Background: The prevalence of psoriasis differs by population, and it appears to be more common among Europeans than in East Asians. Recent genome-wide association studies (GWAS) have identified alleles that increase the risk of psoriasis, and these alleles may present different frequencies in different geographic regions. Objective: We aimed to gain insights into the causes of differences in disease frequencies according to populations and the factors affecting prevalence and pattern differences. Methods: We collected a total of 147 psoriasis-associated single-nucleotide polymorphisms (SNPs) from the GWAS catalog and compared the allele frequency differences in 27 populations using public population frequency in the 1000 Genomes Project phase 3 (n=2,504) and the Korean Reference Genome Database (n=1,722). Additionally, we calculated the composited genetic risk scores across the population groups. Results: There were distinct patterns of allele frequencies in different population groups.In many cases, East Asians exhibited allele frequencies opposite to that of Europeans. The genetic risk score was higher in Europeans (average: 0.487) and Americans (average: 0.492) than in East Asians (average: 0.471). The prevalence of psoriasis correlated with the average genetic risk score of the population. Conclusion We observed a difference in the allele frequencies of psoriasis-associated SNPs between the studied populations. This result suggests that the difference in the prevalence of psoriasis between population groups can be interpreted to some extent by the genotype.

Fibrofolliculoma is a benign perifollicular connective tissue tumor that usually occurs in the face. Most fibrofolliculoma present as multiple lesions and typically occur with trichodiscomas and acrochordons, constituting the Birt-Hogg-Dube syndrome. Solitary fibrofolliculoma is nonhereditary and unassociated with other cutaneous abnormalities. A 72-year-old man visited our clinic complaining of a solitary umbilicated nodule on the antitragus of the left ear. Skin biopsy from the lesion showed a central dilated follicular infundibulum with anastomosing bands of follicular epithelium extending into the fibrous stroma. The diagnosis of a solitary fibrofolliculoma was made based on the clinical and histopathological findings. No signs of lesion recurrence for 1 year after shave removal were noted. We report a rare case of solitary fibrofolliculoma that occurred on the antitragus of the ear.

Nivolumab is a fully-humanized IgG4 monoclonal antibody that competitively binds to the programmed cell death receptor-1 protein (an immune check-point molecule) present on activated T cells. Nivolumab is approved for the treatment of advanced melanoma, lung cancer, and renal cell carcinoma. It attenuates the inactivation of cytotoxic CD8+ T cells and, produces an antitumor effect; however it may be associated with immune-related adverse events, including the development of lichen planus (LP). A 72-year-old man presented with a 2-month history of multiple, polygonal, purplish papules on the dorsal aspect of both hands. He was diagnosed with large cell neuroendocrine carcinoma (LCNEC) of the lung 4 years earlier and was treated with nivolumab (3 mg/kg every 2 weeks) for 9 months. By the 14th course of nivolumab therapy, the patient developed multiple rashes on the dorsal aspect of both hands, and biopsy was consistent with findings of LP. We report a rare case of LP in a patient with lung cancer treated with nivolumab.
Aged ; Biopsy ; Carcinoma, Neuroendocrine ; Carcinoma, Renal Cell ; Cell Death ; Exanthema ; Hand ; Humans ; Immunoglobulin G ; Lichen Planus ; Lichens ; Lung Neoplasms ; Lung ; Melanoma ; T-Lymphocytes

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is the first report of paradoxical air embolism associated with patent foramen ovale during percutaneous nephrolithotomy.
Adult ; Diverticulum/surgery ; Embolism, Air/*etiology ; Embolism, Paradoxical/*etiology ; Foramen Ovale, Patent/complications/surgery ; Humans ; Intraoperative Complications/*etiology ; Male ; Nephrostomy, Percutaneous/*adverse effects

PURPOSE: The sensitivity of antegrade pyelogram (AGP), plain film radiography (KUB) and non-contrast, thin cut abdomen computerized tomography (CT) were prospectively compared for the detection of residual stones following a percutaneous nephrolithotomy. MATERIALS AND METHODS: Fifty patients (53 renal units), who had undergone a percutaneous nephrolithotomy for radiopaque renal pelvis stone, as well as a non-contrast abdomen CT 1 month postoperatively, were prospectively evaluated. The number and size of residual fragments, as determined by immediate postoperative AGP, postoperative 1 month KUB and abdomen CT, were compared. RESULTS: The stone-free rates according to the AGP, KUB and non-contrast CT were 73.6 (39/53), 62.3 (33/53) and 20.8% (11/53), respectively. In terms of clinically insignificant residual fragments (CIRFs), the success rates were 84.9 (45/53), 83.0 (44/53) and 41.5% (22/53), respectively. With respect to the residual stones (22 cases), which were detected by CT, but not by KUB, 45.5% (10 cases) were more than 4mm in size on CT, with a mean size of 7.4mm. The sensitivity for the detection of residual fragments was 47.6% for KUB compared to 100% for non-contrast CT. Seven patients received additional extracorporeal shock wave lithotripsy (ESWL) for residual stones following CT. CONCLUSIONS: Non-contrast, thin cut abdomen CT is the most accurate imaging modality for determination of the stone-free rate following a PCNL. Non-contrast abdomen CT gives accurate information for the selection of patients who may benefit from additional ESWL treatment and for follow-up planning.
Abdomen ; Follow-Up Studies ; Humans ; Kidney Calculi ; Kidney Pelvis ; Lithotripsy ; Nephrostomy, Percutaneous* ; Prospective Studies ; Radiography ; Shock ; Tomography, X-Ray Computed

Purpose: The treatment outcome of endopyelotomy is now being re-evaluated in the era of laparoscopic pyeloplasty. This study was performed to evaluate the long-term success rate of an endopyelotomy for the treatment of an ureteropelvic junction obstruction (UPJO). Materials and Methods: Between January 1995 and December 2003, 77 patients with an UPJO (mean age 35.2+/-13.89) underwent 85 endopyelotomies, with a percutaneous approach in 10 and a retrograde approach in the other 75 cases. The mean number of the procedure was 1.14, with 69 patients undergoing a single procedure. Endopyelotomies were performed using either a cold knife (n=26), Ho:YAG laser (n=47) or a hook electrode (n=12). Treatment success was defined as symptomatic relief, with radiographic resolution or stabilization of renal function in the excretory and/or diuretic renograms. A Kaplan-Meier curve of the long-term success was generated, and the preoperative hydronephrosis and renal function correlated with the success rate. Results: With a median follow-up of 37.1 months (3-98), the overall success rate was 67.5%. The median time to failure was 7.7 months (1-50). The Kaplan-Meier estimates of success were 87.8, 76.9, 72.2, 68.7, 64.8 and 61.6% at 1, 12, 18, 24, 36 and 60 months, respectively. The success rate was not significantly affected by the etiology, the approach and the incisional methods. The degree of hydronephrosis and renal function showed no significant correlation with the success rate. Conclusions: The success rates of an endopyelotomy decreased with increasing follow-up period. In our conclusion, a long-term follow-up, at least as long as 36 months, is mandatory in patients having undergone an endopyelotomy for an ureteropelvic junction obstruction, although the majority of failures were found within 1 year.
Electrodes ; Endoscopy ; Follow-Up Studies ; Humans ; Hydronephrosis ; Treatment Outcome ; Ureter ; Ureteral Obstruction

PURPOSE: Because metastatic renal cell carcinoma responds to various forms of therapy with low remission rates, safe therapeutic agents is urgently needed. Ceramide is a potent and specific suppressor of cell growth and an inducer of apoptosis via an intracellular mediation of the sphingomyelin cycle. The present study was designed to assess the growth inhibitory effects and their mechanisms of C2-ceramide and C6-ceramide in renal cell carcinoma cells. MATERIALS AND METHODS: A standard microculture tetrazolium(MTT) assay was used to measure the cytotoxicity of C2-ceramide and C6-ceramide in renal cell carcinoma cell line A498. Apoptosis was confirmed by DNA fragmentation assay using agarose gel and TdT-mediated biotin-dUTP nicked-end labelling(TUNEL) technique. C2-ceramide and C6-ceramide were injected to the A498 tumor which was formed after A498 cells were implanted subcutaneously in athymic mice. Growth inhibitory effects of ceramides were examined biweekly. RESULTS: The survival fractions of A498 cells were 92.6+/-6.0, 82.8+/-14.0, 66.4+/-11.3, 41.8+/-9.6 and 24.3+/-6.3% for the concentrations of C2-ceramide 2, 4, 6, 8 and 10microM, repectively. IC50 of C2-ceramide was approximately 6.7microM. The survival fractions of A498 cells were 60.9+/-5.0, 23.4+/-3.0, 8.7+/-2.1, 5.0+/-1.2 and 3.3+/-0.6% for the concentrations of C6-ceramide 2, 4, 6, 8 and 10microM, respectively. IC50 of C6-ceramide was about 2.3microM. There were DNA fragmentations in A498 cells treated with C2-ceramide or C6-ceramide on the agarose gel and apoptotic tumor cells were also identified after treatment of C2-ceramide and C6-ceramide in TUNEL method. In in vivo study using athymic mice, the growth of A498 tumors was significantly suppressed by C2-ceramide and C6-ceramide. In vivo tumor suppressive effect was more prominent with C6-ceramide than with C2-ceramide. There`s no toxicity-related death of ceramide-treated athmic mice for 3 months. CONCLUSIONS: C2-ceramide and C6-ceramide have the growth inhibitory effects in human renal cell carcinoma cell line A498 by apoptosis mechanism in vitro and they have the in vivo tumor suppressive effects in athymic mice. C6-ceramide was more effective than C2-ceramide in both in vitro cytotoxicity test and in vivo animal experiment of growth inhibition. Therefore, ceramides may be used to treat metastatic renal cell carcinoma in the future.
Animal Experimentation ; Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Cell Line ; Ceramides* ; DNA ; DNA Fragmentation ; Humans ; In Situ Nick-End Labeling ; Inhibitory Concentration 50 ; Mice ; Mice, Nude ; Negotiating ; Sepharose

PURPOSE: TUNA is a new minimally invasive treatment modality for the patients with benign prostatic hyperplasia of prostate utilizing low levels of radiofrequency energy. We presented our early experiences of TUNA for the treatment of BPH to evaluate its clinical outcome. MATERIALS AND METHODS: From July 1995 to March 1997, 36 patients were treated with TUNA(15 with manual system, 21 with automatic system). Mean age of the patients was 63.5 years. All patients were evaluated preoperatively with PSA, AUA symptom score, uroflowmetry and transrectal ultrasonography(TRUS). AUA symptom score at 1, 3, 12 month and uroflowmetry at 1, 3 month postoperatively were available for analysis. RESULTS: Mean PSA value was 3.4ng/ml and mean prostate volume by TRUS was 35.5gram preoperatively. Nine out of 36 procedures were performed with local anesthesia. Mean operating time was 45.6 minutes. At postoperative 3 and 12 month, symptom score was improved from 22.0+/-1.5 to 11.7+/-1.6 and 11.0+/-1.9(p<0.05), respectively and maximal flow rate was increased from 11.2+/-0.7ml/sec to 14.4+/-1.5ml/sec at postoperative 3 month(p<0.05). Results have been far better since using automatic system. Complications were observed in one patient with clot retention and in 11 patients with postoperative urinary retention. CONCLUSIONS: TUNA is a simple, safe, efficacious and minimally invasive treatment procedure with short hospital stay, less morbidity for treatment of the patients with BPH. It could also be performed with local anesthesia. We suggest that TUNA would be a new promising treatment modality for BPH.
Anesthesia, Local ; Humans ; Hyperthermia, Induced ; Length of Stay ; Needles* ; Prostate ; Prostatic Hyperplasia ; Tuna ; Urinary Retention

PURPOSE: The interest has been growing in the investigation and management of lower urinary tract symptoms, but their prevalence in the general population has so far been based on the estimates made in selected groups of women in Korea. The object of this study was to determine the prevalence of stress urinary incontinence and bladder irritative symptoms of women in rural region in Korea through a community based survey. Also, we investigated the relationship between age, parity, oral contraception, smoking, menopause and obesity and the prevalence of stress urinary incontinence. MATERIALS AND METHODS: A questionnaire survey was performed in a sample of randomly selected 1162 women aged 30 years and over, in 31 villages in the town of Jeong-Eup, Korea. From February 4th to February 22nd, 1997, trained field workers visited every home and interviewed every eligible individual with the questionnaires, which included data on stress urinary incontinence, bladder irritative symptoms, quality of life, reproductive and menstrual history, and use of oral contraceptives. Among 1162 women, 857 responded to questionnaires, and 827 questionnaires were available for analysis. The response rate was 73.5%. The prevalence of stress urinary incontinence was defined as the proportion of the women in the population surveyed who experienced stress urinary incontinence at least twice a week. We defined diurnal frequency as the episodes of voiding again within 2 hours after initial voiding in the series of 5 consecutive voidings during one month period. The urgency was defined as she found it difficult to hold urination, once or more in the series of 5 consecutive voidings and nocturia twice or more per night. RESULTS: The prevalence of stress urinary incontinence was 20.4%. Only seven(4.1%) women carried a sanitary towel or diaper as protection against urinary leakage. The prevalence of stress incontinence among age groups revealed no significant difference. Statistically significant correlation was noted between obesity and the prevalence of stress incontinence. Diurnal frequency was recorded by 375 women(45.3%); 171(20.6%) experienced this symptom more than three times. Urgency was reported by 268 women(32.4%) and 63(7.6%) were always troubled by this symptom. Nocturia 3 times or more every night was recorded by 341 women(42.2%) and 83(10.0%) had nocturia 5 times or more. The severity of nocturia increased significantly with age. CONCLUSIONS: The prevalence of stress urinary incontinence and irritative symptoms in this study is similar to previous studies performed in other countries while the rate of nocturia is much higher in this study. Although stress urinary incontinence and bladder irritative symptoms are relatively common in this community, only few people are seeking for care of these symptoms. Therefore, it is very important to educate the public and promote awareness of this medical problem in this community.
Contraception ; Contraceptives, Oral ; Female ; Health Personnel ; Humans ; Jeollabuk-do ; Korea ; Lower Urinary Tract Symptoms ; Menopause ; Nocturia ; Obesity ; Parity ; Prevalence* ; Quality of Life ; Surveys and Questionnaires ; Smoke ; Smoking ; Urinary Bladder* ; Urinary Incontinence* ; Urination