This study was performed to measure early changes in the serotype distribution of pneumococci isolated from children with invasive disease during the 3-year period following the introduction of 10- and 13-valent pneumococcal conjugate vaccines (PCVs) in Korea. From January 2011 to December 2013 at 25 hospitals located throughout Korea, pneumococci were isolated among children who had invasive pneumococcal disease (IPD). Serotypes were determined using the Quellung reaction, and the change in serotype distribution was analyzed. Seventy-five cases of IPD were included. Eighty percent of patients were aged 3-59 months, and 32% had a comorbidity that increased the risk of pneumococcal infection. The most common serotypes were 19A (32.0%), 10A (8.0%), and 15C (6.7%). The PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F, and 6A) accounted for 14.7% of the total isolates and the PCV13 minus PCV7 types (1, 3, 5, 7F and 19A) accounted for 32.0% of the total isolates. Serotype 19A was the only serotype in the PCV13 minus PCV7 group. The proportion of serotype 19A showed decreasing tendency from 37.5% in 2011 to 22.2% in 2013 (P = 0.309), while the proportion of non-PCV13 types showed increasing tendency from 45.8% in 2011 to 72.2% in 2013 (P = 0.108). Shortly after the introduction of extended-valent PCVs in Korea, serotype 19A continued to be the most common serotype causing IPD in children. Subsequently, the proportion of 19A decreased, and non-vaccine serotypes emerged as an important cause of IPD. The impact of extended-valent vaccines must be continuously monitored.
Adolescent ; Bacteremia/complications/diagnosis ; Child ; Child, Preschool ; Female ; Hospitals ; Humans ; Infant ; Male ; Pneumococcal Infections/microbiology/*prevention & control ; Pneumococcal Vaccines/*immunology ; Republic of Korea ; Serotyping ; Streptococcus pneumoniae/*classification/isolation & purification ; Vaccines, Conjugate/*immunology

No abstract available.
Hair*

No abstract available.
Aged* ; Herpes Zoster* ; Humans ; Neuralgia, Postherpetic* ; Pain Management*

Nevus sebaceous (NS) is a benign neoplasm occurring mainly on the face and scalp. It commonly occurs as a solitary, well-demarcated lesion. This paper presents a case of multiple nevus sebaceous, which presented as multiple lesions occurring on the temporal scalp and on the contralateral side of the chin. Multiple NS have only rarely been reported.
Chin ; Nevus ; Scalp

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are being used to treat malignancies originating from epithelia. Unfortunately, blocking the EGFR pathway leads to various side effects, most frequently acneiform eruptions. OBJECTIVE: To probe the mechanism underlying this side effect, we investigated the effect of EGFR inhibitors on cultured sebocytes. METHODS: To examine the effects of an EGFR inhibitor (cetuximab, Erbitux(R) 10 ng/ml) and the effects of EGFR ligands, such as epidermal growth factor (EGF, 10 ng/ml) and transforming growth factor-alpha (TGF-alpha, 5 ng/ml), on the production of inflammatory cytokines in cultured sebocytes, we used reverse transcriptase-polymerase chain reaction, immunocytofluorescence and Western blots. Outcomes included the expression of interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-alpha), peroxisome proliferator-activated receptor-gamma (PPAR-gamma) and EGFR. RESULTS: There were no significant differences in the expression of IL-1, IL-6, TNF-alpha, PPAR-gamma and EGFR between (a) groups treated with an EGFR inhibitor or an EGFR ligand and (b) the control group, except for a significant increase in the expression of IL-1 in the EGF-treated group. CONCLUSION: EGFR inhibitors and EGFR ligands do not provoke the expression of inflammatory biomarkers in cultured sebocytes. The role of the sebaceous glands in EGFR inhibitor-induced acneiform eruption should be investigated more thoroughly.
Acneiform Eruptions ; Biomarkers ; Blotting, Western ; Cytokines ; Epidermal Growth Factor ; Interleukin-1 ; Interleukin-6 ; Interleukins ; Ligands ; Peroxisomes ; Receptor, Epidermal Growth Factor ; Sebaceous Glands ; Tumor Necrosis Factor-alpha ; Up-Regulation

According to Western reports, there's a 1~8% possibility that multiple melanomas can occur in one individual. Although two melanomas occurring simultaneously or metachronously on different areas of the skin in a patient are rare and this has not yet been reported in the Korean dermatological literature, there could be two possible explanations. One is cutaneous recurrence/metastasis from a primary cutaneous melanoma (PCM) and the other is development of another new PCM, and this is the so called multiple primary cutaneous melanoma (MPCM). We report here on a 72-year-old man who presented with a subungual melanoma on the right thumb (T2bN0M0, duration: 3 years) and the other melanoma was on the right sole (TisN0M0, duration: 10 years). We could not find any evidence of recurrence/metastasis on the physical examinations and various imaging studies. Pathological differences were shown between the 2 melanomas and, more importantly, the differences were anatomically irrelevant. So, we diagnosed the lesions as MPCM instead of recurrence/metastasis of PCM or other possibilities.
Aged ; Humans ; Melanoma ; Physical Examination ; Skin ; Thumb

BACKGROUND: The tie-over dressing is the classic dressing method for a full thickness skin graft (FTSG) to secure the graft on the skin defect. Although many methods to secure the graft have currently been employed, they have some disadvantages such as stretching discomforts and irregular pressure delivery to the graft, resulting in partial necrosis or surface irregularity. OBJECTIVE: The aim of this study was to evaluate the usefulness of a porous, flexible and distensible silicone wound contact layer (Mepitel(R)) for securing a graft as a bolster fixation in FTSG reconstruction. METHODS: Sixty seven patients with surgical defects following mainly malignant tumor excision were included in this study. After suturing and bolstering the graft in place, a piece of silicone contact layer was used to cover the graft, and then second sutures were placed to apply uniform pressure. RESULTS: Thirty three cases of basal cell carcinoma, 14 cases of malignant melanoma and 10 cases of squamous cell carcinoma were included as a cause of the defects. Forty six defects were located on the head and neck, and the rest were on the trunk and extremities. The size of the surgical defects ranged from 0.5 to 14.0 cm at the greatest diameter (mean: 4.0 cm). One major and 1 minor loss of graft developed. Mild to moderate scar formation, mainly marginal elevation, occurred in 9 patients. Sixty five percents of the patients who had facial defects were satisfied with their results. CONCLUSION: We suggested that a silicone wound contact layer for bolster fixation might be a useful material to secure a FTSG, and this is easy to apply and the resulting cosmesis is good and there are few problems with using it.
Bandages ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cicatrix ; Extremities ; Head ; Humans ; Hypogonadism ; Melanoma ; Mitochondrial Diseases ; Neck ; Necrosis ; Ophthalmoplegia ; Silicones ; Skin ; Sutures ; Transplants

Patients with stage IV metastatic melanoma have been traditionally managed with mainly palliative therapy such as chemotherapy, radiation therapy or biologic therapy, yet their overall survival is unsatisfactory. Several recent series have indicated a long-term survival benefit after complete resection, (termed "metastasectomy") of distant metastatic foci in patients with metastatic melanoma. Unlike other palliative modalities, surgery like metastasectomy can rapidly render a patient clinically disease-free with rather minimal morbidity, a short-term of hospitalization and a quick recovery time. This may prolong the survival and improve the quality of life of patients with stage IV melanoma if all the clinicoradiologically-evident tumors can be completely resected. We report herein on a case of performing metastasectomy in a patient who had malignant melanoma with soft tissue metastasis of the breast (T3a/bN0M1a), even though there was a regrettable result.
Biological Therapy ; Breast ; Hospitalization ; Humans ; Melanoma ; Metastasectomy ; Neoplasm Metastasis ; Palliative Care ; Quality of Life

Acquired digital arteriovenous malformation (ADAVM) consists of an abnormal connection between the arteriole and venule in the acral area of extremities, particularly the fingers. Clinically, the lesions appear as small, slightly- elevated, dark brown erythematous macules on the distal part of fingers. The histological specimens shows close approximation between thin-walled venule and thick-walled arteriole and possibly a direct arteriovenous shunt adjacent to each other lying in the dermis. We herein report seven stereotypical cases of ADAVM.
Arterioles ; Arteriovenous Malformations ; Deception ; Dermis ; Extremities ; Fingers ; Venules

Pyoderma gangrenosum is an uncommon, neutrophilic, ulcerating, chronic dermatosis with obscure etiology. Many therapeutic modalities have been used in the past, but they have not always provided favorable outcomes. Recently, tumor necrosis factor-alpha inhibitors have been gaining attention in the treatment of recalcitrant pyoderma gangrenosum. A 57-year-old woman presented with painful, recurrent erythematous nodules and ulcers on both legs. She had been treated with systemic steroids, immunosuppressants, dapsone, and colchicine, and she experienced improvement with systemic steroids only. After using infliximab (5 mg/kg), she experienced dramatic improvement in her lesions. Thus, we report a recalcitrant case of pyoderma gangrenosum that was successfully treated with infliximab.
Antibodies, Monoclonal ; Colchicine ; Dapsone ; Female ; Humans ; Immunosuppressive Agents ; Leg ; Middle Aged ; Neutrophils ; Pyoderma ; Pyoderma Gangrenosum ; Skin Diseases ; Steroids ; Tumor Necrosis Factor-alpha ; Ulcer ; Infliximab