Review of Diabetic Foot Complication Assessment Tools Developed from 2007 to 2016 / 기본간호학회지

PURPOSE@#The purpose of this study was to analyze the attributes and psychometric properties of newly developed diabetic foot complication assessment tools. The attributes of diabetic foot complication assessment tools were evaluated using a systematic review.@*METHODS@#The search terms: “diabetes mellitus” and “foot ulcer” were retrieved using Boolean operators of “and”, “or”, and “not”. The search was limited to articles published between 2007 and 2016. The literature was analyzed by division of methodological characteristics, instrumental characteristics, and item and stratified outcome characteristics.@*RESULTS@#Six assessment tools were found for diabetic foot complications. Only three of the six tools presented the evidence in terms of validity and reliability. In all six tools, “ulcer” was the measured item with the highest frequency, but the contents of items varied. The six identified tools focused on assessing current physical symptoms, but not on predicting diabetic foot complications.@*CONCLUSION@#Preventive foot self-care should be used to predict diabetic foot complications before symptoms appear. Moreover, the reliability and validity of existing tools should be verified in terms of discrimination, prediction, and evaluation.

Reliability and Validity of Korean version of Diabetes Empowerment Scale Short Form / 기본간호학회지

PURPOSE: The purpose of this study was to evaluate the reliability and validity of the Korean version of Diabetes Empowerment Measurement Scale Short Form (DES-SF) for use with diabetic patients in Korea. METHODS: A cross-sectional descriptive study was used with 107 participants. Bilingual nursing professionals performed translation and reverse translation. Reliability and validity such as face validity, construct validity, and concurrent validity were conducted. To assess the concurrent validity, the correlation coefficients between the Korean version of the DES-SF and a concurrent scale (Diabetes Self-Efficacy Scale, DSES) were calculated. RESULTS: In the explanatory factor analysis, a uni-dimension was proposed, the one factor accounted for 49.4% of total variances. The Korean version of the DES-SF correlated with a concurrent variable such DSES for reliability of the Korean version of the DES-SF, Cronbach's α=.85. CONCLUSION: The findings show that the Korean version of the DES-SF is reliable and valid for evaluating empowerment in patients with diabetes in Korea.

Revision of the Measurement Tool for Patients' Health Information Protection Awareness / 대한의료정보학회지

OBJECTIVES: Despite the importance of the protection of patients' health information in clinical settings, little is known about the awareness of this concept in nursing students due to the lack of a suitable measurement tool. Hence, this study attempted to redevelop the Patients' Health Information Protection Awareness Scale, and evaluate its construct validity and reliability for nursing students. METHODS: A cross-sectional descriptive study was conducted. Nursing students who were in their 3rd and 4th year were recruited from 10 universities in Korea to assess the construct validity, and 30 experts (27 nurses and 3 faculty members) participated in the content validation process. RESULTS: The content validity assessment indicated that 23 items were ideal. The assessment of construct validity using exploratory factor analysis revealed three factors: communication, management, and referrals. They together accounted for 54.1% of the variance in scale scores. The three-factor scale had good fit in the confirmatory factor analysis. Scale reliability was confirmed, with a Cronbach's alpha of 0.94 for all items. CONCLUSIONS: This study was the first attempt to redevelop the Patients' Health Information Protection Awareness Scale for student nurses. The 23-item scale was shown to be a reliable and valid tool. It facilitates the assessment of nursing students' awareness of patient information protection. Academic nursing programs and health organizations can use its scores to implement adequate education plans to safeguard information in nursing students.

Hair Shaft Damage from Heat and Drying Time of Hair Dryer

BACKGROUND: Hair dryers are commonly used and can cause hair damage such as roughness, dryness and loss of hair color. It is important to understand the best way to dry hair without causing damage. OBJECTIVE: The study assessed changes in the ultra-structure, morphology, moisture content, and color of hair after repeated shampooing and drying with a hair dryer at a range of temperatures. METHODS: A standardized drying time was used to completely dry each hair tress, and each tress was treated a total of 30 times. Air flow was set on the hair dryer. The tresses were divided into the following five test groups: (a) no treatment, (b) drying without using a hair dryer (room temperature, 20degrees C), (c) drying with a hair dryer for 60 seconds at a distance of 15 cm (47degrees C), (d) drying with a hair dryer for 30 seconds at a distance of 10 cm (61degrees C), (e) drying with a hair dryer for 15 seconds at a distance of 5 cm (95degrees C). Scanning and transmission electron microscopy (TEM) and lipid TEM were performed. Water content was analyzed by a halogen moisture analyzer and hair color was measured with a spectrophotometer. RESULTS: Hair surfaces tended to become more damaged as the temperature increased. No cortex damage was ever noted, suggesting that the surface of hair might play a role as a barrier to prevent cortex damage. Cell membrane complex was damaged only in the naturally dried group without hair dryer. Moisture content decreased in all treated groups compared to the untreated control group. However, the differences in moisture content among the groups were not statistically significant. Drying under the ambient and 95degrees C conditions appeared to change hair color, especially into lightness, after just 10 treatments. CONCLUSION: Although using a hair dryer causes more surface damage than natural drying, using a hair dryer at a distance of 15 cm with continuous motion causes less damage than drying hair naturally.

Secondary Milia Occurring after Bullous Cellulitis / 대한피부과학회지

Milia are small, white to yellow, benign, superficial keratinous cysts. They are divided into primary or secondary cysts. Secondary milia are associated with disease, medication, and trauma. We report a case of a 45 year-old woman with grouped yellowish papules and brownish patches on her left ankle after bullous cellulitis. This case shows that bullous cellulitis may be one of the causes of secondary milia.

A Case of Atrophoderma of Pasini and Pierini Associated with Borrelia burgdorferi Infection Successfully Treated with Oral Doxycycline

Atrophoderma of Pasini and Pierini is a form of dermal atrophy that manifests as either single or multiple, sharply demarcated, hyperpigmented, non-indurated patches. These patches are marked by a slight depression of the skin, with an abrupt edge (i.e., the "cliff-drop" borders), usually located on the backs of adolescents or young adults. The pathophysiology of the disease is unknown, but some authors have suggested a role of Borrelia burgdorferi infection. A 35-year-old woman visited our department because of asymptomatic, hypopigmented, depressed patches on her chest and back lasting for three months. Laboratory evaluations were normal, except for positive serum antibodies to Borrelia burgdorferi. Histologic examination revealed a significantly decreased thickness of the dermis. The patient underwent treatment with oral doxycycline 200 mg/day for six weeks, after which the depth of depression was improved. Herein, we report a case of atrophoderma of Pasini and Pierini, associated with Borrelia burgdorferi infection, successfully treated with oral doxycycline.

Late-Onset Eccrine Angiomatous Hamartoma Associated with a Ganglion Cyst on the Sole of the Foot

Eccrine angiomatous hamartoma (EAH) is a benign, uncommon, combined vascular and eccrine malformation. Most cases of this disorder have been single or multiple nodules or plaques that appear red, yellow, blue, violaceous, or skin colored. EAH may be congenital or appear later in childhood; it rarely arises during puberty or adulthood. A 52-year-old female patient visited our department for tender subcutaneous cystic tumor on the right sole with a one month history. Histopathologic examination confirmed EAH. During excisional biopsy procedure, mucinous discharges were observed which were histopathologically diagnosed as ganglion.

Clinical Improvement of Atopic Dermatitis by a Topical Cream Containing a Protease-Activated Receptor-2 (PAR-2) Inhibitor 'Pal-KTTKS Peptide' / 대한피부과학회지

BACKGROUND: Serine protease promotes desquamatation of the stratum corneum and this is controlled by serine protease inhibitors (SPI). After disruption of the skin barrier, signals for barrier recovery are started with the activation of cytokines and a migration of calcium ions. On the other hand, the protease-activated receptor-2 (PAR-2) pathway is initiated as a negative signal. As the pH of the stratum corneum become neutral, activated serine protease and PAR-2 inhibit the secretion of lamellar bodies and the formation of the lamellar structure. OBJECTIVE: We wanted to screen noble synthetic peptides and identify the efficacy of a selected peptide, Palmitic acid-Lysine Threonine Threonine Lysine Serine (Pal-KTTKS), on PAR-2 in vitro and in vivo, and a clinical study was performed. METHODS: in vitro:Changes of the intracellular calcium ion concentration were measured in cultured HaCaT cells by fluorescence imaging according to treatment with sample peptides and trypsin. in vivo animal study:The efficacy of 2% Pal-KTTKS cream as a selected noble peptide was evaluated in an oxazolone-induced atopic dermatitis animal model. Clinical study:A total of twenty three atopic dermatitis patients applied 2.5% Pal-KTTKS peptide-containing cream on the one side of their extremities and pseudo-ceramide containing moisturizer on the other side of the extremities as a control twice a day for 4 weeks. Clinical improvement was evaluated by the Eczema Area Severity Index (EASI) score, a subject questionnaire and comparison of photographs. RESULTS: Suppression of the intracellular calcium concentration via PAR-2 inhibition was noted in the Pal-KTTKS peptide treated cultured HaCaT cells. In the oxazolone-induced atopic dermatitis hairless mice model, 2% Pal-KTTKS peptide containing lotion was more effective than vehicle lotion only. In the atopic dermatitis patients, the sites treated with 2.5% Pal-KTTKS peptide-containing cream showed better improvement for the EASI score, the subject questionnaire and the clinical photographs as compared to that of the control sites. There were no remarkable side effects related to the treatment. CONCLUSION: A PAR-2 inhibitor-containing topical agent would be an effective and safe modality for treating atopic dermatitis.

A Case of Membranous Lipodystrophy Observed in Lichen Amyloidosis

Membranous lipodystrophy is characterized by the presence of microcysts lined by amorphous, eosinophilic material with an arabesque appearance. We experienced a case of a 72-year-old man who had dark brownish, pruritic papules on the arms, legs, and back. Histopathologic examination of a biopsied lesion showed homogeneous, eosinophilic material in the papillary dermis, as well as membranous lipodystrophy. We report a case of membranous lipodystrophy observed in lichen amyloidosis.

A Case of Relapsing Polychondritis Associated with Scleritis / 대한피부과학회지

Relapsing polychondritis is a rare rheumatologic disorder most commonly presenting as recurring episodes of inflammation in cartilaginous tissues. Auricular chondritis with red ears resembling cellulitisis the most common clinical manifestation. Other manifestations include arthritis, nasal chondritis, and ocular, pulmonary, and cardiovascular disease. Here we report the case of a 54-year-old female patient with relapsing polychondritis and associated scleritis. On histologic examination, the auricle, including cartilaginous tissues, showed loss of the normal basophilia of cartilage and perichondrial infiltration of inflammatory cells. The patient was treated with systemic steroids. Symptoms in both auricles were reduced, scleritis developed, and ocular symptoms were waning.

A Case of Erythema Multiforme in Adults Associated with Mycoplasma pneumoniae Infection / 대한피부과학회지

Erythema multiforme is an acute self-limited, usually mild, and often relapsing mucocutaneous syndrome. This disease is usually related to acute infections, most often a recurrent herpes simplex viral infection or other infectious agents such as Mycoplasma pneumoniae. Mycoplasma pneumoniae infection has been reported to be a cause of bullous erythema multiforme in children and Stevens-Johnson syndrome in young adults. To our knowledge, there has been no report of typical erythema multiforme associated with Mycoplasma pneumoniae infection in adults. We report a case of erythema multiforme associated with acute infection of Mycoplasma pneumoniae in a 30-year-old woman.

A Case of Acquired Dermal Melanocytosis Occurring on the Chest / 대한피부과학회지

Dermal melanocytosis, which is histologically characterized by the presence of dermal melanocytes, is most commonly found in Asians and other darkskinned people. It is observed in various congenital conditions such as the nevus of Ota, the nevus of Ito, the Mongolian spot and the blue nevus, and typically appears at birth or in early childhood. However, several cases that have appeared in adult life have been reported as acquired dermal melanocytosis. Herein, we report a unique case of acquired dermal melanocytosis diffusely affecting the left side of the chest of a 45-year old female. Additionally, a review of Korean literature regarding reported cases of unusual acquired dermal melanocytosis will be presented.

A Case of Pseudolymphoma which Developed after Gold Acupuncture / 대한피부과학회지

Cutaneous pseudolymphoma refers to a heterogeneous group of benign reactive T- or B-cell lymphoproliferative diseases of the skin that resembles cutaneous lymphoma both clinically and histologically. Although most pseudolymphomas develop from unknown causes, various stimuli can induce pseudolymphomas. Pseudolymphomas have developed followed medications, infections, insect bites, ear piercing, and gold. To date, no case of pseudolymphoma developing after gold acupuncture has been reported in the Korean dermatologic literature. We report a case of a 49-year-old female who presented with multiple skin-colored papules on the left lower eyelid that showed features of a pseudolymphoma based on histopathologic assessment.

A Case of Hunter Syndrome / 대한피부과학회지

We report a case of Hunter syndrome in a 4 year old boy, who presented with firm skin colored papules and nodules that coalesce to form a reticular pattern (pebbling of the skin) with extensive Mongolian spots. The lesions are arranged bilaterally and symmetrically over the scapulae, upper arm and lateral aspects of the thighs. He also has low intelligence, coarse face, saddle nose and claw hand contracture of both hands. The result of qualitative analysis of urine was positive for dermatan sulfate and heparan sulfate. And enzyme activity of iduronate-2-sulfatase is decreased in plasma and leukocyte. A skin biopsy specimen section stained with hematoxylin-eosin showed widely separated collagen bundles in the dermis associated with mucin deposition.

Comparision of Effectiveness between the ThinPrep(R) and the Cytospin Preparations of the Repeated Urine Cytology / 대한세포병리학회지

Once diagnosed as "cell paucity" or "atypia" by the cytospin (CS) preparation, this CS preparation does not secure a precise diagnosis by repeated testing alone. Although the ThinPrep(R) (TP) preparation is acknowledged to show increased cellularity, performing the screening tests for the cases that have enough cellularity, according to CS, raises issues for the cost-effectiveness. To obtain a more precise diagnosis through increasing the cellularity by performing TP, we selected the cases that were diagnosed as "cell paucity" or "atypia" by CS, but they required a more precise diagnosis, and the samples were processed via both CS and TP to compare the results. 11 patients diagnosed as "cell paucity" and 22 patients diagnosed as "atypia" by CS participated in this study. When the detection rate of atypical cells in both preparations with repeated urine cytology was compared, the overall detection rate of TP (16cases, 48.5%) was superior than that of CS (11cases, 33.3%), with statistical significance. The cellularity of both preparations was compared on repeated urine cytology; the general cellularity of TP (29cases, 87.9%) was higher than that of CS (20cases, 60.6%), but there was no statistical significance. Particularly, we repeated the TP for the 1 case that was diagnosed as "atypia" and we performed polyoma virus immunohistochemical staining, which confirmed polyoma virus. In conclusion, we can avoid obtaining negative diagnosis from cases with uncertain "atypia" or "cell paucity" by performing repeated TP testing.