Skin atrophy is one of the most common side effects of topical steroid use and results from decreased skin proalphaI collagen mRNA production due to specific alterations in collagen gene transcription or from reduced collagen mRNA stability. This report describes a case of a 8 year-old-girl who visited our hospital with a complaint of ambiguous genitalia. She was observed to have atrophic labia majora and atrophic striae resembling scrotal rugae. However, her serum levels of FSH, LH, 17-KS, 17-OHCS, 5-DHT, DHT and DHEA-S were all in normal range and her karyotype was 46,XX. Abdominal and pelvic ultrasonogram showed a normal uterus and ovaries. Careful history taking revealed frequent use of steroid ointment due to vulvar pruritus for 2 years and she was finally diagnosed to have atrophy of external genitalia induced by long-term use of topical steroid.
Atrophy* ; Collagen ; Disorders of Sex Development ; Female ; Genitalia* ; Karyotype ; Ovary ; Pruritus ; Reference Values ; RNA Stability ; RNA, Messenger ; Skin ; Ultrasonography ; Uterus

No abstract available.

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravid 2, para 0, abortus 1 with known uterine subserosal myoma(5.3 x5.5cm sized) 26-year-old woman presented with acute dysuria and urinary retention. The patient was 14 weeks and 3 days pregnant and presented several week history of urinary frequency and sensation of incomplete bladder emptying. Examination revealed a retroflexed uterus with cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a thin, elongated maternal bladder and a uterus incarcerated between the sacral promontary and the pubis. The incarceration was successfully reduced by tenaculum traction of the cervical posterior lip without surgical intervention and had a normal infant of appropriate weight at term.
Abdominal Wall ; Adult ; Dysuria ; Female ; Humans ; Infant ; Leiomyoma ; Lip ; Myoma* ; Pregnancy ; Sensation ; Traction ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Uterine Retroversion ; Uterus*

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.
Anti-Bacterial Agents ; Child ; Communicable Diseases ; Drainage ; Epidural Abscess* ; Fever ; Humans ; Lateral Sinus Thrombosis ; Masks ; Mastoid* ; Mastoiditis* ; Otitis Media ; Streptococcus pneumoniae*

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

Objectives: . Resident macrophages are well known to be present in the cochlea, but the exact patterns thereof in spiral ligaments have not been discussed in previous studies. We sought to document the distribution of macrophages in intact cochleae using three-dimensional imaging. Methods: . Cochleae were obtained from C-X3-C motif chemokine receptor 1+/GFP mice, and organ clearing was performed. Three-dimensional images of cleared intact cochleae were reconstructed using two-photon microscopy. The locations of individual macrophages were investigated using 100-μm stacked images to reduce bias. Cochlear inflammation was then induced by lipopolysaccharide (LPS) inoculation into the middle ear through the tympanic membrane. Four days after inoculation, three-dimensional images were obtained. Results: . Macrophages were scarce in areas adjacent to the stria vascularis, particularly the area just beneath it even though many have suspected macrophages to be abundant in this area. This finding remained consistent upon LPS-induced cochlear inflammation, despite a significant increase in the number of macrophages, compared to non-treated cochlea. Conclusion . Resident macrophages in spiral ligaments are scarce in areas adjacent to the stria vascularis.

PURPOSE: In cases of overactive bladders, especially hyperreflexic neurogenic bladders, that arise in patients with spine disorder above sacral micturition center, current primary treatment modalities include the administration of anticholinergics and the intermittent catheterization. Because anticholinergics have many side effects including dry mouth, the demand for new agents has been rising. This study was designed to investigate the effects of ylang-ylang (YY) essential oil, which is currently used in aromatherapy, on the relaxation of urinary bladder muscle in vitro. MATERIALS AND METHODS: Isometric tension changes of isolated rat bladder muscle strips were recorded in an organ bath using a pressure transducer. Effects of YY oil were assessed on resting tension, electrical field stimulation(EFS)-, bethanechol-, ATP- and KCl-induced contraction. In order to determine the mechanism of YY oil, effects of YY oil on above all stimulations were assessed in the presence of methylene blue, L-NAME(N-nitro-L-arginine methyl ester) and N-ethylmaleimide. RESULTS: The contractility of strips pre-treated with YY oil was significantly decreased on all stimulation-induced contractions. There was no statistically significant difference between treated group only with YY oil and pre-treated group with YY oil and methylene blue. Similar findings were obtained when L-NAME(another NOS inhibitor) was used. When N-ethylmaleimide(c-AMP inhibitor) was employed, there was a statistically significant decrease in the rate of contraction induced by EFS, bethanechol, KCl and ATP applications. CONCLUSION: From the obtained data, the results of this study indicate that YY essential oil has relaxing effect on the bladder, and such mechanism is thought to be brought about by a pathway mediated by c-AMP.
Adenosine Triphosphate ; Animals ; Aromatherapy ; Baths ; Bethanechol ; Cananga* ; Catheterization ; Catheters ; Cholinergic Antagonists ; Ethylmaleimide ; Humans ; Methylene Blue ; Mouth ; Muscles* ; Rats* ; Relaxation* ; Spine ; Transducers, Pressure ; Urinary Bladder* ; Urination

Rhabdomyolysis is a potentially life-threatening disease which may result from a variety of causes. We describe the features of magnetic resonance imaging(MRI) and bone scintigraphy, and their importance for diagnosis and treatment of a patient with rhabdomyolysis.
Humans ; Magnetic Resonance Spectroscopy ; Rhabdomyolysis

PURPOSE: To evaluate the availability of ultra-wide-field fundus photography compared to fundus examination after pupil dilatation in Korean patients with retinal break. METHODS: For this retrospective case review of consecutive 160 patients, 230 lesions with retinal breaks were recruited. The ultra-wide-field images were taken after fundus examination with pupil dilatation performed by a retinal specialist. We analyzed ultra-wide-field images according to patient characteristics and separated area. We divided lesions into anterior and posterior areas, and each area was separated into 4 quadrants (superior, inferior, temporal, and nasal). RESULTS: The sensitivity of ultra-wide-field imaging for detecting retinal break was 72% (95% confidence interval [CI] 65-79%), and the specificity was 94% (95% CI 90-98%). The sensitivity of detection of posterior retina was 89% (95% CI 85-93%), and that of anterior retina was 72% (95% CI 66-78%); this difference was significant (p = 0.007). There was a significant statistical difference at the inferior quadrant between anterior and posterior retina, but not at superior, temporal, or nasal quadrants. The sensitivity of detection in the inferior quadrant in the anterior retina was 43% (95% CI 29-57%). CONCLUSIONS: Ultra-wide-field fundus photography can detect retinal break, but there is limitation in anterior retinal lesions, especially the inferior area. Therefore, ultra-wide-field fundus photography cannot be an alternative method instead of fundus examination with pupil dilatation.
Dilatation ; Humans ; Methods ; Photography ; Pupil ; Retina ; Retinal Perforations* ; Retinaldehyde* ; Retrospective Studies ; Sensitivity and Specificity ; Specialization

BACKGROUND: Type 2 diabetes is usually preceded by a long and clinically silent period of increasing insulin resistance. The purpose of this study is to demonstrate that rosiglitazone and metformin fixed-dose combination therapy (RSG/MET) will safely and effectively control glycemia as a first line of oral therapy, better than rosiglitazone (RSG) or metformin (MET) monotherapy in Korean type 2 diabetes patients. METHODS: This study was a 32-week, multicenter, randomized, double-blind study. Twenty-seven type 2 diabetes patients (males 14; females 13) were included and randomly divided into the rosiglitazone, metformin group, or rosiglitazone /metformin combination groups. The primary objective of this study was to determine the change in HbA1c from baseline (week 0) to week 32. The secondary end-points were to determine changes in fasting plasma glucose (FPG) and homeostasis model assessment insulin resistance (HOMA-IR), from baseline to week 32. Other cardiovascular risk markers were also assessed. RESULTS: At week 32, there were significant reductions in HbA1c and FPG, in all three treatment groups. There was no statistical difference in HbA1c among the three groups, but the decrease in FPG in the RSG/MET group was statistically significant compared to the MET group (P < 0.05). RSG/MET significantly reduced HOMA-IR at week 32 compared to baseline, but there was no difference among the three groups. RSG/MET significantly decreased high-sensitive C-reactive protein (hs-CRP) value at week 32, compared to baseline. There were increases in adiponectin from baseline to week 32 in the RSG and RSG/MET groups, and the increase in the RSG/MET group was statistically significant compared to that of the MET group (P < 0.05). At week 32, there was a significant decrease in plasminogen activator inhibitor-1 (PAI-1) in all three treatment groups, but no statistically significant difference among them. The RSG/MET group significantly decreased in terms of urinary albumin-creatinine ratio at week 32, compared to baseline. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control as an initial therapy, and it improved cardiovascular risk markers in Korean type 2 diabetes patients.
Adiponectin ; C-Reactive Protein ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Fasting ; Female ; Glucose ; Homeostasis ; Humans ; Insulin Resistance ; Metformin ; Plasma ; Plasminogen Activators ; Thiazolidinediones