Background: The well known clinical feature of the classic acute telogen effluvium is diffuse hair loss from all over the scalp and the diagnosis is confirmed by a trichogram showing an increased telogen count. While the telogen hair shedding continues, newly cycled back young anagen hairs develop in the involved scalp. Objective: To see if there is a regional difference in the numbers of the involved hair follicles in that seemingly diffuse hair loss. Methods: In 7 cases of the telogen effluvium, the telogen count was done at two sites, anterior parietal and occipital. During the count, the short tapered anagen hairs(<1cm) which developed during the course of the telogen effluvium were counted together and compared according to the regions. Results: The sum of the short anagen hairs and the telogen hairs was 50.3% in anterior parietal area, whereas it was 31.6% in occipital area(p<0.0l). Conclusion: Hair follicles in anterior scalp appear to be more vulnerable than occipital scalp in the acute telogen effluvium.
Diagnosis ; Hair Follicle* ; Hair* ; Rabeprazole* ; Scalp

Hibernoma is a rare subcutaneous neoplasm resembling the brown fat of the hibernating animal. It is usually found in the interscapular, cervical or axillary regions. We report a case of this rare tumor which developed on the occeipital scalp of a 42-year-old woman.
Adipose Tissue, Brown ; Adult ; Animals ; Female ; Humans ; Lipoma* ; Scalp*

BACKGROUND: It has been known that androgenetic alopecia in both male and female is due to the role of the androgen hormone in the hair follicle, but the level of the androgen hormone in the plasma is controversial in relation with the development of the alopecia. OBJECTIVE: We have tried the clarify if there is any or no difference in the plasma levels of the hormones between the normal female and the patient with alopecia, because the range of the plasma DHEA-S and total testosterone in the normal female is very wide. METHODS: Plasma levels if the hormones were examined in 22 patients with female androgenetic alopecia and 20 normal females. RESULTS: 1. In DHEA-S, 21(95.5%) aut of 22 female androgenetic alopecia patients were in the normal range while 20(100%) of the 20 normal females were all within the normal range. However the mean value of the hormone(88.89+101.41 g/dl) in the patient group was significantly higher than that(82.18+44.03 g/dl) of the normal group(p<0.05). 2. In total testosterone, 17(94.4%) out of the 18 patents were in the normal range while 20 (100%) of 20 normal females were all within the normal range. However the mean value of the hormone(0.22+0.20ng/ml) in the patient group was significantly higher than that(0.08+0.09ng/ml) of the normal group(p<0.05). 3. As for distribution of DIEA S according to the age, the value of the patient group was higher than that of the normal group in all age groups studied. In the distribution of total testosterone according to age, there was no difference between the normal and the patient in the twenties. After the twenties, the testosterone levels were higher in the patients than the normal females. CONCLUSION: There were significant differences in mean values of plasma DHEA-S and total testosterone between the patients and the normal females although individuals in both groups were largely wit,hin normal range of the hormones.
Alopecia* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Female* ; Hair Follicle ; Humans ; Male ; Plasma* ; Reference Values ; Testosterone*

Papillary endothelial hyperplasia(PEH), usually originates in extracranial soft tissue, is considered a reactive proliferation of endothlium and an unusual form of thrombus organization. However the occurance of PEH in the cranial cavity is very rare. The authors report a case of a PEH involving intracranial sella, parasella, cavernous sius, ethmoid and sphenoid sinus in an 11-year-old boy. The patient was presented with sudden right visual disturbance. Magnetic resonance image showed a well-enhanced mass in the right cavernous sinus extending into the ethmoid and sphenoid sinus. The cerebral angiography demonstrated a vigorous tumor staining supplied by both internal and external carotid arteries. The right fronto-temporal craniotomy and subtotal resection of the tumor were performed. The mass was comprised in a highly vascular red-black nodular tissue associated with a mixture of fresh and organizing thrombi. The histopathological examination revealed papillary structures lined by endothelium within vascular space with organized thrombus. While the patient was waiting for second operation in order to remove remaining small tumor in the ethmoid and sphenoid sinues, the lesion exhibited rapid regrowth and the size became to the preoperative size at three months after operation. At reoperation, gross total removal was accomplished by a combination of trans-cranial and trans-sphenoidal approaches. Postoperative radiotherapy was given.
Carotid Artery, External ; Cavernous Sinus* ; Cerebral Angiography ; Child ; Craniotomy ; Endothelium ; Humans ; Hyperplasia* ; Male ; Radiotherapy ; Reoperation ; Sphenoid Sinus* ; Thrombosis

In order to evaluate the effect of the lumbar epidural steroid injection in the low back pain and/or radicular pain. We studied 66 patients who were treated and followed for an average of 8.6 months. In the initial evaluation, main pain sites were as follows: low back pain in 41 patients, buttock pain in 7 patients, and leg pain. In 18 patients. Immediate response and delayed response in the patients were studied. Immediate response within 1 day after injection revealed the following : dramatic improvement in 3.0%;some improvement in 56.1%; no improvement in 27.3%; and more aggravated in 13.6%. Delayed response after 1 month revealed the following : 15.2% continuously maintained improvement; 9.1 showed progressive improvement;36.4% experienced recurring pain; 27.3% had no improvement; and 10.6% had aggravating pain. The effect of the lumbar epidural steroid injection was not affected by the severity of pain in the initial evaluation. Better improvements were noted in patients who suffered radicular pain than those who suffered low back or buttock pain. Good prognostic factors were young age and male. Complications that the patients suffered were transient injection pain(6), edema of the face or extremity(10), transient leg weakness(5) and dural puncture(1). The number of patients who wanted to recommend this procedure to others were 22(33.3%). In conclusion, epidural steroid injection was one of the methods in the management of the patients who suffered low back pain and/or radicular pain and had no effect by any other therapies.
Buttocks ; Edema ; Humans ; Leg ; Low Back Pain* ; Male

BACKGROUND: Prevention of postherpetic neuralgia as well as management of the symptoms of the acute stage is an important therapeutic goal in the treatment of herpes zoster. Corticosteroid, acyclovir and sympathetic block have all been advocated as effective therapeutic tools for the treatment of the disease. OBJECTIVE: This study was conducted to evaluate the necessity of sympathetic block for prevention of postherpetic neuralgia in acute herpes zoster. METHODS: The author observed the duration and degree of pain and the incidence of postherpetic neuralgia in 54 patients with herpes zoster treated with three different therapeutic measures. Group A was treated with triamcinolone acetonide 80mg three times, acyclovir and sympathetic blockade, group B with triamcinolone acetonide 80mg three times and acyclovir, and group C with triamcinolone acetonide 40mg three times and acyclovir. RESULTS: 1. Addition of sympathetic blockade to corticosteroid and acyclovir therapy did not seem to reduce the duration of pain and incidence of postherpetic neuralgia. 2. The Incidence of postherpetic neuralgia was higher in the elderly, especially with underlying systemic disease including diabetes melitus, hypertension, etc. Al] the therapeutic measures could not completely prevent the development of postherpetic neuralgia in those patients. 3. Regarding corticosteroid dosage, daily triamcinolone acetonide 80mg for three consecutive days showed no better effect than daily 40mg for consecutive days. CONCLUSION: When herpes zoster was treated with proper dosages of corticosteroid and acyclovir in its acute stage, sympathetic block showed no additional beneficial effect.
Acyclovir ; Aged ; Herpes Zoster* ; Humans ; Hypertension ; Incidence ; Neuralgia, Postherpetic ; Triamcinolone Acetonide

BACKGROUND: Intralesional injection of corticosteroids has widely been used for the t,reatment of alopecia areata. The pair produced during the repeated multiple injection procedures is an actual therapeutic obstacle in both adult and child patients. Buffering of the local anesthetics is known to reduce the pain. OBJECTIVE: The purpos; of this study was to evaluate the degree of pain reduction and hair regrowing effect by the use of buffered lidocain-triamcinolone acetonide suspension(BLT) compared with nonbuffered lidocairi triamcinolone acetonide suspension(LT) in the intralesional injection of alopecia areata. METHODS: We evaluat d the degree of pain reduction by the use of BLT compared with LT in the intralesional injection in 40 cases of alopecia areata. The pain was ineasured by patients verbal pain score from zerc to ten and simultaneously observed if there were be any differences in hair regrowing bet,ween the two groups. RESULTS: 1. Remarkable reduction of the pain du~ring the inject,ion was noted by the buffering agent and the pain was further reduced by the vertical insertion of the needle. The pain score of BLT was 1.5 by vertically inserted injections and 2.4 by ~30 degree angle injections while the pain score of LT was 4.4 by the vertical and 5.6 by t.he 30 degree, Z. The mean time for appearance of regrowing hairs was 3.6 weeks in the BLT area and 4.0 weeks in the LT area. The use of BLT area showed a statistically faster response than the LT area. CONCLUSION: The use ot BLT is recommended not only by it,s remarkable effect on pain reduction but also by its sigriificantly accelerated hair regrowing effect in the trea~tment of alopecia areata.
Adrenal Cortex Hormones ; Adult ; Alopecia Areata* ; Alopecia* ; Anesthetics, Local ; Child ; Hair ; Humans ; Injections, Intralesional* ; Needles ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND: Intralesional injection of corticosteroids has widely been used for the t,reatment of alopecia areata. The pair produced during the repeated multiple injection procedures is an actual therapeutic obstacle in both adult and child patients. Buffering of the local anesthetics is known to reduce the pain. OBJECTIVE: The purpos; of this study was to evaluate the degree of pain reduction and hair regrowing effect by the use of buffered lidocain-triamcinolone acetonide suspension(BLT) compared with nonbuffered lidocairi triamcinolone acetonide suspension(LT) in the intralesional injection of alopecia areata. METHODS: We evaluat d the degree of pain reduction by the use of BLT compared with LT in the intralesional injection in 40 cases of alopecia areata. The pain was ineasured by patients verbal pain score from zerc to ten and simultaneously observed if there were be any differences in hair regrowing bet,ween the two groups. RESULTS: 1. Remarkable reduction of the pain du~ring the inject,ion was noted by the buffering agent and the pain was further reduced by the vertical insertion of the needle. The pain score of BLT was 1.5 by vertically inserted injections and 2.4 by ~30 degree angle injections while the pain score of LT was 4.4 by the vertical and 5.6 by t.he 30 degree, Z. The mean time for appearance of regrowing hairs was 3.6 weeks in the BLT area and 4.0 weeks in the LT area. The use of BLT area showed a statistically faster response than the LT area. CONCLUSION: The use ot BLT is recommended not only by it,s remarkable effect on pain reduction but also by its sigriificantly accelerated hair regrowing effect in the trea~tment of alopecia areata.
Adrenal Cortex Hormones ; Adult ; Alopecia Areata* ; Alopecia* ; Anesthetics, Local ; Child ; Hair ; Humans ; Injections, Intralesional* ; Needles ; Triamcinolone Acetonide* ; Triamcinolone*

Ectopia lentis, Synonymously with Congenital dislocated lens, is defined as a dislocation of the ocular lens, of greater or less degree, based on a developmental anomaly. It occurs in three conditions, as an isolated anomaly, in association with ocular anomaly, and as a part of a systemic syndrome with other mesodermal, particularly skeletal anomalies. Among these, simple ectopia lentis is a hereditary autosomal dominant disorders without skeletal, connective tissue or metabolic symptomatology. Except for the dislocation of the lens, these eyes are in other respects grossly normal. Regarding its management, there is a continuing debate proponents of active surgical intervention to prevent future problems to those who will not remove the lens and advocates of conservative treatment because lens surgery can be difficult and has a high rate of intraoperative and post operative complication. Recently, the authours have experienced three patients with simple ectopia lentis, which occurred in one family with autosomal dominant inheritance and achieved satisfactory result surgically. Thus these cases are presented with brief review of literatures.
Connective Tissue ; Dislocations ; Ectopia Lentis* ; Humans ; Mesoderm ; Wills

No abstract available.
Pregnancy* ; Pyelonephritis*