Background: Atopic dermatitis (AD) patients usually wonder if their condition will worsen after vaccination or if they should continue with the treatment they are receiving. Considering that many patients treated with dupilumab had previously experienced severe AD symptoms and flares, the concerns are more understandable. Objective: This study aimed to investigate the safety of the coronavirus disease 2019 (COVID-19) vaccination in patients with AD treated with dupilumab. Methods: We enrolled 133 patients (101 dupilumab-treated and 32 systemic oral agentstreated as control group) with AD from six hospitals. Patients were asked about worsening pruritus and AD (5-point Likert scale) after vaccination. AD variables (eczema area and severity index [EASI], investigator’s global assessment [IGA], itch numerical rating scale [NRS], sleep NRS, and patient-oriented eczema measure [POEM]) were compared pre- and postvaccination. Adverse reactions to the COVID-19 vaccination were observed. Results: The incidence of adverse reactions to COVID-19 vaccines and worsening AD symptoms in dupilumab-treated patients were not significantly different compared with that in the control group. The itch NRS score increased significantly after vaccination (p<0.001).However, there were no statistically significant differences between the pre-and post-EASI, IGA, and POEM scores. Eight patients (7.9%) had worse EASI scores and required rescue therapy; however, most were easily managed with low-dose steroids or topical agents. None of the patients discontinued dupilumab treatment. Conclusion No serious adverse reactions were observed in patients with AD after COVID-19 vaccination. Exacerbation of pruritus and AD symptoms was observed but was mostly mild and transient.

Background: Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. Objective: The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. Methods: We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. Results: A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. Conclusion These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.

Background: Occupational allergic contact dermatitis accounts for about half of all occupational skin diseases. Patch testing is essential for establishing a diagnosis of occupational allergic contact dermatitis. To date, allergic contact dermatitis caused by seawater has rarely been reported. Objective: The aim of this study was to investigate the patch test results of seawater in foreign maritime workers. Methods: We retrospectively reviewed the clinical photos and medical records of patients who underwent the patch test with the Korean standard series and sea-water at Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital from January 2017 to August 2020. Results: A total of 26 patients were enrolled in the study. All patients were men with a median age of 26.5 years.Twenty-five patients were Sri Lankan, and 25 patients (96.2%) showed a positive reaction to seawater. Patients showed positive reactions with multiple allergens (average: 4), and the positive rates were higher than those reported in previous studies. Atypical reactions, such as pricking patterns or erosive patches, have been observed. A marked erosive reaction was observed even at the site without allergen attachment in a patient who showed a negative reaction to seawater. Conclusion These results suggest the possibility of artificially inducing positive reactions to seawater in maritime workers. Therefore, it is necessary to identify atypical reactions and confirm the relationship between positive reactions and medical history when judging contact dermatitis with unknown substances such as seawater. This study emphasizes education on the standardization of the reading of results.

PURPOSE: To investigate the usefulness of transvaginal ultrasonographic measurement of cervical length in patients with preterm labor for prediction of preterm delivery within 7 days. METHODS: Cervical length was measured by transvaginal ultrasound in 140 women with singleton pregnancies presenting with preterm labor and intact membranes from 24(+0) to 33(+6) weeks of gestation. Other potential predictive factors, such as Bishop score, previous history of preterm delivery, and parity were assessed. RESULTS: The mean gestational age at presentation was 30.5+/-14.7 (range, 24.0 to 33.6) weeks and the mean cervical length was 29.0+/-0.9 (range, 31.0 to 52.1) mm. Delivery within 7 days occurred in 7.9% (11/140). Receiver-operating characteristics (ROC) curves established a cervical length of 25 mm as the most relevant cut off level for prediction of delivery within 7 days. Interval between admission and delivery was significantly short when ultrasonographic cervical length was less than or equal to 25 mm. Logistic regression analysis demonstrated that the significant independent risk factors were cervical length < or =25 mm (OR: 24.64, 95% Cl: 2.97~204.20, P=0.003). CONCLUSION: Ultrasonographic cervical length measurement is a useful tool for prediction of progression to preterm delivery within 7 days with patients with preterm labor.
Cervical Length Measurement ; Female ; Gestational Age ; Humans ; Lipids ; Logistic Models ; Membranes ; Obstetric Labor, Premature ; Parity ; Pregnancy ; Quaternary Ammonium Compounds ; Risk Factors

Primary ovarian transitional cell carcinoma (TCC) is extremely rare type of tumor and resembles transitional cell carcinoma of the bladder. Primary ovarian TCC has been classified as a different subtype from malignant Brenner tumor for it's histologic and clinical characteristics. It usually presents at an advanced stage .Though more aggressive than malignant Brenner tumor, it shows more favorable prognosis because of better response to the chemotherapy than other epithelial ovarian carcinomas. We experienced a case of primary ovarian transitional cell carcinoma in a premenopausal woman who underwent staging operation and chemotherapeutic treatment, and herein report the case with a brief review of related literatures.
Brenner Tumor ; Carcinoma, Transitional Cell ; Female ; Humans ; Ovary ; Prognosis ; Urinary Bladder

OBJECTIVE: To evaluate obstetric variables in the placental abruption that affect on perinatal mortality. METHODS: We reviewed clinical data of all singleton deliveries complicated with placental abruption between January 2000 and December 2007, in Department of Ob. & Gyn., Sanggye Paik Hospital. RESULTS: Placental abruption complicated 54 cases (0.55%) of all deliveries (n=9,903) from January 2000 to December 2007. The peak age was 26-30 years (42.1%). The most common symptom was vaginal bleeding (57.4%) and intrauterine fetal death had already occurred in 9.3%. Perinatal mortality rate was 13.0% and there was no maternal death. 38.9% of placental abruption occurred between 33 to 36weeks of gestational age. 38.9% of placental abruption was diagnosed before delivery with ultrasonography and 9.3% was chronic placental abruption. 33.3% of placental abruption was associated with preeclampsia, and then associated with PPROM (24.1%), uterine myoma (3.7%), chronic hypertension (1.9%) and smoking (1.9%). When the hypertensive disorders were associated, fetal distress rate was higher than normotensive pregnancy (63.2% vs 20.0%, P-value: 0.005). Mean gestational age (days) (194+/-32.8 vs 248.12+/-28.0, P-value<0.001) and the severity of placental abruption (P-value: 0.005) affect perinatal mortality in placental abruption. The most common complication of placental abruption was DIC (16 cases, 29.6%), followed by Couvelaire uterus (4 cases, 7.4%) and uterine rupture (1 case, 1.9%). CONCLUSION: Obstetric variables that affect perinatal mortality were gestational age at the diagnosis and the severity of placental abruption.
Abruptio Placentae ; Dacarbazine ; Female ; Fetal Death ; Fetal Distress ; Gestational Age ; Hypertension ; Maternal Death ; Myoma ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Smoke ; Smoking ; Uterine Hemorrhage ; Uterine Rupture ; Uterus

The birth prevalence of limb reduction defect is 6 per 10,000 births. Most common type of limb reduction defect is terminal transverse defect and its birth prevalence is 1.6 per 10,000 births. Genetic variation, environmental teratogen, genetic-environmental interactions are known to causes of congenital limb defect. But, its exact causes are not known. Especially, congenital limb deficiency of right upper and lower limb has a very low incidence. We experienced one case of right femur-ulna-radius complex among recently delivered fetuses. So, we report this case with review of the literatures.
Extremities ; Fetus ; Genetic Variation ; Incidence ; Lower Extremity ; Parturition ; Prevalence ; Ultrasonography, Prenatal*

OBJECTIVE: To examine clinical characteristics and risk factors and to assess prognosis of peripartum cardiomyopathy (PPCM). METHODS: We retrospectively reviewed the medical records of 10 patients with confirmed PPCM by clinical symptoms and echocardiography, who delivered between January 1995 and December 2005 at our Hospital. Clinical and serial echocardiographic data of these patients were collected. RESULTS: Mean maternal age at the time of diagnosis was 28.8+/-3.2 years and the mean gestational age was 37(+3)+/-4 weeks. Common associated conditions were nulliparity (90%), cesarean delivery (70%), anemia (70%), preeclampsia (60%), transfusion before diagnosis (40%), twin pregnancy (30%). At the time of diagnosis, the mean left ventricular ejection fraction (EF) was 42.84+/-9.69%, fractional shortening (FS) was 23.41+/-5.49%, and left ventricular end diastolic dimension (LVEDD) was 5.58+/-0.55 cm/m2. Normalization of left ventricular function occurred in 8 patients (80%). After recovery of the left ventricular function, mean EF was 61.41+/-4.21%, FS was 34.08+/-3.26%, and LVEDD was 4.68+/-0.76 cm/m2. Incidence of PPCM was 1 in 2455 pregnancies, and maternal mortality was 12.5% in 10 months follow-up. CONCLUSION: The risk of PPCM may increase in puerperal women with rapid dramatic hemodynamic change. Echocardiography may provide significant prognostic information.
Anemia ; Cardiomyopathies* ; Diagnosis ; Echocardiography ; Female ; Follow-Up Studies ; Gestational Age ; Heart Failure ; Hemodynamics ; Humans ; Incidence ; Maternal Age ; Maternal Mortality ; Medical Records ; Parity ; Peripartum Period* ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Prognosis* ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Ventricular Function, Left

OBJECTIVE: To compare umbilical cord plasma leptin level between infants of mothers with gestational diabetes and infants of control subjects and to evaluate the regulation of leptin in GDM. METHODS: Leptin concentrations were measured in cord blood at birth using a specific radioimmunoassay employing human recombinant leptin (Human Leptin RIA kit; Linco Research, Inc. USA). We compared cord plasma leptin level between gestational diabetes (n=18 women) and control pregnancies (n=21 women). RESULTS: Maternal weight, fetal birth weight, Ponderal index and placental weight were significant variables among the demographic variables. There was statistical difference in cord plasma leptin level between infants of mothers with gestational diabetes and infants of control subjects (Control subjects: 4.8 [3.7-7.9]ng/mL, GDM women: 8.0 [6.6-11.9]ng/mL, P=0.022). There was also statistical difference in the ratio between cord plasma leptin level and birth weight (Control subjects: 0.001 [0.001-0.002]ng/mL/gm, GDM women: 0.002 [0.002-0.003]ng/mL/gm (P=0.022)), and between cord plasma leptin level and Ponderal index (Control subjects: 0.280 [0.217-0.579], GDM women: 0.605 [0.452-1.005], (P=0.008)). There was no difference in gender. CONCLUSION: We found significant difference in umbilical cord plasma leptin level and adjusted leptin level for fetal birth weight, Ponderal index and placental weight between infants of mothers with gestational diabetes and infants of control subjects. It is suggested that umbilical cord plasma leptin is produced by fetal fat tissue, but it is more complicatedly regulated by placenta and other factors in gestational diabetes.
Birth Weight ; Diabetes, Gestational* ; Female ; Fetal Blood ; Fetal Weight ; Humans ; Infant ; Leptin* ; Mothers ; Parturition ; Placenta ; Plasma* ; Pregnancy ; Pregnancy* ; Radioimmunoassay ; Umbilical Cord*

OBJECTIVE: This study was performed to evaluate of correlation between ultrasonographic findings of endometrosis and endometriosis stage and recurrence. METHODS: We reviewed medical records of fifty-nine patients who admitted the department of Obstetrics and Gynecology of Sanggye Paik Hospital from April 1998 to June 2004 and were surgically confirmed endometriosis stage 3-4. GnRH agonist was injected every 4 weeks after the first injection following initial operation and a total of six doses were injected to a patient. We performed ultrasonographic examination of pre- and post-operation at an interval of 3 or 6 months. The endometriotic ultrasonographic findings were classified into three group; low-level internal echo (LIE), LIE and septation, LIE and hyperechoic wall foci. The correlation between ultrasonographic finding of endometrioma and endometriosis stage and recurrence were analyzed by Fisher's exact test and Pearson's chi-square test. RESULTS: The follow-up periods after operation were about 11.9 months. Typical ultrasonographic findings of endometrioma were observed on 50 of 59 patients, diagnostic performance of ultrasound in the detection of endometrioma had a 84.7% sensitivity in this study. In 50 cases, 48% (n=24) had a only low-level internal echoes, 32% (n=16) had a low-level internal echoes and multiple septation, 20% (n=10) had a low-level internal echoes and hyperechoic wall foci. The most common ultrasonographic findings were LIE (50%) in stage 3, LIE and septation (33.3%) in stage 4. During follow-up we observed ultrasonographic recurrence in 6 (10.2%) cases. There were no statistically significant correlation between ultrasonographic finding and endometriosis stage or recurrence. CONCLUSION: Ultrasound is a convenient and reliable method for diagnosis of endometrioma. But, it appears that ultrasonographic findings of endometrioma not correlate with endometriosis stage or recurrence. Further long term follow-up studies in large scale is needed for correlation between ultrasonographic findings of endometriosis and clinical significance.
Diagnosis ; Endometriosis* ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gynecology ; Humans ; Medical Records ; Obstetrics ; Recurrence* ; Ultrasonography