OBJECTIVES: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. METHODS: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. RESULTS: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. CONCLUSION: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.
Adult ; Aged ; Humans ; Hygiene ; Independent Living ; Primary Health Care ; Sleep Initiation and Maintenance Disorders ; Treatment Outcome

No abstract available.
Child* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Tendons*

Pseudoxanthoma elasticum is a multiorgan disorder, characterized by ectopic mineralization of elastic fibers of skin, eyes, and cardiovascular system. The dermatologic manifestations include laxity of skin, as well as cutis laxa-like wrinkling especially on both axillae. The classic forms of pseudoxanthoma elasticum are due to mutations in the ATP-binding cassette subfamily C member 6 (ABCC6) gene, a presumed transmembrane transporter expressed primarily in the liver and the kidneys. Recent case reports of mutations of gamma-glutamyl carboxylase (GGCX) gene describe associations with vitamin K-dependent coagulation factor deficiency and pseudoxanthoma elasticum as well. A 23-year old woman presented with laxity on both axillae and trunk and a history of vitamin K-dependent coagulation factor deficiency, diagnosed 2 years ago. Fragmented and markedly degenerated elastic fibers with calcium deposition were identified on biopsy specimens. Herein, we report a case of autosomal recessive pseudoxanthoma elasticum combined with vitamin K-dependent coagulation factor deficiency.
Axilla ; Biopsy ; Blood Coagulation Factors ; Calcium ; Carbon-Carbon Ligases ; Cardiovascular System ; Elastic Tissue ; Eye ; Female ; Genes, vif ; Humans ; Kidney ; Liver ; Pseudoxanthoma Elasticum ; Skin ; Vitamins

No abstract available.
Alopecia ; Humans ; Male

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Squamous Cell ; Epidermis ; Genitalia ; Genitalia, Male ; Male ; Paget Disease, Extramammary ; Pluripotent Stem Cells ; Skin

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Squamous Cell ; Epidermis ; Genitalia ; Genitalia, Male ; Male ; Paget Disease, Extramammary ; Pluripotent Stem Cells ; Skin

BACKGROUND: Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis. OBJECTIVE: The objective of this study was to assess the reliability of intra-laboratory and inter-laboratory data at three commercial laboratories conducting hair mineral analysis, compared to serum mineral analysis. METHODS: Two divided hair samples taken from near the scalp were submitted for analysis at the same time, to all laboratories, from one healthy volunteer. Each laboratory sent a report consisting of quantitative results and their interpretation of health implications. Differences among intra-laboratory and interlaboratory data were analyzed using SPSS version 12.0 (SPSS Inc., USA). RESULTS: All the laboratories used identical methods for quantitative analysis, and they generated consistent numerical results according to Friedman analysis of variance. However, the normal reference ranges of each laboratory varied. As such, each laboratory interpreted the patient's health differently. On intra-laboratory data, Wilcoxon analysis suggested they generated relatively coherent data, but laboratory B could not in one element, so its reliability was doubtful. In comparison with the blood test, laboratory C generated identical results, but not laboratory A and B. CONCLUSION: Hair mineral analysis has its limitations, considering the reliability of inter and intra laboratory analysis comparing with blood analysis. As such, clinicians should be cautious when applying hair mineral analysis as an ancillary tool. Each laboratory included in this study requires continuous refinement from now on for inducing standardized normal reference levels.
Hair ; Hematologic Tests ; Minerals ; Reference Values ; Scalp

Temporal triangular alopecia is a triangular or oval shaped non-scarring alopecia, occurring on the temporal side of a scalp. Although surgical excision or hair transplantation has been known to be an effective therapy for this condition, so far only a few case reports have proved their usefulness. A 27-year-old male patient presented with a history of congenital hair loss affecting left frontotemporal area which persisted after simple excision done 10 years ago. We transplanted 270 follicular units into the alopecic patch using follicular unit hair transplantation method. About 75% of alopecic patch was covered with newly grown hairs 15 months after hair transplantation and the patient was satisfied with the result. Herein, we report a case of temporal triangular alopecia which underwent both simple excision and hair transplantation, which provides information about the benefit and loss for each procedure.
Adult ; Alopecia* ; Hair* ; Humans ; Male ; Scalp ; Transplantation*

Inflammatory linear verrucous epidermal nevi (ILVEN) were first described in the literature, in 1971, by Altman and Mehregan. Most cases were reported as solitary lesions. In contrast, systematized ILVEN, involving wide areas of the integument, has only rarely been reported. A variety of treatment modalities has been reported, ranging from topical medications, such as potent corticosteroids or tretinoin 0.1% to variable procedures, including CO2 and pulsed dye laser, cryotherapy, and surgical excision. However, multifocal skin lesion is more difficult to treat. An 8-year old boy was presented with an extensive thick scaly plaques and patches, affecting the trunk and the four extremities sparing face. It developed when he was 3 years old, and he complained pruritus. On physical examination, linear, or whirl-like scaly plaques were seen, along with Blaschko lines. Pathologic finding was in accordance to ILVEN. We treated him with topical calcipotriol, tacrolimus and systemic acitretin. After 8 months, the lesion and symptoms improved.
Acitretin ; Adrenal Cortex Hormones ; Calcitriol ; Cryotherapy ; Extremities ; Lasers, Dye ; Nevus ; Nevus, Sebaceous of Jadassohn ; Physical Examination ; Pruritus ; Skin ; Tacrolimus ; Tretinoin

Collagenous fibroma is a recently described rare benign tumor that mainly affects those in the fifth through seventh decades. It is a painless solitary mass, which grows slowly for more than 6 months, up to 20 cm. Several cases were reported chromosomal rearrangements with a breakpoint at 11q12. Histopathologically, it shows well-circumscribed mass that consists of scattered stellate cells in hypovascular collagenous matrix without atypia or mitosis. Management method is excision with functional preservation. In Korea, only two cases of collagenous fibroma have been reported so far. A 69-year-old woman was presented to our clinic with two painless well-demarcated hard masses, 4.5x4.5 and 4.5x2.5 cm in size, on both anterior superior iliac spine. Traumatic injury or a previous event was not noticed by the patient. After histopathologic examination, those masses were diagnosed as collagenous fibroma.
Aged ; Collagen ; Female ; Fibroma ; Humans ; Korea ; Mitosis ; Spine