No abstract available.
Education, Medical* ; Female ; Humans ; Korea

No abstract available.
Child ; Histiocytoma, Benign Fibrous ; Humans

PURPOSE: The purpose of this study was to develop and evaluate a coping scale for families of patients with schizophrenia(CSFPS). METHODS: Item construction was derived from literature reviews and interviews with family members and psychiatric nurses. Content validity was tested by experts. Each item was scored on a four-point Likert scale. The preliminary questionnaire was administered to 188 family members of patients with schizophrenia. The data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha. RESULTS: From the factor analysis, 32 items in five factors were derived. The factors were named active coping strategies, avoidance coping strategies, hospital treatment-oriented coping strategies, emotional coping strategies, and suppressive coping strategies for problematic behaviors. The five factors explained 49.7% of the total variance, Cronbach's alpha of the total items was .83 and the factors ranged from .66 to .86. CONCLUSION: The results of this study suggest that CSFPS is a reliable and valid instrument to measure coping in families of patients with schizophrenia.
*Adaptation, Psychological ; Adult ; Aged ; Aged, 80 and over ; Caregivers/*psychology ; Factor Analysis, Statistical ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; *Program Development ; Psychometrics ; Questionnaires ; Schizophrenia/*pathology

BACKGROUND: Serial (staged) excision of congenital melanocytic nevi (CMN) is an important treatment option for medium-sized CMN. However, few studies have investigated the outcomes of serial excision in detail.OBJECTIVE: We report our experience regarding serial excision of CMN, including methods to effectively reduce the procedural stages and scar length.METHODS: We retrospectively reviewed medical records of patients with CMN treated between 2008 and 2015; 33 patients (7 men and 26 women) underwent serial excision.RESULTS: The CMN were located on the face (n=11), arms (n=6), legs (n=11), and other areas of the body (n=11), including the back (n=2), chest (n=1), deltoid region (n=1), and buttocks (n=1). The mean CMN area was 19.7 cm². The mean number of surgical stages was 2.2. The mean interval between surgeries was 10.6 months. A marginal S-shaped incision along both edges of the nevus was preferred over elliptical excision, to reduce scarring. Pulsed dye, erbium:yttrium–aluminum–garnet (YAG), neodymium-doped:YAG, and carbon dioxide fractional lasers were used to improve the final outcomes and minimize scarring.CONCLUSION: Serial excision is an effective treatment option associated with greater patient satisfaction, particularly for medium-sized and hairy CMN. Conventional elliptical serial excision is associated with the formation of elongated scars and sacrifices normal skin adjacent to the lesion. The marginal S-shaped incision reduces scarring by dispersing mechanical tension on the scar without skin wastage. Compared with the elliptical excision method, the marginal S-shaped incision reduces the number of surgical stages and results in a cosmetically superior scar. Performing a marginal S-shaped incision is technically challenging in certain anatomical locations, such as the eyes, nose, and mouth. Therefore, it is necessary to combine this procedure with erbium:YAG and neodymium-doped:YAG ablation.
Arm ; Buttocks ; Carbon Dioxide ; Cicatrix ; Dermatologic Surgical Procedures ; Humans ; Leg ; Male ; Medical Records ; Methods ; Mouth ; Nevus ; Nevus, Pigmented ; Nose ; Patient Satisfaction ; Retrospective Studies ; Skin ; Thorax

PURPOSE: Leptin has been considered a link between metabolic state and reproductive activity. Defective reproductive function can occur in leptin-deficient and leptin-excessive conditions. The aim of this study was to examine the effects of centrally injected leptin on the hypothalamic KiSS-1 system in relation to gonadotropin-releasing hormone (GnRH) action in the initial stage of puberty. METHODS: Leptin (1 microg) was injected directly into the ventricle of pubertal female mice. The resultant gene expressions of hypothalamic GnRH and KiSS-1 and pituitary LH, 2 and 4 hours after injection, were compared with those of saline-injected control mice. The changes in the gene expressions after blocking the GnRH action were also analyzed. RESULTS: The basal expression levels of KiSS-1, GnRH, and LH were significantly higher in the pubertal mice than in the prepubertal mice. The 1-microg leptin dose significantly decreased the mRNA expression levels of KiSS-1, GnRH, and LH in the pubertal mice. A GnRH antagonist significantly increased the KiSS-1 and GnRH mRNA expression levels, and the additional leptin injection decreased the gene expression levels compared with those in the control group. CONCLUSION: The excess leptin might have suppressed the central reproductive axis in the pubertal mice by inhibiting the KiSS-1 expression, and this mechanism is independent of the GnRH-LH-estradiol feedback loop.
Aluminum Hydroxide ; Animals ; Axis, Cervical Vertebra ; Carbonates ; Female ; Gene Expression ; Gonadotropin-Releasing Hormone ; Humans ; Leptin ; Luteinizing Hormone ; Mice ; Puberty ; RNA, Messenger

BACKGROUND/AIMS: Thrombopoietin (TPO) is an important cytokine for megakaryocyte maturation and platelet production. Because the main site of its production is liver, the failing liver may have a role in thrombocytopenia in chronic liver disease. The aims of this study were to determine the serum TPO levels in cirrhotic patients with thrombocytopenia and clarify the relation between the serum TPO levels and liver function impairment. METHOD: Cirrhotic paitents with thrombocytopenia (LC, n=57, Child class A/B/C; 20/13/24), chronic hepatitis patients (CH, n=24), oncologic patients with thrombocytopenia induced by chemotherapy (HO, n=7), acute viral hepatitis patients (AVH, n=5) and healthy controls (HC, n=5) were enrolled. Serum TPO was measured by an ELISA method. RESULTS: Although the mean platelets counts of LC (69+/-32, x103/ul: mean+/-SD) were lower than those of HC (229+/-29, x103/ul), serum TPO levels in LC (108+/-63 pg/ml: mean+/-SD) were not significantly different from HC (122+/-24 pg/ml). In HO, serum TPO was significantly higher than LC (623+/-746 vs 108+/-63 pg/ml, p<0.05) inspite of comparable platelets counts. In LC, serum TPO level was not significantly different among Child class groups. It was not correlated with serum ALT, serum albumin levels, prothrombin time, serum bile acid, Child class, Child score and partial thromboplastin time, but weakly correlated with serum total bilirubin (p=0.038, r=0.288) and platelet counts (p=0.041, r=0.287). CONCLUSIONS: Although impaired hepatic production of TPO seems to be the main cause of low serum TPO levels in thrombocytopenic cirrhotic patients, there was no correlation between serum TPO level and the severity of liver dysfunction. The role of other factors such as megakaryocyte mass in bone marrow, portal hypertension and hypersplenism may be necessary to explain the putative mechanism between TPO and platelet numbers in liver cirrhosis with thrombocytopenia.
Bile ; Bilirubin ; Blood Platelets ; Bone Marrow ; Child ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hypersplenism ; Hypertension, Portal ; Liver ; Liver Cirrhosis ; Liver Diseases ; Megakaryocytes ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Serum Albumin ; Thrombocytopenia* ; Thrombopoietin*

BACKGROUND: Depending on the light dose and concentration of photosensitizer for photodynamic treatment (PDT), a multitude of dose-related events are demonstrable in PDT-treated cells. Sublethal doses may result in the alteration of cytokine release and consequently modify immune actions, rather than cause cell death. OBJECTIVE: The purpose of this study was to investigate cytokine expression in cultured HaCaT cells after intense pulse light (IPL) treatment or PDT utilizing 5-aminolevulinic acid (ALA) and IPL at sublethal doses. METHODS: Cultured HaCaT cells were treated with either IPL only (4, 8 and 12 J/cm2) or ALA-IPL PDT (100micromol/L of ALA; 0, 4, 8, and 12 J/cm2 of IPL). The expression of IL-10, TGF-beta1 and TNF-alpha was investigated by reverse transcription-polymerase chain reaction and enzyme linked immunosorbent assay. RESULTS: IL-10 protein increased up to 5.95-fold after IPL treatment and up to 2.85-fold after PDT. TGF-beta1 mRNA and protein showed slight increases after both IPL treatment and PDT, of which the latter induced slightly larger increases. TNF-alpha mRNA and protein showed no induction or reduction after PDT. CONCLUSION: Increased expressions of IL-10 and TGF-beta1 was observed after PDT. The induction of IL-10 may contribute to the anti-inflammatory effect, which explains the therapeutic benefit of PDT for inflammatory dermatoses, and that of TGF-beta1 may be related to the therapeutic effect for psoriasis. The finding that IL-10 induction was more marked after IPL treatment than after PDT suggests that other mechanisms than IL-10 induction in keratinocytes after PDT may participate in the anti-inflammatory effect of PDT.
Cell Death ; Enzyme-Linked Immunosorbent Assay ; Interleukin-10 ; Keratinocytes ; Light ; Photochemotherapy ; Psoriasis ; RNA, Messenger ; Skin Diseases ; Transforming Growth Factor beta1 ; Triazenes ; Tumor Necrosis Factor-alpha

Periumbilical perforating pseudoxanthoma elasticum is a rare acquired disorder of connective tissue. It has been suggested that repeated traumas of pregnancy, obesity, or abdominal surgery promote localized degeneration of elastic fibers. Most cases reported in the English literature occurred in obese, middle aged, multiparous women. We describe a 29-year-old male who had two hyperpigmented plaques on the periumbilical area. He had angioid streaks, but was not obese and did not have hypertension. A skin biopsy revealed transepidermal elimination of degenerated and calcified elastic fibers, which was consistent with periumbilical perforating pseudoxanthoma elasticum. We report an interesting case of periumbilical perforating pseudoxanthoma elasticum that occurred in a young man with no known predisposing risk factors.
Adult ; Angioid Streaks ; Biopsy ; Connective Tissue ; Elastic Tissue ; Female ; Humans ; Hypertension ; Male ; Middle Aged ; Obesity ; Pregnancy ; Pseudoxanthoma Elasticum ; Risk Factors ; Skin

BACKGROUND: Topical photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) was originally used for treating superficial skin tumors. The application of PDT to other inflammatory dermatoses like acne vulgaris, psoriasis, granuloma annulare, localized scleroderma and lichen sclerosus has recently been introduced. However, the underlying mechanisms are not well understood. We've previously reported the induction of tumor growth factor (TGF)-beta1 and interleukin (IL)-10 after PDT with ALA and intense pulsed light (IPL) in cultured HaCaT cells. OBJECTIVE: The purpose of this study was to investigate the expressions of TGF-beta1 and IL-10 in cultured fibroblasts after PDT with using ALA and IPL. METHODS: Cultured fibroblasts were treated with ALA-IPL PDT (1micromol/L of ALA; 0, 4, 8 and 12 J/cm2 of IPL). The expressions of TGF-beta1 and IL-10 were investigated by reverse transcription-polymerase chain reaction and enzyme linked immunosorbent assay. RESULTS: TGF-beta1 mRNA and protein were reduced down to 0.52- and 0.63-fold, respectively, after PDT and the IL-10 protein was increased up to 2.74-fold after PDT. CONCLUSION: The reduction of TGF-beta1 was prominent after PDT and so an antisclerotic effect can be expected after PDT. The induction of IL-10 may contribute to the anti-inflammatory effect, which explains the therapeutic benefit of PDT for inflammatory dermatoses.
Acne Vulgaris ; Aminolevulinic Acid ; Fibroblasts ; Granuloma Annulare ; Interleukin-10 ; Interleukins ; Lichen Sclerosus et Atrophicus ; Light ; Photochemotherapy ; Psoriasis ; RNA, Messenger ; Scleroderma, Localized ; Skin ; Skin Diseases ; Transforming Growth Factor beta1 ; Triazenes

Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin(R). Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin(R) contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin(R). We report another case of allergic contact dermatitis due to Duoderm extrathin(R) in a 32 year-old woman.
Bandages, Hydrocolloid ; Debridement ; Dermatitis, Allergic Contact ; Dermatitis, Irritant ; Edema ; Female ; Humans ; Hydrogen ; Inflammation ; Iron ; Patch Tests ; Resins, Plant ; Skin ; Ulcer