A Clinical Study of Noninflammatory Skin-Colored Tumors on Forehead / 대한피부과학회지

Background@#The forehead is a region connected to the scalp and is accompanied by various structures. In some tumors, the pattern of development may differ from that of other anatomical sites. When a noninflammatory skin-colored tumor develops on the forehead, it is difficult to diagnose accurately. @*Objective@#This study aimed to identify the epidemiologic data and clinical features of noninflammatory skin-colored tumors of the forehead. @*Methods@#We retrospectively reviewed the medical records of 200 patients with noninflammatory, skin-colored tumors diagnosed after skin biopsy over a period of 11 years. We evaluated tumor prevalence, clinical features, and differences according to sex and age. If the tumor was large and deeply located, a radiologic study was performed. @*Results@#Of the 12 different histopathologic results, lipoma (52.0%) was the most frequent, followed by epidermal cyst (17.0%), osteoma (13.5%), steatocystoma (6.0%), and pilomatricoma (3.5%). Statistical analysis showed that females were dominant in the osteoma group. For an accurate diagnosis, 25 of the 52 patients who underwent computed tomography were diagnosed with lipoma, and 19 (76.0%) of them were identified as deep-seated lipoma. @*Conclusion@#The most common tumor among noninflammatory, skin-colored tumors of the forehead was lipoma.When they occur on the forehead, the proportion of deep-seated lipomas is higher than that at other sites. In the case of a solid and fixed tumor, a deep-seated lipoma should be considered. Computed tomography should be performed in addition to ultrasonography because the sensitivity of ultrasonography for the diagnosis of deep-seated lipoma is unsatisfactory.

Bilateral Involvement of Juvenile Temporal Arteritis with Eosinophilia: A Rare Case / 대한피부과학회지

Juvenile temporal arteritis (JTA) is a non-giant cell inflammation of the temporal artery, characterized by eosinophilic infiltration. It generally affects both adolescents and young adults. JTA is clinically represented by an asymptomatic, palpable lump in the temporal area, with no associated signs, such as fever, myalgia, or visual symptoms. A 38-year-old female presented to our hospital with a history of bilateral linear plaques in both temporal areas for 3 months. Histopathological findings of the right temporal lesion showed infiltration of eosinophils and lymphocytes in the arterial wall and intimal hyperplasia but no giant cell or granulomatous lesions. Doppler ultrasonography revealed a tortuous tubular anechoic lesion, with non-visualization of internal vascular flow. Laboratory findings highlighted eosinophilia of up to 13.8% and a total immunoglobulin E level of 1,182 IU/mL. Here, we report a rare case of bilateral JTA with eosinophilia.

A Clinical Study of Dermatology Inpatients with Cellulitis Over an 8-Year Period (between 2012 and 2020) in a Single Center / 대한피부과학회지

Background@#Cellulitis is one of the most common infectious skin diseases treated by hospitalization, and presents with various clinical features and treatment responses. Therefore, more detailed analysis on this condition is required. @*Objective@#To investigate the clinical characteristics of cellulitis among dermatology inpatients in a single center. @*Methods@#We retrospectively reviewed the medical records of 84 patients hospitalized with cellulitis between January 2012 and August 2020. We analyzed the differences by dividing them into ＜60-year-old and ＞60-year-old age groups. @*Results@#The average age of the 84 inpatients in this study was 48.8 years with the peak incidence in fifties.Cellulitis was most prevalent in the calf (39.8%). Erythrocyte sedimentation rate (ESR) and risk factors such as obesity and smoking had positive correlations with duration of hospital stay (p＜0.05). There was no significant difference in duration of hospital stay between those administered first-generation cephalosporin and other antibiotics. @*Conclusion@#Our data showed that ESR, obesity, and smoking were correlated to the hospitalization periods. In particular, it showed positive correlation of C-reactive protein and ESR with duration of hospital stay in those below the age of 60 years.

A Clinical Study of Dermatology Inpatients with Cellulitis Over an 8-Year Period (between 2012 and 2020) in a Single Center / 대한피부과학회지

Background@#Cellulitis is one of the most common infectious skin diseases treated by hospitalization, and presents with various clinical features and treatment responses. Therefore, more detailed analysis on this condition is required. @*Objective@#To investigate the clinical characteristics of cellulitis among dermatology inpatients in a single center. @*Methods@#We retrospectively reviewed the medical records of 84 patients hospitalized with cellulitis between January 2012 and August 2020. We analyzed the differences by dividing them into ＜60-year-old and ＞60-year-old age groups. @*Results@#The average age of the 84 inpatients in this study was 48.8 years with the peak incidence in fifties.Cellulitis was most prevalent in the calf (39.8%). Erythrocyte sedimentation rate (ESR) and risk factors such as obesity and smoking had positive correlations with duration of hospital stay (p＜0.05). There was no significant difference in duration of hospital stay between those administered first-generation cephalosporin and other antibiotics. @*Conclusion@#Our data showed that ESR, obesity, and smoking were correlated to the hospitalization periods. In particular, it showed positive correlation of C-reactive protein and ESR with duration of hospital stay in those below the age of 60 years.

Unilateral Abdominal Distention due to Diabetic Radiculoneuropathy / 대한피부과학회지

Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.

Unilateral Abdominal Distention due to Diabetic Radiculoneuropathy / 대한피부과학회지

Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.

Usefulness of MR Urography in the Diagnosis of Hydroureteronephrosis

PURPOSE: To evaluate the clinical usefulness of the MR urography (MRU) in the diagnosis of hydroureteronephrosis. MATERIALS AND METHODS: Twenty-five patients with hydronephrosis (26 cases) underwent MR urography, using a 1.5T MR scanner (Signa Horizon, GE Medical Systems, Milwaukee, U.S.A). The causes of hydronephrosis included benign ureteral stricture (12), ureteral stones (8) and malignant strictures (6), and were confirmed by operation, biopsy, conventional urography or clinical follow up. For MRU, a fat suppressed, respiratory-triggered, heavily T2-weighted fast spin echo (FSE) pulse sequence was used, and the 3-dimensional MR images were subsequently processed by a maximum-intensity-projection algorithm. We evaluated the success rate of MRU and its accuracy in determining the level and cause of obstruction, and compared the degree of hydroureteronephrosis seen on MRU with that seen on conventional urography. RESULTS: In all cases, a urogram was successfully obtained. In determining the degree of hydroureteronephrosis and the level of obstruction (in the upper ureter in 11 cases, in the mid-ureter in four, and in the lower ureter in 11), MRU findings matched those of conventional urography. In 24/26 cases (92%), MRU accurately determined the cause of urinary tract obstruction ; the two exceptions were in cases involving ureteral stones. CONCLUSION: MRU is a promising, noninvasive diagnostic method for evaluating hydroureteronephrosis, especially in children, pregnant women and patients with an allergic reaction to iodinated contrast material.

Dysphagia Following Stroke: Evaluation with Digital Radiography

PURPOSE: To evaluate the usefulness of digital radiography in the assessment of dysphagia following stroke. MATERIALS AND METHODS: Eighteen stroke patients (8 men, 10 women) referred for dysphagia and ten controls without known pharyngeal swallowing difficulty underwent digital radiography using a 1:1 mixture of barium and water. We evaluated oropharyngeal transit time and the location and severity of dysphagia; transit time was defined as the time from the first movement of the bolus to the return of the epiglottis to its original position. We sought to observe specific patterns of oropharyngeal dysfunction; dysphagia was classified as mild, moderate, or severe. RESULTS: In the control group, oropharyngeal transit time was 1.25sec (1.0-1.5sec), and for dysphagia patients, this was 4.32sec (1.75-6.5sec). Eleven patients (61%) had oral dysfunction, and 12 (67%), pharyngeal dysfunction; eight (44%) showed both oral and pharyngeal dysfunction. Mild swallowing difficulties occurred in six patients (33%), moderate dysfunction in six (33%), and severe dysfunction in three (17%). CONCLUSION: The dynamic image of the pharynx, as seen on a digital radiograph, may be diagnostically useful for defining the location and severity of dysphagia; in order to make feeding recommendations, this information is essential.

Blocking Action of Nicardipine on alpha1-Adrenoceptors in Circulatory System of Rabbit

To investigate relationship between alpha1-acrenoceptors and nicardipine, an 1,4-dihydropyridine calcium antagonist, effects of nicardipine, on phenylephrinne(PE)-induced vasoconstriction in isolated arterial rings and pressor response of rabbits were observed. In normal physiological salt solution(NPSS), 35mM KCI produced persistent contractions of thoracic aorta and carotid artery and the contractions were dose-dependently inhoboted by cumulative admini-stration of nicardipine in the range of doses from 10(-10)M to 10(-4)M, IC50s of nicardipine in the thoracic aorta and carotid artery were 3.3x10(-7)M and 4.6x10(-7)M, respectively and there was no difference between both values. Constant contractions induced by 10(-5)M PE in both rings were inhibited by the same doses of nicardipine in a dose-dependent fashion. The IC50s were 2.8x10(-4)M in thoracic aorta and 2.9x10(-5)M in carotid artery respectively, and the former was about 10 times greater than the latter. In Ca2+ free PSS, KCI did not produce any contractionn. Though constant and reproducible in NPSS, PE-induced contraction was transient and not reproducible in Ca2+ free PSS. The contraction in both rings were weakened to about 70% of those in NPSS. Pretreatment with nicardipine in the range of doses from 10-8M to 10-5M hardly affected the PE-induced contraction and the largest dose 10(-4)M slightly inhibited the contraction. Intravenous injection of nicardipine 10 to 1000microg/kg decreased blood pressure and heart rate of rabbits in a dose-dependent manner. The % decrease of heart rate was much smaller in comparison with the %decrease of blood presseure. Pressor effect of 30microg/kg PE was dose-dependently inhibited after treatment with nicardipine 10 to 1000microg/kg and ID50 was 314microg/kg(6.1x10(-7)mole/kg). Above results suggest that nicardipine blocks extracellulr Ca2+ influx by membrane depolarization and in a part by alpha1-adrenceptors, then relaxes arterial smooth muscles in rabbits.