BACKGROUND: Recently, the prevalence of colorectal cancer related with metabolic syndrome is increasing in Korea. The aim of this study was to reveal a relationship between components of metabolic syndrome and the development of colon polyp. METHODS: Among the subjects who visited a health promotion center of one university hospital and underwent colonoscopic examination from February 2010 to February 2011, a total of 1,630 (males 1,156, females 474) asymptomatic adults were included for the study. Sex, age, body mass index, waist circumference, blood pressure, fasting blood glucose, total cholesterol, triglyceride, HDL-cholesterol levels and the presence of colorectal polyps were measured. Alcohol consumption, smoking and exercise were assessed by a self-administered questionnaire. Metabolic syndrome was defined by criteria of 2004 American Heart Association/Updated NCEP Adult Treatment Panel III. RESULTS: The prevalence of colon polyps and metabolic syndrome was 21.7% and 16.0% respectively among study subjects. After adjustment for sex and age, metabolic syndrome (odds ratio [OR]=1.72, 95% confidence interval [CI] 1.05-2.82, P=0.031) and waist circumference (OR=1.04, 95% CI 1.01-1.06, P=0.009) were associated with increased risk of colorectal polyps. CONCLUSION: Metabolic syndrome and waist circumference were associated with increased risk of colon polyps in asymptomatic Korean adults.
Adult* ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Colon* ; Colorectal Neoplasms ; Fasting ; Female ; Health Promotion ; Heart ; Humans ; Korea ; Polyps* ; Prevalence ; Smoke ; Smoking ; Triglycerides ; Waist Circumference ; Surveys and Questionnaires

Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature.
Abdomen ; Aged ; Cell Lineage ; Dermis ; Epidermis ; Female ; Humans ; Hyperplasia ; Keratosis ; Lymphocytes ; Middle Aged ; Parakeratosis

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.
Activities of Daily Living ; Dermatology ; Health Expenditures ; Humans ; Quality of Life ; Questionnaires ; Skin ; Warts

BACKGROUND: Although warts are common viral infections of the skin, no single optimal treatment has been determined and most warts are resistant to the current treatment modalities. As a result, many patients suffer from viral warts. Nevertheless, there have been few studies on the patients' quality of life and the economic burden associated with viral warts. Objective: The purpose of this study is to assess the quality of life and the economic burden in the population affected by viral warts by administering a survey questionnaire. METHODS: A questionnaire quoted from the Dermatology life Quality Index was administered to one hundred twenty patients who had viral warts. RESULTS: The data for the quality of life revealed that warts do not particularly affect the patient's daily living activities nor their psychological status. However, the data indicated that the treatment of warts had significantly negative effects on the quality of life of our patients. With regard to treatment satisfaction, many were unsatisfied with 'the pain associated with treatment'. The estimated cost for the treatment of warts was 45,900 won per treatment and the estimated total treatment expenditure of each patient was 236,800 won. CONCLUSION: These results suggest that warts significantly affect the patients' quality of life and especially due to its resistance to treatment and the pain associated with the treatment. Moreover, warts can impose a considerable economic burden.
Activities of Daily Living ; Dermatology ; Health Expenditures ; Humans ; Quality of Life ; Questionnaires ; Skin ; Warts

We evaluated the recent trend in the incidence of premalignant and malignant skin lesions between 1991 and 2006. Among 571,057 newly registered dermatology out-patients from our 8 affiliated university hospitals, 2,598 were diagnosed with a premalignant (899, 0.16%) or malignant skin lesions (1,699, 0.30%). Of 899 premalignant cases, 71.2% were actinic keratosis (AK), and 24.6% were Bowen's disease. Of 1,699 malignant cases, 46.2% were basal cell carcinoma, followed by squamous cell carcinoma (19.1%) and melanoma (7.1%). This 16-yr survey was divided equally into two time periods to compare the incidence of premalignant and malignant skin lesions at different time settings. Between 1991 and 1998, the incidence of cutaneous premalignancy was 0.10% which doubled during 1999-2006. For cutaneous malignancy, the incidence was 0.25% during 1991-1998 and 0.34% in 1999-2006. Incidence of AK among the new outpatients was 0.07% in 1991-1998 which staggered up to 0.15% in 1999-2006. These findings show an increase of both premalignant and malignant skin lesions, AK in particular in the dermatology outpatient-based incidence.

Left cervical lymphadenopathy was found in a 48-year-old Korean female patient who had been treated for breast cancer 3 years ago. A presumative diagnosis was lymph nodal and lung metastasis of breast cancer during chest CT and neck CT. Core needle biopsy was undertaken. Pathological examination of lymph node revealed reactive hyperplasia consistent with toxoplasmosis, and toxoplasma Ig M antibody was also positive. Finally, she was diagnosed as toxoplasmosis, not metastasis of breast cancer. As she had no symptoms, no specific treatment was necessary. Follow up chest and neck CT scan after 5 months later showed resolved lung lesion, and size decrement of cervical lymph node. So, she has no evidence of recurrence and is now under clinical follow up. Recognition that toxoplasmosis can mimic metastasis is important in reaching the correct diagnosis and treatment.
Biopsy, Large-Core Needle ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis ; Recurrence* ; Thorax ; Tomography, X-Ray Computed ; Toxoplasma ; Toxoplasmosis*

Extramammary Paget's disease (EMPD) typically presents as an eczematous, eroded or crusted plaque. Only a few cases with depigmentation have been reported. We herein report a patient with a depigmented scrotal patch as the sole finding of EMPD. Since he had concurrent rectal cancer, we stained the tissue with gross cystic disease fluid protein-15 (GCDFP-15) and cytokeratin 20 (CK20) in order to differentiate primary/secondary EMPD. This case represents coincidental primary EMPD and rectal cancer, of which the initial features of EMPD were unusual.
Adenocarcinoma* ; Cytochrome P-450 CYP1A1 ; Humans ; Keratin-20 ; Paget Disease, Extramammary* ; Rectal Neoplasms*

Approximately 6% of all head and neck skin cancers arise from the external ear, of which squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common. Acquired helical rim defects can be caused by injury or after excision of a tumor. Since many patients feel that the auricle has a functional and cosmetic importance, it is crucial to consider the esthetics. In cases where the defect exposes bare cartilage, second-intention healing is usually not achieved. Therefore, full-thickness skin grafts have been adopted, but the healing time is long and in many cases, mismatch of color between the grafted skin and the surrounding ear has been observed. Alternatively, reconstruction with flaps may provide optimal coverage. Among the many possible flap designs, the rhombic transposition flap has become widely utilized in dermatologic surgery, due to its simplicity and versatility. Herein, we report a case of SCC on the superior helical rim (of which the cartilage was spared) successfully managed with a rhombic transposition flap. The surgical procedure had been relatively simple and the resultant ear helix was free from deformity. In future, we recommend that defects of the ear helix, which have an intact cartilage, should be treated with a rhombic transposition flap to give a successful cosmetic and functional outcome.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Cartilage ; Congenital Abnormalities ; Dermatologic Surgical Procedures ; Ear* ; Ear, External ; Esthetics ; Head ; Humans ; Neck ; Skin ; Skin Neoplasms ; Transplants

BACKGROUND: Due to its less invasive nature and superior visual field, video-assisted thoracoscopic excision of mediastinal mass is thought to be comparable to open thoracotomy. MATERIAL AND METHOD: From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy. RESULT: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2 +/-35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6+/-7.0 minutes, mean postoperative tube stay was 4.2+/-0.4 days, mean postoperative hospital stay was 5.2+/-0.4 days, and mean number of injection of analgesics was 1.9+/-0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of video- assisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. CONCLUSION: As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.
Analgesics ; Chylothorax ; Female ; Humans ; Length of Stay ; Male ; Mediastinal Cyst ; Mediastinal Neoplasms ; Medical Records ; Paralysis ; Pathology ; Patient Discharge ; Phrenic Nerve ; Postoperative Complications ; Retrospective Studies ; Thoracoscopy ; Thoracotomy ; Visual Fields

BACKGROUND: In patients with stage C colon cancer, surgery followed by adjuvant chemotherapy with 5-fluorouracil (5-FU)/leucovorin (LV) is considered to be the standard treatment. However, the objects of adjuvant therapy and the duration of treatment are still matters of controversy. We investigated the effect of dose related factor(delivered total dose of 5-FU per body square meter, actual dose intensity and relative dose intensity) of the adjuvant 5-FU/leucovorin regimen on survival in coloncancer. METHODS: Of the colon cancer patients with Duke's B2 and C stage diseases treated with curative resection from December, 1990 to December, 1996, 139 patients treated with 5-FU/LV as an adjuvant chemotherapy were evaluated. The delivered total dose of 5-FU per body square meter, actual dose intensity and relative dose intensity were obtained. The patients were divided into two groups according to the median value of each factor and the survival rates were compared. RESULTS: The total dose of 5-FU administrated per body square meter had a significant effect on the 5-year disease free and overall survival in stage B2 and C colon cancer patients(B2; p=0.025, p=0.045, respectively, C; p=0.011, p=0.0002, respectively). But survival was not affected by the dose intensity. Multivariate analysis demonstrated that only the total dose of 5-FU administrated per body surface area affected the 5-year disease free and overall survival(p=0.0016, p=0.0007, respectively). CONCLUSION: It can be concluded that the total dose of 5-FU administered is more important than the DI in adjuvant chemotherapy of colon cancer and the total dose of 5-FU had a significant effect on the survival rate in colon cancer patients. To confirm the total dose effect of 5-FU on survival in this study, multi-institutional, prospective randomized studies should be carried out.
Body Surface Area ; Chemotherapy, Adjuvant* ; Colon* ; Colonic Neoplasms* ; Dosage Forms ; Drug Therapy ; Fluorouracil ; Humans ; Leucovorin* ; Multivariate Analysis ; Survival Rate