Young-Gun Kim

Oestrogen and progesterone receptor expression in melasma: an immunohistochemical analysis.

Background  Melasma is a commonly acquired symmetrical hypermelanosis on sun‐exposed areas of the skin. The development of melasma appears to be associated with increased levels of oestrogen, exposure to sunlight and a genetic predisposition. Several in vitro studies have partially clarified the effects of oestrogen and progesterone on melasma. However, oestrogen receptor (ER) and progesterone receptor (PR) expression in melasma‐affected skin has not been investigated to date, except for one case report on ER expression.

Immunohistochemical expression of matrix metalloproteinases in the granulomatous rosacea compared with the non‐granulomatous rosacea

Background  There is a granulomatous variant which is recognized in the rosacea spectrum. However, the pathogenesis of granuloma formation in rosacea has not been clearly demonstrated. Matrix metalloproteinases (MMPs) are required for recruitment of inflammatory cells and for tissue remodelling, making way for the development of well‐organized granuloma.

Clinical characteristics and risk of melanoma development from giant congenital melanocytic naevi in Korea: a nationwide retrospective study.

Background  Giant congenital melanocytic naevi (GCMN) are known risk factors for the development of melanoma. However, melanoma risk among Asians is rarely evaluated.

Treatment of Fordyce spots with 5-aminolaevulinic acid–photodynamic therapy

1 Lawrence CM, Lonsdale Eccles AA. Selective sweat gland removal with minimal skin excision in the treatment of axillary hyperhidrosis: a retrospective clinical and histological review of 15 patients. Br J Dermatol 2006; 155:115–18. 2 Bechara FG, Sand M, Sand D et al. Surgical treatment of axillary hyperhidrosis: a study comparing liposuction cannulas with a suction-curettage cannula. Ann Plast Surg 2006; 56:654–7. 3 Perng CK, Yeh FL, Ma H et al. Is the treatment of axillary osmidrosis with liposuction better than open surgery? Plast Reconstr Surg 2004; 114:93–7. 4 Bechara FG, Sand M, Sand D et al. Postoperative situation after axillary suction-curettage: an endoscopical view. J Plast Reconstr Aesthet Surg 2006; 59:304–6.

Dipeptidyl Peptidase-4 Inhibitors and Risk of Heart Failure in Patients With Type 2 Diabetes Mellitus: A Population-Based Cohort Study

Background: The association between dipeptidyl-peptidase IV inhibitors (DPP-4i) and heart failure (HF) remains unclear. In 1 randomized controlled trial and some observational studies, DPP-4i reportedly increased the risk of HF, but 2 other randomized controlled trials and observational studies have shown no such risk. Here, we evaluated the risk of HF and cardiovascular outcomes of DPP-4i compared with sulfonylureas. Methods and Results: A population-based retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment Service database from January 1, 2009, to December 31, 2015. Incident users of sulfonylurea and DPP-4i who were not prescribed the comparator drug in the year before treatment initiation were included. DPP-4i–treated and sulfonylurea-treated patients were matched on propensity score, calculated with >40 variables. The risk of hospitalization for HF was evaluated with a Cox proportional hazards model in 255 691 matched pairs. Analyses were conducted in the total patient population and in both strata divided by the presence of cardiovascular disease during the baseline period. The hazard ratios (HRs) of hospitalization for HF for DPP-4i–treated patients were 0.78 (95% confidence interval [CI], 0.67–0.86) in all of the patients, 0.77 (95% CI, 0.68–0.79) in patients with baseline cardiovascular disease, and 0.71 (95% CI, 0.56–0.90) in patients without baseline cardiovascular disease compared with HRs for sulfonylurea-treated patients. Sitagliptin and linagliptin showed statistically lower risk for hospitalization for HF (HR, 0.76; 95% CI, 0.67–0.86 for sitagliptin-prescribed patients; HR, 0.74; 95% CI, 0.59–0.92 for linagliptin-prescribed patients) than for sulfonylurea. The HRs for hospitalization for myocardial infarction and stroke with the use of a DPP-4i versus sulfonylurea were HR, 0.76 (95% CI, 0.67–0.87) and HR, 0.63 (95% CI, 0.60–0.67), respectively. Conclusions: Our findings suggest that DPP-4i use did not increase the risk of HF compared with sulfonylurea. In addition, the risks for cardiovascular outcomes were not elevated in DPP-4i–treated patients compared with sulfonylurea-treated patients.

Renal Protective Effect of DPP-4 Inhibitors in Type 2 Diabetes Mellitus Patients: A Cohort Study.

Aims. Dipeptidyl-peptidase IV inhibitors (DPP-4i) are among the most popular oral antidiabetic agents. However, the effects of DPP-4i on diabetic nephropathy are not well-established. The aim of this study was to determine the renoprotective effects of DPP-4i, using albuminuria and glomerular filtration rate (GFR) as indicators, in type 2 diabetes mellitus (T2DM) patients. Methods. This retrospective observational cohort study used the clinical database of a tertiary hospital. The changes of urine albumin/creatinine ratio (UACR), estimated GFR (eGFR), and metabolic parameters after treatment were compared with the changes of those parameters before treatment using paired Students t-test. Results. The mean UACR in the entire study population decreased to approximately 45 mg/g 1 year after DPP-4i treatment, while it was increased approximately 39 mg/g 1 year before DPP-4i treatment (p < 0.05). Patients with macroalbuminuria showed a significant reduction in albumin levels after DPP-4i treatment (p < 0.05); however, patients with microalbuminuria and normoalbuminuria did not show improvements in albuminuria levels after treatment. Although eGFR was not changed 1 year after DPP-4i treatment, reductions in eGFR were slowed in patients with microalbuminuria and reversed in the macroalbuminuria or normoalbuminuria groups, 4 years after treatment. Conclusions. Administration of DPP-4i reduces urine albumin excretion and mitigates reduction of eGFR in T2DM patients.

Factors affecting quality of life in patients with vitiligo: a nationwide study

Little is known about factors affecting the quality of life (QoL) of patients with vitiligo, and previous studies have shown conflicting results.

Rate of electronic health record adoption in South Korea: A nation-wide survey

OBJECTIVE The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US. METHODS All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities. RESULTS EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%). DISCUSSION The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009. CONCLUSIONS The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries.

Acquired bilateral melanosis of the neck in perimenopausal women

Background  Acquired bilateral patchy or mottled pigmentation of the neck has occasionally been observed.

Acquired bilateral naevus of Ota-like macules: an immunohistological analysis of dermal melanogenic paracrine cytokine networks

Background  Acquired bilateral naevus of Ota‐like macules (ABNOM) is similar to melasma with regard to their clinical features, including female predominance, acquired onset, and predominant involvement of the malar area. The similar clinical features suggest the possibility of a shared pathogenesis. Dermal factors including vascularity and melanogenic paracrine networks such as the stem cell factor (SCF)/c‐kit pathway have recently been suggested to play an important role in the pathogenesis of melasma. However, the role of dermal factors in ABNOM remains unknown.