OBJECTIVE: This study was performed to determine the smoking status and its associated factors in military life among young Korean men to provide date for smoking prevention in military areas as a part of the health promotion program for soldiers. METHODS: 1,033 infantrymen serving in 17 military units, which are located in suburbs of K city, were enrolled in this study. A questionnaire on the soldiers smoking status and other various characteristics was obtained from October 2nd to 12th, 2000. Logistic regression analysis was performed on the various variables in order to determine the factors related to smoking. RESULTS: 1) 830(80.3%) out of 1033 subjects had smoked cigarettes and 759 persons(73.4%) were regular smokers. 2) Among the 734 soldiers who started smoking before their military service, 714 soldiers(97.2%) continued to smoke after, while 45 soldiers(15.0%) among the 299 non-smokers started smoking after joining the army. 3) Through the logistic regression analysis, the education level, specialty in the army, smoking amongst the friends they met before military service, smoking amongst soldiers in the army, dating girl friends, drinking, satisfaction with their army lives and the presence of convenient smoking places at the barracks were significant factors related to the prevalence of smoking in soldiers. CONCLUSION: the factors related with incidence of smoking in the army are the complicated interactions among the individuals personal background, general charcterisitcs of the solider and the special environment in the barracks. Therefore, to improve national soldiers' health, an active non-smoking campaign and education should be pushed to discourage smoking in the barracks.
Drinking ; Education ; Female ; Friends ; Health Promotion ; Humans ; Incidence ; Logistic Models ; Male ; Military Personnel* ; Prevalence ; Smoke* ; Smoking* ; Tobacco Products

Hemophagocytic lymphohistiocytosis (HLH) is a fatal, systemic inflammatory syndrome that characteristically presents hemophagocytic histiocytes infiltrating into various organs. Common features of HLH are abrupt onset of high fever, malaise, lymphadenopathy, hepatosplenomegaly, and abnormal laboratory findings including pancytopenia, hypertriglyceridemia, hypofibrinogenemia, and high ferritin levels. Cutaneous manifestations, which occur in 6~65% of patients, can develop at any moment in the clinical course of the syndrome. Most skin eruptions in HLH patients are generalized, transient maculopapular rashes. We describe an HLH patient who first manifested cutaneous symptoms as a large purpuric patch on her thigh. A skin biopsy found high levels of hemophagocytic histiocytes.
Biopsy ; Exanthema ; Ferritins ; Fever ; Histiocytes ; Humans ; Hypertriglyceridemia ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Purpura ; Skin ; Thigh

BACKGROUND: A variety of dermatological disorders develop in hospitalized patients and the need for dermatological consultations is on the rise. OBJECTIVE: We analyzed 2 years of dermatological consultation data from a tertiary medical center in Korea and compared dermatological problems among individual departments. METHODS: We reviewed 3,102 dermatological inpatient consultations by performing a retrospective chart review. RESULTS: Contact dermatitis (11.4%), drug eruption (9.6%), tinea pedis (5.5%), xerotic eczema (5.3%), and seborrheic dermatitis (5.2%) were the 5 dermatological disorders that were most commonly referred to dermatologists. Patients in the allergy and pulmonology departments had higher rates of drug eruptions. Endocrinology-admitted patients, especially diabetic patients, frequently complained of foot dermatitis. The cardiology, gastroenterology, and hemato-oncology departments referred many patients with purpuric dermatosis to dermatologists. Patients from the surgical departments consulted more frequently consulted contact dermatitis and drug eruptions. The neurology and rehabilitation medicine departments referred more seborrheic dermatitis patients than other departments. Pediatric patients commonly consulted for atopic dermatitis, viral exanthemata, and seborrheic dermatitis. Regardless of department, patients who suffered from severe illness and underwent major surgery developed herpes zoster and cutaneous fungal infections more frequently than other patients. Personal hygiene was closely related to the development of follicular disorders. CONCLUSION: Dermatologists should be familiar with the diverse dermatological complaints of patients admitted to various departments and be actively involved in the diagnosis, treatment, and education of doctors and patients to improve the quality of inpatient care.
Cardiology ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Diagnosis ; Drug Eruptions ; Eczema ; Education ; Foot ; Gastroenterology ; Herpes Zoster ; Humans ; Hygiene ; Hypersensitivity ; Inpatients* ; Korea ; Neurology ; Pulmonary Medicine ; Referral and Consultation ; Rehabilitation ; Retrospective Studies ; Skin Diseases ; Tinea Pedis

BACKGROUND: The role of the phosphatidylinositol-3 kinase signaling pathway in the development of acral melanoma has recently gained evidence. Phosphatase and tensin homologue (PTEN), one of the key molecules in the pathway, acts as a tumor suppressor through either an Akt-dependent or Akt-independent pathway. Akt accelerates degradation of p53. OBJECTIVE: We assessed the expression of PTEN, phospho-Akt (p-Akt), and p53 by immunohistochemistry in benign acral nevi, acral dysplastic nevi, and acral melanomas in the radial growth phase and with a vertical growth component. METHODS: Ten specimens in each group were included. Paraffin-embedded specimens were immunostained with antibodies for PTEN, p-Akt, and p53. We scored both the staining intensity and the proportion of positive cells. The final score was calculated by multiplying the intensity score by the proportion score. RESULTS: All specimens of benign acral nevi except one showed some degree of PTEN-negative cells. The numbers of p-Akt and p53-positive cells were higher in acral dysplastic nevi and melanoma than in benign nevi. P-Akt scores were 1.7, 1.8, 2.6, and 4.4, and p53 scores were 2.0, 2.1, 3.8, and 4.1 in each group. PTEN and p-Akt scores in advanced acral melanoma were higher than in the other neoplasms. CONCLUSION: The expression of PTEN was decreased and the expression of p-Akt was increased in acral melanoma, especially in advanced cases. The PTEN-induced pathway appears to affect the late stage of melanomagenesis. Altered expression of p-Akt is thought to be due to secondary changes following the loss of PTEN.
Antibodies ; Dysplastic Nevus Syndrome* ; Immunohistochemistry ; Melanoma ; Nevus* ; Phosphotransferases

Necrobiosis lipoidica is a chronic granulomatous disease that has a well-known association with diabetes mellitus. It usually affects the bilateral lower legs of middle-aged women. Over time, the clinical features vary from red-brown papules to sharply demarcated yellow-brown plaque with atrophic center. Some of the lesions may become ulcerated, especially in diabetic patients. A 61-year-old Korean female with a history of diabetes, ischemic heart disease, and pancreatic cancer was referred to our clinic for evaluation of the painful papulovesicles on her left lower leg. Under the assumptive diagnosis of herpes zoster, we immediately started an antiviral agent. However, her skin lesions rapidly increased in size and in number, and progressed to the multiple ulcerations in 9 days. Histopathologic examination showed several poorly circumscribed necrobiotic granulomas in the deep dermis and subcutis levels of the skin. In addition, prominent vascular ectasia and vasculitis were observed. We diagnosed the patient as having necrobiotic lipoidica, and treated her with oral dapsone, colchicine, phentoxifylline and antiplatelets. Her leg ulcerations healed after four weeks of treatment.
Colchicine ; Dapsone ; Dermis ; Diabetes Mellitus ; Dilatation, Pathologic ; Female ; Granuloma ; Granulomatous Disease, Chronic ; Herpes Zoster ; Humans ; Leg ; Leg Ulcer ; Myocardial Ischemia ; Necrobiosis Lipoidica ; Necrobiotic Disorders ; Pancreatic Neoplasms ; Skin ; Ulcer ; Vasculitis

BACKGROUND: The aim of this study was to investigate the prevalence, clinical and laboratory findings of hereditary hemolytic anemia (HHA) in Korea from 1997 to 2006 and to develop the appropriate diagnostic approach for HHA. METHODS: By the use of questionnaires, information on the clinical and laboratory findings ofHHA diagnosed from 1997 to 2006 in Korea was collected and analyzed retrospectively. A total of 431 cases were enrolled in this study from 46 departments of 35 hospitals. RESULTS: The overall frequency of HHA did not change through the 10-year period for pediatrics but did show an increasing tendency for internal medicine. The overall male to female sex ratio did not show sex predominance (1.17:1), but a significant male predominance with a ratio of 1.49:1 was seen for pediatrics while a significant female predominance with a ratio of 1:1.97 was seen forinternal medicine. Of the total cases, 74.2% (282/431) were diagnosed before the age of 15 years. The etiologies of HHA were classified as red cell membrane defects, hemoglobinopathies, red cell enzyme deficiencies and unknown causes. There were 382 cases (88.6%) of red cell membrane defects with 376 cases (87.2%) of hereditary spherocytosis and 6 cases (1.4%) of hereditary elliptocytosis, 20 cases (4.6%) of hemoglobinopathies with 18 cases (4.2%) of beta-thalassemia, a case (0.2%) of alpha-thalassemia and a case (0.2%) of Hemoglobin Madrid, 7 cases (1.6%) of red cell enzyme deficiencies with 5 cases (1.2%) of glucose-6- phosphate dehydrogenase (G-6-PD) deficiency, a case (0.2%) of pyruvate kinase (PK) deficiency and a case (0.2%) of enolase deficiency, and 22 cases (5.1%) of unknown causes. The most common chief complaint in pediatric patients was pallor and that in adult patients was jaundice. In the red cell membrane defect group of patients, the level of hemoglobin was significantly higher than in adult patients. The mean corpuscular volume, mean corpuscular hemoglobin, corrected reticulocyte count, total and indirect bilirubin level and lactate dehydrogenase levels in the hemoglobinopathy group of patients were significantly lower than the values in the red cell membrane defect group of patients. The mean concentration of G-6-PD was 0.8+/-0.7U/1012RBC in the G-6-PD deficient patients, PK was 1.7U/1010 RBC in the PK deficient patient, and the level of enolase was 0.04U/g of Hb in the enolase deficient patient. CONCLUSION: The most prevalent cause of HHA in Korea during 1997 to 2006 was hereditary spherocytosis, but HHA by other causes such as hemoglobinopathy and red cell enzyme deficiency gradually increased with the development of molecular diagnostic methods and increasing general interest. However, the etiologies of HHA need to be pursued further in 5.1% of the patients. An systematic standard diagnostic approach is needed in a nationwide prospective study for correct diagnoses and appropriate management of HHA.
Adult ; alpha-Thalassemia ; Anemia, Hemolytic, Congenital* ; beta-Thalassemia ; Bilirubin ; Cell Membrane ; Diagnosis ; Elliptocytosis, Hereditary ; Erythrocyte Indices ; Female ; Hemoglobinopathies ; Humans ; Internal Medicine ; Jaundice ; Korea* ; L-Lactate Dehydrogenase ; Male ; Oxidoreductases ; Pallor ; Pathology, Molecular ; Pediatrics ; Phosphopyruvate Hydratase ; Prevalence ; Pyruvate Kinase ; Reticulocyte Count ; Retrospective Studies* ; Sex Ratio ; Surveys and Questionnaires