Epidermolytic hyperkeratosis is a rare disease which is extremely variable in its severity. In some patients it may be so severe and generalized during the neonatal period as to be lifethreatening, in others, it is relatively inconspicuous. A bullous eruption is the characteristic finding of the epidermolytic hyperkeratosis The bullous episodes soon become less frequent and more localized and may eventually cesse, but continue into adult life after the age of 20 years in at least 20% of cases. A case of epidermolytic hyperkeratosis is represented. The patient was a 25-year-old male who had ichthyosiform erythroderma and the frequent episades of bullous eruption. The bullous eruption had been subsided under the treatment with oral penicillin administration. The histopathological features of the bullous lesion on his abdomen revealed the features of epidermolytic hyperkeratosis.
Abdomen ; Adult ; Blister ; Dermatitis, Exfoliative ; Humans ; Hyperkeratosis, Epidermolytic* ; Male ; Penicillins ; Rare Diseases

OBJECTIVE: To test if the intake of H2 receptor antagonists (H2-RAs) increases the risk of gastric cancer in the elderly. METHODS: The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1993. The information on H2-RAs exposure was obtained from a drug prescription database compiled between Jan. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. RESULTS: After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 (95% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). CONCLUSION: The intake of H2-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.
Achlorhydria ; Aged* ; Body Mass Index ; Busan ; Case-Control Studies* ; Cimetidine ; Cohort Studies ; Drug Prescriptions ; Famotidine ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Logistic Models ; Odds Ratio ; Parturition ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Ranitidine ; Stomach Neoplasms* ; Stomach Ulcer

Cancer metastasis to the skin, especially epidermotropic metastasis, is uncommon. Sometimes it is difficult to find the primary lesion; immunohistochemical (IHC) staining of cutaneous metastasis is used to determine the origin, but diagnosis may occasionally prove difficult. A 77-year-old man visited our hospital with a 1-month diagnostic history of multiple nodules in the right axilla. The patient had undergone surgery for gastric adenocarcinoma (T3N3M0) 21 years ago, and was diagnosed with lung adenocarcinoma 1 year previously; however, no treatment was ongoing. Biopsy of the lesions revealed atypical cells surrounding the papillary projections of the epidermis and tumor nests of the upper dermis. IHC staining was positive for CK7 and CEA and negative for CK5/6, CK20, napsin A, TTF-1, GCDFP 15, and p63. The tissues revealed glandular structures and tested negative for p63 and CK5/6 on IHC staining. The patient was diagnosed with epidermotropic metastasis of lung adenocarcinoma.

No abstract available.
Carcinoma, Basal Cell*

BACKGROUND: Patients with acne are at risk of using various over-the-counter drugs (OTCs). In addition, several OTCs are introduced in pharmacies in Korea. However, only few drugs are supported by well-established data. Among the treatments, acne patches are easy to purchase and use. Thus, they are widely used by patients. OBJECTIVE: This study aimed to investigate the patient's perception and usage of acne patches. METHODS: A questionnaire survey was conducted on 80 patients with acne who visited the outpatient department of the National Medical Center for 2 months. RESULTS: A total of 42 (52.5%) patients answered that they had used acne patches, and 38 (47.5%) patients stated that they had never used patches. Moreover, 27 (64.29%) patients responded that they used the patches on inflammatory lesions. Moreover, several patients were using acne patches after pricking themselves. There was only one response to confirm the ingredient when purchasing acne patch. Moreover, 14 (33.33%) participants responded that they noted side effects after using acne patches. Overall, the satisfaction score for the use of acne patches was 5.05. CONCLUSION: Patients often use acne patches because they can be easily purchased and used. However, they do not know how to properly choose and use the product that fits their skin. Therefore, doctors must educate patients on how to properly select and use the products.
Acne Vulgaris* ; Bandages ; Colloids ; Humans ; Korea ; Nonprescription Drugs ; Outpatients ; Pharmacies ; Skin

OBJECTIVES: Numerous studies have revealed the adverse health effects of acute and chronic exposure to particulate matter less than 10 mum in aerodynamic diameter (PM10). The aim of the present study was to examine the spatial distribution of PM10 concentrations and cardiovascular mortality and to investigate the spatial correlation between PM10 and cardiovascular mortality using spatial scan statistic (SaTScan) and a regression model. METHODS: From 2008 to 2010, the spatial distribution of PM10 in the Seoul metropolitan area was examined via kriging. In addition, a group of cardiovascular mortality cases was analyzed using SaTScan-based cluster exploration. Geographically weighted regression (GWR) was applied to investigate the correlation between PM10 concentrations and cardiovascular mortality. RESULTS: An examination of the regional distribution of the cardiovascular mortality was higher in provincial districts (gu) belonging to Incheon and the northern part of Gyeonggido than in other regions. In a comparison of PM10 concentrations and mortality cluster (MC) regions, all those belonging to MC 1 and MC 2 were found to belong to particulate matter (PM) 1 and PM 2 with high concentrations of air pollutants. In addition, the GWR showed that PM10 has a statistically significant relation to cardiovascular mortality. CONCLUSIONS: To investigate the relation between air pollution and health impact, spatial analyses can be utilized based on kriging, cluster exploration, and GWR for a more systematic and quantitative analysis. It has been proven that cardiovascular mortality is spatially related to the concentration of PM10.
Air Pollutants ; Air Pollution ; Gyeonggi-do ; Incheon ; Mortality* ; Particulate Matter ; Seoul ; Spatial Analysis*

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. Objective: To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. Methods: We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. Results: A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). Conclusion Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. Objective: To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. Methods: We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. Results: A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). Conclusion Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.

PURPOSE: To investigate the frequency of underlying diseases associated with respiratory distress in full-term infants, as well as its relation to the mode of delivery and clinical outcomes. METHODS: We conducted a retrospective review of 4,264 infants who had been admitted to the neonatal intensive care unit (NICU) of Chonnam University Hospital (CUH) over 5 years from January 2000 to December 2004. Full-term infants with respiratory distress such as transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), congenital pneumonia, meconium aspiration syndrome (MAS) and pneumothorax were included. We analysed the incidence of underlying disease, its relation to the mode of delivery, rate of mechanical ventilator therapy, prevalence of hypoxic ischemic encephalopathy (HIE), mortality and the length of hospitalization of surviving patients. RESULTS: Of the 4,264 patients who admitted to the NICU of CUH over the last five years, preterm infants made up 2,278 (53.4%) and full-term infants made up 1,982 (46.5%). The number of full-term patients who admitted due to respiratory distress associated with respiratory system problems excluding a congenital anomaly was 246 (12.4%). The most common underlying disease was TTN (n=161, 65.4%), and the next was RDS (n=39, 15.9 %), congenital pneumonia (n=11, 4.5%), MAS (n=7.9, 8.5%), and pneumothorax (n=14, 5.7 %). RDS was more statistically common in full-term infants born by Caesarian section (P<0.05). But there was no difference according to the mode of delivery statistically in other respiratory tract diseases. The rate of mechanical ventilator therapy was significantly higher in RDS and MAS, and the prevalence of HIE was higher in MAS (P<0.05). Mortalities of RDS and MAS were 7.7% and 9.5% each. There was no significant difference in the length of hospitalization of surviving patients. CONCLUSION: TTN was the most common respiratory tract disease in the full-term infant, and RDS was more common in the infant who was born by Cesarean section. The rates of mechanical ventilator therapy and mortality were significantly higher in the infants with RDS and MAS, and HIE was exclusively manifested by infants with MAS.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hypoxia-Ischemia, Brain ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Jeollanam-do ; Meconium Aspiration Syndrome ; Mortality ; Pneumonia ; Pneumothorax ; Pregnancy ; Prevalence ; Respiratory System* ; Respiratory Tract Diseases* ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Ventilators, Mechanical

OBJECTIVE: Decidualization of endometrial stromal cells is essential for a successful implantation of the embryo. The process of decidualization can be modulated by sex steroids, growth factors and cytokines. Leukemia inhibitory factor (LIF) is a pleiotropic cytokine of the interleukin-6 family and has different biological actions in various tissue systems. Recently, LIF has been reported as an important factor for adequate decidualization of endometrium. However, the effect on production of prolactin (PRL), known as the decidualization marker, are not clearly understood. The objective of this study was to determine whether LIF is capable of modulating prolactin production during 8-bromo (Br)-cAMP induced decidualization in vitro. METHODS: Human endometrial stromal cells were cultured and decidualization was induced by 0.5 mM 8-Br-cAMP. Phase contrast microscopy was used to verify morphological changes associated with differentiation in vitro in response to 8-Br-cAMP. Both stromal cells exposed to 8-Br-cAMP and cells not exposed to 8-Br-cAMP were also incubated with LIF (10 ng/mL). PRL levels in each supernatant were measured by a commercial PRL ELISA kit. Immunostaining and reverse transcription-polymerase chain reaction (RT-PCR) for PRL were performed. RESULTS: The concentration of PRL in the supernatant increased significantly in the cells treated with 8-Br-cAMP plus LIF (10 ng/mL) at culture day 6 compared with the others. The results of immunohistochemical staining reflected that of immunoassay. The PRL genes are expressed in the decidualized stromal cells treated with 8-Br-cAMP. No PRL mRNA was detectable in the absence of the 8-Br-cAMP. The intensity of the PCR band measured by densitometry is stronger in the cells treated with 8-Br-cAMP plus LIF than that with the others. CONCLUSION: These results suggested that LIF increased the production of PRL in decidualizing human endometrial stromal cells and may play a role in preparing the human endometrium for implantation through the promotion of PRL production.
Cytokines ; Densitometry ; Embryonic Structures ; Endometrium ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans* ; Immunoassay ; Intercellular Signaling Peptides and Proteins ; Interleukin-6 ; Leukemia Inhibitory Factor* ; Leukemia* ; Microscopy, Phase-Contrast ; Polymerase Chain Reaction ; Prolactin ; RNA, Messenger ; Steroids ; Stromal Cells*