Background: Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts. Methods: We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location. Results: From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area. Conclusion The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.

This regulatory post-marketing surveillance study aimed to evaluate the therapeutic efficacy and safety of drospirenone (DRSP) 2 mg/estradiol (E₂) 1 mg tablet in Korean postmenopausal women. A total of 4,149 patients were enrolled and the study was conducted at 207 clinical research centers. The patients' source data was collected between November 2006 and November 2012. More than 85% of patients experienced improvement of menopausal symptoms. The most frequently reported adverse events were vaginal bleeding and breast pain; most of the women suffering from these symptoms fully recovered. The incidence of adverse event was higher in patients of younger age (20 to 39 years), in patients with concomitant diseases, previous hormone replacement therapy in medical history, those treated with DRSP 2 mg/E₂ 1 mg for shorter duration (3 years or less) and in patients using concomitant medication. In conclusion, the results from this large post-marketing surveillance study confirm the efficacy and safety of DRSP 2 mg/E₂ 1 mg tablet in Korean postmenopausal women.
Female ; Hormone Replacement Therapy ; Humans ; Incidence ; Mastodynia ; Menopause ; Uterine Hemorrhage

Opioid-induced chest wall rigidity is an uncommon complication of opioids. Because of this, it is often difficult to make a differential diagnosis in a mechanically ventilated patient who experiences increased airway pressure and difficulty with ventilation. A 76-year-old female patient was admitted to the intensive care unit (ICU) after surgery for periprosthetic fracture of the femur neck. On completion of the surgery, airway pressure was increased, and oxygen saturation fell below 95% after a bolus dose of fentanyl. After ICU admission, the same event recurred. Manual ventilation was immediately started, and a muscle relaxant relieved the symptoms. There was no sign or symptom suggesting airway obstruction or asthma on physical examination. Early recognition and treatment should be made in a mechanically ventilated patient experiencing increased airway pressure in order to prevent further deterioration.
Aged ; Airway Obstruction ; Analgesics, Opioid ; Asthma ; Diagnosis, Differential ; Female ; Femur Neck ; Fentanyl* ; Humans ; Intensive Care Units ; Lung Diseases, Obstructive ; Muscle Rigidity ; Oxygen ; Periprosthetic Fractures ; Physical Examination ; Thoracic Wall* ; Thorax* ; Ventilation

Opioid-induced chest wall rigidity is an uncommon complication of opioids. Because of this, it is often difficult to make a differential diagnosis in a mechanically ventilated patient who experiences increased airway pressure and difficulty with ventilation. A 76-year-old female patient was admitted to the intensive care unit (ICU) after surgery for periprosthetic fracture of the femur neck. On completion of the surgery, airway pressure was increased, and oxygen saturation fell below 95% after a bolus dose of fentanyl. After ICU admission, the same event recurred. Manual ventilation was immediately started, and a muscle relaxant relieved the symptoms. There was no sign or symptom suggesting airway obstruction or asthma on physical examination. Early recognition and treatment should be made in a mechanically ventilated patient experiencing increased airway pressure in order to prevent further deterioration.
Aged ; Airway Obstruction ; Analgesics, Opioid ; Asthma ; Diagnosis, Differential ; Female ; Femur Neck ; Fentanyl ; Humans ; Intensive Care Units ; Lung Diseases, Obstructive ; Muscle Rigidity ; Oxygen ; Periprosthetic Fractures ; Physical Examination ; Thoracic Wall ; Thorax ; Ventilation

Swiprosin-1 exhibits the highest expression in CD8+ T cells and immature B cells and has been proposed to play a role in lymphocyte biology through actin remodeling. However, regulation of swiprosin-1 gene expression is poorly understood. Here we report that swiprosin-1 is up-regulated in T cells by PKC pathway. Targeted inhibition of the specific protein kinase C (PKC) isotypes by siRNA revealed that PKC-theta is involved in the expression of swiprosin-1 in the human T cells. In contrast, down-regulation of swiprosin-1 by A23187 or ionomycin suggests that calcium-signaling plays a negative role. Interestingly, swiprosin-1 expression is only reduced by treatment with NF-kappaB inhibitors but not by NF-AT inhibitor, suggesting that the NF-kappaB pathway is critical for regulation of swiprosin-1 expression. Collectively, these results suggest that swiprosin-1 is a PKC-theta-inducible gene and that it may modulate the late phase of T cell activation after antigen challenge.
Actins ; Biology ; Calcimycin ; Down-Regulation ; Gene Expression ; Humans ; Ionomycin ; Lymphocytes ; NF-kappa B ; Precursor Cells, B-Lymphoid ; Protein Kinase C ; Protein Kinases ; RNA, Small Interfering ; T-Lymphocytes

Autoimmune thyroid disease associated with Moyamoya syndrome has mostly been reported as Graves' disease, and not as Hashimoto's thyroiditis. We report a case of a 70-year-old man with right posterior cerebral artery territorial infarction and bilateral distal internal carotid artery occlusion, which suggests Moyamoya syndrome, but who was diagnosed as Hashimoto's thyroiditis.
Aged ; Carotid Artery, Internal ; Graves Disease ; Humans ; Infarction ; Moyamoya Disease ; Posterior Cerebral Artery ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate and compare the incidence and the characteristics of parameters of cervical vestibular-evoked myogenic potentials (cVEMPs) using air-conducted (AC) and bone-conducted (BC) stimulations in normal subjects. SUBJECTS AND METHOD: Twenty-four normal subjects (48 ears) with normal hearing and no previous history of dizziness were included. cVEMP responses were recorded by surface electrodes on sternocleidomastiod muscles in response to AC and BC stimuli sequentially. Variances of parameters, including thresholds, amplitudes and interaural amplitude difference ratios (IADR), were analyzed and compared. RESULTS: cVEMP responses were clearly observed in all 48 ears in both AC and BC cVEMP tests. There was no significant difference in latencies (p1 and n1). However, the thresholds in BC cVEMP testing were significantly lower than those in AC cVEMP testing, when compared to the maximum stimulation level. Interaural amplitude difference ratios showed no significant difference in between the two tests, although amplitudes at maximum stimulation intensity in BC cVEMP testing were significantly larger than those in AC cVEMP testing. CONCLUSION: This study shows that BC cVEMP testing shows lower thresholds compared to AC cVEMP testing in normal subjects, suggesting that the threshold value can be used as a parameter in detecting vestibular dysfunction in the clinic. Further studies in patients with various vestibular disorders are needed.
Dizziness ; Ear ; Electrodes ; Hearing ; Humans ; Incidence ; Muscles ; Vestibular Evoked Myogenic Potentials ; Vibration

PURPOSE:The objective of this study was to evaluate the indications, effectiveness and complications associated with uterine arterial embolization as an alternative treatment of obstetrical hemorrhage. METHODS:From January 2006 to December 2008, 25 patients who underwent angiographic embolization for the obstetrical hemorrhage that was not responsive to conventional treatments, like obstetric maneuvers and uterotonic drugs, were included in our study. All medical records were reviewed and detailed clinical data such as clinical status, underlying conditions, amount of transfusion, embolized arteries, hospital stay, the success rate and the complications were collected. RESULTS:We have experienced clinically successful embolization in 22 (88%) of 25 patients with obstetrical hemorrhage resulting from various causes. After embolization, the patients' vital signs were stabilized. The causes of hemorrhage were atony of uterus (n=10), myomectomy during cesarean section (n=6), abnormal placentation (n=5), arterio-venous malformation (n=3), and cervical pregnancy (n=1). The average amount of blood transfusion was 7.2 units (range; 0~39 units). The average length of the time for the procedure was 55 minutes (range: 25~96 minutes). The average duration of hospitalization was 5.5 days (range: 2~14 days). In 22 patients, menses resumed spontaneously after procedures. The main complications after embolization were numbness and pain on lower extremities (n=1), and hypomenorrhea (n=1). CONCLUSION:The atrerial embolization is one of the safe and effective procedures that offers patients an alternative to hysterectomy for the treatment of intractable postpartum hemorrhage.
Arteries ; Blood Transfusion ; Cesarean Section ; Female ; Hemorrhage ; Hospitalization ; Humans ; Hypesthesia ; Hysterectomy ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation Disturbances ; Placentation ; Postpartum Period ; Pregnancy ; Uterus ; Vital Signs

Uterine leiomyoma is common benign tumor in reproductive age woman. And secondary degeneration of uterine leiomyoma can be occurred usually during midpregnancy and the puerperium. But, spontaneous perforation of uterine leiomyoma with cystic degeneration is very rare. We have experienced a case of spontaneous perforation of a huge cystic degenerative uterine leiomyoma associated with massive hemoperitoneum in a menopausal woman, and report it with a brief review of literature.
Female ; Hemoperitoneum ; Humans ; Leiomyoma ; Postpartum Period