Clinical Features and Awareness of Hand Eczema in Korea.

BACKGROUND: Hand eczema is one of the most common skin disorders and negatively affects quality of life. However, a large-scale multicenter study investigating the clinical features of patients with hand eczema has not yet been conducted in Korea. OBJECTIVE: To identify the prevalence of various hand diseases, which is defined as all cutaneous disease occurring in hands, and to investigate the clinical features of patients with hand eczema and the awareness about hand eczema in the general population and to compare the prevalence of hand eczema between health care providers and non-health care providers. METHODS: To estimate the prevalence of hand diseases, we analyzed the medical records of patients from 24 medical centers. Patients were assessed by online and offline questionnaires. A 1,000 from general population and 913 hand eczema patients answered the questionnaire, for a total of 1,913 subjects. RESULTS: The most common hand disease was irritant contact dermatitis. In an online survey, the lifetime prevalence of hand eczema was 31.2%. Hand eczema was more likely to occur in females (66.0%) and younger (20~39 years, 53.9%). Health care providers and housewives were the occupations most frequently associated with hand eczema. Winter (33.6%) was the most common season which people experienced aggravation. The 63.0% and 67.0% answered that hand eczema hinders their personal relationship and negatively affects daily living activities, respectively. CONCLUSION: Hand eczema is a very common disease and hinders the quality of life. The appropriate identification of hand eczema is necessary to implement effective and efficient treatment.

A case of motor neuropathy after cryolipolysis of the arm.

Cryolipolysis treatment is a non-invasive option for localized fat reduction without damaging the surrounding tissue. Clinical studies about cryolipolysis show various side effects, including temporary erythema, bruising, and transient numbness. But, no reports are available on motor nerve malfunction after cryolipolysis. A 24-year-old female received cryolipolysis treatment on abdomen, both arms. After 10 days, patient complained of weakness and inability to lift heavy objects. Symptoms continued for 6 months, and fully recovered without treatment. Thus, we report a case of motor neuropathy after cryolipolysis, which is a rare complication of cryolipolysis.

How stress triggers itch: a preliminary study of the mechanism of stress-induced pruritus using fMRI.

BACKGROUND: Itch is one of the most prevalent and familiar nociceptions in humans and can result in impaired quality of life. The central processing of itch is known to be important in perceptions of itch and strategies for coping with it, and various triggers have been reported to be associated with patterns of brain activation in pruritus. Stress is known to be an important aggravating factor in itch, but the precise mechanism by which brain activation results in stress-induced pruritus remains elusive. METHODS: Using functional magnetic resonance imaging (fMRI), we attempted to evaluate if stress-induced pruritus is associated with the activation of certain areas of the brain. Furthermore, we investigated whether sedating antihistamines are more effective than non-sedating antihistamines in decreasing stress-induced pruritus. Memories of stressful events followed by visual stimuli using a series of pictures depicting fearful and stressful conditions, mixed with neutralizing pictures, were used to evoke pruritus. RESULTS: The hippocampus and subcortical structures were found to be involved in stress-associated pruritus. Interestingly, sedating antihistamines were involved in the deactivation of brain regions associated with the relief of itch by active scratching, which suggests that sedating antihistamines may mitigate pruritus by instigating patterns of brain activity similar to those induced by scratching behavior. CONCLUSIONS: Itch scratching reflects a complicated pattern of brain activity. Activation of the hippocampus appears to be involved in stress-associated pruritus, and sedating antihistamines may work in a manner similar to that of scratching behavior. To our knowledge, this is the first study to evaluate brain functioning in relation to stress-induced pruritus.

Safety and Efficacy of Rice Bran Supercritical CO2 Extract for Hair Growth in Androgenic Alopecia: A 16-Week Double-Blind Randomized Controlled Trial.

We conducted a 16-week double-blind randomized controlled single-center trial to evaluate the safety and efficacy of dermal rice bran supercritical CO2 extract (RB-SCE) in the treatment of androgenic alopecia. Fifty alopecia patients were randomly assigned to the experimental and placebo groups. The experimental group received a dermal application of 0.5% RB-SCE (8 mL/d) to the head skin for 16 weeks while the control group received a dermal application of placebo. Changes in hair count, diameter, and density were evaluated with a Folliscope(®). Patient satisfaction was evaluated via questionnaire and clinical photographs were rated by dermatologists. The results showed that RB-SCE significantly increased hair density and hair diameter in male subjects. Patient satisfaction and the evaluation of photographs by dermatologists also confirmed the effectiveness of RB-SCE in the treatment of alopecia. No adverse reactions related to RB-SCE were reported. Therefore, RB-SCE shows promise for use in functional cosmetics and pharmaceuticals.

Delayed Orbital Hemorrhage around Alloplastic Implants after Blowout Fracture Reduction.

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

VersaJet Hydrosurgery System: an effective device for flap deepithelialization.

Many instruments and techniques to reduce time and effort for deepithelialization have been described, but they are time-consuming and labor-intensive. The VersaJet Hydrosurgery System (Smith Nephew, Hull, United Kingdom) has gained widespread acceptance and use for fast, selective, and easy soft tissue debridement. The authors described the use of the VersaJet Hydrosurgery System for flap deepithelialization. Operative techniques, overall time, and histology are reviewed. Six gluteus maximus myocutaneous V-Y advancement flaps were used in 3 patients who underwent flap insetting with partial deepithelialization by VersaJet. The mean time savings was 12 minutes (range, 10-15 min). The flap deepithelialized by VersaJet shows significantly even and regular surface in gross view. In the histologic study, the thickness of preserved papillary dermis was thicker using the Versajet because it contains much skin appendages when compared with conventional scalpel debridement. No patients developed infection, epidermal cyst, or hematoma. The VersaJet provides safe, effective, and tissue-preserving deepithelialization compared with using scalpel.

Exposure-Response Relationship Between Aircraft Noise and Sleep Quality: A Community-based Cross-sectional Study.

OBJECTIVES: Exposure to aircraft noise has been shown to have adverse health effects, causing annoyance and affecting the health-related quality of life, sleep, and mental states of those exposed to it. This study aimed to determine sleep quality in participants residing near an airfield and to evaluate the relationship between the levels of aircraft noise and sleep quality. METHODS: NEIGHBORING REGIONS OF A MILITARY AIRFIELD WERE DIVIDED INTO THREE GROUPS: a high exposure group, a low exposure group, and a control group. A total of 1082 participants (aged 30-79 years) completed a comprehensive self-administered questionnaire requesting information about demographics, medical history, lifestyle, and the Pittsburgh Sleep Quality Index. RESULTS: Of the 1082 participants, 1005 qualified for this study. The prevalence of sleep disturbance was 45.5% in the control group, 71.8% in the low exposure group, and 77.1% in the high exposure group (p for trend < 0.001). After adjusting for potential confounding factors, we determined the exposure-response relationship between the degree of aircraft noise and sleep quality. Of the participants with a normal mental status, the prevalence of sleep disturbance was 2.61-fold higher in the low exposure group and 3.52-fold higher in the high exposure group than in the control group. CONCLUSION: The relationship between aircraft noise and health should be further evaluated through a large-scale follow-up study.

ABO incompatible living donor kidney transplantation in Korea: highly uniform protocols and good medium-term outcome.

The organ shortage is as serious in Korea as in other parts of the world. As about one-third of the potential living donors are ABO incompatible (ABOi), transplantation across the blood group barrier can help overcome this shortage. One hundred and twenty-five ABOi kidney transplantations (KTs) were performed between 2007 and 2010 in Korea. We collected the perioperative and follow-up data for 118 of these patients until September 2011. The preconditioning and immunosuppressive protocols were almost identical across the different transplant centers, with rituximab but no splenectomy; pre-transplant plasmapheresis (PP) with target anti-A/B titer 8 or 16 on transplant day, on-demand, rather than routine, post-transplant PP, and tacrolimus-based immunosuppressants. The number of patients and participating centers showed a rapid increase over time, and in 2010, ABOi KT (n = 79) comprised 10% of all the living donor KTs in Korea. The mean follow-up period was 21 months (range, 1-56 months). Sixteen (14%) patients developed acute rejection, and three of these had antibody-mediated rejection (AMR). Two-yr patient and graft survival were 99.2% and 97.5%, respectively. No graft was lost due to AMR. ABOi KT is rapidly expanding in Korea with excellent medium-term outcome and will help mitigate the organ shortage.

Thigh circumference and low ankle brachial index in US adults: results from the National Health and Nutrition Examination Survey 1999-2004.

OBJECTIVE: Recent studies have suggested that smaller thighs are a disadvantage for health and survival, but the association of thigh circumference with atherosclerosis remains uncertain. The purpose of this study was to investigate the association between thigh circumference and peripheral arterial disease (PAD), as measured by ankle brachial index (ABI). METHODS: This study used data from the National Health and Nutrition Examination Survey (1999-2004), in which participants' ABI and thigh circumference were measured simultaneously. A total of 5716 participants (2959 men and 2757 women) were included in the final analysis. A diagnosis of PAD was determined on the basis of ABI <0.9. RESULTS: The overall prevalence of PAD in this sample was 6.6%. Thigh circumference of those with PAD was 50.1cm compared to 52.2 cm for those without PAD (p < 0.0001). After adjusting for potential covariates, the prevalence of PAD generally decreased as thigh circumference increased up to 55 cm. In the first quantile (smallest thigh circumference), men and women had as much as a 4.8-fold (95% CI, 2.28-10.29) and a 3-fold (95% CI, 1.45-6.18) increased risk of PAD, respectively. Above 55 cm, PAD was no longer related to thigh circumference. CONCLUSIONS: Small thigh circumference may be associated with PAD, as measured by ABI.

Social engagement, health, and changes in occupational status: analysis of the Korean Longitudinal Study of Ageing (KLoSA).

BACKGROUND: We focused on whether changes in the occupational status of older male adults can be influenced by social engagement and health status measured at the baseline. METHODS: This study used a sample of the Korean Longitudinal Study of Aging (KLoSA), and the study population was restricted to 1.531 men who were aged 55 to 80 years at the 2006 baseline survey and participated in the second survey in 2008. Social engagement and health status, measured by the number of chronic diseases, grip strength, and depressive symptoms as well as covariates (age, marital status, educational level, and household income) were based on data from the 2006 baseline survey. Occupational engagement over the first and second survey was divided into four categories: 'consistently employed' (n=892), 'employed-unemployed' (n=152), 'unemployed-employed' (n=138), and 'consistently unemployed' (n=349). RESULTS: In the multinomial model, the 'consistently employed' and 'unemployed-employed' groups had significantly higher social engagement (1.19 and 1.32 times, respectively) than the referent. The number of chronic diseases was significantly associated with four occupational changes, and the 'unemployed-employed' had the fewest chronic conditions. CONCLUSION: Our finding suggests that social engagement and health status are likely to affect opportunities to continue working or to start working for older male adults.

Perfluorooctanoic acid exposure is associated with elevated homocysteine and hypertension in US adults.

OBJECTIVE: To investigate the association between serum perfluorooctanoic acid (PFOA) concentration and cardiovascular disease, as measured by homocysteine level and blood pressure in a representative sample of US adults. METHODS: A cross-sectional study of 2934 adults (≥20 years) who participated in the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey and had detectable levels of PFOA in their serum. The health effects analysed as potentially associated with PFOA exposure included homocysteine level and blood pressure. RESULTS: The geometric mean value (95% CI) of the study participants' serum PFOA concentration was 4.00 µg/l (95% CI 3.86 to 4.13). The homocysteine and systolic blood pressure were shown to increase significantly with an increase in the log-transformed serum PFOA concentration, after adjusting for potential confounding variables. Adjusted ORs comparing participants at the 80th versus the 20th percentiles were 2.62 for hypertension (95% CI 2.09 to 3.14), and a positive association was also evident in models based on quartiles or based on restricted cubic splines. CONCLUSION: These findings suggest that background exposure to PFOA may continue a risk factor for the development of cardiovascular diseases.

Lead and cadmium levels and balance and vestibular dysfunction among adult participants in the National Health and Nutrition Examination Survey (NHANES) 1999-2004.

BACKGROUND: Few studies have been conducted to identify risk factors for balance and vestibular dysfunction in general populations, but previous studies have reported evidence of adverse effects of lead and cadmium on balance control in high-risk groups. OBJECTIVE: We evaluated the relationship between blood lead and cadmium levels and balance and vestibular dysfunction in a general population study. METHODS: We analyzed data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) of 5,574 adults ≥ 40 years of age. Balance dysfunction was evaluated by the Romberg Test of Standing Balance on Firm and Compliant Support Surfaces, which examines the ability to stand unassisted using four test conditions to evaluate vestibular system, vision, and proprioception inputs that contribute to balance. Blood levels of lead and cadmium were measured by atomic absorption spectrometry. Associations were estimated using logistic regression models adjusted for potential confounders. Associations with time to loss of balance were estimated using adjusted Cox proportional hazard models. RESULTS: The adjusted odds ratio (OR) for balance dysfunction in association with the highest quintile (3.3-48 µg/dL) versus the lowest quintile (< 1.2 µg/dL) of lead was 1.42 [95% confidence interval (CI): 1.07, 1.89]. The corresponding OR for cadmium (0.9-7.4 µg/L vs. < 0.2 µg/L) was 1.27 (95% CI: 1.01, 1.60). The adjusted hazard ratio for time to failure for the most physiologically challenging balance test among subjects with the highest vs. lowest quintiles of blood lead was 1.24 (95% CI: 1.04, 1.48). Cadmium levels were not associated with time to failure. CONCLUSIONS: Our findings suggest that blood lead and cadmium levels may be associated with balance and vestibular dysfunction in a general sample of U.S. adults.

Potential role for organochlorine pesticides in the prevalence of peripheral arterial diseases in obese persons: results from the National Health and Nutrition Examination Survey 1999-2004.

OBJECTIVES: The purpose of this study was to investigate the association between organochlorine (OC) pesticides and the prevalence of peripheral arterial disease (PAD). METHODS AND RESULTS: This study included 2032 participants from the National Health and Nutrition Examination Survey (1999-2004), in which the ankle brachial index (ABI) and serum levels of OC pesticides (p,p'-DDE, trans-nonachlor, oxychlordane, dieldrin, and ß-HCH) were measured simultaneously. A diagnosis of PAD was determined on the basis of an ABI<0.9. The obesity status was categorized as obese group (BMI ≥ 25 kg/m(2)) or non-obese group (BMI<25 kg/m(2)). Compared with subjects without PAD, those with PAD had significantly higher lipid-standardized and wet-weight concentrations of OC pesticides. Obese subjects with PAD had significantly increased mean lipid-standardization value of p,p'-DDE (OR=1.47; 95% CI, 1.08-1.99), trans-nonachlor (OR=1.68; 95% CI, 1.10-2.56), oxychlordane (OR=1.82; 95% CI, 1.09-3.03), dieldrin (OR=2.36; 95% CI, 1.69-3.31), and sums of all five pesticides (OR=1.19; 95% CI, 1.07-1.33). For non-obese group, increases in the levels of OC pesticides and their sums did not account for increased risk ratio of PAD. CONCLUSION: OC pesticides are a potent risk factor for PAD. Additionally, obesity may modulate the association between OC pesticides and the development of PAD.

Relationship between depression anxiety stress scale (DASS) and urinary hydroxyproline and proline concentrations in hospital workers.

OBJECTIVES: Although increased reactive oxygen species (ROS) is caused by stress accelerates collagen degradation, there was no data on the relationship between stress and urinary hydroxyproline (Hyp) and proline (Pro), a good marker of collagen degradation. The purpose of this study was to evaluate the relationship between depression, anxiety, and stress (DAS) and concentrations of urinary Hyp and Pro. METHODS: 97 hospital employees aged 20 to 58 were asked to fill out comprehensive self-administrated questionnaires containing information about their medical history, lifestyle, length of the work year, shift-work and DAS. depression anxiety stress scale (DASS) was applied to evaluate chronic mental disorders. Urine samples were analyzed using high performance liquid chromatography (HPLC) with double derivatization for the assay of hydroxyproline and proline. RESULTS: The mean value of Hyp and Pro concentration in all subjects was 194.1 ± 113.4 µmol/g and 568.2 ± 310.7 µmol/g. DASS values and urinary Pro concentrations were differentiated by sex (female > male, p < 0.05) and type of job (nurse > others, p < 0.05). In the stepwise multiple linear regressions, urinary Hyp and Pro concentrations were influenced by stress (Adjusted r2 = 0.051) and anxiety and job (Adjusted r2 = 0.199), respectively. CONCLUSIONS: We found that stress and anxiety were correlated with urinary Hyp and Pro concentrations. To identifying a definite correlation, further study in large populations will be needed.

Chemical and electronic properties of Ba/bis(2-methyl-8-quinolinolato)(4-phenylphenolato)aluminum(III) interfaces for organic light-emitting diodes.

The chemistry, electronic structure, and electron-injecting characteristics at the interfaces that were formed between bis(2-methyl-8-quinolinolato)(4-phenylphenolato)aluminum(III) (BAlq) and barium (Ba) were investigated using ultraviolet photoemission spectroscopy, near-edge X-ray absorption fine structure spectroscopy, X-ray photoemission spectroscopy, and current-voltage-luminance measurements. The device performance of organic light-emitting diodes (OLEDs), which have a glass/ITO/MoO3/2-TNATA/NPB/BAlq/Ba/Au structure, was significantly improved by inserting a Ba coverage (thetaBa) of 0.2 nm between BAlq and the cathode. For thetaBa'S that were thicker than 0.2 nm, however, even though the electron-injecting barrier heights at the Ba-on-BAlq interfaces were all 0.1 eV, the device performance of the OLEDs with Ba at the interface was degraded with increasing thetaBa. This result indicates that the device performance is largely dependent on the interfacial chemical degradation of the BAlq molecule itself, rather than the electron-injecting barrier height that is determined by the width and chemical structure of the interface, and the formation of barium-induced new gap states at the Ba-on-BAlq interface.

Changes in occupational safety and health indices after the Korean economic crisis: analysis of a national sample, 1991-2007.

We examined how the deregulation of South Korea's labor laws during the country's 1997 to 1998 economic crisis affected occupational safety and health. Although the economic index improved after the reforms, the total injury rate declined slowly and the incidence of occupational disease increased. The withdrawal of support for occupational safety and health is likely to have a sustained effect on public health.