Ota's nevus is a mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. We report a case of Ota's nevus treated by combination therapy with cryosurgery and a Q-switched Alexandrite laser. A 48-year-old female had had a type III Ota's nevus from birth. Cryosurgery was tried at first using hard chalk dry ice on the lesion of the forehead and cheek. After that, The Q-switched Alexandrite laser was used three times at twelve week intervals at the site of the eyelid. Good therapeutic effects were gained and our patient was very satisfied. There were no complications or scarring. A Biopsy of the area treated revealed a similar histological pattern with significantly less melanin indicating melanin removal. Combination therapy with cryosurgery and an Alexandrite laser on the Ota's nevus may be cheaper, more effective and a safer method. It may also reduce the limitation of the two methods when used individually.
Biopsy ; Calcium Carbonate ; Cheek ; Cicatrix ; Cryosurgery* ; Dry Ice ; Eyelids ; Female ; Forehead ; Humans ; Lasers, Solid-State ; Melanins ; Middle Aged ; Nevus of Ota* ; Parturition ; Pigmentation ; Trigeminal Nerve

BACKGROUND: Ultraviolet B(UVB) light, which can cause severe damage like induction and promotion of cancer, cutaneous inflammation and immunosuppression, represents one of the most important environmental impacts for humans. Keratinocytes are natural target cells of UVB in humans. NF-kB plays a role in the cell of the immune system, where it controls the expression of various cytokines and the major histocompatibility complex gene. OBJECTIVE: The purpose of this study was to examine the effect of UVB on the NF-kB and AP-1 activity in cultured human keratinocytes and fibroblasts. METHODS: Keratinocyte and fibroblast cultures were produced with DMEM medium. Cells were irradiated for 100J/m, 200J/m, 300 J/m. and Nuclear proteins were extracted. AP-1 and NF-kB activities were measured by the gel shift mobility assay. RESULTS: Gel shift mobility assay. 1. The NFkB activity was increased upon UVB in a dose dependent manner in the keratinocyte. 2. Enhanced levels of AP-1 binding activity in the radiated extracts frorn human skin keratinocytes were detected. 3. The levels of GRE (glucocorticoid responsive element) binding activity were similar in both radiated and unradiated extracts from fibroblasts and keratinocytes. CONCLUSIONS: The activities of NF-aB and AP-1 are increased following stimulation of a cell with UVB irradiation. Therefore, UV induced skin tumors, abnormal cell proliferation, cutaneous inflammation and immunosuppression, may be due to these transcriptional factors.
Cell Proliferation ; Cytokines ; Fibroblasts* ; Humans* ; Immune System ; Immunosuppression ; Inflammation ; Keratinocytes* ; Major Histocompatibility Complex ; NF-kappa B* ; Nuclear Proteins ; Skin ; Transcription Factor AP-1*

BACKGROUND: A clinical study of rosacea has never been reported in Korea. OBJECTIVE: The purpose of this study was to elucidate the clinical observations of rosncea. METHODS: During a 5-year-period from Jan. 1990 to Dec. 1994, 133 patients were evaluated with regard to age, sex, location of skin lesions, clinical type, duration, and precipitating factors. RESULTS AND CONCLUSIONS: 1. Of the 7,787 cases amongst outpatients, 133 cases(1.7% ) were dignosed with rosacea. Of there 46 were male patients and 87 females, giving a sex ratio of 1:1.9 in favor of females. 2. The most common type of rosacea was vascular rosacea(60.2%) 3. The average duration of rosacea was 3.4 years. 4. Rosacea afflict persons aged 40-49 most frequently. 5. The predilection sites of the rosacea were : cheek(42.9%), nose(23.3%), entire face(11.3%), cheek & nose(9%), zygomatic area(6.8%), extra-facial area(3.8%), forehead(2.9%). 6, The aggravating factors of rosacea were : unknown cause(32.3%), coffee & tea(18%), alcohol(13.5%), emotional stress(10.5%), sun exposure(9.8%), multi-factoral(7.5%), drugs(steroids)4.6%).
Cheek ; Coffee ; Female ; Humans ; Korea ; Male ; Outpatients ; Precipitating Factors ; Rosacea* ; Sex Ratio ; Skin ; Solar System

Iatrogenic Cushings syndrome is caused by administration of systemic steroids for some disorders, and is clinically characterized by truncal obesity, hypertension, fatigability, amenorrhea, hirsutism, abdominal striae, edema, glucosuria and osteoporosis. We report herein a case of iatrogenic Cushings syndrome in the treatment of atopic dermatitis. The patient, a 32-year-old male, had been diagnosed with atopic dermatitis and was intermittently treated with topical and systemic steroids for 12 years. He revealed facial edema, truncal obesity and striae distensae in both the axilla and abdomen. Steroids are one of the important agents in the treatment of atopic dermatitis but care must be taken in their administration.
Abdomen ; Adult ; Amenorrhea ; Axilla ; Cushing Syndrome* ; Dermatitis, Atopic* ; Edema ; Female ; Hirsutism ; Humans ; Hypertension ; Male ; Obesity ; Osteoporosis ; Steroids ; Striae Distensae

We observed a 55-year-old man who had granuloma pyogenicum on the medial border of the right fifth toe which developed after scratching of the wound. Histopathological findings showed many newly formed capillaries that had prominant endothelial cells and showed varying degrees of dilation without appearance of epidermal collarette signs. We tried intralesional treatment with triamcinolone acetonide (10mg%, 1/week*3). After 3 sessions of treatment, the lesion dramatically regressed nearly to normal size.
Capillaries ; Endothelial Cells ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Middle Aged ; Toes ; Triamcinolone Acetonide* ; Triamcinolone* ; Wounds and Injuries

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence.
Blister ; Dermis ; Diagnosis ; Epidermis ; Fluorescent Antibody Technique, Direct ; Foot ; Forehead ; Hand ; Humans ; Inflammation ; Lip ; Lupus Erythematosus, Systemic* ; Male ; Neutrophils ; Prednisolone ; Recurrence ; Rheumatic Diseases ; Skin ; Young Adult

Ecthyma Gangrenosum is a rapidly progressing skin infection charact,erized by edema, hemorragic bullae and necrosis. Ecthyma Gangrenosum occurs almost exclusively in severely imrnunocompromised patients during the course of pseudomanas aeruginosa septisemia. A 5 month-old boy was transferred to our department because of multiple well defined central necrotic black-colored large erythematous bullae. In the bacterial cultures of skin, stool and liver aspiration fluid, Pseudomonas aeruginosa was grown. In the abdominal ultrasonogram and computed tomogram, the multiple liver abscess, hepatomegaly and ascites were shown on both hepatic lobes. Herein we report a case of ecthyma gangrenosum associated with liver abscess.
Ascites ; Ecthyma* ; Edema ; Hepatomegaly ; Humans ; Infant ; Liver Abscess* ; Liver* ; Male ; Necrosis ; Pseudomonas aeruginosa ; Skin ; Ultrasonography

From July 1997, Authors have reconstructed the posterior cruciate ligament(PCL) deficient knees with two graft tendons; an autogenous bone-patellar tendon-bone (BPTB) and a semitendinosus tendon. At Femoral side, the two graft tendons were fixed through the two tunnels which were made at the site of foot print of PCL. The original site of anterolateral bundle of the PCL was reconstructe(I with the autogenous BPTB and the original site of posteromedial bundle with the semitendinosus tendon. At tibial side, the two graft tendons were fixed by modified inlay technique; the BPTB was fixed with a cancellous screw and the semitendinosus tendon with staples. Seven cases were followed up more than six months and authors evaluated the results with the KT-1000TM arthrometer and the posterior stress radiographs by Telos stress dcvice and compared the resu]t of injured knee with the uninjured side of each patient. The results of manual maximal displacement test with arthrometer were less than 4 mm in six patients and 8 rnm in one patient at last follow up. The average distance of posterior displacement on stress radiographs was 10.3 mm preoperatively and 2.7 mm at final follow up period. Six of the seven patients had a good stability on posterior stress radiographs compared with the uninjured side. One patient had posterior knee insta- bility on stress radiographs due to loosening of the grafted tendon and retightening of the grafted tendon was performed through the posterior approach to the proximal tibia. The original idea of femoral dual tunnel method in PCL reconstructiori is to reconstruct the PCL more anatomically and the modified tibial inlay technique can solve the problern of graft tendon abrasion at the posterior opening of the tibial tunnel in transtibial tunnel method and retightening of the loose grafted tendon is simple than the other methods of PCL reconstruction. Authors expect that this combined femoral dual tun- nel and modified tibial inlay method may improve the quality of the outcome of the arthroscopic PCL reconstruction.
Arthroscopy ; Follow-Up Studies ; Foot ; Humans ; Inlays* ; Knee ; Posterior Cruciate Ligament* ; Tendons* ; Tibia ; Transplants*

BACKGROUND: During pediatric general anesthesia with Mapleson D-circuit, we used large amount of FGF(fresh gas flow) for avoidance of rebreathing of expired gas but low FGF are employed, the amount of anesthetic consumption and air contamination can be reduced. The aim of this study was to evaluate the fact that FGF of 220 ml/kg/min is clinically acceptable. METHODS: We selected sixty children weighing < or =20 kg who were scheduled for inguinal hernia repair under general anesthesia. The study was performed by 2 steps; In the step 1, the patients were divided into two groups according to weight(less than or greater than 8 kg) and end-tidal Pco2 were compared with simultaneous arterial Pco2 measurements. In the step 2, the patients were divided into two groups according to FGF(2MV or 220 ml/kg) and arterial Pco2, end tidal Pco2 and PminCO2(minimum inspired Pco2) were measured. RESULTS: In the step 1 study, arterial Pco2 was significantly higher than end-tidal Pco2 in the group 1 and there was slight difference in arterial Pco2 and end-tidal Pco2 in the group 2. In the step 2 study, PaCO2, PetCO2, PminCO2 were significantly increased in the group 3 than group 2 but there were no clinical hypoxemia in all patients. CONCLUSIONS: We consider that FGF of 220 ml/kg/min is appropriate during controlled ventilation with Mapleson D circuit in children weighing > or =8 kg because of economic and ecological advantages. Also, we consider FGF can be reduced in children weighing <8 kg under accurate respiratory gas monitoring.
Anesthesia, General* ; Anesthetics ; Anoxia ; Blood Pressure ; Child ; Heart Rate ; Hernia, Inguinal ; Humans ; Lidocaine ; Ventilation

PURPOSE: Clinical and radiologic results of operative versus nonoperative treatment were compared in patients 70 years or older who had an unstable distal radius fracture. MATERIALS AND METHODS: From March 2007 to April 2009, 49 patients who had an unstable distal radius fracture treated nonoperatively (22 patients) or operatively (27 patients) were investigated. The radiologic results between the two patient groups were compared based on bone union, dorsal tilt, radial inclination and radial shortening. The clinical results were compared based on disabilities of arm, shoulder & hand (DASH) score, the patient-rated wrist evaluation (PRWE) score, the grip strength and the motion range of the wrist joint. RESULTS: At the last follow-up examination, DASH score, PRWE score, the flexion, supination and radial deviation of wrist joint and the grip strength did not showed significant difference. Among the patients who received non-operative treatments, 18 of 22 showed radiologically recognizable deformation; average dorsal tilt of 11.9degrees, the average radial inclination of 18.9degrees, and average radial shortening of 3.8 mm. The patients who received operative treatments showed average volar tilt of 3.3degrees, radial inclination of 18.8degrees+/-3.7degrees, and radial shortening of 1.5 mm. Three patients showed radiologically recognizable deformation. CONCLUSION: Our results suggest that nonoperative treatment is initially recommended in patients with the age of 70 years or older who have an unstable distal radius fracture in terms of functional results.
Arm ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Radius ; Radius Fractures ; Shoulder ; Supination ; Wrist ; Wrist Joint