Background: More than half of acne patients have truncal acne on their chest, back, and shoulders. However, since most studies on acne have focused on the face, data on clinical characteristics and proper management for truncal acne are insufficient. Objective: To establish a Korean Acne Rosacea Society (KARS) consensus for experts’ perception and treatment patterns of truncal acne. Methods: We conducted two rounds of the Dephi technique to gather expert opinion and reach a consensus on truncal acne. The first round comprised 48 questionnaires focusing on various aspects such as epidemiology, clinical features, diagnosis, treatment, prognosis and more, while second rounds consisted of 26 questionnaires. Results: A total of 36 dermatologists (36/38 KARS members, 94.7%) completed this survey. In the first-round survey, consensus was reached on 20 out of the 48 questions (41.7%). In the secondround questionnaire, consensus was achieved on 9 of the 26 questions (34.6%). The most unresponsive lesion to truncal acne treatment was scars (atrophic/hypertrophic). The most commonly used treatments for each non-inflammatory and inflammatory truncal acne lesions were selected to use topical retinoids (78.1% of the responders) and oral antibiotics (93.8% of the responders). Conclusion Our study has yielded valuable insights into the epidemiology, clinical manifestations, diagnosis, treatment, and quality of life of patients with truncal acne. We anticipate that this study will inspire further comprehensive research for individuals with truncal acne.

PURPOSE: The purpose of this study was to investigate the predictability of pretreatment values including Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) derived parameters (Ktrans, Kep and Ve), early changes in parameters (Ktrans, tumor volume), and heterogeneity (standard deviation of Ktrans) for radiation therapy responses via a human colorectal cancer xenograft model. MATERIALS AND METHODS: A human colorectal cancer xenograft model with DLD-1 cancer cells was produced in the right hind limbs of five mice. Tumors were irradiated with 3 fractions of 3 Gy each for 3 weeks. Baseline and follow up DCE-MRI were performed. Quantitative parameters (Ktrans, Kep and Ve) were calculated based on the Tofts model. Early changes in Ktrans, standard deviation (SD) of Ktrans, and tumor volume were also calculated. Tumor responses were evaluated based on histology. With a cut-off value of 0.4 for necrotic factor, a comparison between good and poor responses was conducted. RESULTS: The good response group (mice #1 and 2) exhibited higher pretreatment Ktrans than the poor response group (mice #3, 4, and 5). The good response group tended to show lower pretreatment Kep, higher pretreatment Ve, and larger baseline tumor volume than the poor response group. All the mice in the good response group demonstrated marked reductions in Ktrans and SD value after the first radiation. All tumors showed increased volume after the first radiation therapy. CONCLUSION: The good response after radiation therapy group in the DLD-1 colon cancer xenograft nude mouse model exhibited a higher pretreatment Ktrans and showed an early reduction in Ktrans, demonstrating a more homogenous distribution.
Animals ; Colonic Neoplasms/*pathology/*radiotherapy ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Mice ; Mice, Nude ; Xenograft Model Antitumor Assays

OBJECTIVE: To investigate the correlation between quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters and microvascular density (MVD) in a human-colon-cancer xenograft mouse model using 3 Tesla MRI. MATERIALS AND METHODS: A human-colon-cancer xenograft model was produced by subcutaneously inoculating 1 x 106 DLD-1 human-colon-cancer cells into the right hind limbs of 10 mice. The tumors were allowed to grow for two weeks and then assessed using MRI. DCE-MRI was performed by tail vein injection of 0.3 mmol/kg of gadolinium. A region of interest (ROI) was drawn at the midpoints along the z-axes of the tumors, and a Tofts model analysis was performed. The quantitative parameters (Ktrans, Kep and Ve) from the whole transverse ROI and the hotspot ROI of the tumor were calculated. Immunohistochemical microvessel staining was performed and analyzed according to Weidner's criteria at the corresponding MRI sections. Additional Hematoxylin and Eosin staining was performed to evaluate tumor necrosis. The Mann-Whitney test and Spearman's rho correlation analysis were performed to prove the existence of a correlation between the quantitative parameters, necrosis, and MVD. RESULTS: Whole transverse ROI of the tumor showed no significant relationship between the MVD values and quantitative DCE-MRI parameters. In the hotspot ROI, there was a difference in MVD between low and high group of Ktrans and Kep that had marginally statistical significance (ps = 0.06 and 0.07, respectively). Also, Ktrans and Kep were found to have an inverse relationship with MVD (r = -0.61, p = 0.06 in Ktrans; r = -0.60, p = 0.07 in Kep). CONCLUSION: Quantitative analysis of T1-weighted DCE-MRI using hotspot ROI may provide a better histologic match than whole transverse section ROI. Within the hotspots, Ktrans and Kep tend to have a reverse correlation with MVD in this colon cancer mouse model.
Animals ; Capillary Permeability ; Colorectal Neoplasms/*blood supply/pathology ; *Contrast Media ; Female ; Gadolinium/diagnostic use ; Humans ; Image Processing, Computer-Assisted ; Immunohistochemistry ; *Magnetic Resonance Imaging ; Mice ; Mice, Nude ; Microvessels/*pathology ; Neoplasm Transplantation ; Neovascularization, Pathologic/diagnosis

PURPOSE: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. METHODS: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass(1.9x1.2x0.9cm size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. RESULTS: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. CONCLUSION: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.
Adult ; Anesthesia, Local ; Biopsy ; Bronchi ; Colon ; Conjunctiva ; Eyelids ; Follow-Up Studies ; Humans ; Immunophenotyping ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Monocytes ; Mucous Membrane ; Orbit ; Plasma Cells ; Salivary Glands ; Thyroid Gland ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluated the etiological imprtance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. METHOD: The CAP patient over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age 63.8±15.3) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. RESULT: The average Fine's PORT score was 99.7(±44.9). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pneumophila serogroup 1 were not detected. CONCLUSION: Legionella pneumophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.
Adult ; Americas ; Classification ; Communicable Diseases ; Diagnosis ; Female ; Gangwon-do ; Heart ; Hospitalization ; Humans ; Immunoenzyme Techniques ; Intensive Care Units ; Korea* ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease ; Mortality ; Pneumonia*

No abstract available.
Sciatic Nerve*

To evaluate the effects of kerationocytes on the growth of melanocytes, keratinocyte conditioned media (K-CM) with different molecular weight obtained by dialysis were added to melanocyte growth medium (M-GM). In addition, K-CM only, and K-CM mixed with each component of M-GM, such as TPA(12-tetradecanoyl- phorbol-13-acetate), IBMX(isobutylmethylxanthine) and CT(cholera toxin), were used for the culture of melanocytes. 1) The proliferation of melanocytes was incresased to 2.86 x 10(5)+/-0.87 x 10(5) cells/ well and 2.87 x 10(5)+/-0.71 x 10(5) cells/well in 25% K-CM with a cut-off molecular weight of 2,000 and 25% K-CM with a cut,-off molecular weight between 6000 8000 respectively, as compared to 1.88 x 10(5)+/-0.45 x 10(5) cells/well in the control group (p < 0.05). 2) The amount of melanin was increased to 0.2987+/-0.0830ng/mlin 25% un- dialyzed K-CM, as compared to 0.2264+/-0.0643ng/ml in the control group, but this differnce was not statistically significant. 3) Maximum proliferation of melanocytes was observed in 35% concentration of K-CM with a cut-off molecular weight of 6000 8000. 4) Maximum of melanin production was observed in 35% concentration of undialyzed K-CM 5) As compared to 7.86 x 10+/-1.74 x 10(5) cells/well in M-GM,proliferation of melanocytes in 35% K-CM with a cut-off molecular weight of 6000 8000 was de- creased to 1.38 X 10(5)+/-0.97 X 10(5) cells/well. 6) There was no difference in melanocyte proliferation between 6.81 x 10(5)+/-2.19 x 10(5) cells/well in 35% 6,000 8,000 M.W. cut-off dialyzed K-CM, with IBMX only, and 7.86 x 10(5)+/-1.74 x 10(5) cells/well in M-GM. 7) Compared to 0.2303+/-0.0700ng/well cell in M-GM, the amount of melanin was increased to 0.3227+/-0.0900ng/cell, 0.3624+/-0.0900ng/cell and 0.2928+/-0.0500ng/cell, respectively, when TPA, IBMX, CT was added to 35% undialyzed K-CM. It also increased to 0.3176+/-0.1100 in 35% undialyzed K-CM(p<0.05). In summary, the results proved that cellular activating substances released from keratinocytes affect the proliferation of melanocyte and the synthesis of melain. It is also expected that methods used in this study can be clinically utilized because melanocyte culture is possible on K-CM without adding tumor promotors.
1-Methyl-3-isobutylxanthine ; Culture Media, Conditioned ; Dialysis ; Keratinocytes* ; Melanins ; Melanocytes* ; Molecular Weight

No abstract available.
Mycobacterium*

Erythrasma is a chronic, superficial bacterial skin infection involving the body folds and toewebs, and sametimes it may be generalized. The causative organism of this disease is Corynebacterium minutissimum. But, in Korea, there are few reported case about this common condition. We experienced a case of erythrasma on 39-year-old male who have had well defined, brownish fine scaly patches on both crural areas for 15 years. We had treated this patient with topical antifungal agent for 1 month under impression of tinea cruris, But skin lesion was not improved. So, we reexamined the lesion and diagnosed it as genitocrural form of erythrasma with it's clinical appearance, red fluorescence under Wood's light. And we treated it with oral erythromycin.
Adult ; Corynebacterium ; Erythrasma* ; Erythromycin ; Fluorescence ; Humans ; Korea ; Male ; Skin ; Tinea

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*