BACKGROUND: Inflammatory bowel disease(IBD) such as ulcerative colitis or Croln's disease is often related with varied diseases including pyoderma gangrenosum, erythema nodosum, ankylosing arthritis and psoriasis. To date, however, a cIinical observation of IBD accompanied by psoriasis has been sparcely accomplished although an immunogenetic mechanism explaining a coexistence of IBD and psoriasis has been proposed. OBJECTIVE: We estimated the prevalence of IBD in patients with psoriasis in Korea and investigated the clinical characteristics of IBD accompanied by psoriasis. METHODS: 92 psoriatic patients and 389 non-psoriatic control subjects were enrolled in this study. Colonoscopic biopsy and barium series were performed in 47 psoriatic patients and 110 control subjects showing irritative intestinal symptoms. RESULTS: 1. The prevalence of IBD in psoriatic patients(14.1%) was significantly greater than in the control group(1.0%). 2. In the temporal relationship, psoriasis developed several years prior to the onset of IBD in 84.6% of psoriatic patients. 3. The frequency of arthropathies in the psoriatic patients possessing IBD(84.6%) was significantly higher than that of non-psariatic counterparts with IBD(25.0%) or that of psoriatics without lBD(2.5%), 4. The psoriatir. patients with IBD demonstrated much more frequently diffuse colonal extension than in non-psoriatic subjects with IBD. CONCLUSION: Our findings of an increased prevalence of IBD in the psoriatic population present further evidence of an association between IBD and psoriasis. In the psoriatic patients showing acute or chronic gastrointestinal symptoms, colonoseopic evaluation might be mandatory for the evaluation of IBD.
Arthritis ; Barium ; Biopsy ; Colitis, Ulcerative ; Colon ; Erythema Nodosum ; Humans ; Immunogenetics ; Inflammatory Bowel Diseases* ; Korea ; Prevalence ; Psoriasis* ; Pyoderma Gangrenosum

No abstract available.
Classification* ; Wounds and Injuries* ; Wounds, Gunshot*

The etiology of the postoperative discitis is not fully known, but most likely, the cause seems to be of a low grade infection and chemical and mechanical injuries. The incidence of these complication is from 0.12% to 2.6% of all cases. The characteristics of this disease are recurrence of severe lower back and gluteal pain, spasm of lumbar paravertebral muscle and elevated E.S.R. following the asymptomatic post-operative period, a roentgenogram showed an early destructive change in the adjacent vertebra, the narrowing of the intervertebral disc space, sclerotic changes in the vertebral bone and occasional fusion of the spine, and relatively good prognosis. We present a case of recurrent postoperative discitis with E.S.R. change and roentgenographic change.
Discitis* ; Incidence ; Intervertebral Disc ; Prognosis ; Recurrence ; Spasm ; Spine

PURPOSE: Sleep disorder is common in childhood and adolescence with prevalence of 27-62%, and the patients could have trouble with their daily life due to fatigue and headache; and it can also cause developmental disability, learning disorder, anxiety disorder, and depressive disorder. We studied the prevalence of anxiety and depressive disorder in childhood and adolescence with sleep disorder. METHODS: We studied 34 cases of patients under twenty-year-old who took a sleep polysomnography test at Sleep Center of Keimyung University Dongsan Medical Center and who could answer sleep survey questionnaires; and we used testing methods of Questionnaire for insomnia, Epworth sleepness scale, Hospital Anxiety Depression Scale, and Back Depression Inventory. We studied sleep disorder as two categories of sleep apnea and other sleep disorders and also the relationships of sleep and anxiety and depressive disorder with chi-square test. RESULTS: 29.4% of sleep disorder patients had anxiety disorder, and 47.1% depressive disorder. Considering the two categories of sleep disorder, anxiety disorder was significantly higher(P<0.005) in sleep apnea group with 43.5% than in other sleep disorder group with 9.1%. Depressive disorder was also significantly higher(P<0.05) in sleep apnea group with 65.6% than in other sleep disorder group with 36.4%. CONCLUSION: The patients with sleep disorder also had a tendency of having mood disorder, with prevalence of 29.4% of anxiety disorder and 47.1% of depressive disorder; especially in the group of sleep apnea, mood disorders was significantly higher than other sleep disorder group, which means more aggressive diagnosis and treatment are needed for the combined condition of sleep and mood disorder.
Adolescent ; Anxiety ; Anxiety Disorders ; Depression ; Depressive Disorder ; Developmental Disabilities ; Fatigue ; Humans ; Learning Disorders ; Mood Disorders ; Polysomnography ; Prevalence ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

Objective: To investigate the suitability of citrus-press cakes, by-products of the juice industry as a source for the whitening agents for cosmetic industry.
Methods:Ethylacetate extracts of citrus-press cakes (CCE) were examined for their anti-melanogenic potentials in terms of the inhibition of melanin production and mechanisim of melanogenesis by using Western Blot analysis with tyrosinese, tyrosinase-related protein-1 (TRP-1), TRP2, and microphthalmia-associated transcription factor (MITF) proteins. To apply the topical agents, citrus-press cakes was investigated the safety in human skin cell line. Finally flavonoid analysis of CCE was also determined by HPLC analysis.
Results: Results indicated that CCE were shown to down-regulate melanin content in a dose-dependent pattern. The CCE inhibited tyrosinase, TRP-2, and MITF expressions in a dose-dependent manner. To test the applicability of CCE to human skin, we used MTT assay to assess the cytotoxic effects of CCE on human keratinocyte HaCaT cells. The CCE exhibited low cytotoxicity at 50 μg/mL. Characterization of the citrus-press cakes for flavonoid contents using HPLC showed varied quantity of rutin, narirutin, and hesperidin.
Conclusions:Considering the anti-melanogenic activity and human safety, CCE is considered as a potential anti-melanogenic agent and may be effective for topical application for treating hyperpigmentation disorders.

Background: The advance in microsurgical technique has facilitated a proper approach for reconstruction of extensive head and neck defects. For the success of free tissue reconstruction, selection of the recipient vessel is one of the most important factors. However, the vascular anatomy of this region is very complex, and a clear guideline about this subject is still lacking. In this study, we present our 30 years of experiences of free tissue reconstruction for head and neck defects. Methods: In this retrospective study, we analyzed a total of 138 flaps in 127 patients who underwent head and neck reconstruction using free tissue transfer following tumor resection between October 1986 to August 2019. Patients who underwent facial palsy reconstruction were excluded. Medical records including patient’s demographics, detailed operation notes, follow-up records, and photographs were collected and analyzed. Results: Among a total of 127 patients, 10 patients underwent a secondary operation due to cancer recurrence. The most commonly used type of flap was radial forearm flap (n= 107), followed by the anterolateral thigh flap (n= 18) and fibula flap (n= 10). With regard to recipient vessels, superior thyroid artery was most commonly used in arterial anastomosis (58.7%), and internal jugular vein (51.3%) was the first choice for venous anastomosis. The flap survival rate was 100%. Four cases of venous thrombosis were resolved with thrombectomy and re-anastomosis. Conclusion Superior thyroid artery and internal jugular vein were reliable choices as recipient vessels. Proper recipient vessel selection could improve the result of head and neck reconstruction.

BACKGROUND/AIMS: Although balloon-occluded retrograde transvenous obliteration (BRTO) has been used as a new procedure for gastric variceal bleeding due to its feasibility and minimal invasiveness, reports regarding the results of BRTO are not well presented in Korea. Therefore, we analyzed the results of our experience in recent 39 months. METHODS: Twenty eight patients who received BRTO for primary hemostasis or secondary prevention of gastric variceal bleeding from December 2001 to March 2005 were analyzed retrospectively. RESULTS: Twenty three men and five women were involved, and the mean age was 53.7+/-9.6 years. Technical and clinical success rates were 89.3% and 85.7%, respectively. Follow-up duration was 17.5+/-12.5 months in 23 patients. Gastric varices disappeared in 78.3% and decreased in 21.7%. Relapses occurred in 4.3% of the patients. Preexisting hepatic encephalopathy improved in all 11 patients. Aggravation of ascites, esophageal varices, portal hypertensive gastropathy were observed in 45.8%, 30.4%, 56.5%, respectively. Increased Child-Pugh score (p<0.001) and decreased albumin concentration (p=0.002) were observed 3 days after BRTO, but resolved 7 days later. Increased albumin concentration and decreased Child-Pugh score maintained thereafter. Rebleeding occurred in 3 patients which were caused by esophageal varices. Two-year survival rate was 54.6%. Presence of hepatocellular carcinoma (HCC) (p=0.001) and Child-Pugh grade (p=0.033) affected the survival, but HCC was the only independent risk factor (p=0.010, OR=15.837) in multivariate analysis. CONCLUSIONS: BRTO is an effective therapeutic procedure for primary hemostasis, secondary prevention, and for improving survival in gastric variceal bleeding patients.
Adult ; Aged ; Aged, 80 and over ; *Balloon Occlusion ; Esophageal and Gastric Varices/*complications ; Female ; Gastrointestinal Hemorrhage/etiology/*therapy ; Humans ; Male ; Middle Aged ; Recurrence

BACKGROUND/AIMS: Inflammatory pseudotumor rarely occurs in the liver. However, it is important to discriminate it from malignant hepatic tumor in order to avoid unnecessary surgery. We aimed to elucidate the characteristic features of this disease entity by analyzing our experiences and by reviewing the related literatures. METHODS: Fifteen patients were enrolled during a recent three-year period. The patients were pathologically diagnosed with inflammatory pseudotumor of the liver, and their clinical and imaging findings were analyzed retrospectively. RESULTS: Our study population was composed of ten men and five women, and their mean age was 60.3+/-9.2 years. Their initial diagnoses were inflammatory pseudotumor (n=8), malignant tumors (n=3) and abscess (n=4). Twelve of 15 patients were associated with biliary diseases such as biliary stone, gallbladder cancer, empyema or cholangiocarcinoma. The most common symptom was abdominal pain. The most common CT and MR findings could be summarized as a delayed hyperattenuating mass with an internal hypoattenuating component. The tumors were solitary in 13 patients and multiple in two patients. The lesions regressed spontaneously in seven patients. Four patients were treated by antibiotics and 3 patients by surgical resection. CONCLUSIONS: Inflammatory pseudotumor of the liver seems to have relatively common clinical and imaging features, as described above. However, these features are not disease-specific; thus, preoperative histologic confirmation is necessary to avoid unnecessary surgery.
Adult ; Aged ; Female ; Granuloma, Plasma Cell/*diagnosis/radiography ; Humans ; Liver Diseases/*diagnosis/radiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Plasma Cells ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is not commonly used in the colorectal area because of technical difficulty and due to the characteristics of the organ. We therefore wanted to determine the efficacy and safety of endoscopic submucosal dissection in colorectal neoplasms. METHODS: Colorectal tumor lesions resected by ESD in a single medical center were analyzed retrospectively. RESULTS: A total of 47 patients were treated for 50 lesions. Mean age was 64.3+/-9.8 (43~85) years. Laterally spreading tumors were the most common type (44, 88%) followed by Is+IIa type tumors (6, 12%). The en bloc resection rate was 76% and the complete resection rate was 74%. The mean procedure time was 81.1+/-44.7 (20~180) minutes. The mean size of resected specimen was 26.9+/-10.4 (10~50) mm. The histological diagnosis determined that 24 lesions (48%) were tubular adenoma, 18 lesions (36%) were intramucosal cancer, 7 lesions (14%) were sm1 cancer and 1 lesion (2%) was over sm2 cancer. Bleeding occurred in 6 (12%) and perforations in 13 (26%) of the patients and all were treated successfully by endoscopic or conservative treatment. The concordance rate of pre and post ESD pathological diagnosis was only 47%. CONCLUSIONS: ESD is a feasible technique for treating superficial colorectal tumors with a high complete resection rate, minor invasiveness, and a high safety rate. In addition, ESD might be useful in establishing the complete pathological evaluation of colorectal epithelial neoplasm.
Adenoma ; Colorectal Neoplasms ; Hemorrhage ; Humans ; Neoplasms, Glandular and Epithelial ; Retrospective Studies

BACKGROUND/AIMS: Although transcatheter arterial chemoembolization (TACE) is a major treatment modality for unresectable hepatocellular carcinoma (HCC), acute hepatic failure after TACE is not rare. However, reports dealing with this important complication are not good enough and results are often variable. The purpose of this study was to evaluate the incidence and associated risk factors of acute hepatic failure after TACE. METHODS: From January 2001 to November 2004, six hundred and thirtytwo TACE sessions were performed in 377 patients (294 men and 83 women). Adriamycin mixed lipiodol solution and gelfoam were used for TACE. Various clinical and radiological factors before and after the procedure were reviewed retrospectively. Univariate and multivariate analyses were performed to evaluate the risk factors associated with the development of acute hepatic failure after TACE. RESULTS: Acute hepatic failure occurred in 76 (12.0%) of the 632 TACE sessions within 14 days. Univariate analysis revealed that Child-Pugh class, 1st TACE, total bilirubin level, number of involved segments, total size of tumor, presence of right portal vein thrombosis (PVT) or main PVT, involvement of segment 1, 5, 6, 7, modified UICC stage, and doses of chemotherapeutic agent were significantly different between the patients with or without hepatic failure after TACE. Among them, elevated total bilirubin (p=0.001, E (beta)=1.449), presence of right (p=0.035, E (beta)=2.109) or main (p=0.011, E (beta)=4.067) PVT were independently associated factors in multivariate analysis. CONCLUSIONS: The incidence of acute hepatic failure after TACE was 12.0%. Elevated bilirubin level and portal vein thrombosis could be considered as the predictive factors for acute hepatic failure after TACE in HCC patients.
Adult ; Aged ; Aged, 80 and over ; Antibiotics, Antineoplastic/adverse effects/therapeutic use ; Carcinoma, Hepatocellular/complications/pathology/*therapy ; Chemoembolization, Therapeutic/*adverse effects/methods ; Doxorubicin/adverse effects/therapeutic use ; Female ; Humans ; Incidence ; Iodized Oil/adverse effects/therapeutic use ; Liver Failure, Acute/epidemiology/*etiology ; Liver Function Tests ; Liver Neoplasms/complications/pathology/*therapy ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Severity of Illness Index