Pseudocyst of the scalp is described in the Japanese literature as a skin-colored cystic tumor localized on the forehead, whereas alopecic and aseptic nodules of the scalp are described in the French literature as asymptomatic nodules on the scalp that lack a pseudocyst-like architecture. The etiology of these diseases is unknown, but the lesions are likely due to follicular occlusion. Here, we report a case of pseudocyst of the scalp in a 72-year-old woman. The patient had a dome-shaped painless tumor on her scalp. Histologic examination showed a pseudocyst-like architecture with no true cystic wall. Here, we report a case of pseudocyst of the scalp and summarize the characteristic features of both pseudocyst of the scalp and alopecic and aseptic nodules of the scalp.
Aged ; Asian Continental Ancestry Group ; Female ; Forehead ; Humans ; Scalp

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.
Forearm ; Skin

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.
Forearm ; Skin

Objective and METHOD: In order to identify the aggravating agents for intrinsic asthma, we performed ASA- and food additive-challenge tests on 182 subjects diagnosed as having intrinsic asthma. The following tests were performed: Lysine-aspirin bronchoprovocation test to confirm aspirin-sensitivity, sodium bi-sulfite (40-200mg) oral provocation test for sulfite sensitivity, tartrazine oral provocation test (50mg) for tartrazine sensitivity, and sodium benzoate (400mg) oral provocation test for sodium benzoate sensitivity. Positive reaction was defined as decrease in FEV, by more than 20% from the baseline value after the provocation. RESULT: Seventy-five (41.2%) of 182 subjects showed positive responses to more than one agent among the aspirin and three food additives challenged. The prevalence of aspirin-sensitivity was the highest (22.5%), followed by sulfite-sensitivity (8.8%), and then concurrent sensitivity to both aspirin and sulfite (6.0% ), to both aspirin and tartrazine (1.6% ), to aspirin, sulfite and tartrazine (1.1%) and to aspirin, sulfite and sodium benzoate (0.5%). Rhino-sinusitis was noted in 62.5% of aspirin-sensitive asthmatic subjects, 60% of sulfite-sensitive ones, and 80% of tartrazine-sensitive ones. Urticaria was noted in 21.4% of aspirin-sensitive asthmatic subjects, 16.6% of sulfite-sensitive ones and 6.3% of tartrazine-sensitive ones. Thirty-seven to 83% of positive responders had no adverse reaction history. CONCLUSION: These findings suggest that ASA and food additive challenge tests should be considered as a screening test to evaluate any aggravating factors in subjects with intrinsic asthma, even though they may not have experienced any adverse reactions.
Aspirin* ; Asthma* ; Food Additives* ; Mass Screening ; Prevalence ; Sodium ; Sodium Benzoate ; Tartrazine ; Urticaria

PURPOSE: Gastric stump cancer is defined as a cancer that develops in the stomach after a resection in cases of non-malignant or malignant gastric disease. The interval between the gastrectomy and the detection of gastric stump cancer must be over 5 years. Since duodenogastric reflux gastritis is a precancerous condition and one of the most important factors inducing gastric stump cancer, we compared the bile-acid content of gastric juice between gastric stump cancer patients and controls. MATENRIALS AND METHODS: To evaluate retrospectively the surgical treatment of patients with gastric stump cancer, we reviewed the cases histories of 1016 stomach cancer patients who had been operated on at the Department of General Surgery, Kosin University Gospel Hospital, between 1995 and 1998. The gastric juice was collected during the operations on the gastric stump cancer patients by using a needle puncture of the fundus of the stomach and during the endoscopic examinations of the control subjects. The samples were analyzed for various bile acids (gas chromatography/mass spectrometry). RESULTS: The 6 gastric stump cancer cases accounted for 0.6% of all gastric cancer patients; 5 patients were first operated on for a peptic ulcer and the remaining one for an adenocarcinoma of the stomach. All of the cases were men. The reconstruction method after the initial gastrectomy was a Billroth II in all cases. The sites of the gastric stump cancer were the anastomotic sitein 2 patients, the upper body in 2, the fundus in 1 and the cardia in 1. The operative methods were 3 total gastrectomies, 2 subtotal gastrectomies with Roux en Y anastomosis, and 1 partial gastrectomy with lymph node dissection and had a curative intention in all patients. All of the patients were still surviving at the time of this report. The gastric juices of 4 gastric stump patients showed significantly higher contents of cholic acid (36.42microgram/ ml) compared to the gastric juices of 35 control subjects (12.82microgram/ml)(p< or =0.0001). Chenodeoxycholic acid and lithocholic acid were not significantly different. CONCLUSION: The gastric juice of gastric stump cancer patients contained a significantly higher cholic acid content. At the time of the initial gastrectomy, an operative method that prevents duodenogastric reflux may prevent or minimize the development of gastric stump cancer, and more aggressive surgical treatment may improve survival.
Adenocarcinoma ; Anastomosis, Roux-en-Y ; Bile Acids and Salts ; Cardia ; Chenodeoxycholic Acid ; Cholic Acid ; Duodenogastric Reflux ; Gastrectomy ; Gastric Juice ; Gastric Stump* ; Gastritis ; Gastroenterostomy ; Humans ; Intention ; Lithocholic Acid ; Lymph Node Excision ; Male ; Needles ; Peptic Ulcer ; Precancerous Conditions ; Punctures ; Retrospective Studies ; Stomach ; Stomach Diseases ; Stomach Neoplasms

Takayasu's arteritis(TA) is a chronic inflammatory and obliterative disease of medium- and large-sized arteries characterized by a strong predilection for the aortic arch and its branches. Renal involvement is usually manifested by renovascular hypertension. Glomerular involvement is rare and largely exists as a mild mesangial proliferative glomerulonephritis, commonly manifesting microscopic hematuria and proteinuria. The association of glomerular disease with TA is of interest since common immunologic mechanisms are proposed for the pathogenesis of both entities. We report a case of TA associated with focal segmental glomerulosclerosis. The patient presented with hypertension(Upper limb; Rt. 200/80mmHg, Lt. 95/60mmHg, Lower limb; Rt. 140/90mmHg, Lt. 110/70mmHg) and nephrotic syndrome(Serum albumin : 2.3g/dL, cholesterol : 454mg/dL, BUN : 18.0mg/dL, creatinine 1.3mg/dL, 24-hour urine protein : 5.17g). Digital substraction angiography showed multiple narrowing and occlusive changes of aortic arch and its branches. Renal biopsy was interpreted as focal segmental glomerulosclerosis. Therapy was instituted with prednisolone.
Angiography ; Aorta, Thoracic ; Arteries ; Biopsy ; Cholesterol ; Creatinine ; Extremities ; Glomerulonephritis ; Glomerulosclerosis, Focal Segmental* ; Hematuria ; Humans ; Hypertension, Renovascular ; Lower Extremity ; Prednisolone ; Proteinuria ; Takayasu Arteritis*

PURPOSE: The optimal cytotoxic regimens have not been established for patients with non-small cell lung cancer (NSCLC) who develop disease progression on first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). MATERIALS AND METHODS: We conducted a multi-center randomized phase II trial to compare the clinical outcomes between pemetrexed plus cisplatin combination therapy followed by maintenance pemetrexed (PC) and pemetrexed monotherapy (P) after failure of first-line EGFR-TKI. The primary objective was progression-free survival (PFS), and secondary objectives included overall response rate (ORR), overall survival (OS), health-related quality of life (HRQOL), and safety and toxicity profiles. RESULTS: A total of 96 patientswere randomized, and 91 patientswere treated at 14 centers in Korea. The ORR was 34.8% (16/46) for the PC arm and 17.8% (8/45) for the P arm (p=0.066). With 23.4 months of follow-up, the median PFS was 5.4 months in the PC arm and 6.4 months in the P arm (p=0.114). The median OS was 17.9 months and 15.7 months in PC and P arms, respectively (p=0.787). Adverse events ≥ grade 3 were reported in 12 patients (26.1%) in the PC arm and nine patients (20.0%) in the P arm (p=0.491). The overall time trends of HRQOL were not significantly different between the two arms. CONCLUSION: The outcomes of pemetrexed therapy in NSCLC patients with disease progression after firstline EGFR-TKI might not be improved by adding cisplatin.
Arm ; Carcinoma, Non-Small-Cell Lung ; Cisplatin ; Disease Progression ; Disease-Free Survival ; Epidermal Growth Factor ; Follow-Up Studies ; Humans ; Korea ; Lung Neoplasms ; Lung ; Pemetrexed ; Protein-Tyrosine Kinases ; Quality of Life ; Receptor, Epidermal Growth Factor ; Tyrosine

Kawasaki disease (KD) is an acute pediatric vasculitis that affects genetically susceptible infants and children. To identify coding variants that influence susceptibility to KD, we conducted whole exome sequencing of 159 patients with KD and 902 controls, and performed a replication study in an independent 586 cases and 732 controls. We identified five rare coding variants in five genes (FCRLA, PTGER4, IL17F, CARD11, and SIGLEC10) associated with KD (odds ratio [OR], 1.18–4.41; p = 0.0027–0.031). We also performed association analysis in 26 KD patients with coronary artery aneurysms (CAAs; diameter > 5 mm) and 124 patients without CAAs (diameter < 3 mm), and identified another five rare coding variants in five genes (FGFR4, IL31RA, FNDC1, MMP8, and FOXN1), which may be associated with CAA (OR, 3.89–37.3; p = 0.0058–0.0261). These results provide insights into new candidate genes and genetic variants potentially involved in the development of KD and CAA.