Pneumonia frequently leads to intensive care unit (ICU) admission and is associated with a high mortality risk. This study aimed to assess the impact of early bronchoscopy administered within 3 days of ICU admission on mortality in patients with pneumonia using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Methods: A single-center retrospective analysis was conducted using the MIMIC-IV data from 2008 to 2019. Adult ICU-admitted patients diagnosed with pneumonia were included in this study. The patients were stratified into two cohorts based on whether they underwent early bronchoscopy. The primary outcome was the 28-day mortality rate. Propensity score matching was used to balance confounding variables. Results: In total, 8,916 patients with pneumonia were included in the analysis. Among them, 783 patients underwent early bronchoscopy within 3 days of ICU admission, whereas 8,133 patients did not undergo early bronchoscopy. The primary outcome of the 28-day mortality between two groups had no significant difference even after propensity matched cohorts (22.7% vs. 24.0%, P=0.589). Patients undergoing early bronchoscopy had prolonged ICU (P<0.001) and hospital stays (P<0.001) and were less likely to be discharged to home (P<0.001). Conclusions: Early bronchoscopy in severe pneumonia patients in the ICU did not reduce mortality but was associated with longer hospital stays, suggesting it was used in more severe cases. Therefore, when considering bronchoscopy for these patients, it's important to tailor the decision to each individual case, thoughtfully balancing the possible advantages with the related risks.

Pneumonia frequently leads to intensive care unit (ICU) admission and is associated with a high mortality risk. This study aimed to assess the impact of early bronchoscopy administered within 3 days of ICU admission on mortality in patients with pneumonia using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Methods: A single-center retrospective analysis was conducted using the MIMIC-IV data from 2008 to 2019. Adult ICU-admitted patients diagnosed with pneumonia were included in this study. The patients were stratified into two cohorts based on whether they underwent early bronchoscopy. The primary outcome was the 28-day mortality rate. Propensity score matching was used to balance confounding variables. Results: In total, 8,916 patients with pneumonia were included in the analysis. Among them, 783 patients underwent early bronchoscopy within 3 days of ICU admission, whereas 8,133 patients did not undergo early bronchoscopy. The primary outcome of the 28-day mortality between two groups had no significant difference even after propensity matched cohorts (22.7% vs. 24.0%, P=0.589). Patients undergoing early bronchoscopy had prolonged ICU (P<0.001) and hospital stays (P<0.001) and were less likely to be discharged to home (P<0.001). Conclusions: Early bronchoscopy in severe pneumonia patients in the ICU did not reduce mortality but was associated with longer hospital stays, suggesting it was used in more severe cases. Therefore, when considering bronchoscopy for these patients, it's important to tailor the decision to each individual case, thoughtfully balancing the possible advantages with the related risks.

Pneumonia frequently leads to intensive care unit (ICU) admission and is associated with a high mortality risk. This study aimed to assess the impact of early bronchoscopy administered within 3 days of ICU admission on mortality in patients with pneumonia using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Methods: A single-center retrospective analysis was conducted using the MIMIC-IV data from 2008 to 2019. Adult ICU-admitted patients diagnosed with pneumonia were included in this study. The patients were stratified into two cohorts based on whether they underwent early bronchoscopy. The primary outcome was the 28-day mortality rate. Propensity score matching was used to balance confounding variables. Results: In total, 8,916 patients with pneumonia were included in the analysis. Among them, 783 patients underwent early bronchoscopy within 3 days of ICU admission, whereas 8,133 patients did not undergo early bronchoscopy. The primary outcome of the 28-day mortality between two groups had no significant difference even after propensity matched cohorts (22.7% vs. 24.0%, P=0.589). Patients undergoing early bronchoscopy had prolonged ICU (P<0.001) and hospital stays (P<0.001) and were less likely to be discharged to home (P<0.001). Conclusions: Early bronchoscopy in severe pneumonia patients in the ICU did not reduce mortality but was associated with longer hospital stays, suggesting it was used in more severe cases. Therefore, when considering bronchoscopy for these patients, it's important to tailor the decision to each individual case, thoughtfully balancing the possible advantages with the related risks.

Pneumonia frequently leads to intensive care unit (ICU) admission and is associated with a high mortality risk. This study aimed to assess the impact of early bronchoscopy administered within 3 days of ICU admission on mortality in patients with pneumonia using the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Methods: A single-center retrospective analysis was conducted using the MIMIC-IV data from 2008 to 2019. Adult ICU-admitted patients diagnosed with pneumonia were included in this study. The patients were stratified into two cohorts based on whether they underwent early bronchoscopy. The primary outcome was the 28-day mortality rate. Propensity score matching was used to balance confounding variables. Results: In total, 8,916 patients with pneumonia were included in the analysis. Among them, 783 patients underwent early bronchoscopy within 3 days of ICU admission, whereas 8,133 patients did not undergo early bronchoscopy. The primary outcome of the 28-day mortality between two groups had no significant difference even after propensity matched cohorts (22.7% vs. 24.0%, P=0.589). Patients undergoing early bronchoscopy had prolonged ICU (P<0.001) and hospital stays (P<0.001) and were less likely to be discharged to home (P<0.001). Conclusions: Early bronchoscopy in severe pneumonia patients in the ICU did not reduce mortality but was associated with longer hospital stays, suggesting it was used in more severe cases. Therefore, when considering bronchoscopy for these patients, it's important to tailor the decision to each individual case, thoughtfully balancing the possible advantages with the related risks.

Schwannoma, also known as a neurilemmoma, is a benign neurogenic tumor that arises from Schwann cells of the nerve sheath. Usually, it occurs as a slowly-growing, well-circumscribed solitary nodule on the head and neck, trunk, or extremities. However, it is rare on the oral mucosa, especially on the lip. Histologically, the lesion is characterized by an encapsulated nodule that consists of Antoni A cellular tissues with verocay bodies, and Antoni B loose myxoid tissues. Herein, we report a case of a schwannoma of the upper lip, which is a rare location
Extremities ; Head ; Lip ; Mouth Mucosa ; Neck ; Neurilemmoma ; Schwann Cells

BACKGROUND: Lyme disease, an infection caused by Borrelia(B.) burgdorferi, has been reported in many countries. But in Korea, only 5 cases of serologically diagnosed lyme disease have been reported. Because several strains of B. burgdorferi were isolated from Ixodes ticks which were captured in Kangwon and Chungbuk province, there might be more cases of serologically undiagnosed lyme diseases presenting with erythema migrans. OBJECTIVE: To understand the clinical patterns and laboratory findings of erythema migrans in Korea. METHODS: A clinical survey was retrospectively performed on 9 patients with erythema migrans which occurred after tick bites. RESULTS: Among 9 patients with erythema migrans, 3 patients were male and 6 patients were female. The onset age of erythema migrans ranged from 26 to 71 years old (mean, 51.3 years old). The mean duration of erythema migrans after tick bite was 26.4 days and the diameter of the lesion ranged from 6 to 34 cm (mean, 18.3 cm). All cases developed from May to September and systemic symptoms such as fatigue, fever and/or chills, myalgia, palpitation, headache, arthralgia and dyspnea were present at the time of hospital visits of 3 patients. Clinically, 3 patterns of erythema migrans were seen; typical target pattern, homogenous and erythematous plaque pattern, and linear solitary plaque pattern with central postinflammatory pigmentation. Only 2 of the 7 patients (28.6%) were seropositive for IgM and IgG antibody titers by enzyme-linked immunosorbent assay in consecutive serologic tests. PCR for Borrelia DNA in paraffin-embedded tissue showed full negativity in 6 patients with erythema migrans. CONCLUSION: Although lyme disease is not endemic in Korea, some patients with erythema migrans might be undiagnosed as lyme disease serologically with erythema migrans. To take into consideration false negative serelogic results in early erythema migrans, early oral tetracycline therapy should be included through clinical and historical diagnosis.
Age of Onset ; Arthralgia ; Bites and Stings ; Borrelia ; Chills ; DNA ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Erythema ; Fatigue ; Female ; Fever ; Glossitis, Benign Migratory ; Headache ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Ixodes ; Korea ; Lyme Disease ; Male ; Pigmentation ; Polymerase Chain Reaction ; Retrospective Studies ; Serologic Tests ; Tetracycline ; Ticks

Cutaneous lymphadenoma (CL) is a rare, benign, epithelial neoplasm with a prominent lymphocyte infiltration of unknown histogenesis. Both pilosebaceous and eccrine origins have been suggested, and the current view is that CL is a variant of trichoblastoma with adamantinoid features. We report a case of cutaneous lymphadenoma which developed on the left postauricular area of a 46-year-old woman, plus a review of the related literature.
Female ; Humans ; Lymphocytes ; Middle Aged ; Neoplasms, Glandular and Epithelial

Cutaneous plasmacytoma (CP) is a localized collection of monoclonal plasma cells in the skin. The disease is divided into primary cutaneous plasmacytoma and secondary cutaneous plasmacytoma groups. Secondary cutaneous plasmacytoma, which is so rare as to occur in only 2% of myeloma cases, usually represents terminal expression of the primary diseases and is associated with increased tumor burden. CP can occur at any site of the skin, but we could find only 1 case in English literature related to scalp metastasis alone. Also serum and urine electrophoresis, tissue immunohistochemistry for IgD are not usually conducted in the laboratory. IgDlambda subtype seems to be another value to report. We report a case of secondary cutaneous plasmacytoma, IgDlambda type which developed on the scalp alone of a 41-year-old woman, with a review of related literatures.
Adult ; Electrophoresis ; Female ; Humans ; Immunoglobulin D ; Immunohistochemistry ; Multiple Myeloma ; Neoplasm Metastasis ; Plasma Cells ; Plasmacytoma ; Scalp ; Skin ; Tumor Burden

OBJECTIVES: Purpose of this study was to develop a test screening children's emotional and behavioral problem. METHODS: Child Problem-Behavior Screening Test (CPST) is a brief behavioral screening questionnaire that can be completed by parents or teachers. The 2nd to 4th graders (N=970) of the two elementary schools in Seoul, Korea, participated in the study. Parents and teachers completed a CPST and parents completed Child Behavior Checklist-Korean version (K-CBCL). The Reliability and validity of the CPST was evaluated by comparing with K-CBCL and by performing the factor analysis, t-test and correlation analysis. RESULTS: Internal Consistency of CPST was relatively good (Cronbach's alpha; Parent=.846, Teacher=.834). The result of factor analysis shows that the CPST has a four-factor structure, representing 'externalizing problem', 'internalizing problem', 'physical health problem' and 'cognitive problem'. In the parent's and teacher's CPST, total variance of the four factor was 37.8% and 43.8%, respectively. There were significant correlations among subscales of parent's CPST and K-CBCL. CPST effectively distinguished children with psychiatric problems from children without psychiatric problems. CONCLUSION: The results support that the test developed in this study is efficient to identify the children's emotional and behavioral problmes. This study also proves the usefulness of the CPST as a promising screening test of child problem behavior for large epidemiological study. In the future, a study to standardize this test is necessary, and from this, the cut-off score and norms should be developed.
Child Behavior ; Child* ; Epidemiologic Studies ; Epidemiology ; Humans ; Korea ; Mass Screening* ; Mental Disorders ; Parents ; Surveys and Questionnaires ; Reproducibility of Results ; Seoul

Atrophoderma of Pasini and Pierini is a form of dermal atrophy that manifests as either single or multiple, sharply demarcated, hyperpigmented, non-indurated patches. These patches are marked by a slight depression of the skin, with an abrupt edge (i.e., the "cliff-drop" borders), usually located on the backs of adolescents or young adults. The pathophysiology of the disease is unknown, but some authors have suggested a role of Borrelia burgdorferi infection. A 35-year-old woman visited our department because of asymptomatic, hypopigmented, depressed patches on her chest and back lasting for three months. Laboratory evaluations were normal, except for positive serum antibodies to Borrelia burgdorferi. Histologic examination revealed a significantly decreased thickness of the dermis. The patient underwent treatment with oral doxycycline 200 mg/day for six weeks, after which the depth of depression was improved. Herein, we report a case of atrophoderma of Pasini and Pierini, associated with Borrelia burgdorferi infection, successfully treated with oral doxycycline.
Adolescent ; Adult ; Antibodies ; Atrophy ; Borrelia ; Borrelia burgdorferi ; Depression ; Dermis ; Doxycycline ; Female ; Humans ; Skin ; Thorax ; Young Adult