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Purpose@#Since patients on hemodialysis (HD) are known to be vulnerable to coronavirus disease 2019 (COVID-19), many studies were conducted regarding the effectiveness of the COVID-19 vaccine in HD patients in Western countries. Here, we assessed antibody response of HD patients for 6 months post-vaccination to identify the duration and effectiveness of the COVID-19 vaccine in the Asian population. @*Materials and Methods@#We compared antibody response of the COVID-19 vaccine in HD patients with healthy volunteers. Patient and control groups had two doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) was measured before vaccination, 2 weeks after the first dose, 2 and 4 weeks, 3 and 6 months after the second dose. Neutralizing antibody was measured before vaccination and at 2 weeks, 3 and 6 months after second dose.Since the third dose was started in the middle of the study, we analyzed the effect of the third dose as well. @*Results@#Although antibody production was weaker than the control group (n=22), the patient group (n=39) showed an increase in IgG and neutralizing antibody after two doses. And, 21/39 patients and 14/22 participants had a third dose (BNT162b2 or mRNA-1273 in the patient group, mRNA-1273 in the control group), and it did not affect antibody response in both group. Trend analysis showed IgG and neutralizing antibody did not decrease over time. Age, sex, and HD vintage did not affect antibody production in HD patients. Patients with higher body mass index displayed better seroresponse, while those on immunosuppressants showed poor seroresponse. @*Conclusion@#Two doses of vaccination led to significant antibody response in HD patients, and the antibody did not wane until 6 months.
ABSTRACT
BACKGROUND: Malignant melanoma is a cutaneous malignancy with a high mortality rate and high potential for metastases. Detailed information on the clinicopathologic characteristics and prognostic factors of cutaneous melanoma is currently limited in Korea. This study aimed to identify the epidemiological and clinicopathologic characteristics of primary cutaneous melanoma in Korean patients, and to assess which prognostic variables could influence both the development of metastases in primary cutaneous melanoma and overall survival (OS). METHODS: A total of 261 patients diagnosed with primary cutaneous melanoma in seven medical centers between 1997 and 2017 were retrospectively investigated with regard to clinical presentation, localization of the tumor, histopathologic subtype, and survival time. RESULTS: The nodular histologic subtype, ulceration, and Breslow thickness were significantly associated with the development of metastasis; and overweight and obesity (body mass index > 23) were significantly associated with increased Breslow thickness. The location of the metastases appeared to influence OS: brain metastases were associated with the highest risk of death, followed by gastrointestinal, lung, and extra-regional lymph node metastases. CONCLUSION: In this study, tumor thickness, nodular histologic subtype, and ulceration predicted metastatic spread of primary cutaneous melanoma. In addition, OS was associated with the location of metastases. Obesity was related to the prognosis of primary cutaneous melanoma. Clinicians should bear these findings in mind when forming a diagnosis because of the risk of a poor prognosis.
Subject(s)
Humans , Brain , Diagnosis , Korea , Lung , Lymph Nodes , Melanoma , Mortality , Neoplasm Metastasis , Obesity , Overweight , Prognosis , Retrospective Studies , Skin Neoplasms , UlcerABSTRACT
BACKGROUND: Face-lifting procedures are often performed to hide the effects of aging. Thread-lifting, a minimally invasive technique for the correction of facial aging, has become increasingly popular, and various materials for the procedure have been developed. OBJECTIVE: This study compared tissue responses to two types of threading sutures placed under rat skin: polypropylene (PP) monofilament mesh suspension thread (a novel face-lifting material) and polydioxanone (PDO) barbed thread. METHODS: Eight rats each were assigned to the PP monofilament mesh suspension, PDO barbed thread, and control groups. Tissue reactions were evaluated 28 days after subcutaneous loading of the materials. RESULTS: Significant increases in tensile strength and the mean area occupied by collagen fibers were evident in skin loaded with PDO barbed thread and PP monofilament mesh suspension thread compared to control skin (p<0.05). Compared to sites loaded with PDO barbed thread, those loaded with PP monofilament mesh suspension thread showed a significant increase in the number of collagen fibers and a lower grade of inflammation (p<0.05). CONCLUSION: PP monofilament mesh suspension thread has skin-rejuvenating effects comparable to those of PDO barbed thread, but induces a less severe inflammatory response. This indicates that it is a safe and effective material for use in thread-lifting procedures on aging skin.
Subject(s)
Animals , Rats , Aging , Collagen , Inflammation , Polydioxanone , Polypropylenes , Skin , Sutures , Tensile StrengthABSTRACT
No abstract available.
ABSTRACT
BACKGROUND: Acne vulgaris is one of the most common disorders of the pilosebaceous unit. Although doxycycline is considered to be a first-line anti-acne antibiotic, various other antibiotics have been tried due to its adverse effects and contraindications. We performed a meta-analysis of randomized controlled trials (RCTs) that compared the efficacy of oral azithromycin pulse therapy with that of oral daily doxycycline in the management of moderate to severe acne vulgaris. METHODS: Five scientific databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science) were searched to identify relevant studies. A review of 1,341 publications produced six RCTs that met our predefined inclusion criteria. The clinical outcome measures were remaining acne lesion counts, patients' self-assessment of treatment, and the investigators' assessment of treatment after 12 weeks. RESULTS: We included six studies assessing 906 patients with moderate to severe acne vulgaris. Meta-analyses of clinical outcome measures revealed no significant difference between the two groups regarding remaining acne lesion counts (p=0.27), patients' self-assessment of treatment (p=0.67), and the investigators' assessment of treatment (p=0.32). The incidence of severe adverse events leading to the discontinuation of therapy was higher in the doxycycline daily therapy group when compared with the azithromycin pulse therapy group CONCLUSION: This study indicates that azithromycin pulse therapy is equivalent to doxycycline at 12 weeks in the efficacy of the treatment for moderate to severe acne vulgaris Therefore, oral azithromycin pulse therapy may be a good alternative to doxycycline in the management of acne for those unable to tolerate doxycycline.
Subject(s)
Humans , Acne Vulgaris , Anti-Bacterial Agents , Azithromycin , Doxycycline , Incidence , Outcome Assessment, Health Care , Self-AssessmentABSTRACT
No abstract available.
Subject(s)
Female , Humans , Pregnancy , Cesarean Section , Lichen Planus , Lichens , SteroidsABSTRACT
PURPOSE: The purpose of this study was to investigate the factors associated with atopic dermatitis in Korean adults. METHODS: The data were obtained from the Korean National Health and Nutrition Survey on 2008. Subjects of this study were 7,280 adults aged older than 18 years. The data were analyzed for demographic characteristics, health status, alcohol drinking, smoking, hypertension, hyperlipidemia, asthma, chronic sinusitis, rhinitis, stress, depression, and suicidal ideation between atopy group and non-atopy group. RESULTS: Among 7,280 subjects, 2.9% of Korean adults had a diagnosis of atopic dermatitis from doctor. Multiple logistic regression identified that the presence of atopic dermatitis was associated with marital status (OR=2.66, CI 1.84~3.86, p<.001), rhinitis (OR=1.52, CI 1.04~2.22, p = .030), and depression (OR=1.89, CI 1.04~3.41, p = .036). CONCLUSION: Based on these results, marital status, rhinitis, and depression should be considered in addressing individuals with atopic dermatitis. And the other factors contributing to atopic dermatitis need to be specifically identified.
Subject(s)
Adult , Aged , Humans , Alcohol Drinking , Asthma , Depression , Dermatitis, Atopic , Hyperlipidemias , Hypertension , Logistic Models , Marital Status , Nutrition Surveys , Rhinitis , Risk Factors , Sinusitis , Smoke , Smoking , Suicidal IdeationABSTRACT
OBJECTIVE: Staphylococcal scalded skin syndrome (4S) is not common, but has been increasingly recognized. We investigated the clinical features of 4S for the last 10 years. METHODS: This retrospective study was performed on 68 children who were admitted with 4S during 2001 to 2011. The patients were divided into 3 age groups: or =48 months. We evaluated the clinical findings and the differences among the 3 age groups. RESULTS: The mean age was 32 months with a peak incidence at age 12 to 47 months. The peak incidence was observed in 2007 with a seasonal occurrence, mainly from July to October. Except 2007, there was no obvious seasonal pattern in incidence. Atopic dermatitis was combined in 10 patients (14.7%). By clinical types, 4 patients (5.9%) were in generalized type, 17 patients (25%) in intermediate type, and 47 patients (69.1%) in abortive type. The patients with generalized type were all neonates, and intermediate type was more frequent in children younger than 12 months. In contrast, abortive type was a most frequent form after 12 months of age. Of 44 patients performed skin culture, methicillin-resistant Staphylococcus aureus was isolated in 25 cases. All affected patients recovered completely with semi-synthetic penicillin or 3rd generation cephalosporins. Four neonates were treated with vancomycin or teicoplanin. CONCLUSION: The peak incidence of 4S was at age 12 to 47 months. The severity of 4S was most severe in children younger than 12 months, showing a difference in clinical types according to the age groups.
Subject(s)
Child , Humans , Infant, Newborn , Cephalosporins , Dermatitis, Atopic , Incidence , Methicillin-Resistant Staphylococcus aureus , Penicillins , Retrospective Studies , Seasons , Skin , Staphylococcal Scalded Skin Syndrome , Staphylococcus aureus , VancomycinABSTRACT
OBJECTIVE: Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity, and for which there is a need for safe and effective alternative therapies. Although a few observations on the efficacy of intravenous immunoglobulin (IVIG) in AD have been reported, clinical evidence of effectiveness from controlled trials is lacking. Therefore, the purpose of this study was to clarify whether IVIG therapy (1.0 g/kg body weight at each monthly visit for 6 months) is effective in childhood atopic dermatitis and to analyze the clinical characteristics of IVIG responses in this disease. METHODS: Forty three atopic dermatitis patients who had characteristic clinical features of atopic dermatitis were included in this study. The patients received an injection of IVIG at 1.0 g/kg body weight at each monthly visit for 6 months. Laboratory tests were performed for blood chemistry, total immunoglobulin E, immunoglobulin G/immunoglobulin A/immunoglobulin M, blood eosinophil count, and C-reactive protein. RESULTS: In total forty three atopic dermatitis patients, only 14 patients completely underwent 6 cycles, but other 29 patients incompletely (1-5 cycles). In the 14 patients, there were just 13 records of scoring atopic dermatitis (SCORAD) index. The mean SCORAD score in the 13 patients was 39.6+/-24.4. SCORAD score decreased significantly (initial SCORAD, 39.6+/-24.4; final SCORAD, 21.3+/-15.6; P=0.016). CONCLUSION: IVIG therapy may be recommended in the treatment of recalcitrant atopic dermatitis. In addition, further investigation on predictive markers for responses of IVIG therapy in atopic dermatitis may be needed.
Subject(s)
Child , Humans , Body Weight , Complementary Therapies , Dermatitis, Atopic , Eosinophils , Immunization, Passive , Immunoglobulin E , Immunoglobulins , Immunoglobulins, Intravenous , Skin DiseasesABSTRACT
PURPOSE: The purpose of this study was to examine the training effectiveness and behavior towards the elderly of 180 caregiver trainees. METHODS: Data were collected from five caregiver training institutions located in G city. All subjects were surveyed about the training effectiveness and behavior towards the elderly by using the Training Effectiveness Scale and the Behavior towards the Elderly Scale. Data were analyzed by SPSS/WIN 12.0 program. RESULTS: The study subjects gained a training effectiveness score of 3.84 out of 5 points and a behavior towards the elderly score 3.40 out of 4 points. The training effectiveness differed significantly depending on subject's characteristics, intention to work as a caregiver, and hours of training. There were significant differences in behavior towards the elderly depending on their age and hours of training. The training effectiveness was significantly correlated with the level of behavior towards the elderly. CONCLUSION: These findings demonstrated the necessity of developing a level of educational training that will help improve caregiver trainees' care by positively changing their behavior towards the elderly.
Subject(s)
Aged , Humans , Caregivers , IntentionABSTRACT
We report herein a case of hepatoid adenocarcinoma of the stomach with liver metastasis. Gastric carcinoma generally presents as adenocarcinoma and rarely shows a hepatoid pattern, which can produce alpha-fetoprotein (AFP). The stomach is one of the common sites at which hepatoid adenocarcinoma has been detected. A 75-year-old female patient was admitted to the hospital with a symptom of epigastric discomfort. Gastrofibroscopy revealed a large tumor occupying the greater curvature of the stomach body. The level of serum AFP was markedly increased. Abdominal computed tomography revealed multiple liver masses. Biopsy samples of the gastric lesion and liver masses finally confirmed her case as hepatoid adenocarcinoma in the stomach with liver metastasis. The AFP-producing gastric carcinoma needs special attention because it often presents with early liver metastasis and has a poor prognosis.
Subject(s)
Aged , Female , Humans , Adenocarcinoma/diagnosis , Gastroscopy , Liver Neoplasms/diagnosis , Lymphatic Metastasis , Stomach Neoplasms/diagnosis , Tomography, X-Ray Computed , alpha-Fetoproteins/metabolismABSTRACT
Myopathy is a well known side effect of corticosteroid therapy. We report a case of iatrogenic steroid therapy induced myopathy in a 79-year-old female who had taken steroids for more than three years due to treatment for degenerative osteoarthritis. She complained of severe proximal muscle wasting and lower extremities weakness. Also, she had typical features of Cushing syndrome such as moon face, buffalo hump and easy bruising. Needle electromyogram showed no abnormal spontaneous activities in both lower extremities, but peripheral nerve conduction study showed motor conduction defect of both deep peroneal and tibial nerves. And, low SNAP (sensory nerve action potential) of both superficial peroneal and sural nerves, which were compatible with peripheral polyneuropathy in both lower extremities. The muscle biopsy revealed a pronounced muscle fiber atrophy, fatty degenerative change and selective type 2 fiber depletion on ATPase staining in pH 9.4 buffer. She was treated isotonic exercise physical therapy and slowly improved. After three months later, she complained sudden onset of chest discomfort and died due to congestive heart failure.
Subject(s)
Aged , Female , Humans , Adenosine Triphosphatases , Atrophy , Biopsy , Buffaloes , Cushing Syndrome , Heart Failure , Hydrogen-Ion Concentration , Lower Extremity , Muscular Diseases , Needles , Osteoarthritis , Peripheral Nerves , Polyneuropathies , Steroids , Sural Nerve , Thorax , Tibial NerveABSTRACT
PURPOSE: To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. METHODS: 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine b2-microg1obuin/creatinine(b2MG/cr) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. RESULTS: There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine b2MG/cr and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. CONCLUSION: There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.