We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiomyopathies ; Extracorporeal Membrane Oxygenation* ; Extremities ; Heart Transplantation* ; Heart* ; Humans ; Mediastinitis* ; Myocardial Infarction ; Perfusion ; Shock ; Transplantation ; Wound Infection

Objectives: . Studies on the aeroallergen sensitization status of South Koreans based on large-scale data are lacking. Methods: . We analyzed data from 368,156 multiple allergosorbent tests collected by a domestic medical diagnosis company from 3,735 hospitals nationwide from 2018 to 2021. We additionally collected sex, age, and regional data. If the level of an aeroallergen was 0.35 IU/mL or more, the test result for that aeroallergen was defined as positive, and positive cases were defined as those where one aeroallergen was positive. The positive ratio (PR) for aeroallergens was calculated using positive cases. Results: . In total, 347,996 cases were analyzed, excluding cases with missing data. The percentage of positive cases was 56.7%, which was highest in adolescents (74.1%) and lowest in the elderly (47.0%). All four types of mites had high PRs (0.382–0.655), and mold had low PRs (0.023–0.058). Among pollens, the PRs of grasses were generally high (more than 0.14), followed by weeds (approximately 0.10), and the PRs of woods was less than 0.1. For animals, cats and dogs had the highest PRs, at 0.231 and 0.183, respectively. The value for cockroaches was also high, at 0.211. The PRs of indoor aeroallergens, such as mites, molds, and animals, were high in adolescents, and those of pollen and cockroaches were high in the elderly. In Jeju, the PR of Japanese cedars was extremely high (0.222). Conclusion . Koreans were found to be sensitized to a wide variety of aeroallergens. There were significant differences in sensitization patterns according to age and region.

Melorheostosis is a rare disorder characterized by irregular, flowing hyperostosis in long bones, commonly described on radiographs as wax flowing down a candle. In addition to bony sclerosis, cutaneous manifestations overlying the involved bones have been reported including linear scleroderma, neurofibromatosis, and vascular and lymphatic malformations. Unilateral nevoid telangiectasia (UNT) is a rare primarily cutaneous condition characterized by linearly arranged small dilated blood vessels in dermatomal or Blaschkoid patterns on the skin. Here, we present the case of a nine-year-old Korean male with UNT associated with ipsilateral melorheostosis.
Blood Vessels ; Humans ; Hyperostosis ; Male ; Melorheostosis ; Neurofibromatoses ; Scleroderma, Localized ; Sclerosis ; Skin ; Telangiectasis

Behcet's disease is a chronic relapsing multisystemic inflammatory disorder characterized by four major symptoms (oral aphthous ulcers, genital ulcers, skin lesions, and ocular lesions) and occasionally by five minor symptoms (arthritis, gastrointestinal ulcers, epididymitis, vascular lesions, and central nervous system symptoms). Although the etiology of Behcet's disease is still unknown, there have been recent advances in immunopathogenic studies, genome-wide association studies, animal models, diagnostic markers, and new biological agents. These advances have improved the clinical understanding of Behcet's disease and have enabled us to develop new treatment strategies for this intractable disease, which remains one of the leading causes of blindness.
Animals ; *Behcet Syndrome/epidemiology/immunology/therapy ; Biological Therapy/*trends ; Disease Models, Animal ; Humans ; Prevalence ; *World Health

The concept of oriental medicine is according to the Yin-Yang Doctrine and the Five Elements theory which is based on oriental philosophy. Traditionally, doctors of oriental medicine have practiced by feeling pulses for diagnosis, acupuncturing, and prescribing herbal medicine for treatment. Nowadays, however, most oriental doctors are having hard time in managing their own clinics by progressive worsening of the medical environment, because the numbers of patients are absolutely decreasing, but the numbers of oriental clinics are relatively increasing. Therefore, they are intending to overcome the difficulties by enlarging their field of medical treatment in various aspects, and introducing treatment remedies including unreasonable or unproved methods, especially into the field of dermatology. Here we present a case of multiple scarring of the face following removal of pigmented nevi by acupuncture in an oriental clinic. We report this case to emphasize the necessity of understanding the current status of dermatologic treatments conducted in oriental clinics, and to inform the dangerousness and correct medical information to the public.
Acupuncture ; Cicatrix ; Dangerous Behavior ; Dermatology ; Herbal Medicine ; Humans ; Medicine, East Asian Traditional ; Nevus, Pigmented ; Philosophy ; Yin-Yang

BACKGROUND: The sensitivities and specificities of interferon-gamma release assays (IGRAs) vary among different population studies, and the data on the routine use of IGRAs are limited. The aim of this study was to evaluate the role of QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of active tuberculosis. METHODS: We conducted a prospective study, enrolling 77 patients with suspected pulmonary tuberculosis (TB), at a secondary care teaching hospital in Seoul. RESULTS: In total, 12 (15.6%) patients showed indeterminate results due to positive control failure on the QFT-GIT test. Indeterminate results were significantly associated with the elderly, history of the intensive care unit stay, lymphocytopenia, especially low CD4 count, increased C-reactive protein and decreased protein levels. Of the 77 patients, 44 (57.1%) were diagnosed with active pulmonary tuberculosis, and the percentage of false negative results of the QFT-GIT was 36.4% (vs. 31.8% with TST). In the TB group with >65 years old (n=12), the proportions of the indeterminate (33.3% vs. 3.1%) and the false negative results (58.3% vs. 25.0%) of the QFT-GIT were significantly higher than in the younger TB group (n=32). CONCLUSION: Indeterminate and false negative results of QFT-GIT test were not infrequent in tuberculosis, especially in the elderly. Care should be considered for the interpretation with the elderly, immunocompromised, chronic and severely diseased patients.
Aged ; C-Reactive Protein ; CD4 Lymphocyte Count ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Interferon-gamma Release Tests ; Lymphopenia ; Prospective Studies ; Secondary Care ; Tuberculin Test ; Tuberculosis ; Tuberculosis, Pulmonary

We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiomyopathies ; Extracorporeal Membrane Oxygenation ; Extremities ; Heart Transplantation ; Heart ; Humans ; Mediastinitis ; Myocardial Infarction ; Perfusion ; Shock ; Transplantation ; Wound Infection

Cutaneous pseudolymphoma is a heterogeneous group of benign reactive T-cell or B-cell lymphoproliferative process, which clinically and histologically simulates cutaneous lymphomas. A few cases of pseudolymphomas, showing atypical clinical forms, have been reported previously in the literature, but are rare. A 23-year old male was presented with 4-year duration of cutaneous lesion on the right retroauricular area. On physical examination, about a 2x1 cm sized erythematous, elevated and protruded, firm nodule was seen. The cutaneous lesion resembled the appearance of keloid, but the patient did not have any obvious history of trauma. A punch biopsy was performed, and histologically, the lesion was diagnosed as cutaneous pseudolymphoma. After a single treatment of triamcinolone acetonide intralesional injection, the lesion was almost cleared. In this report, we present an interesting case of pseudolymphoma with a clinical finding resembling the appearance of keloid in a patient without any traumatic history.
B-Lymphocytes ; Biopsy ; Humans ; Injections, Intralesional ; Keloid ; Lymphoma ; Male ; Physical Examination ; Pseudolymphoma ; T-Lymphocytes ; Triamcinolone Acetonide

A 53-year-old male presented with a 6-year duration of a child's-palm sized hypopigmented patch located on his neck. He had a history of surgical excision of an epidermal cyst on the neck, and the hypopigmented patch developed about one month after the excision next to the surgery site. Application of cold or heat did not make the lesion distinct from the surrounding skin. Pressure on the lesion by a glass slide made the lesion indistinguishable from surrounding uninvolved lesions. Giving friction to the lesion failed to induce erythematous change, making it clearly visible. Histologically, the lesion showed normal findings with adequate numbers of melanocytes in the basal layer. Herein, we present an interesting case of an acquired anemic patch which developed after a cyst excision. We postulate that nerve damage after surgery that regulates the vascular tone of cutaneous vessels may have been an inducing event of the anemic patch in this patient.
Cold Temperature ; Epidermal Cyst ; Friction ; Glass ; Hot Temperature ; Humans ; Male ; Melanocytes ; Middle Aged ; Neck ; Nevus ; Skin

Acrodermatitis continua of Hallopeau (ACH) is a rare form of acropustular eruption characterized by a presence of aseptic pustules on inflammatory periungual or subungual regions. Frequently accompanied by paronychia, atrophic skin changes, onychodystrophy, and osteolysis of distal phalanges of the digits, it is considered to be a variant of pustular psoriasis with a chronic relapsing course and refractoriness to many therapeutic modalities. Here, we present a case of a 45-year-old female who presented with multiple pustules pathologically diagnosed as pustular psoriasis on her left thumb. She suffered from ACH for over a decade, and in the process experienced frequent relapses and showed poor response to numerous treatment modalities such as narrow band UVB, topical steroid, steroid intralesional injection, oral retinoids, 308 nm excimer laser, and oral immune suppressants. However, the patient showed dramatic clinical improvements to administration of etanercept (TNF-alpha antagonist, twice a week) for a period of one month. The cessation of etanercept led to recurrence of symptoms and marked deterioration of the skin lesion within a month again, but the re-initiation of treatment soon relieved the problem. After completion of a three months trial of etanercept, the cutaneous lesion subsided, and the patient is now successfully controlled with topical steroid maintenance therapy. Hereby, we report a patient with ACH successfully treated with etanercept.
Acrodermatitis ; Female ; Humans ; Immunoglobulin G ; Injections, Intralesional ; Lasers, Excimer ; Middle Aged ; Osteolysis ; Paronychia ; Psoriasis ; Receptors, Tumor Necrosis Factor ; Recurrence ; Retinoids ; Skin ; Thumb ; Etanercept