Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

Background: Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. Objective: To investigate the economic burden of psoriasis in Korea. Methods: The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. Results: The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. Conclusion This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

PURPOSE: We investigated the effect of chemoradiotherapy with PP2 and temozolomide (TMZ) on malignant glioma cells using clonogenic assays and in vivo brain tumor model. MATERIALS AND METHODS: The effect of PP2 on radiosensitivity of U251 and T98G cells was investigated using clonogenic assays. The expression of E-cadherin, matrix metalloproteinases 2 (MMP2), Ephrin type-A receptor 2 (EphA2), and vascular endothelial growth factor (VEGF) was measured by Western blotting and an accumulation of γH2AX foci 6 hours after radiotherapy was measured after PP2 treatment. The effect of PP2 on migration, invasion, and vasculogenic mimicry formation (VMF) of U251 cells was evaluated. In an orthotopical brain tumor model with U251 cells, PP2 was injected intraperitoneally with or without oral TMZ before, during and after whole brain radiotherapy. Bioluminescence images were taken to visualize in vivo tumors and immunohistochemical staining of VEGF, CD31, EphA2, and hypoxia-inducible factor 1a was performed. RESULTS: PP2 increased radiosensitivity of U251 and T98G cells without decreasing survival of normal human astrocytes. Chemoradiotherapy with PP2 and TMZ resulted in increased accumulation of γH2AX foci. PP2 induced overexpression of E-cadherin and suppression of MMP2, VEGF, and EphA2. PP2 also compromised invasion, migration, and VMF of U251 cells. In brain tumors, chemoradiotherapy with PP2 and TMZ decreased tumor volume best, but not statistically significantly compared with chemoradiotherapy with TMZ. The expression of VEGF and CD31 was suppressed in PP2-treated tumors. CONCLUSION: PP2 enhances radiosensitivity of malignant glioma cells and suppresses invasion and migration of U251 cells. Chemoradiotherapy with PP2 and TMZ resulted in non-significant tumor volume decrease.
Astrocytes ; Blotting, Western ; Brain ; Brain Neoplasms ; Cadherins ; Chemoradiotherapy* ; Glioblastoma ; Glioma* ; Humans ; Matrix Metalloproteinases ; Protein-Tyrosine Kinases* ; Radiation Tolerance ; Radiotherapy ; Tumor Burden ; Tyrosine* ; Vascular Endothelial Growth Factor A

We evaluated the performance of a new chromogenic medium for detection of Clostridium difficile, chromID C. difficile agar (CDIF; bioMerieux, France), by comparison with BBL C. difficile Selective Agar (CDSA; Becton Dickinson and Company, USA). After heat pre-treatment (80degrees C, 5 min), 185 diarrheal stool samples were inoculated onto the two media types and incubated anaerobically for 24 hr and 48 hr for CDIF and for 48 hr and 72 hr for CDSA. All typical colonies on each medium were examined by Gram staining, and the gram-positive rods confirmed to contain the tpi gene by PCR were identified as C. difficile. C. difficile was recovered from 36 samples by using a combination of the two media. The sensitivity with CDIF 48 hr was highest (100%) and was significantly higher than that with CDIF 24 hr (58.3%; P<0.001), because samples with a low burden of C. difficile tended to require prolonged incubation up to 48 hr (P<0.001). The specificity of CDIF 24 hr and CDIF 48 hr (99.3% and 90.6%, respectively) was significantly higher than that of CDSA 48 hr and CDSA 72 hr (72.5% and 67.1%, respectively; P<0.001). CDIF was effective for detecting C. difficile in heat-pretreated stool specimens, thus reducing unnecessary testing for toxin production in non-C. difficile isolates and turnaround time.
Agar/chemistry ; Bacterial Proteins/genetics ; Bacteriological Techniques/*methods ; Chromogenic Compounds/chemistry/metabolism ; Clostridium difficile/genetics/*isolation & purification ; Culture Media/chemistry ; DNA, Bacterial/analysis/metabolism ; Diarrhea/microbiology/pathology ; Feces/*microbiology ; Humans ; Polymerase Chain Reaction ; Time Factors

Knowledge of the prevalence of human Toxoplasma gondii infection is required in the Republic of Korea. In this study, we surveyed the seroprevalence of T. gondii infection and analyzed the risk factors associated with seropositivity among residents in 2 administrative districts; Seoul and the island of Jeju-do, which have contrasting epidemiologic characteristics. Sera and blood collected from 2,150 residents (1,114 in Seoul and 1,036 in Jeju-do) were checked for IgG antibody titers using ELISA and for the T. gondii B1 gene using PCR. In addition, participants completed a questionnaire that solicited information on gender, age, occupation, eating habits, history of contact with animals, and travel abroad. The T. gondii B1 gene was not detected in all residents examined. However, ELISA showed 8.0% (89 of 1,114 sera) positive for IgG antibodies against T. gondii in Seoul and 11.3% (117 of 1,036 sera) in Jeju-do. In both districts, the positive rates were higher in males than in females, and those 40-79 years of age showed higher rates than other ages. In Seoul, residents older than 70 years of age showed the highest positive rate, 14.9%, whereas in Jeju-do the highest prevalence, 15.6%, was in those in their sixties. The higher seropositive rate in Jeju-do than in Seoul may be related to eating habits and occupations. The present results and a review of related literature are indicative of an increased seroprevalence of T. gondii in Korea in recent years.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Antibodies, Protozoan/*blood ; Child ; DNA, Protozoan/blood ; Female ; Humans ; Immunoglobulin G/*blood ; Male ; Mice ; Mice, Inbred BALB C ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Seroepidemiologic Studies ; Sex Factors ; Toxoplasma/genetics/*immunology ; Toxoplasmosis/*epidemiology/parasitology ; Young Adult

BACKGROUND: TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin), a material of agent orange, was reported as a deadly poison in spite of its presence at extremely small doses. It has been reported that TCDD can cause various kinds of cancers and harmful effects on humans. However, a correlation between exposure to TCDD and cardiovascular disease is not yet known. Thus, we intended to examine the correlation between TCDD exposure and cardiovascular disease through an analysis of coronary angiograms in veterans of the Vietnam War. METHODS: A consecutive 115 patients undergoing coronary angiograms between April 2004 and June 2005 at Gwangju Veterans Hospital were analyzed. The patients were divided into two groups: 57 patients exposed to TCDD (Group I, average age 59.2+/-4.2 years) and 58 patients that were not exposed to TCDD (Group II, Average age 60.1+/-5.6 years). The clinical and coronary angiographic findings were evaluated. RESULTS: Baseline clinical characteristics, inflammatory markers and echocardiographic parameters were not different between patients in the two groups. The incidence of diabetes (43.9% vs. 25.0%, p=0.035) and hyperlipidemia (47.4% vs. 27.6%, p=0.028) were higher in group I patients than group II patients. Significant coronary artery stenosis was more common in group I (45 cases, 78.9%) thanin group II (33 cases, 56.9%) (p=0.011). CONCLUSIONS: There was a higher incidence of diabetes, hyperlipidemia, and significant coronary artery stenosis in patients that underwent a diagnostic coronary angiogram that were previously exposed to TCDD.
Angioplasty ; Cardiovascular Diseases* ; Citrus sinensis* ; Coronary Disease ; Coronary Stenosis ; Echocardiography ; Gwangju ; Hospitals, Veterans ; Humans ; Hyperlipidemias ; Incidence ; Tetrachlorodibenzodioxin ; Veterans* ; Vietnam*

Rheumatoid vasculitis usually occurs in patients with long standing, seropositive, erosive rheumatoid arthritis. It involves typically small to medium-sized vessels and is associated with peripheral neuropathy, digital gangrene, nail fold infarcts, livedo reticularis, and palpable purpura. Histologic examination of skin biopsy specimens usually shows leukocytoclastic vasculitis. We report a case of rheumatoid vasculitis developed on both extremities in a 63-year-old female with rheumatoid arthritis for 15 years.
Arthritis, Rheumatoid ; Biopsy ; Extremities ; Female ; Gangrene ; Humans ; Livedo Reticularis ; Middle Aged ; Peripheral Nervous System Diseases ; Purpura ; Rheumatoid Vasculitis* ; Skin ; Vasculitis

Acquired digital fibrokeratoma (ADFK) is a solitary round, firm and hyperkeratotic projection seen most commonly on the digits, but it is occasionally found on the palm, dorsum of the hand, wrist, periungual area, and rarely on the sole. We report herein three cases of ADFK in an adult occuring on the sole. As being continuously exposed to the pressure, ADFKs are transformed and may easily be mistaken for more common plantar lesions including plantar warts and corns.
Adult ; Callosities ; Hand ; Humans ; Warts ; Wrist ; Zea mays

BACKGROUND: The histologic distinction between basal cell carcinoma(BCC) and squamous cell carcinoma(SCC) is sometimes difficult, but clinically important, because SCC has worse prognosis than BCC. Cytokeratins(CKs) are the major component of intermediate filaments and are subdivided into at least 20 different polypeptides. Monoclonal antibodies developed against these individual keratins become very useful in the classification of the major types of epithelial tumors. OBJECTIVE: The purpose was to investigate the usefulness of CK staining in distinguishing BCC from SCC. METHODS: We studied 10 cases of BCC and 10 cases of SCC with 6 anticytokeratin antibodies including AE1, CAM5.2, CK7, CK16, CK10, and CK8. RESULTS: All cases of BCC and SCC stained with AE1. Six and 5 cases out of 10 cases of BCC stained with CAM5,2 and CK7, respectively, but all cases of SCC stained with neither CAM5.2 nor CK7. All cases of SCC stained with CK16, but all cases of BCC did not. Two out of 10 cases of SCC stained focally with CK10, while all cases of BCC did not stain with CK10. All cases of BCC and SCC did not stain with CK8. CONCLUSION: We conclude that a panel of antibodies for CKs including CK7, CAM5.2, and CK16 may be useful in distinguishing BCC from SCC. In particular, CK16 may be the most useful marker because it was positive for all cases of SCC while negative for all cases of BCC.
Antibodies ; Antibodies, Monoclonal ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell* ; Classification ; Intermediate Filaments ; Keratins* ; Peptides ; Prognosis

BACKGROUND: There have been only a few morphological studies after laser treatment of pigmented skin lesions. OBJECTIVE: The purpose was to investigate the clinicopathologic and immunohistochemical changes following copper vapor laser treatment of superficial pigmented skin lesions. METHODS: Three patients with Becker's nevus, 1 patient with partial unilateral lentiginosis, and 1 patient with nevus spilus were irradiated with copper vapor laser. Forty-two biopsies were taken before, immediately after, and 3 months after laser treatment. Hematoxylin-eosin, Fontana-Masson, and S-100 protein staining were performed for the evaluation of the histopathologic and immunohistochemical findings of the specimens. RESULTS: Clinically, immediate greyish whitening, immediate erythema, and delayed edema were observed immediately after copper vapor treatment. Histopathologically, suprabasilar separation with elongated cells in the basal cell layer was observed immediately after laser treatment. A few vacuolated cells were found mainly in the basal cell layer. Fontana-Masson and S-100 protein staining positivity decreased a lot in the epidermis, but they hardly decreased in the dermis immediately after laser treatment. CONCLUSION: For the treatment of pigmented skin lesions, copper vapor laser was more effective in the epidermal pigmented structures than the dermal pigmented structures. Selective photothermolysis of melanosome was not so prominent after copper vapor laser treatment.
Biopsy ; Copper* ; Dermis ; Edema ; Epidermis ; Erythema ; Humans ; Lasers, Gas* ; Lentigo ; Melanosomes ; Nevus ; S100 Proteins ; Skin*