Background/Aims: This study aimed to determine changes in endoscopist-driven sedation practices 5 years after the first nationwide survey in 2014 by the Korean Society of Gastrointestinal Endoscopy (KSGE). Methods: A 59-item survey covering current practices was electronically mailed to all members of the KSGE in 2019. Results: In total, 955 (12.8%) out of 7,486 questionnaires were returned. A total of 738 (77.7%) out of 955 respondents attended dedicated sedation education programs. The American Society of Anesthesiologists class was recorded by 464 (51.2%) out of 907 respondents. The recording rate was higher in respondents who completed sedation education (p=0.014) and worked in general or tertiary hospitals (p<0.001). Compared to that reported in the previous survey, the reported use of propofol was higher in 2019. The respondents had higher satisfaction scores for propofol-based sedation compared with midazolam monotherapy (p<0.001). The rates of oxygen supplementation (p<0.001) and oxygen saturation level monitoring (p<0.001) during sedative endoscopy were higher in 2019 than in the previous survey. A total of 876 (98.4%) out of 890 respondents reported a separate recovery bay, and 615 (70.5%) out of 872 respondents reported that personnel were assigned solely to the recovery bay. Conclusions Endoscopist-driven sedation and monitoring practices in 2019 were significantly different than those in 2014. The respondents favored propofol-based sedation and utilized oxygen supplementation and monitoring of O2 saturation more frequently in 2019 than in 2014.

PURPOSE: Birthmarks are commonly observed during neonatal period and its prevalence varies between races and countries. Most skin lesions are transient and not require medical treatment. But some birthmarks have potential medical significance and may be the first sign of systemic medical problems. We carried out a prospective study to determine the prevalence of birthmarks in Korean newborn infants. METHODS: From October 2012 to January 2013, 1,964 Korean newborn infants who were born in Cheil General Hospital, Kwandong University College of Medicine were evaluated for the presence of birthmarks within 48 hours after birth. RESULTS: Among 1,964 newborn infants, 980 (49.9%) infants were male and 984 (50.1%) were female. The most common pigmentary birthmark was Mongolian spot (97.1%), which was mostly presented on sacrogluteal area, and was followed by nevocellular nevi (0.8%), cafe-au-lait spot (0.8%), and sebaceous nevi (0.2%). Among vascular birthmarks, the most common lesion was salmon patch (30.8%), and followed by port-wine stain (0.2%) and hemangioma (0.2%). The common other lesions were sebaceous hyperplasia (37.4%), erythema toxicum neonatorum (10.2%), milia (4.1%), skin appendage (2.6%), anal dimple (1.2%), auricular pit (0.9%), miliaria (0.5%), aplasia cutis congenita (0.2%) in the order of frequency. CONCLUSION: We studied the prevalence of the birthmarks in Korean newborn infants. The most common pigmentary birth mark was mongolian spot, and the most common vascular birthmark was salmon patch in Korean newborn infants.
Cafe-au-Lait Spots ; Continental Population Groups ; Ectodermal Dysplasia ; Erythema ; Female ; Hemangioma ; Hospitals, General ; Humans ; Hyperplasia ; Incidence* ; Infant ; Infant, Newborn* ; Male ; Miliaria ; Mongolian Spot ; Nevus ; Parturition ; Port-Wine Stain ; Prevalence ; Prospective Studies ; Salmon ; Skin

PURPOSE: Allergic diseases have been increased in Korea. The aim of this study was to investigate the changes of sensitization rate to inhalant allergens over 10 years in children with allergic diseases from a tertiary referral hospital. METHODS: Skin prick tests were done in total 2,225 children in 2000, 2005, and 2010. Changes of skin reactivity to 12 major inhalant allergens, including Tree pollen mixture I (Alder, Elm, Hazel, Poplar, Willow), Tree pollen mixture II (Beech, Birch, Oak, Plane tree), Dermatophagoides pteronyssinus, Dermatophagoides farina, Alternaria, cat dander, and dog dander were investigated. RESULTS: The sensitization rates to Tree pollen mixture I and II were increased as 5.0%, 6.8% in 2000, 8.5%, 9.8% in 2005, and 14.8%, 17.3% in 2010, respectively (trend P<0.001, P<0.001, respectively). And the sensitization rates to D. pteronyssinus cat dander and dog dander were changed as 55%, 4.8%, 4.8% in 2000, 62.2%, 11.9%, 28% in 2005, and 63.1%, 12.7%, 16.7% in 2010, respectively. The distribution of sensitized pollens was oak (12.8%), beech (12.4%), pine (10.3%), birch (10%), hazel (9.6%), alder (8%), elder (6.9%), elm (5.4%) in the study of 2010. When allergen/histamine ratio was compared, rates of strong sensitization over 4+ to tree pollen were increased. CONCLUSION: The sensitization rates to inhalant allergens were increased in children with asthma or allergic rhinitis from a tertiary referral hospital in Seoul over last 10 years. Especially, an increase in the degree of skin reactivity was observed in cat dander, dog dander, and tree pollens. The studies to investigate the etiology of this increase and prevention will be needed.
Allergens ; Alnus ; Alternaria ; Animals ; Asthma* ; Betula ; Cats ; Child* ; Dander ; Dermatophagoides pteronyssinus ; Dogs ; Fagus ; Humans ; Hypersensitivity ; Korea ; Pollen ; Pyroglyphidae ; Rhinitis* ; Seoul ; Skin ; Tertiary Care Centers*

BACKGROUND: Vitamin E is widely known to be one of the reactive oxygen species (ROS) scavengers and a drug that can easily be obtained, and it has been shown to attenuate the pain responses induced by various causes in animal pain models. Thus, this experiment was conducted to assess the antinociceptive effects of vitamin E by comparing intraperitoneal and intrathecal injections in rats subjected to the formalin test. METHODS: After the intraperitoneal and intrathecal injections of vitamin E were carried out, respectively (IP: 500 mg/kg, 1 g/kg, and 2 g/kg, IT: 3 mg/kg, 10 mg/kg, and 30 mg/kg), the formalin test was perfumed. As soon as 5% formalin was injected into left hind paw, the number of flinches induced by pain was measured at 5-minute intervals for 1 hour. RESULTS: Formalin injected into the left hind paw induced biphasic nociceptive behavior in all animals. Intraperitoneal injection of vitamin E diminished the nociceptive behavior in a dose-dependent manner during the early and late phase. Intrathecal vitamin E diminished nociceptive behavior dose dependently during the late phase but showed no significant difference in the early phase. CONCLUSIONS: Vitamin E attenuated acute nociception when it was injected systemically, while both systemic and intrathecal injection produced analgesia in a rat model of formalin-induced hyperalgesia.
Analgesia ; Animals ; Formaldehyde ; Hyperalgesia ; Injections, Intraperitoneal ; Injections, Spinal ; Nociception ; Pain Measurement ; Rats ; Reactive Oxygen Species ; Vitamin E ; Vitamins

No abstract available.

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease and its prevalence has recently increased. Epidemiological research for associated factors of AD has recently been reported. However, a large population study on the factors affecting the disease development and progression in childhood AD has not yet been carried out in Suwon. OBJECTIVE: We investigated the prevalence of AD in elementary school students and the associated factors of the disease development and progression in Suwon. METHODS: This study was carried out among 1,330 elementary school students from April to July, 2009. First, a questionnaire study (International Study of Asthma and Allergies in Childhood, ISSAC) which covered clinical manifestations, environment, and life style was performed. Then, two dermatologists examined the skin of students with symptoms suspicious of AD and evaluated the severity using the Eczema Area and Severity Index (EASI) score. RESULTS: The prevalence of AD among the elementary school students in Suwon as evaluated by questionnaire was 22.9%. However, the prevalence confirmed by two dermatologists was 6.7%. The average EASI score measured by the two dermatologists was 3.52+/-3.05. The most common age of onset was under 2 years, followed by 2~4 years. The two major risk factors of AD showing statistical significance were parental past history of atopic disease and moving to a new residence within a year after birth. CONCLUSION: These results suggest that certain genetic and environmental factors may affect the prevalence of childhood AD in Suwon.
Age of Onset ; Asthma ; Dermatitis, Atopic ; Eczema ; Humans ; Hypersensitivity ; Life Style ; Parents ; Parturition ; Prevalence ; Risk Factors ; Skin ; Skin Diseases

Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy.
Adult ; Bilirubin/*blood ; Disease Progression ; Female ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/*blood/complications ; Humans ; Hypertension/complications ; Incidence ; Kidney Failure, Chronic/*blood/complications ; Male ; Middle Aged ; Risk ; Risk Factors ; Treatment Outcome

Primary cutaneous anaplastic large cell lymphoma (ALCL) is composed of large cells with anaplastic, pleomorphic cytomorphology and the expression of the CD30 antigen by the majority (more than 75%) of tumor cells. Recently some variants of ALCL with extensive inflammatory cell infiltration have been reported. A 34-year-old male presented with multiple tumors over the arm, groin, and legs. The tumors of the right groin showed ulceration and purulent discharge. The biopsy specimens revealed extensive infiltrate of large atypical lymphoid cells with mixed inflammatory cells consisting of numerous eosinophils and neutrophils. Immunohistochemical staining was positive for CD3, CD4, and CD30. TCR-gamma gene rearrangement was detected. There was no evidence of extracutaneous involvement. We report a case of primary cutaneous ALCL, associated with marked inflammatory cell infiltration. Diagnosis in such cases is challenging because the large atypical lymphoid cells may be easily obscured by the massive infiltrate of eosinophils and neutrophils.
Adult ; Antigens, CD30 ; Arm ; Biopsy ; Eosinophils ; Gene Rearrangement ; Groin ; Humans ; Leg ; Lymphocytes ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; Male ; Neutrophils ; Ulcer

Atrophia maculosa varioliformis cutis (AMVC) is a type of idiopathic noninflammatory macular atrophy that occurs in young individuals. It is clinically characterized by shallow, sharply demaracated depressions of various shapes. Considering that atrophia maculosa varioliformis cutis can be mistaken as scarring and artifact dermatitis, it is important for physicians to distinguish this condition and to diagnose it correctly.
Artifacts ; Atrophy ; Cicatrix ; Depression ; Dermatitis

Birt-Hogg-Dube syndrome (BHDS) is an autosomal dominant genodermatosis characterized by cutaneous hair follicle tumors (fibrofolliculoma or trichodiscoma), pulmonary cysts, and increased risk of renal neoplasia. The genetic alteration for BHDS has been mapped to chromosome 17p12q11, and the gene in this region has been cloned and believed to be responsible for the BHDS. Mutations in the BHD gene (also known as FLCN) have been described in the patients with BHDS. We present a case of a 30-yr-old Korean woman with multiple mildly pruritic papules on her face and neck area. The patient had several firm, flesh-colored, dome-shaped, papular lesions measuring between 2 to 5 mm. Except for a history of pneumothorax her medical records were not remarkable. Mutation analysis of the BHD gene was performed, and a novel deletion mutation (p.F519LfsX17 [c.1557delT]) causing truncation of the gene product, folliculin, was found in the exon 14. The actual incidence of BHDS is unknown, but it is most likely underdiagnosed. So it is imperative that doctors recognize the skin lesions of BHDS and institute proper screening to detect other manifestations of the disease. Here, we report a case of BHDS with a novel mutation, which is the first report in Korea.
Adult ; Biopsy ; DNA Mutational Analysis ; Diagnosis, Differential ; Estrone/biosynthesis ; Exons ; Female ; Gene Deletion ; Genetic Predisposition to Disease ; Humans ; Kidney Neoplasms/genetics ; Models, Genetic ; Mutation ; Skin Diseases/diagnosis/*genetics ; Syndrome