Diabetes is a rapidly increasing heath care problem all over the world due to increased prevalence during past decade. Diabetic nephropathy develops in 25-30% of patients with type 1 diabetes and is the leading cause of end stage renal disease. Diabetic nephropathy is characterized by persistent proteinuria, decline in renal function, hypertension and increased cardiovascular morbidity and mortality. Early detection of diabetic nephropathy risk is an important goal because early diagnosis and treatment prevent advanced renal damage and other diabetic complications. Increased urinary albumin excretion rate is widely accepted as the first clinical sign of diabetic nephropathy. However, reduced glomerular filtration or hypertension could be the first manifestation in some diabetic patients. We need improved markers and predictors of diabetic nephropathy risk. We report a case of diabetic nephropathy and decreased glomerular filtration rate (GFR) without microalbuminuria occcured in type 1 diabetic patient.
Diabetes Complications ; Diabetic Nephropathies* ; Early Diagnosis ; Filtration ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality ; Prevalence ; Proteinuria

Most of thyroid lymphomas are B-lineage, and T-cell lymphomas are rare. Here, we report a case of primary thyroid T-cell lymphoma associated with Hashimoto's thyroiditis. A 48-yr-old woman presented with incidentally found neck mass. Histologically, the resected right lobe of the thyroid was replaced by monomorphic small atypical lymphoid cells with lymphoepithelial lesion-like change, most of which were immunoreactive for CD3, CD8, betaF-1, and TIA-1. Peripheral T-cell lymphoma, unspecified, was finally diagnosed after molecular study for TCR-gamma gene rearrangement. This is the second case of cytotoxic T-cell lymphoma reported in the thyroid gland so far. Unique association between thyroid follicles and neoplastic lymphocytes may be characteristic feature of this type of T-cell lymphoma.
Female ; Hashimoto Disease/*pathology ; Humans ; Lymphoma, B-Cell, Marginal Zone/*pathology ; Lymphoma, T-Cell/*pathology ; Middle Aged ; T-Lymphocyte Subsets/immunology/pathology ; T-Lymphocytes, Cytotoxic/immunology/pathology ; Thyroid Gland/*pathology

No abstract available.
Maxillary Sinus*

Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals.
Anthozoa ; Aquatic Organisms ; Bacterial Infections ; Biopsy ; Bites and Stings ; Blister ; Burns ; Cellulitis ; Cnidaria ; Diving ; Erythema ; Foreign Bodies ; Humans ; Male ; Necrosis ; Nematocyst ; Neutrophils ; Panniculitis ; Young Adult

We report a case of a 67-year-old man presenting with a 2-week history of erythematous zosteriform indurated confluent nodules and plaques on the right chest which was affected by a herpes zoster infection one month ago. The previous history revealed an adenocarcinoma with malignant pleural effusion on the right lung (stage IV, T4N1M1) 3 months ago. Histopathologic findings showed tumor cells infiltrated throughout the dermis, forming focal glandular structures. We think that the case was the isotopic response in the form of an occurrence of a new skin disorder at the site of another unrelated and already healed skin disease. Many cases of isotopic response have been reported in Korean literature such as lichen planus, granuloma annulare, benign fibrous histiocytoma and reactive perforating collagenosis occurring on the healed site of herpes zoster infection. This is the first report of cutaneous metastatic carcinoma as an isotopic response in Korea.
Adenocarcinoma ; Aged ; Dermis ; Granuloma Annulare ; Herpes Zoster ; Histiocytoma, Benign Fibrous ; Humans ; Lichen Planus ; Lung ; Pleural Effusion, Malignant ; Skin ; Skin Diseases ; Thorax

Elephantiasis nostras verrucosa is an uncommon disorder that is characterized by dermal fibrosis, hyperkeratotic verrucous and papillomatous lesions and this is all caused by chronic non-filarial lymphedema secondary to infections, surgeries, tumor obstructions, radiations, congestive heart failure and obesity. We report here on a case of elephantiasis nostras verrucosa that occurred on the left lower leg of a 54-year-old woman who had a past history of extensive skin grafts and recurrent infection.
Elephantiasis ; Female ; Fibrosis ; Heart Failure ; Humans ; Leg ; Middle Aged ; Non-Filarial Lymphedema ; Obesity ; Skin ; Skin Transplantation ; Transplants

Eccrine angiomatous hamartoma (EAH) is a rare benign disease that is characterized by an abnormal proliferation of eccrine glands and vascular elements. It is generally congenital, but it can appear before puberty. It usually presents as a single plaque or nodule, but multiple patch-like lesions are also possible. EAH is mostly asymptomatic, but it is sometimes associated with pain or hyperhidrosis. It generally does not require aggressive treatment, but the lesion can be excised due to pain, enlargement and cosmetic reasons. A 3-week-old Korean female presented with a hemorrhagic skin lesion on the right foot since birth. There was no specific birth history. The lesion first appeared on the third toe of the right foot and quickly spread to almost half of the right foot. Histopathology examination revealed acanthosis in the epidermis and a proliferation of eccrine ducts, glands and capillaries. The eccrine glands were immunohistochemically-positive for carcinoembryonic antigen.
Capillaries ; Carcinoembryonic Antigen ; Cosmetics ; Eccrine Glands ; Epidermis ; Female ; Foot ; Hamartoma ; Hemorrhage ; Humans ; Hyperhidrosis ; Parturition ; Puberty ; Reproductive History ; Skin ; Toes

OBJECTIVE: The purpose of this study was to investigate the aortic isthmus (AoI) flow difference between larger fetus and smaller fetus of twin; and to evaluate the predictive value of early diagnosis of hemodynamic change in twin growth. METHODS: This prospective study on 49 pairs of twin fetuses was performed to obtain AoI blood flow data. Cases with structural or chromosomal abnormalities and co-twin death were excluded. The interval from examination to delivery was within 4 weeks and 3 cases over 4 weeks interval were re-examined. Assessment of fetal AoI Doppler parameters were peak systolic velocity (PSV), end-diastolic velocity, times-averaged maximum velocities, pulsatility index (PI), and resistance index (RI). According to the direction of the diastolic flow in the AoI, antegrade and retrograde flow were made and was used to analyze the perinatal outcomes of each fetus. The predictive value of AoI Doppler parameters in predicting fetal growth was obtained by using ANOVA and logistic regression analysis of quantitative variables in each fetus of twins. RESULTS: There were significant differences in the gestational weeks at delivery, birth weight and the incidence of growth discordance over 20% or more between monochorionic twin and dichorionic twin. The AoI PI and RI were significantly higher in smaller fetus than in larger regardless of chorionicity. Retrograde flow was noted in 8 of 98 cases (8.2%) and the only one case was of the larger fetus and the others were smaller fetuses of twin. Significant correlations were found between the AoI PI and birthweight (P=0.018) and between the PSV and growth discordance (P=0.032). In monochorionic twin, linear correlation was shown between the AoI PI and birthweight (P=0.004) and between AoI PI and growth discordance (P=0.031). Also, the meaningful correlation between the PSV and birthweight (P=0.036) was found by using logistic regression analyses. CONCLUSION: On the basis of our observation, AoI PI has revealed their hemodynamic status and this result may improve the understanding of growth patterns in twins.
Birth Weight ; Chorion ; Chromosome Aberrations ; Early Diagnosis ; Fetal Development ; Fetus ; Hemodynamics ; Humans ; Incidence ; Logistic Models ; Prospective Studies ; Twins*

BACKGROUND: Demodicosis is a common cutaneous disease that is caused by demodex mites, which reside in the pilosebaceous follicles. However, any data of the clinical features and the factors that induce or aggravate demodicosis is lacking in the Korea literature. OBJECTIVE: We aimed to demonstrate the clinical feature and determine the medical or personal history that influences demodicosis. METHODS: We performed a retrospective study to review clinical features, the histopathologic findings and the past medical and personal history of Korean patients who suffer with demodicosis. RESULTS: Thirty-four patients were diagnosed with demodicosis based on the clinical features, the potassium hydroxide examination and/or the skin biopsy specimen. There were 11 males and 23 female patients (mean age: 44.4 years). The mean duration of disease was 15.5 months. The clinical features were classified to acne rosacea-like (n=26), perioral dermatitis-like (n=3), granulomatous rosacea-like (n=2), pityriasis folliculorum (n=2) and demodex abscess (n=1). Skin biopsy was performed on 10 patients and the histopathologic findings showed demodex mites in the follicular infundibulum or sebaceous ducts with a perifollicular and perivascular inflammatory infiltrate in all case. According to the medical history, 17 patients had history of chronic use of topical steroid and calcineurin inhibitor and 5 patients didn't use the soap during washing their face. CONCLUSION: Our findings indicate that demodicosis demonstrates various clinical presentations. If patients with facial eruption chronically use topical steroid or calcineurin inhibitor or they do not use soap, demodicosis should be considered in the differential diagnosis and a potassium hydroxide examination or skin biopsy may be helpful to diagnose and treat the facial eruption.
Abscess ; Acne Vulgaris ; Biopsy ; Calcineurin ; Diagnosis, Differential ; Female ; Humans ; Hydroxides ; Korea ; Male ; Mites ; Pityriasis ; Potassium ; Potassium Compounds ; Retrospective Studies ; Skin ; Soaps

Neurogenic bladder (NB) after spinal cord injury (SCI) is a common complication that inhibits normal daily activities and reduces the quality of life. Regrettably, the current therapeutic methods for NB are inadequate. Therefore, numerous studies have been conducted to develop new treatments for NB associated with SCI. Moreover, a myriad of preclinical and clinical trials on the effects and safety of stem cell therapy in patients with SCI have been performed, and several studies have demonstrated improvements in urodynamic parameters, as well as in sensory and motor function, after stem cell therapy. These results are promising; however, further high-quality clinical studies are necessary to compensate for a lack of randomized trials, the modest number of participants, variation in the types of stem cells used, and inconsistency in routes of administration.