BACKGROUND: Androgenic alopecia, commonly known in men as male pattern baldness is the gradual balding of the scalp in response to androgens in genetically predisposed individuals. Androgens can gradually transform large scalp hair follicles to smaller vellus ones, causing balding. The mechanisms involved are unclear, although androgens are believed to act on the epithelial hair follicle via the mesenchymal derived dermal papilla. During pregnancy, hair growth is increased, as estrogen appears to prolong the anagen phase, and postpartum hair loss may be related to a rapid decrease in estrogen. OBJECTIVE: The aim of the present study was to evaluate the difference of the expressions of androgen receptors(AR) and estrogen receptors(ER) by monoclonal antibodies in biopsy specimens between bald area and non-bald area. METHODS: Immunohistochemical analysis of AR and ER receptor were preformed on the paraffine-embedded tissue sections of bald area and non-bald area in 6 cases of androgenic alopecia using anti-AR and anti-ER monoclonal antibodies with avidin-biotin peroxidase complex procedure. RESULTS: The results were that androgen receptors were higher level in bald area and estrogen receptors showed no difference between bald and non-bald area. CONCLUSION: This study supports that locally increased androgen activities may be related with hair loss in androgenic alopecia and estrogens have less relationship in the pathogenesis of androgenic alopecia.
Alopecia* ; Androgens ; Antibodies, Monoclonal ; Biopsy ; Estrogens* ; Hair ; Hair Follicle ; Humans ; Male ; Peroxidase ; Postpartum Period ; Pregnancy ; Receptors, Androgen* ; Receptors, Estrogen* ; Scalp

No abstract available.
Humans ; Infant* ; Rhabdomyoma* ; Tetralogy of Fallot*

Peutz-Jeghers syndrome(PJS) is a relatively rare autosomal-dominant disease characterized by the occurrence of extensive mucocutaneous hyperpigmentation and gastrointestinal polyps. PJS patients are considered to have a high prevalence of intussusception due to polyps. We report the radiological findings in two cases of intussusception due to polyps in patients with PJS, and review the literature.
Humans ; Hyperpigmentation ; Intussusception* ; Peutz-Jeghers Syndrome* ; Polyps ; Prevalence

Lipedema is a chronic disease of lipid metabolism that results in the symmetrical impairment of fatty tissue distribution and storage combined with the hyperplasia of individual fat cells. Lipedema occurs almost exclusively in women and is usually associated with a family history and characteristic features. It can be diagnosed based on clinical history and physical examination. Lipedema is usually symmetrical, but spares the feet, is often painful to palpation, and is negative for Stemmer's sign. Additionally, lipedema patients can present with microangiopathies and lipomas. The well-known therapies for lipedema include complex decongestive therapy, pneumatic compression, and diet modifications. However, whether these treatments help reduce swelling is debatable. We encountered a case of lipedema that was initially misdiagnosed as lymphedema. The patient's clinical features and history were different from those typical of lymphedema, prompting a diagnosis of lipedema and she was treated with a complex decongestive therapy program.
Adipocytes ; Adipose Tissue ; Chronic Disease ; Female ; Food Habits ; Foot ; Humans ; Hyperplasia ; Lipid Metabolism ; Lipoma ; Lymphedema ; Palpation ; Physical Examination ; Rare Diseases

BACKGROUND: Alopecia areata(AA) is believed to be an autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no clearly superior therapy in the treatment of AA, especially AA with atopic dermatitis and alopecia universalis. The theory of autoimmune pathogenesis of alopecia areata suggests a potential therapeutic effect of cyclosporin-A(CsA). OBJECTIVE: The purpose of this study is to evaluate the effectiveness of CsA in the treatment of AA. METHOD: 12 patients with severe or refractory AA were treated with DPCP for at least 12 months. They showed resistance to treatment using DPCP. CsA was made up as a 0.01M, 0.005M solution in an ethanol preparation. 1cc of 0.01M CsA solution was applied on the Lt. side scalp and 1cc of 0.005M CsA solution was applied on the Rt. side scalp. The drug was applied once per week. Response to treatment was evaluated as follows: complete recovery, more than a 80% extent of hair regrowth; marked recovery, hair regrowth of 60% to 80%, moderate recovery, hair regrowth of 40% to 60%; slight recovery, hair regrowth of 20% to 40%; no response, hair regrowth of 0% to 20%. RESULT: The Six patients with focal type AA showed a moderate recovery. Of the six patients with alopecia totalis, 4 patients showed a moderate recovery, two patients showed no response. CONCLUSION: Topical CsA therapy is recommended in severe and refractory AA.
Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Dermatitis, Atopic ; Ethanol ; Hair ; Hair Follicle ; Humans ; Scalp

Actinic lichen planus is a particular subtype of lichen planus with a distinct photodistribution. This disease has been variously named lichen planus in subtropical countries, such as lichen planus subtropicus annularis, lichen planus tropicus, summertime actinic lichenoid eruption, and lichenoid melanodermatitis. It is a disorder seen most frequently in Africa, the Middle East, and the Indian subcontinent, favoring Asians. This disease presents in the spring or summer and is frequently quiescent during the winter. A 61-year-old man with unusual lichenoid photosensitive eruption is presented. The lesions developed during the late spring, appearing on both dorsa of hands, wrists, and lower legs. We report a case of actinic lichen planus with a review of the literature.
Actins* ; Africa ; Asian Continental Ancestry Group ; Hand ; Humans ; Leg ; Lichen Planus* ; Lichenoid Eruptions ; Lichens* ; Middle Aged ; Middle East ; Wrist

OBJECTIVES: Shoulder subluxation is common complication after stroke. And it can result in delayed neurological recovery in hemiplegic stroke patients. The aim of this study is identifying the incidence and associating factors of shoulder subluxation in stroke patients. METHODS: Stroke patients from 1 rehabilitation center from January 2008 to January 2012 were enrolled in the present study. The basic demographic data were registered at the time of admission or transfer to rehabilitation center. To assess the shoulder subluxation, we have used fingers' breadth method and plain radiography. We diagnosed shoulder subluxation with vertical distance (VD) were more than 12.4cm on plain anteroposteior view. And then shoulder subluxation was analyzed with associated factors. RESULTS: Of 154 stroke patients, this retrospective study included 109 patients who met the inclusion criteria, 28 patients had shoulder subluxation. After univariated analysis, shoulder subluxation was significantly associated with motor power of shoulder and elbow, loss of proprioception, stroke duration and functional ability. Especially elbow extensor less than poor grade is mostly related to shoulder subluxation among the motor powers. Then multivariated analysis was carried out including all significant subjects, elbow extensor less than poor grade, loss of proprioception and stroke duration more than 6 months were related to shoulder subluxation. CONCLUSIONS: Post stroke shoulder subluxation was commonly observed, and the incidence was 25.6% in this study. Shoulder subluxation was correlated with muscle power of elbow(less than F grade), loss of proprioception and stroke duration more than 6 months.
Elbow ; Humans ; Incidence ; Proprioception ; Radiography ; Rehabilitation ; Rehabilitation Centers ; Retrospective Studies ; Shoulder* ; Stroke*

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by pigmented or dematiaceous fungi that are implanted into the dermis from the external environment. The vast majority of infections are caused by Fonsecaea pedrosoi and Cladosporium carrionii. Several drugs, such as itraconazole, amphotericin B, terbinafine, have been tried with variable success and various therapeutic techniques, including radiotherapy, cryosurgery, electrodesiccation and surgical excision, can be applied as a further treatment. So far, there are five cases filed as chromoblastomycosis in Korea. Four of them are reported from the southern part of the Korea. Intralesional injection or occlusive dressing of Amphotericin B, and oral administration of intraconazole have been used for the treatment in reported cases. Now, we report firstly a case of chromoblastomycosis treated with terbinafine. A 54-year-old Korean teacher had 10 x 5.5 cm sized dark purple colored plaque with crusts 4 years earlier as a linear plaque after an injury by the thorns of wooden chair. A skin biopsy revealed pseudoepitheliomatous hyperplasia and dermal infiltration of mixed inflammatory cells and Touton type multinucleated giant cells with numerous sclerotic cells. Several clusters of sclerotic bodies were observed also within the giant cells. On the fungus culture, the colony showed slowly growing dark-brown colored heaped appearance in 4 weeks. Isolated fungus was identified as Fonsecaea pedrosoi. Because of partial response to 10 months' itraconazole treatment, the treatment regimen was changed to terbinafine 500 mg/d with marked improvement after 4 months.
Administration, Oral ; Amphotericin B ; Biopsy ; Chromoblastomycosis* ; Cladosporium ; Cryosurgery ; Dermis ; Fungi ; Giant Cells ; Humans ; Hyperplasia ; Injections, Intralesional ; Itraconazole ; Korea ; Middle Aged ; Occlusive Dressings ; Radiotherapy ; Skin ; Subcutaneous Tissue

OBJECTIVES: To determine which factors are changed in the thyroid cancer postoperative care and how quality of life compared between patients who had undergone modified radical neck dissection and selective neck dissection. METHODS: Prospectively, total 151 patients who diagnosed as thyroid cancer and underwent 16 modified radical neck dissection (mRND) or 135 selective neck dissection (SND) were evaluated for shoulder function, neck mobility, and quality of life and degree of depression at baseline, 2 days and 1 week postoperatively. All patients performed neck and shoulder stretching exercise three times a day beginning the morning following surgery. Shoulder function was assessed with the Constant's shoulder scale. Quality of life was assessed with the SF36v2 questionnaire. And depression was assessed with Beck depression inventory (BDI). RESULTS: The disability scores of patients were significantly worse for neck range of motion (ROM), shoulder pain, ADL, shoulder ROM, shoulder abduction power, total score of Constant's shoulder scale, physical function domain in SF-36v2 and BDI score & grade 2 days after the surgeries. SF36v2 domain score was no significantly difference between two groups. CONCLUSION: The mRND and SND are risk factors for neck ROM limitation, shoulder dysfunction, and onset of depression. In comparison between mRND and SND, more deterioration in ADL, shoulder abduction power, total score of Constant's shoulder scale are associated with modified radical neck dissection. More study is needed about usefulness of the stretching exercise in shoulder pain onset through comparison with control group.
Activities of Daily Living ; Depression ; Humans ; Neck ; Neck Dissection ; Postoperative Care ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Range of Motion, Articular ; Risk Factors ; Shoulder ; Shoulder Pain ; Thyroid Gland ; Thyroid Neoplasms

OBJECTIVE: To evaluate the effect of complex decongestive physiotherapy (CDPT) on malignant lymphedema patients. METHODS: Patients (n=22) with malignant lymphedema of the upper or the lower limb were assigned to this study. CDPT without manual lymphatic drainage (MLD) was used five times per week for two weeks. The main outcome measurements included measurement of the circumference of the limb (proximal, distal, and total) to assess volume changes. We also employed the visual analog scale (VAS) to evaluate pain, and the short form-36 version 2 questionnaire (SF-36) to assess quality of life (QOL). All items were assessed pre and post-treatment for each patient. RESULTS: There was a statistically significant difference in the volume change of the upper limbs (3.7%, p=0.001) and the lower limbs (10.9%, p=0.001). A 1.5 point reduction on the ten-point VAS was noted after CDPT. The scores on the physical and the mental components of the SF-36 showed statistical improvement after treatment (p=0.006, p=0.001, respectively). CONCLUSION: These results suggest that all components of the CDPT program except MLD are helpful in treating malignant lymphedema in terms of pain reduction and reduction of the volume of the affected upper or lower limb. This treatment regimen also has positive effects on QOL.
Drainage ; Extremities ; Humans ; Lower Extremity ; Lymphedema ; Pilot Projects ; Quality of Life ; Upper Extremity