PURPOSE: To evaluate whether there are any differences in MR findings between the childhood and the adult moyamoya disease. MATERIALS AND METHODS: We compared the brain MR findings in 22 children (13 boys and 9 girls, 2-18 years of age) who had moyamoya disease with 15 adult patients (7 men and 8 women, 19-55 years of age). The MR findings were classified as parenchymal-(infarctions and intracranial hemorrhages) and vascular abnormalities (intracranial vascular patency and moyamoya vessels). The difference in each of these MR findings was analyzed using Chi-squaretest and Fisher's exact test (two-tailed). Out of 22 children, two children with normal MR finding were excluded from the statistical analysis. Moyamoya diseases were diagnosed angiographically in all adult patients. In children, they were diagnosed by MR imaging, MR angiography(6), and/or conventional cerebral angiography(18). RESULTS: In children, cerebral infarctions were observed in 20 of 22 patients (91%) (cortex 86%, periventricular white matter/centrum semiovale 32%, basal ganglia 10%). In two patients, there was no parenchymal abnormality. Intra-cranial hemorrhages were not demonstrated in any patients. In adults, intra-cranial hemorrhages(intracerebral hematoma, intraventricular hemorrhage, alone or combined) were demonstrated in 10 of 15 patients(67%). Cerebral infarctions with or without intracranial hemorrhage were detected in 10 of 15 patients(67%)(cortex 40%, periventricular white matter/centrum semiovale 53%, basal ganglia 20%). The difference in parenchymal abnormalities between the childhood and the adult moyamoya disease was statistically significant (p=0. 000164). There was no significant difference between the two groups with regard to the occlusive changes of the internal carotid and middle cerebral arteries or to moyamoya vessels(p> 0.01 ). CONCLUSION: This study could prove the fact that the principal clinical symptoms in the childhood moyamoya disease were due to cerebral infarction and those in the adult cases were due to infarction and intracranial hemorrhage. In addition, cortical infarction was more prevalent in children and infarction in periventricular white matter/centrum semivoale and basal ganglia was more frequentin adults. There was no significant difference in vascular abnormalities between the two groups.
Adult* ; Basal Ganglia ; Brain ; Cerebral Infarction ; Child* ; Female ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; Moyamoya Disease* ; Vascular Patency

To elucidate the complex of insulin-like growth factor binding proteins (IGF-BPs) in short stature patients, we carried out a prospective study on three patients who were diagnosed as complete GH deficiency at the department of pediatrics from July 1992 to June 1993. The results were summarized as follows: 1) Two circulating IGFs complexed to specific binding protein existed in normal serum. Binding activity was found to be in the 150,000 molecular weight area (the large complex) and 50~60,000 molecular weight area (the small complex). 2) Binding activity for the large complex was seen to be dependent on advancing age, level of large IGF-BP3 complex peacked at the age of 15~16 years. 3) The binding activity for large complex diminished in three GH deficient patients and increased after hGH injection to near or above normal level. 4) Increased growth rate after GH treatment in GH deficient patient was closely related with increasing level of the large IGF-BP3 complex. Therefore we suggest that the large IGF-BP3 complex is regulated by GH. Estimating its serum level is useful for screening of GH deficiency and the monitoring of response to GH therapy.
Carrier Proteins ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I* ; Mass Screening ; Molecular Weight ; Pediatrics ; Prospective Studies

No abstract available.
Cutaneous Fistula ; Fistula*

No abstract available.
Compartment Syndromes*

Background: Reduced lipid content in the stratum corneum is a major cause of skin-barrier dysfunction in various pathological conditions. Promoting lipid production is a potential strategy to improve skin-barrier function. Recent evidence supports the beneficial effects of adiponectin on lipid metabolism and senescence in keratinocytes. Objective: This study aimed to investigate whether plant extracts can enhance skin-barrier function. Methods: We screened fruit and herb extracts that enhance the lipid synthesis of keratinocytes via AMP-activated protein kinase (AMPK) activation and SIRT1 signaling in the adiponectin pathway. The levels of major lipid synthesis enzymes and transcription factors as well as epidermal barrier lipids involved in adiponectin-associated epidermal barrier formation were evaluated in the herbal extracts- or adiponectin-treated human epidermal keratinocyte and equivalent models. The mRNA expression of major lipid synthesis enzymes increased following treatment with Lycii Fructus, Prunus tomentosa, and Melia toosendan extracts. Results: The expression of transcription factors SIRT1, liver X receptor α, peroxisome proliferator-activated receptors (PPARs), and sterol regulatory element-binding proteins (SREBPs) were upregulated. Levels of free fatty acids, cholesterol, and ceramides were elevated. The expression of keratinocyte differentiation markers increased. In particular, among fruit extracts with a detectable effect, Melia toosendan induced the highest expression of lipid synthase. Conclusion These results indicate that Melia toosendan is a promising candidate for improving skin-barrier function.

Nail psoriasis is a common finding in psoriatic patients and is associated with substantial adverse effects on the patient's quality of life. Although several treatment options are available, nail psoriasis tends to be persistent and refractory to therapy. Pulse dye laser (PDL) has been demonstrated to be effective for plaque-type psoriasis, but there are no reports on nail psoriasis being successfully treated with PDL in the Korean literature. We here report on a 46-year-old woman presenting with nail psoriasis recalcitrant to conventional treatment modalities, showing pitting, nail bed discoloration, and crumbling. We successfully treated the symptoms with 595 nm PDL, supporting the hypothesis that PDL may be a safe and effective therapeutic option in patients with recalcitrant nail psoriasis.
Female ; Humans ; Lasers, Dye* ; Middle Aged ; Psoriasis* ; Quality of Life

BACKGROUND: Diphencyclopropenone (DPCP) has recently been reported to be a potent contact sensitizer in the treatment of alopecia areata. However, the concentration for sensitization and optimal treatment method has not been standardized. In addition, highly variable results of DPCP use have been reported to date. OBJECTIVE: The purpose of our study was to find the optimal concentration for sensitization and to evaluate efficacy, prognostic factors and side effects of DPCP in the treatment of AA. METHODS: A total of 33 healthy people were enrolled in an open-label clinical trial to ascertain the concentration of DPCP needed for sensitization. The patients were sensitized with 0.1%, 0.5%, 1.0%, 1.5% of DPCP on a 2 cm2 area of each extremity (both arms and legs). We also reviewed the medical records of 48 alopecia areata patients who had been treated with DPCP. We evaluated both therapeutic efficacy and prognostic factors influencing the therapeutic effect of DPCP immunotherapy. RESULTS: Sensitization of 1.0% DPCP in 91% of patients. This concentration showed a higher sensitization rate than 0.5% DPCP, but a lower irritation rate than 1.5% DPCP. 56.3% (27/48) of patients showed terminal hair growth and 33.3% (16/48) completely responded with a cosmetically-acceptable result. The prognostic factor which influenced the result of therapy was the extent of alopecia areata. CONCLUSION: Topical DPCP treatment for alopecia is quite effective and well-tolerated. This therapy also provides safe therapeutic benefits if it is carried out with the correct sensitization concentration and treatment procedure.
Alopecia Areata* ; Alopecia* ; Arm ; Extremities ; Hair ; Humans ; Immunotherapy ; Medical Records

PURPOSE: The aim of this study was to evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of renal stones and to analyze the predictive factors for stone-free. MATERIALS AND METHODS: We retrospectively reviewed the records of patients who underwent RIRS for renal stones from January 2000 to July 2009. We identified 66 RIRSs (63 patients with 3 bilateral renal stones) and collected data. Stone-free and success were respectively defined as no visible stones and clinically insignificant residual stones less than 3 mm on postoperative imaging; predictive factors for stone-free were evaluated. RESULTS: Of the 66 renal stones, 18 stones (27.3%) were located in the upper pole or midpole or renal pelvis and 48 (72.7%) in the lower pole with or without others, respectively. The mean cumulative stone burden was 168.9+/-392.5 mm2. The immediate postoperative stone-free rate was 69.7%, and it increased to 72.7% at 1 month after surgery. The success rate was 80.3% both immediately after the operation and 1 month later. In the multivariate analysis, stone location except at the lower pole (p=0.049) and small cumulative stone burden (p=0.002) were significantly favorable predictive factors for the immediate postoperative stone-free rate. The overall complication rate was 6%. CONCLUSIONS: RIRS is a safe and effective treatment for renal stones. The stone-free rate of RIRS was particularly high for renal stones with a small burden, except for those located in the lower pole. RIRS could be considered in selective patients with renal stones.
Humans ; Kidney Calculi ; Kidney Pelvis ; Lithotripsy ; Multivariate Analysis ; Retrospective Studies ; Ureteroscopy

Bier's spots present as vascular mottling, and this consists of small, irregular macules surrounded by a red to cyanotic background. The macules most commonly occur on the arms and legs of young adults, but they may also appear on the trunk. They are considered a vascular anomaly, with vasoconstriction in the pale areas and vasodilatation in the erythematous skin. Although Bier's spots are occasionally discovered in young adults, they are still a challenge to differentiate from other hypopigmentation disorders. We report here on two cases of Bier's spots on the extremities and trunk of 2 young adults.
Adult ; Arm ; Extremities ; Humans ; Hypopigmentation ; Leg ; Male ; Skin ; Vasoconstriction ; Vasodilation ; Young Adult

BACKGROUND: Acute diffuse alopecia areata (AA) was described as a unique AA which mimics anagen effluvium, or in which the initial hair loss is diffuse and followed by total denudation of scalp within several weeks or months. In spite of its peculiar clinical feature, there was neither further characterization nor known effective treatment for this form of AA. OBJECTIVE: To evaluate the characteristic clinical findings of acute diffuse AA and confirm the effect of high dose methyl prednisolone therapy. METHODS: The medical records of 13 patients with acute diffuse AA between January 2002 and April 2006 at the Department of Dermatology, Chungnam National University Hospital were reviewed. All patients were treated with high dose methylprednisolone therapy. RESULTS: Of the 13 patients who completed the study, 8 patients (61.5%) were male and 5 patients (38.5%) were female. The mean age was 29.6 years old. The progress of hair loss stopped 2.4 weeks on average after initial treatment and newly emerging hairs were recognized 4.1 weeks on average after initial treatment. 84.6% (11/13) of patients showed terminal hair growth, and 46.2% (6/13) of patients completely responded to this therapy. CONCLUSION: Acute diffuse alopecia areata can occur in male as well as in female patients. High dose methylprednisolone therapy appears to be effective in patients with rapidly progressing acute diffuse alopecia areata to prevent the progression of the disease.
Alopecia Areata* ; Alopecia* ; Chungcheongnam-do ; Dermatology ; Female ; Hair ; Humans ; Male ; Medical Records ; Methylprednisolone ; Prednisolone ; Scalp