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testing revealed that the patient was positive for HLA-DRB1*04, HLA-DRB1*12, HLA-DQB1*03, andHLA-DQB1*04. To the best of our knowledge, this is the first case of fulminant T1DM reported to occurimmediately after COVID-19 infection.
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BACKGROUND: Simvastatin belongs to the statin family, whose members have immunomodulatory activities. Ezetimibe have synergetic effects when co-administered with simvastatin. In several case reports, alopecia totalis and alopecia universalis were successfully treated with simvastatin/ezetimibe, suggesting that this combination could be a new efficient therapy for recalcitrant alopecia areata (AA). OBJECTIVE: To verify the efficacy of the simvastatin/ezetimibe combination therapy for recalcitrant AA and investigate the relationship between various treatment responses and prognostic factors. METHODS: This prospective open study was performed in patients with recalcitrant AA with the bald surface exceeding 75%. All patients took simvastatin (40 mg) and ezetimibe (10 mg) daily. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy. RESULTS: Of 14 enrolled patients, 4 patients (28.6%) were judged as responders showing regrowth of 30% to 80% after 3 months of treatment. The mean age of onset in non-responders was significantly lower than in responders. The total score of prognostic factors, calculated as a sum of factors related to poor prognosis, was much lower in responders than in non-responders. CONCLUSION: The remission rate in this study was unsatisfactory. However, since the recruited patients had not responded to any other treatments for AA, simvastatin/ezetimibe can still be considered as an alternative treatment for recalcitrant AA. The total scores of the prognostic factors were statistically different between responders and non-responders. These results can be used to predict the outcome of treatment with simvastatin/ezetimibe and anticipate prognosis.
Subject(s)
Humans , Age of Onset , Alopecia Areata , Alopecia , Ezetimibe , Hair , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Prognosis , Prospective Studies , SimvastatinABSTRACT
Syringoid eccrine carcinoma (SEC) is a rare cutaneous malignant tumor thought to be derived from eccrine sweat apparatus. It is usually present in the head, neck and trunk region, and often occurs in the fourth to seventh decades of life. A 94-year-old male patient visited our department with an 80-year history of a lesion showing a 2×2 cm sized well-demarcated round shaped erythematous to pinkish colored nodule with ulcer on his left thigh. Histological findings revealed a tumor consisted mainly of numerous small cords and nests forming luminal or tubular structures and tumor cells showing variable atypia. Some ductal structures showed tadpole appearance. On immunohistochemical staining, epithelial membrane antigen, S-100, cytokeratin 7 and carcinoembryonic antigen were reactive and Ki-67 showed less than 10% positivity. Based on these findings, the final diagnosis was made as SEC. The patient was treated with local wide excision and didn't show any recurrence during the follow-up period of 12 months. Herein, we report a very rare case of SEC which occurred on the left thigh and discuss 10 cases of SEC presented on the extremities, including our case.
Subject(s)
Humans , Male , Carcinoembryonic Antigen , Diagnosis , Extremities , Follow-Up Studies , Head , Keratin-7 , Larva , Mucin-1 , Neck , Phenobarbital , Recurrence , Sweat , Sweat Gland Neoplasms , Thigh , UlcerABSTRACT
Epithelioid blue nevus is a rare variant of blue nevus that has been recently described in patients with the Carney complex. However, sporadic cases have been reported even without the Carney complex. It typically presents as an asymptomatic, blue-gray, smooth-surfaced macule or papule occurring most often on the extremities and trunk. However, a few cases occurring on the mucosa have been reported. A 21-year-old man presented with a 0.4-cm sized solitary dark brownish or black papule on the lower lip. On histological examination, the major part of the specimen showed an infiltration of intensely pigmented epithelioid cells, the rest was composed of mildly pigmented spindle cells. There was no junctional activity, necrosis, or cellular atypia. These findings were consistent with epithelioid blue nevus. The patient did not exhibit any features associated with the Carney complex. No evidence of recurrence was observed during the follow-up period of 24 months. Herein, we report a rare case of epithelioid blue nevus arising on an unusual site.
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Humans , Young Adult , Carney Complex , Epithelioid Cells , Extremities , Follow-Up Studies , Lip , Mucous Membrane , Necrosis , Nevus, Blue , RecurrenceABSTRACT
Angioleiomyoma is a rare benign tumor arising from vascular smooth muscle which commonly develops on the lower extremities of middle-aged women. It is rare to occur on the fingers. Angioleiomyoma is classified into three histological subtypes; solid, venous and cavernous. The solid type is most common but the cavernous type is very rare. We report a case of a 53-year-old female with a digital cavernous angioleiomyoma. The patient had a 2-year history of an asymptomatic and slowly enlarging 1.3x1.0 cm-sized subcutaneous nodule on the distal phalanx of her second left finger. Histopathologic examination showed a well-demarcated nodular tumor in the dermis, which composed of numerous, dilated vessels and bundles of smooth muscle fibers.
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Female , Humans , Angiomyoma , Caves , Dermis , Fingers , Lower Extremity , Muscle, Smooth , Muscle, Smooth, VascularABSTRACT
Tinea incognito is a dermatophytosis of atypical clinical manifestation due to improper use of topical or systemic corticosteroids. We report two cases of tinea incognito misdiagnosed as eczema by non-dermatologist physicians. First, the lesions were manifested by pruritic, scaly localized erythematous macules and patches on the left ankle in a 61-year-old woman. She had been treated with topical steroids for 1 month without improvement. KOH smear revealed multiple fungal hyphae and histopathologic examination revealed the presence of fungal hyphae in the stratum corneum. Second, the lesions were manifested by localized scaly erythematous patches with pruritus on the face in a 76-year-old woman. She had been also treated with topical steroids for 2 months. KOH mount was positive for hyphae. All two patients were treated with 250 mg of terbinafine daily for 2 weeks and topical flutrimazole application. The lesions improved one month after treatment and no recurrence was observed.
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Aged , Female , Humans , Middle Aged , Adrenal Cortex Hormones , Ankle , Eczema , Hyphae , Pruritus , Recurrence , Steroids , TineaABSTRACT
PURPOSE: The present study examined the positive-thinking and life satisfaction of the general Korean population. In particular, we examined the role of positive-thinking on participants' life satisfaction. MATERIALS AND METHODS: We conducted a telephone survey of 409 respondents (194 males, 215 females). The participants provided self-reports on their positive thinking, life satisfaction and demographic information. ReESULTS: The results showed that age, education, occupation, and family income had an influence on positive- thinking as well as life satisfaction in Korea. Specifically, younger respondents and persons with high incomes or higher education degrees were more likely to have higher positive scores and thus higher life satisfaction scores. However, after controlling for the demographic variables, positive thinking significantly affected life satisfaction(R(2) Change=0.170, F= 88.56, p < 0.001). CONCLUSION: We provided empirical evidence that positive thinking may indeed play a significant role in life satisfaction. Therefore, positive thinking would offer important direction for the growth of life satisfaction and interventions aiming to remediate the effects of demographic variables on life satisfaction.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Analysis of Variance , Attitude , Educational Status , Income , Interviews as Topic , Korea , Occupations , Personal Satisfaction , Quality of Life/psychology , Surveys and Questionnaires , Thinking/physiologyABSTRACT
PURPOSE: The present study examined the positive-thinking and life satisfaction of the general Korean population. In particular, we examined the role of positive-thinking on participants' life satisfaction. MATERIALS AND METHODS: We conducted a telephone survey of 409 respondents (194 males, 215 females). The participants provided self-reports on their positive thinking, life satisfaction and demographic information. ReESULTS: The results showed that age, education, occupation, and family income had an influence on positive- thinking as well as life satisfaction in Korea. Specifically, younger respondents and persons with high incomes or higher education degrees were more likely to have higher positive scores and thus higher life satisfaction scores. However, after controlling for the demographic variables, positive thinking significantly affected life satisfaction(R(2) Change=0.170, F= 88.56, p < 0.001). CONCLUSION: We provided empirical evidence that positive thinking may indeed play a significant role in life satisfaction. Therefore, positive thinking would offer important direction for the growth of life satisfaction and interventions aiming to remediate the effects of demographic variables on life satisfaction.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Analysis of Variance , Attitude , Educational Status , Income , Interviews as Topic , Korea , Occupations , Personal Satisfaction , Quality of Life/psychology , Surveys and Questionnaires , Thinking/physiologyABSTRACT
OBJECTIVES: This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). METHODS: The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-IV. RESULTS: Notable modifications were done in sex-related expression, health system and help-seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. CONCLUSION: The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.
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Humans , Diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Epidemiology , Phobic Disorders , Psychology , Reproducibility of ResultsABSTRACT
OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.