 716 individuals extracted from the Korea National Health and Nutrition Examination Survey from 2008 to 2010. The statistical package of SPSS and MATLAB were used for data analysis and development of the prediction model. The algorithms used in the study were the following: stepwise logistic regression (SLR) analysis and machine learning (ML) techniques, such as decision tree, random forest, and support vector machine methods. RESULTS: Five factors with statistical significance were identified for HRQoL in the elderly with chronic diseases: 'monthly income', 'diagnosis of chronic disease', 'depression', 'discomfort', and 'perceived health status.' The SLR analysis showed the best performance with accuracy = 0.93 and F-score = 0.49. The results of this study provide essential materials that will help formulate personalized health management strategies and develop interventions programs towards the improvement of the HRQoL for elderly people with chronic diseases. CONCLUSIONS: Our study is, to our best knowledge, the first attempt to identify the influencing factors and to apply prediction models for the HRQoL of the elderly with chronic diseases by using ML techniques as an alternative and complement to the traditional statistical approaches.
Aged* ; Chronic Disease* ; Complement System Proteins ; Decision Trees ; Humans ; Korea ; Logistic Models ; Machine Learning* ; Nutrition Surveys ; Quality of Life* ; Statistics as Topic ; Support Vector Machine

PURPOSE: The prevalence of type 2 diabetes mellitus (T2DM) and obesity are currently increasing. Accordingly, the concept of "preventing diabetes" in high-risk groups has become more important in diabetic care, but the use of glycated hemoglobin (HbA1c) as a measure has limitations in this field. The aim of this study was to investigate the utility of 1,5-anhydroglucitol (1,5-AG) in assessing prediabetes status in obese children. METHODS: The medical records of 74 subjects aged 6-19 years (of which 27 were overweight/obese and 47 had diabetes) who had 1,5-AG data were reviewed retrospectively. We compared 1,5-AG with HbA1c using the Pearson correlation test to assess the clinical utility of 1,5-AG. RESULTS: 1,5-AG levels were higher (31.1+/-10.1 microg/mL vs. 7.4+/-7.3 microg/mL) and HbA1c levels were lower (5.5%+/-0.3% vs. 8.9%+/-2.7%) in the overweight/obese group than in the diabetics group. The range of 1,5-AG levels in obese children was wide (16.8-59.3 microg/mL), and did not have significance with HbA1c. A negative correlation between 1,5-AG and HbA1c was significant in the entire subject (r=-0.822, P<0.001), and also in the HbA1c range of 5.5% to 8% (r=-0.736, P<0.001). CONCLUSION: 1,5-AG is a valuable index in the HbA1c range of 5.5%-8% and it might be considered an early glycemic control index in insulin-resistant obese children with an HbA1c level above 5.5%. Moreover, the 1,5-AG level assessment should be presented as a supplementary tool for better compliance, as well as being an improvement in diabetes management for the short-term glucose control in relatively well-controlled diabetes patients with an HbA1c level below 8%.
Child ; Compliance ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucose ; Hemoglobin A, Glycosylated ; Humans ; Medical Records ; Obesity ; Pediatric Obesity* ; Prediabetic State ; Prevalence ; Retrospective Studies