Background: The objective of this study was to evaluate the immunogenicity of coronavirus disease 2019 (COVID-19) vaccination in patients with end-stage renal disease (ESRD) on hemodialysis. Methods: ESRD patients at the hemodialysis center of a tertiary-care university-affiliated hospital and healthy employees at the clinical laboratory center were prospectively recruited between March and June 2021. For severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) antibody analysis, blood samples were collected serially on days 0, 14, 28, and 56 after the first vaccine dose, and on days 7 and 50 after the second dose. Antibodies against the SARS-CoV-2 spike protein were quantified, and SARS-CoV-2 neutralizing antibodies were measured in the serum and plasma. Results: Thirty-one ESRD patients and 55 healthy employees were regularly monitored.Twenty-five (80.6%) ESRD patients on hemodialysis received a mix-and-match strategy with ChAdOx1-BNT162b2 (AZ–Pf group) and six (19.4%) received two doses of ChAdOx1 (AZ–AZ group). ESRD patients on hemodialysis showed lower binding antibody titers and neutralizing antibody activities compared to healthy participants following the first vaccination with ChAdOx1. After the second dose, AZ-Pf group had higher immunogenicity than healthy people on days 7 and 50. The binding antibody titer and neutralizing antibody activities on days 7 and 50 were significantly higher in the AZ–Pf group than in the AZ–AZ group. Conclusion ESRD patients on hemodialysis receiving the mix-and-match strategy (ChAdOx1–BNT162b2) have COVID-19 vaccine immunogenicity comparable to healthy individuals receiving two doses of ChAdOx1.

Background: Pain is one of the most common chief complaints in neurological field. Authors try to inform the current situation of pain medicine in neurological practice and present an effective method for pain-related education during neurology residency and for practicing neurologists. Methods: A survey was conducted from November 16 to November 27, 2020 for members of the Korean Neurological Association, and the results were analyzed. Results: About two-thirds of neurologists replied that more than 25% of their patients were suffered from diverse pain including headache, spine pain or neuropathic pain. Despite many patients are visiting to neurologist for pain treatment, most neurologists are aware that they have not received sufficient practical pain education in the past and present. Therefore, they want more educational opportunities in pain medicine including interventional pain management and physical and pharmacologic therapies for more effective treatment. Conclusions More follow-up studies on pain treatment and education should be conducted. It is also essential that the members of the society continue to interest and participate in the change of the pain education program.

Background: Pain is one of the most common chief complaints in neurological field. Authors try to inform the current situation of pain medicine in neurological practice and present an effective method for pain-related education during neurology residency and for practicing neurologists. Methods: A survey was conducted from November 16 to November 27, 2020 for members of the Korean Neurological Association, and the results were analyzed. Results: About two-thirds of neurologists replied that more than 25% of their patients were suffered from diverse pain including headache, spine pain or neuropathic pain. Despite many patients are visiting to neurologist for pain treatment, most neurologists are aware that they have not received sufficient practical pain education in the past and present. Therefore, they want more educational opportunities in pain medicine including interventional pain management and physical and pharmacologic therapies for more effective treatment. Conclusions More follow-up studies on pain treatment and education should be conducted. It is also essential that the members of the society continue to interest and participate in the change of the pain education program.

PURPOSE: Dermatofibrosarcoma protuberans is a relatively rare tumor that originates from the dermis and subcutaneous tissue. It is generally known that this tumor easily recurs but can be successfully treated with a wide excision. Therefore, this study was conducted to investigate postoperative outcomes and risk factors for recurrence in patients with dermatofibrosarcoma protuberans who were treated at a single institution for 20 years. METHODS: We retrospectively reviewed the medical records of 35 patients who had underwent surgery between June 1992, and September 2010. The patients were assessed in terms of predilection site and size of the tumor, the incidence according to sex, discrepancy between biopsy results and histopathological diagnosis of the surgical specimen, additional treatment after recurrence, recurrence rate and the time interval to recurrence. RESULTS: In multivariate analysis, the depth and site of the tumor were significant risk factors for tumor recurrence. The recurrence rate was significantly higher in tumors occurring in the upper extremity than those occurring in other regions(p=0.0348). In addition, the recurrence rate was significantly higher in tumors with involvement of the fascia and the deeper structures(p=0.0324, odds ratio=6, relative risk=1.588). Since dermatofibrosarcoma protuberans has strong invasiveness, its tissue involvement is difficult to evaluate accurately. CONCLUSION: The results of this study shows that involvement of the fascia and the deeper structures and occurrence in the upper extremity were associated with tumor recurrence. Therefore, clinicians should be aware of these risk factors to achieve better treatment outcomes.
Biopsy ; Dermatofibrosarcoma ; Dermis ; Fascia ; Humans ; Incidence ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Risk Factors ; Subcutaneous Tissue ; Upper Extremity

PURPOSE: Lobular capillary hemangioma is a vascular tumor that commonly occurs as a cutaneous lesion. Intravenous pyogenic granuloma is a rare form of lobular capillary hemangioma that usually occurs in the veins of the neck and the upper extremities. METHODS: A 41-year-old man presented with 3 months history of nodules on the left temporal area and these lesions were clinically mistaken for a typical lipoma or epidermal cyst, but the nodules appeared unusually vascular with sentinel veins on excision. RESULTS: On the histopathologic examination, the excised tissue was observed as an intraluminal polypoid mass, which was attached to the vein via a fibrovascular stalk and capillaries in a loose edematous fibromyxoid stroma, and so the lesions were confirmed to be intravenous pyogenic granuloma. At 6 months after excision, there has been no recurrence and the patient is asymptomatic. CONCLUSION: Intravenous pyogenic granuloma is a rare variant of lobular capillary hemangioma. This article describes the surgical and histopathological findings of treating pyrogenic granuloma.
Adult ; Capillaries ; Epidermal Cyst ; Granuloma ; Granuloma, Pyogenic ; Humans ; Lipoma ; Neck ; Nitriles ; Pyrethrins ; Recurrence ; Upper Extremity ; Veins

PURPOSE: For a proper wound care, the correct evaluation of wound is very important. Usually the evaluation of wound was subjective, and as a result, wound care was empirical. There were many attempts to objectify the wound evaluation, and one of them was measurement of the wound pH. The purpose of this study is to observe the wound pH changes during wound healing phase. METHODS: From 2005 to 2007, we measured the pH values of 6 acute wounds, which were split thickness skin graft donor sites. In addition, we measured the pH values of 18 chronic wounds, which were 17 pressure sores and 1 tuberculosis ulcer. After pH meter (SkinCheck1(R), Hanna Instruments, Italy) was calibrated, wound pH was checked. Wound was cleansed with saline gauze and dressed with polyurethane foam dressing(Medifoam(R), Biopol, Korea). RESULTS: In split thickness skin graft donor sites, the pH raised(mean pH value: 7.45-<7.62) when the wound was on the process of healing(*p=0.027, analysis of Wilcoxon signed-rank test). If wound became re-epithelialised, the pH value dropped to that of normal skin. However, we could not find a relation between time and the pH values in chronic wound. CONCLUSION: We could observe the consistent wound pH changes during wound healing phase in acute wound.
Humans ; Hydrogen-Ion Concentration ; Polyesters ; Polyurethanes ; Pressure Ulcer ; Skin ; Tissue Donors ; Transplants ; Tuberculosis ; Ulcer ; Wound Healing

BACKGROUND: Transcranial Doppler ultrasonography (TCD) can detect microembolic signals (MES) in the patients with a potential embolic source. Clinical significance of MES has not been demonstrated in patients with prosthetic mechanical heart valves. We studied the correlation between cerebral thromboemoblic events after the mechanical heart valve surgery (MHVS) and residual MES during TCD monitoring with 100% oxygen inhalation in patients with mechanical heart valves. MATERIAL AND METHOD: Twenty patients with previous cerebral thromboemoblic events after MHVS and a sex- and age-matched control group (n=30) were studied. TCD monitoring was performed from unilateral middle cerebral artery. After baseline monitoring for 20 minutes, 6L of oxygen was inspired for 40 minutes. RESULT: The site of valve and the duration after MHVS of the patients did not differ from those of controls. During baseline monitoring, there was no significant difference in MES prevalence or counts compared to controls. During oxygen inhalation, patients showed a higher MES prevalence (55%, 27.6%, p=0.045) and a more frequent MES counts (p=0.027) compared to controls. CONCLUSION: TCD monitoring with oxygen inhalation may be useful to differentiate clinically significant MES in patients with mechanical heart valve.
Embolism ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; Inhalation* ; Middle Cerebral Artery ; Oxygen* ; Prevalence ; Ultrasonography ; Ultrasonography, Doppler, Transcranial

BACKGROUND: Microabluminuria is defined as the amount of albumin in urine that is excreted above the normal but cannot be detected by the standard clinical dipstick test, and is used as a predictor for clinical diabetic nephropathy. It is therefore important to diagnose microalbuminuria with a sensitive, rapid and simple method. We developed a home-made ELISA for measuring microalbumin and a home-made latex agglutination method for diagnosing microalbuminuria. The aim of this study is to evaluate these methods and to evaluate the possibility of application for clinical uses. METHODS: We collected 24 hour urine samples from 86 patients at Hanyang University Kuri Hospital from January 1999 to April 1999. The principle of the ELISA is a double antibody sandwich technique. The latex agglutination method used rabbit anti-human albumin and latex bead. RESULTS: Within-run precisions of ELISA were 8.3% in low concentrations and 7.7% in high concentrations. Between-run precisions were 8.7% and 7.8%, respectively. The correlation coefficient between ELISA and RIA in samples from 80 patients was 9.4(P < 0.01). The sensitivity and specificity of the latex method were 90% and 97%, respectively. CONCLUSIONS: The home-made ELISA was a sensitive and relatively simple method for quantitation of microalbumin and correlated highly with the RIA. Therefore, this ELISA may replace RIA and can be used in other clinical uses. The latex agglutination method is simple, rapid, inexpensive and sensitive and correlated highly with the RIA. Clinically, this method may help patients and physicians in screening microalbuminuria.
Agglutination* ; Diabetes Mellitus ; Diabetic Nephropathies ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Latex* ; Mass Screening ; Microspheres ; Sensitivity and Specificity

We report a case of microgranular variant of acute promyelocytic leukemia with strong positivity in nonspecific esterase stain (inhibited by sodium fluoride) in a 21-onth-ld girl who had complained of intermittent fever and severe vomiting. At admission, she showed marked leukocytosis in the peripheral blood. The majority of leukocytes were immature cells which exhibited marked nuclear irregularity and had sparse dust-ike granules in their cytoplasm. In immunophenotyping, these cells showed CD13 and CD33 positivity and in cytogenetic study, they showed t(15;17) abnormality. The patient died at the 6th hospital day because of pulmonary and intracranial hemorrhage.
Carboxylesterase* ; Cytogenetics ; Cytoplasm ; Female ; Fever ; Humans ; Immunophenotyping ; Intracranial Hemorrhages ; Leukemia, Promyelocytic, Acute* ; Leukocytes ; Leukocytosis ; Sodium ; Vomiting

We report a case of microgranular variant of acute promyelocytic leukemia with strong positivity in nonspecific esterase stain (inhibited by sodium fluoride) in a 21-onth-ld girl who had complained of intermittent fever and severe vomiting. At admission, she showed marked leukocytosis in the peripheral blood. The majority of leukocytes were immature cells which exhibited marked nuclear irregularity and had sparse dust-ike granules in their cytoplasm. In immunophenotyping, these cells showed CD13 and CD33 positivity and in cytogenetic study, they showed t(15;17) abnormality. The patient died at the 6th hospital day because of pulmonary and intracranial hemorrhage.
Carboxylesterase* ; Cytogenetics ; Cytoplasm ; Female ; Fever ; Humans ; Immunophenotyping ; Intracranial Hemorrhages ; Leukemia, Promyelocytic, Acute* ; Leukocytes ; Leukocytosis ; Sodium ; Vomiting