A Case of Paenibacillus pasadenensis Bacteremia in a Patient with Acute Respiratory Distress Syndrome after Microsurgical Clipping / 감염과화학요법

We report the first case of bacteremia by a novel Paenibacillus species, Paenibacillus pasadenensis, from a 55-year-old male patient with acute respiratory distress syndrome, following a microsurgical clipping procedure of a ruptured intracranial aneurysm. The bacterium was identified using 16S rRNA gene sequencing analysis, which was applied because current conventional methods employed in the clinical microbiology laboratory proved unsuccessful. Since this bacterium was first identified in 2006 and has never been reported elsewhere, we believe this report can provide practitioners with useful insight on the pathogenicity of this species.

Apocrine Hidrocystoma of the Cheek

No abstract available.

Clinical Application of the Delayed Procedure in the Distally Based Sural Flap

PURPOSE: Reconstruction of soft tissue defects with osteomyelitis in the lower third of the leg represents a challenge to plastic surgeons. Moreover, it is more arduous in multimorbid patients. One excellent option for reconstruction of these defects is to use a delayed distally based sural flap. METHODS: We successfully used delayed distally based sural flap with a two-step procedure. During the first operation, radical debridement and elevation of flap were performed. The raised flap was fixed again at the donor site. The delay period ranged from seven to ten days. Between August 2008 and July 2009, we underwent operations for five patients using this technique. The size of flap varied from 10 x 6 cm to 12 x 14 cm. RESULTS: All flaps successfully survived. Partial skin loss of the grafted site was seen in two patients but no further surgical procedure was required for wound healing. Complaints of hypoesthesia on the lateral part of the foot was observed. In a three month follow-up period, hypoesthesia was resolved spontaneously. CONCLUSION: Delayed procedure improves the viability of distally based sural flap in high risk, critically multimorbid patients. We recommend that, if a two-stage operative approach is required, the delayed procedure should be considered.

Glomus Tumor in Subcutaneous Layerof Forearm : A Case Report

PURPOSE: Glomus tumor is rare benign neoplasm arising from the normal glomus, which is a neuromyoarterial apparatus, usually seen in the nail bed of fingers. Concerning about the origin, there were few written reports about extra-digit glomus tumor of elderly patient. MATERIALS AND METHODS: A 69-year-old man presented with severe pain and tenderness localized to the distal dorsal portion of forearm for 5 years. The pain was sudden in onset resting several seconds, cold frequently exacerbated these symptoms. So much pain was caused by touching the sensitive area that the patient was quite reluctant to have the maneuver repeated. The clinical suspicion of glomus tumor was made and the lesion was completely excised. Glomus tumor was confirmed by the pathologist. RESULTS: After the operation, patient didn't complain of his symptoms anymore and there was no evidence of recurrence during 6 months follow-up period. CONCLUSIONS: We report a rare case of glomus tumor arising in subcutaneous layer of forearm with elderly patient.