BACKGROUND: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. METHODS: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. RESULTS: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. CONCLUSION: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.
Humans ; Lung Diseases ; Nontuberculous Mycobacteria

Desmoplastic trichoepithelioma is a rare benign adnexal tumor that usually presents as an asymptomatic, firm, annular plaque. It most commonly occurs on sun-exposed areas in middle-aged women, especially on the face. Patients typically give a history of a single, slow-growing lesion that has been present for several years. The diagnosis of desmoplastic trichoepithelioma can be made when a triad of microscopic findings are observed in combination with a compatible clinical picture. We herein report a case of desmoplastic trichoepithelioma associated with syringomas on the face of a young woman.
Diagnosis ; Female ; Humans ; Syringoma*

Acitretin, the principal and free acid metabolite of etretinate, is used to treat patients with several types of psoriasis. The common side effects encountered with acitretin therapy are cheilitis, conjunctivitis, xerosis, dryness of the nasal mucosa with minor nosebleeds, pruritis, and desquamation of the palms and soles. Granulation tissue is a well recognized side effect of oral acitretin. This reaction is characterized by ulceration, hemorrhagic crusting and excess granulation tissue. It occurs between the third and 12th weeks of therapy, most commonly affects the hands and feet. We present a case of multiple granulation tissues associated with acitretin therapy.

PURPOSE: The International Prostate Symptom Score (IPSS) is generally self- administrated; however, it is doubtful that the self-administrated IPSS score correctly reflects patients' symptoms; therefore, the difference in the IPSS self-administrated score and physician-interviewed patients was studied. MATERIALS AND METHODS: A total of 202 patients completed two IPSS questionnaires during the same office visit, one by self-administration and the other by physician-interview, at two medical centers, one located in an urban area and the other in a rural area. The mean total symptom score and the score for each question, and the quality of life score were compared between the two modes of administration. A multi-logistical regression analysis was performed to identify differences due to the effects of age, the order of administration, location and educational level. RESULTS: The mean total symptom score and quality of life score were higher in the self-administrated than physician-interviewed group (14.16 vs. 13.07, p=0.001, 3.27 vs. 3.2, p=0.090). The residual sense (2.03 vs. 1.97, p=0.20), frequency (2.07 vs. 1.97, p=0.026), interruption (1.83 vs. 1.61, p=0.002), urgency (1.89 vs. 1.55, p=0.001), weak stream (2.74 vs. 2.60, p=0.042), hesitancy (1.77 vs. 1.59, p=0.005) and nocturia (1.82 vs. 1.77, p=0.12) were also higher in the self-administrated group. The multi- logistical regression analysis revealed statistically significant differences in relation to age and location. CONCLUSIONS: The self-administrated IPSS score was higher than the physician-interview score, especially in relation to an older age and an urban location. Therefore, active intervention should be considered during the administration of the IPSS, especially for old aged patients living in urban areas.
Humans ; Lower Urinary Tract Symptoms* ; Nocturia ; Office Visits ; Prostate* ; Quality of Life ; Questionnaires ; Rivers ; Urinary Tract

Rice is a popular food all over the world. Rice is regarded as hypoallergenic and rice hypersensitivity is not common. We experienced a case of multiple food allergy including cow's milk, egg white, buckwheat, soybean and rice. The 8 month-old boy presenting with atopic dermatitis developed recurrent wheezing later. Laboratory findings showed a high serum level of total IgE (561 kU/L), and high levels of specific IgE to rice (11.0 kU/L), egg white (13.0 kU/L), cow's milk (5.73 kU/L), buckwheat (5.45 kU/L), and soybean (25.5 kU/L) using the immune-CAP system. Foods causing allergic reaction were absolutely eliminated and substituted with hypoallergic formula milk. Thereafter, his skin lesions began to improve, and 5 months later, he was tolerable to eat rice. However, he developed recurrent wheezing at the age of 23 months. At now 4 years, he is regularly followed up without any symptoms of food allegy.
Dermatitis, Atopic ; Egg White ; Fagopyrum ; Food Hypersensitivity ; Hypersensitivity ; Immunoglobulin E ; Milk ; Respiratory Sounds ; Skin ; Soybeans

Calcaneal petechiae (black heel) is a traumatic lesion affecting the back or posterolateral aspect of the heel. An asymptomatic, pigmented, macular lesion is found on one or both heels immediately above the hyperkeratotic border of the foot. It is caused by any sport, such as basketball, tennis, or football, that leads to slamming of the foot against the shoe. Calcaneal petechiae is probably more common than is realized. As it is usually symptomless, it may be disregarded or only observed by chance. The importance of the lesion lies in its clinical resemblance to a malignant melanoma. We report a case of calcaneal petechiae which was confused clinically with a melanoma.
Child ; Male ; Female ; Humans

BACKGROUND AND PURPOSE: The Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version. METHODS: Ninety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants. RESULTS: The test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87–1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups. CONCLUSIONS: The newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.
Aged ; Dementia ; Humans ; Memory ; Memory, Short-Term ; Mild Cognitive Impairment ; Seoul ; Verbal Learning

Background: Diabetes is recognized as a risk factor for various inflammatory conditions, including periodontitis. There exists a bidirectional relationship between glycemic control and oral health in individuals with diabetes. This study aimed to analyze the link between glycemic control and oral health status among Korean patients with diabetes. Methods: Using data from a population-based nationwide survey conducted between 2007 and 2019, we identified 70,554 adults with diabetes-related information. The study population included 9,090 individuals diagnosed with diabetes and 61,164 healthy controls. The association between glycemic control, defined by mean glycated hemoglobin (HbA1c) values, and various oral health measures, such as tooth brushing frequency, periodontitis, denture wearing, Decayed, Missing, and Filled Teeth (DMFT) index, number of remaining teeth, and past-year dental clinic visits, was evaluated using multivariate logistic regression analyses. Results: Compared to the control group, patients with diabetes exhibited a higher prevalence of periodontitis (88.6% vs. 73.3%), complete dentures (5.0% vs. 1.5%), and elevated DMFT index (33.2% vs. 26.7%) (all P < 0.001). Multivariate analyses revealed significant associations between diabetes and several oral health factors: denture status (No denture: adjusted odds ratio [aOR], 0.784; 95% confidence interval [CI], 0.627–0.979), and having fewer permanent teeth (0–19) (aOR, 1.474; 95% CI, 1.085–2.003). Additionally, a positive correlation was found between higher HbA1c levels and the risk of having fewer remaining teeth (0–19) (HbA1c < 6.5%: aOR, 1.129; 95% CI, 0.766–1.663; 6.5% ≤ HbA1c < 8.0%: aOR, 1.590; 95% CI, 1.117– 2.262; HbA1c ≥ 8%: aOR, 1.910; 95% CI, 1.145–3.186) (P for trends = 0.041). Conclusion We found a positive association between diabetes and poor oral health, as well as a noteworthy relationship between reduced permanent teeth (≤ 19) and glycemic control.These insights emphasize the critical role of oral health management in diabetic care and underscore the importance of maintaining effective glycemic control strategies for overall health and well-being in patients with diabetes.

We have experienced three cases of mucinous ductal ectasia of the pancreas. They showed the characteristic duodenoscopic findings and underlying pathology was hyperplasia in two cases and adenocarcinoma in one case. When endoscopic retrograde pancreatography was performed, bulging ampulla of Vater, patulous ampullary orifice and mucus leakage from papillary orifice were noted. Also cyst-like dilatation of main duct or side branch of the uncinate process were observed.
Adenocarcinoma ; Ampulla of Vater ; Dilatation ; Dilatation, Pathologic* ; Hyperplasia ; Mucins* ; Mucus ; Pancreas* ; Pathology

OBJECTIVE: The aim of this study is to clarify the characteristics of patients with dementia using long-term care hospitals and the demands of their caregivers. It will provide a perspective for establishing the specialized dementia hospital and appropriate dementia services in the future. METHODS: The survey was performed to the caregivers of the dementia inpatients of 71 public long-term care hospitals and outpatients from local hospitals. We distributed the questionnaires to 3,600 caregivers. Of these, 1,572 returned and then included in the analysis. RESULTS: High number of both inpatients (85.7%) and outpatients (61.5%) were diagnosed with dementia in psychiatric or neurologic department. Time laps from onset of symptoms thought as dementia to actual diagnosis was about a year. Caregivers of dementia inpatients wanted mostly dementia related welfare and care products (85.5%), physical and exercise program (84.0%), specialized dementia ward (83.1%), behavioral management (82.1%), and cognitive rehabilitation (80.5%). CONCLUSION: It is important to provide adequate management to both the patients with dementia and the caregivers. Thus, specialized institutional arrangements and medical service improvement supported by government is needed to reduce the psychological and financial burden of caregivers. We hope these results will be used to establish the principals and standards of specialized dementia hospital.
Caregivers* ; Dementia* ; Diagnosis ; Hope ; Hospitals, General* ; Humans ; Inpatients* ; Long-Term Care* ; Outpatients* ; Surveys and Questionnaires ; Rehabilitation