Juvenile pemphigus vulgaris (JPV) is a rare variant of pemphigus vulgaris (PV) occurring in childhood and adolescence that has similar symptoms and the same histological and immunopathological features as classic adult PV. Although rare, advanced cases of JPV can be fatal due to secondary sepsis. Many patients with JPV are misdiagnosed and therefore not properly treated in the early stages of the disease. Although systemic corticosteroids are the therapeutic mainstay, long-term corticosteroid use has various adverse effects. Intravenous immunoglobulin (IVIG) was recently reported to reduce the side effects of corticosteroids. Here, we report a case of JPV in a 14-year-old boy treated with IVIG.
Adolescent ; Adrenal Cortex Hormones ; Adult ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Male ; Pemphigus* ; Sepsis

Emphysematous gastritis is a rare disorder characterized by emphysematous change of the gastric wall due to infection with a gas-forming organism. Acute necrotizing esophagitis is a rare disorder with an unknown pathogenesis. Above two disorders rarely occur together, only three global cases have been reported to date. Such a case has never been reported in Korea, we report a novel case of severe emphysematous gastritis with concomitant portal venous air and acute necrotizing esophagitis in type 1 diabetes presenting with diabetic ketoacidosis. A 24-year-old man known to have type 1 diabetes and pulmonary tuberculosis was brought to the emergency room for epigastric pain with vomiting. His body mass index was 14.7, and the laboratory findings demonstrated leukocytosis and acidosis, as well as elevated serum glucose, ketone, and C-reactive protein levels. Enhanced computed tomography showed portal vein gas and edematous wall thickening without enhancement in the stomach wall, with air density along the stomach and esophageal wall. The patient required surgical intervention of total gastrectomy and cervical esophagostomy followed by esophagocolostomy and esophageal reconstruction. Early radiologic diagnosis and clinical suspicion of this disease and prompt intervention including antibiotics, decompression, and surgery are important for a good prognosis.
Acidosis ; Anti-Bacterial Agents ; Blood Glucose ; Body Mass Index ; C-Reactive Protein ; Decompression ; Diabetic Ketoacidosis* ; Diagnosis ; Emergency Service, Hospital ; Esophagitis* ; Esophagostomy ; Gastrectomy ; Gastritis* ; Humans ; Korea ; Leukocytosis ; Portal Vein ; Prognosis ; Stomach ; Tuberculosis, Pulmonary ; Vomiting ; Young Adult

OBJECTIVE: To prevent the occurrence of CV events such as MI and stroke among professional drivers in Korea, bus drivers were compared to other occupations through the Framingham risk scoring system (FRS) or metabolic syndrome (MS) of cardiovascular disease (CVD) risk assessment methods. METHODS: In October 2012, a health examination survey was conducted for 443 male bus drivers in a big city. Their CVD risk factors were compared to those of a 'total employed' (A group) and 'crafts and machine operators' (B group) extracted from Fifth Korea National Health and Nutrition Examination Survey (KNHANES, 2010) data by using FRS and MS. We calculated proportions of the CVD risk factors distribution between bus drivers and the A, B groups by the bootstrapping method. The Odds ratio (OR) between CV event risk combining MS with CHD equivalent risk of FRS and occupational factors like shift patterns and professional driving duration/age ratios (PDAR) of bus drivers was calculated through multinominal logistic regression. RESULTS: The proportion of BMI > or = 25 kg/m2 was 53.9% and waist circumference > or = 90cm was 40.9% among bus drivers. Hypertension and MS prevalence of bus drivers was 53.3%, 49.9% which is higher than 17.6%, 22.6% in the A group and 19.7%, 23.8% in the B group respectively. OR of high CV event risk in alternate shift was 2.58 (95% CI 1.33~5.00) in comparison with double shift pattern and OR in PDAR > or = 0.5 was 2.18 (95% CI 1.15~4.14). CONCLUSION: Middle aged male drivers in a big city of Korea stand a higher chance of developing CV event than other professions of the same age.
Cardiovascular Diseases* ; Humans ; Hypertension ; Korea* ; Logistic Models ; Male ; Methods ; Middle Aged ; Nutrition Surveys ; Occupations ; Odds Ratio ; Prevalence ; Risk Assessment ; Risk Factors ; Stroke ; Waist Circumference

Carbol fuchsin is a mixture of phenol and basics fuchsin, used in bacterial staining procedures. It is a component of Ziehl-Neelsen stain. Phenol in Carbol fuchsin is a toxic agent which can lead to various gastrointestinal, ocular, skin, neurologic and renal side effects. We hereby report a case of Carbol fuchsin poisoned patient. Acute renal failure with metabolic acidosis was rapidly progressed. However, she was treated successfully by continuous veno-venous hemodiafiltration.
Acidosis ; Acute Kidney Injury ; Dialysis ; Hemodiafiltration ; Hemoperfusion ; Humans ; Phenol ; Rosaniline Dyes ; Skin

Here we report a case of Strongyloides stercoralis infection of the gastric and pancolonic mucosa in a 79-year-old female with a monoclonal gammopathy of undetermined significance. Endoscopic biopsies were performed in gastric antrum, cecum, distal ascending colon, and hepatic flexure of the colon. On microscopic examination, there were many adult worms, larvae and eggs in the gastric and colonic mucosa. Worms, larvae, and eggs were located in the crypts and within the lumen of the crypts. The body wall of the adult worm was composed of cuticle and a weak muscle layer. A routine stool examination failed to detect larvae or ova. Based on the histopathologic examination, these parasites were confirmed as S. stercoralis.
Adult ; Aged ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Eggs ; Female ; Humans ; Larva ; Monoclonal Gammopathy of Undetermined Significance ; Mucous Membrane ; Muscles ; Ovum ; Paraproteinemias ; Parasites ; Pyloric Antrum ; Stomach ; Strongyloides stercoralis ; Strongyloidiasis

Here we report a case of Strongyloides stercoralis infection of the gastric and pancolonic mucosa in a 79-year-old female with a monoclonal gammopathy of undetermined significance. Endoscopic biopsies were performed in gastric antrum, cecum, distal ascending colon, and hepatic flexure of the colon. On microscopic examination, there were many adult worms, larvae and eggs in the gastric and colonic mucosa. Worms, larvae, and eggs were located in the crypts and within the lumen of the crypts. The body wall of the adult worm was composed of cuticle and a weak muscle layer. A routine stool examination failed to detect larvae or ova. Based on the histopathologic examination, these parasites were confirmed as S. stercoralis.
Adult ; Aged ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Eggs ; Female ; Humans ; Larva ; Monoclonal Gammopathy of Undetermined Significance ; Mucous Membrane ; Muscles ; Ovum ; Paraproteinemias ; Parasites ; Pyloric Antrum ; Stomach ; Strongyloides stercoralis ; Strongyloidiasis

Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Colorectal Neoplasms/drug therapy ; Fluorouracil/*adverse effects/therapeutic use ; Humans ; Leucovorin/*adverse effects/therapeutic use ; Lung Diseases, Interstitial/chemically induced/*etiology/radiography ; Male ; Organoplatinum Compounds/*adverse effects/therapeutic use

Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Colorectal Neoplasms/drug therapy ; Fluorouracil/*adverse effects/therapeutic use ; Humans ; Leucovorin/*adverse effects/therapeutic use ; Lung Diseases, Interstitial/chemically induced/*etiology/radiography ; Male ; Organoplatinum Compounds/*adverse effects/therapeutic use

Pigmented spindle cell nevus (PSCN) is a solitary heavily pigmented macule or papule that usually occurs on the lower legs of women in the second decade of life. Histologically, fascicles of uniform, elongated, pigmented nevoid cells at the dermo-epidermal junction tend to fuse with neighboring nests. PSCN should be differentiated from Spitz nevus, dysplastic nevus, and malignant melanoma. For making the differential diagnosis of PSCN from malignant melanoma of nevoid cells, the overall symmetry, relative uniformity, maturation with depth and no nuclear atypia are important clues. A 3-year-old girl presented with a black papule on the anterior aspect of the ankle. We diagnosed PSCN by the histologic findings and the specific "starburst" dermoscopic pattern.
Animals ; Ankle ; Dermoscopy ; Diagnosis, Differential ; Dysplastic Nevus Syndrome ; Female ; Humans ; Leg ; Melanoma ; Nevus, Epithelioid and Spindle Cell ; Nevus, Spindle Cell ; Preschool Child

PURPOSE: A CXCR4/stroma derived factor-1alpha (SDF-1alpha, CXCL12) interaction is involved in many metastatic cancer mechanisms, including breast cancer. The primary objectives of this study were to investigate the correlation between CXCR4 and axillary lymph node metastasis and to clarify the interaction between CXCR4 in primary tumor cells and SDF-1alpha in metastatic lymph nodes. An analysis of the correlation between CXCR4, SDF-1alpha and clinicopathologic features was also performed. METHODS: Representative areas from 44 invasive ductal carcinomas were selected for construction of tissue microarrays using a 5 mm punch. Breast cancers (n=44), metastatic axillary lymph nodes (n=18) and non-metastatic axillary lymph nodes (n=26) were immunohistochemically stained for CXCR4, SDF-1alpha, estrogen receptor (ER), progesterone receptor (PR) and HER2. The parameters of age, tumor size, nuclear grade, histologic grade, lymph node status and pathologic node (pN) stage pN0 to pN3 were evaluated. RESULTS: CXCR4 expression was negatively correlated with increased age (p=0.005) and positively correlated with a large tumor size (p=0.043) and PR expression (p=0.027). CXCR4 expression was not correlated with metastatic lymph nodes (p=0.079) and SDF-1alpha expression in metastatic lymph nodes (p=0.062). However, CXCR4 nuclear positivity is correlated with lymph node metastasis (p=0.044). SDF-1alpha was not correlated with any clinicopathologic feature in a statistically significant manner. CONCLUSION: An evaluation of young age, large tumor size and PR expression helps predict lymph node metastasis and poor prognosis. Expression of CXCR4 nuclear positivity is correlated with a poor prognosis.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Chemokine CXCL12 ; Estrogens ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Receptors, Progesterone