In order to investigate the efficacy and safety of oral fosinopril, a new phosphorus containing angiotensin converting enzyme inhibitor, a single dose of 10 to 20mg was administered in 23 hypertensive patients with diastotic blood pressure above 95mmHg and all other anti-hypertensive agents were not administered during 4 weeks of study. Blood pressure and heart rate were measured on the 2nd and 4th week of therapy. The complete blood count with platelet count, blood chemistry by SMA-12 and serum electrolytes were performed at the begining and 4th week of therapy. The urinalysis and electrocardiography were performed at the beginning and 4th week of therapy. Any kinds of side effects were actively questioned by the examining physicians. The following results were obtained : 1) At the beginning and 4th weeks of therapy, the average systolic and diastolic pressure were 170.0+/-17.6/101.6+/-6.1mmHg, 142.7+/-15.1/87.3+/-6.7mmHg respectively. The systolic and diastolic blood pressure were declined statistically significantly(p<0.05) throughout the period of treatment and diastolic blood pressure of all subjects except 3 patients(86%) was maintained below 90mmHg after 4th week of treatment. 2) There was no significant change in the pulse rate before and after therapy. 3) There were no significant changes in blood chemistry, serum electrolytes, hematologic findings, urinalysis and electrocardiographic findigns. 4) side effect were developed in 5 patients(23%) with dry cough, 3 patients(13%) with headache and 2 patients with facial edema but side effects were mostly mild in nature without potenitally serious episodes. These results suggested that antihypertensive therapy with onec-daily fosinopril was effective and well tolerated in essential hypertensive patients.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Cough ; Edema ; Electrocardiography ; Electrolytes ; Fosinopril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Peptidyl-Dipeptidase A ; Phosphorus ; Platelet Count ; Urinalysis

OBJECTIVE: Here we describe a microsurgical method for decompression and the radiological findings of the extraforaminal entrapment of the L5 spinal nerve. METHODS: The authors reviewed the clinical and neurodiagnostic findings, surgical management, and outcomes in 53 patients with extraforaminal entrapment of L5 who had been successfully decompressed via a microsurgical paramedian tangential approach. A total of 28 women and 25men ranging in age from 54 to 73(mean age 65 years). All patients had uni- or bilateral leg pain due to extraforaminal entrapment of L5 in the lumbosacral spine. The mean follow-up period was 9 months (range 3-15 months). RESULTS: Pain was measured by the Numerical Rating Scale. The function of back was assessed by the Oswestry Disability Index score, and the patient satisfaction was evaluated by the North American Spine Society Outcome Questionnaire. Relief of back pain was obtained for all patients immediately after surgery. The mean Numerical Rating Scale improved from 8.2 before the surgery to 1.7 after the surgery (P<0.0001). The mean ODI score improved from 74.6 before the surgery to 15.3 after the surgery (P<0.0001). Overall, excellent and good result were achieved in 27(51%) and 23(43%) at the last follow-up examination. There was no complications related to the surgery, nor was any spinal instability was detected. The parasagittal T-1 weighted magnetic resonance images showed foraminal stenosis with the circumferential loss of the perineural fat signal at L5-1 level in 23 of 53(43%) patients. Radiological and operating finding showed narrowing of the extraforaminal tunnel that resulted from the annulus bulging in 36 patients(68%), disc protrusion or rupture in 17 patients(30%) and osteophytes of the vertebral body in 39 patients(74%). CONCLUSION: The paramedian tangential approach is a safe, effective procedure that avoids the risk of secondary spinal instability. This study showed that the major causes of the extraforaminal nerve root entrapment in the lumbosacral spine are the bulged annulus, the disc protrusion and osteophytes. The major pathognomonic cause of the extraforaminal L5 nerve entrapment was the bulged annulus fibrosus with the osteophytes.
Back Pain ; Constriction, Pathologic ; Decompression ; Female ; Follow-Up Studies ; Humans ; Leg ; Nerve Compression Syndromes ; Osteophyte ; Patient Satisfaction ; Surveys and Questionnaires ; Radiculopathy ; Rupture ; Spinal Nerves ; Spine*

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

No abstract available.
Dermoscopy ; Melanoma*

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, is an extremely rare case. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has increased after wider use of assisted reproductive technology. The rising incidence presents a serious problem as the diagnosis of this potentially fatal condition is often missed. Careful pelvic examination combined with serial beta-hCG determinations, and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in vitro fertilization and embryo transfer(IVF-ET) with a brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro* ; Gynecological Examination ; Incidence ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

Objectives: This study aimed to investigate the association between food insecurity and periodontitis in Korean adults. Methods: The data used for analysis were obtained from the 7th Korean National Health and Nutrition Examination Survey (2016-2018). Data were analyzed using chi-square test. Additionally, multiple logistic regression analysis was performed to assess the association between food insecurity and periodontitis. Statistical significance level was set at <0.05. Results: In models corrected for social, economic, medical, and health behavioral factors, logistic regression analysis for food anxiety and periodontitis showed a significant correlation with F4 (odds ratio [OR]: 2.22, 95% confidence interval [CI]: 1.03-4.79). Conclusions There was a significant association between food insecurity and periodontitis in Korean adults. These results show that food insecurity is associated with periodontitis, and that food stability is an essential factor in improving or managing periodontitis.

Purpose: To report a case of successful treatment of bilateral infectious keratitis combined with endophthalmitis caused by Pseudomonas aeruginosa in an immunocompromised patient.Case summary: A 66-year-old male with colon cancer and lung metastasis was referred to our clinic with ocular pain and reduced visual acuity in both eyes for 3 days. Visual acuity was “light perception” in both eyes at the first visit. On slit lamp examination, he presented with corneal central necrosis with mucopurulent discharge and anterior chamber hypopyon in both eyes. The left eye especially had vitreous haziness using a B-scan. Pseudomonas aeruginosa was detected in the corneal scrape culture and percutaneous transhepatic biliary drainage culture. After administration of topical eye drops, intravitreal injection, and systemic antibiotics, visual acuity improved from “light perception” to 20/63 in the right eye and to 20/125 in the left eye. Conclusions Although bilateral corneal ulcers combined with endophthalmitis induced by Pseudomonas aeruginosa are rare it can occur in immunocompromised patients. In the case of corneal ulcers combined with endophthalmitis, thorough ocular examinations and active treatments with intravitreal injections and systemic administration of antibiotics can help to recover vision.

Asian Continental Ancestry Group ; Child ; Diagnosis ; Female ; Fever ; Fever of Unknown Origin ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Neck ; Rare Diseases ; Young Adult

Spark’s nevus is a compound word composed of Spitz nevus and Clark’s nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark’s nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark’s nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark’s nevus in which dermoscopy was helpful for differentiating it from malignant melanoma.

Targetoid hemosiderotic nevus (THN) is a rare variant of melanocytic nevus, characterized by a sudden development of a targetoid ecchymotic halo around a pre-existing nevus. THN clinically raises concern for malignant transformation due to its abrupt change in color and size. THN should be distinguished from other diseases showing a peripheral halo, including targetoid hemosiderotic hemangioma, halo nevus, and Meyerson nevus. Dermoscopy can help clinicians to differentiate THN from these diseases. The typical dermoscopic features of THN are known to be divided into two distinctive areas: the central melanocytic area and the peripheral ecchymotic area. In our case, dermoscopy revealed a novel bull’s eye pattern composed of a central area with characteristic features of benign melanocytic nevus, an intermediated white circular ring, and a peripheral milky red area. When a sudden change occurs in a pre-existing nodule showing targetoid features, dermoscopy should be considered before conducting a biopsy or surgical intervention.