The incidence of ischemic stroke increases with age due to improvements in health care and living conditions. With increasing proportion of old age, the proportion of old age is rapid expansion in acute ischemic stroke patients. Young and old age groups in acute ischemic stroke patients have different risk factors and clinical features. But, many patients of old age are excluded from active treatment like thrombolysis due to hemorrhagic transformation, poorer clinical outcome etc. So we studied clinical features, risk factor, outcome in ≧80 years old patients compared with <80 years. We enrolled 1,445 patients, who diagnosed acute ischemic stroke in Chosun university hospital, from January 2013 to December 2015. Patients were divided into two groups: ≧80 years versus <80 years. We compared with two groups about risk factors, stroke subtypes, thrombolysis, complications in hospital, initial National Institutes of Health Stroke Scale (NIHSS) score, prognosis. Of the total 172 patients, 54(31.4%) patients were 80 years or older. Symptomatic hemorrhage and asymptomatic hemorrhage was not different between both groups [over 79 years patients: 4/54 (7.4%) vs. under 80 years patients: 10/118 (8.5%), p>0.302], [16.7% vs. 17.7%, p>0.701]. There were no difference in mortality and favorable prognosis at 3 months later between both groups [over 79 years patients: 5/54 (9.3%) vs. under 80 years patients: 5/118 (4.2%), p=0.290], [over 79 years patients: 13/ 21 (24.1%) vs. under 80 years patients: 56/86 (47.5%), p=0.803]. There was difference in early neurological improvement rate(improvement > NIHSS 3) and degree of improvement (NIHSS at discharge - NIHSS at admission) were significant[over 79 years patients: 24/54 (44.4%) vs. under 80 years patients: 77/118 (65.8%), p=0.012], [2.69 vs 5.55, p=0.017]. Intracranial hemorrhage(symptomatic and asymptomatic) and favorable prognosis are not different significantly between two groups. Elderly patients is not a absolute contraindication for intravenous thrombolysis. For intravenous thrombolysis in elderly ischemic stroke patients, we need more study to exclude the poor prognostic factors and to consider of gain of patients.

This study is to make a comparison between the one liquid emulsion with and without fish oil containing higher omega-3 fatty acid in parenteral nutrition (PN) of newborns. Serum chemistry and clinical complications from Medical Records of 76 newborns who had received PN with either SMOFlipidⓇ or ClinOleicⓇ for at least 7 days in NICU at Chosun Univeristy Hospital from January 2011 to December 2014 were reviewed retrospectively. Serum chemistry revealed no significant difference between the two groups except for total bilirubin (TB), glucose, blood urea nitrate (BUN), creatine (Cr), and cholesterol, but they even were not clinically significant as their values were within almost normal range. In terms of the difference in clinical complications, the incidence of cholestasis was higher in newborns given ClinOleicⓇ. However, there was no statistically significance. In this study, no significant difference between ClinOleicⓇ and SMOFlipidⓇ in their clinical efficacy was proven. But, considering the advantage of omega-3 fatty acid in reduction of cholestasis and infection risk, more studies may be needed using lipid emulsions containing higher content of fish oil with high omega-3 fatty acid, and they may be better if done with larger groups.

This study aimed to identify the respiratory viral etiology and clinical features in febrile neonates and young infants younger than 3 months of age. From June 2015 to March 2016, 126 patients who admitted to the pediatrics department of Kwangju Christian Hospital due to febrile illness (body temperature ≥ 38.0℃) without definite focus of fever. We tested nasopharyngeal aspiration specimens with real time reverse transcriptase polymerase chain reaction. Respiratory viruses identified in 66 patients, and not identified in 60 patients. Among identified viruses, the most common pathogen was rhinovirus. Respiratory virus identified patients showed significantly higher presence of sibling (p=0.015), sibling who attending day care center (p=0.022), respiratory symptoms of family members (p=0.022), concomitant respiratory symptoms of the patient (p=0.001).

The study aimed to evaluate the usability of sterile bag collection (SBC) urinalysis and urine culture for diagnosing urinary tract infections (UTI). Urine culture is key for diagnosing UTI, and transurethral catheterization (TUC) or suprapubic aspiration is recommended for non-toilet-trained children. Although urine testing using SBC is non-invasive and easy, UTI can be diagnosed only if other criteria including clinical symptoms and positive urinalysis results are met. This study included 228 infants who were hospitalized for unexplained fever from October 2015 to June 2016. TUC culture, SBC urinalysis, and urine culture were performed for all patients. UTI was diagnosed when the TUC culture results met the criterion of ≥104 colony-forming units (CFU)/mL. When UTI diagnosis was made based on SBC urine colony counts ≥105 CFU/mL, the false-positive and false-negative rates were 6.3% and 70.0%, respectively. When the criterion was set as ≥104 CFU/mL, they were 23.7% and 30.0%, respectively. When both the criteria of ≥105 CFU/mL and positive urinalysis results were met, the false-positive rate was 2.4%, and the false-negative rate was 80%. Our results suggest that diagnosing UTI using SBC urinalysis and urine culture is not useful in infants with unexplained fever.

Diagnosis of scrub typhus is difficult because of its unspecific symptoms. The authors studied the correlation between serum adenosine deaminase (ADA) levels and scrub typhus, with the aim of aiding diagnose of the disease. The medical records of 64 children, who visited Wonkwang University Hospital from 2005 to 2015 for fever of undetermined origin, were analyzed retrospectively. Serum ADA levels were measured and indirect immunofluorescence antibody (IFA) assays were conducted. The patients were divided into two groups based on diagnosis of scrub typhus. Of 64 febrile patients, 39 were confirmed to have scrub typhus. Mean serum ADA level in the scrub typhus group (58.54±2.82 IU/L) was significantly higher than that in the non-scrub typhus group (29.30±4.03 IU/L, p<0.05). In the 25 non-scrub typhus patients, mean serum ADA level was significantly higher (50.24±8.52 IU/L) in patients with Mycoplasma infection than that in those with other diseases (19.46±1.39 IU/L, p<0.05). The study shows that in patients with only fever who are difficult to diagnose, serum ADA levels substantially aid the diagnosis of scrub typhus. Ed:- please consider carefully

Photodynamic therapy is a non-invasive cancer therapy that has recently attracted much attention in the field of cancer treatment. This study is an experiment to observe the effect of laser dose difference in photodynamic therapy. Murine breast cancer cells, EMT6 cells, were used to generate tumor bearing mouse models. The experimental group was divided into 5 groups as control group, laser 100 J/cm2, 200 J/cm2, 300 J/cm2 and 400 J/cm2 irradiation group. Photofrin was administered intraperitoneally and after 48 hours, laser irradiated on tumor with energy 0-400 J/cm2. the tumor volume was measured with a digital caliper on day 0, day 2, day 4, day 8 and day 12. The volume of tumor after photodynamic therapy was increased in the control group, laser 100 J/cm2 irradiation group and laser 200 J/cm2 irradiation group until day 12 after irradiation. Both the laser 300 J/cm2 irradiated group and the laser 400 J/cm2 irradiated group showed a decrease in the tumor volume from 2 to 12 days after irradiation. These results suggested that treatment effect will be obtained at a dose of 300 J/cm2 or more in the experiment using the tumor bearing mouse model and photoprin.

Ranula refers to mucous retention cyst or mucocele that develops on the oral floor and it appears most frequently among oral masses derived from salivary glands. Ranula that is extended into submandibular space or into other cervical spaces due to defective mylohyoid muscle is particularly called plunging ranula. Various types of treatments have been conducted for ranula: surgical treatments such as simple excision, marsupialization, and removal of sublingual gland; and sclerotherapy utilizing OK-432 (Picibanil) are being reported. We performed concurrent excision of ranula and sublingual gland through intraoral approach. This technique leaves no post-surgical scars and shows very low recurrence rate and incidence rate of complications. Therefore, in this study, we would like to analyze the treatment methods and results of our patients.

A 67-year-old man presented with painful whitish mucosal rashes on the left side of his palate at initial presentation, and subsequently, multiple, grouped erythematous vesicular eruptions developed on the left side of his face (V2-V3 distribution). In this case, the distribution pattern of oral lesions were atypical of herpes zoster infection. Attention should be paid to the possibility that such symptoms could be early signs of herpes zoster infection.

Acinetobacter baumannii is one of the most problematic causative agents of nosocomial infections, especially in the immune compromised or patients in intensive care units. In recent years, as multiple antibiotic resistant A. baumannii has increasingly emerged, it has become difficult to treat infections effectively. The authors report a case of extreme drug resistant A. baumannii bacteremia caused by catheter-related infection, as confirmed by blood and catheter tip culture, in a 63-year-old man. The patient responded well to 24 days of doripenem and colistin treatment.

Breast specific gamma imaging (BSGI) is a nuclear medicine breast imaging technique. The sensitivity of BSGI is unaffected by post-operative scars or implants, and thus, BSGI is helpful for the differential diagnosis of postoperative recurrence. Here, the authors report a case of diffuse chest wall recurrence on the side of radical mastectomy that was not detected by BSGI, but was detected using other nuclear medicine imaging techniques.

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of retroperitoneal tissue marked by chronic inflammation and prominent fibrosis. A 67-year-old man presented with general weakness and oliguria. Laboratory findings showed blood urea nitrogen 77.7 mg/dL, serum creatinine 9.24 mg/dL, and an IgG4 level within the normal range. Computed tomography (CT) findings showed bilateral hydronephrosis and distal ureteral obstruction due to fibrotic adhesion to a presacral mass. Laparoscopic biopsy was performed. The authors report a case of acute kidney injury caused by non-IgG4 related focal retroperitoneal fibrosis in the pelvis that was successfully treated using prednisolone and tamoxifen… non-IgG4 related focal retroperitoneal fibrosis caused byacute kidney injury.

High intensity focused ultrasound (HIFU) treatment of uterine myoma is a non-invasive procedure that uses high intensity, focused ultrasound to heat and destroy the tissue of uterine myoma. The history of using therapeutic ultrasound dates back to the early 20th century, and since, the technique has been continuously improved to an extent that the breadth of its clinical applications, both diagnostic and therapeutic, justify the integral role it plays in medicine today. HIFU treatment requires that ultrasound beams be focused on targeted uterine myoma. Due to significant energy dissipation at the focus, temperatures within tissues increase to more than 65℃, and destroy diseased tissue. This technology can achieve precise "ablation" of myoma tissue, and because it destroys diseased tissue non-invasively, it is also known as "Non-invasive HIFU surgery". Development of this technology significantly broadened the range of treatment options for patients suffering from uterine myoma. Furthermore, in contrast to surgery, HIFU requires only a short period of hospitalization and has a low complication rate. Today, HIFU is being used more frequently to treat adenomyosis, but its increased use has led to the reporting of more complications. Here, the authors report a case of uterine perforation after HIFU ablation for adenomyosis.

Leiomyomas are rare, benign tumors that may arise from smooth muscle cells anywhere along the genitourinary tract. Leiomyomas are known to be the commonest neoplasm arising from the uterus, but leiomyoma originating from the scrotum is a rare entity. These tumors originate from subcutaneous tissue or tunica dartos and can be solitary or multiple. The authors report the case of a 53-year old man who presented with a slowly growing, painless, firm, mobile, 3-cm lump in the left side scrotum. The lesion was completely excised, and subsequent pathological examination revealed distinguishing features of leiomyoma. No recurrence occurred over the 12 months following excision.

Uterine rupture in pregnancy is a rare event and may lead to fatal complications for both mother and fetus. It is commonly occurred in women who have a history of an operation that involves the uterine myometrium. Cornual ectopic pregnancy is quite rare, and it is usually managed by cornual resection on laparotomy or laparoscopy. Uterine rupture at third trimester following laparoscopic cornual resection is very rare. Here we report a case of uterine rupture in a pregnant woman at 35 weeks gestation with previous history of right cornual pregnancy treated with laparoscopic salpingectomy and cornual resection.

Obturator hernia is a rare case of pelvic hernia. It is important cause of small bowel obstruction in older wemen. It frequently occurs who has multiparous, skinny body, and old age. Patients presented with nausea, vomiting, and abdominal pain. Most common symptom is a strangulation combined with mechanical intestinal obstruction. It has a high mortality that associated with difficult diagnosis and delayed operation.

Miliaria crystallina is due to obstruction of the eccrine sweat duct as it courses through the stratum corneum. Miliaria crystallina consists of superficial, subcorneal, and noninflammatory vesicles. Ultraviolet light exposure, resident organisms on skin, and repeated sweating episodes are considered as facilitating factors. Ultraviolet phototherapy with narrowband ultraviolet B (NBUVB) has been known to have a beneficial effect on various skin diseases. It may be considered to be an alternative for generalized pruritus patients, especially if they are resistant to standard treatments. Herein, we present a case of adult miliaria crystallina due to artificial ultraviolet radiation for phototherapy. Although it is underestimated for self-limited disorder and short duration, we should keep in mind that NBUVB phototherapy commonly used in dermatology may cause a miliaria crystallina.