Objective: Chronic subdural hematoma (CSDH) is a neurological complication following clipping surgery. However, the natural course and ideal approach for the treatment of clipping-related-CSDH (CR-CSDH) have not been clearly established. We aimed to investigate the course of CR-CSDH using chronological radiological findings. Methods: We performed a retrospective analysis of 28 (3.8%) patients who developed CSDH among 736 patients who underwent surgical clipping using pterional approach for unruptured aneurysms at our institution between December 2010 and December 2018. Patients underwent follow-up CT scan 6–8 weeks after clipping surgery and decision to pursue surgical intervention rests upon the patient’s symptom based on the Markwalder’s grading scale (MGS) and numeric rating scale (NRS). Results: Of the 28 patients, 3 patients (10.7%) underwent surgery, while 25 (89.2%) showed spontaneous resolution of CR-CSDH. Eighteen patients (64.2%) had mild headache with MGS of 0–1. The mean maximum hematoma volume was 41.9±30.9 ml (5.8–135 ml), and 26 patients (92.8%) had homogeneous hematoma. The mean time to hematoma resolution was 126.7±52.9 days (46–228 days). Comparing group of CR-CSDH volume ≥43 ml or a midline shift ≥5 mm, the difference in presence of linear low-density area (p=0.002) and age (p=0.026) between the conservative and operative groups were found to be statistically significant. Conclusions Most CR-CSDH cases spontaneously resolved within 4 months. Therefore, we suggest that close observation should be performed if patient’s symptoms are mild and special radiologic findings are present, despite its relatively large volume and midline shifting.

Nontuberculous mycobacteria are ubiquitous environmental organisms that are rare pathogens in immunocompetent individuals. However, cutaneous nontuberculous mycobacteria infections have been increasingly associated with invasive procedures, including surgery, liposuction, filler injection, intramuscular injection, mesotherapy, piercing, acupuncture, and cupping therapy. Herein, we report the first case of cutaneous nontuberculous mycobacteria infection caused by the East-Asian traditional treatment ‘Gua Sha’, also known as scraping, coining or spooning in English. A 35-year-old healthy female presented with widespread, painful skin nodules and pustules on her upper and lower extremities that had developed after Gua Sha treatment for body contouring. Histopathologic examination of the lesions revealed granulomatous inflammation in the dermis and the culture isolates were identified as Mycobacterium massiliense with molecular identification. The patient was successfully treated with intermittent incision and drainage of persistent nodules and oral clarithromycin based on antimicrobial susceptibility testing. We recommend implementation of a standard safety protocol for Gua Sha practitioners to minimize the risk of infection transmission.

No abstract available.
Humans ; Keratoderma, Palmoplantar ; Pityriasis Rubra Pilaris ; Pityriasis ; Siblings

No abstract available.
Aged ; Dermoscopy ; Diagnosis ; Female ; Humans

No abstract available.
Breast Neoplasms, Male* ; Humans ; Male ; Male* ; Neoplasm Metastasis*

Dermatophytosis of the palm of the hands (tinea manus) tends to involve one hand. We encountered a case of bilateral tinea manus in a patient with type 1 diabetes mellitus and bilateral tinea pedis. A 57-year-old man presented for evaluation of hyperkeratotic lesions on both his palms and soles. Skin examination revealed hyperkeratotic scaly lesions on the palmar surfaces of his hands and plantar surfaces of his feet. Yellow discoloration and thickening were observed on both his nails. Fasting venous plasma glucose concentration and hemoglobin A1c levels were 332 mg/dL and 7.5%, respectively. Fungus cultures revealed white colonies with brown color on the reverse side in a 14-day incubation period. Trichophyton rubrum infection was identified using polymerase chain reaction with amplified internal transcribed spacer regions. He was treated with oral fluconazole (150 mg/week) and topical flutrimazole spray. In addition, we examined the frequency of 77 superficial fungal hand infections (age, sex, seasonal distributions and coexisting fungal infections) among patients who visited the dermatologic clinic of Chonbuk University Hospital between January 1997 and December 2016.

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.
Adolescent ; Adult ; Anxiety Disorders ; Autistic Disorder ; Behavior Rating Scale ; Child ; Cognition Disorders ; Comorbidity ; Diagnosis* ; Humans ; Intellectual Disability ; Korea ; Mass Screening ; Mental Disorders ; Mental Health ; Mood Disorders ; Psychological Tests ; Weights and Measures

No abstract available.
Herpes Zoster* ; Intestinal Pseudo-Obstruction*