Posterior epidural migration of a sequestrated intervertebral lumbar disc is rare with only five cases ever reported in the literature so far. The objective of this paper is to report our experience of such a extremely rare case with a review the literature

Seborrheic keratosis is a benign epithelial neoplasia that occurs mainly in the skin of the eyelids and face. We describe a case of seborrheic keratosis of the conjunctiva confirmed by histopathology. A 72-year-old man presented with a recurrent conjunctival mass involving the nasal side of his right eye. Clinically, a diagnosis of conjunctival papilloma was made, and a mass excision was performed. The histopathological analysis evidenced a conjunctival-covering epithelium with papillomatous changes and irregular acanthosis, at the expense of a proliferation of basaloid cells. In addition, the lesion exhibited multiple pseudohorn cysts containing keratin. With the above findings, a diagnosis of conjunctival seborrheic keratosis was established. The occurrence of seborrheic keratosis on the conjunctiva is rare. In this case, seborrheic keratosis was confirmed by pathologic report despite its similar appearance with papilloma. Seborrheic keratosis should be considered in the differential diagnosis of conjunctival lesions.
Aged ; Conjunctival Diseases/*diagnosis/surgery ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Keratosis, Seborrheic/*diagnosis/surgery ; Male ; Microscopy, Acoustic ; Ophthalmologic Surgical Procedures/methods

The present study was designed to observe the expression patterns of NF-kappa B and AP-1, redox-sensitive transcription factors, and Bcl-2 and Bax, apoptosis repressing and promoting factors, respectively, upon repetitive cycles of short ischemia and reperfusion. Nine and thirty five weeks old Sprague-Dawley rats were subjected to the 3, 6, and 10 cycles of the ischemic process for 5 minutes followed by reperfusion for 5 minutes. The rats were divided by 5 groups, according to the time after treatment, such as 0, 3, 6, 24 and 72 hours. For short ischemia and reperfusion, left common iliac artery was occluded 3, 6, and 10 times for 5 minutes of ischemia followed by 5 minutes of reperfusion using rodent vascular clamps and left rectus femoris muscles were removed. The expression profiles and distribution of NF-kappa B, AP-1, Bcl-2, and Bax which were observed using immunohistochemical staining methods with 6 microgram thick paraffin sections of the rectus femoris tissue were as follows: The distribution of NF-kappa B was increased as the cycles of ischemia and reperfusion increased up to 3 hours after treatment. This phenomenon was prominent in 35 weeks-old rats. The distribution of AP-1 was increased as the cycles of ischemia and reperfusion increased up to 3 hours after treatment. This phenomenon was prominent in 9 weeks-old rats. The distribution of Bcl-2 was decreased as the cycles of ischemia and reperfusion increased up to 3 hours after treatment. The extent of such reduction was more prominent in 35 weeks-old rats than 9 weeks-old rats. The distribution of Bax was increased as the cycles of ischemia and reperfusion increased up to 3 hours after treatment. After 3 hours of treatment, Bax positivity was gradually decreased in 9 weeks-old rats, but increased in 35 weeks-old rats to reach a peak at 24 hour after reperfusion. The extent of enhancement in 9 weeks-old rats was higher than that in 35 weeks-old rats. In summary, multiple episodes of short ischemia and reperfusion altered the expression profiles of NF-kappa B, AP-1, Bcl-2, and Bax in the rectus femoris muscle at the similar extents in 9 and 35 weeks-old rats. Such alterations were more more increased when the episodes were more repeated.
Animals ; Apoptosis ; Iliac Artery ; Ischemia* ; Muscles* ; NF-kappa B* ; Paraffin ; Quadriceps Muscle* ; Rats* ; Rats, Sprague-Dawley ; Reperfusion* ; Rodentia ; Transcription Factor AP-1* ; Transcription Factors

PURPOSE: To evaluate postoperative spherical aberration, contrast sensitivity and depth of focus after implanting 3 different aspheric intraocular lenses. METHODS: Fifty-six eyes (18 eyes for Akreos adapt Advanced Optics (AO), 20 eyes for AcrySof IQ SN60WF and 18 eyes for Tecnis Acrylic IOL ZA9003) of 48 patients were evaluated. Internal ocular aberration including spherical aberration and higher-order aberration and contrast sensitivity were evaluated 3 months after lens implantation. In addition, visual acuities at 33 cm and 1 m distance were measured with the far vision corrected state to calculate depth of focus. RESULTS: The total and internal ocular spherical aberration of the AO implanted group was slightly higher than the other groups with statistical significance. However, there was no statistically significant difference of contrast sensitivity and depth of focus among the 3 groups. CONCLUSIONS: A subtle difference of spherical aberration among the 3 groups without a statistically significant difference in other factors may not induce the differences of contrast sensitivities and depths of focus in each group.
Contrast Sensitivity ; Eye ; Humans ; Lenses, Intraocular ; Vision, Ocular ; Visual Acuity

PURPOSE: The purpose of this study was to report the long-term clinical and radiological results of reverse hybrid total hip arthroplasty. MATERIALS AND METHODS: Between Oct. 1984 and Dec. 1987, reverse hybrid total hip replacements were performed using cemented all-polyethylene acetabular cup and porous coated tri-lock femoral stem. 26 cases in 25 patients were followed up more than 10 years. RESULTS: The average Harris hip score was 50 points preoperatively, 88 points at last follow-up. Two patients (7.7%) complained thigh pain at POD 1 years and 4 patients (15.4%) complained inguinal pain at last follow-up. On the radiologic findings, endosteal bone formation were observed with bone apposition mainly on the Gruen zone 2 and 6. Osteolysis developed in the proximal portion of the femoral stem, respectively. Definite loosening were found in 9 cases (34.6%) in the acetabulum and none in the femur. The mean rate of linear wear of polyethylene was 0.14 mm/year and the mean rate of volumetric wear was 108.75 mm3/year. CONCLUSION: The high incidence of acetabular loosening, presumably because of poor bone stock and great volumetric wear associated with use of the thirty-two-millimeter head. The result of tri-lock component can provide satisfactory clinical and radiological result.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Osteogenesis ; Osteolysis ; Polyethylene ; Thigh

BACKGROUND: The aim of this study was to determine the prevalence and antimicrobial susceptibility of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum among patients displaying symptoms of genitourinary infections and asymptomatic volunteers. METHODS: Genitourinary samples were collected from 897 participants (365 symptomatic patients and 532 asymptomatic volunteers). The samples were analyzed using multiplex real-time PCR (Anyplex™ II, Seegene, Korea), multiplex PCR (Seeplex®, Seegene), and Mycoplasma IST 2 Kit (bioMerieux, France). RESULTS: The prevalence of M. hominis, U. urealyticum, and U. parvum in the genitourinary samples of symptomatic patients compared with asymptomatic volunteers was 9.9% vs. 5.5%, 12.3% vs. 9.0%, and 36.4% vs. 30.8%, respectively. After eliminating cases of co-infections with other pathogens, there was a significant difference in the prevalence of M. hominis between symptomatic patients and asymptomatic volunteers (9.1% vs. 5.2%, P<0.05), but not in the prevalence of U. urealyticum and U. parvum organisms. When tested for antimicrobial susceptibility, more than 95.5% of each species were susceptible to tetracycline, doxycycline, josamycin, and pristamycin. More than 78.9% of Ureaplasma spp. were susceptible to azithromycin, erythromycin, and clarithromycin; however less than 4.2% of M. hominis were susceptible to these antibiotics. When tested with ofloxacin and ciprofloxacin, 40.9-58.9% and 9.1-25.0% of the three species were susceptible to these drugs, respectively. CONCLUSIONS: M. hominis is the leading causative pathogen for genitourinary infection; however the involvement of Ureaplasma spp. is debatable. For optimal antimicrobial therapy, the accurate detection of these organisms and determination of antimicrobial susceptibility is crucial considering their diverse antimicrobial susceptibility patterns.
Anti-Bacterial Agents ; Azithromycin ; Ciprofloxacin ; Clarithromycin ; Coinfection ; Doxycycline ; Erythromycin ; Humans ; Josamycin ; Multiplex Polymerase Chain Reaction ; Mycoplasma hominis* ; Mycoplasma* ; Ofloxacin ; Prevalence* ; Real-Time Polymerase Chain Reaction ; Tetracycline ; Ureaplasma urealyticum* ; Ureaplasma* ; Volunteers

BACKGROUND: Three-dimensional echocardiography has good feasibility and real image display in dynamic and spatial cardiac structures. So we designed this study to assess both the feasibility and potential role of three-dimensional echocardiography for the evaluation of cardiac structures and adjacent relationships. METHOD: We studied 25 patients with various heart structures. Cross-sectional images of specific interesting region were acquired from multiplane transesophageal echocardiography and reconstructed to three-dimensional images by TomTec image processing system. These images were presented in volume-rendered dynamic display for assessing of additonal informations. RESULTS: Three-dimensional reconstructions of usual viewpoints and interesting cut planes were possible in all patients. When compared with standard two dimensional images, additional informations were provided in all reconstructed cases. Among these images, mitral valve morphology, aortoseptal continuity and interatrial septum were the structures for which three-dimensional echocardiography were most useful. CONCLUSION: Although it was preliminary datas which needs large-scale randonmized prospective studies, three-dimensional echocardiograpy may be most potent and promising methods in evaluating anatomic and functional assessment of heart structures.
Echocardiography, Three-Dimensional* ; Echocardiography, Transesophageal ; Heart ; Humans ; Imaging, Three-Dimensional ; Mitral Valve

BACKGROUND AND OBJECTIVES: This study was to evaluate the long-term effect of immunotherapy on the allergic rhinitis patients to house dust mite (HDM) patients. SUBJECTS AND METHOD: Sixty-five patients were treated for allergic rhinitis in the allergy clinic. Every patient underwent immunotherapy for 3 to 5 years and did not receive any additional treatments after the completion of the initial one. The survey on the symptom improvement and the patients' satisfaction was carried out 3 and 10 years after the immunotherapy treatment. The results of skin prick test for each individual were analyzed before, 3 and 10 years after the immunotherapy, respectively. RESULTS: Overall symptom improvement surveyed 10 years after the immunotherapy decreased compared with that taken after 3 years of the treatment (p<0.05). In particular, symptom improvements on sneezing, itching sensation, and rhinorrhea was significantly decreased after 10 years (p<0.05). Patients' satisfaction level was 64.6% after 3 years and 49.2% after 10 years of the immunotherapy treatment. Skin prick test reactivity was significantly decreased after 3 years of the treatment compared to before the treatment. Although skin prick test reactivity measured in 10 years after immunotherapy increased compared with that measured in 3 years after, there was little statistical significance when compared with the reactivity before the treatment. CONCLUSION: The immunotherapy has long term efficacy on allergic rhinitis to HDM. However, the efficacy decreased after the discontinuance of the immunotherapy treatment.
Dust* ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunotherapy* ; Personal Satisfaction ; Pruritus ; Pyroglyphidae* ; Rhinitis* ; Sensation ; Skin ; Sneezing

Whole-genome sequencing (WGS) is an easily accessible and valuable tool in clinical microbiology, which can be used for identifying novel and rare species. We isolated grampositive cocci from the blood of a pediatric patient, which could not be phenotypically identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (BioMérieux, Marcy-l’Étoile, France). We could not identify the isolate to the species level using 16S ribosomal RNA (rRNA) sequencing. WGS was performed using the Illumina MiSeq platform (Illumina, San Diego, CA, USA); however, the subsequent genomic sequence database search using the TrueBac ID-Genome system (ChunLab, Inc., Seoul, Korea) did not yield any hits with an average nucleotide identity value > 95.0%, which is the cut-off for species-level identification. Phylogenetic analysis suggested that the isolate belonged to a new Arsenicicoccus species, forming a subcluster with Arsenicicoccus bolidensis. Our data demonstrate that WGS allows a more accurate annotation of microbial genomes than other clinical microbiology tools, such as MALDITOF MS and 16S rRNA sequencing. This is the first report of the isolation of a novelArsenicicoccus species from a clinical sample.

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult