Acral pseudolymphomatous angiokeratoma of children (APACHE) is a recently recognized, rare clinical entity with only 20 reported cases worldwide. It is characterized by unilateral eruptions of multiple angiomatous papules, mostly on acral areas and mainly in children, although some cases have also been reported with involvement of non-acral areas and occurring in adults. The histopathologic examination revealed diffuse dermal infiltrates of lymphohistiocytes and thick-walled vessels lined with prominent plump endothelial cells. APACHE is a cutaneous pseudolymphoma, rather than a vascular neoplasm, because of distinct histopathologic and immunohistochemical findings. We report a case of a 9-year-old girl who presented with multiple angiomatous papules on her right upper arm. The histopathologic and immunohistochemical findings in our patient were consistent with a diagnosis of APACHE.
Adult ; Angiokeratoma* ; APACHE ; Arm ; Child* ; Diagnosis ; Endothelial Cells ; Female ; Humans ; Pseudolymphoma ; Vascular Neoplasms

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Purpose: This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals. Methods: One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems. Results: A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians’ workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital’s workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (p=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence. Conclusion Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers’ competency in managing workplace violence.

Grisel’s syndrome is a non-traumatic atlantoaxial rotatory subluxation for which the underlying mechanism has not yet been identified. It is known to occur following upper respiratory infections, tonsillitis, ear, nose, and throat (ENT) surgeries such as tonsillectomy and adenoidectomy. The diagnosis of Grisel’s syndrome can be made by plain x-ray, CT scanning, and/or MRI scanning. The first choice of treatment is conservative therapy such as bed rest, muscle relaxation, analgesic therapy, antibiotics, and simple traction. While Grisel’s syndrome occurs rarely, delayed treatment may lead to neurological complications or requires surgical treatment. Early diagnosis and treatment are important in preventing fatal outcome. We report the case of a 9-year-old male who developed Grisel’s syndrome after tonsillectomy and adenoidectomy.

PURPOSE: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems. We postulate that there might be an individual variation in the distribution of cam deformity in the asymptomatic Korean population. MATERIALS AND METHODS: From January 2011 to December 2015, CT images of the hips of 100 subjects without any history of hip joint ailments were evaluated. A computer program which generates 3D models from CT scans was used to provide sectional images which cross the central axis of the femoral head and neck. Alpha angles were measured in each sectional images. Alpha angles above 55° were regarded as cam deformity. RESULTS: The mean alpha angle was 43.5°, range 34.7–56.1°(3 o'clock); 51.24°, range 39.5–58.8°(2 o'clock); 52.45°, range 43.3–65.5°(1 o'clock); 44.09°, range 36.8–49.8°(12 o'clock); 40.71, range 33.5–45.8°(11 o'clock); and 39.21°, range 34.1–44.6°(10 o'clock). Alpha angle in 1 and 2 o'clock was significantly larger than other locations (P < 0.01). The prevalence of cam deformity was 18.0% and 19.0% in 1 and 2 o'clock, respectively. CONCLUSION: Cam deformity of FAI was observed in 31% of asymptomatic hips. The most common region of cam deformity was antero-superior area of femoral head-neck junction (1 and 2 o'clock).
Adult ; Congenital Abnormalities ; Femoracetabular Impingement ; Femur ; Head ; Hip Joint ; Hip ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Methods ; Neck ; Orthopedics ; Osteoarthritis ; Outpatients ; Prevalence ; Tomography, X-Ray Computed

Dermatofibroma is a common benign fibrohistiocytic tumor which may present with a variety of pathological variants. Combined dermatofibromas are defined as dermatofibromas which show two or more histological variants in a single lesion. We herein report an unusual case of dermatofibroma in a 39-year-old man who presented with a solitary asymptomatic black-colored nodule on his right thigh, which showed histological features of aneurysmal and atypical variants simultaneously. Histologically, it showed cleft-like vascular spaces with hemorrhaging and focal cellular atypia in the background of typical dermatofibroma.
Adult ; Aneurysm* ; Histiocytoma, Benign Fibrous* ; Humans ; Thigh

Public health strategies designed to accomodate the ever-increasing human lifespan are urgently required. A good clinical understanding of frailty, as well as knowledge regarding how to prevent it, will therefore be required in order to overcome this challenge. Sarcopenia is an important component of the frailty syndrome, and its association with osteoporosis can lead to fractures and incident disability. Therefore, this review examined the literatuire pertaining to the association of sarcopenia with osteoporosis in order to assess preventive strategies.
Aged ; Frail Elderly ; Humans ; Osteoporosis* ; Public Health ; Sarcopenia*

In atypical melanocytic hyperplasia, histopathologically atypical melanocytes are not distributed throughout the epidermis, but are present in some parts of the basal layer of the epidermis without dermal invasion, despite the lesion being present for a long time. Differential diagnosis of melanoma in situ (MIS) from atypical melanocytic hyperplasia is difficult. Furthermore, the concept of atypical melanocytic hyperplasia remains controversial, and the criteria for clinical and histologic diagnosis of atypical melanocytic hyperplasia have not yet been fully determined. Many further studies are needed to define the clinical and histologic characteristics of atypical melanocytic hyperplasia. A 48-year-old man presented with asymptomatic, solitary, 2 x 1.5 cm sized, poorly-defined, irregular, brownish to black patch on the volar area of the left index finger for 5 years. The histopathologic findings revealed an increased number of large atypical melanocytes in the basal layer, consistent with atypical melanocytic hyperplasia. Therefore, we report a case of atypical melanocytic hyperplasia.
Diagnosis ; Diagnosis, Differential ; Epidermis ; Fingers ; Humans ; Hyperplasia* ; Melanocytes ; Melanoma ; Middle Aged

This study evaluated the effects of alfaxalone (3 mg/kg, intravenously) on echocardiographic examination in healthy dogs using echocardiography. Six adult Beagle dogs were used for this study. Left ventricular dimensions with systolic indexes, trans-blood flow at all cardiac valvular annulus and trans-mitral tissue Doppler values were measured from routine transthoracic echocardiography. Although the changes were not statistically significant, heart rate, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, peak velocities of tricuspid A-wave and transpulmonic flow were increased after alfaxalone induction, while systolic blood pressure, fractional shortening, left ventricular ejection fraction, peak velocities of mitral E-wave, mitral A wave, tricuspid E-wave, transaortic flow and medial e'-, a'- and s'-peaks decreased after alfaxalone induction. No dogs showed hypoxemia during sedation, regardless of intubation and oxygen supply. Although alfaxalone showed mild cardiovascular depression, this protocol could be a good alternative sedative protocol for echocardiographic examination in healthy dogs because the cardiovascular depression was statistically and clinically insignificant. However, further studies in dogs with heart diseases should be conducted to confirm these findings after alfaxalone induction.
Adult ; Animals ; Anoxia ; Blood Pressure ; Depression ; Dogs* ; Echocardiography* ; Heart Diseases ; Heart Rate ; Heart Ventricles ; Humans ; Intubation ; Oxygen ; Stroke Volume

Cardiopulmonary depression of long-term constant rate infusion (CRI) administration of multiple analgesic drugs is important, especially in critically ill dogs. Therefore, this study was conducted to evaluate the effects of lidocaine, ketamine or combined lidocaine-ketamine combination CRI treatment on vital signs and left ventricular (LV) function in healthy dogs. Six adult Beagle dogs were administered either ketamine (initial loading dose of 0.5 mg/kg followed by 10 microg/kg/min CRI), lidocaine (initial loading dose of 2 mg/kg followed by 0.025 mg/kg/min CRI), or combined lidocaine-ketamine intravenously. Arterial blood pressure (BP), heart rate (HR), respiratory rate (RR), body temperature (BT) and echocardiographic LV dimensions were measured before administration of medications, immediately after administration of drugs, and then every 10 min for 2 h. There were no significant changes in HR, RR, BT and BP after the administration of either lidocaine CRI, ketamine CRI, or combined lidocaine and ketamine CRI. There were also no significant changes in LV dimensions and stroke volume. The results revealed that treatment with either lidocaine, ketamine or combined lidocaine-ketamine may not cause cardiopulmonary suppression in healthy dogs.
Adult ; Analgesia ; Analgesics ; Animals ; Arterial Pressure ; Body Temperature ; Critical Illness ; Depression ; Dogs* ; Echocardiography* ; Heart Rate ; Humans ; Ketamine* ; Lidocaine* ; Respiratory Rate ; Stroke Volume ; Ventricular Function, Left* ; Vital Signs*