Inflammatory myofibroblastic tumor (IMT) of the biliary tree is extremely rare and is generally a benign condition, though malignant change is possible. Making a differential diagnosis between this lesion and other malignant conditions is very difficult on preoperative imaging studies. Hence, the final diagnosis of IMT may be made during or after operation depending on the pathologic examination. We treated a 63-year-old woman who received right hepatectomy with caudate lobectomy under the suspicion of hilar cholangiocarcinoma. Frozen biopsy during the operation showed carcinoma in situ and there were stromal cells in the bile duct's resection margins. The postoperative hospital course was uneventful except for minor bile leakage. At postoperative month 4, she developed jaundice, ascites and pleural effusion. Computed tomography images showed a mass-like lesion in the porta hepatis with portal vein thrombosis and a right chest wall mass. Excisional biopsy was done and the pathology report was malignant spindle cell tumor suggestive of an aggressive form of IMT. Her condition rapidly deteriorated regardless of the best supportive care and she expired at postoperative month 5. Further investigation is necessary to clarify the reasons for recurrence and infiltration of this disease.
Ascites ; Bile ; Bile Ducts ; Biliary Tract ; Biopsy ; Carcinoma in Situ ; Cholangiocarcinoma ; Diagnosis, Differential ; Female ; Hepatectomy ; Humans ; Jaundice ; Middle Aged ; Myofibroblasts ; Pleural Effusion ; Portal Vein ; Recurrence ; Stromal Cells ; Thoracic Wall ; Thrombosis

BACKGROUND: Acne is a common chronic disease which most frequently affects the face. This visibility is a major cause for concern in affected individuals. OBJECTIVE: The purpose of this study was to investigate the quality of life of patients with acne. METHODS: We interviewed 130 acne patients, and determined the impact of acne on the quality of life with a questionnare. RESULTS: Among 130 cases of acne, the numbers of male and female patients were 52(40.0%) and 78(60.0%) respectively, and tbe mean age was 21 years. There was no difference between the sexes in the quality of life criteria used. The scores of social criteria of patients older than 20 years were significantly higher than thme of patients younger than 20 years. The severity of facial acne was correlated with the severity of chest acne but not with that of back acne. The severity of chest acne was correlated with that of back acne. The severity of facial acne was correlated with the scores of the physical, social and psychological criteria, and the severity of chest acne was correlated with that of physical and social criteria. However, the severity of back acne was not correlated with those of any of the criteria. The psychological well-being of the patients was moderately or highly affected by the acne more often than the other criteria. CONCLUSION: Acne has a substantial impact on the quality of life. The practical use of these indices are: (1) reveal areas of particulur concern in patients with acne; (2) to identify individuals who may require more intensive treaiment; and (3) to give a patient oriented inforrnation on the quality of life expected.
Acne Vulgaris* ; Chronic Disease ; Female ; Humans ; Male ; Quality of Life* ; Thorax

The clinical symptom complex characterized by syncopal attacks and sudden death in patients with electrocardiographic anomalies, especially a prolonged Q-T interval is known as the Romano-Ward syndrome. When a similar symptom complex is accompanied by congenital deafness, it is called Jervell and Lange-Nieisen syndrome. This study was undertaken to investigate the investigate the incidence of the latter syndrome in the Seoul area. A total of 1,013 children with congenital deafness who attend schools for the deaf were studied by analyzing their electrocardiograms. A corrected Q-T interval of> or =0.44 seconds was defined as a prolonged Q-T interval. The overall incidence of long Q-T syndrome observed in the deaf in the Seoul area was 0.49% as compared to 0.25% reported from elsewhere in the world. The mean age of patients with long Q-T syndrome was 11.3+/-5.9 years and the first syncopal attacks was 4.6+/-1.1 per patient. A valsalva maneuver and exercise tests in the test group were associated with significant changes in T wave configuration and prolonged Q-T intervals while similar changes were not observed in the control group. A larger survey is needed to derive more statistically significant conclusions.
Child* ; Deafness* ; Death, Sudden ; Electrocardiography ; Exercise Test ; Humans ; Incidence ; Romano-Ward Syndrome ; Seoul ; Valsalva Maneuver

PURPOSE: Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children. METHODS: Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low. CONCLUSION: The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.
Adolescent ; Area Under Curve ; Body Temperature ; Child ; Child, Preschool ; Databases, Factual ; Fever/*diagnosis ; Humans ; Infant ; Infant, Newborn ; Infrared Rays ; Odds Ratio ; ROC Curve ; Sensitivity and Specificity ; Thermometers/*standards

No abstract available.
Ichthyosiform Erythroderma, Congenital*

The anti-inflammatory activity of a corticosteroid may mask the contact allergic reaction it is causing. This may be an important reason why contact allergy to corticosteroids has often been missed. A simple persistent aggravation of a dermatitis in a patient treated with one or more topical corticosteroids is sufficient to raise a suspicion of corticosteroid hypersensitivity. A 23-year-old male visited our department for the evaluation of his aggravated pruritic oozing erythematous papules, scales and edema of the face. Previously, he was treated with Dermatop ointment and Plancollotion. A Patch test showed positive reactions to prednicarbate 10%, 1%, hydrocortisone-17-butyrate 10%, and triamcinolone 10%. We conclude prednicarbate in Dermatop ointment, hydrocortisone-17-butyrate in Plancol lotion to be the etiological agents.
Adrenal Cortex Hormones ; Dermatitis ; Dermatitis, Allergic Contact* ; Edema ; Humans ; Hypersensitivity ; Male ; Masks ; Patch Tests ; Triamcinolone ; Weights and Measures ; Young Adult

It was previously reported that sudden loss of central vision and small residual fields in advanced glaucomatous eyes after filtering surgery. This study was undertaken to assess the risk of sudden wipe-out phenomenon on 57 eyes of advanced glaucomatous patients who could be followed up at least 8 weeks after filterlng surgery. The eyes were classified into three categones according to the seventy of visual field loss, evaluated with Humphrey computerized visual field analyzer and Goldmann perimetry using target with I-4-e. Sudden wipe-out phenomenon was divided into absolute and relative. The former was sudden complete loss of central vision immediately after filtering surgery. The latter was visual acuity decreasing 2 or more lines in Snellen visual acuity chart compared with before surgery or obvious progress1on of visual field defect at the t1me of 8 to 1O weeks after surgery However there were no absolute and relative sudden wipe-out phenomenon in our study. In the light of our experiences, it is concluded that filtering surgery can be performed with caution in advanced glaucomatous eye whenever it is indicated.
Filtering Surgery ; Glaucoma* ; Humans ; Visual Acuity ; Visual Field Tests ; Visual Fields

Early detection of glaucoma by mass screening is the most practical approach for prevention of blindness. An epidemIOlogical study gives the most essential information on prevalence an distribution of the disease in relation to diverse background factors. But, before now, an epidemiological study for glaucoma has not been carried out in Korea. Our glaucoma survey was conducted in the health examination center of Yongdong Severance hospital during 1990 and 1991. The total numbers of subjects examined was 4424 persons aged 30 years or older. A mainstay of the screening consisted of applanation tonometry and fundus photography with a non-mydriatic camera, followed by automated perimetry as a recall examination. Overall prevalences of glaucoma obtained were primary open angle glaucoma 0.23% (10 patients), low tension glaucoma 2.04% (108 patients), and ocular hypertension 0.23% (10 patients). The mean lOP obtained with applanation tonometry was 14.04 +/- 2.99 mmHg for men and 14,07 +/- 2.67 mmHg for women. In additon, our data have pointed out that the lOP in different ages tends to be constant, whereas prevalences of glaucoma and low tension glaucoma increase with aging.
Adult* ; Aging ; Blindness ; Epidemiologic Studies ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Korea ; Low Tension Glaucoma ; Male ; Manometry ; Mass Screening ; Ocular Hypertension ; Photography ; Prevalence* ; Visual Field Tests

The purpose of this study is to investigate the response of human pulp cell on Portland cement mixed with beta-glycerophosphate. To investigate the effect of beta-glycerophosphate and/or dexamethasone on human pulp cell, ALP activity on various concentration of beta-glycerophosphate and dexamethasone was measured and mineral nodule of human pulp cell was stained with Alizarin red S. MTS assay and ALP activity of human pulp cell on Portland cement mixed with various concentration of beta-glycerophosphate (10 mM, 100mM, 1M) was measured and the specimens were examined under SEM. Addition of beta-glycerophosphate or dexamethasone alone had no effect however, the addition of 5 mM beta-glycerophosphate and 100 nM dexamethasone had the largest increasement in ALP activity. There was no toxicity in all samples and the data showed that Portland cement mixed with 10 mM beta-glycerophosphate had more increase in ALP activity compared with control. In conclusion, Portland cement mixed with beta-glycerophosphate has no toxicity and promotes differentiation and mineralization of pulp cell compared with additive-free Portland cement. This implicated that application of Portland cement mixed with beta-glycerophosphate might form more reparative dentin and in turn it would bring direct pulp capping to success.
Anthraquinones ; Dental Pulp Capping ; Dentin ; Dexamethasone ; Glycerophosphates ; Humans

No abstract available.
Allergens* ; Hypersensitivity* ; Lymphocyte Activation* ; Lymphocytes* ; Mitogens* ; T-Lymphocytes*