BACKGROUND: Lipids of horny layer forming multiple lamellar structure in the intercellular space acts as a skin barrier having a primary protective function and keeps softness and flexibility of the skin by absorbing and maintaining moistures. Among the intercellular lipids, ceramides mainly contribute to this important role. In xerotic eczema, atopic dermatitis, psoriasis, ichthyosis, and experimentally induced scaly lesion showing dryness and scales, the amount of ceramides is decreased or distribution of ceramide is changed. In addition to lipids, free amino acids, a component of NMFs, serve as a water retainer and are decreased in ichthyosis or experimentally induced scaly lesion. Hand eczema has dry and scaly lesion showing impaired skin barrier and low water content. So, changes of ceramides or free amino acids can be considered in the lesion of hand eczema. OBJECTIVE: The purpose of this study was to confirm the relationship between the development of hand eczema and changes of ceramides or free amino acids. METHOD: The lipids and free amino acids in scales from lesion of hand eczema were analyzed by using high performance thin layer chromatography and amino acid analyzer. RESULTS: Amounts of total lipids extracted were 0.63+/-0.33 microgram/cm2 in hand eczema and 0.44+/-0.26 microgram/cm2 in control. There was no difference between the two groups. Cholesterol sulfate, glucosyl ceramide, cholesterol, triglyceride, sterol ester, and n-alkane showed no difference between hand eczema and control. But ceramides were significantly decreased in hand eczema(11.0+/-5.5%) compared with control(21.4+/-8.0%)(p<0.05). Especially, ceramide type IV was significantly decreased in hand eczema (6.6+/-5.3%) compared with control(15.6+/-6.2%)(p<0.05) but ceramide type III in hand eczema did not differ from control. Amounts of total free amino acids in 10mg of scale were 10.4+/-3.1nmol in hand eczema and 9.5+/-3.0nmol in control. There was no significant difference between the two groups. CONCLUSION: Dry skin and scales in hand eczema are related to the decrease of total amount of ceramides and ceramide type IV than amino acids in horny layer. To clarify the exact pathogenesis of hand eczema, further investigations on all types of ceramides and their defect in the process on biosynthesis of ceramides will be necessary.
Amino Acids* ; Ceramides* ; Cholesterol ; Chromatography, Thin Layer ; Dermatitis ; Dermatitis, Atopic ; Eczema* ; Extracellular Space ; Hand* ; Ichthyosis ; Pliability ; Psoriasis ; Skin ; Triglycerides ; Water ; Weights and Measures

BACKGROUND: Lipids of horny layer forming multiple lamellar structure in the intercellular space acts as a skin barrier having a primary protective function and keeps softness and flexibility of the skin by absorbing and maintaining moistures. Among the intercellular lipids, ceramides mainly contribute to this important role. In xerotic eczema, atopic dermatitis, psoriasis, ichthyosis, and experimentally induced scaly lesion showing dryness and scales, the amount of ceramides is decreased or distribution of ceramide is changed. In addition to lipids, free amino acids, a component of NMFs, serve as a water retainer and are decreased in ichthyosis or experimentally induced scaly lesion. Hand eczema has dry and scaly lesion showing impaired skin barrier and low water content. So, changes of ceramides or free amino acids can be considered in the lesion of hand eczema. OBJECTIVE: The purpose of this study was to confirm the relationship between the development of hand eczema and changes of ceramides or free amino acids. METHOD: The lipids and free amino acids in scales from lesion of hand eczema were analyzed by using high performance thin layer chromatography and amino acid analyzer. RESULTS: Amounts of total lipids extracted were 0.63+/-0.33 microgram/cm2 in hand eczema and 0.44+/-0.26 microgram/cm2 in control. There was no difference between the two groups. Cholesterol sulfate, glucosyl ceramide, cholesterol, triglyceride, sterol ester, and n-alkane showed no difference between hand eczema and control. But ceramides were significantly decreased in hand eczema(11.0+/-5.5%) compared with control(21.4+/-8.0%)(p<0.05). Especially, ceramide type IV was significantly decreased in hand eczema (6.6+/-5.3%) compared with control(15.6+/-6.2%)(p<0.05) but ceramide type III in hand eczema did not differ from control. Amounts of total free amino acids in 10mg of scale were 10.4+/-3.1nmol in hand eczema and 9.5+/-3.0nmol in control. There was no significant difference between the two groups. CONCLUSION: Dry skin and scales in hand eczema are related to the decrease of total amount of ceramides and ceramide type IV than amino acids in horny layer. To clarify the exact pathogenesis of hand eczema, further investigations on all types of ceramides and their defect in the process on biosynthesis of ceramides will be necessary.
Amino Acids* ; Ceramides* ; Cholesterol ; Chromatography, Thin Layer ; Dermatitis ; Dermatitis, Atopic ; Eczema* ; Extracellular Space ; Hand* ; Ichthyosis ; Pliability ; Psoriasis ; Skin ; Triglycerides ; Water ; Weights and Measures

BACKGROUND: Massive bleeding, inability to identify important landmarks and structures, and necessity for a blood transfusion have been the usual problems of hemangioma excision. OBJECTIVE: We introduce a CO2 laser excision technique as a surgical method for the treatment of hemangioma of the lips and demonstrate its benefits. METHODS: In 4 patients with nevus flammeus of hemiface and accompanying hemangioma of the lips, excision of the hemangioma was performed using a focused beam from a CO2 laser under local anesthesia. RESULTS: Excellent to good results were achieved with minimal blood losses in all patients. No or minimal post-operative pain and edema and no significant complications were observed. CONCLUSION:The CO2 laser excision technique is recommended since it renders less textural change, greater volume reduction, hemostasis and an overall good cosmetic outcome than defocused modes or conventional scalpel surgery.
Anesthesia, Local ; Blood Transfusion ; Edema ; Hemangioma* ; Hemorrhage ; Hemostasis ; Humans ; Lasers, Gas* ; Lip* ; Port-Wine Stain

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

OBJECTIVE: The purpose of this study was to analyze current status of the web sites dealing with asthma in the Internet, and to evaluate their technical aspects and contents. METHODS: The evaluation tool consisted of four areas(construction, operation, accessibility, and content) with twenty-six items. Four sites including the contents related with symptoms of asthma, consultation of health professionals, and treatment and nursing for asthma were selected to be analyzed. RESULTS: The results of the analysis were as follows: 1) there was no web site dealing with asthma managed by public institutions 2) the only 5% of the top 100 sites were found to be related with the asthma by exploring the top five search engines in Korea and 3) the evaluation scores four web sites were 6-11 out of 18 in the category of construction, 10-21 out of 24 in operation, 5-10 out of 15 in accessibility, and 8-18 out of 21 in content. CONCLUSION: In conclusion, it will be possible to prevent asthma at first through web sites, which will be one of the most beneficial aspects of web site, so the system to evaluate web sites should be developed to provide high-quality information about asthma.
Asthma ; Health Occupations ; Internet ; Korea ; Nursing ; Search Engine

The proliferating trichilemmal cyst is a rare, usually benign tumor of external root sheath origin. About 90% of the cases gccur on the scalp, with the residual 10% occurring mainly on the back. More than 80% of the patients are women, most of whom are elderly. The cysts are commonly large, measuring up to 6 cm or more in diameter. A 33-year-old woman visited our department with a history of a matchhead- sized erythematous tender papule on her left knee that had been present for two years. A histopathological examination revealed a well-circumscribed, multilobulated cystic tumor with trichilemmal keratinization in the dermis. There were individual cell keratinization and focal calcification in some areas. This case was diagnosed as a proliferating trichilemmal cyst. This case was very unusual not only because the tumor occurred on the knee as a matchhead-sized papule but also because of her young age at presentation.
Adult ; Aged ; Dermis ; Female ; Humans ; Knee ; Scalp

PURPOSE: To investigate the relation of the gastric epithelial cell proliferation, apoptosis and genotypes of H. pylori in children. METHODS: Histologic grading by updated Sydney system, PCNA immunostaining, TUNEL method and the genotypes (cagA, picB and iceA) by PCR were performed in H. pylori positive (N=20) and negative (N=20) gastric biopsy specimens. RESULTS: PCNA index was significantly different between H. pylori positive children (77.4+/-13.12) and H. pylori negative children (52.3+/-12.20) (p=0.000). There were positive correlations between PCNA index and H. pylori density (r=0.624, p=0.000), polymorphonuclear neutrophil activity (r=0.460, p=0.005) and chronic inflammation (r=0.433, p=0.009). Apoptosis index of H. pylori positive children (0.70+/-0.411) was significantly higher than of H. pylori negative children (0.14+/-0.201) (p=0.000). Positive correlations between apoptosis index and H. pylori density (r=0.691, p=0.000), polymorphonuclear neutrophil activity (r=0.585, p=0.000) and chronic inflammation (r=0.535, p=0.001) were noted. As PCNA index increased, apoptosis index significantly increased (r=0.527, p=0.001). The positive rates of genotypes were cagA 90%, picB 75%, iceA1 60% and iceA2 15%, respectively. There were no significant correlations between the status of the genotypes and PCNA index, apoptosis index, the endoscopic findings and the histologic findings. CONCLUSION: PCNA index and apoptosis index in H. pylori positive children were higher than in H. pylori negative children but were not related to H. pylori genotypes. This study suggested that correlatively increased gastric epithelial cell proliferation and apoptosis are important to pathogenesis of H. pylori infection in children.
Apoptosis* ; Biopsy ; Child* ; Epithelial Cells* ; Genotype* ; Helicobacter pylori* ; Helicobacter* ; Humans ; In Situ Nick-End Labeling ; Inflammation ; Neutrophils ; Polymerase Chain Reaction ; Proliferating Cell Nuclear Antigen

The purpose of this study was to develop a fusion-food cooking program and apply that to sixth grade elementary school students, and to investigate its' effects on their knowledge, preferences, and perceptions of Korean traditional foods. The program focused on ten components. Students learned the general features of Korean traditional foods and Western foods in the 1st lesson. They learnt about kinds, nutrition value, and histories of kimchi, Tteok (rice cake), and Jeon (pan fried food), and cooked two fusion-foods of kimchi, Tteok, and Jeon each. As a result of learning about those food items, the students advanced their knowledge (p < 0.001) of kimchi, Tteok, and Jeon. Their preferences for Tteok (p < 0.05) and Jeon (p < 0.01) were increased, but those for kimchi remained unchanged. The interest (p < 0.05) and preferences (p < 0.01) for the general Korean traditional foods were increased. In conclusion, our results suggested that the fusion-food cooking program had the ability to improve elementary school students' perceptions of Korean traditional foods by increasing their knowledge, preferences, and interest in them. Furthermore it was considered that the program could help students understand the value of Korean traditional foods and in turn may encourage them to consume such food items more frequently. Since the fusion-food cooking activity program can be a good learning program as shown by the results of this study, more fusion-foods cooking activity programs, which are not discussed in this study, should be evaluated and developed in the future.
Cooking ; Humans ; Learning ; Nutritive Value

PURPOSE: Duane's retraction syndrome is a congenital eye movement disorder caused by innervational disturbance. It is rare that Duane's retraction syndrome is associated with Goldenhar's syndrome which shows systemic congenital malformations. We report a case of bilateral Duane's retraction syndrome associated with Goldenhar's syndrome, which was treated with strabismus surgery and excision of epibulbar lipodermoid. METHODS: A 14-month-old boy with exotropia showed severe limitation of adduction, mild limitation of abduction, globe retraction and palpabral fissure narrowing on attempted adduction in both eyes. He also had a diffuse small epibulabar mass under the lateral conjunctiva in the left eye. The angle of exodeviation was 45PD on alternate prism cover and uncover test. He had had cleft lip, multiple skin tags on the face and preauricular appendages since birth and undergone an operation for these abnormalities at age of 4 months. Bilateral 7.5mm recession of the lateral recti and excisional biopsy of epibulbar mass of the left eye were performed. RESULTS: A case of Duane's retraction syndrome associated with Goldenhar's syndrome was found. The patient obtained orthophoria in his primary gaze after bilateral recession of lateral recti. The epibulbar mass was consistent with lipodermoid on pathologic examination.
Biopsy ; Cleft Lip ; Conjunctiva ; Duane Retraction Syndrome* ; Exotropia ; Humans ; Infant ; Male ; Ocular Motility Disorders ; Parturition ; Skin ; Strabismus

PURPOSE: We performed this study to evaluate the occurrence of consecutive esotropia after early surgery in the patients with intermittent exotropia less than 4 years of age. METHODS: We analyzed the surgical results of 37 patients who underwent surgery before 4 years of age retrospectively. They were followed up at least more than 1 year after surgery. The orthophoria was defined as an exophoria of 0 to 12PD or an esophoria of 0 to 5PD after surgery. The consecutive esotropia was defined as an esodeviation lasting more than 3 months that needed surgical correction due to sensorial deterioration. RESULTS: Preoperative angle of exodeviation at distance ranged from 20PD to 60PD (mean 35.1 +/- 9.2PD). Twenty-seven of 37 patients (75.7%) showed orthophoria after surgery in 1 year follow-up and 20 of 31 patients (64.5%) in 2 years follow-up. Five patients (13.5%) showed recurrence and 4 patients (10.8%) consecutive esotropia. Immediate postoperative overcorrection was 14.1 +/- 8.7PD(0-30) in patients who were orthophoric after postoperative follow-up more than 2 years. The rate of consecutive esotropia was high in patients with an exo-angle of 30PD or more and a large amount of recession of lateral recti more than 7mm. CONCLUSIONS: This study revealed that consecutive esotropia after early surgery for intermittent exotropia less than 4 years of age was noted to the 10.8%.
Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies