PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.
Adult ; Aged ; Autoimmune Diseases/*epidemiology/immunology ; Comorbidity ; Diabetes Mellitus, Type 1/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance ; Prevalence ; Republic of Korea/epidemiology ; Socioeconomic Factors ; Thyroid Diseases/epidemiology ; Vitiligo/*epidemiology

BACKGROUND: It was previously thought that persons with genetic predispositions to vitiligo develop the condition after exposure to various precipitating environmental factors. However, in many cases, the aggravating factors of vitiligo have not been clearly identified. OBJECTIVE: To identify the aggravating factors of vitiligo in the working environment and daily life. METHODS: A total of 489 vitiligo patients were recruited from 10 institutions in South Korea; patients were provided with a questionnaire about environmental factors and behavior patterns in the workplace and in daily life, and their association with vitiligo. RESULTS: Ninety-five of the 470 enrolled patients (20.2%) answered that environmental risk factors in daily life and in the workplace affected the development of vitiligo. The most frequently attributed causes were trauma and burn (13.6%), followed by sunlight (12.8%), stress (12.8%), cleaning products/disinfectant/chemicals (4.9%), and hair dye (2.1%). CONCLUSION: Vitiligo of the hand and foot was associated with frequent exposure to aggravating materials and overexposure to sunlight, along with frequent trauma of these areas, all of which could be considered important risk factors of vitiligo. The development of vitiligo could potentially be controlled through the early detection of aggravating factors.
Burns ; Foot ; Genetic Predisposition to Disease ; Hair ; Hand ; Humans ; Korea ; Occupations* ; Risk Factors ; Sunlight ; Vitiligo* ; Surveys and Questionnaires

BACKGROUND/AIMS: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea. METHODS: We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained. RESULTS: 7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy. CONCLUSIONS: Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor.
Adult ; Aged ; Biopsy ; Dyspepsia/etiology ; Eosinophilia/epidemiology/*pathology ; Esophagitis/epidemiology/*pathology ; Female ; Humans ; Incidence ; Incidental Findings ; Male ; Middle Aged ; Regurgitation, Gastric/etiology ; Retrospective Studies

Angiography is a useful diagnostic tool in cases with massive gastrointestinal bleeding such as angiodysplasia and varicosis when endoscopy is not available. Angiodysplasia and varicosis have distinguishable characteristic features on angiography, such as the presence of a nidus, visible late-draining veins, and the typical vascular tuft. We recently treated a rare case of congenital angiodysplasia without the characteristic angiodysplasia features on angiography. Instead, the patient presented with a very rare case of idiopathic jejunal varicosis. A 42-year-old woman visited the emergency room with the chief complaint of melena for three days and a hemoglobin level of 5.9 g/dL. An abdominal CT angiogram showed varicosis at the jejunal mesentery. Angiography of the superior and inferior mesenteric arteries showed tortuous and dilated jejunal and ileal branches during the venous phase, suggesting a vascular malformation such as varicosis of the jejunum. Surgical exploration with intraoperative endoscopy revealed diffuse engorged veins and a 1.0-cm-diameter superficial ulcer covered with a blood clot that was 70 cm from the ligament of Treitz. A 100-cm segment of jejunum was resected. Histological examination revealed that the lesion was angiodysplasia, not varicosis. The final diagnosis was congenital angiodysplasia.
Adult ; Angiodysplasia ; Angiography ; Emergencies ; Endoscopy ; Female ; Hemoglobins ; Hemorrhage ; Humans ; Jejunum ; Ligaments ; Melena ; Mesenteric Artery, Inferior ; Mesentery ; Ulcer ; Vascular Malformations ; Veins

PURPOSE: We evaluated the expressions of hTERT, Ki-67 and p53 in patients who underwent a curative resection for hepatic colorectal metastasis to see if there was any relationship of these immunohistochemical analyses with the disease free survival. METHODS: Patients who underwent a curative resection for hepatic colorectal metastasis, between 1995 and 2003, were analyzed. For each patient, the clinical prognostic score was derived from the patient's sex, age, tumor size and lymph node status, and serum CEA level. Tumor specimens were analyzed for Ki-67, hTERT and p53 using standard immunohistochemical techniques. RESULTS: The study included 23 patients: 9 and 12 survived without disease for less and more than 12 months, respectively. Ki-67, hTERT (labeling indexes greater than or equal to 50%) and p53 positivities (labeling indexes greater than or equal to 10%) were observed in 5, 17 and 11 patients, respectively. CONCLUSION: In patients undergoing resection of hepatic colorectal metastasis, the expressions of Ki-67, hTERT and p53 did not correlate with the disease free survival.
Colorectal Neoplasms ; Disease-Free Survival ; Hepatectomy ; Humans ; Humans* ; Liver* ; Lymph Nodes ; Neoplasm Metastasis* ; Telomerase*

Signet ring cell carcinoma of lung is an unique variant of mucin producing adenocarcinoma which is characterized by abundant intracellular mucin accumulation. Only a few cases of primary signet ring cell carcinoma of lung have been reported in the world wide literature. And we have, recently experienced one case of primary signet ring cell carcinoma of lung. A 55 years old man was evaluated for paralysis of lower extremities and was found to have lung cancer in the left upper and lower lobe with pleural, multiple spinal, bone and liver metastases. Signet ring tumor cells were revealed by cytologic examination of pleural fluids. And there were no evidence of signet ring cell carcinoma of other organs. Primary signet ring cell carcinoma of lung seems to have an aggressive behavior and therapeutic modalities could be different from those for signet ring cell carcinomas from other organs. Therefore it is important to separate primary signet ring cell adenocarcinoma of lung from metastatic tumors.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Humans ; Liver ; Lower Extremity ; Lung Neoplasms ; Lung* ; Middle Aged ; Mucins ; Neoplasm Metastasis* ; Paralysis

BACKGROUND: Osteogenesis imperfecta (OI) is a congenital disorder of type I collagen, with variable phenotypes, due to increased bone fragility and low bone mass. Previous pharmacological treatments for OI have been attempted with calcitonin and growth hormone but with little beneficial effects. Recently, Glorieux reported the beneficial effects of bisphosphonates in OI. METHODS: In this study, the effects of pamidronate treatment were evaluated in 9 patients with OI. All patients received intravenous pamidronate infusions, which was dose adjusted according to the patients' age. The outcome measures included the biochemical bone markers; serum alkaline phosphatase, urine deoxy-pyridinoline, urine Ca/Cr ratio, and bone mineral density (BMD). RESULTS: Serum alkaline phosphatase, urine deoxypyridinoline, and urine Ca/Cr ratio were slightly decreased after 1 year of therapy, although these changes were not statistically significant. The BMDs of the lumbar spine and proximal femur were significantly increased after 1-year of pamidronate treatment. No fractures were reported during the 1 year treatment periods. CONCLUSION: Pamidronate treatment had an effect on the BMD in osteogenesis imperfecta, probably due to decreasing bone resorption
Alkaline Phosphatase ; Bone Density ; Bone Resorption ; Calcitonin ; Collagen Type I ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diphosphonates ; Femur ; Growth Hormone ; Humans ; Osteogenesis Imperfecta* ; Osteogenesis* ; Outcome Assessment (Health Care) ; Phenotype ; Spine

Microscopic polyangiitis is a systemic small-vessel vasculitis that is primarily associated with necrotizing glomerulonephritis and pulmonary capillaritis. Lung involvement is characterized by a diffuse alveolar hemorrhage. However, rarely central nervous system involvement has been reported to be occurred with the microscopic polyangiitis. Relapse of microscopic polyangiitis are reported to be more frequent than those of polyarteritis nodosa, often after a reduction or discontinuation of the therapy. We would like to report two patients with microscopic polyangiitis. One presented with clinical manifestations of both lung and central nervous system involvements and the other was a case of recurrence during steroid tapering following the steroid pulse therapy.
Antibodies, Antineutrophil Cytoplasmic ; Central Nervous System ; Glomerulonephritis ; Hemorrhage ; Humans ; Lung ; Microscopic Polyangiitis* ; Polyarteritis Nodosa ; Recurrence ; Vasculitis ; Vasculitis, Central Nervous System

Mesoblastic nephroma is a neoplasm of the kidney which is characterized by interlacing bundles of spindle mesenchymal cells. It is usually diagnosed during the first six months of life and is mostly benign. Incidence in adults is exceedingly rare. In most cases, only total excision is required without postoperative adjuvant therapy, and the rare cases of local recurrence have usually been related to incomplete removal. However, mesoblastic nephroma may behave aggressively, in contrast to a congenital mesoblastic nephroma. Several cases of metastatic mesoblastic nephroma have been previously described. We report herein a case of a 42-year-old woman with mesoblastic nephroma which recurred as a large metastatic lung mass seven years after the nephrectomy. The patient presented with chest wall discomfort for four days. Seven years previously, total nephrectomy had been performed because of a right renal tumor which had been diagnosed as a mesoblastic nephroma. There had been no evidence of recurrence for five years, after which she discontinued follow-up. On readmission two years later, chest X-ray and CT scan revealed a large lung mass in the left upper lobe. It was completely excised and the pathologic examination was identical with that of the original renal tumor. Synovial sarcoma was excluded because the fusion transcripts of the SYT-SSX fusion gene associated with the t(X;18) translocation were negative. The final diagnosis was a lung metastasis of mesoblastic nephroma and the patient remained free of disease for 7 months postoperatively.
Adult ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Lung* ; Neoplasm Metastasis* ; Nephrectomy ; Nephroma, Mesoblastic* ; Recurrence ; Sarcoma, Synovial ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: This study was done to analyze the treatment outcomes of adult lymphoblastic lymphoma patients according to the risk groups and the treatment regimens. METHODS: The analysis was performed on twenty patients histologically diagnosed as lymphoblastic lymphoma at Seoul National University Hospital. The high-risk group was defined as patients with Ann Arbor stage IV with bone marrow, central nervous system (CNS) involvement or initial serum lactate dehydrogenase level more than 1.5 times upper normal limits. Twelve patients received dose-intensive Stanford/Northern California Oncology Group (NCOG) regimen consisted of four phase of induction, CNS prophylaxis, consolidation, and maintenance. Eight patients received conventional dose regimen, either six courses of vincristine, bleomycin, cyclophosphamide, doxorubicin, prednisolone, procarbazine (COPBLAM-V) or cyclophosphamide, vincristine, doxorubicin, prednisolone, L-asparaginase (CHOP/L-ASP) with CNS prophylaxis. We analyzed the response rate and the survival rate according to the risk groups and treatment regimens. RESULTS: The overall response rate was 90% (75% complete response). In low-risk group, the complete response (CR) rate was 100% irrespective of treatment regimen. In high-risk group, conventional dose regimen did not produce CR. Four of the six high-risk patients receiving dose-intensive regimen achieved CR. The 5-year overall survival (OS) rate was 52% in total patients. The 5-year OS rate were 77% and 30% for low- and high-risk group, respectively (P=0.242). In low-risk group, conventional dose regimen showed similar survival outcomes compared with that of dose intensive regimen. Toxicity profile was more favorable in the patients with conventional dose regimens. CONCLUSION: For low-risk patients, conventional dose regimen showed similar effect in comparison with dose-intensive regimen. However, for high-risk patients, CR was observed only with dose-intensive regimen. Multi-center clinical trials are necessary to confirm our observation.
Adult ; Male ; Female ; Humans