No abstract available.
Muir-Torre Syndrome*

BACKGROUND: During a 1-month period in 2005 , a series of 4 Leclercia adecarboxylata and 8 Pseudomonas aeruginosa bacteremias were reported from patients admitted to the emergency room. METHODS: An outbreak of L. adecarboxylata and P. aeruginosa bacteremia that occurred from February to March 2005 was investigated. The infection control nurse reviewed medical records and observed the procedures of blood cultures at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from alcohol sponge, tray, sink, water of sink, saline cotton, microscope, computer, and telephone. RESULTS: L. adecarboxylata was isolated from 4 patients and P. aeruginosa from 8 patients during a 1-month period. Observation of the culture procedure revealed that saline cotton was used to prevent betadin skin discoloration. The culture of the saline solution yielded a heavy growth of P. aeruginosa, which was not isolated from any other specimens. CONCLUSIONS: This was a pseudoepidemic caused by contaminated saline cotton. The use of the saline cotton was stopped, and during the follow-up period of 3 months, no additional L. adecarboxylata or P. aeruginosa bacteremia were reported.
Bacteremia ; Emergency Service, Hospital ; Enterobacteriaceae* ; Follow-Up Studies ; Humans ; Infection Control ; Medical Records ; Porifera ; Pseudomonas aeruginosa ; Skin ; Sodium Chloride ; Telephone ; Water

PURPOSE: Diabetic children should be classified into type 1 or 2 for adequate diabetic control. However, there is a shortage of information of the appropriate criteria in Korea. This study is desinged to discover the clinical types and characteristics of diabetes mellitus(DM) in Korean children. METHODS: We studied the clinical characteristics and laboratory findings of 177 diabetic children. Classification was based on the serum C-peptide levels, presence of ketoacidosis, autoantibodies, and insulin dependence. RESULTS: Among 177 diabetic children, 147(83.1%) were classified as type 1 and 21(11.9%) as type 2, and 12(57.1%) children in type 2 were obese. All patients with age of onset before 9 were type 1. In cases of type 1, initial serum C-peptide levels were < 0.6(50%), 0.6-1.0(44%) and > 1.0ng/mL (6%). All patients with initial serum C-peptide level above 1.5ng/mL were type 2. Four patients initially diagnosed as type 2 DM changed to type 1 during follow-up, and 2 patients of type 1 DM changed to type 2. Only 55.4% of type 1 DM patients had insulin autoantibody, islet cell cytoplasmic antibody or anti-glutamic acid decarboxylase antibodies. CONCLUSION: Most diabetic children in Korea were classified as type 1. Our results suggest that insulin requiring lean patients with positive autoantibody should be classified as type 1 even if their serum C-peptide levels are within normal range, and the clinical types could be changed during follow-up in a small proportion of diabetic children.
Age of Onset ; Antibodies ; Autoantibodies ; C-Peptide ; Child* ; Classification ; Cytoplasm ; Diabetes Mellitus* ; Follow-Up Studies ; Humans ; Insulin ; Islets of Langerhans ; Ketosis ; Korea ; Reference Values

PURPOSE: This study was performed to investigate the relationship between serum vitamin D and parathyroid hormone (PTH) levels as well as to describe the prevalence and the risk factors of vitamin D deficiency (VDD) in Korean children. METHODS: Participants were 1,212 children aged 4 to 15 years, who visited Bundang CHA Medical Center (located at 37degreesN) between March 2012 and February 2013. Overweight was defined as body mass index> or =85th percentile. Participants were divided into 4 age groups and 2 seasonal groups. VDD was defined by serum 25-hydroxyvitamin D (25OHD) <20 ng/mL. RESULTS: The level of 25OHD was significantly lower in overweight group than in normal weight group (17.1+/-5.1 ng/mL vs. 19.1+/-6.1 ng/mL, P<0.001). Winter-spring season (odds ratio [OR], 4.46; 95% confidence interval [CI], 3.45-5.77), older age group (OR, 1.60; 95% CI, 1.36-1.88), and overweight (OR, 2.21; 95% CI, 1.62-3.01) were independently related with VDD. The PTH levels were significantly higher in VDD group compared to vitamin D insufficiency and sufficiency group (P<0.001). In normal weight children, 25OHD (beta=-0.007, P<0.001) and ionized calcium (beta=-0.594, P=0.007) were independently related with PTH, however, these associations were not significant in overweight children. CONCLUSION: VDD is very common in Korean children and its prevalence increases in winter-spring season, in overweight children and in older age groups. Further investigation on the vitamin D and PTH metabolism according to adiposity is required.
Adiposity ; Body Mass Index ; Calcium ; Child* ; Humans ; Metabolism ; Overweight ; Parathyroid Hormone* ; Prevalence* ; Risk Factors* ; Seasons ; Vitamin D ; Vitamin D Deficiency*

Purpose: Overweight (OW)/obese girls tend to have an earlier pubertal onset than girls with normal weight. However, only a few studies have reported the progression of puberty in these girls. This study aimed to identify risk factors for rapid pubertal progression in OW/obese girls presenting with precocious breast development. Methods: This retrospective cohort study reviewed the medical records of 110 OW (body mass index [BMI] ≥85th percentile for age and sex) and 213 nonoverweight (NW, BMI <85th percentile for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into 2 subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP). Results: Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, p<0.001), and progression-free survival for 1, 2, and 3 years was higher in the OW group (p<0.001). In a subgroup analysis of OW girls, the OW-RP subgroup had more advanced bone age (BA) at the first visit (p=0.047) and higher initial luteinizing hormone (LH, p=0.010) levels than the OW-SP subgroup. Being NW (p=0.001) and having more advanced BA (p=0.023) at the initial workup were the risk factors for pubertal progression before age 9. Conclusion Pubertal progression seems to be slower in OW girls than in NW girls presenting with precocious breast development. However, it can progress rapidly in OW girls with particularly pronounced BA advancement and high LH levels at the initial workup.

Punctate leukoderma presents as numerous, distinct, round or oval depigmented spots. Recently, laser therapy-induced punctate leukoderma associated with various Q-switched laser and carbon dioxide laser have been reported. A 25-year-old man presented with numerous, discrete, round, confetti-like, depigmented macules on his left neck. He had undergone 3 sessions of 532-nm Q-switched Neodymium: Yttrium-Aluminum-Garnet laser treatment for café-au-lait macules three years ago. After the last laser treatment session, the punctate leukoderma had been developed. We started treatment with the 308-nm excimer laser twice a week. After 7 months of treatment duration, complete repigmentation was achieved without serious adverse effects. We recommend the 308-nm excimer laser as an effective treatment modality for laser therapy-induced punctate leukoderma.
Adult ; Humans ; Hypopigmentation ; Lasers, Excimer* ; Lasers, Gas ; Neck ; Neodymium ; Vitiligo

No abstract available.
Carcinoma, Basal Cell*

No abstract available.
Herpes Simplex* ; Humans ; Lasers, Excimer* ; Simplexvirus* ; Vitiligo*

BACKGROUND: The effects of the Notch signaling pathway in fibroproliferative skin diseases have not been fully elucidated. OBJECTIVE: The aim of this study was to investigate the expression of activated Notch signaling molecules in various skin fibroproliferative diseases. METHODS: Immunohistochemical analysis of Notch intracellular domain (NICD) expression in keloid, hypertrophic scar, morphea, dermatofibroma, and normal control skin specimens was performed, and the clinical characteristics of patients with various skin fibroproliferative diseases were analyzed. RESULTS: NICD was highly expressed in fibroblasts of keloids and moderately to highly expressed in hypertrophic scars and dermatofibromas, whereas low or no expression was detected in the fibroblasts of normal skin specimens and morpheas. NICD was constitutively expressed in keratinocytes, endothelial cells, and immune cells in normal skin specimens. CONCLUSION: NICD was significantly expressed in human fibroproliferative skin disorders, especially keloids, suggesting that an activated Notch signaling pathway is involved in the pathogenesis of skin fibrosis.
Cicatrix, Hypertrophic ; Endothelial Cells ; Fibroblasts ; Fibrosis ; Histiocytoma, Benign Fibrous ; Humans ; Keloid ; Keratinocytes ; Receptors, Notch ; Scleroderma, Localized ; Skin Diseases ; Skin*

PURPOSE: The increasing prevalence of breast feeding has led to concerns about vitamin D deficiency (VDD) and iron deficiency anemia (IDA) in children. We evaluated the prevalence of VDD in a population of Korean children with IDA and assessed the risk factors for VDD in these children. METHODS: A total of 79 children who were diagnosed with IDA were prospectively surveyed from April 2010 to March 2011. Data were collected by questionnaire, medical assessment, and laboratory tests, including measurement of 25-hydroxyvitamin D (25OHD), hemoglobin, and wrist radiography. RESULTS: The median age was 22 months and 30% of the subjects were female. Over a half of subjects (58%) had subnormal vitamin D level (25OHD<30 ng/mL), and VDD (25OHD<20 ng/mL) was present in 39% of children. There was no difference in serum hemoglobin level between IDA patients with VDD and those without VDD. Most subjects (89%) were currently or had recently been breastfed and almost all subjects (97%) who had VDD received breastfeeding. Children with VDD were more likely to be younger than 2 years, to have been breastfed, and to have been tested in winter or spring. Multivariable analysis indicated seasonal variation was a significant independent risk factor for VDD in our IDA patients. CONCLUSION: Our results demonstrated that VDD has a high prevalence in Korean children with IDA. Primary care physicians should be aware of the possibility of VDD in children with IDA and should supplement the vitamin D as well as iron.
Anemia, Iron-Deficiency ; Breast Feeding ; Child ; Female ; Hemoglobins ; Humans ; Iron ; Physicians, Primary Care ; Prevalence ; Prospective Studies ; Surveys and Questionnaires ; Risk Factors ; Seasons ; Vitamin D ; Vitamin D Deficiency ; Vitamins ; Wrist