BACKGROUND: PUVA has been used effectively in the treatment of vitiligo, but the mechanism by which PUVA stimulates melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and the incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies ; Candida* ; Classification* ; DNA* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo

BACKGROUND: PUVA has been used effectively in the treatment of vitiligo, but the mechanism by which PUVA stimulates melanocyte proliferation in vitiligo is not known. Several mechanisms have been suggested to be involved in the process of repigmentation of vitiligo. First, UV light, with or without psoralen, directly stimulates the proliferation of melanocytes. Secondly, PUVA may act. on epidermal keratinocytes or dermal components to stimulate t,hem to release certain melanocyte growth st,inulation factors that enhance the proliferation of melanocytes in depigmented lesions. Thirdly, PUVA irnmunologically leads to the impairment of epidermal Langerhans cell function and alteration of circulating T and B cell function, which results in the suppression of the stimuli is for rnelanocyte destruction during the therapy. OBJECTIVE: To test, th hypothesis that PUVA induced repigmentation in vitiligo results from the stimulation of growth factors that induce melanocyte proliferation, and that PUVA may suppress the immune reacticin to melanocytes, especially in autoantibody synt,hesis, we examined the effects of sera on the growth of epidermal melanocytes and control cells, and the incidence of antibodies to melanocyte and melanoma cells(SK-Mel 2~3) in the sera of patients with vitiligo. We also had normal control individuals and studied the changes of the antibody titer in the sera of patients with vitiligo. METHODS: The rate of H thymidine uptake was estimat,ed in cultured melanocytes and fibroblasts t,reated by patients sera before and after PUVA treatment. SDS-PAGE and immunoblotting analysis were used to idcntify anti pigment cell autoantibodies and were compared to the titers of autoantibodies after PUVA. RESULTS: 1. Melanocyte and fibrablast proliferation was increased by PUVA treated sera. Their proliferation was in proportion to the duration of the PUVA treatment. Melanocytes proliferated more than fibroblasts. 2. Significant differences between vitiligo patients and normal controls were found in the inci dence of anti-pigment cell antibodies. The antibodies were predominantly directed to melanocyte antigens of 110 kD, 65 kD, 45 kD and melanoma cell antigens of 110 kD, 103 kD, 88kD, 70 kD, 56 kD, 41 kD. 3. The titer of anti piment cell antibodies showed a tendency to decrease after PUVA treat- ment in most patients regardless of clinical improvement. Conclusion ; PUVA treated sera induced proliferation of melanocytes and fibroblasts and the production of aut,oantibodies was suppressed against pigment cell antigens through irnmunosuppression, which might help in the repigmentation of vitiligo.
Antibodies ; Autoantibodies ; Candida* ; Classification* ; DNA* ; Electrophoresis, Polyacrylamide Gel ; Fibroblasts ; Ficusin ; Humans ; Immunoblotting ; Incidence ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Melanocytes ; Melanoma ; Thymidine ; Ultraviolet Rays ; Vitiligo

We report a case of subungual solitary glomus tumor in a 28-year-old female, who has suffered from pain and tenderness of the left 4th finger tip for about 5 years. Simple surgical excision was performed for removal of the tumor mass and for the relief of the subjective symptoms. No recurrence has been observed for 5 months following excision of the tumor.
Adult ; Female ; Fingers ; Glomus Tumor* ; Humans ; Recurrence

Using audiometric test data, noise exposed workers were followed up to assess the activities for hearing conservation from 1989 to 1992. The subjects of study were 71 workers who could be followed up at least two years during this follow-up period. In all subjects, increasing trend of hearing threshold levels (HTLs) was observed after three years of follow-up at all testing frequencies in audiometry and this increase was statistically significant at 8KHz(p<0.05). Also, HTLs increased significantly(p<0.05) in the workers who complained tinnitus(at 0.25, 8KHz), who ws below 90 dB (at 8KHz). Effectiveness of the activities for hearing conservation, assessed by sequential test-retest comparisons, was lower in the workers who complained tinnitus, who had past history of ear disease, and whose workplace noise level was below 90 dB. These findings suggest that the activities for hearing conservation at workplace may have been unsatisfactory until now and more stringent measures may be necessary, especially in the workers who complain tinnitus, who have past history of ear disease, and whose workplace noise level is below 90dB.
Audiometry ; Ear Diseases ; Follow-Up Studies ; Hearing* ; Noise ; Tinnitus

We report a case of type IV hyperlipoproteinemia associated with xanthoma tuberosum and diabets mellitus in a 48 year old female patient. She had several yellowish-brown papules on the knees and palms. The blood glucose level was elevated and serum lipid and lipoprotein analysis revealed patterns of type IV hyperlipoproteinemia. Histopathologic findings of yellowish-brown papules on the knee showed the aggregation of foam cells in the dermis. She has been treated with diet control and hypolipidemic drug(lovastatin and procetofen) and is under our continuing supervision.
Blood Glucose ; Dermis ; Diabetes Mellitus* ; Diet ; Female ; Foam Cells ; Humans ; Hyperlipoproteinemia Type IV* ; Knee ; Lipoproteins ; Middle Aged ; Organization and Administration ; Xanthomatosis*

No abstract available.
Hyperthyroidism*

PURPOSE: In general, the amount of vertical rectus surgery is based on achieving 3 prism diopters (PD) of realignment for each millimeter of muscle recession. The study aimed to determine the surgical correction of vertical deviation in patients with hypertropia after superior rectus muscle recession. METHODS: A total of 32 patients with hypertropia underwent 2-8 mm recession of the superior rectus muscle. The average surgical correction for each millimeter of recession was calculated by deducting the post-surgical deviation from the pre-surgical vertical deviation and dividing the remnant by the amount of recession (mm). RESULTS: The average surgical correction was 2.2 +/- 0.7 PD for each millimeter of superior rectus recession. There was no statistical significance in the change in surgical correction in terms of follow-up period, which was categorized as one day, one, two, and six months, and one year (P>0.05). The relationship between surgical correction and age (below and above 11 years old), gender or the amount of recession (below or above 5 mm) was not statistically significant (P>0.05). There was no statistically significant difference in vertical correction between esodeviation and exodeviation (P>0.05). CONCLUSIONS: The study showed an average surgical correction of vertical deviation of 2.2 PD for each millimeter of superior rectus muscle recession. The results suggest that increased recession, within the maximum limit of 8 mm, is an effective approach to prevent undercorrection for children who have hypertropia but cannot undergo adjustable strabismus surgery.
Child ; Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Strabismus*

Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins

BACKGROUND: Tinea pedis is one of the most comrnon dermatoses in the general population. But its prevalence in the general populat,ion was not yet reported in Korea. OBJECTIVE: Prevalence of tinea pedis and associated tinea unguium were checked in the general population. METHODS: Six hundred fifty eight persons from 179 families of the college students were evaluated. Clinical examinatior. for tinea pedis and onychomycosis and collecting scales from the suspicious lesions of the family members were perforrned by educated college students. Then dermatologists exarnined those specimens mycologically by KOH ~tnount and fungal culture. RESULTS: The results were as follows 1. The prevalence of tinea pedis was 41.2% in the studied 658 persons. 2. Among all 271 patients with tinea pedis, 201 strains of dermatophytes were isolated. They were 143 strains of Trichophyton(T) rubrum, 49 strains of T. mentagrophytes and 9 mixed infections of T. rubrum and T. mentagrophytes. In the co existence of i,inea pedis and tinea unguiurn, isolated species were corresponding. 3. Among 179 families, 143 families (79.9%) had at least one patient with tinea pedis. The isolated species of derrnatophytes in a farnily were one organism, 71.4% and two or more organisms, 28.6% of 77 familiys with more than one patient. CONCLUSION: In our study, the prevalence rate of tinea pedis was 41.2%. That suggests that tinea pedis is a wide spr .ad disease in healthy adult in Korea.
Adult ; Arthrodermataceae ; Coinfection ; Daegu* ; Humans ; Korea ; Onychomycosis ; Prevalence* ; Skin Diseases ; Tinea Pedis* ; Tinea* ; Weights and Measures

OBJECTIVE: To assess the relationship between vaginal cytology and bone mineral density in postmenopausal women. METHODS: In 93 postmenopausal women, vaginal cytology smears were taken for maturation index, serum estradiol level and bone mineral density were also taken. the percentage of each cell type found By vaginal cytology was multiplied to its specific value:superficial cells, 1.0; intermediate cell, 0.6; parabasal cell, 0.2 and modified to maturation value. Bone mineral density was measured at lumbar spine using DEXA. RESULTS: The mean bone mineral density was 0.88+/-0.14g/cm2. Mean maturation value was 50.53+/-20.74 and it was related with age and bone mineral density. CONCLUSION: Maturation value of vaginal epithelial cell represents the influence of estrogen on bone mineral density.
Bone Density* ; Epithelial Cells ; Epithelium* ; Estradiol ; Estrogens ; Female ; Humans ; Spine