Alport's syndrome is a hereditary disorder whose incidence is 1 in 10,000 in general population, and, majority are developed in childhood, so it is rare to develop in adults. This syndrome consists of hematuria, sensorineural hearing loss, and lenticonus, in classic form. However, there are many atypical forms which have not all clinical manifestations. Although most asymptomatic hematuria in adults results from IgA nephropathy(Berger's disease) or thin basement disease(benign hematuria), Alport's syndrome should be considered as a cause of hematuria. The authors experienced a case of Alport's syndrome in a 21-year-old man who showed only hematuria and proteinuria, and who was diagnosed by history, family history, audiogram, and kidney needle biopsy. So, we report this case with a review of literature.
Adult* ; Biopsy, Needle ; Hearing Loss, Sensorineural ; Hematuria ; Humans ; Immunoglobulin A ; Incidence ; Kidney ; Nephritis, Hereditary* ; Proteinuria ; Young Adult

BACKGROUND: A good acne grading system should reflect epidemiological and clinical features of a particular patient group. Current Korean acne grading systems are mostly based on the skin colors, epidemiology, and clinical features of Western countries, which make them less than being ideal for Korean acne patients. OBJECTIVE: We tried to devise an acne grading system based on clinical and epidemiological characteristics of Korean acne patients. This system is intended for use in primary care setting as well as in research purposes. METHODS: In the formulation of a new acne grading system, a panel of 5 dermatologists from 5 referral centers took into account the degree of complexity of the system, criteria for severity as well as skin colors through the review of clinical photographs of 250 acne patients. The new grading system then underwent inter-rater and intra-rater discrepancy assessment and simulation with 149 patient photos to find out an optimal epidemiological representation. RESULTS: We developed 6-scale grading system with both standard pictures and ranges of number of lesions as criteria. Intra-rater and inter-rater reproducibility turned out to be moderate to strong, suggesting clear instruction and easy performance. Simulation with 4 different models yielded best parameter ranges for the optimal criteria. CONCLUSIONS: With the feedback from the large-scale field applications, this new acne grading system will serve as a multipurpose acne grading system for Korean patients.
Acne Vulgaris* ; Epidemiology ; Humans ; Primary Health Care ; Referral and Consultation ; Skin

OBJECTIVES: This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. METHODS: This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chi-squared test and student's t-test were used as statistical analysis methods. RESULTS: There were differences in education level between two groups divided according to FGID status (χ²=10.139, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (χ²=11.408, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=−3.106, p=0.002), depressive symptom (t=−2.105, p=0.037), somatic symptom (t=−3.565, p < 0.001), trait anger (t=−3.683, p < 0.001), anger-in (t=−2.463, p=0.015), and anger-out (t=− 2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=−4.893, p < 0.001), depressive symptom (t=−3.459, p < 0.001), somatic symptom (t=−7.906, p < 0.001), trait-anger (t=−4.148, p < 0.001), state-anger (t=−2.181, p=0.031), anger-in (t=−2.684, p=0.008), and anger-out (t=−3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=−4.286, p < 0.001), depressive symptom (t=−3.402, p < 0.001), somatic symptom (t=−7.162, p < 0.001), trait anger (t=−2.994, p=0.003), state anger (t=−2.259, p=0.025), anger-in (t=−2.772, p=0.006), and anger-out (t=−2.958, p=0.004). CONCLUSIONS: Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.
Anger ; Anxiety ; Demography ; Depression ; Dyspepsia ; Education ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Prevalence ; Psychology