We report a case of acantholytic dyskeratotic epidermal nevus in a 28-year-old female. The patient showed unilateral, asymptomatic, grouped, 2 mm sized, brownish, follicular ant non-follicular, keratotic papules disposed along Blaschko´s lines on the right side of th back, flank and abdomen. She had had this condition for 4 years. The biopsy specimen obtaine, from the abdomen showed hyperkeratosis, parakeratosis, acanthosis, acantholytic suprabasal clefts, corps ronds, and grains. Although cryotherapy with liquid nitrogen was per formed on half of the lesions, the whole skin lesions healed with focal hypertrophic scars 4 weeks later. There was no recurrence after a 12 months follow-up period. To our knowledge this is the first reported case of acantholytic dyskeratotic epidermal nevus in Korean dermatologi, literature.
Abdomen ; Adult ; Ants ; Biopsy ; Cicatrix, Hypertrophic ; Cryotherapy ; Darier Disease* ; Female ; Follow-Up Studies ; Humans ; Nitrogen ; Parakeratosis ; Recurrence ; Skin

The aim of this study was to investigate the influencing factors that characterize low density lipoprotein (LDL) phenotype and the levels of LDL particle size in healthy Korean women. In 57 healthy Korean women (mean age, 57.4 +/- 13.1 yrs), anthropometric and biochemical parameters such as lipid profiles and LDL particle size were measured. Dietary intake was estimated by a developed semi-quantitative food frequency questionnaire. The study subjects were divided into two groups: LDL phenotype A (mean size: 269.7A, n = 44) and LDL phenotype B (mean size: 248.2A, n = 13). Basic characteristics were not significantly different between the two groups. The phenotype B group had a higher body mass index, higher serum levels of triglyceride, total-cholesterol, LDL-cholesterol, apolipoprotein (apo)B, and apoCIII but lower levels of high density lipoprotein (HDL)-cholesterol and LDL particle size than those of the phenotype A group. LDL particle size was negatively correlated with serum levels of triglyceride (r = -0.732, P < 0.001), total-cholesterol, apoB, and apoCIII, as well as carbohydrate intake (%En) and positively correlated with serum levels of HDL-cholesterol and ApoA1 and fat intake (%En). A stepwise multiple linear regression analysis revealed that carbohydrate intake (%En) and serum triglyceride levels were the primary factors influencing LDL particle size (P < 0.001, R2 = 0.577). This result confirmed that LDL particle size was closely correlated with circulating triglycerides and demonstrated that particle size is significantly associated with dietary carbohydrate in Korean women.
Apolipoproteins ; Apolipoproteins B ; Body Mass Index ; Dietary Carbohydrates ; Female ; Humans ; Linear Models ; Lipoproteins ; Particle Size ; Phenotype ; Surveys and Questionnaires ; Triglycerides

BACKGROUND/OBJECTIVES: This study aimed to test the association between APOA5 3'-UTR variants (rs662799) and cardiometabolic traits in Koreans. SUBJECTS/METHODS: For this study, epidemiological data, Apolipoprotein A5 (APOA5) genotype information, and lymphoblastoid cell line (LCL) biospecimens from a subset of the Ansung-Ansan cohort within the Korean Genome and Epidemiology study (KoGES-ASAS; n = 7,704) as well as epidemiological data along with genomic DNA biospecimens of participants from a subset of the Korea National Health and Nutrition Examination Survey (KNHANES 2011-12; n = 2,235) were obtained. APOA5 mRNA expression was also measured. RESULTS: APOA5 rs662799 genotype distributions in both the KoGES-ASAS and KNHANES groups were 50.6% for TT, 41.3% for TC, and 8.1% for CC, which are similar to those in previous reports. In both groups, minor C allele carriers, particularly subjects with CC homozygosity, had lower high-density lipoprotein (HDL) cholesterol and higher triglyceride levels than TT homozygotes. Linear regression analysis showed that the minor C allele significantly contributed to reduction of circulating HDL cholesterol levels [β = −2.048, P < 0.001; β = −2.199, P < 0.001] as well as elevation of circulating triglyceride levels [β = 0.053, P < 0.001; β = 0.066, P < 0.001] in both the KoGES-ASAS and KNHANES groups. In addition, higher expression levels of APOA5 in LCLs of 64 healthy individuals were negatively associated with body mass index (r = −0.277, P = 0.027) and circulating triglyceride level (r = −0.340, P = 0.006) but not significantly correlated with circulating HDL cholesterol level. On the other hand, we observed no significant difference in the mRNA level of APOA5 according to APOA5 rs662799 polymorphisms. CONCLUSIONS: The C allele of APOA5 rs662799 was found to be significantly associated with cardiometabolic traits in a large Korean population from the KoGES-ASAS and KNHANES. The effect of this genotype may be associated with post-transcriptional regulation, which deserves further experimental confirmation.
Alleles ; Apolipoproteins ; Asian Continental Ancestry Group ; Body Mass Index ; Cell Line ; Cholesterol ; Cholesterol, HDL ; Cohort Studies ; DNA ; Epidemiologic Studies ; Epidemiology ; Genome ; Genotype ; Hand ; Homozygote ; Humans ; Korea ; Linear Models ; Lipoproteins ; Nutrition Surveys ; RNA, Messenger ; Triglycerides

This present study aimed to investigate the association effect of obesity status, physical symptom, insecure attachment, and depression on psychological well-being in non-diabetic healthy Koreans. Height, weight, waist circumference, blood pressure, and socio-psychological questionnaires (insecure attachment, depression, and physical symptom psychological well-being, etc.) were examined in 123 healthy Koreans. Student t-test, correlation analysis, and mediation analysis were performed. Study subjects were divided into 2 groups based on body mass index (BMI, kg/m²): obesity (BMI ≥ 25, n = 36) and non-obesity (BMI < 25, n = 87). Obese people were older and showed higher proportion of males than non-obese ones. Regarding the values of socio-psychological test, obesity group showed lower insecure attachment, and higher physical symptom than non-obesity group. In correlation and mediation analyses, depression was positively related to insecure attachment and physical symptom in both BMI groups. Positive relationship between physical symptom and insecure attachment was observed only in non-obesity group, but not in obesity group. The effect of insecure attachment on psychological well-being was completely mediated by depression in both BMI groups. On the other hand, the effect of physical symptom on psychological well-being was completely mediated by depression in obesity group, but not in non-obesity group. In conclusion, this study presented that the effects of physical symptom and insecure attachment on psychological well-being were completely mediated by depression in obese healthy Koreans, but not in non-obese ones. It will provide useful data for extending the knowledge on the relationship between the physical health and mental health.
Blood Pressure ; Body Mass Index ; Depression* ; Hand ; Humans ; Male ; Mental Health ; Negotiating ; Obesity ; Waist Circumference

Purpose: Concept that modification of immunosuppression can delay the deterioration of graft function and graft failure is the one of strategies for chronic rejection. We analyzed the effect of modification of immunosuppression in 116 recipients with biopsy confirmed mild chronic rejection retrospectively. Methods: Mild chronic rejection was diagnosed by single renal pathologist under the uniformed criteria; mild tubular atrophy & interstitial fibrosis (less than 25%) combined with vascular change such as fibrous intimal thickening. General rules of modification after chronic rejection in our center were (1) strict adjustment of cyclosporine (CsA) dosage around 100~120microgram/L of trough blood level, (2) triple conversion in double therapy recipients (add anti-metabolites; azathioprine or MMF), (3) dose increment of anti-metabolites, (4) maintain of immunosuppression if ongoing immunosuppression is satisfactory to above criteria. Results: After 74.8+/-44.5 months of follow-up, we identified 72 graft failures (62.1%). Overall post-diagnosis graft survival rate were 93.1%, 79.7%, 63.6% and 35.8% in 1, 3, 5 and 10 years respectively. The status of graft function categorizedn by stage of chronic kidney disease (CKD) at diagnosis (CKD 4 or 5 stage), timing of diagnosis (more than post-transplant 3 years) and presence of severe proteinuria (more than 1 g/day of urinary excretion) were significant risk factors affecting the post-diagnosis graft survival rate. In multivariate survival analysis, these factors were confirmed as independent variables affecting post-diagnosis graft survival rate. But modification of immunosuppressive regimen after mild chronic rejection which was classified by modification (yes versus no), type of anti-metabolites (azathioprine versus MMF) and change of immunosuppressive strength (equal versus additional versus incremental) didn't cause the significant difference of post-diagnosis graft survival rate. Conclusion: Though pathologic change is mild, the modification of immunosuppression is not effective to delay graft failure in renal allograft recipient with pathologically established chronic rejection.
Allografts* ; Atrophy ; Azathioprine ; Biopsy ; Cyclosporine ; Diagnosis ; Fibrosis ; Follow-Up Studies ; Graft Survival ; Immunosuppression ; Proteinuria ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Survival Rate* ; Transplants

Objective: To determine the prognostic value of MRI-based tumor regression grading (mrTRG) in rectal cancer compared withpathological tumor regression grading (pTRG), and to assess the effect of diffusion-weighted imaging (DWI) on interobserveragreement for evaluating mrTRG. Materials and Methods: Between 2007 and 2016, we retrospectively enrolled 321 patients (male:female = 208:113; meanage, 60.2 years) with rectal cancer who underwent both pre-chemoradiotherapy (CRT) and post-CRT MRI. Two radiologistsindependently determined mrTRG using a 5-point grading system with and without DWI in a one-month interval. Two pathologistsgraded pTRG using a 5-point grading system in consensus. Kaplan-Meier estimation and Cox-proportional hazard models wereused for survival analysis. Cohen’s kappa analysis was used to determine interobserver agreement. Results: According to mrTRG on MRI with DWI, there were 6 mrTRG 1, 48 mrTRG 2, 109 mrTRG 3, 152 mrTRG 4, and 6 mrTRG 5.By pTRG, there were 7 pTRG 1, 59 pTRG 2, 180 pTRG 3, 73 pTRG 4, and 2 pTRG 5. A 5-year overall survival (OS) was significantlydifferent according to the 5-point grading mrTRG (p= 0.024) and pTRG (p= 0.038). The 5-year disease-free survival (DFS)was significantly different among the five mrTRG groups (p= 0.039), but not among the five pTRG groups (p= 0.072). OSand DFS were significantly different according to post-CRT MR variables: extramural venous invasion after CRT (hazard ratio= 2.259 for OS, hazard ratio = 5.011 for DFS) and extramesorectal lymph node (hazard ratio = 2.610 for DFS). For mrTRG, kvalue between the two radiologists was 0.309 (fair agreement) without DWI and slightly improved to 0.376 with DWI. Conclusion mrTRG may predict OS and DFS comparably or even better compared to pTRG. The addition of DWI on T2-weightedMRI may improve interobserver agreement on mrTRG.

This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Fasting* ; Female ; Glucose* ; Hemoglobin A, Glycosylated* ; Humans ; Kidney ; Liver ; Triglycerides ; Waist Circumference

A woman aged 40 years presented with symmetric band of depigmented patches on her hand dorsum and forearms. Under the diagnosis of focal vitiligo, we initially treated her with oral and topical steroids and local UVB irradiation. However, the wrist lesions were recalcitrant. Therefore, we tried a non-cultured epidermal cellular graft using autologous melanocyte-keratinocyte suspension. Twelve months after the procedure, higher than 70% of repigmentation was observed. This procedure seems to be an effective and practical treatment for recalcitrant vitiliginous lesions.
Aged ; Female ; Forearm ; Hand ; Humans ; Steroids ; Transplants ; Vitiligo ; Wrist

Ischemic colitis is the most common form of ischemic injury to the gastrointestinal tract and this frequently occurs in the elderly. It manifests with sudden, left lower abdominal pain, diarrhea and hematochezia. Radiologic modalities such as barium enema may be helpful in delineating the degree and location of ischemic colitis, but colonoscopy is the procedure of choice for making the diagnosis. Ischemic colitis generally runs a benign course lasting a few days and it requires only supportive treatment in most cases. Complications of ischemic colitis and recurrence are rare. We report here on a case of colonic stricture that was caused by ischemic colitis, and we include a brief review of the relevant literature.
Abdominal Pain ; Aged ; Barium ; Colitis ; Colitis, Ischemic ; Colon ; Colonoscopy ; Constriction, Pathologic ; Diarrhea ; Enema ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans ; Recurrence

Metastatic or septic endogenous endophthalmitis is a rare, but devastating complication of systemic septicemia. This condition may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungi) and many clinical conditions (pyelonephritis, endocarditis, meningitis, pneumonia) have been reported to cause endogenous endophthalmitis. Risk factors include most of the known reasons for immune suppression and chronic illness. A high clinical suspicion is required in early diagnosis and treatment. Early antibiotics and vitrectomy are more widely accepted as therapeutic modalities.
Abscess* ; Anti-Bacterial Agents ; Chronic Disease ; Early Diagnosis ; Endocarditis ; Endophthalmitis* ; Escherichia coli* ; Escherichia* ; Humans ; Meningitis ; Pneumonia* ; Risk Factors ; Sepsis* ; Vitrectomy