BACKGROUND: Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) has increasingly been used for the treatment of acne vulgaris and several studies have shown its clinical efficacy. However, ALA-PDT needs a relatively long incubation period and is frequently associated with adverse effects. Indole-3-acetic acid (IAA) has been introduced as a new photosensitizer for the treatment of acne in recent study. IAA-PDT requires only a short incubation period and the procedure is relatively painless in contrast to ALA-PDT. OBJECTIVE: To investigate the efficacy and safety of IAA- PDT in the treatment of acne. METHODS: Twenty-five patients with facial acne lesions were enrolled in this study. IAA-PDT was performed for five sessions at 1-week intervals (week 0~4). IAA was treated with 15 minute occlusion, and green light was given for 15 minutes. Clinical efficacy was determined by evaluating acne lesion counts, severity grading, and the Dermatology Life Quality Index (DLQI) at week 0, 2, 4, and 5. Sebum secretion and erythema index was measured by Sebumeter and Mexameter, respectively, at baseline and one week after each treatment session (week 1~5). Histopathological examination was performed at baseline and week 5. Adverse effects were recorded throughout the study. RESULTS: All the patients completed the study. Numbers of both inflammatory and non-inflammatory acne lesions were significantly decreased. Acne severity grade and the DLQI showed significant reduction. Sebum secretion and erythema were also reduced. Histopathological examination showed a reduction in inflammatory reactions. No adverse effects were observed except for transient pruritus in one patient. CONCLUSION: PDT using IAA and green light was an effective, simple and safe treatment for acne.
Acne Vulgaris ; Aminolevulinic Acid ; Dermatology ; Erythema ; Humans ; Indoleacetic Acids ; Light ; Photochemotherapy ; Pruritus ; Quality of Life ; Sebum ; Triazenes

No abstract available.
Aneurysm*

Pilar leiomyoma or piloleiomyoma is a benign neoplasm of the smooth muscle arising from the arrector pili muscle. It manifests as brown to red firm papulonodules with sites of predilection being the face, trunk, and extensor surfaces of the extremities. Histologically, the lesions exhibit ill-defined dermal tumors with interlacing fascicles of spindle cells. Some genodermatoses are characterized by the development of visceral tumors and cutaneous leiomyomatosis such as Reed’s syndrome, and hereditary leiomyomatosis and renal cell cancer (HLRCC). A 55-year-old male presented with reddish-brown papules and nodules on the face and upper back, accompanied by sharp episodic pain on the face. He had undergone nephrectomy for renal cancer 9 years ago, and his younger brother had similar cutaneous manifestation. Histopathologic findings were consistent with pilar leiomyoma, showing bundles of smooth muscle tumors in the dermis. Based on the clinical information including clinical features, past medical history, and family history, HLRCC was highly suspected.To confirm the diagnosis, whole exome sequencing was performed using peripheral blood, which revealed a novel point mutation (c.739G>A, p.Glu247Lys) in the fumarate hydratase (FH) gene. We describe a confirmed case of HLRCC, which is a genetic disorder with a potential to cause visceral cancers, which dermatologists might overlook as a benign condition.

Nevus sebaceus is a hamartomatous lesion characterized by epidermal, follicular, sebaceus, and apocrine gland abnormalities. Approximately 25% of affected individuals may develop benign or malignant secondary neoplasms within the preceding nevus sebaceus. Primary cutaneous apocrine carcinoma (PCAC) is a rare malignant skin tumor affecting elderly adults in their sixth decade of life. Histologically, PCAC appears as a dermal tumor displaying apocrine differentiation with decapitation secretion and malignant features. Secondary malignancy arising from nevus sebaceus is a rare complication, especially for apocrine carcinoma. To date, approximately 200 cases of PCAC have been reported in the literature, and only a few cases have developed PCAC on the scalp. Very few cases (approximately only 12) of PCACs developing in nevus sebaceus have been reported. Here, we report an extremely rare case of the coexistence of PCAC and syringocystadenoma papilliferum arising within nevus sebaceus of the scalp.

Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients’ greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

OBJECTIVES: This study investigated the prevalence of reading and mathematical learning disabilities of students at primary schools in Jeju Island, South Korea. We examined major causes of learning disabilities including reading disorder, mathematical disorder, attention deficit, and other causes including socioemotional factors. METHODS: We conducted screening processes to 659 participants (340 male, 51%) in 4 elementary schools in Jeju Island. To identify the causes of learning problems, 84 children were administered tests such as the Korean-Wechsler Intelligence Scale for Children-fourth edition, the Comprehensive Learning Test-Reading/Math, and the Comprehensive Attention Test. RESULTS: This study found that 13% of elementary school students in the Jeju region had learning disabilities. Among learning disabilities, specific reading and mathematical disorders accounted for 9% of study subjects. In addition, 2% of participants had intellectual impairment and 1% had other causes such as socioemotional factors. 65% of children with learning disabilities and 74% of children with reading or mathematic disorders had concurrent attention deficit disorder. 68% of children with reading disorders also had comorbid mathematical disorder. CONCLUSION: The prevalence, causes, and comorbidity of reading and mathematical learning disabilities of students in Jeju Island, South Korea did not differ from those in foreign countries. Because most learning disabilities are complex, comprehensive evaluations and tailored interventions are necessary to help children with learning disabilities.
Attention Deficit Disorder with Hyperactivity ; Child* ; Comorbidity ; Dyscalculia ; Dyslexia ; Epidemiology ; Humans ; Intelligence ; Korea ; Learning Disorders* ; Learning* ; Male ; Mass Screening ; Mathematics ; Prevalence*

No abstract available.
Alagille Syndrome* ; Cholestasis ; Xanthomatosis*

STUDY DESIGN: A retrospective comparative study. PURPOSE: To provide an ideal correction angle of lumbar lordosis (LL) in degenerative flat back deformity. OVERVIEW OF LITERATURE: The degree of correction in degenerative flat back in relation to pelvic incidence (PI) remains controversial. METHODS: Forty-nine patients with flat back deformity who underwent corrective surgery were enrolled. Posterior-anterior-posterior sequential operation was performed. Mean age and mean follow-up period was 65.6 years and 24.2 months, respectively. We divided the patients into two groups based on immediate postoperative radiographs-optimal correction (OC) group (PI-9degrees< or =LL or =55degrees). Radiological and clinical results were analyzed. RESULTS: Patients in OC group had significantly less correction loss and maintained normal sagittal alignment (sagittal vertical axis<5 cm), as compared to patients in UC group (p<0.05). LL of low PI group significantly maintained within 9degrees better than high PI group (p<0.05). Oswestry disability index (ODI) significantly decreased at last follow-up, as compared to preoperative state. However, there was no significant difference in last follow-up ODI between the groups. CONCLUSIONS: In flat back deformity, correction of LL to within 9degrees of PI will result in better sagittal balance. Thus, we recommend sufficient LL to prevent correction loss, especially in patients with high PI.
Animals ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Incidence ; Lordosis* ; Retrospective Studies

Objectives: This study investigated the effectiveness of the intervention program for elementary school students with reading disorders. Methods: The intervention program focused on phonological awareness, phonics, and decoding training applied individually to 25 children with a reading disorder by the teachers in charge for four months. To measure the efficacy, this study evaluated the word reading accuracy, fluency, and the related cognitive functions, including phonemic awareness, phonics, and rapid automatized naming using the Computerized Comprehensive Learning Test-Reading before and after the program. Results: After the intervention, improvements were observed in the following: the reading fluency score and fluency percentile in the word attack test; reading accuracy rate, fluency score, and fluency percentile in the nonword decoding test; fluency score and fluency percentile in the rapid automatized naming tests; accuracy rate in the letter-sound matching test; accuracy rate in the nonword repetition test. On the other hand, there was no significant difference in the paragraph reading fluency test. According to the subtypes of reading disabilities, children with dyslexic or mixed types improved after the intervention. Conclusion Reading accuracy and fluency of school-aged children with reading disorders improved through the intervention program by the schoolteachers.

Objectives: This study investigated the effectiveness of the intervention program for elementary school students with reading disorders. Methods: The intervention program focused on phonological awareness, phonics, and decoding training applied individually to 25 children with a reading disorder by the teachers in charge for four months. To measure the efficacy, this study evaluated the word reading accuracy, fluency, and the related cognitive functions, including phonemic awareness, phonics, and rapid automatized naming using the Computerized Comprehensive Learning Test-Reading before and after the program. Results: After the intervention, improvements were observed in the following: the reading fluency score and fluency percentile in the word attack test; reading accuracy rate, fluency score, and fluency percentile in the nonword decoding test; fluency score and fluency percentile in the rapid automatized naming tests; accuracy rate in the letter-sound matching test; accuracy rate in the nonword repetition test. On the other hand, there was no significant difference in the paragraph reading fluency test. According to the subtypes of reading disabilities, children with dyslexic or mixed types improved after the intervention. Conclusion Reading accuracy and fluency of school-aged children with reading disorders improved through the intervention program by the schoolteachers.