ABSTRACT
Immune checkpoint inhibitor (ICI), including programmed cell death protein 1 and cytotoxic T-lymphocyte-associated protein 4 inhibitors, has emerged as a pillar in the management of advanced malignancies. A drug-induced sarcoidosis-like reaction (DISR) is a rare cutaneous adverse event of ICI. A 47-year-old male presented with one-month history of a solitary erythematous nodule on his forehead. He had been diagnosed with metastatic adenocarcinoma of the lung and was treated with nivolumab and ipilimumab for three months. Histological findings revealed multinucleated giant cells forming non-caseating granulomas with moderate peripheral lymphocyte infiltration in the dermis. Also, new hilar lymphadenopathy of the lung was identified in a systemic evaluation. Given the temporal relationship with ICI treatment, the final diagnosis was ICI-induced sarcoidosis-like reaction. To our knowledge, this is the first report of a case of DISR that developed following ICI treatment in the dermatologic literature in Korea.
ABSTRACT
Hypertriglyceridemia is an important cause of acute pancreatitis, and its symptoms are similar to those of pancreatitis of other causes. Moreover, the possibility of recurrence renders accurate diagnosis critical, and treatment, lifestyle modifications, and education should be performed simultaneously. For treatment during the acute phase of the disease, insulin or plasmapheresis can be combined with modalities used for acute pancreatitis of other causes; fibrate administration is recommended. In addition, hypertriglyceridemia-induced acute pancreatitis requires daily management, such as continuous administration of lipid-lowering agents, and lifestyle modifications are needed even after completion of acute-phase treatment.
ABSTRACT
Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
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Background/Aims@#Stress is closely related to the deterioration of digestive disease. Melatonin has potent anti-inflammatory properties. The objective of this study was to determine the effect of water stress (WS) and sleep deprivation (SD) on intestinal microbiota and roles of melatonin in stressful condition. @*Methods@#We used C57BL/6 mice and specially designed water bath for stress and SD for 10 days. We measured melatonin concentrations in serum, feces, and colon tissues by high-performance liquid chromatography. Genomic DNA was extracted from feces and amplified using primers targeting V3 to V4 regions of bacterial 16S ribosomal RNA genes. @*Results@#Compared to the control, melatonin concentration was lower in the WS and SD. Fecal concentration was 0.132 pg/mL in control, 0.062 pg/mL in WS, and 0.068 pg/mL in SD. In colon tissue, it was 0.45 pg/mL in control, 0.007 pg/mL in WS, and 0.03 pg/mL in SD. After melatonin treatment, melatonin concentrations in feces and colon tissue were recovered to the level of control. Metagenomic analysis of microbiota showed abundance in colitogenic microbiota in WS and SD. Melatonin injection attenuated this harmful effect. WS and SD showed decreased Lactobacillales and increased Erysipelotrichales and Enterobacteriales. Melatonin treatment increased Akkermansia muciniphila and Lactobacillus and decreased Bacteroides massiliensis and Erysipelotrichaceae. @*Conclusions@#This study showed that stress and SD could affect intestinal dysbiosis and increase colitogenic microbiota, which could contribute to the aggravating digestive disease. Melatonin concentrations in feces and colon tissue decreased under WS and SD. Melatonin treatment brought recovery of melatonin concentration in colon tissue and modulating dysbiosis of intestinal microbiota.
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Background/Aims@#Although the diarrheal disease caused by Campylobacter bacteria has been continuously increasing in Korea, there has been limited study on the clinical aspects of Campylobacter enteritis in adults in Korea. The purpose of this study was to analyze the clinical features and characteristics of adult patients with Campylobacter enteritis. @*Methods@#This retrospective study included patients diagnosed with Campylobacter enterocolitis at Nowon Eulji University Hopsital between January 2016 and December 2017. Campylobacter enterocolitis was diagnosed through polymerase chain reaction of stools from patients with acute diarrhea. @*Results@#Among 630 hospitalized patients with acute diarrhea, Campylobacter enterocolitis was diagnosed in 88 patients (14.0%). The mean age was 37.9±19.1 years. Campylobacter enterocolitis was most prevalent in the summer (52 patients, 59.1%). Patients exhibited more than 10 times of diarrhea in 36 (40.9%), high fever above 39℃ in 19 (21.59%), and abdominal pain above 5 points on the numeric rating scale in 23 (26.14%) cases. In abdominal CT scan, pancolitis was found in 58 patients (65.9%). Small intestine was involved in 37 patients (42.4%). Mean CRP was 10.14 mg/dL (range 0.72-32.27 mg/dL). The duration of diarrhea after antibiotics treatment was 2.34±1.51 days in the ciprofloxacin treatment group and 2.26±1.71 days in the 3rd cephalosporin treatment group. @*Conclusions@#Campylobacter enterocolitis was common during summer. Commonly healthy young adults were hospitalized due to severe symptoms of Campylobacter enterocolitis. Whole colon and small bowel were frequently involved. Most patients were treated with antibiotics, and the efficacy of 3rd cephalosporin treatment was not inferior to that of ciprofloxacin treatment.
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Background@#Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. @*Objective@#We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. @*Methods@#An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). @*Results@#Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. @*Conclusion@#Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure.
ABSTRACT
Hypertriglyceridemia is an important cause of acute pancreatitis, and its symptoms are similar to those of pancreatitis of other causes. Moreover, the possibility of recurrence renders accurate diagnosis critical, and treatment, lifestyle modifications, and education should be performed simultaneously. For treatment during the acute phase of the disease, insulin or plasmapheresis can be combined with modalities used for acute pancreatitis of other causes; fibrate administration is recommended. In addition, hypertriglyceridemia-induced acute pancreatitis requires daily management, such as continuous administration of lipid-lowering agents, and lifestyle modifications are needed even after completion of acute-phase treatment.
ABSTRACT
Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
ABSTRACT
The purpose of the present study was to examine the relationship between the form of the clinical crowns in the maxillary anterior segment and the clinical feature of gingiva such as morphological characteristics and the gingival thickness. Fifty periodontally healthy subjects were clinically examined regarding the probing depth, the thickness of the free gingiva, and the width of the keratinized gingiva. From study models of the maxillary anterior region, the width at cervical third(CW) and the length(CL) of the clinical crown, the papillary height, and the gingival angle of the 6 anterior teeth were measured. Each tooth was classified into 4 groups (long-narrow, NL; narrow, N; wide, W; short-wide, WS) according to CW/CL ratio and all the data were compared between groups NL and WS using independent t-test. Stepwise multiple regression analysis was performed for each tooth region with the gingival thickness at the level of sulcus bottom, the width of keratinized gingiva, and gingival angle as the dependent variables. As the results, the NL group of the upper anterior teeth displayed, higher papilla height, and narrower keratinized gingiva, more acute gingival angle resulting in pronounced "scalloped" contour of the gingival margin, compared to the WS group. There was no significant difference between groups NL and WS with respect to probing depth and the gingival thickness. The regression analyses demonstrated that the gingival thickness in central incisors was significantly associated to the mesio-distal width and bucco-lingual width of the crown, and labial probing depth. The width of keratinized gingiva was significantly associated with labial probing depth in central incisors and with proximal probing depth and gingival angle in lateral incisors, and with labial and proximal probing depth, and gingival angle in canines. The gingival angle was significantly associated with papillary height and CW/CL ratio and additionally with proximal probing depth in central incisors, with the width of keratinized gingiva in lateral incisors, and with labial probing depth and the width of keratinized gingiva in canines. These results indicate that the form of clinical crown in upper anterior region could influence the clinical feature of gingiva and the influencing factors might be different according to the tooth region.
ABSTRACT
BACKGROUND AND OBJECTIVES: Vascular brachytherapy for stent restenosis has been demonstrated to reduce restenosis and major adverse cardiac events (MACE). However, the angiographic and clinical outcomes after beta-radiation, using a 166Holmium (Ho)-DTPA filled balloon, has not been sufficiently evaluated. SUBJECTS AND METHODS: Between March 2002 and August 2003, 78 consecutive patients (mean age 50 yrs, 53 male) with in-stent restenosis were randomly enrolled for either cutting balloon angioplasty only (control group, n=38) or in combination with vascular brachytherapy using a 166Ho-DTPA filled balloon (brachytherapy group, n=40). The radiation dose applied was 18 Gy, at a depth of 1.0 mm from the vascular lumen. RESULTS: The treated vessels comprised of 50 left anterior descending arteries (64.1%), 23 right coronary arteries (29.5%) and 5 circumflex arteries. The mean radiation dose and time were 375+/-67.8 mCi/ml and 191+/-76 seconds, respectively. Six cases were fractionated. The mean lesion length was 18.2+/-7.9 mm, with no difference between the 2 groups. Eight month follow-up coronary angiography revealed a restenosis rate of 17.1% (6/35) in the brachytherapy group vs. 39.3% (11/27) in the control group (p=0.042). However, there was no difference in the 1 year MACE. CONCLUSION: In patients with in-stent restenosis, vascular brachytherapy, using a 166Ho-DTPA filled balloon, showed favorable angiographic outcomes at the 8 month follow-up compared to the control group.
Subject(s)
Humans , Angioplasty , Angioplasty, Balloon , Arteries , Brachytherapy , Coronary Angiography , Coronary Restenosis , Coronary Vessels , Follow-Up Studies , StentsABSTRACT
PURPOSE: Current epidemiologic study indicates that the incidence of breast cancer has increased in Korea. However, significantly more women will develop benign breast disease during their adult lives. Even though benign breast disease is not life threatening, it can cause patient discomfort, anxiety, and fear. This study evaluates the safety, efficacy, and patient acceptance of an ultrasound guided vacuum-assisted mammotome (UVAM) in percutaneous total removal of benign breast lesions. METHODS: From Aug. 2002 to Feb. 2003, 106 sonographically benign breast lesions (up to 2.5 cm in size) of 86 patients underwent total removal under local anesthesia using 11-guage or 8-guage UVAM needles. Ultrasonographic follow-up evaluation was performed at 14 days post operation to assess the residual lesions and complications. RESULTS: UVAM allows total removal of benign breast lesions that are up to 2.5 cm in size and no residual lesions were found in follow-up breast sonogram for any of the patients. Forty-one patients (47.7%) were younger than 40. The pathologists classified the majority of removed lesions as fibroadenoma (52.9%) or fibrocystic changes (34.9%). Most complications were mild or moderate. Among the complications such as hematoma, pain, and skin dimpling, hematoma was most common and resolved spontaneously without additional intervention. All of the patients were satisfied with this procedure. CONCLUSION: Percutaneous excision of benign breast lesions using UVAM is feasible, safe, and yields high patient satisfaction. Long-term efficacy is being evaluated in an ongoing study.
Subject(s)
Adult , Female , Humans , Anesthesia, Local , Anxiety , Breast , Breast Diseases , Breast Neoplasms , Fibroadenoma , Follow-Up Studies , Hematoma , Incidence , Korea , Needles , Patient Satisfaction , Skin , UltrasonographyABSTRACT
Though ultrasonogram has many advantages, including no ionizing radiation, the non-invasive character of procedure, the rapidity of study and economy, it is used for complementing modality yet due to the in accuracy of image. Previously in our department of Urology, the report on "A Study on Measurement of Kidney Size by Ultrasonography in Normal Kidney and Hydronephrosis of Korean Adults" had been published. It is an important indicator to measure the renal size and parenchymal depth accurately for indicator of nephrectomy. The author measured the size of the kidney longitudinally, transversely and parenchymal depth by ultrasonogram and computerized tomography (CT) compared with that of excretory urogram in 22 kidneys without hydronephrosis and 15 kidneys with hydronephrosis. In the same method, the kidney was measured by ultrasonogram and CT compared with postoperative specimen in 5 nonvisualized kidneys. The results were obtained as follows 1. Among the 22 kidneys without hydronephrosis, the length and width of the kidney on ultrasonogram (11.2 ( 0.67cm, 5.7( 0,58cm) were very similar to CT (11. 1 ( 0.53cm, 5.5( 0.54 cm) . Among the 9 kidneys with hydronephrosis, the size of the kidney on ultrasonogram were similar to CT 2. Among the 22 kidneys without hydronephrosis, the parenchymal depth of the kidney on ultrasonogram (2.0 ( 0.66cm) was smaller than on CT (2.4 (0.47cm) and the difference was 0.4cm. Among the 9 kidneys with hydronephrosis, the difference was 0.3cm. 3. In comparison with 5 kidneys of the specimen, the length and width of the kidney on ultrasonogram and CT were similar to the specimen. The parenchymal depth of the kidney on CT was similar to the specimen( mean error rate 7 29 (0.18% , correlation coefficient 0.97, P <0.005) but ultrasonogram was much different from the specimen (mean error rate 19.99 ( 6.45% , correlation coefficient 0.94, P <0.005) . By reviewing the above results, CT is more informative and accurate in evaluation of the renal size and parenchymal depth than other modalities, such as excretory urogram or ultrasonogram.
Subject(s)
Complement System Proteins , Hydronephrosis , Kidney , Nephrectomy , Radiation, Ionizing , Ultrasonography , UrologyABSTRACT
A clinical observation was made on 10 patients with aberrant renal vessels who had been admitted to the Department of Urology, Ewha Woman's University Hospital during the period from Apr. 1976 to Sept. 1983. The following results were obtained. 1. Conservative treatment and periodical observation were done in 2 cases of aberrant renal vessels of both mild hydronephrosis with intermittent flank pain. 2. Left renal ptosis combined with moderate hydronephrosis revealed in I case of aberrant renal vessels, only nephropexy was done. 3. Right UPJ stricture combined with renal pelvis stone revealed in 1 case of aberrant renal vessels, right pyelolithotomy and nephropexy were done. 4. Horseshoe kidney combined with right renal pelvis stone was treated with isthmectomy, right pyelolithotomy and nephropexy in 1 case of aberrant renal vessels. 5. In 5 cases, RGP revealed UPJ stricture combined with marked hydronephrosis and aberrant renal vessels were discovered during operation. Dismembered pyeloplasty in 3 cases and nephrectomy in 2 cases of severe hydronephrosis were done.
Subject(s)
Humans , Constriction, Pathologic , Flank Pain , Hydronephrosis , Kidney , Kidney Pelvis , Nephrectomy , UrologyABSTRACT
Before nephrectomy three patients with hypernephroma underwent occlusion of the renal arteries with Gelform via selective catheterization. This technique facilitated nephrectomy, decreased blood loss and prevented the dissemination of tumor cells or septic emboli from organ manipulation. Reduction of the vascular bed of the tumors shortened operative time and simplified the procedure. We report three cases with review of literature.
Subject(s)
Humans , Carcinoma, Renal Cell , Catheterization , Catheters , Nephrectomy , Operative Time , Renal ArteryABSTRACT
Patient with urethral syndrome constitute by far the largest percentage of women in the urologist' office. Many have already to its prevalence but also to the frustration in therapy for both patient and doctor. Anatomic obstruction in the urethra of these women has been widely reported as a etiology by bougie-a-boule calibration and also by uroflowmetry. So we applied internal urethrotomy to reduce urethral resistance in urethral syndrome patient. Because there is no clear-cut best treatment there are many different modalities available to treat urethral strictures. Nearly all strictures can be cured by aggressive treatment with urethroplasty but these methods often involve multiple stages and considerable patient inconvenience. One technique used to treat urethral strictures with a minimum of morbidity is internal urethrotomy. We herein report our experience with internal urethrotomy for the treatment of urethral stricture in men and urethral syndrome in women. Of 41 urethral syndrome treated by internal urethrotomy, 24 patients were followed and 18 patients of them were cured. Of 9 urethral stricture patients in men, 6 patients werecured completely and 2 patients needed periodic dilatation.
Subject(s)
Female , Humans , Male , Calibration , Constriction, Pathologic , Dilatation , Frustration , Prevalence , Urethra , Urethral StrictureABSTRACT
We experienced a case with benign recurrent hematuria in a 13-year-old boy. He had 5 times of gross hematuria during past four years. There was no abnormal findings on physical examination. He had normal renal function. However the renal biopsy specimen revealed IgA deposits in mesangium under immunofluorescent stain. A brief review of related literatures is also presented.
Subject(s)
Adolescent , Humans , Male , Biopsy , Hematuria , Immunoglobulin A , Physical ExaminationABSTRACT
Lupus nephritis is one of complication of systemic lupus erythematous involving many organ systems. And the incidence of renal involvement is about 80%. Principal site of renal injury is glomerulus, and immune complex and complements are deposited in mesangium, basement membrane capillary loops of the glomerulus in lupus nephritis. Histopathologically, 4 distinct forms of renal injury may be seen such as minimal form, focal segnemtal proliforative form, membranous form and diffuse proliferative form. The treatment of lupus nephritis requires steroid and immunosuppresive drugs, but the prognosis varies according to the types of renal lesion, and the time of therapy. Recently we had the opportunity to observe 2 cases of lupus nephritis at this hospital whose clinical and histopathological features were consistent with criteria criteria for the disease. Inspite of conservative treatment and steroid therapy, one case died, the other was discharged in grave condition.
Subject(s)
Antigen-Antibody Complex , Basement Membrane , Capillaries , Complement System Proteins , Incidence , Lupus Nephritis , PrognosisABSTRACT
A case of infantile polycystic kindney disease confirmed by computerired tomoraphy in a newborn female infant was reported with a brief review of references.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Polycystic Kidney DiseasesABSTRACT
Two hundred and thirteen cases of acute poisoning who were admitted in pediatric wards of Severance Hospital and Won ju Christian Hospital from April, 1966 to March, 1976 (10 years) were statistically analyzed and compared it with the statistical study of same hospitals from April, 1956 to March, 1966 (10 years). 1. Incidence of poisoning was 1.2% of all admitted cases. Severance Hospital and Won ju Christian Hospital were corresponding to 0.9% and 2.0% of all pediatric admitted patients respectively 2. Sex incidence was more higher in boys than girls, The highest incidence (39%) was noted in the 1 to 4 year age group. 3. Seasonal incidence was more prevalent in summer months. (form June to August) 4. Fortyseven kinds of various poisonous substances were observed to be causative. The most common causative was insecticide (made for aggricultual use) which was 52% of all cases. (Severance Hospital: 37%, Won ju Christian Hospital: 76%). Drug (23%), CO gas (8.5%) and rodenticide (5%) were the next common causative agnts. 5. Poisoning of accidental cause was frequent (69%) than therapeutic and suicidal purpose, which were 26% and 6% respectively. 6. Mortality rate was 8% and insecticide was the most common cause of death. 7. There was no statistically significant difference between the past study and this study which were performed from two same hospitals in sex incidence, age incidence, seasonal distribution, motivations of poisoning, duration from poisoning to arrival to emergency room and mortality rate. In the past study the most common causative substance was CO gas in Severance Hospital and insecticide in Won ju Christian Hospital. In this study insecticide become the most common causative substance in both hospitals and the incidence was significantly increased than the past. Drug was second common causative agent. Lye was markedly decreased poisoning to compare with past study. Incidence of patients who were treated at the other clinic was increased from 14% to 33%.
Subject(s)
Female , Humans , Infant , Cause of Death , Emergency Service, Hospital , Incidence , Lye , Mortality , Poisoning , Seasons , Statistics as TopicABSTRACT
The clinical studies were performed on 757 patients who had been admitted to Severance Hospital from May, 1964 to June, 1975 with the diagnosis of congenital heart disease. The following results were obtained; 1. Among 757 patients, cardiac catheterization was performed on 367 patients. 2. Four hundred and thirty eight patients were male and 319 were female. Over half of them were below two years of age, but among 357 cardiac catheterized patients, 137 (37.3%) patients were ranged between 6 to 10 years. 3. V.S.D., Tetralogy of Fallot, P.D.A., A.S.D. were found in order of frequency. 4. Among 757 patients, combined extra-cardiac anomalies were found in 42 patients, and 14 patients were with Downanjx syndrome. 5. Among 367 cardiac catheterized patients, 164 (44.7%) patients had cardiac operations, and among these, 18 (11.0%) patients died including 7 patients of Tetralogy of Fallot.