BACKGROUND: The distribution of Malassezia yeasts on normal human skin was varied according to the age and race of the volunteers and the methodologies used. In Korea, most reports of Malassezia yeast distribution have relied on direct skin smears rather than culture methods. OBJECTIVE: The aim of this work was to perform a comprehensive survey of the distribution of Malassezia yeasts on normal human skin to provide a base line for a companion study of Malassezia yeasts in patients with various dermatoses. METHODS: Malassezia yeasts were cultured using the swabbing technique from the scalp, forehead, chest, upper back, upper arm and upper thigh in 137 subjects, infancy to 80 years of age. RESULTS: Malassezia yeasts were present in the lowest incidence(0-30%) on six sites of infants and present in 60.0-66.7% on the sebum-rich sites (scalp, forehead, chest, upper back) of children aged 1-9. Malassezia yeasts were present in 80.0-86.7% on the sebum-rich sites of the elderly group(over 60 years of age), about the same frequency as in the middle-aged groups. The population density of these organisms was significantly higher on the upper back than on the forehead, chest, upper arm and upper thigh in all age groups except the infant group and the group aged 1 to 9 (p<0.05). There were no regular quantitative variations in the distribution of Malassezia yeasts on a given site between age groups. On Leeming and Notman media, besides three morphotypes of Malassezia yeasts reported by Cunningham et al(1990), one additional type was identified. CONCLUSION: The results showed regional variations in the distribution of Malassezia yeasts in all ages except infancy and no regular age variations on a given site. Additionally, four colony types of Malassezia yeasts were found. The findings of our study coold help to investigate the role of Malassezia yeasts in related disorders.
Aged ; Arm ; Child ; Continental Population Groups ; Forehead ; Friends ; Humans* ; Infant ; Korea ; Malassezia* ; Population Density ; Scalp ; Skin Diseases ; Skin* ; Thigh ; Thorax ; Volunteers ; Yeasts*

BACKGROUND: Cutaneous vasculitis associated with viral hepatitis seems to occur as a hypersensitivity reaction against the circulating viral antigens. Hepatitis B virus(HBV)-encoded X antigen(HBxAg) is known to participate in the carcinogenesis of hepatocellular carcinoma(HCC) by the inactivation of p53. However, HBxAg has been found in chronic infiammatory lesions without the overexpression of p53. Accordingly, not only EBsAg and HBcAg but also HBxAg may be involved in HCC-associated cutaneous vasculitis, regardless of the alteration of p53. OBJECTIVE: This study was conducted to investigate the expression of HBV-encoded antigens in cutaneous vasculitis accompanied by HBV hepatopathy. Additionally, we have compared the expression of 3 HBV antigens and p53 between vasculitic patients with HCC and in others showing HCC-non-associated vasculitis. METHODS: Immunohistochemically, we examined the expression of HBsAg, HBcAg, and HBxAg in the tissue specimens taken from the vasculitic lesions of the 33 HBsAg-positive enrolled patients with cutaneous vasculitis proven by skin biopsy. RESULTS: 1. The immunohistochemical positivity rate to HBsAg in vasculitic patients with HBV hepatopathy was 66.7% overall. It was 90% in HCC-associated vasculitic subjects and 56.5% in the vasculitic subjects without HCC, respectively. 2. We found the expression of HBxAg in 80% of the vasculitic subjects showing HCC. The vasculitic patients without HCC showed 17,3% of the positivity rate to HBxAg. 3. We could not find the overexpression of p53 in the vasculitic tissue specimens of the HCC patients without the cutaneous metastasis from primary HCC. CONCLUSION: HBsAg, HBcAg and HBxAg may participate in the pathogenesis of cutaneous vasculitis with HBV hepatopathy, regardless of tumorigenesis.
Antigens, Viral ; Biopsy ; Carcinogenesis ; Hepatitis ; Hepatitis B ; Hepatitis B Core Antigens ; Hepatitis B Surface Antigens ; Humans* ; Hypersensitivity ; Malassezia* ; Neoplasm Metastasis ; Skin* ; Vasculitis ; Yeasts*

Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

No abstract available.
Humans ; Psychotic Disorders* ; Schizophrenia*

Time to time, we face patients who missed the proper time for primary palatal repair. Although we do not have enough available documents, it is important to establish efficacy of palatal repair in patients more than 4 years old. From May 1995 to March 2005, we selected 14 patients who underwent palatal repair in more than 4 years old patients and they are able to tolerate speech articulation tests. Out of 14 patients 5 males an 9 females in sex, aged form 4 to 50 years old. 6 patients with incomplete cleft palate and 8 patients with submucous cleft palate. Double reversing Z-plasty(n=5), pushback palatoplasty(n=4), two flap palatoplasty(n=2), von Langenbeck palatoplasty(n=2), and intravelar veloplasty(n=1) were performed. Preoperative and postoperative speech articulation test, "Simple method of speech evaluation in Korean patients with cleft palate", were conducted. Satisfaction rate was sorted into 5 levels. There is no significant statistical correlation in the speech improvement, satisfaction rate, patients sex, cleft type and operative method. But there is significant statistical correlation between the speech improvement and patienet's age. There were better result in younger patient group than aged patients group.
Child, Preschool* ; Cleft Palate ; Female ; Humans ; Male ; Middle Aged ; Speech Articulation Tests

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because post operative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.
Cleft Palate* ; Female ; Follow-Up Studies ; Humans ; Male ; Palate ; Parents ; Speech Articulation Tests ; Uvula ; Velopharyngeal Insufficiency

PURPOSE: Endoscopic transnasal correction of the blowout fractures has many advantages over other techniques. But after removal of packing material, there were some patients with recurrence of preoperative symptoms. Authors tried to make a quantitative anterograde analysis of orbital volume change over whole perioperative period which might be related with recurrence of preoperative symptoms. METHODS: 10 patients with pure medial wall fracture(Group I) and 10 patients with medial wall fracture combined with fracture of orbital floor(Group II) were selected to evaluate the final orbital volume change with 3 CT scans, preoperatively, postoperatively and 4 months after packing removal. By multiplying cross-section area of orbit in coronal view with section thickness, orbital volume were calculated. Then, mean orbital volume increment after trauma, mean orbital volume decrement after endoscopic correction and volume increment after packing removal were found out. And we tried to find correlations between type of fracture, initial correction rate and final correction rate. RESULTS: The mean orbital volume increase of the fractured orbits were 7.23% in group I and 13.69% in group II. After endoscopic surgery, mean orbital volume decrease were 11.0% in group I and 12.46% in group II. Mean volume increase after packing removal showed 3.10% in group I and 6.50% in group II. The initial correction rate(%) showed linear correlation with final correction rate(%) after packing removal. And there were negative linear correlation between increment percentage of orbital volume by fracture and final correction rate(%). CONCLUSION: Orbital volume was proved to be increasing after removal of packing or foley catheter and it was dependent upon type of fracture. Overcorrection should be done to improve the final result of orbital blowout fracture especially when severe fracture is present.
Catheters ; Endoscopy ; Humans ; Orbit ; Orbital Fractures ; Perioperative Period ; Recurrence

OBJECTIVE: Our study aimed to measure inter-rater and test-retest reliability, concurrent and convergent validity, and factor solutions of the Korean version of the Clinical Language Disorder Rating Scale (CLANG). METHODS: The Korean version of the CLANG for assessing thought, language, and communication, the Brief Psychiatric Rating Scale, Young Mania Rating Scale, and Calgary Depression Scale for Schizophrenia were used to evaluate language disorder, formal thought disorder, positive and negative symptoms, manic symptoms, and depressive symptoms, respectively, in 167 hospitalized patients with schizophrenia. The factor solution was obtained by the direct oblimin method. A receiver operating characteristic curve was used to find the optimal cut-off score for discriminating schizophrenia patients with and without disorganized speech. RESULTS: Inter-rater reliability was considered moderate (intraclass coefficient=0.67, F=3.30, p=0.04), and test-retest reliability was considered high (r=0.94, p<0.001). Five factors, namely, pragmatics, disclosure, production, prosody, and association, were identified. An optimal cut-off score of 7 points with 84.5% sensitivity and 81.7% specificity was proposed for distinguishing schizophrenia patients with and without disorganized speech. CONCLUSION: Our findings suggest that the Korean version of the CLANG is a promising tool for evaluating language disorder in patients with schizophrenia.
Bipolar Disorder ; Brief Psychiatric Rating Scale ; Depression ; Disclosure ; Humans ; Language Disorders* ; Psychometrics* ; ROC Curve ; Schizophrenia ; Sensitivity and Specificity

No abstract available.
Hemiarthroplasty* ; Hemorrhage* ; Hip* ; Hypotension* ; Retrospective Studies*

PURPOSE: Dermatofibrosarcoma protuberans(DFSP) is a moderate-degree malignant tumor of soft tissue from dermis to fat layer with high recurrences(11% to 73%) due to its local infiltrative characteristic. Many debates and controversies in deciding accurate surgical margin were presented before, but references about depth of invasion and appropriate surgical excision level were not properly made out. Therefore, we tried to identify the degree of tissue invasion of DFSP. METHODS: Twenty patients, including 8 patients with recurrent lesions, over last 10 years were reviewed retrospectively. Different surgical margins were applied according to the location and based on histopathologic result, we have defined as a 'deep tissue invasion' if there were infiltration of tumor cell into fascia or underlying muscle layer was present. All invaded tissue including dermis, fat, fascia and muscle were excised until no tumor cell was found during intraoperative frozen section biopsy. And comparative analysis of deep tissue invasion according to age, primary site, duration of disease and recurrence was done. RESULTS: Thirteen patients(65%) showed deep tissue invasion and incidence was found to be increasing with age (over 30 years old). All patients with DFSP on head and neck region revealed deep tissue invasion followed by trunk(54%) and lower extremities(50%). There was no relationship between duration of disease and deep tissue invasion. CONCLUSION: It is clear that many cases of DFSP had a deep tissue invasion. And high prevalence of deep tissue invasion with age, primary site was intimately associated. So, underlying deep tissue must be completely examined and excised sufficiently throughout the operation for clear resection of DFSP with no recurrences, especially when the age is over 30s and on head and neck region.
Biopsy ; Dermatofibrosarcoma ; Dermis ; Fascia ; Frozen Sections ; Head ; Humans ; Incidence ; Muscles ; Neck ; Prevalence ; Recurrence ; Retrospective Studies