Lymphomatoid granulomatosis (LYG) is an Epstein-Barr virus (EBV)-associated lymphoproliferative disease. It is considered a rare entity in pediatric patients. An adolescent male with lobar consolidation suspected of having pneumonia was resistant to antibiotics and had persistently abnormal radiographs with chest pain. The patient was diagnosed with pulmonary LYG through video-assisted thoracoscopic surgery (VATS) lung biopsy. He received eight cycles of rituximab, vincristine, cyclophosphamide, and prednisolone (R-CVP) but had progressive disease. As the patient developed hypogammaglobulinemia after eight courses of rituximab, he received intravenous gamma globulin (IVIG) at regular interval. With immune augmentation effect of IVIG and immune modulation treatment with prednisolone, the patient has shown no aggravation of the lung lesions. Considering its rarity, high mortality, and frequent relapses, diagnostic methods investigating the radiologic abnormalities can help in early treatment initiation.

PURPOSE: This study aimed to evaluate the clinical usefulness of non-invasive prenatal testing (NIPT) as an alternative testing of invasive diagnostic testing in pregnancies with ultrasound abnormalities. MATERIALS AND METHODS: This was a retrospective study of pregnant women with abnormal ultrasound findings before 24 weeks of gestation between April 2016 and March 2017. Abnormal ultrasound findings included isolated increased nuchal translucency, structural anomalies, and soft markers. The NIPT or diagnostic test was conducted and NIPT detected trisomy 21 (T21), T18, T13 and sex chromosomal abnormalities. We analyzed the false positive and residual risks of NIPT based on the ultrasound findings. RESULTS: During the study period, 824 pregnant women had abnormal ultrasound findings. Among the study population, 139 patients (16.9%) underwent NIPT. When NIPT was solely performed in the patients with abnormal ultrasound findings, overall false positive risk was 2.2% and this study found residual risks of NIPT. However, the discordant results of NIPT differed according to the type of abnormal ultrasound findings. Discordant results were significant in the group with structural anomalies with 4.4% false positive rate. However, no discordant results were found in the group with single soft markers. CONCLUSION: This study found different efficacy of NIPT according to the ultrasound findings. The results emphasize the importance of individualized counseling for prenatal screening or diagnostic test based on the type of abnormal ultrasound.
Chromosome Aberrations ; Congenital Abnormalities ; Counseling ; Diagnostic Tests, Routine ; Down Syndrome ; Female ; Humans ; Nuchal Translucency Measurement ; Pregnancy* ; Pregnant Women ; Prenatal Diagnosis ; Retrospective Studies ; Ultrasonography*

BACKGROUND: Atopic dermatitis (AD) is a common, complex disease that follows a chronic relapsing course and significantly affects the quality of life of patients. Skin barrier dysfunction and inflammatory processes induce and aggravate this skin condition. Proper use of an emollient for hydration is a keystone of AD treatment. Bee venom is known to have anti-inflammatory effects and has been widely used in traditional medicine to treat various inflammatory disorders. OBJECTIVE: To find out the beneficial effect of an emollient containing bee venom in the treatment of patients with AD. METHODS: This study included 136 patients with AD who were randomized to receive either an emollient containing bee venom and silk-protein or a vehicle that was identical except for the bee venom for 4 weeks. The patients were instructed to apply the emollient twice daily on their entire body and not to use other medications, including topicals, during the course of the study. The eczema area and severity index (EASI) score, transepidermal water loss, and visual analogue scale (VAS) score of itching were evaluated at the first visit and after 2 and 4 weeks. The investigator global assessment was evaluated at 2 and 4 weeks after the application of emollient containing bee venom or vehicle. RESULTS: Patients applying emollient containing bee venom showed significantly lower EASI score and VAS value compared to patients applying emollient without bee venom. CONCLUSION: Emollient containing bee venom is a safe and effective option for patients with AD.
Bee Venoms* ; Bees* ; Dermatitis, Atopic* ; Eczema ; Emollients ; Humans ; Medicine, Traditional ; Pruritus ; Quality of Life ; Research Personnel ; Skin ; Water

PURPOSE: To evaluate the clinical outcome of retreatment after refractive surgery. METHODS: Retrospective analysis of 38 eyes of 24 patients who received retreatment surgery after refractive surgery from August 2008 to May 2013 was performed. Pre-initial surgery characteristics and the reason for retreatment were investigated, and preand post-retreatment uncorrected visual acuity, best corrected visual acuity, safety index, efficacy index, predictability, and postoperative complication were also investigated. RESULTS: Age at initial refractive surgery and retreatment were 28.50 +/- 7.29 years (17-49 years) and 31.21 +/- 6.49 years (21-49 years). Reasons for retreatment were myopic regression in 36 eyes (94.7%) and overcorrection in two eyes (5.3%). Methods of retreatment were laser subepithelial keratomileusis (LASEK) in 31 eyes (81.6%) and laser-assisted in situ keratomileusis (LASIK) in seven eyes (18.4%). Safety index values for all were above 1.0 and efficacy index values were 0.92, 0.93, and 0.95 in postoperative examination at 1 month, 3 months, and 6 months, respectively. No eye showed a decrease in best corrected visual acuity. One eye had transient hyperopia after retreatment, and two eyes had postoperative corneal opacity, but no eye experienced significant alteration in visual prognosis. CONCLUSIONS: Retreatment after refractive surgery was an efficient and safe clinical course in our clinic. No long-term complications were observed, and uncorrected visual acuity and refractive errors significantly improved after retreatment. In particular, LASEK can be considered as a safe and efficient retreatment modality without risk of keratectasia.
Corneal Opacity ; Humans ; Hyperopia ; Keratectomy, Subepithelial, Laser-Assisted ; Keratomileusis, Laser In Situ ; Postoperative Complications ; Prognosis ; Refractive Errors ; Refractive Surgical Procedures* ; Retreatment* ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluation the accuracy of the IOL power calculation formulae measured by IOL Master(R) and applanation ultrasonography for the Tecnis ZCB00 IOL. METHODS: We performed a retrospective study of 170 eyes in 121 patients who underwent cataract surgery in our hospital with AMO Tecnis ZCB00 IOL.s. The SRK/T formula was used to predict the patient's implanted IOL power. Differences in the predicted refractive errors between IOL Master(R) and ultrasonography were analyzed and factors attributed to the differences were also analyzed. Three months after cataract surgery, mean numeric error and mean absolute error were analyzed. RESULTS: SRK/II and SRK/T formulas calculated using ultrasonography showed differences compared to the same formulas calculated using IOL Master(R), in which hyperopic shift was also demonstrated. No definite factor was attributed to the differences between the 2 methods. Although the 3 formulas of IOL Master(R) showed no significant difference in refractive errors, the SRK/T formula calculated using IOL Master(R) showed the least mean absolute and numeric errors. CONCLUSIONS: IOL Master(R) is considered more suitable when determining proper AMO Tecnis ZCB00 IOL power in cataract surgery. The hyperopic shift should be considered when calculating the IOL power using only ultrasonography.
Cataract ; Ultrasonography* ; Humans ; Lenses, Intraocular* ; Refractive Errors ; Retrospective Studies ; Ultrasonography

PURPOSE: The studies concerning the clinical features of patients with anaphylaxis, who meet the newly established diagnostic criteria, are reported in Korea, but comparative studies regarding the clinical features of children and adult patients with anaphylaxis are lacking. The purpose of this study is to compare the clinical features of the children and adults with anaphylaxis, who meet the new diagnostic criteria at a single hospital. METHODS: We reviewed the medical records of patients who were diagnosed with anaphylaxis, anaphylactic shock, urticaria, and angioedema, including inpatients, outpatients and emergency room visited patients, at the National Medical Center from July, 2005 to August, 2011. The clinical characteristics of children and adults, who met the new diagnostic criteria for anaphylaxis, were analyzed. RESULTS: We identified 91 patients with anaphylaxis. Sixteen were children and 75 were adults. The sex ratio (male:female) and the mean age were 1:1.7 and 9.6 years among children, respectively, and 1:2.3 and 42.3 years, respectively, among adults. The most common cause of anaphylaxis based on clinical history was foods in 15 children (93.7%) and 35 adults (46.7%). Twelve children (75%) and 36 adults (48%) were rediagnosed with anaphylaxis. Patients with cardiovascular symptoms and severe severity were 1 (6.3%) and 1 (6.3%), respectively, among children, and 28 (37.3%) and 23 (30.3%), respectively, among adults. CONCLUSION: We rediagnosed some cases of anaphylaxis, using the new diagnostic criteria and most of the cases were diagnosed initially as urticaria or angioedema. The adults had more severe and more cardiovascular symptoms than children. In the future, a nationwide, multiinstitutional research will be necessary for the prevalence and the clinical features of anaphylaxis by the new diagnostic criteria in Korea.
Adult ; Anaphylaxis ; Angioedema ; Child ; Emergencies ; Humans ; Inpatients ; Korea ; Medical Records ; Outpatients ; Prevalence ; Sex Ratio ; Urticaria

PURPOSE: Anaphylaxis is a medical emergency requiring immediate recognition and treatment. Despite the serious nature of these reactions, there is no universal agreement on the definition and there have been few epidemiologic studies of anaphylaxis in children. The purpose of the study is to investigate the causative agents, presenting signs and symptoms and course of disease in children suitable for established diagnostic criteria for anaphylaxis in the middle area of South Korea. METHODS: We identified potential episodes of anaphylaxis occuring between March 1994 and October 2007 from the university hospitals in the middle area of South Korea. We reviewed all patients' medical records diagnosed with anaphylaxis and other related diagnoses. From chart review, we retrospectively collected demographic and epidemiologic data. RESULTS: We identified 40 patients with anaphylaxis. Patients' ages ranged from 2 months to 17 years, with a mean age of 6.6 years. A causative agent was recognized in 84.5%. The inciting agent included foods in 26 cases (65%), medication in 7 cases (17.5%) and bee sting in 1 case (2.5%). Mucocutaneous manifestations were the most common, respiratory symptoms were in 35 patients, cardiovascular symptoms were in 8 patients, and gastrointestinal symptoms were in 5 patients. CONCLUSION: We found some cases of anaphylaxis which had misdiagnosed as urticaria or angioedema using the established diagnostic criteria. Therefore, clinicians must accurately know the criteria of anaphylaxis and make an effort to identify cases of anaphylaxis with a high suspicion. Also, we found the epidemiology, causative agents, and symptoms and treatments of anaphylaxis in the middle area of South Korea. Our data will be the basis for anaphylactic studies in South Korea.
Anaphylaxis ; Angioedema ; Bees ; Bites and Stings ; Child ; Collodion ; Emergencies ; Epidemiologic Studies ; Hospitals, University ; Humans ; Medical Records ; Republic of Korea ; Retrospective Studies ; Urticaria

A 77-year old man presented with a fungating mass on the oral mucosa and lip, which had an irregular margin. An incisional biopsy of the mass revealed an invasive squamous cell carcinoma. PCR analysis detected HPV DNA in the biopsy specimen. The HPV type was determined as HPV-53 by direct cycle sequencing. This is the first report of HPV-53 in an oral malignant tumor.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; DNA ; Humans ; Lip ; Mouth Mucosa* ; Mouth Neoplasms ; Polymerase Chain Reaction

Folliculosebaceous cystic hamartoma (FSCH) is a recently-recognized cutaneous hamar- toma composed of follicular, sebaceous and mesenchymal elements. We describe an unusual case of FSCH in a 61-year-old male, who had a relatively large, 3x2.5cm sized, smooth subcutaneous nodule on the occipital area of the scalp, an uncommon location for FSCH.
Hamartoma* ; Humans ; Male ; Middle Aged ; Scalp

BACKGROUND: Although atopic dermatitis (AD) is a very common disease, there is no specific diagnostic or prognostic marker for it. Minor clinical features and a few laboratory findings can be used as ancillary diagnostic criteria and reflect the present state of AD, but cannot predict the disease severity. OBJECTIVE: We performed this study to find out if there is any correlation among minor clinical features, laboratory findings such as blood eosinophil count and serum IgE levels, and the severity of AD. METHODS: One hundred patients with AD were involved in the study. They were divided into two groups by the age of 12 years; group 1(< or = 12-year-old, n=47) represented childhood AD and group 2 (> or = 12-year-old, n=53) represented adolescence and adult AD. Subsequently, the severity of AD was assessed by the SCORAD index, and then all the patients were classified into 3 subgroups; mild, moderate and severe groups. They were evaluated for 28 minor clinical features of AD. In addition, blood samples were measured for blood eosinophil count and serum IgE levels. RESULTS: The pattern of minor clinical features correlated significantly with the disease severity was quite different between the two groups, except ventral wrist eczema and eyelid eczema. Blood eosinophil count and serum IgE levels increased significantly as the SCORAD index increased. While perifollicular accentuation was a significant minor clinical feature that correlated with blood eosinophil count in the both groups, there were no minor features showing statistically significant correlation with serum IgE levels. In group 1, keratosis pilaris and infragluteal eczema appeared more frequently as all 3 variables such as the SCORAD index, blood eosinophil count and serum IgE levels, increased simultaneously. However, no minor clinical features which correlated significantly with all variables were observed in group 2. CONCLUSION: We concluded that minor clinical features such as keratosis pilaris and infragluteal eczema reflect the disease severity and can be used as an anticipating sign of severe disease, especially in childhood AD.
Adolescent ; Adult ; Child ; Dermatitis, Atopic* ; Eczema ; Eosinophils ; Eyelids ; Humans ; Immunoglobulin E ; Keratosis ; Wrist