Sclerosing panniculitis refers to the skin induration and hyperpigmentation of the legs that often occurs in patients who have venous insufficiency. Sclerosing panniculitis is similar to those described under the designations hypodermitis sclerodermiformis or lipodermatosclerosis. Histologically the septa of the subcutis become thickening by inflammation and fibrosis. Adipocytes coalesce to form small and large pseudocysts. Some of these are lined by refractile, amphophilic crenulated membranes. This alteration was referred to as lipomembranous change. We report a case of sclerosing panniculitis in a 40-year-old female patient presented as induration and depression of the skin and subcutaneous tissues of the lower third of the leg.
Adipocytes ; Adult ; Depression ; Female ; Fibrosis ; Humans ; Hyperpigmentation ; Inflammation ; Leg ; Membranes ; Panniculitis* ; Skin ; Subcutaneous Tissue ; Venous Insufficiency

Glaucoma cases undoubtedly represent one of the biggest ophthalmic problems in the field of public health. We analysed statistically 456 cases of the glaucoma patients among 35150 outpatients who visited to our eye department from Jan. 1982 to Dec. 1986. Diagnosis was performed by intraocular pressure, visual acuity, visual field, fundus and gonioscopic examination. The prevalence of the galucoma was 1.3% which was similar as other reports. The following results were obtained. 1. Among the 456 cases including 218 male and 238 female patients, there was no significant sexual difference statistically. 2. The age group over 40 years old occupied 65.9%. 3. The age group 4th and 6th decade in male and 6th and 7th decade in female occupied higher prevalence rate. 4. Open angle glaucoma has the highest prevalence rate. 5. Visual acuity was not significantly correlated to the latency. 6. Intraocular pressure appeared not to have significant correlation to the latency. 7. There was no significant difference in left and right eye. 8. There was significant correlation between the visual acuity and the intraocular pressure.
Adult ; Diagnosis ; Female ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Male ; Outpatients* ; Prevalence ; Public Health ; Visual Acuity ; Visual Fields

BACKGROUND: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. MATERIALS AND METHODS: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. RESULTS: The male to female ratio was 1.8: 1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7% of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3%). Intravenous immunoglobulin therapy was performed in 29 cases (64.4%). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. CONCLUSION: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.
Action Potentials ; Cerebrospinal Fluid ; Extremities ; Female ; Guillain-Barre Syndrome* ; Humans ; Immunization, Passive ; Incidence ; Male ; Muscle Weakness ; Paralysis ; Reflex, Stretch ; Respiratory Tract Infections ; Retrospective Studies ; Seasons

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is a chronic condition and accompanied by frequent relapses. We aimed to evaluate the clinical practice patterns of gastroenterologists for initial and maintenance therapy of GERD in Korea. METHODS: We administered a nationwide, multi-center, and questionnaire-based online survey between December 2007 and January 2008. The questionnaire consisted of 15 questions about prescribing patterns of initial and maintenance therapy for GERD. RESULTS: A total of 371 gastroenterologists participated in the survey with the response rate of 77%. For mild cases of GERD, the most common choice of initial therapy was full dose proton-pump inhibitors (PPIs) (59%), followed by half dose PPIs (20%), and H2 receptor antagonists (4%). For severe cases, full dose PPIs were prescribed in 99%. Almost all gastroenterologists agreed to the need for maintenance therapy. For both mild (95%) and severe (99%) cases of GERD, gastroenterologists preferred the use of PPI-based maintenance regimen. The preferred maintenance strategy for GERD was continuous therapy in erosive esophagitis (67%), and on-demand therapy in non-erosive reflux disease (68%). The overall duration of the therapy (initial+maintenance) was 7.7+/-5.1 wk in mild cases and 15.0+/-9.4 wk in severe cases. The duration of maintenance therapy was affected by symptom severity, followed by symptom frequency and endoscopic finding. CONCLUSIONS: In this study, a majority of the gastroenterologists is aware of importance on PPI-based pharmacological treatment for GERD. Further studies are needed to clarify the appropriate strategy and duration of maintenance therapy.
Adult ; Aged ; Female ; *Gastroenterology ; Gastroesophageal Reflux/*drug therapy ; Humans ; Male ; Middle Aged ; Online Systems ; *Physician's Practice Patterns ; Proton Pump Inhibitors/therapeutic use ; Questionnaires ; Republic of Korea ; Time Factors

Chronic colonic pseudo-obstruction is a rare disease that results in colorectal dilatation without any obstructing lesions. Colonic dilatation does not usually cause colonic wall thickening and colonic visceral myopathy with muscular hypertrophy has not been reported in Korea. A 31-year-old female patient was transferred for treatment of refractory constipation accompanied by megacolon. She had suffered from recurrent attacks of severe abdominal pain with the sensation of a mass in the left lower quadrant. An abdominal CT revealed a large luminal dilatation of the sigmoid colon where massive stool was impacted. There was no obstructing lesion or luminal dilatation of the rectum. To relieve her refractory symptoms, a total colectomy with an ileorectal anastomosis was performed. Pathologic examination of the sigmoid colon revealed that the muscle layers were dysplastic and hypertrophied, and the innervations into the muscle fibers were markedly decreased. She was discharged without any intra-abdominal symptoms.
Abdominal Pain ; Adult ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Pseudo-Obstruction ; Constipation ; Dilatation ; Female ; Humans ; Hypertrophy ; Intestinal Pseudo-Obstruction ; Korea ; Megacolon ; Muscles ; Phenobarbital ; Rare Diseases ; Rectum ; Sensation

Pityriasis rubra pilaris is a rare papulosquamous and keratotic disease. The orange hue to the erythema, the thickening of the palms and soles and so called 'islands of normal skin' contribute to establish the diagnosis based on morphologic features. We present a 6-month-old male patient with multiple scaly erythematous patches and 'island of normal skin' on the face. There is no palmoplantar keratoderma, nor onychopathy. Histopathologic findings revealed alternating parakeratosis and hypergranulosis in the epidermis and mild perivascular lymphocytic infiltration in the dermis. Unlike to Griffiths classification, he showed good responses to topical steroid and UV phototherapy.
Citrus sinensis ; Classification ; Dermis ; Diagnosis ; Epidermis ; Erythema ; Humans ; Infant* ; Keratoderma, Palmoplantar ; Male ; Parakeratosis ; Phototherapy ; Pityriasis Rubra Pilaris* ; Pityriasis*

PURPOSE: To compare the accuracy and clinical usefulness of different devices by measuring anterior chamber depth (ACD) with three devices and central corneal thickness (CCT) with four devices. METHODS: In 180 eyes of 90 healthy subjects, ACD was measured using A-scan, Lenstar LS900®, Pentacam®, and CCT was measured using ultrasound pachymetry (USP), Lenstar LS900®, Pentacam®, and anterior segment optical coherence tomography (OCT). RESULTS: The average ACT measurements using Lenstar LS900®, A-scan, and Pentacam® were 3.27 ± 0.35 mm, 3.26 ± 0.36 mm, and 3.25 ± 0.36 mm, respectively. The measurements were significantly correlated (p < 0.001) but without statistically significant difference (p = 0.017). The Bland-Altman plots showed a low degree of agreement. The average CCT measurements using Pentacam®, USP, Lenstar LS900®, and OCT were 553.31 ± 25.23 µm, 547.26 ± 23.83 µm, 541.38 ± 24.49 µm, and 531.40 ± 22.33 µm, respectively. The measurements were significantly correlated (p < 0.001) and statistically significantly different (p < 0.05). The Bland-Altman plots showed a low degree of agreement. CONCLUSIONS: ACD and CCT measured using different devices were highly correlated, but the ACD measurements were not statistically different; however, the CCT measurements were statistically different, and agreement was low between both measurements.
Anterior Chamber* ; Healthy Volunteers ; Tomography, Optical Coherence ; Ultrasonography

Asian eyes may have a narrow palpebral fissure and an upward Mongolian slant that is sometimes perceived as an angry or unfavorable expression. Among the various methods of oculoplastic surgery, lateral canthoplasty can alter the structure of the eyes such that they appear much bigger, thereby conveying a more favorable expression. We performed a lateral canthoplasty in which the lower eyelid tarsus was fixed to the periosteum while the lateral canthus was moved downward and backward. Here, we describe the surgical procedure we used to perform this technique.
Ankle ; Asian Continental Ancestry Group ; Blepharoplasty ; Cosmetic Techniques ; Eyelids ; Humans ; Lacrimal Apparatus ; Periosteum*

Asian eyes may have a narrow palpebral fissure and an upward Mongolian slant that is sometimes perceived as an angry or unfavorable expression. Among the various methods of oculoplastic surgery, lateral canthoplasty can alter the structure of the eyes such that they appear much bigger, thereby conveying a more favorable expression. We performed a lateral canthoplasty in which the lower eyelid tarsus was fixed to the periosteum while the lateral canthus was moved downward and backward. Here, we describe the surgical procedure we used to perform this technique.
Ankle ; Asian Continental Ancestry Group ; Blepharoplasty ; Cosmetic Techniques ; Eyelids ; Humans ; Lacrimal Apparatus ; Periosteum*

BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
Anti-Bacterial Agents ; beta-Lactamases* ; Drug Resistance, Multiple* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units* ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Sepsis* ; Urinary Tract ; Urinary Tract Infections