Atopic dermatitis (AD) is a chronically relapsing inflammatory disorder of the skin. It is characterized by severe pruritus, sleep disturbance, and poor quality of life. In addition, AD frequently occurs in childhood and is considered the first manifestation of atopic march, which progresses into respiratory allergic diseases, such as asthma and allergic rhinitis, as the patient grow older. In this regard, the early diagnosis and active treatment of AD are required to lower the severity of disease and to prevent the development of atopic march. The proper management of AD includes avoidance of aggravating factors, barrier repair by skin care, and control of inflammation and infection with appropriate medications. Among them, identification and elimination of environmental risk factors responsible for worsening skin symptoms are essential. They include temperature, humidity, food and inhalant allergens, microorganisms, air pollutants, ultraviolet radiation, water hardness, and so forth. In particular, there is growing concern about indoor environment because time spent indoors and exposure to various kinds of pollutants is increasing with modernization and industrialization. In this review, we summarize the hazardous effect of temperature, humidity, cigarette smoke, volatile organic compounds, formaldehyde, and phthalates on the development or aggravation of AD. Current epidemiological studies and animal experiments suggest possible contributions of various indoor environmental factors to the development and aggravation of AD. However, further studies are needed to demonstrate a causal relationship between indoor environmental factors and AD.

Objective: Research on neural correlates in the prefrontal cortex (PFC) associated with self-injurious behavior has mainly been performed in adults. However, studies on adolescents are scarce. We aimed to investigate the activation and connectivity of the PFC between adolescents with self-injurious behavior (ASI) and psychiatric controls (PC) using functional near-infrared spectroscopy (fNIRS). Methods: We used an emotion recognition task during fNIRS to assess 37 adolescents (23 with self-injurious behavior and 14 PC) between June 2020 and October 2021 and compared connectivity and activation between the two groups. We also measured adverse childhood events (ACE, Adverse Childhood Experiences) and performed a correlation analysis of channel activation according to ACE total scores. Results: The difference in activation between the groups was not statistically significant. The connectivity of channel 6 was statistically significant. The interaction between channel 6 and the ACE total score showed statistical significance between the two groups(t[33] -2.61; p=0.014). The ASI group showed a negative correlation with the total ACE score. Conclusion This is the first study to investigate PFC connectivity using fNIRS in ASI. It has the implication of a novel attempt with a practically useful tool to uncover neurobiological differences among Korean adolescents.

A substantial proportion of adrenal incidentalomas demonstrates subtle hormonal hypersecretion; however, adenomas that cosecrete aldosterone and cortisol are rare. We here report a case of an adrenal mass that was incidentally detected on a computed tomography scan in a 57-year-old man. The patient had a 10-year history of diabetes mellitus and a 5-year history of hypertension. Evaluation revealed hyperaldosteronemia with an elevated plasma aldosterone-to-renin ratio, hypokalemia, unsuppressed cortisol after dexamethasone administration, and elevated urinary free cortisol concentration. The appearance of the right adrenalectomy specimen indicated adrenal adenoma. Postoperatively, the blood glucose and blood pressure control improved and the urinary cortisol and aldosterone-to-renin ratio normalized. A complete endocrine evaluation in patients with incidentally discovered adrenal masses should be performed, even if the patient has a long-standing history of hypertension and diabetes, to avoid any postoperative adrenal crises.
Adenoma ; Adrenalectomy ; Adrenocortical Adenoma* ; Aldosterone* ; Blood Glucose ; Blood Pressure ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone* ; Hyperaldosteronism ; Hypertension ; Hypokalemia ; Middle Aged ; Plasma

We found a mistake in our recently published article.

Transient global amnesia(TGA) is a transient neurological syndrome, which occurs mostly once in life. Although the pathophysiology of TGA is not yet clear, there are well-known precipitating events such as emotional stress, physical exertion, sexual intercourse, painful experiences, and immersion in cold water. We report a 67-year-old man who developed recurrent amnestic episodes fulfilling the criteria for TGA. He had vascular risk factors and precipitating events. We suggest that the number of trigger events and vascular risk factors is associated with TGA recurrence.
Aged ; Amnesia, Transient Global ; Coitus ; Cold Temperature ; Humans ; Immersion ; Memory ; Physical Exertion ; Recurrence ; Risk Factors ; Stress, Psychological ; Water

LEOPARD multiple congenital anomaly syndrome inherited in an autosomal dominant manner. LEOPARD is an acronym for Lentigines, Eletrocardiographic conduction defects, Ocular hypertelorism, Pulmonary valve stenosis, Abnormalities of the genitalia, Retardation of growth, and Deafness. Clinical diagnosis is primarily based on multiple lentigines, typical facial features, and the presence of hypertrophic cardiomyopathy and/or cafe-au-lait macules. We report a typical case of LEOPARD syndrome with PTPN11 gene mutation associated with lentigines, electrocardiograph abnormality, ocular hypertelorism, pulmonary valve stenosis, growth retardation, and sensorineural hearing loss.
Cardiomyopathy, Hypertrophic ; Deafness ; Electrocardiography ; Genitalia ; Hearing Loss, Sensorineural ; Hypertelorism ; Lentigo ; LEOPARD Syndrome ; Panthera ; Pulmonary Valve Stenosis

OBJECTIVES: To investigate the effect of a worksite-based dietary intervention program for the management of metabolic syndrome (MS) among male employees. METHODS: A dietary intervention program combining individual and environmental approach was implemented targeting white-collar employees at a worksite located in Seoul for 10 weeks. Out of 104 employees having agreed to participate in the program, those having three or more out of five components of MS and having two components, including a waist circumference component were classified into "the high risk group" (n=41) and received group nutrition education and individual nutrition counseling three times each. The rest of the study subjects were considered as "the low risk group" (n=63). The food environment at the worksite, where both the high and low risk groups were exposed, was changed to promote healthy eating. Physical data including MS components were collected and a questionnaire on dietary behaviors was administered before and after the intervention. The data from the high risk group (n=17) and the low risk group (n=20), excluding the subjects ineligible for or failed to complete the study (n=67), were analyzed. The difference before and after intervention was tested for significance by Wilcoxon signed-rank tests. RESULTS: Weight, body mass index (BMI), waist circumference, blood pressure, HDL-cholesterol, and HbA1c and the healthy dietary practice score improved significantly after intervention in the high risk group. The median number of MS components decreased significantly from 3.0 to 1.0 in the high risk group. In the low risk group, only HbA1c significantly decreased. Conclusions: The 10-week worksite-based dietary intervention program combining individual and environmental approach was found to be effective for managing MS of male employees. CONCLUSIONS: The 10-week worksite-based dietary intervention program combining individual and environmental approach was found to be effective for managing MS of male employees.
Blood Pressure ; Body Weight ; Counseling ; Eating ; Education ; Humans ; Male ; Seoul ; Waist Circumference ; Workplace

Gastric Hodgkin's lymphoma is extremely rare. We present a case of primary Hodgkin's lymphoma arising in the stomach of a 65-year-old woman. The patient complained of epigastric discomfort and reflux for one month. Endoscopic examination revealed a protruding lesion characterized by a smooth surface at the antrum. An abdominal computed tomography uncovered a 2.5 x 2.0 cm, exophytic submucosal mass. After the tentative preoperative diagnosis of a gastrointestinal stromal tumor, a gastric wedge resection was performed. Microscopic examination of the mass demonstrated a diffuse proliferation of large atypical lymphoid cells with mono- and binucleated pleomorphic nuclei and prominent nucleoli. Immunohistochemically, the tumor cells were positive for CD30, CD20, and CD79a, whereas they were negative for cytokeratin, carcinoembryonic antigen, CD3, CD15, epithelial membrane antigen, and anaplastic lymphoma kinase-1. Based on the morphological features and immunohistochemical results, in addition to the clinical findings, a diagnosis of primary gastric Hodgkin's lymphoma was established.
Aged ; Antigens, CD30 ; Carcinoembryonic Antigen ; Female ; Gastrointestinal Stromal Tumors ; Hodgkin Disease ; Humans ; Keratins ; Lymphocytes ; Lymphoma ; Mucin-1 ; Stomach

OBJECTIVES: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smart-toy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. METHODS: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. RESULTS: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. CONCLUSION: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.
Child* ; Humans ; Memory ; Memory, Short-Term ; Methods ; Motivation ; Neuropsychological Tests ; Sample Size

PURPOSE: This study reports a case of bilateral acute angle-closure crisis induced by two kinds of serotonin-norepinephrine reuptake inhibitors (SNRIs), duloxetine and tramadol.CASE SUMMARY: A 55-year-old female visited our clinic, complaining of bilateral visual impairment, ocular pain, and headache, which began 2 days after taking several drugs including duloxetine and tramadol for the purpose of back pain relief. On the day of the first visit, her uncorrected visual acuity was 0.04 in the right eye and 0.02 in the left eye, and the intraocular pressure (IOP) was 45 mmHg in the right eye and 51 mmHg in the left eye. The anterior chamber was shallow and the anterior chamber-angle was closed in both eyes on gonioscopy. There was mild nuclear sclerosis of both lenses. Assuming drug-induced bilateral acute angle-closure crisis, all medications were discontinued, and IOP-lowering agents were prescribed. The symptoms, visual acuity, and IOP improved; however, both anterior chambers were still shallow and the iridocorneal angle was still closed in both eyes. Laser iridotomy was tried in the right eye but failed because the pupils were not completely constricted, and iris bleeding occurred. Phacoemulsification and posterior chamber lens insertion were conducted in both eyes, and her visual acuity, IOP, anterior chamber depth, and iridocorneal angle have been stable at 9 months since her first visit. CONCLUSIONS The combined administration of SNRI may cause bilateral acute angle-closure attacks.