Meningiomas are common intracranial tumors; however, reports on extracranial cutaneous meningiomas are exceedingly rare. A 77-year-old woman visited our hospital with an asymptomatic child fist-sized mass on the scalp.Biopsy results indicated nuclear atypia and mitoses of sarcomatous cells. Brain magnetic resonance imaging revealed a subgaleal mass with strong enhancement. Suspecting sarcoma, wide excision was performed jointly by the departments of plastic surgery and neurosurgery, during which no evidence of cranial invasion was noted. In the surgical specimen, numerous mitoses of sarcomatous cells and poorly formed nests of epithelioid cells were observed. This led to the diagnosis of anaplastic meningioma without intracranial origin. Subsequently, the patient received adjuvant radiotherapy and is currently under close follow-up. Anaplastic meningioma is rare, but early diagnosis is important as it enables timely and appropriate treatment, thus, improving survival rates. Dermatologists should remain vigilant as meningiomas can manifest as cutaneous scalp nodules, and their accurate diagnosis can profoundly impact prognosis.

B₃ is a rare finding, but it is most common in the B subgroup, which been reported as being 0.025% of the total B group in Koreans. ABO*B3.01 is a specific allele for B₃, a missense mutation with a substituted thymine from cytosine of the 1,054th nucleotide of the ABO*B.01 allele, but rather unexpectedly, it has not been reported in Koreans. We report here the first Korean case of the serological A₁B₃ phenotype with ABO*B3.01, which was confirmed by sequencing of exons 6 and 7 of the ABO gene, found in a pregnant woman.

A primary benign schwannoma of the liver is extremely rare. Only 30 cases have been reported in the medical literature worldwide, and only one case has been reported in Korea previously. A 56-year-old man was admitted to Gil Medical Center with incidental findings of a hepatic mass by abdominal computed tomography. The computed tomography and magnetic resonance image revealed a 3×2 cm-sized solid mass in the left lobe of the liver. Histological examination confirmed the diagnosis of a benign schwannoma, proven by positive immunoreaction with the neurogenic marker S-100 protein and a negative response to CD34, CD117, and smooth muscle actin. We report a primary benign schwannoma of the liver and review the literature.
Actins ; Diagnosis ; Humans ; Incidental Findings ; Korea ; Liver ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Peripheral Nervous System Neoplasms ; S100 Proteins

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies* ; Humans ; Intensive Care Units ; Internal Medicine ; Korea* ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects* ; Retrospective Studies ; Vital Signs

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies ; Humans ; Intensive Care Units ; Internal Medicine ; Korea ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects ; Retrospective Studies ; Vital Signs

Hansen's disease(HD) is a chronic infectious disorder acquired by inoculation of Mycobacterium leprae. With the establishment of complex multidrug therapy, the incidence rate of leprosy patients has continually shown to decline by 90% compared to the incidence rate in the 1990s. However, the prevalence of the disease still remains high in southeast asian countries. Due to the rarity and diverse nature of cutaneous presentation, HD is often misdiagnosed with other dermatoses or infectious conditions. Especially, when a patient presents with unusual presentation with leprosy reaction with no classical feature such as sensory disorders and skin lesion, the diagnosis is further delayed with misguided treatments. Herein we present a 27-year-old Indonesian immigrant who displayed clinical features mimicking that of orbital cellulitis who was later diagnosed with borderline lepromatous leprosy through histologic and PCR confirmation, in light of alerting the probability of leprosy in immigrants with intractable skin presentations.
Adult ; Asian Continental Ancestry Group ; Diagnosis ; Emigrants and Immigrants ; Humans ; Incidence ; Leprosy ; Leprosy, Borderline ; Leprosy, Multibacillary ; Mycobacterium leprae ; Orbit ; Orbital Cellulitis ; Polymerase Chain Reaction ; Prevalence ; Sensation Disorders ; Skin ; Skin Diseases

BACKGROUND: Arsenic is a carcinogenic heavy metal that has a species-dependent health effects and abandoned metal mines are a source of significant arsenic exposure. Therefore, the aims of this study were to analyze urinary arsenic species and their concentration in residents living near abandoned metal mines and to monitor the environmental health effects of abandoned metal mines in Korea. METHODS: This study was performed in 2014 to assess urinary arsenic excretion patterns of residents living near abandoned metal mines in South Korea. Demographic data such as gender, age, mine working history, period of residency, dietary patterns, smoking and alcohol use, and type of potable water consumed were obtaining using a questionnaire. Informed consent was also obtained from all study subjects (n = 119). Urinary arsenic species were quantified using high performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICP/MS). RESULTS: The geometric mean of urinary arsenic (sum of dimethylarsinic acid, monomethylarsonic acid, As3+, and As5+) concentration was determined to be 131.98 μg/L (geometric mean; 95% CI, 116.72–149.23) while urinary inorganic arsenic (As3+ and As5+) concentration was 0.81 μg/L (95% CI, 0.53–1.23). 66.3% (n = 79) and 21.8% (n = 26) of these samples exceeded ATSDR reference values for urinary arsenic (>100 μg/L) and inorganic arsenic (>10 μg/L), respectively. Mean urinary arsenic concentrations (geometric mean, GM) were higher in women then in men, and increased with age. Of the five regions evaluated, while four regions had inorganic arsenic concentrations less than 0.40 μg/L, one region showed a significantly higher concentration (GM 15.48 μg/L; 95% CI, 7.51–31.91) which investigates further studies to identify etiological factors. CONCLUSION: We propose that the observed elevation in urinary arsenic concentration in residents living near abandoned metal mines may be due to environmental contamination from the abandoned metal mine. TRIAL REGISTRATION: Not Applicable (We do not have health care intervention on human participants).
Arsenic* ; Cacodylic Acid ; Chromatography, Liquid ; Delivery of Health Care ; Drinking Water ; Environmental Health ; Female ; Humans ; Informed Consent ; Internship and Residency ; Korea* ; Male ; Mass Spectrometry ; Plasma ; Reference Values ; Smoke ; Smoking

Perforating disorders are a group of skin disorders that present the characteristic clinical finding of transepidermal elimination. Acquired reactive perforating collagenosis is an uncommon condition characterized by umbilicated hyperkeratotic papules, and in almost all cases, it coexists with other disease conditions, such as diabetes mellitus, renal failure, and malignancies. The pathologic mechanism of this disease remains largely unknown. Here, we describe the case of a 42-year-old man who developed acquired reactive perforating collagenosis after coronary artery bypass graft surgery.
Adult ; Coronary Artery Bypass* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Renal Insufficiency ; Skin ; Transplants

Dermatophytosis in children is relatively infrequent than adults. Dermatophytosis in children can be different clinically and mycologically from those in adults in that children experience rapid physical changes and they have different skin features and environments from those of adults. Microsoprum (M.) canis is one of the zoophilic dermatophytes responsible for 3~30% of tinea corporis and tinea capitis in children. It is most likely transmitted by contact with infected animals such as cats and dogs. Clinical manifestations were single or multiple annular shaped, erythematous scaly patches and sometimes hard to differentiate with other skin diseases. A 6-year-old girl presented with multiple, pruritic, erythematous scaly patches on cheek and buttock. The lesion started 3 weeks before visiting our skin clinic. There was no personal or family history of any skin disease but she had a history of contacting with a dog. A fungal culture from tissue of the lesions grown on potato dextrose agar-corn meal-tween 80 showed typical Microsporum canis. The skin lesions were clinically improved after topical treatment for 4 weeks.
Adult ; Animals ; Arthrodermataceae ; Buttocks ; Cats ; Cheek ; Child* ; Dogs* ; Female ; Glucose ; Humans ; Infant* ; Microsporum ; Skin ; Skin Diseases ; Solanum tuberosum ; Tinea Capitis ; Tinea*

Leprosy is a chronic granulomatous disease affecting the skin and peripheral nervous system. Because of its variable manifestations, leprosy can be misdiagnosed as syphilis, sarcoidosis, psoriasis and eczema. A 73 year-old man showed erythematous papules on his arms and legs. He had been erroneously treated as eczema before the correct clinicopathological diagnosis of borderline lepromatous leprosy was made. We report this case to suggest that dermatologists should pay careful attention while diagnosing new cases of leprosy.
Arm ; Diagnosis ; Eczema* ; Granulomatous Disease, Chronic ; Leg ; Leprosy* ; Leprosy, Multibacillary* ; Peripheral Nervous System ; Psoriasis ; Sarcoidosis ; Skin ; Syphilis