BACKGROUND: Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM. METHODS: Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used. RESULTS: The weighted impact score change for local or long-distance journey (P=0.0049), holidays (P=0.0364), and physical health (P=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change. CONCLUSION This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.

No abstract available.
Dermatofibrosarcoma

BACKGROUND: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group A beta-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. OBJECTIVE: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. METHODS: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. RESULTS: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. CONCLUSION: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.
Acetamides ; Acinetobacter baumannii ; Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Candida albicans ; Ciprofloxacin ; Clindamycin ; Dibekacin ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Gentamicins ; Humans ; Impetigo ; Incidence ; Klebsiella oxytoca ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Penicillins ; Prevalence ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin ; Linezolid

A 29-year-old man presented with well-demarcated brown-to-erythematous patches with scales on the perioral and periocular areas. We could not find any other systemic signs and symptoms, except for the cutaneous findings and no abnormal results were found on laboratory tests. Histologic examination showed upper dermal granulomatous infiltrate and led us consider the diagnosis of granulomatous periorificial dermatitis. After daily taking oral minocycline 200 mg with application of topical tacrolimus ointment for 8 weeks, combined with the application of topical tacrolimus ointment, the lesion showed a marked improvement without scarring.
Adult ; Cicatrix ; Dermatitis ; Dermatitis, Perioral ; Humans ; Minocycline ; Tacrolimus ; Weights and Measures

Cutaneous horn is a clinical description for a protruding mass of keratin, which may arise from benign and malignant lesions. There have been 21 cases of cutaneous horns reported in Korea: 19 cases in adults, 2 cases in children, and no case in infants. We report the case of an 8-month-old girl who presented with a pea-sized, hyperkeratotic nodule on the dorsum of the right foot. Histopathologic examination confirmed the nodule to be a cutaneous horn arising from an angiokeratoma.
Adult ; Angiokeratoma* ; Animals ; Child ; Female ; Foot ; Horns* ; Humans ; Infant ; Korea

BACKGROUND: Bowen's disease is a challenging condition to treat because lesions often affect the elderly who are usually intolerable to invasive treatment modalities and lesions are often located at sites that heal poorly. OBJECTIVE: The aim of this study was to evaluate the effectiveness and the safety of 5% imiquimod cream for the treatment of Bowen's disease. METHODS: Eleven patients with biopsy-proven Bowen's disease were treated with once-daily or twice-daily self- application of 5% imiquimod cream for a maximum of 16 weeks. RESULTS: Nine of ten (90%) patients who completed the treatment schedule showed complete clinicopathologic regression. One (11%) patient showed recurrence of Bowen's disease on the treated site. 5% imiquimod cream was generally well-tolerated and no serious side effects were observed. CONCLUSION: 5% imiquimod cream appears to be an effective modality for treatment of Bowen's disease and might represent a valuable alternative to surgery or other invasive treatment methods.
Aged ; Appointments and Schedules ; Bowen's Disease* ; Humans ; Recurrence

Immunosuppressive therapy has been reported to exacerbate or initiate the development of porokeratosis. We report a patient who noted a dramatic worsening of previously unrecognized lesions of porokeratosis accompanied by malaise and fatigue. He was subsequently found to have myelodysplastic syndrome. On the basis of this case, the sudden appearance or exacerbation of disseminated porokeratosis without immunosuppressive therapy may justify the search for underlying immunodepressive conditions.
Fatigue ; Humans ; Myelodysplastic Syndromes* ; Porokeratosis*

Semicircular lipoatrophy is a rare entity characterized by atrophic cutaneous indentation, typically involving the anterolateral thigh of young women. Although many previous reports have failed to reveal underlying trauma histories, repeated external microtraumas seem to be the most plausible causal factor at present. We report a case of semicircular lipoatrophy which occurred on both thighs of a 23-year-old woman after she started a new job as a waitress in fast-food restaurant.
Female ; Humans ; Restaurants ; Thigh ; Young Adult

PURPOSE: Tumor suppressor gene called PTEN has been localized to 10q23 in 1997 and its mutation has been implicated in some malignancies. Loss of the PTEN gene has been clinically associated with unfavorable histology and influencing tumor staging and recurrence in the determination of a prognosis in patients suffering from other cancers, its role in colorectal cancers is inconclusive as of yet. The purpose of this study is shed light on PTEN expression in colorectal cancer and its significance associated with pathological findings and clinical findings. METHODS: A total of 217 patients who had been diagnosed with colorectal cancer, had undergone radical colectomy from October of 1993 to December of 2000, and for whom follow-up was possible were selected for this study. Their clinical records were analyzed and specimens were stained immunohistochemically RESULTS: In comparing the PTEN positive group (48 patients, 22.1%) with the negative group (171 patients, 77.9%), there was a significantly (P=0.021) higher frequency of recurrence in the negative group (29.0%) than in the positive group (12.5%), and an especially higher frequency of distant metastasis in the negative group (18.3%) than in the positive group (4.2%), with P=0.010. Although there was no meaningful difference in the overall five year survival rate, the five year disease free survival rate was significantly (P=0.029) higher in the positive group. CONCLUSIONS: The results of this study reveal the possibility of using PTEN as a prognostic indicator in colorectal cancer.
Colectomy ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Genes, Tumor Suppressor ; Humans ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Recurrence ; Survival Rate

This study compares the sexual differences among rectal prolapse patients regarding the clinical and the physiologic characteristics with emphasis on males. METHODS: The clinical data, functional status and operative records of 43 patients, who had completed both clinical and functional evaluations were collected in a prospective database and were analyzed according to sex. The functional status of the patients was evaluated by Wexner's constipation score (0~30), Wexner's incontinence score (0~20), anorectal manometry, and pudendal nerve terminal motor latency (PNTML). RESULTS: The incidences of rectal prolapse in males (n=22) and in females (n=21) were similar. The age of onset for males was lower (mean standard deviation, 19.6 19.59 (50% in childhood) vs 52.0 20.75 years; p=0.001) and the duration of symptoms was longer (31.5+/-19.87 vs 12.5+/-14.31 years; p<0.001). Surgery in males was most commonly performed during the sexually active years (51.2+/-16.34 vs 64.5+/-13.19; p=0.006). The incidence of mucosal prolapse in males was higher (10/22 vs 4/17; p=0.065). The incidences and the severities of defecation difficulty in males and females were similar (n=12, mean Wexner score=8.4 vs n=12, mean Wexner score=9.9; p=NS) but, the incidences and the severities of fecal incontinence were lower in males (n=4, mean Wexner score=4.3 vs n=17, mean Wexner score= 14.2; p<0.001). The maximum resting pressure was higher in males (39.2+/-21.46 vs 26.3+/-19.98 mmHg; p=0.049), and the maximum squeezing pressure was better preserved (131.2+/-62.63 vs 67.5+/-37.99 mmHg; p<0.001). No significant difference existed in the PNTML. Female patients underwent abdominal resection rectopexy (n=6), perineal rectosigmoidectomy with lavatoroplasty (n=11), and Delorme's procedure (n=4), but all male patients preferred the perineal approach (rectosigmoidectomy with lavatoroplasty (n=8), Delorme's procedure (n=14)) for fear of sexual dysfunction after the abdominal approach. CONCLUSIONS: These findings suggest that the mechanism for developing rectal prolapse in male and female may be different and that surgical treatment should be tailored to the patient.
Age of Onset ; Constipation ; Defecation ; Fecal Incontinence ; Female ; Humans ; Incidence ; Male* ; Manometry ; Prolapse ; Prospective Studies ; Pudendal Nerve ; Rectal Prolapse*