BACKGROUND: Postpartum thyroiditis(PPT) is one of syndromes of thyroid dysfunction that occurs in the first year after parturition. Reported incidence of PPT is 3.9-8.2% of postpartum women in several studies from different countries. The fact that 52-100% of patients with PPT have thyroid autoantibodies, and that lymphocytic infiltration of thyroid gland is the characteristic pathological feature of PPT suggest that PPT is an autoimmune disease. High iodine intake in short term period is known to aggrevate the experimental autoimmune thyroiditis. This study was performed to investigate the incidence and clinical features of PPT in Korean postpartum women who usually ingest excessive amount of idine in immediate postpartum period and to investigate the predictive value of thyroid autoantibodies in the development of PPT in them. METHOD: Between March 1996 and February 1997, 99 women without previous history of any thyroid disease who delivered babies at Boramae hospital were enrolled. Thyroid function parameters(T3, T4, free T4, TSH), thyroid autoantibodies(anti-microsomal antibody, anti-thyroglobulin antibody) and urinary iodine excretion were measured prospectively before and 1, 3 months after delivery. Dietary iodine intake during postpartum period was evaluated by questionnaire, and clinical parameters were followed up. RESULTS: During 3 months of observation, PPT developed in 8.1%(8/99) of postpartum women. Five cases had typical course having thyrotoxic phase and the other 3 cases had hypothyroid phase without toxic phase. However, only one of those required thyroid hormone replacement therapy in the latter group. There were no differences in age, baseline thyroid function parameters, parity, percent cases with family history of thyroid disease between those developed PPT (n=8) and those did not develop PPT(n=91). Duration of high iodine intake(3.8 +- 0.5 wk. vs. 3.7 +- 0.8 wk., p>0.05), total ingested amount of high iodine diet(77 +- 28 vs. 79 +- 24 bowels of miyokguk, p)0.05), and the urinary iodine excretion(1.9 +- 1.4 mg/g creatinine vs. 3.7 +- 3.7mg/g creatinine, p0.05) at 1 month postpartum were not different between two groups. Of 99 total subjects, anti-microsomal antibody(AMA) was present in 13.1%(13/99) before delivery in their sera. Positive predictive value of the presence of AMA before delivery in predicting the development of PPT was 30.8%. CONCLUSION: The fact that incidence of PPT in normal Korean postpartum women who usually have high iodine intake in immediate postpartum period is not higher than those of other countries, and that there was no difference in the amount of iodine intake between those developed PPT and those did not suggest that high iodine intake in immediate postpartum period do not influence on the incidence of PPT. The presence of AMA before delivery had low specificity in prediction of development of PPT, so the measurement of AMA seems not to be a useful screening test.
Autoantibodies ; Autoimmune Diseases ; Creatinine ; Female ; Hormone Replacement Therapy ; Humans ; Incidence* ; Iodine* ; Mass Screening ; Parity ; Parturition ; Postpartum Period* ; Postpartum Thyroiditis* ; Prospective Studies ; Surveys and Questionnaires ; Sensitivity and Specificity ; Thyroid Diseases ; Thyroid Gland ; Thyroiditis, Autoimmune

BACKGROUND: Mohs surgery is an increasingly appealing option for skin cancer. It is traditionally performed by a Mohs dermatologist, followed by a secondary repair by a head and neck or plastic surgeon. But one-stage procedure Mohs surgery with immediate reconstruction enhances patient's satisfaction and reduces the need for more than one procedure or multiple postoperative visits. OBJECT: The purpose of this study was to report our experience of Mohs surgery and immediate reconstruction by a dermatologist. Results, complications, and recurrence rates were reviewed. METHODS: Seventy five skin cancers, which were treated by Mohs surgery and reconstructed immediately were analysed retrospectively. RESULT: There were 43 females and 32 males. The mean age was 62.2. Basal cell carcinoma was the most common skin tumor. The Nose was the most common anatomic site. The mean size of tumor was 1.8cm. The local flap was the most common used to repair surgical defects. Complications were minimal. Recurrent cases were none during 40-months follow up (range, 12-58 months). CONCLUSION: Immediate one-stage reconstruction after Mohs surgery by a dermatologist is a safe, convenient method to treat skin cancers.
Carcinoma, Basal Cell ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Mohs Surgery* ; Neck ; Nose ; Recurrence ; Retrospective Studies ; Skin Neoplasms* ; Skin*

BACKGROUND: The aging of skin is influenced by genetic, environmental, and hormonal factors. Estrogens are the "missing" player in the skin of postmenopausal women. In postmenopausal women, loss of collagen was related to decreased estrogen level. Phytoestrogens, i.e. isoflavone, are plant compounds with estrogen-like biologic activities. OBJECTIVE: The effects of 18beta-estradiol, and isoflavones on production of type I collagen in the fibroblast of postmenopausal woman, keloid and Detroit cell line were examined. METHODS: Type I collagen was measured with procollagen type I C-peptide EIA KIT. RESULTS: 18beta-estradiol and isoflavone enhanced the production of type I collagen in cultured fibroblast of postmenopausal woman and keloid. But isoflavone inhibited the production of collagen in cultured fibroblast of Detroit cell. CONCLUSION: 18beta-estradiol and isoflavone can prevent and improve the cutaneous alterations caused by loss of collagen of postmenopausal women.
Aging ; C-Peptide ; Cell Line ; Collagen Type I ; Collagen* ; Estradiol ; Estrogens* ; Female ; Fibroblasts ; Humans ; Isoflavones* ; Keloid ; Phytoestrogens ; Plants ; Skin

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure