BACKGROUND: The pathogenic role of the hair follicle mite in rosacea is still a matter of debate. Although the hair follicle mite may induce a pathologic condition by dermal invasion or excessive number of mites, the number of mites necessary to induce a pathologic condition has not been established in Korea. OBJECTIVE: The purpose of our study was to know the causative role of the hair follicle mite in rosacea and the threshold value between 'normal' and 'abnormal' density of the hair follicle mite on Korean facial skin. METHODS: We applied skin surface biopsy to investigate the population density and distribution of hair follicle mites in the facial skin of 50 patients with rosacea (9 with episodic erythema, 29 with stage I, 12 with stage II), 7 patients with demodicidosis and 54 control subjects. The mites were counted in measured skin surface biopsy specimens obtained from three standard facial sites(2cm on cheek and chin, 1cm on nose) with cyanoacrylate glue. RESULTS: 1. The mean mite count per 5cm was 3.4+/-0.7 in control subjects and 10.7+/-1.9 in patients with rosacea(p<0.05) The density of Demodex(mite count/ 5cm) was significantly higher in patients with demodicidosis (115+/-14.2) than in the control (p<0.001) and rosacea patients(p<0.05). 2. The highest density of mites was found on the cheek in the control and diseased subjects. The incidence of hair follicle mites was higher on the nose than on the cheek in the control subjects and rosacea patients. In demodicidosis, the incidence of the hair follicle mites was higher on the cheek than on the nose. 3. The distribution of hair follicle mite was not significantly different among the three clinical stages of rosacea. The mite counts in stage II rosacea were higher than those of control subjects (p<0.05). 4. The distribution of the hair follicle mite in the control subjects was related to a increase of age but not related to sex. The distribution of the hair flooicle mites in rosacea patients was not related to age or sex. 5. Hair follicle mites were found in 33 out of 54 control subjects(61%) and in 40 out of 50 rosacea patients (80%). The mite counts of all control subjects and all rosacea patients were less than 5/cm and 10/cm, respectively. The mite counts of all demodicidosis patients were more than 10/cm. CONCLUSION: These results suggest that the increased nomber of mites play a part in the pathogenesis of rosacea and demodicidosis is a specifio disease entity differentiated from rosacea. When the density of the hair follicle mites is above 5 /cm2, a pathologic condition of the skin, such as rosacea and demodicidosis, would have to be considered. Demodicidosis should be suspected when the density of the hair follicle mites is above 10 /cm. In addition, skin surface biopsy is recommended as the most simple and useful clinical method in search of the distribution of the distrbution of the hair follicle mites.
Adhesives ; Biopsy* ; Cheek ; Chin ; Cyanoacrylates ; Erythema ; Hair Follicle* ; Hair* ; Humans ; Incidence ; Korea ; Mites* ; Nose ; Population Density ; Rosacea ; Skin*

Histiocytosis X(Langerhans cell histiocytosis) is a rare prolifertive disorder of Langerhans cells that includes Lettere-Siwe disease, Hand-Shiiller-Christian his ase and eosinophilic granuloma. Since many authors have reported in anintermediate and poarl classified form histiocytosis X has a namenclatural had nosologic problem. We report a case benign cutaneous variant of histiocytisis X. A four-month-old boy had shown multiple skin-colour papules on the trunk, head and nik for one month. Extensive in- vestigations failed to detcct any systemic involvement. The clixron microscopic findings of the skin biopsy specimen were Qefinitely diagnostic for histiocytosi. X Since he did not sbow evidence of internal organ involvernent and any further progression of he skin lesion, no therapy was given. Over the next two months the disease underwent spontane us and complete remission.
Biopsy ; Eosinophilic Granuloma ; Head ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Langerhans Cells ; Male ; Remission, Spontaneous* ; Skin

No abstract available.
Humans ; Interferon-beta* ; Interferons* ; Multiple Sclerosis ; Multiple Sclerosis, Relapsing-Remitting*

No abstract available.
Humans ; Interferon-beta* ; Interferons* ; Multiple Sclerosis ; Multiple Sclerosis, Relapsing-Remitting*

No abstract available.
Brain Stem* ; Encephalitis* ; Humans ; Optic Neuritis*

We report a patient who was diagnosed as subacute combined degeneration (SCD) with elevated homocysteine and methylmalonic acid levels in the situation of a spurious elevation of the vitamin B12 concentration. A false-positive elevation of the vitamin B12 level could lead to a delayed diagnosis and cause irreversible changes in the nervous systems. We therefore suggest that the homocysteine and methylmalonic acid levels should be checked in patients with a normal or elevated vitamin B12 level for whom there is a high clinical suspicion for vitamin B12 deficiency, as a further evaluation for SCD.
Delayed Diagnosis ; Gastritis, Atrophic* ; Homocysteine ; Humans ; Methylmalonic Acid ; Nervous System ; Subacute Combined Degeneration* ; Vitamin B 12 Deficiency ; Vitamin B 12* ; Vitamins*

Complications related to a broken stylet during endotracheal intubation have been infrequently reported. In most cases, broken stylets have been recognized by chest radiography. We report a case of unrecognized iatrogenic aspiration of a broken stylet. A 37-year-old man, who underwent explo-laparotomy two days previously, was reintubated with an uncoated stylet in the intensive care unit because of dyspnea and pulmonary congestion. He was on artificial ventilation for one day and was extubated one week later. We could not find the broken stylet on serial chest x-ray films until a metallic substance was expectorated while the patient was coughing 28 days after extubation. During the intervening period the patient did not complain of any chest discomfort and we did not realize that the broken stylet remained. The use of a plastic coated stylet and its careful observation after intubation are recommended to avoid this complication.
Adult ; Cough* ; Dyspnea ; Estrogens, Conjugated (USP) ; Humans ; Intensive Care Units ; Intubation ; Intubation, Intratracheal ; Plastics ; Radiography ; Thorax ; Ventilation ; X-Ray Film

No abstract available.
Chediak-Higashi Syndrome* ; Hyperpigmentation*

PURPOSE: To investigate the clinical manifestations and characteristics of extruded conjunctival melanocytic mass. METHODS: A total of 33 patients who had extruded conjunctival melanocytic mass and who underwent excisional biopsy were retrospectively reviewed. RESULTS: Based on the excisional biopsy results, 13 patients (40%) were diagnosed with compound nevus, nine patients (27%) with subepithelial nevus, eight patients (24%) with primary acquired melanosis without atypia, and three patients (9%) with malignant melanoma. Compound nevus was located on the temporal side of the cornea in 54% of affected cases, bulbar conjunctival in 77%, and was partially pigmented (brown) in 61%. The average size of the melanocytic mass was 24 mm when histological analysis showed melanin nevus cells in the conjunctival epithelial layer and subepithelial stromal layer. Subepithelial nevus was located on the temporal side of the cornea (56%) and in the bulbar conjunctival (78%) and had a brown color (78%). The average size of the melanocytic mass was 28 mm when histological analysis showed melanin nevus cells located only in the subepithelial stromal layer and forming nest shapes. Primary acquired melanosis without atypia was located on the temporal side of the cornea (62.5%) and bulbar conjunctival (75%) and had brown color (75%). The average size of melanin nevus cells located only in the basement membrane of the epithelial layer was 30 mm. Three of these masses were malignant melanoma, and all cases were located on the superior side of the cornea and palpebral conjunctiva. All cases were black and had an average size of 53 mm, with malignant cells observed in all layers of the conjunctiva and connective tissue. CONCLUSIONS: A conjunctival melanocytic mass located on the palpebral conjunctiva, extruding onto the surface, and large in size should be suspected as malignant melanoma. In such cases, early biopsy and aggressive resection are required.
Basement Membrane ; Biopsy ; Conjunctiva ; Connective Tissue ; Cornea ; Humans ; Melanins ; Melanoma ; Melanosis ; Nevus ; Retrospective Studies

Primary leptomeningeal melanoma is a rare and aggressive tumor that originates from pial melanin-bearing cells typically along the cerebral conveidties or at the. Base of the brain. It has been hypothesized that malignant transformation Of the preexisting precursor cells leads to diffuse infiltration of the meninges by tumor and the onset of neurological symptoms and signs . The typical neurological symptoms and signs include psychiatric disturbances, seizures, and symptoros and signs of raised intracranial pressure secondary to hydrocephalus. Blindness has been reported as a late feature. Radiotherapy and chemotherapy has been using, but prognosis is poor We d be our experience with 24-years-woman in which the diagnosis of primary leptomeningea1 melanoma without melanotic pigmentation of variable areas of the skm was made.
Blindness ; Brain ; Diagnosis ; Drug Therapy ; Hydrocephalus ; Intracranial Pressure ; Melanoma* ; Meninges ; Pigmentation ; Prognosis ; Radiotherapy ; Seizures