Purpose: Congenital heart disease (CHD) is a known risk factor for acquired cardiovascular and cerebrovascular diseases. However, available evidence on CHD is limited mostly to Western populations. This study aimed to evaluate the prevalence of vascular events and all-cause mortality in Korean patients with CHD and to further corroborate CHD as a predictor of vascular events and all-cause mortality. Materials and Methods: The claims data of the Korean National Health Insurance Service (NHIS) were retrospectively reviewed. Information regarding diagnostic codes, comorbidities, medical services, income level, and residential area was also collected. Outcomes of interest included stroke, myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE). Results: We included 232203 patients with CHD and 3024633 individuals without CHD as a control group through age- and sexmatched 1:10 random sampling. The prevalences of hypertension, congestive heart failure, ischemic heart disease, hyperlipidemia, and atrial fibrillation were significantly higher in the CHD group, which had a more than two-fold higher incidence of vascular events and all-cause mortality, than in the group without CHD. Multivariable models demonstrated that CHD was a significant risk factor for stroke, MI, all-cause mortality, and MACE. Conclusion In conclusion, this nationwide study demonstrates that Korean patients with CHD have a high incidence of comorbidities, vascular events, and mortality. CHD has been established as an important predictor of cardiovascular events. Further studies are warranted to identify high-risk patients with CHD and related factors to prevent vascular events.

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple's operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.
Hyperplasia ; Pancreas* ; Pancreatectomy ; Pancreatitis* ; Prognosis

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple's operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.
Hyperplasia ; Pancreas* ; Pancreatectomy ; Pancreatitis* ; Prognosis

BACKGROUND: Packs are viscous preparations that produce a film over the skin surface, thus preventing the evaporation of water and increasing the skin temperature. Because of this occlusive effect, packs can be used as the vehicle to which active pharmacologic agents produce a therapeutic effect. OBJECTIVE: This study aimed to explore the feasibility of pack formulation as a vehicle by comparing percutaneous absorption with ointment formulation. METHODS: After 0.5, 1, 2 and 6 hours of topical applications of 0.05% clobetasol 17-propionate ointment and pack on each forearm of 9 young, healthy male subjects, the amounts of the drug in tape-stripped stratum corneum were assessed using high performance liquid chromatography(HPLC). RESULTS: There was no significant difference with regard to the amount of the drug in tape-stripped stratum corneum between ointment and pack formulations of 0.05% clobetasol 17-propionate. CONCLUSION: Pack formulations delivered similar amount of drugs to the skin compared to ointment formulations, suggesting peel-off type pack can be used as a new vehicle of topical corticosteroids.
Adrenal Cortex Hormones* ; Clobetasol ; Forearm ; Humans ; Male ; Skin ; Skin Absorption* ; Skin Temperature

A 42-year-old woman with systemic lupus erythematosus (SLE) has had wide-spread erythemas with some purpuric patches on her trunk and upper extremities during exacerbation of her disease. Biopsy findings from erythematous lesions and purpuric areas revealed the pathology of lupus erythematosus and leukocytoclastic vasculitis (LCV) with immune deposits, respectively. A feature of wide-spread symmetrical erythemas with foci of LCV occurring in this patient is considered to be an unusual presentation.
Adult ; Biopsy ; Erythema* ; Female ; Glycogen Storage Disease Type VI ; Humans ; Lupus Erythematosus, Systemic* ; Pathology ; Upper Extremity ; Vasculitis*

Papular acantholytic dermatosis localized to the anogenital area is clinically characterized by discrete and grouped papules confined to the anogenital area. Histologically, it shows suprabasal acantholysis resembling that observed in familial benign chronic pemphigus or Darier's disease. However, lack of family history and characteristic skin lesions at other body sites help to distinguish it from those conditions. We describe a 53-year-old woman with unusual asymptomatic, grouped papular lesions on the left perianal area, resembling lichen planus, clinically and familial benign chronic pemphigus, histologically. We think the findings of our patient may represent a distinct acantholytic eruption that should be distinguished from other generalized blistering acantholytic dyskeratotic disorders that may also involve the anogenital area.
Acantholysis ; Blister ; Darier Disease ; Female ; Humans ; Lichen Planus ; Middle Aged ; Pemphigus, Benign Familial ; Skin ; Skin Diseases*

Synthetic progesterones have been used to treat menstrual disorders and to prevent habitual or threatened abortion. Recently, they are increasingly used as a part of assisted reproductive technique(ART) for the infertility related to the luteal insufficiency. Cutaneous reactions related to progesterone are rare and only isolated cases of autoimmune progesterone dermatitis have been described. We report, here in, a case of drug-induced progesterone dermatitis which was proved by positive skin test to intradermal progesterone.
Abortion, Threatened ; Dermatitis* ; Female ; Infertility ; Pregnancy ; Progesterone* ; Skin Tests

Hypertrophic discoid erythema is a clinical variant of chronic cutaneous lupus erythematosus (CCLE) found most often in association with the more classical lesions of discoid erythemas. We report two cases of CCLE with hypertrophic discoid erythemas occurred on the arms; a rare form of cutaneous lesion of CCLE.
Arm ; Erythema* ; Humans ; Lupus Erythematosus, Cutaneous*

PURPOSE: To evaluate the efficacy and toxicity of oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic colorectal cancer who previously treated with 5-FU-based chemotherapy. MATERIALS AND METHODS: Between April 1999 and January 2001, thirty-two patients were enrolled in this study. Oxaliplatin 130 mg/m2 was given intravenously (IV) on day 1 as was 5-FU 500 mg/m2 IV followed by continuous infusion of 5-FU 3,000 mg/m2 and LV 100 mg/m2 for 48 hours administered every 3 weeks. Six patients had received 5-FU as an adjuvant setting and 26 patients as a palliative regimen. RESULTS: The median age of the patients was 50 years (range; 19-69) and the dominant sites of metastasis were the liver, lung or both in 9, 5 and 2 patients respectively. In 30 evaluable patients, the overall response rate was 27% including 1 complete response and 7 partial responses. The median response duration was 28 weeks (95% confidence interval; 22~34 weeks) and the median progression free survival of all patients was 24 weeks (95% confidence interval; 15~33 weeks). A median 5 cycles (range; 2~9) and total 155 cycles were performed in 32 patients. 150 cycles were evaluable for toxicity. The most common hematologic toxicity was grade 1~2 anemia in 78 cycles (52%). Leukopenia (39%) and thrombocytopenia (23%) were fully reversible. The most common non-hematologic toxicity was nausea/vomiting (43/30%) followed by diarrhea (23%), hepatotoxicity (21%) and neurotoxicity (21%). One patient ceased therapy due to grade 4 diarrhea. No other severe toxicity interrupted this treatment. CONCLUSION: Oxaliplatin, 5-FU and LV in combination showed significant activity in previously treated metastatic colorectal cancer with favorable toxicity.
Anemia ; Colorectal Neoplasms* ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Leucovorin* ; Leukopenia ; Liver ; Lung ; Neoplasm Metastasis ; Thrombocytopenia

PURPOSE: To establish the feasibility of high dose ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by autologous stem cell transplantation (ASCT) in patients with high-risk or metastatic breast cancer. MATERIALS AND METHODS: High-risk breast cancer is defined as 10 or more involved axillary lymph nodes (n=3) or stage III (n=2). Patients with metastatic cancer have relapsed diseases after curative resection (n=10) or initially metastatic lesion (n=1). Colony stimulating factor with either cyclophosphamide or combination chemotherapy was administered to mobilize the stem cells. High dose chemotherapy consisted of ifosfamide 16 g/m2, carboplatin 1.8 g/m2, and etoposide 0.75 g/m2 (dose I) and later modified to ifosfamide 12 g/m2, carboplatin 1.35 g/m2, and etoposide 1.2 g/m2 (dose II). RESULTS: The median duration of grunulocyte nadir (<500/ microliter) was 11 (10~17) days and platelet transfusion dependency (<20,000/ microliter) was 11 (7~53) days in 14 patients who achieved engraftment. One out of 5 patients with high-risk breast cancer relapsed after high dose therapy. Two patients remain disease-free at 18th and 40th months. Two among the 4 patients treated with dose I died due to treatment-related complications. The responses of metastatic diseases to ICE chemotherapy were 1 continuing CR, 1 CR, 1 PR, 4 SD and 3 PD in 10 evaluable patients. CONCLUSION: High dose ICE chemotherapy, especially dose II and ASCT were feasible in high-risk or metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Carboplatin* ; Colony-Stimulating Factors ; Cyclophosphamide ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide* ; Humans ; Ice ; Ifosfamide* ; Lymph Nodes ; Platelet Transfusion ; Stem Cell Transplantation* ; Stem Cells*