BACKGROUND: The patients with atopic dermatitis (AD) show a defective barrier function of the skin and symptoms such as xerosis, pruritus and erythematous lesions with increased transepidermal water loss (TEWL). The choice of topical moisturizer is very significant for AD patients because these symptoms could be relieved by a local moisturizing agent that strengthens the epidermal barrier function. OBJECTIVE: This study was performed to evaluate the effects of the moisturizer APDDR-0801, which contains physiologic lipid granules (DermaON(R)), for relieving the symptoms associated with AD. METHODS: 128 patients (17.8+/-12.1 years) who were suffering from mild to moderate AD topically applied the test moisturizer twice daily for up to 4 weeks. The treatment efficacy was evaluated by the investigator global assessment (IGA) score, the eczema area and severity index (EASI) score, the transepidermal water loss (TEWL), the visual analogue scale (VAS) for pruritus and sleep disturbance, and the level of inflammatory cytokines in the horny layer of the flexural areas. RESULTS: The test moisturizer was well-tolerated and 58.6% of the patients achieved clinical improvements (over moderate) after the application of the test moisturizer for 4 weeks. The significant relief of AD symptoms was observed from 2 week to 4 week in a time-dependent manner. Significant improvements in the signs and symptoms of AD were observed at 4 week, such as the EASI score (37.8% improvement), the TEWL (20.3% improvement in the antecubital fossa lesion), the VAS score for pruritus (26.2% improvement), and VAS score for insomnia (39.7% improvement). CONCLUSION: The moisturizer APDDR-0801 (Atobarrier Cream(R), which contains physiologic lipid granules, effectively relieved the symptoms associated with AD.
Cytokines ; Dermatitis, Atopic ; Eczema ; Humans ; Pruritus ; Research Personnel ; Skin ; Sleep Initiation and Maintenance Disorders ; Stress, Psychological ; Treatment Outcome

BACKGROUND: Antimicrobials have been a mainstay of inflammatory acne treatment for more than 30 years. However, antibiotic-resistant propionibacteria had been isolated with increased frequency, and associated with failure to respond to antibiotic therapy. OBJECTIVE: The aim of this study was to investigate the clinical efficacy and tolerance of 1% nadifloxacin cream. METHODS: In the final analysis, 197 patients with mild to moderate facial acne vulgaris were enrolled. The patients were instructed to apply 1% nadifloxacin cream twice daily to the affected skin after washing the face. Following 2 and 4 weeks of treatment, patients were observed for clinical response: number of the acne lesions, Korea acne grading system (KAGS), global improvement, and occurrence of adverse reactions. RESULTS: During 4 weeks of treatment, nadifloxacin caused significant reduction in the number of inflamed papulo-pustular lesions and open/closed comedones. In addition, significant reduction of KAGS was observed. About 96% of patients showed clinical improvement in the overall evaluation of the therapeutic effect by physicians. All reported adverse events were mild. CONCLUSION: This study shows that 1% nadifloxacin cream can be an effective and safe treatment for mild to moderate acne vulgaris.
Acne Vulgaris ; Fluoroquinolones ; Humans ; Korea ; Quinolizines ; Republic of Korea ; Skin

Laparoscopic approaches are increasingly used in pancreatic surgery. In the treatment of neuroendocrine tumors (NETs) of the pancreas, enucleation is one of the recommended surgery. Although many clinical experiences have reported the safety and efficacy of laparoscopic enucleation of functioning NETs, such as insulinomas, few reports have explored such treatment for non-functioning NETs. Here, we present a case of 70-year old female patient who underwent successful laparoscopic enucleation of a nonfunctioning NET located in the body of the pancreas.
Aged ; Female ; Humans ; *Laparoscopy ; Neuroendocrine Tumors/pathology/*surgery/ultrasonography ; Pancreatic Neoplasms/pathology/*surgery/ultrasonography

Biliary cystadenomas are very rare cystic neoplasms usually arising from the intrahepatic bile ducts. The majority of patients are middle-aged women who present with abdominal discomfort and/or a palpable mass. The diagnosis was performed using several methods such as abdominal ultrasonography, computed tomography, percutaneous cholangiography or endoscopic retrograde cholangiopancreatography, and showed multiloculated cystic tumors with multiple internal septation. But confirmatory diagnosis was done by surgical pathology. Because the prognosis is comparatively better than after complete resection and the cystadenoma is warranted to avoid malignant change, early detection and surgical resection must be needed. We have experienced two cases, 30 and 50 year old females, which presented with nonspecific abdominal pain and dyspepsia. They were diagnosed as having intrahepatic biliary cystadenoma histopathologically which was confirmed after surgical resection. We report two cases of intrahepatic biliary cystadenoma with a review of literature.
Abdominal Pain ; Bile Ducts, Intrahepatic ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cystadenoma* ; Diagnosis ; Dyspepsia ; Female ; Humans ; Liver ; Middle Aged ; Pathology, Surgical ; Prognosis ; Ultrasonography

Background: We used machine learning and population-based data for analyzing the determinants of sarcopenia in adult women and developing its decision support systems for various subgroups. Methods: All data was acquired from the Korea National Health and Nutrition Examination Survey, and women 18 years and older were included in this research. The variables were selected based on female characteristics and the ability to be acquired in a survey format, and were ranked by importance using Random Forest. From this ranking, four main variables were selected, age, menopause age, menarche age and number of pregnancy. A decision supporting system was constructed based on a tree randomly selected from Random Forest. Results: We defined sarcopenia as -2SD below the appendicular skeletal mass (ASM) index reference of 0.5136, and 89.87% (n = 8,610) were found non-sarcopenic and 10.13% (n = 971) were found sarcopenic. The subjects were divided into 6 groups based on menopausal status and BMI. The obese postmenopausal women had the highest number of sarcopenia, whereas the non-obese premenopausal women had the least number of sarcopenic subjects. In non-obese premenopausal women, which was considered to be at the lowest risk for sarcopenia, the most determining variable was the menarche age, followed by age and number of pregnancies. In obese and postmenopausal women, which was considered to be at the highest risk for sarcopenia, the most influential factor was the menopausal age, followed by age and menarche age. Conclusions We identified the major determinants of sarcopenia using machine learning and population-based data. This study demonstrated the strengths of the random forest as an effective decision support system for each stratified subgroup to find its own optimal cut-off points for the major variables of sarcopenia.

Osteoporosis is a worldwide disease leading to significant economic and societal burdens globally. Osteoporosis is caused by unbalanced bone remodeling between the rate of osteoclast bone resorption and osteoblast bone formation. Acer tegmentosum Maxim (AT) is a traditional herbal medicine containing multiple biological activities such as anti-oxidant and anti-inflammatory purposes. However, its role in osteoporosis has not been fully studied. Therefore, we investigated whether AT has a potent inhibitory effect on osteoporosis and its mechanism through a systemic evaluation in ovariectomized (OVX) mice. OVX mice were orally administrated with the AT at doses of 50, 100, and 200 mg/kg for 10 weeks. Histological images and histomorphometry analyses were performed by H&E and Toluidine blue satin, and the expression levels of receptor activator for nuclear factor-kB ligand (RANKL), nuclear factor of activated T cells cytoplasm 1 (NFATc1), c-Fos, and matrix metalloproteinase 9 (MMP9) related to the osteoclast differentiation were investigated using immunohistochemical analysis. Administration of AT prevented bone loss and the alternations of osteoporotic bone parameters at the distinct regions of the distal femur and spongiosa region in OVX mice. Further, administration of AT increased periosteal bone formation in a dose-dependent manner. Meanwhile, AT inhibited not only the expression of NFATc1 and c-Fos, which are two major regulators of osteoclastogenesis but also reduced bone resorbed encoding expression of MMP9 and RANKL. Our results indicated that administration of AT prevented bone loss and the alternations of osteoporotic bone parameters at the distinct regions of the distal femur and spongiosa region in OVX mice. Also AT has the bone protective effect through the suppression of osteoclast and promotion of osteoblast, suggesting that it could be a preventive and therapeutic candidate for anti-osteoporosis.

Amyloidosis is a rare complication of nonhodgikin's lymphoma. In review of the literature, almost all amyloidosis in lymphoma are the AL type and they are resulted frorn monoclonal light chains synthesized by the lymphoma cells. But we want to describe the AA type in patient with small lymphocytic lymphoma. A 60-year-old male patient admitted due to generalized edema and asthenia. He complained anorexia and dizziness at standing. Initial laboratory test revealed nephrotic range proteinuria and hypoalbuminemia. Combined pituitary stimulation test confirmed a decreased pituitary function and the adrenal function was also regarded hypofunctioning status in view of decreased cortisol response. Serum protein electrophoresis revealed monoclonal peak in gamma globulin area. This protein was composed by IgG and Lambda. We found the monotonous cellular infiltration in bone marrow specimen. These cells were lamMa positive in immunohistochemical stain- ing and only CD 20 positive in immunophenotype study. We made a diagnosis of small lymphocytic lymphoma with bone marrow involvement. Kidney biopsy revealed amyloidosis and the electrornicroscopy showed definite randomly arranged amyloid fibril, but immunohistochemical staining was positive with AA amyloid, unexpectedly. We suggest that all amyloidosis in lymphoma patient should be explored the origin of the amyloid fibrile, that is AA type or AL type.
Amyloid ; Amyloidosis* ; Anorexia ; Asthenia ; Biopsy ; Bone Marrow ; Diagnosis ; Dizziness ; Edema ; Electrophoresis ; gamma-Globulins ; Humans ; Hydrocortisone ; Hypoalbuminemia ; Immunoglobulin G ; Kidney ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma* ; Male ; Middle Aged ; Nephrotic Syndrome ; Proteinuria

We report on a case of hepatic splenosis. A 32-yr-old man underwent a splenectomy due to trauma at the age of 6. He had been diagnosed as being a chronic hepatitis B-virus carrier 16 yr prior to the surgery. The dynamic computer tomography (CT) performed due to elevated serum alpha-fetoprotein (128 ng/mL) demonstrated two hepatic nodules, which were located near the liver capsule. A nodule in Segment IVa had a slight enhancement during both the arterial and portal phases, and another nodule in Segment VI showed a slight enhancement only in the portal phases. Dynamic magnetic resonance imaging (MRI) of the mass in Segment VI showed enhanced development in the arterial phases and slight hyperintensivity to the liver parenchyma in the portal phases. These imaging findings suggested a hypervascular tumor in the liver, which could be either focal nodular hyperplasia, adenoma, or hepatocellular carcinoma (HCC). Even though these lesions were diagnosed as HCC, some of the findings were not compatible with typical HCC. On dynamic CT and MRI, all lesions showed a slight arterial enhancement and did not show early venous washout. All lesions were located near the liver capsule. These findings, along with a history of splenectomy, suggested a diagnosis of hepatic splenosis.
Adult ; Carcinoma, Hepatocellular/complications/*diagnosis/surgery ; Focal Nodular Hyperplasia/diagnosis/pathology ; Hepatitis B, Chronic/complications/*diagnosis ; Humans ; Liver/*pathology ; Liver Neoplasms/complications/*diagnosis/surgery ; Magnetic Resonance Imaging ; Male ; Splenosis/*diagnosis ; Tomography, X-Ray Computed ; Treatment Outcome ; alpha-Fetoproteins/biosynthesis

Duodenal duplication cyst is an uncommon congenital anomaly that is usually encountered during infancy or in early childhood. The clinical manifestation is that of duodenal obstruction or, less commonly, obstructive jaundice, acute pancreatitis, or gastrointestinal bleeding. Here, we report a case of duodenal duplication cyst on the juxtapapillary region in a 19-year-old woman with an unusual clinical manifestation of recurrent pancreatitis and peculiar endoscopic finding of the cyst.
Adult ; Duodenal Obstruction ; Female ; Hemorrhage ; Humans ; Jaundice, Obstructive ; Pancreatitis* ; Young Adult

OBJECT: The purpose of this study was to determine the prevalence of fungal infection and ulcer on the feet of diabetic patients and the existence of correlation between ulcer and fungal infection. METHODS: A total of 21, 693 outpatients diagnosed as diabetes mellitus at the department of endocrinology of 32 hospitals were examined. The diabetic patients with foot problems were consulted to the department of dermatology. Physical examination and KOH preparation were performed. RESULTS: 13, 271 patients had certain kinds of foot problem, accounting for 61.2% of 21, 693 diabetics examined. Of these, fungal foot disease were found in 10, 403 that constituted 78.4% (48.0% of the entire diabetic population). Tinea pedis was the diagnosis in 6, 496 (29.9%), onychomycosis in 7, 783 (35.9%), and coexistence was in 3, 883 (17.9%). Foot deformity was in 1, 346 (6.2% of diabetics; 10.1% of foot disease), non-palpable pulse in 1, 051 (4.8% ; 7.9%), and foot ulcer was in 425 (2.0% ; 3.2%), following in a descending order of frequency. Odds ratios for diabetic foot ulcer were 2.5 in patients with the foot deformity, 1.6 with fungal foot disease and 2.2 with non-palpable pulse. Conversely, Odds ratios for fungal foot disease were 2.5 with foot deformity, and 1.6 with foot ulcer. A total of 5, 486 patients paid a visit to the department of dermatology. Of these, 4, 519 patients were diagnosed with fungal infection through physical examination and KOH smear by dermatologists. The population comprised of 2, 272 males and 2, 247 females, showing similar prevalence between sexes. However, age did have positive correlation regarding prevalence of fungal foot disease. The number of diabetic patients with toenail problems was 3, 847 patients (70%) and onychomycosis was proven mycologically in 3, 276. Onychomycosis of distal subungal type was the most common clinical finding, most frequently involving the great toenails. Abnormal skin findings of the foot were seen in 3, 885(70.8%) and tinea pedis was found in 3, 209 (58.5%), most commonly involving the soles. CONCLUSION: This study showed that fungal infection might be regarded as a risk factor of foot ulcer. Treatment of fungal infection in diabetic patients might prevent diabetic foot disease such as ulcer and reduce the disability, morbidity and mortality in diabetic patients.
Dermatology ; Diabetes Mellitus ; Diabetic Foot ; Diagnosis ; Endocrinology ; Female ; Foot Deformities ; Foot Diseases ; Foot Ulcer ; Foot* ; Humans ; Male ; Mortality ; Nails ; Odds Ratio ; Onychomycosis ; Outpatients ; Physical Examination ; Prevalence* ; Risk Factors ; Skin ; Tinea Pedis ; Ulcer*