BACKGROUND: Although the histologic picture of epidermolytic hyperkeratosis is diagnostic for bullous congenital ichthyosiform erythrokerma (BCIE), it is not specific for it. It is found also in several other conditions, that is, linear epidermal nevus, epidermolytic keratisis palmaris et plantaris and epidermolytic acnthoma. Among these, BCIE is caused by mutations of the defferentiation s0pecific keratins K1 and K1-. These mutations produce a weakened cytoskeleton that is prone to collapse resulting I cell fragility and lysis. But the pathogenesis of epidermal nevus showing the similar histologic feature with BCIE is not known. OBJECTIVE: The purpose of our study is to conpare the electron microscopic picture and the immunohistochemical features, and to find the possible pathogenesis of both diseases. METHODS: We evaluated the clinical, histopathologic nd electron microscopic features of 5 BCIE cases and 14 epidermal nevus cases which were histologically diagnosed with epidermolytic hyperkeratosis at the department of dermatology at Wonju Christian Hospital, Shinchon Severance Hospital and Yongdong Severance Hospital, from January 1981 to June 1994. The immunohistochemical staining(PAP method) using monoclonal antibody against cytokeratin was performed on BCIE and epidermal nevus. RESULTS: Light microscopy of both BCIE and epidermal nevus showed the same histologic changes including hyperkeratosis, increased keratohyaline granules, acanthosis and perinuclear vacuolization of upper malpighia layer. Electron mioroscopic findings in both diseases were similar. Aggregation of tonofilaments is noted in the squamous cells, but is not evident in basal cells.In immunohistochemical study of both diseases, 34betaE12 is stained in the whole epidermis and is stuonger ex0ressed in the basal layer tan suprabasal layers. LP34 staining is evident in suprabasal cell layers up to the cornified cell layer. CONCLUSION: Electron microscopy and immunohistochemical study of both diseases showed the same finding. We thind that a defect in the differentiation specific keratins, K1 and K10 is perhaps involved in epidermal nevus histologically showing epidermolytic hyperkeratosis as in BCIE.
Cytoskeleton ; Dermatology ; Epidermis ; Gangwon-do ; Hyperkeratosis, Epidermolytic* ; Intermediate Filaments ; Keratins ; Microscopy ; Microscopy, Electron ; Nevus* ; Triacetoneamine-N-Oxyl

Background: The coronavirus disease 2019 (COVID-19) pandemic has greatly altered the daily lives of people in unprecedented ways, causing a variety of mental health problems. In this study, we aimed to evaluate the prevalence of depression among Korean adults during the COVID-19 pandemic and explore the factors associated with depressive mood using data from the Korea National Health and Nutrition Survey (KNHANES). Methods: We analyzed participants aged ≥ 19 years from KNHANES 2018 (n = 5,837) and 2020 (n = 5,265) to measure and compare the prevalence of depression before and during the COVID-19 pandemic. Depression was defined as a score ≥ 10 on the Patient Health Questionnaire-9. Furthermore, we performed a multivariate logistic regression analysis to investigate the independent predictors of depressive mood during the COVID-19 pandemic. Results: The prevalence of depression was notably higher during the COVID-19 pandemic than in the pre-pandemic period (5.2% vs. 4.3%, P = 0.043). In a multivariate model, female sex (adjusted odds ratio [aOR], 1.63; 95% confidence interval [CI], 1.10-2.41), age < 50 years (19–29 years: aOR, 7.31; 95% CI, 2.40–22.21; 30–39 years: aOR, 7.38; 95% CI, 2.66–20.47; 40–49 years: aOR, 4.94; 95% CI, 1.84–13.31 compared to ≥ 80 years), unemployment (aOR, 2.00; 95% CI, 1.41–2.85), upper-middle class household income (aOR, 1.83; 95% CI, 1.18– 2.85 compared to upper-class income), being a beneficiary of Medicaid (aOR, 2.35; 95% CI, 1.33–4.14), poor self-rated health (aOR, 4.99; 95% CI, 1.51–3.47 compared to good self-rated health), and current smoking (aOR, 2.29; 95% CI, 1.51–3.47) were found to be significant risk factors for depression during the pandemic. Conclusion Depression was significantly more prevalent among Korean adults during the COVID-19 pandemic than in the pre-pandemic era. Therefore, more attention should be paid to individuals vulnerable to depression during pandemics. Implementing psychological support public policies and developing interventions to prevent the adverse outcomes of COVID-19-related depression should be considered.

Congenital esophago-respiratory fistulae in adults have rarely been reported. Moreover, most of those are the cases of bronchoesophageal fistulae, that is to say esophago-lower respiratory fistulae. We experienced case of a congenital tracheoesophageal fistula in an adult, not a bronchoesophageal fistula. At our hospital, a 20-year-old male with recurrent episodes of a paroxysmal(especially postprandial) cough, respiratory infection and relative growth retardation had been diagnosed by using esophagography and esphagoscopy as having a congenital tracheoesophageal fistula with a concomittant esophageal diverticulum. The surgical correction was done successfully. We are excited to report a case of a congenital tracheoesophageal fistula in an adult, which is believed to be the first case of its kind in Korea.
Adult* ; Cough ; Diverticulum, Esophageal ; Fistula ; Humans ; Korea ; Male ; Tracheoesophageal Fistula* ; Young Adult

A clinical observation was made on 92 patients of renal injury at the Department of Urology, Kyung Hee University during the period from January, 1980 to July, 1988. The results were as follows. 1. Among the 92 patients, 77 patients were male and 15 patients were female and most favorable age was 10 to 29 years for 41.3%. The most common injury was traffic accident for 39.1% and then fall down, assault, play and sport in order. 2. Associated injuries were seen in 34 patients, the most common injury was head injury. The most common clinical presentation was flank pain and tenderness for 92.4% and then hematuria, wound and bulging on flank, shock and abdominal pain in order. 3. Severity of renal injury was classified in 3 categories according to Scot's Classification. Among 92 patients, 50 patients were minor injury, major injury in 39 patients, pedicle injury in 3 patients. 4. Radiologic study was performed with excretory urography (86 cases), renal angiography (17 cases), RGP. (2 cases), abdominal sonography (7 cases) and abdominal C. T. was performed in recent years (12 cases). 5. All minor injuries were treated conservatively, pedicle injuries were nephrectomy, 21 patients of major injury were managed conservatively and 17 patients were managed operatively (14 cases: nephrectomy). 6. Among the 92 patients, complications were developed in 18 patients and then nephrectomy was performed in 5 patients.
Abdominal Pain ; Accidents, Traffic ; Angiography ; Classification ; Craniocerebral Trauma ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Nephrectomy ; Shock ; Sports ; Urography ; Urology ; Wounds and Injuries

PURPOSE: To compare T2 relaxation times (T2) in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex between 1.5T and 3.0T MR imagers. MATERIALS AND METHODS: Twelve healthy volunteers underwent FLAIR and CPMG imaging perpendicular to the hippocampal body at both 3.0T and 1.5T. T2 was measured in the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex. The T2 relaxation time ratios of the cingulate cortex, insular cortex, and amygdaloid body to the hippocampal body were compared between 1.5T and 3.0T. RESULTS: The mean T2 of the cingulate cortex, amygdaloid body, hippocampal body, and insular cortex at 1.5T were 109.5+/-3.1, 117.0+/-7.1, 114.7+/-2.4, and 111.3+/-2.4, respectively; 99.7+/-3.8, 100.7+/-4.3, 97.9+/-3.4, and 96.2+/-2.0, respectively, at 3.0T. Percentage changes of T2 in the cingulate cortex, insular cortex, amygdaloid body, and hippocampal body at 3.0T with respect to those at 1.5T were -8.9%, -13.5%, -14.6%, and -13.5%, respectively. The mean T2 ratios of the cingulate gyrus, insular cortex, and amygdaloid body to the hippocampal body at 1.5T and 3.0T were 0.96 and 1.02 (p=0.003); 1.02 and 1.03 (p>0.05); 0.97 and 0.98 (p>0.05), respectively. CONCLUSION: T2 decrease in the cingulate cortex was less than the amygdaloid body, insular cortex, and hippocampal body at 3.0T. The mean T2 ratio of the cingulate gyrus to the hippocampal body was significantly different between 1.5T and 3.0T.
Amygdala ; Brain ; Gyrus Cinguli ; Hippocampus ; Relaxation

No Abstract Available.
Humans ; Kidney Failure, Chronic* ; Rupture* ; Tendons*

BACKGROUND: There has been controversy over the prevalence of recoarctation in infants treated by subclavian flap aortoplasty (SFA) for coarctation of the aorta. To assess the rate of recurrence of coarctation after SFA, we reviewed the surgical results of SFA in infants with coarctation of the aorta. MATERIAL AND METHOD: Between 1986 and 1998, a total of 25 patients less than 1 year of age (12 neonates and 13 infants) underwent SFA for aortic coarctation. Age at operation was 3.0+/-3.0 months (mean +/- standard deviation); mean weight was 5.0+/-1.4kg. Classic SFA was performed in 20 patients, reversed SFA in 2 patients, subclavian artery reimplantation in 2 patients and the combined resection-flap aortoplasty in one. The aortic clamping time ranged from 20 to 88 minutes(mean 35.8 minutes). There were one operative death and two late deaths. There was no case of paraplegia or left arm ischemia in complications. Twenty-one (84%) of 24 hospital survivors were followed for 26.0+/-24.0 months. The risk of recoarctation in neonates (33.3%) was a little greater than infants (25.0%) without statistical significance. CONCLUSION: This study revealed that SFA resulted a relatively high incidence of recarctation in infants. It is desirable to select other methods of surgical treatment (combined resection-flap aortoplasty, extended end-to-end repair etc.) for severe isthmic coarctation or hypoplasia of the distal aortic arch in infants, instead of choosing SFA indiscriminately.
Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Constriction ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Ischemia ; Paraplegia ; Prevalence ; Recurrence ; Replantation ; Subclavian Artery ; Survivors