Publications by authors named "Ji-Hye Park"

302 Publications

An Intervention Program Targeting Daily Adaptive Skills Through Executive Function Training for Adults with Autism Spectrum Disorder: A Pilot Study.

Psychiatry Investig 2021 Jun 24;18(6):513-522. Epub 2021 Jun 24.

Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Objective: Adults with autism spectrum disorders (ASD) experience significant difficulties with executive functioning (EF) and related adaptive skills, yet the lack of interventions in South Korea targeting these areas has resulted in a heightened need to develop an evidence- based program. Therefore, we developed a novel intervention aiming to enhance everyday EF and daily adaptive skills in adults with high-functioning ASD and conducted a pilot study to evaluate the validity and feasibility of the program.

Methods: A behavioral intervention of 10-weekly sessions was developed based on literature searches and focus group interviews. Seven adults with high-functioning ASD (mean age=20.29) participated in a single-group pilot trial. We used self and parent-report questionnaires as well as skills measured by assessment instruments to analyze differences before and after the intervention.

Results: Significant improvements were shown in everyday EF, including time management, organization, self-restraint, and regulation of emotions. Additionally, results demonstrated an enhancement in adaptive functioning, especially in the subdomains of daily living skills. Analyses of parental outcomes only revealed a significant decrease in the scores of emotion regulation.

Conclusion: The current study provides good evidence for the validity and feasibility of an intervention to improve everyday EF and adaptive skills in adults with ASD.
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http://dx.doi.org/10.30773/pi.2020.0423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256144PMC
June 2021

Acute and Subchronic Toxicological Evaluation of the Herbal Product HAD-B1 in Rats.

Evid Based Complement Alternat Med 2021 31;2021:9970822. Epub 2021 May 31.

East West Cancer Center, Seoul Korean Medicine Hospital, Daejeon University, 32, Beobwon-ro 11-gil, Songpa-gu, Seoul 05-836, Republic of Korea.

This study evaluates acute and subchronic toxicity of a Korean herbal formula HAD-B1 in rat to investigate whether HAD-B1 has potential toxicity to humans. First, the study to assess the acute oral toxicity at dose levels of 0, 500, 1000, and 2000 mg/kg body weight (BW) was performed in male and female SD rats (Crl: CD, specific pathogen-free) ( = 5/group). Based on the result of the acute oral study, 4 weeks' dose range finding study and 13 weeks' subchronic study were performed (dose range finding study, DRF;  = 5/group) and 13 weeks (subchronic study;  = 10/group) in male and female SD rats. The control group was administered with distilled water (DW). Clinical signs, body weight, food consumption, ophthalmic examination, urinalysis, hematological/biochemical parameters, gross finding at necropsy, and histopathological examination were investigated and recorded. In the oral acute toxicity study of SD rats, no clinical signs, mortality, body weight changes, and gross findings were observed. Also, there were no treatment-related changes in the 4-week DRF study. Based on these results, a 13-week repeated-dose toxicity study (subchronic) in SD rats was performed. HAD-B1 showed temporal hypersalivation in clinical signs and an increased tendency in body weight at 2000 mg/kg BW. However, there were no treatment-related changes in mortality, food consumption, ophthalmology, urinalysis, hematology, biochemistry, gross finding at necropsy, organ weights, and histopathology in either sex of any group. Based on this toxicological evaluation of HAD-B1, we concluded that no target organ was determined, and the no observed adverse effect level (NOAEL) of HAD-B1 was determined to be > 2000 mg/kg B W. Therefore, we decided that consuming HAD-B1 is relatively nontoxic.
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http://dx.doi.org/10.1155/2021/9970822DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184334PMC
May 2021

Effects of Trabecular Meshwork Width and Schlemm's Canal Area on Intraocular Pressure Reduction in Glaucoma Patients.

Korean J Ophthalmol 2021 Jun 21. Epub 2021 Jun 21.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.

Purpose: To evaluate the effects of baseline trabecular meshwork (TM) and Schlemm's canal (SC) microstructures on intraocular pressure (IOP) reduction amount in treatment-naïve patients with primary open-angle glaucoma (POAG).

Methods: A total 69 eyes of POAG patients who had not been treated with IOP-lowering agent were enrolled in this retrospective study. The patients had been prescribed topical IOP-lowering agent and used it for 1 year. The morphologic features of the TM and SC were collected using anterior segment module of spectral-domain optical coherence tomography with enhanced depth imaging (EDI) at baseline. Images of the nasal and temporal corneoscleral limbus were obtained with serial horizontal EDI B-scans and TM width and SC area were measured in each scan. We investigated the effects of baseline TM and SC microstructures on IOP reduction amount.

Results: The baseline IOP of 69 glaucomatous eyes was 17.9 ± 3.8 mmHg, and the mean amount of IOP reduction was 3.5 ± 2.1 mmHg after 1 year. Mean TM widths of nasal and temporal sector were 470.33 ± 80.05 μm and 479.74 ± 79.59 μm, respectively. SC area was measured as 4818.50 ± 1464.28 μm2, 4604.23 ± 1567.73 μm2 at nasal sector and temporal sector, respectively. The correlation analysis revealed a positive correlation between SC area and average amount of IOP reduction, indicating that the larger baseline SC area, the greater the IOP drop with topical IOP-lowering agents. However, no correlation was found between TM width and IOP lowering amount in patients with POAG.

Conclusion: The baseline SC area showed positive correlation with the IOP reduction amount in patients with POAG. This finding suggests that the SC area can be a clinical parameter to predict the IOP reduction amount before using IOP-lowering agents in POAG patient.
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http://dx.doi.org/10.3341/kjo.2021.0007DOI Listing
June 2021

Single-cell RNA sequencing of human nail unit defines RSPO4 onychofibroblasts and SPINK6 nail epithelium.

Commun Biol 2021 Jun 7;4(1):692. Epub 2021 Jun 7.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Research on human nail tissue has been limited by the restricted access to fresh specimen. Here, we studied transcriptome profiles of human nail units using polydactyly specimens. Single-cell RNAseq with 11,541 cells from 4 extra digits revealed nail-specific mesenchymal and epithelial cell populations, characterized by RSPO4 (major gene in congenital anonychia) and SPINK6, respectively. In situ RNA hybridization demonstrated the localization of RSPO4, MSX1 and WIF1 in onychofibroblasts suggesting the activation of WNT signaling. BMP-5 was also expressed in onychofibroblasts implicating the contribution of BMP signaling. SPINK6 expression distinguished the nail-specific keratinocytes from epidermal keratinocytes. RSPO4 onychofibroblasts were distributed at close proximity with LGR6 nail matrix, leading to WNT/β-catenin activation. In addition, we demonstrated RSPO4 was overexpressed in the fibroblasts of onychomatricoma and LGR6 was highly expressed at the basal layer of the overlying epithelial component, suggesting that onychofibroblasts may play an important role in the pathogenesis of onychomatricoma.
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http://dx.doi.org/10.1038/s42003-021-02223-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184830PMC
June 2021

Histological severity of nonalcoholic fatty liver disease is associated with 10-year risk for atherosclerotic cardiovascular disease.

Hepatol Int 2021 Jun 3. Epub 2021 Jun 3.

Division of Cardiovascular Disease Research, Department for Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju, Republic of Korea.

Background And Aim: Nonalcoholic fatty liver disease (NAFLD) is associated with atherosclerotic cardiovascular disease (ASCVD). However, few studies have investigated the association between the histological severity of NAFLD and ASCVD. Therefore, we investigated whether the histological severity of NAFLD is associated with ASCVD risk.

Methods: We performed cross-sectional analysis of prospectively enrolled, biopsy-proven NAFLD patients. The 10-year ASCVD risk was assessed using the Korean Risk Prediction Model. The histological spectrum of NAFLD was classified by the nonalcoholic steatohepatitis (NASH) clinical research network histological scoring system. The association between each histological subgroup and ASCVD risk was analyzed using logistic regression analysis.

Results: This study included 398 Korean subjects (mean age, 57.9 years; male, 44.2%) with biopsy-proven NAFLD and 102 no-NALFD controls. Subjects with ASCVD risk ≥ 10% showed more severe grades of hepatocellular ballooning and more advanced stages of fibrosis when compared with subjects with ASCVD risk < 10% (p < 0.05 for each). The presence of NASH (odds ratio [OR] 4.07; 95% confidence interval [CI] 1.40-11.88) or advanced fibrosis (OR 8.11; 95% CI 1.83-35.98) was independently associated with a higher risk of ASCVD even after adjustment for age, sex, body mass index, blood pressure, lipids, liver enzymes, systemic inflammation, and insulin resistance.

Conclusions: Patients with NASH or advanced fibrosis are at an increased risk of developing ASCVD compared with no-NAFLD controls or subjects with NAFL, independent of conventional metabolic risk factors for CVD. Histological information on NAFLD may be helpful to promote our understanding of extrahepatic complications, such as ASCVD, resulting from NAFLD progression.
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http://dx.doi.org/10.1007/s12072-021-10209-3DOI Listing
June 2021

A Case Report of Multiple Capillary Hemangioma in a Chronic Myeloid Leukemia Patient Taking Tyrosine Kinase Inhibitors.

Ann Dermatol 2021 Jun 4;33(3):278-280. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

A capillary hemangioma is a vascular tumor with small capillary sized vascular channel. Multiple capillary hemangioma in relation with drugs have been rarely reported. Here in, we report a case of multiple capillary hemangioma in patient diagnosed with chronic myeloid leukemia who received tyrosine kinase inhibitors (TKIs). Histopathological findings have shown capillary proliferation in the upper dermis, which is consistent with capillary hemangioma. Since TKIs can paradoxically activate the MEK/ERK pathway which is required for angiogenesis, we presumed that the lesions as the cutaneous side effects of TKIs.
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http://dx.doi.org/10.5021/ad.2021.33.3.278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137332PMC
June 2021

Effects of Particulate Matter on Healthy Skin: A Comparative Study between High- and Low-Particulate Matter Periods.

Ann Dermatol 2021 Jun 4;33(3):263-270. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: The influence of airborne particulate matter (PM) on skin has primarily been studied in patients with skin diseases such as atopic dermatitis. Recently, the effect of PM on healthy human skin has gained attention.

Objective: To evaluate the relationship between PM concentration and objective skin changes in healthy subjects.

Methods: This prospective study enrolled 25 healthy volunteers without any skin disease. Data regarding daily meteorological parameters and air pollution were collected during a high-PM period and a low-PM period for 14 days. Environmental and lifestyle factors that might influence skin conditions of subjects were also collected during the study period. Biophysical parameters of the skin such as transepidermal water loss (TEWL), hydration, erythema index, and melanin index were measured. Pores, wrinkles, sebum, and skin tone were evaluated using a facial analysis system.

Results: Mean TEWL value during the high-PM period was significantly higher than that during the low-PM period (10.16 g/m/h vs. 5.99 g/m/h; =0.0005). Mean erythema index was significantly higher in the high-PM period than that in the low-PM period (4.3 vs. 3.42; =0.038). For facial analysis system indices, uniformity of skin tone was higher in the low-PM period than that in the high-PM period (<0.0001). In addition, with increasing PM and PM, TEWL also showed increase when other environmental components were constant (regression coefficient [RC]=0.1529, <0.0001 for PM; RC=0.2055, =0.0153 for PM).

Conclusion: Increased PM concentrations may contribute to disturbed barrier function, increased facial erythema, and uneven skin tone even in healthy human skin.
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http://dx.doi.org/10.5021/ad.2021.33.3.263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137329PMC
June 2021

Hydroa Vacciniforme-Like Lymphoproliferative Disorder in Korea: Prognostic Implication of Clinical Signs and Whole Blood Epstein-Barr Virus DNA.

Ann Dermatol 2021 Jun 4;33(3):222-227. Epub 2021 May 4.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Hydroa vacciniforme-like lymphoproliferative disorder (HVLPD) is rare Epstein-Barr virus (EBV)-associated disease. The classic form of HVLPD is a self-resolving disease, whereas the systemic form can progress to malignant lymphoma, resulting in fatal outcomes. However, the prognostic factors remain unclear.

Objective: This study aimed to evaluate the clinical characteristics of HVLPD and the association between whole blood EBV DNA and clinical outcomes.

Methods: We retrospectively reviewed our 25-year experience involving 11 patients with HVLPD from a single tertiary center in South Korea and evaluated the clinical characteristics of HVLPD and the correlation between whole blood EBV DNA and clinical outcomes.

Results: Of the total 11 patients, 54.5% (6/11) manifested classic HVLPD that resolved with conservative treatment, while 45.5% (5/11) patients had systemic HVLPD, four of whom died of progressive disease or hemophagocytic syndrome. Five patients with systemic HVLPD manifested severe skin lesions such as prominent facial edema, deep ulcers and necrotic skin lesions involving sun-protected areas. Median EBV DNA levels at initial diagnosis were higher in three dead patients than in those alive (2,290 vs. 186.62 copies/µl).

Conclusion: When EBV DNA levels were high, patients showed severe skin lesions and when EBV DNA levels were low, skin lesions tended to improve. Thus, patients with high EBV DNA levels showed an increased risk of severe skin lesions and disease progression.
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http://dx.doi.org/10.5021/ad.2021.33.3.222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137328PMC
June 2021

Effect of prostaglandin analogues on anterior scleral thickness and corneal thickness in patients with primary open-angle glaucoma.

Sci Rep 2021 May 27;11(1):11098. Epub 2021 May 27.

Department of Ophthalmology, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea.

Prostaglandin (PG) analogues are usually prescribed as a first-line therapy in patients with glaucoma because of its once-daily dosing benefit and effective intraocular pressure (IOP) reduction. However, the mechanism of PG analogues is not completely understood. In this study, we investigated the effect of PG analogues on the anterior scleral thickness (AST) in treatment-naïve eyes with primary open-angle glaucoma using anterior segment optical coherence tomography. The AST was measured at the location of the scleral spur, 1000 μm, and 2000 μm posterior to the scleral spur and was compared before and after using the medications for 3 months and 1 year. Among 54 patients enrolled in this study, 31 patients used prostaglandin analogues and 23 patients used dorzolamide/timolol fixed combination (DTFC) drugs. There was no significant difference in untreated IOP, glaucoma severity, and baseline AST values between the two groups. While there was no significant changes in AST after using the DTFC drugs, the AST at all 3 locations showed a significant reduction in both the nasal and temporal sectors after using PG analogues for 1 year (all, P < 0.05). These findings suggest that the AST reduction after using PG analogues might be related with the increased uveoscleral outflow.
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http://dx.doi.org/10.1038/s41598-021-90696-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160208PMC
May 2021

Efficacy and Safety of Yukgunja-Tang for Patients with Cancer-related Anorexia: A Randomized, Controlled Trial, Pilot Study.

Integr Cancer Ther 2021 Jan-Dec;20:15347354211019107

Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea.

Objective: The purpose of this study is both to estimate the efficacy and the safety of Yukgunja-tang (YGJT) and to establish evidence for the use of herbal medicines in the management of patients with cancer-related anorexia.

Methods: We enrolled 40 patients with cancer-related anorexia. The enrolled participants were randomly allocated to 2 groups: the control group (n = 20), which received nutrition counseling, and the treatment group (n = 20), which received nutrition counseling and was administered YGJT at twice a day for 4 weeks (a total of 56 times @ 3.0 g each time). The primary outcome of this study was the score on the anorexia/cachexia subscale (ACS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes were the FAACT score with the ACS score excluded, the score on the Visual Analog Scale (VAS) for appetite, and the results on laboratory tests regarding appetite, such as leptin, tumor necrosis factors (TNF-α), interleukin-6 (IL-6), and ghrelin. All variables related to the safety assessment, such as vital signs, electrocardiography results, laboratory test results (complete blood cell count, chemistry, urine test), and adverse events, were documented on the case report form (CRF) at every visit.

Result: The difference in the primary outcome, that is, the score on the anorexia/cachexia subscale (ACS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT), between the control and the treatment groups was statistically significant ( = .023) as was the difference in the FAACT scores with the ACS score excluded, a secondary outcome, between the 2 groups; however, no statistically significant differences were noted in the scores on the VAS or the levels of leptin, TNF-α, IL-6, and ghrelin. In addition, no significant differences in the numbers and the types of adverse events or in the results on the laboratory tests between the control and the treatment groups were recorded.

Conclusion: These results obtained in this research confirmed the efficacy and the safety of using YGJT as a herb-medicine treatment option for patients with cancer-related anorexia.
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http://dx.doi.org/10.1177/15347354211019107DOI Listing
May 2021

Combination Treatment of Intra/Perilesional Botulinum Toxin-A Injection and Ablative Fractional Laser for Better Clinical Outcomes of Hypertrophic Fibrotic Thyroidectomy Scars Following Fractional Ablative Laser Resurfacing.

Ann Dermatol 2021 Apr 8;33(2):170-177. Epub 2021 Mar 8.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Recent reports have shown that intralesional botulinum toxin type-A (BTX-A) works on scar cosmesis.

Objective: To evaluate the clinical efficacy of combination treatment of laser and BTX-A injection and compare the effects of conventional intralesional injection and intra- and perilesional BTX-A injection on fibrotic thyroidectomy scars.

Methods: Patients with fibrotic thyroidectomy scars showing insufficient responses to previous ablative fractional laser (AFL) treatment were enrolled. Combination treatment with AFL and BTX-A injection was performed. Patients who received intra/perilesional BTX-A injections were classified into group A. Group B was patients in whom the injection was performed only intralesionally. The improvement was assessed based on the Vancouver Scar Scale (VSS).

Results: A total of 24 patients was included. Statistically significant improvement in pliability and total VSS score after the combination treatment were observed in overall patient group. Subgroup analysis demonstrated that pliability, height, and total VSS improved significantly in group A. In group B, only pliability significantly improved.

Conclusion: BTX-A injection combined with AFL can provide better relief for the previously treated fibrotic thyroidectomy scars. Injection of BTX-A not only into the scar itself, but also into perilesional muscles that can exert tension on the scar site may provide additional benefit in flattening scar height.
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http://dx.doi.org/10.5021/ad.2021.33.2.170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082008PMC
April 2021

Characterization of the Onychomatricodermis Containing Onychofibroblasts of the Nail Unit : Histology, Immunohistochemistry, and Electron Microscopic Study.

Ann Dermatol 2021 Apr 8;33(2):108-115. Epub 2021 Mar 8.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: We recently discovered the presence of specialized nail mesenchyme below the nail matrix and designated it as onychomatricodermis.

Objective: We did further research to characterize the histologic, histochemical, immunohistochemical and ultrastructural features of the onychomatricodermis containing onychofibroblasts in the nail unit.

Methods: Ten polydactyly nail unit specimens and 8 nail matrix biopsies were included. H&E-stained slides were reviewed. We did Alcian blue staining and Masson Trichrome staining, as well as immunohistochemical staining for type I collagen, CD10, CD13 and CD34. In addition, polydactyly nail units were examined by transmission electron microscopy.

Results: In H&E staining, the specialized mesenchyme called onychomatricodermis was observed to be slightly distant from the undersurface of the nail matrix and be less eosinophilic area. Onychomatricodermal onychofibroblasts showed light purple abundant cytoplasm. Masson Trichrome staining revealed fewer collagen fibers within the onychomatricodermis. In Alcian blue staining the onychomatricodermis showed mucin deposition within the onychofibroblasts and around them. Immunohistochemically, type I collagen was expressed much less in the onychomatricodermis while it was strongly expressed elsewhere in the nail unit. In nail matrix biopsy specimens onychomatricodermal onychofibroblasts expressed CD10 and CD13 strongly, and expressed CD34 as well. Ultrastructurally, collagen fibrils were found sparsely within the onychomatricodermis, whereas collagen fibrils were densely distributed in the dermis of other parts of the nail unit.

Conclusion: We demonstrated that there was less collagen expression in the onychomatricodermis containing onychofibroblasts. In addition, we found morphological and immunohistochemical features of onychomatricodermal onychofibroblasts (onychofibroblasts of Dongyoun). These findings support the presence of onychomatricodermis containing onychofibroblasts in the nail unit.
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http://dx.doi.org/10.5021/ad.2021.33.2.108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082007PMC
April 2021

The Growth Model of Forensically Important (Meigen) (Diptera: Calliphoridae) in South Korea.

Insects 2021 Apr 6;12(4). Epub 2021 Apr 6.

Department of Legal Medicine, Korea University College of Medicine, Seoul 02841, Korea.

Development of forensically important (Meigen) was analyzed in South Korea. Rearing was replicated five times at seven constant temperatures between 20-35 °C to elucidate changes in accumulated degree hours, based on developmental stage and body length, and 2673 individuals were statistically analyzed. The results indicated that the optimum temperature, the base temperature, and the overall thermal constant were 22.31 °C (±1.21 °C, 95% CI), 9.07 °C, and 232.81 ± 23 (mean ± SD) accumulated degree days, respectively. In the minimum ADH models of each development stage, nonlinear regression graphs were parallel at the immature stages. Based on the scatter plot ( = 973) of immature stages using ADH values and body length, the logarithmic model using LogADH as the dependent variable was identified as the best fitting regression model. Additionally, the adjusted value and mean square of error were 0.911 and 0.007, respectively. This is the first forensically focused study on the development of for the estimation of minimum postmortem interval in South Korea. In future studies, we intend to study the development of other necrophagous fly species and to identify parameters for the determination of age at post-feeding and pupal stages.
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http://dx.doi.org/10.3390/insects12040323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067387PMC
April 2021

Two Cases of Multiple Epidermolytic Acanthomas Mimicking Verruca Vulgaris.

Ann Dermatol 2020 Dec 11;32(6):512-515. Epub 2020 Nov 11.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Epidermolytic acanthoma (EA) is a rare benign tumor, which usually appears as a solitary small papule. However, there are a few case reports of multiple EA, most of which occurs on the genital area. Cases of multiple EA may mimic verruca vulgaris, condyloma accuminatum, seborrheic keratosis, and bowenoid papulosis, and therefore, can be easily misdiagnosed. A 78-year-old male presented with a 2-week history of discrete, small skin-colored papules around the anus. The other case involved a 47-year-old male with a 5-year history of skin-colored papules on the scrotum. Skin biopsy of both cases revealed a well-demarcated papular lesion characterized by compact hyperkeratosis, perinuclear vacuolization, and reticular degeneration in the granular and upper spinous layer with coarse basophilic keratohyalin granules. Epidermal invagination was consistent with a cup-shaped type of EA. Both cases tested negative for human papillomavirus. We report typical cases of multiple EA, which should be considered as the differential diagnosis of small skin-colored papules in the anogenital area, to prevent the misdiagnosis.
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http://dx.doi.org/10.5021/ad.2020.32.6.512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875239PMC
December 2020

A Retrospective Clinicopathologic Study of Korean Patients with Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified at a Single Tertiary Center.

Ann Dermatol 2020 Aug 30;32(4):337-342. Epub 2020 Jun 30.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.5021/ad.2020.32.4.337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992657PMC
August 2020

A Case of Cutaneous Leukocytoclastic Vasculitis Associated with Granulocyte Colony-Stimulating Factor: An Unusual Presentation.

Ann Dermatol 2020 Apr 11;32(2):164-167. Epub 2020 Mar 11.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Drug-induced vasculitis is an inflammation of small-sized blood vessel caused by the use of drugs. It accounts for approximately 10% of acute cutaneous vasculitis. Propylthiouracil, hydralazine, and allopurinol have been widely known as causative agents. The most common clinical feature of drug-induced vasculitis is palpable purpura on lower extremities. A 66-year-old Korean female presented with erythematous nodules on upper chest and back. She had been on medication for multiple myeloma. Laboratory results showed neutropenia. After a single injection of filgrastim (recombinant granulocyte colony-stimulating factor), she developed cutaneous lesions with concurrent increase in absolute neutrophil count. A skin biopsy revealed leukocytoclastic vasculitis. After discontinuation of filgrastim injection, her skin lesions disappeared spontaneously.
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http://dx.doi.org/10.5021/ad.2020.32.2.164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992539PMC
April 2020

Construction of a non-contact community treatment centre for asymptomatic and mildly symptomatic COVID-19 patients during the COVID-19 pandemic.

Epidemiol Infect 2021 04 27;149:e111. Epub 2021 Apr 27.

Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.
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http://dx.doi.org/10.1017/S0950268821000996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8134883PMC
April 2021

Anti-pollution skincare: Research on effective ways to protect skin from particulate matter.

Dermatol Ther 2021 Apr 22:e14960. Epub 2021 Apr 22.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

While there is increasing interest in anti-pollution care to particulate matter (PM), there has been no research evaluating the efficacy of skin care products in a real-world setting. Our objective was to find effective ways to protect skin from PM. In total, 64 volunteers whose skin was classified as reactive to PM concentration in the previous study were enrolled. Through split-face study, different combinations of skin care products (barrier cream, barrier cream/micellar water, antioxidant, and antioxidant/micellar water) were applied for 4 weeks during the high-PM period. The biophysical properties were measured, and a facial analysis system was used to evaluate skin condition at days 0, 14, and 28. The concentrations of PM and daily events that may affect skin conditions were also recorded. The mean concentration levels of PM and PM from days 0 to 14 were higher in the barrier cream group than in the antioxidant group. For each group, aside from skin tone in the antioxidant/micellar water group, there were no statistically significant differences in skin measurements before and after the application, which reflects no aggravation in skin condition during high-PM periods. Intergroup analysis showed no differences in skin measurements among the four groups from day 0 to day 14, from day 14 to day 28, and from day 0 to 28. For anti-pollution care, maintaining skin barrier function using barrier cream seems to be sufficient in individuals sensitive to PM.
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http://dx.doi.org/10.1111/dth.14960DOI Listing
April 2021

Clinical profile of cutaneous adverse events of immune checkpoint inhibitors in a single tertiary center.

J Dermatol 2021 Jul 20;48(7):979-988. Epub 2021 Apr 20.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have demonstrated their efficacy in the treatment of various malignancies. Despite their benefits, their immunomodulatory activities can cause unpredictable cutaneous adverse events (CAE). This study aimed to identify characteristics of CAE in patients treated with PD-1/PD-L1 inhibitors through the medical records, photographs, and pathology reports. Fifty CAE occurred in 47 (2.75%) of 1711 patients treated with PD-1/PD-L1 inhibitors. Pruritic, psoriasiform, urticarial, and acneiform eruptions were the four most common types. Melanoma patients showed CAE more frequently than other malignancies. Acneiform eruption occurred more often at ages under 60 years. Urticarial eruption appeared earlier, while keratoacanthoma appeared later after immunotherapy. The overall survival times were not significantly different between the two groups with and without CAE by Kaplan-Meier analysis (p = 0.055). Studies on CAE may provide more information to understand these drugs and to help manage the patients.
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http://dx.doi.org/10.1111/1346-8138.15824DOI Listing
July 2021

A forensic case study for body fluid identification using DNA methylation analysis.

Leg Med (Tokyo) 2021 Jul 1;51:101872. Epub 2021 Apr 1.

Department of Forensic Sciences, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu Suwon-si, Gyeongi-do 16419, Republic of Korea. Electronic address:

Recently, a method of identifying body fluids using DNA methylation has been developed (Frumkin et al., 2011). An existing multiplex assay using 9 CpG markers could differentiate 5 body fluids: semen, blood, saliva, menstrual blood, and vaginal fluid. To validate this technique, we evaluated the previously described body fluid identification method by means of single base extension (SBE). DNA methylation was applied to 22 samples in 18 forensic cases; seven of these were semen, three were blood, eight were saliva, three were vaginal fluid, and one was menstrual blood. Total of 18 samples were tested, the DNA methylation profiles were coincident from preliminary tests (acid phosphatase (AP), leucomalachite green (LMG, Sigma Aldrich, St Louis, MO, USA) and SALIgAE®) except one sample which displayed an all-negative result. After applying the DNA methylation method to forensic samples, we determined that it could be very useful for differentiating vaginal secretions from menstrual blood, for which there is no conventional preliminary testing method.
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http://dx.doi.org/10.1016/j.legalmed.2021.101872DOI Listing
July 2021

Radiation-Activated PI3K/AKT Pathway Promotes the Induction of Cancer Stem-Like Cells via the Upregulation of SOX2 in Colorectal Cancer.

Cells 2021 Jan 12;10(1). Epub 2021 Jan 12.

Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Korea.

The current treatment strategy for patients with aggressive colorectal cancer has been hampered by resistance to radiotherapy and chemotherapy due to the existence of cancer stem-like cells (CSCs). Recent studies have shown that SOX2 expression plays an important role in the maintenance of CSC properties in colorectal cancer. In this study, we investigated the induction and regulatory role of SOX2 following the irradiation of radioresistant and radiosensitive colorectal cancer cells. We used FACS and western blotting to analyze SOX2 expression in cells. Among the markers of colorectal CSCs, the expression of CD44 increased upon irradiation in radioresistant cells. Further analysis revealed the retention of CSC properties with an upregulation of SOX2 as shown by enhanced resistance to radiation and metastatic potential in vitro. Interestingly, both the knockdown and overexpression of SOX2 led to increase in CD44+ population and induction of CSC properties in colorectal cancer following irradiation. Furthermore, selective genetic and pharmacological inhibition of the PI3K/AKT pathway, but not the MAPK pathway, attenuated SOX2-dependent CD44 expression and metastatic potential upon irradiation in vitro. Our findings suggested that SOX2 regulated by radiation-induced activation of PI3K/AKT pathway contributes to the induction of colorectal CSCs, thereby highlighting its potential as a therapeutic target.
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http://dx.doi.org/10.3390/cells10010135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827893PMC
January 2021

Dual Clarithromycin and Metronidazole Resistance is the Main Cause of Failure in Ultimate Helicobacter pylori Eradication.

Dig Dis 2021 Jan 11. Epub 2021 Jan 11.

Background/aim: Antimicrobial resistance significantly affects the cure rate of Helicobacter pylori (H. pylori) eradication. We evaluated the risk factor of failure in ultimate H. pylori eradication and assessed the efficacy of current regimens to overcome antibiotic resistance.

Methods: Patients with H. pylori infection were prospectively enrolled in a single center. They were classified into three groups according to the previous history of H. pylori eradication, and antibiotic susceptibility was evaluated by culture and minimum inhibitory concentrations (MIC).

Results: 97 patients successfully H. pylori cultured and 81 (83.5%), 7 (7.2%), and 9 (9.3%) were classified into primary resistance, 1st eradication failure, and 2nd or more eradication failure groups; the resistance to clarithromycin (CLA), metronidazole (MET), and levofloxacin (LEV) increased in the 1st eradication failure (85.7%, 57.1%, and 42.9%) and 2nd and more eradication failure (88.9%, 88.9%, and 55.6%) groups. The prevalence of MDR was 21.0% (17/81), 57.1% (4/7), and 88.9% (8/9) in the primary, 1st eradication failure, and 2nd or more eradication failure groups, respectively. In multivariate analysis, dual CLA/MET resistance (CLA/MET-R) (OR=31.432, 95% CI: 3.094-319.266, P=0.004) were independent risk factors for ultimate H. pylori eradication failure. In patients with dual CLA/MET-R, the eradication ratio of concomitant therapy was 57.1% (4/7), whereas that of bismuth-containing quadruple therapy was 27.3% (3/11) (P=0.350).

Conclusions: Dual CLA/MET-R was the main cause of failure in ultimate H. pylori eradication, and 7 days- bismuth quadruple or concomitant regimen would not be suitable for H. pylori eradication in dual CLA/MET-R group.
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http://dx.doi.org/10.1159/000514278DOI Listing
January 2021

Effect of Head Position and Tube Entry on Corneal Endothelial Cells in Patients with Glaucoma Drainage Implants: A Cross-sectional Study.

Korean J Ophthalmol 2020 12 3;34(6):446-453. Epub 2020 Dec 3.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Purpose: To investigate the effect of head tilt on the tube position of the Ahmed glaucoma valve (AGV) implanted in patients with glaucoma and to assess how the head tilt-induced alterations of tube parameters and the level of tube entry influence corneal endothelial cell density (ECD).

Methods: A total of 29 eyes of 26 patients with AGV implantation were included. Tube-cornea distance, tube-cornea angle, and intracameral tube length were measured using anterior segment optical coherence tomography in three different head positions (neutral, 30° temporalward tilt, and 30° nasalward tilt). The tube entry was assessed using static gonioscopy. ECD was measured using specular microscopy before and after surgery.

Results: The mean tube-cornea distance, tube-cornea angle, and intracameral tube length (neutral: 0.87 ± 0.39 mm, 30.56 ± 5.89˚, and 3.10 ± 0.82 mm, respectively) decreased with head tilts (temporalward: 0.82 ± 0.39 mm, 29.27 ± 5.82˚, and 3.04 ± 0.82 mm, respectively; nasalward: 0.83 ± 0.40 mm, 29.61 ± 6.04˚, and 3.05 ± 0.81 mm, respectively; all p < 0.01). The multivariate analyses found age and the tube insertion level to be associated with postoperative changes in the central ECD (p = 0.039 and 0.013, respectively), and the postoperative follow-up period and tube insertion level to be associated with the difference between the inferonasal and superotemporal ECDs (p = 0.034 and 0.007, respectively).

Conclusions: Mild alterations of head positions induced changes in the intracameral tube positions of AGV implants; nevertheless, it did not significantly affect ECD loss. However, the eyes with tubes inserted anteriorly to Schwalbe's line may be more susceptible to corneal ECD loss.
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http://dx.doi.org/10.3341/kjo.2020.0104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738220PMC
December 2020

Duration of Oral Antibiotics Administration for Cetuximab-Induced Acneiform Eruption.

Dermatology 2021 10;237(3):457-463. Epub 2020 Dec 10.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Acneiform eruption is the most common cutaneous adverse event associated with cetuximab. As it can affect quality of life and adversely affect chemotherapy schedule, additional medical care is required.

Objectives: To investigate the adherence to and the duration of antibiotic administration to treat cetuximab-induced acneiform eruption.

Methods: Medical data of patients who were referred to the Department of Dermatology were reviewed from January 2013 to June 2018. Dermatologists assessed the severity of acneiform eruption and prescribed tetracycline-class antibiotics according to the severity every 2 or 4 weeks. We investigated the duration and amount of oral antibiotic administration and analyzed the factors that may affect the control of acneiform eruption statistically.

Results: A total of 207 of 267 patients referred to the Department of Dermatology showed acneiform eruption; 124 patients were treated with minocycline, 34 patients with doxycycline, 27 patients with both, and 22 patients with topical agents. The mean duration of oral antibiotic medication was 82.7 days. A statistical analysis of the factors that prolonged the use of antibiotics for more than 90 days showed that male and younger age were risk factors. Shorter time interval from starting cetuximab to starting antibiotics was associated with longer duration of antibiotic use, statistically.

Conclusions: Cetuximab-induced acneiform eruption can be well controlled with tetracycline-class antibiotics in about 3 months. It can last longer in male and younger patients. The sooner and the more severe it appears, the longer it can last.
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http://dx.doi.org/10.1159/000511623DOI Listing
December 2020

A randomized, multi-center, open-label study to compare the safety and efficacy between afatinib monotherapy and combination therapy of afatinib and HAD-B1 for the locally advanced or metastatic NSCLC patients with EGFR mutations.

Medicine (Baltimore) 2020 Dec;99(49):e23455

East West Cancer Center, Seoul Korean Medicine Hospital of Daejeon University, Seoul.

Background: Afatinib is an epidermal growth factor receptor - tyrosine kinase inhibitor (EGFR-TKI) with proven efficacy for treating patients with advanced or metastatic non-small cell lung cancer (NSCLC). Unfortunately, responses are limited by acquired resistance. Because traditional Korean medicine may have synergistic effects when combined with chemotherapy or radiotherapy, the aim of our study is to elucidate the efficacy and safety of afatinib plus HangAmDan-B1 (HAD-B1) combination therapy in the treatment of patients with NSCLC, as well as EGFR mutations, who need afatinib therapy.

Methods/design: This study is a randomized, multi-center, open clinical trial. A total of 178 eligible subjects, recruited at 8 centers, are randomly assigned to take Afatinib (20-40 mg) ± HAD-B1 (0.972 g/day) for 48 weeks. In the test group, HAD-B1 and afatinib will be used in combination. The primary outcome is a comparison of progression-free survival (PFS) between afatinib monotherapy and afatinib plus HAD-B1 combination therapy in patients with local advanced or metastatic (Stage IIIA, B, C/IV) NSCLC. Secondary outcomes are the overall survival rates, clinical responses, tumor size reductions, health-related qualities of life, and safety.

Discussion: The result of this clinical trial will provide evidence for the efficacy and safety of using HAD-B1 in the treatment of EGFR-positive patients with locally advanced or metastatic NSCLC who require afatinib therapy.

Trial Registration: Clinical Research Information Service (CRIS), Republic of Korea (ID: KCT0005414), on September 23, 2020.
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http://dx.doi.org/10.1097/MD.0000000000023455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717758PMC
December 2020

Coprevalence of Presbycusis and Its Effect on Outcome of Voice Therapy in Patients With Presbyphonia.

J Voice 2020 Oct 14. Epub 2020 Oct 14.

Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address:

Objective: To identify the coprevalence of presbycusis and presbycusis and analyze the effect of presbycusis on compliance and result of voice therapy in presbycusis patients.

Methods: This cross-sectional, prospective cohort study initially screened patients aged ≥65 years who visited our hospital from February 2019 to January 2020. Unaided pure tone audiometry was performed in these subjects to determine the presence of presbycusis. Perceptual voice assessment by an examiner was conducted for screening of presbycusis, and its diagnosis was confirmed through the voice handicap index-10 (VHI-10) questionnaire and a laryngoscopic exam. Patients with presbycusis underwent voice therapy and were assessed for their compliance and outcomes of the treatment according to the coexistence of presbycusis.

Results: Among the 221 patients, presbycusis and presbycusis were diagnosed in 125 (56.6%) and 110 (49.8%) patients, respectively. The copresence of these two disorders were identified in 87 (39.4%) patients, and there was a significant correlation between presbycusis and presbycusis. The effects of voice therapy were examined in the consecutive 40 patients who were diagnosed with presbycusis. There were 21 patients without presbycusis and 19 patients with presbycusis. The average pretreatment voice handicap index-10 score was significantly higher in presbycusis patients; there was no significant difference in the incidence of dropout from voice therapy between the groups. The patients without presbycusis showed a significant improvement in the functional communication measurement (FCM) level and maximum phonation time (MPT) compared with those of patients with presbycusis after voice therapy.

Conclusions: Presbyphonia and presbycusis coexisted in many elderly people. The improvement in the FCM level and MPT after voice therapy was relatively low if patients with presbycusis accompanied by presbycusis. The copresence of presbycusis did not significantly affect compliance with voice therapy in the patients.
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http://dx.doi.org/10.1016/j.jvoice.2020.09.030DOI Listing
October 2020

Effect of photobiomodulation therapy on radiodermatitis in a mouse model: an experimental animal study.

Lasers Med Sci 2021 Jun 2;36(4):843-853. Epub 2020 Sep 2.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.

This study aimed to evaluate the effect of photobiomodulation (PBM) for prevention of radiodermatitis in an irradiated mouse model and compare the efficacy of PBM using 633- or 830-nm wavelengths. Irradiated mice were randomly distributed into three groups: A (633 nm), B (830 nm), and C (without PBM). On post-irradiation days 7 and 21, we compared acute damage and recovery in treated skin samples to non-irradiated skin using H&E, Masson's trichrome, anti-CD45 and PCNA immunohistochemistry, and a TUNEL assay. Grade 3 radiodermatitis was evident only in group C. Compared with that in group C, the skin in groups A and B had significantly less epidermal hyperplasia, inflammatory cell infiltration, and thinner dermis on day 7 and less inflammatory cell infiltration, fewer apoptotic cells, and thinner dermis on day 21. However, there was no significant difference between groups A and B. This study indicates PBM could prevent severe radiodermatitis by reducing epidermal and dermal damage, inflammation, and apoptosis. There was no difference in PBM efficacy between the 633- and 830-nm wavelengths.
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http://dx.doi.org/10.1007/s10103-020-03123-xDOI Listing
June 2021

Subclinical sacroiliitis detected by abdominopelvic computed tomography in Korean patients with Crohn's disease.

Korean J Intern Med 2021 07 22;36(4):868-877. Epub 2021 Mar 22.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Background/aims: Sacroiliitis is a frequent extraintestinal manifestation of inflammatory bowel diseases (IBDs). This study aimed to assess the prevalence of sacroiliitis using a validated screening tool based on abdominopelvic computed tomography (APCT) in Korean patients with Crohn's disease (CD) and examine potential associations between clinical characteristics and sacroiliitis.

Methods: One hundred five patients with CD undergoing APCT for any indication at an IBD clinic were matched 1:1 for age and sex with 105 controls without underlying chronic illnesses. Using a validated APCT screening tool that defines sacroiliitis as either ankylosis or a total erosion score (TES) ≥ 3, all computed tomography scans were assessed by two independent, blinded radiologists. We compared the prevalence of sacroiliitis between CD patients and controls and clinical characteristics between CD patients with and without sacroiliitis.

Results: The prevalence of sacroiliitis was significantly higher in CD patients than in controls (13.3% vs. 4.8%, p = 0.030). All subjects with sacroiliitis had a TES ≥ 3, but no ankylosis. The assessment of sacroiliitis in APCT showed excellent interreader reliability (Cohen's kappa = 0.933 for presence of sacroiliitis). Sacroiliitis in CD patients was bilateral and asymptomatic. There were no significant associations between sacroiliitis and any demographic data or clinical characteristics in these patients.

Conclusion: The prevalence of APCT-detected sacroiliitis in CD patients was higher than that in controls, but the condition was asymptomatic. The clinical significance of asymptomatic sacroiliitis in Korean CD patients remains unclear.
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http://dx.doi.org/10.3904/kjim.2020.199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273833PMC
July 2021
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