Cutaneous horns are conical, circumscribed protuberances formed by densely layered keratin. These lesions originate from basal keratinocytes and may manifest as benign, premalignant, or malignant cutaneous pathology in chronically sun-damaged areas. Complete surgical excision with histologic examination is needed for potential malignancy. In this report, we describe two elderly women presenting with solitary facial cutaneous horns, which were respectively diagnosed as actinic keratosis and squamous cell carcinoma.
Aged ; Animals ; Carcinoma, Squamous Cell ; Female ; Horns* ; Humans ; Keratinocytes ; Keratosis, Actinic ; Pathology

A 6-year-old female presented to our hospital with clitoromegaly. On physical examination, she demonstrated evidence of precocious pubic hair and clitoromegaly. The relaxed clitoris measured 3.7 cm in length. Her uterus was undetectable on diagnostic transvaginal ultrasonography and abdomen-pelvis computed tomography (CT) with otherwise normal-appearing internal female genitalia. We planned reduction clitoroplasty with preservation of the dorsal neurovascular pedicle to maintain sensitivity of the glans clitoris. After surgery, the patient demonstrated good recovery. The parents of the patient were satisfied with the surgical results. The patient was discharged without complications on hospital day 6.
Child* ; Clitoris ; Female* ; Genitalia, Female ; Hair ; Humans ; Parents ; Physical Examination ; Ultrasonography ; Uterus

BACKGROUND: Conscious sedation has been widely utilized in plastic surgery. However, inadequate research has been published evaluating adequate drug dosage and depth of sedation. In clinical practice, sedation is often inadequate or accompanied by complications when sedatives are administered according to body weight alone. The purpose of this study was to identify variables influencing the depth of sedation during conscious sedation for plastic surgery. METHODS: This prospective study evaluated 97 patients who underwent plastic surgical procedures under conscious sedation. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and glucose levels were measured. Midazolam and ketamine were administered intravenously according to a preset protocol. Bispectral index (BIS) recordings were obtained to evaluate the depth of sedation 4, 10, 15, and 20 minutes after midazolam administration. Associations between variables and the BIS were assessed using multiple regression analysis. RESULTS: Alcohol intake and female sex were positively associated with the mean BIS (P<0.01). Age was negatively associated with the mean BIS (P<0.01). Body mass index (P=0.263), creatinine clearance (P=0.832), smoking history (P=0.398), glucose (P=0.718), AST (P=0.729), and ALT (P=0.423) were not associated with the BIS. CONCLUSIONS: Older patients tended to have a greater depth of sedation, whereas females and patients with greater alcohol intake had a shallower depth of sedation. Thus, precise dose adjustments of sedatives, accounting for not only weight but also age, sex, and alcohol consumption, are required to achieve safe, effective, and predictable conscious sedation.
Alanine Transaminase ; Alcohol Drinking ; Aspartate Aminotransferases ; Body Mass Index ; Body Weight ; Conscious Sedation* ; Consciousness Monitors ; Creatinine ; Deep Sedation ; Female ; Glucose ; Humans ; Hypnotics and Sedatives ; Ketamine ; Midazolam ; Plastics* ; Prospective Studies* ; Smoke ; Smoking ; Surgery, Plastic*

Headaches attributed to disorders of the sinonasal region make their diagnosis and treatment sometimes challenging. Contact point between opposing mucosal surfaces in the nasal cavity can cause headache by a mechanism of referred pain in the distribution of trigeminal nerve. The most common anatomic abnormality of intranasal contact point is the diverse pattern of septal deviation in association with turbinate deformity or hypertrophy. In the absence of other pathological findings, the evaluation for intranasal contact points should be considered. We herein report that a patient, suffering from headache and periorbital pain refractory to medical treatment, experienced a complete abolition of pain after surgical correction of mucosal contact point in the nasal cavity.
Congenital Abnormalities ; Diagnosis ; Headache* ; Humans ; Hypertrophy ; Nasal Cavity ; Pain, Referred ; Trigeminal Nerve ; Turbinates

Surfer's myelopathy is a rare nontraumatic spinal cord disorder associated with surfing. This study reports three patients with surfer's myelopathy. All patients were young males who were previously healthy and first-time surfers at the onset of their symptoms. They developed the symptoms while surfing or shortly thereafter, presenting with lower back pain followed by an acute myelopathy. Spine magnetic resonance imaging showed T2 hyperintense cord lesion. Since the number of surfers is increasing in Korea, awareness of surfer's myelopathy is necessary for early recognition and proper management.
Humans ; Korea ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Spinal Cord Diseases* ; Spine

OBJECTIVE: To evaluate the renal function by investigating the relationship among serum cystatin C, serum creatinine, creatinine clearance and the average of bilateral ERPF (effective renal plasma flow) ratio of the MAG3 renal scan for the spinal cord injured patients. METHOD: Seventy-one spinal cord injured patients who admitted to our department were evaluated from January 2004 to October 2004. Blood samples and 24-hour urine of all the subjects were collected for measuring serum cystatin C, serum creatinine and creatinine clearance. MAG3 renal scan was done for 47 subjects. Regression analysis and Pearson's correlation methods were utilized for statistical analysis. RESULTS: There was significant correlation between 1/cystatin C and creatinine clearance (p<0.001) and the correlation coefficient between 1/cystatin C vs. creatinine clearance (R= 0.552) was bigger than that between 1/creatinine and creatinine clearance (R=0.329). The reciprocal of cystatin C was positively correlated with the average of bilateral ERPF ratio of MAG3 renal scan (p=0.01), while there was no significant correlation between 1/creatinine and the average of bilateral ERPF ratio. CONCLUSION: Measurement of serum cystatin C is a useful and convenient method for the evaluation of renal function in spinal cord injured patients.
Creatinine ; Cystatin C* ; Humans ; Plasma ; Renal Plasma Flow, Effective ; Spinal Cord Injuries ; Spinal Cord*

OBJECTIVE: Screening tests for dysphagia have been introduced to prevent complications arising from dysphagia in stroke patients. Among them, Gugging swallowing screen (GUSS) was proven as an effective screening tests for dysphagia of stroke patients in 24 hours after onset. We compared several screening tests and clinical scales including GUSS. METHOD: Subjects were 37 stroke patients 3 months after onset. GUSS, 3 oz water test, Burke dysphagia screening test (BDST) and Standardized swallowing assessment (SSA) were carried out at bedside. VFS was performed in 24 hours after other studies were done. Functional dysphagia scale (FDS) and Penetration-aspiration scale (P/A scale) were derived from VFS. Clinical scales such as American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) swallowing scale and Clinical dysphagia scale (CDS) were measured to see the correlation between GUSS and another dysphagia scales. RESULTS: GUSS had a sensitivity of 90.9% and a specificity of 69.2%. 3 oz water test had a sensitivity of 81.8% and a specificity of 76.9%. Sensitivity and specificity of BDST were respectively 90.9%, 61.5%. Sensitivity of SSA was 90.9%, specificity 61.5%. Correlation between GUSS and FDS was significant (r =-0.527, p<0.01). Correlation between GUSS and P/A scale also showed significance (r=-0.747, p<0.01). ASHA NOMS swallowing scale and GUSS showed significant correlation (r=0.432, p<0.01). CDS and GUSS showed significant correlation as well (r=-0.815, p<0.01). CONCLUSION: The screening ability of GUSS was equal to other screening tests for dysphagia of stroke patients. Correlations among GUSS and other VFS and clinical scales showed availability of GUSS as a clinical scale for dysphagia.

BACKGROUND/AIMS: The reactive oxygen species from thioacetamide (TAA) induces rat liver cirrhosis that resembles the human disease, and it can serve as a suitable animal model for studying human liver cirrhosis. The aim of this study was to identify the molecular protein signatures via a proteomics approach with using a rat model with TAA-induced liver cirrhosis. METHODS: Male Wistar rats were treated with 0.3 g/L TAA in their drinking water. The animals were then sacrificed at 9 and 30 weeks after TAA administration. The development of liver cirrhosis was observed with histological study. The livers were processed for proteins extraction and the proteins were analyzed by 2-dimensional electrophoresis. The proteins were identified by matrix-assisted laser desorption ionizing time-of-flight mass spectrometry and this was validated by immunohistochemical staining. RESULTS: On the proteomics analysis of the liver tissues, a total of 88 proteins showed significant change in their expression between the controls and the cirrhotic rats. When the proteins were categorized by their function, they included ECM/cellular skeleton, cell proliferation/death signal, metabolism, DNA damage/stress and immune response related proteins. The level of expression gradually increased up to 30 weeks for interleukin-6 (IL-6) precursor, transforming growth factor-beta (TGF-beta) induced protein, TIMP-1 and MMP-9. Cytochrome P450 2B, which is required for the metabolic activation of TAA, also showed the same increasing pattern. In contrast, the expression level of the proteins did not show a significant change at 9 weeks, but this increased to 3-fold at 30 weeks for carbonic anhydrase VII, ras related protein Rab 6, Annexin A2, neurofibromatosis type 2 and aldehyde dehydrogenase. CONCLUSIONS: This study showed that there is a repertoire of proteins during the development of liver cirrhosis via TAA. In this model, IL-6, TGF-beta, MMP-9 and TIMP-1 were reconfirmed as the molecular signatures during the development of TAA-induced liver cirrhosis.
Thioacetamide ; Rats, Wistar ; Rats ; Proteomics ; Proteins/*metabolism ; Male ; Liver Cirrhosis, Experimental/*metabolism ; Liver/*metabolism ; Animals

Background: Chronotype refers to individual variations in diurnal preferences that manifest as everyday behaviors, including sleep patterns. Traditionally, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), which comprises of 19 items, has been the standard for determining chronotype. However, its length makes it cumbersome for widespread application. To address this issue, the reduced MEQ (rMEQ), a concise version containing only five items from the MEQ, was developed for a more practical approach to chronotype assessment. This study aimed to evaluate the validity and reliability of Korean version of rMEQ in a sample from the general Korean population. Methods: The Korean version of the rMEQ comprises of items 1, 7, 10, 18, and 19 of the original MEQ. The validity of the rMEQ was assessed by correlating its scores with those of the MEQ and Munich Chronotype Questionnaire (MCTQ). Its reliability was determined by calculating internal consistency. Results: A total of 3,030 individuals participated in the study, yielding an average rMEQ score of 14.0 ± 3.4. There was a substantial positive correlation between the rMEQ and MEQ scores (r = 0.859, P < 0.001). Furthermore, the rMEQ scores were significantly negatively correlated with the midpoint of sleep on free days corrected for sleep debt as measured by the MCTQ (r = −0.388, P < 0.001), indicating a robust association with chronotype. The internal consistency of rMEQ, measured using Cronbach’s alpha, was 0.609. Conclusion This study finds the Korean version of the rMEQ to be a valid and reliable instrument for assessing chronotype in the general population.

Background: Chronotype refers to individual variations in diurnal preferences that manifest as everyday behaviors, including sleep patterns. Traditionally, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), which comprises of 19 items, has been the standard for determining chronotype. However, its length makes it cumbersome for widespread application. To address this issue, the reduced MEQ (rMEQ), a concise version containing only five items from the MEQ, was developed for a more practical approach to chronotype assessment. This study aimed to evaluate the validity and reliability of Korean version of rMEQ in a sample from the general Korean population. Methods: The Korean version of the rMEQ comprises of items 1, 7, 10, 18, and 19 of the original MEQ. The validity of the rMEQ was assessed by correlating its scores with those of the MEQ and Munich Chronotype Questionnaire (MCTQ). Its reliability was determined by calculating internal consistency. Results: A total of 3,030 individuals participated in the study, yielding an average rMEQ score of 14.0 ± 3.4. There was a substantial positive correlation between the rMEQ and MEQ scores (r = 0.859, P < 0.001). Furthermore, the rMEQ scores were significantly negatively correlated with the midpoint of sleep on free days corrected for sleep debt as measured by the MCTQ (r = −0.388, P < 0.001), indicating a robust association with chronotype. The internal consistency of rMEQ, measured using Cronbach’s alpha, was 0.609. Conclusion This study finds the Korean version of the rMEQ to be a valid and reliable instrument for assessing chronotype in the general population.