Tetanus is a rare disease in the developed countries, including Korea, as a result of nearly universal active immunization. Because many physicians have little experience with its diagnosis and management, misdiagnosis and therapeutic delay may result in catastrophic consequences. We report one case of generalized tetanus. A previously healthy 35-year-old man was admitted to the emergency department because of stiffness on jaw and neck. board-like abdomen, extended and rigid both legs, chest tightness, and dyspnea. Seven days before admission, he was injured on the right thing at work. In the emergency department, he was given 5,000 units of human tetanus immunoglobulin intramuscularly, as well as diazepam 2 mg/hr intravenously. On the second hospital day, tracheostomy was performed. Ten days later, his condition was improved. Twenty eight days after admission, he was discharged without any complication.
Abdomen ; Adult ; Developed Countries ; Diagnosis ; Diagnostic Errors ; Diazepam ; Dyspnea ; Emergency Service, Hospital ; Humans ; Immunoglobulins ; Jaw ; Korea ; Leg ; Neck ; Rare Diseases ; Tetanus* ; Thorax ; Tracheostomy ; Vaccination

BACKGROUND: The prevalence of atopic dermatitis (AD) has increased in recent decades. Although the genetic predisposition to this disease has been implicated, environmental factors may play a critical role in the disease expression. OBJECTIVE: We investigated the prevalence of AD symptoms and the effects of suspected environmental factors in rural and urban areas of Gyeonggi Province in Korea. METHODS: This study was carried out among 210 patients with AD. We asked them to fill out a questionnaire covering their clinical manifestations, environment and lifestyle. The severity of AD was evaluated using the SCORAD index and the factors affecting the severity of the disease were determined. RESULTS: There were statistical differences in the SCORAD index between rural and urban residents (p<0.05). The SCORAD index of the rural residents was higher than that of urban residents. There were statistical differences in the frequency of applying moisturizer in five minutes after bathing between rural and urban residents (p<0.05). CONCLUSION: These results suggest that the management of disease is more important than environmental factors in the severity of atopic dermatitis.
Baths ; Dermatitis, Atopic* ; Genetic Predisposition to Disease ; Gyeonggi-do ; Humans ; Korea ; Life Style ; Prevalence ; Surveys and Questionnaires

Poroid hidradenoma is a benign tumor with eccrine differentiation. It is a recently described variant of a group of neoplasms known as poromas. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells). We herein report a case of poroid hidradenoma in a 51-year-old woman who presented with a solitary, bluish, tender nodule on the lateral aspect of her right thigh.
Acrospiroma* ; Dermis ; Female ; Humans ; Middle Aged ; Poroma ; Thigh

Several clinical variants of bullous pemphigoid have been described (e.g. generalized, vesicular, nodular, polymorphic, vegetans, and localized). Dyshidrosiform pemphigoid is an unusual form of the localized variant of bullous pemphigoid, and was first described in 1979. It presents with a localized, persistent, vesicobullous eruption similar to dyshidrosiform dermatitis. Herein, we report a case of dyshidrosiform pemphigoid which presented with bullae localized to both the palms and soles.
Dermatitis ; Pemphigoid, Bullous*

Atrophic dermatofibrosarcoma protuberans (DFSP) is a rare variant of DFSP, which presents as a depressed scar-like lesion with atrophic patch. Although atrophic DFSP is identical to classical DFSP in biologic and histologic features, such atrophic lesions can be difficult to diagnose clinically. Better knowledge of atrophic DFSP is important for making an early diagnosis and for proper surgical treatment. We report the case of a 33-year-old female presented with a gray depressed atrophic patch with a skin-colored, pea-sized nodule on the left lateral rim, and an erythematous indurated plaque on her upper back. Histopathologically, the atrophic patch showed densely packed, monomorphous, plump spindle cells arranged in a storiform pattern, infiltrating the dermis and subcutaneous tissue, producing a characteristic honeycomb pattern. The tumor cells exhibited strong and diffuse positivity with CD34, establishing the diagnosis of DFSP.
Adult ; Dermatofibrosarcoma* ; Dermis ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Subcutaneous Tissue

Malignant transformation of heterotopic pancreas is extremely rare. We report a case of ductal adenocarcinoma arising from heterotopic pancreas in the stomach of a 64-year-old man. Preoperative CT scans showed the lesion as a submucosal mass along the greater curvature of the pyloric antrum and protruding into the pyloric canal. After gastric surgery, the resected tumor was histopathologically diagnosed as a ductal adenocarcinoma arising from heterotopic pancreas with cystic dilatation of aberrant pancreatic duct.
Adenocarcinoma* ; Dilatation ; Humans ; Middle Aged ; Pancreas* ; Pancreatic Ducts ; Pyloric Antrum ; Stomach* ; Tomography, X-Ray Computed

Divided nevus of the eyelids is a rare form of congenital melanocytic nevus that involves the upper and lower eyelids of one eye. About 34 cases in both children and adults at present have been reported, but no case of divided nevus of the eyelids has previously been reported in the literature so far in Korea. A 12-year-old girl presented with a congenital divided nevus of the upper and lower lid. The histology of the pigmented plaque on the lower lid was confirmed to be that of a benign compound nevus. We, herein, report a case of divided nevus of the eyelids.
Adult ; Child ; Eyelids* ; Female ; Humans ; Korea ; Nevus* ; Nevus, Pigmented

No abstract available.
Heart Neoplasms*

Background: Extremely well-differentiated adenocarcinoma (EWDA) is a deceptively bland-looking adenocarcinoma of the stomach. It often causes diagnostic problems, especially in endoscopic biopsy samples. To better recognize this deceptively bland lesion, we carefully reviewed a series of EWDAs treated at our institution. Methods: A total of 55 specimens from 19 patients were obtained. Endoscopic, gross and microscopic features defining EWDA were described and documented. For comparison, hyperplastic polyp specimens were randomly selected and analyzed. Results: Most cases (18 of 19, 94.7%) were advanced gastric cancer (AGC) and primarily located in the body of the stomach (15 of 19, 79.0%). The majority of AGCs were non-ulcerated (11 of 18, 61.1%) with an undermining growth pattern and a relatively small mucosal involvement. Specific histologic features included an irregular glandular shape, an undulating apical cytoplasmic border, disproportionately large glands, a variably distended mucinous cytoplasm. Classical features, such as small infiltrating glands or desmoplastic reactions, were barely observed. Identification of irregularly spaced nuclei and disruption of the foveolar epithelial structure, along with atypical features described above were helpful in making a diagnosis especially in gastric forceps biopsies. Conclusions Awareness of the histomorphologic characteristics described in this report would lead to timely diagnosis and prevent repeated endoscopic procedures.

PURPOSE: To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI. MATERIALS AND METHODS: We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. RESULTS: The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7 %. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. CONCLUSION: In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery.
Humans ; Laminectomy ; Lumbar Vertebrae* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylolisthesis ; Spondylolysis