Background: Longitudinal melanonychia (LM) can be caused by a variety of benign and malignant conditions. Nail matrix biopsy is necessary for the diagnosis of LM; however, physicians hesitate to perform the nail matrix biopsy due to the risk of postoperative complications like permanent matrix damage. Therefore, biopsy methods that minimize the risk of postoperative complications are necessary. Objective: To investigate the efficacy and safety of the nail matrix shave biopsy using a razor blade. Methods: We reviewed the medical records, clinical photographs, and histopathologic slides of patients who underwent shave biopsy for the diagnosis of LM from January 2018 to March 2020 at Wonkwang University Hospital. Results: The entire pigmented lesion was removed completely by shaving only a partial thickness of the superficial matrix in all patients. The histopathologic diagnosis was melanocyte activation with no atypia in all cases. Eight patients were followed up for 7∼19 months. Resting pain after the shave biopsy improved in most cases (75%) within 1 week. One patient experienced numbness lasting for 3 months. Abnormal sensations, such as tingling and itching, were temporarily reported by two patients. One patient (12.5%) had temporary postoperative nail plate dystrophy, and three patients (37.5%) had recurrence of pigmentation. Conclusion Our protocol of shave biopsy showed a lower rate of postoperative nail dystrophy than the conventional shave biopsy. We suggest that the shave biopsy using a flexible stainless steel razor blade is a favorable alternative to the conventional shave biopsy.

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

Tumoral calcinosis is an ectopic calcification syndrome characterized by an irregular soft tissue mass. It has been reported mainly in large joints such as the hip, shoulder, knee, and elbow, but rarely in the hands. When it occurs on the dorsal side of the wrist, there are no specific symptoms except for localized tenderness. Therefore, it is difficult to differentiate the calcification from other common hand tumors, especially ganglions. We report a case of tumoral calcinosis that occurred on the dorsal side of the wrist with magnetic resonance imaging findings.

BACKGROUND: Malassezia yeasts are lipophilic fungi that are found in 75~80% of healthy adults. Recently, various molecular biological techniques are being preferred to identify and classify the Malassezia yeasts. Pyrosequencing is a real-time DNA sequencing technique. This technology has the potential advantage of accuracy, ease-of-use, high flexibility and is now emerging as a popular platform for microbial typing. OBJECTIVE: We sought to implement novel molecular biology technique, namely pyrosequencing method in identifying and classifying Malassezia yeasts, and assess its clinical applicability. METHODS: We obtained ribosomal RNA sequences of 11 Malassezia standard strains from NCBI database. Primers for the initial PCR amplification of the target region (ITS2) and sequencing primers within the regions amplified by the PCR primers were designed using Pyrosequencing Assay Design Software (Biotage AB, Uppsala, Sweden). We obtained PCR amplifying fragments of genomic DNA isolated from the Malassezia yeasts. And pyrosequence reactions were performed using reagents provided with the PSQ 96 Sample Preparation kit. RESULTS: In the PCR analysis, all of 11 standard strains are shown at the 130 bp levels. In the pyrosequencing analysis, M. obtusa and M. furfur sequences were corresponded among 11 Malassezia standard strains. But, in 4 cases, Malassezia strains mismatched with expected Malassezia strain and in rest of 5 Malassezia strains, pyrosequencing was failed. CONCLUSION: As evidenced above, pyrosequencing analysis could provide a sensitive and rapid identification system for Malassezia species. But it still has many limitation to be applied to epidemiological surveys and clinical practice.
Adult ; Classification* ; DNA ; Fungi ; Humans ; Indicators and Reagents ; Malassezia* ; Molecular Biology ; Pliability ; Polymerase Chain Reaction ; RNA, Ribosomal ; Sequence Analysis, DNA ; Yeasts*

BACKGROUND: Malassezia yeasts are lipophilic fungi that are found in 75~80% of healthy adults. The yeasts are known to be associated with pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis, and recently its pathogenicity is being expanded to other various skin disorders, such as atopic dermatitis and acne vulgaris. Recently, various molecular biological techniques are being preferred over morphological analysis. In order to perform a DNA-based diagnostic test, availability of a simple, rapid, and reliable DNA extraction protocol is essential. OBJECTIVE: We sought to implement novel molecular biology technique, namely colony PCR method using microwave as the easiest way to amplification of Malassezia target DNA, and assess its clinical applicability. METHODS: Instead of using templates of purified genomic DNA, we performed the PCR directly from Malassezia colonies. A fresh yeast colony transferred to the bottom of a microcentrifuge tube and microwaved for 1 min three times in the presence of a pyrex beaker containing 50 ml of sterile water to dissipate excess heat. Following this microwave lysis, PCR-reaction mixture was added directly to the microcentrifuge tube. Two DNA extraction methods (boiling method, glass beads method) were used for comparing the sensitivity and effectiveness with the colony PCR method. All reactions were performed using the primers 26S and ITS1 complementary to the rDNA region. Results 1. As a result of gel electrophoresis, we recognized expected PCR products (approximately 580 bp for 26S rDNA and 250~320 bp for ITS1) from both colony PCR method and two DNA extraction methods (boiling method, glass beads method). 2. As a result of measuring nucleic acid level with the spectrophotometer, colony PCR disregarding DNA extraction process shows relatively similar PCR efficacy compared with the boiling and glass beads method. And there is no significant difference among those methods statistically (p>0.001). 3. In conducting the PCR method, boiling method required approximately 400 minutes, and glass beads method required approximately 360 minutes, respectively. As contrasted with two methods, colony PCR method required approximately 150 minutes, and could be capable of saving time. In addithion, colony PCR had an economic efficiency comparing with boiling method and glass beads methods. CONCLUSIONS: All these findings suggest that directly application of the Malassezia yeasts obtained from culture colony for PCR reaction is a fast, reliable, cost-effective and simple method for performing any PCR-based protocol including diagnostic tests.
Acne Vulgaris ; Adult ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Diagnostic Tests, Routine ; DNA ; DNA, Ribosomal ; Electrophoresis ; Folliculitis ; Fungi ; Glass ; Hot Temperature ; Humans ; Malassezia* ; Microwaves ; Molecular Biology ; Polymerase Chain Reaction* ; Skin ; Tinea Versicolor ; Virulence ; Water ; Yeasts*

OBJECTIVE: The incidence of subarachnoid hemorrhage (SAH) worldwide varies considerably. In spite of many reports about the incidence of SAH, there has been no report about the incidence of SAH on the basis of the Korean population. The purpose of this hospital-based study was to assess the actual incidence rates of aneurysmal SAH in Gwangju city and Jeollanamdo province. METHODS: All cases of SAH confirmed by computerized tomography (CT) between January 2007 and December 2007 were selected for analysis. For the data collection, three major training hospital and ten general hospitals working the CT in Gwangju city and four major general hospitals in Jeollanamdo province participate in this study. RESULTS: According to the official census of Korea, the population was 1,413,444 in Gwangju city and 1,929,836 in Jeollanamdo province in 2007. There were 163 patients in Gwangju city and 266 patients in Jeollanamdo province confirmed SAH by CT in 2007. The crude and the age- and sex-adjusted annual incidence rates per 100,000 population for all ages in Gwangju city were 11.5 and 12.4 for aneurysmal SAH and in Jeollanamdo province were 13.8 and 10.8. The incidence was higher in women and increased with age. The gender distribution varied with age. At young ages, the incidence was higher in men while after the age of 40 years, the incidence was higher in women. CONCLUSION: In the present study, the age- and sex-adjusted annual incidence rates is 11.8 in Gwangju city and Jeollanamdo province. The incidence was higher in women and increased with age.
Aneurysm ; Censuses ; Data Collection ; Female ; Hospitals, General ; Humans ; Incidence ; Korea ; Male ; Risk Factors ; Subarachnoid Hemorrhage

BACKGROUND: Malassezia (M.) yeasts are lipophilic fungi which are regarded as normal flora of the skin, and are recovered in 75~98% of healthy adults. Gueho et al reclassified the Malassezia yeasts into 7 species (M. furfur, M. obtusa, M. globosa, M. slooffiae, M. sympodialis, M. pachydermatis, M. restricta) on the basis of molecular biology and by employing an interdisciplinary approach of morphology, microstructurology and physiology. Recently novel species of the genus Malassezia have been discovered as a result of molecular analysis. But there are no additional reports in Korea regarding newly reported Malassezia species because most identification and classification of Malassezia in Korea depend on classical methods and research on molecular biologic application is insufficient. OBJECTIVE: Five clinical isolates of M. dermatis were isolated from the skin of healthy subjects without skin disease or seborrheic dermatitis patients using molecular biology techniques for the first time in Korea. Hence the present study describes mycological and molecular biological characteristics of these five isolates as a novel species of M. dermatis. METHODS: Morphological and biochemical analyses, such as colony morphologies, microscopic morphologies and physiological characteristic were done targeting 5 clinical isolates of M. dermatis. Molecular techniques, namely, 26S rDNA PCR-RFLP, 26S rDNA and internal transcribed spacer region 1 (ITS1) sequencing, were done for identification and phylogenetic systematic analysis. RESULTS: Five clinical isolates of M. dermatis showed positive in the catalase test. No growth is obtained on Sabouraud's dextrose agar (SDA) without lipid supplementation but all grew in 0.5% Tween 60 and 0.1% Tween 80 added 2% glucose/1% peptone culture medium. Round and ellipsoidal yeast cells and budding of the yeast cells were observed under microscope, resembling M. sympodialis, M. furfur, and M. nana. The 26S rDNA PCR-RFLP pattern showed the same pattern as M. dermatis (JCM 11348), the standard strain. 26S rDNA and ITS1 sequencing were performed for exact identification, showing 99% accordance with M. dermatis (AB070361), and M. dermatis (AB070356), confirming the species to be new, the first to be reported in Korea. Phylogenetic trees based on the D1/D2 domains of the 26S rDNA sequences and nucleotide sequences of the ITS 1 region showed that the isolates were conspecific and belonged to the genus Malassezia and crusted with M. sympodialis. CONCLUSION: Taking a molecular biological classification approach, we have successfully isolated 5 cases of M. dermatis-the first in Korea. Although it is not known whether M. dermatis plays a role in Malassezia-related skin disease, this species was part of the microflora in both patients with seborrheic dermatitis and healthy subjects.
Adult ; Agar ; Base Sequence ; Catalase ; Classification ; Dermatitis, Seborrheic ; DNA, Ribosomal ; Fungi ; Glucose ; Humans ; Korea ; Malassezia* ; Molecular Biology ; Peptones ; Physiology ; Polysorbates ; Population Characteristics ; Skin ; Skin Diseases ; Yeasts

BACKGROUND: Exposure to heavy metals from environmental and industrial sources remains a concern of serious public health risk. This study was conducted to analysis the relationship between heavy metal concentrations and bone density. METHODS: This study used data from a nation-based sample of Koreans (n=2,429) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were obtained heavy metals (lead, mercury and cadmium), socioeconomic and demographic factors and bone mineral density (BMD) measured by T-score. RESULTS: Menopausal women, current smoker or the frequent alcohol drinking, low educational level and low family income were greater in the osteopenia or osteoporosis groups than normal group, and were associated with an increased blood heavy metal concentration levels. The highest quartile group in blood lead had a 1.47 times (95% confidence interval [CI] 1.16-1.87) risk of osteopenia or osteoporosis. In case of blood cadmium, the risk for osteopenia or osteoporosis increased 2.1 times (95% CI 1.64-2.68). CONCLUSIONS: We observed a significant association between blood heavy metals (lead and cadmium) levels and low BMD. Our findings suggest that heavy metal exposure may be a risk factor for osteoporosis.
Adult* ; Alcohol Drinking ; Bone Density* ; Bone Diseases, Metabolic ; Cadmium ; Demography ; Female ; Humans ; Korea ; Metals, Heavy ; Nutrition Surveys ; Osteoporosis ; Public Health ; Risk Factors