Purpose: Abeliophyllum distichum (A.distichum) is a plant native to Korea. In this study, we investigated the mechanism of antioxidant and anti-inflammatory effects of the leaf extract of A.distichum. Methods: The antioxidant capacity of the A.distichum leaf extract was determined based on the total polyphenol content, 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assay, and the ferric reducing antioxidant power (FRAP) assay. The anti-inflammatory effects of the A.distichum leaf extract were evaluated by measuring the production of nitric oxide (NO) and the expression levels of proinflammatory cytokines including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 using the enzyme-linked immunosorbent assay (ELISA) and reverse transcription quantitative real-time PCR (RT-qPCR). In addition, the expression of heme oxygenase-1 (HO-1), nuclear transcription factor-erythroid 2 related factor (Nrf2), inducible nitric oxide synthase (iNOS), and cyclooxygenase 2 (COX-2), as well as the activation of nuclear factorkappa B (NF-ĸB) were examined using the western blot analysis. Results: The total polyphenol content of the A.distichum leaf extract was 329.89 ± 30.17 gallic acid equivalents mg/g and the DPPH and ABTS scavenging activities were 55% and 70%, respectively. Additionally, the FRAP value of the extract was 743.68 ± 116.59 mg/mL. After 12-hour treatment with the A.distichum leaf extract, there was a tendency for the Nrf2 expression to increase, and the expression of HO-1 was significantly elevated in the RAW264.7 cells. The A.distichum leaf extract treatment resulted in decreased levels of NO, TNF-α, IL-6, and IL-1β, as well as reduced expression of iNOS and COX-2, along with inhibition of NF-κB activation in lipopolysaccharide-stimulated RAW264.7 cells. Conclusion These results suggest that the A.distichum leaf extract exerts antioxidative and anti-inflammatory effects by upregulating the expression of HO-1 and downregulating NF-κB activation.

PURPOSE: End-of-life caregiving experiences can be complex. Family members experience physical and mental suffering as they anticipate their impending loss. Healthcare providers should be able to provide good quality of end-of-life (EOL) care and support for primary EOL caregivers. Studies have highlighted the role of healthcare providers providing information in the EOL situation to caregivers of chronic disease patients. This has resulted in the development of the End-of-life Caregiving Experience Appraisal Scale (EOLCAS) presented in this paper. The purposes of this study were to develop a scale that can evaluate the experiences of EOL caregivers, and to test the reliability and validity of this scale. METHODS: The scale domains were derived from systematic review of 35 relevant studies. We then examined its content validity with nurse scholars and clinicians using content validity index. To examine construct validity, a total of 175 caregivers from tertiary hospital setting in Korea participated in this study from December 2007 to May 2008. For the construct validity, factor analysis was utilized. RESULTS: The scale was composed of 32 items with four subscales: two negative appraisals (physical suffering and burden), one positive appraisal (maturation), and one neutral appraisal (social support pursuit). In this sample, the Cronbach's alpha for the entire scale was .84 indicating adequate reliability. However, Cronbach's alpha of subscales was varied. CONCLUSION: Nurses and other healthcare professionals could use the EOLCAS to assess the experiences of EOL caregivers to understand their experience in the EOL and enhance their quality of life although psychometrics of EOLCAS shows limited findings.
Advance Care Planning ; Caregivers ; Chronic Disease ; Delivery of Health Care ; Health Personnel ; Humans ; Korea ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Stress, Psychological ; Tertiary Care Centers

Urticaria pigmentosa (UP) is the most common variant of cutaneous mastocytosis. Primarily a disease of childhood, in over one-half of the cases onset is before 2 years of age, and in 90%, the disease is confined to the skin. UP precedes the diagnosis of systemic mastocytosis and is more common in adults than in children. Therefore, systemic examination should be performed in patients with UP. We report a case of adult-onset UP with systemic involvement.
Adult ; Child ; Humans ; Mastocytosis, Cutaneous ; Mastocytosis, Systemic ; Skin ; Urticaria ; Urticaria Pigmentosa

BACKGROUND: Severe alopecia areata (AA) is difficult to treat. Treatment modalities such as topical and systemic immune modulators, corticosteroids and topical sensitizers have been tried. Among them, encouraging RESULTS have been reported with high dose pulse corticosteroid therapy. OBJECTIVE: The aim of this study was to determine the effectiveness of a high dose corticosteroid pulse therapy in patients with severe AA compared with a group treated with oral cyclosporine with low dose corticosteroid. METHODS: A total of 105 patients with severe AA were treated with high dose corticosteroid pulse therapy and 41 patients those were treated with oral cyclosporine (3~5 mg/kg/day) with low dose methylprednisolone (2.5~5 mg/day). RESULTS: Therapeutic effect of high dose corticosteroid pulse therapy was better in shorter disease duration (<6 months, 81.4%;>6~12 months, 52.6%;>13 months, 37.3%) and less extensive type (AA multiplex, 80.0%; alopecia totalis, 41.2%; alopecia universalis, 27.8%). Therapeutic effect of oral cyclosporine with low dose corticosteroid therapy was better in less extensive type (AA multiplex, 75.0%; alopecia totalis, 41.2%; alopecia universalis, 25.0%). Disease duration did not significantly affect treatment response. High dose corticosteroid pulse therapy was more effective method (65.7%) than combination regimen of oral cyclosporine with low dose methylprednisolone (46.3%), especially in the case of shorter disease duration (p<0.05). CONCLUSION: High dose corticosteroid pulse therapy might be a more effective therapy for severe AA than other treatments, especially when in the acute stage (<6 months).
Adrenal Cortex Hormones ; Alopecia ; Alopecia Areata ; Cyclosporine ; Humans ; Methylprednisolone

Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection.
Adult ; Alopecia ; Atrophy ; Dermatology ; Female ; Foot ; Humans ; Hyperpigmentation ; Hypopigmentation ; Injections, Intralesional ; Knee ; Triamcinolone ; Triamcinolone Acetonide

BACKGROUND: Androgenic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. It is the most common form of hair loss in people with a genetic predisposition for baldness. OBJECTIVE: The aim of this study was to evaluate the prevalence, AGA type, family history, co-morbidity diseases, stress factors and endocrine factors of AGA patients. METHODS: We examined a total of 432 male and female AGA patients who visited for two years at the Department of Dermatology, School of Medicine, Chung-Ang University. RESULTS: There were 2.06 times more men (291 patients) than women (141 patients) among the study subjects. Most of the men were in their twenties (108, 37.1%), however, most of the women were in their forties (42, 29.7%). In the 291 male patients, Norwood class IIIv was dominant (120 patients, 41.2%). In the 141 female patients, Ludwig class I was dominant (87 patients, 61.7%). 219 (75.2%) of the 291 male patients and 81 (73.6%) of the 141 female patients had a family history of AGA. 224 (76.9%) of the 291 male patients and 101 (53.4%) of the 141 female patients had a co-morbidity disorder. The most common among these disorders in both the male and female patients was seborrheic dermatitis. Stress factors were observed in 162 (55.6%) of the 291 male patients and in 78 (55.3%) of the 141 female patients. The most common stress factor in both the male and female patients was work tasks. The serum testosterone levels was increased in 51 (17.5%) of the 291 male patients and in 20 (14.1%) of the 141 female patients. CONCLUSION: Most of the study results are compatible with those of our previous study. Yet the following results were different: (1) the number of female AGA patients in their forties is increasing; and (2) stress was found to be associated with AGA in both the male and female patients.
Alopecia ; Dermatitis, Seborrheic ; Dermatology ; Female ; Genetic Predisposition to Disease ; Hair ; Humans ; Male ; Prevalence ; Scalp ; Testosterone

BACKGROUND: Androgenic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. It is the most common form of hair loss in people with a genetic predisposition for baldness. OBJECTIVE: The aim of this study was to evaluate the prevalence, AGA type, family history, co-morbidity diseases, stress factors and endocrine factors of AGA patients. METHODS: We examined a total of 432 male and female AGA patients who visited for two years at the Department of Dermatology, School of Medicine, Chung-Ang University. RESULTS: There were 2.06 times more men (291 patients) than women (141 patients) among the study subjects. Most of the men were in their twenties (108, 37.1%), however, most of the women were in their forties (42, 29.7%). In the 291 male patients, Norwood class IIIv was dominant (120 patients, 41.2%). In the 141 female patients, Ludwig class I was dominant (87 patients, 61.7%). 219 (75.2%) of the 291 male patients and 81 (73.6%) of the 141 female patients had a family history of AGA. 224 (76.9%) of the 291 male patients and 101 (53.4%) of the 141 female patients had a co-morbidity disorder. The most common among these disorders in both the male and female patients was seborrheic dermatitis. Stress factors were observed in 162 (55.6%) of the 291 male patients and in 78 (55.3%) of the 141 female patients. The most common stress factor in both the male and female patients was work tasks. The serum testosterone levels was increased in 51 (17.5%) of the 291 male patients and in 20 (14.1%) of the 141 female patients. CONCLUSION: Most of the study results are compatible with those of our previous study. Yet the following results were different: (1) the number of female AGA patients in their forties is increasing; and (2) stress was found to be associated with AGA in both the male and female patients.
Alopecia ; Dermatitis, Seborrheic ; Dermatology ; Female ; Genetic Predisposition to Disease ; Hair ; Humans ; Male ; Prevalence ; Scalp ; Testosterone

HIV-associated eosinophilic folliculitis is characterized by recurrent crops of severely-pruritic follicular papules, pustules and plaques that occur mainly on the face, trunk and upper extremities of AIDS patients. This disease is distinguished from Ofuji's disease by severe pruritus, leukopenia, sparing of the palm and sole and a good response to phototherapy. Up to now, only three such cases have been reported in the Korean literature. A 55-year-old man, who was confirmed as being HIV positive 6 months previously, presented with severely-pruritic, erythematous pinhead to half pea sized papules and nodules on the face, neck and anterior chest. The skin biopsy from a nodular lesion on the face revealed perifolliculitis with a predominant eosinophilic infiltrate.
Biopsy ; Eosinophilia ; Eosinophils ; Folliculitis ; HIV ; Humans ; Leukopenia ; Middle Aged ; Neck ; Peas ; Phototherapy ; Pruritus ; Skin ; Skin Diseases, Vesiculobullous ; Thorax ; Upper Extremity

BACKGROUND: The purpose of this study was to evaluate whether institutional case volume affects clinical outcomes in patients receiving mechanical ventilation for 48 hours or more. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 158,712 adult patients were included at 55 centers in Korea. Centers were categorized according to the average annual number of patients: > 500, 500 to 300, and < 300. RESULTS: In-hospital mortality rates in the high-, medium-, and low-volume centers were 32.6%, 35.1%, and 39.2%, respectively. After adjustment, in-hospital mortality was significantly higher in low-volume centers (adjusted odds ratio [OR], 1.332; 95% confidence interval [CI], 1.296–1.368; P < 0.001) and medium-volume centers (adjusted OR, 1.125; 95% CI, 1.098–1.153; P < 0.001) compared to high-volume centers. Long-term survival for up to 8 years was better in high-volume centers. CONCLUSION: Centers with higher case volume (> 500 patients/year) showed lower in-hospital mortality and long-term mortality, compared to centers with lower case volume (< 300 patients/year) in patients who required mechanical ventilation for 48 hours or more.
Adult ; Cohort Studies ; Critical Illness ; Delivery of Health Care ; Hospital Mortality ; Humans ; Insurance ; Korea ; Mortality ; Odds Ratio ; Respiration, Artificial ; Retrospective Studies

Background: The purpose of this study was to assess the correlation between sedatives and mortality in critically ill patients who required mechanical ventilation (MV) for ≥ 48 hours from 2008 to 2016. Methods: We conducted a nationwide retrospective cohort study using population-based healthcare reimbursement claims database. Data from adult patients (aged ≥ 18) who underwent MV for ≥ 48 hours between 2008 and 2016 were identified and extracted from the National Health Insurance Service database. The benzodiazepine group consisted of patients who were administered benzodiazepines for sedation during MV. All other patients were assigned to the non-benzodiazepine group. Results: A total of 158,712 patients requiring MV for ≥ 48 hours were admitted in 55 centers in Korea from 2008 to 2016. The benzodiazepine group had significantly higher in-hospital and one-year mortality compared to the non-benzodiazepine group (37.0% vs. 34.3%, 55.0% vs. 54.4%, respectively). Benzodiazepine use decreased from 2008 to 2016, after adjusting for age, sex, and mean Elixhauser comorbidity index in the Poisson regression analysis (incidence rate ratio, 0.968; 95% confident interval, 0.954–0.983; P < 0.001). Benzodiazepine use, older age, lower case volume (≤ 500 cases/year), chronic kidney disease, and higher Elixhauser comorbidity index were common significant risk factors for in-hospital and oneyear mortality. Conclusion In critically ill patients undergoing MV for ≥ 48 hour, the use of benzodiazepines for sedation, older age, and chronic kidney disease were associated with higher in-hospital mortality and one-year mortality. Further studies are needed to evaluate the impact of benzodiazepines on the mortality in elderly patients with chronic kidney disease requiring MV for ≥ 48 hours.