BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

Irradiation which acts directly and produces the reactive oxygen radicals by ionizing water molecules, causes significant morbidity and mortality. The muscle is damaged by direct action, oxygen radicals and the alterations of microcirculation and metabolism after irradiation. The changes of SOD immunoreactivities in muscles of the rats after irradiation were observed. The ultrastructural changes of the irradiated muscles with the pretreatment of SOD (superoxide dismutase) or without were also investigated. A total of 60 healthy Sprague-Dawley male rats weighing from 200g to 250g were used as experimental animals. Under urethane (1.15g/kg. IP.2 times) anesthesia,30 Gy irradiation to lower extremities by PICKER-C9 Cobalt-60 teletherapy unit was done. 15,000 unit/kg of SOD was administered intraperitoneally 1 hour before irradiation. The experimental animals were sacrificed 1 day, 3 days, 7 days, 2 weeks and 4 weeks after irradiation. The superficial portions of the mid-belly of the rectus femoris muscles were obtained and sliced into portions, 2 mm in length, 1 mm in width and in thickness. The specimens were prepared by routine methods for the electron microscopic observation. All preparations were stained with uranyl acetate and lead citrate and observed with a Hitachi-600 electron microscope. The other parts of mid-belly of the rictus femoris muscles were sectioned in 14 micrometer thickness with cryostat at -20 degrees C. The immunoreactivities of SOD by use of antihuman Cu, Zn-and Mn-SOD antibodies were observed. The results were obtained as follows . 1. After irradiation, the immunoreactivities of SOD in the rictus femoris muscle were decreased. 2 weeks after irradiation, the immunoreactivities of Cu, Zn-SOD were trace, which was lowest.4 weeks after irradiation, the immunoreactivities were trace or weak. 1 day after irradiation, the immunoreactivities of Mn-SOD were trace, which was lowest. The immunoreactivities of Mn-SOD were increased gradually 4 weeks after irradiation, the immunoreactivities of Mn- SOD were moderate or weak. 2. The ultrastructural changes in the rectus femoris muscles of the rats were getting severer and severer after irradiation. 2 weeks after irradiation, unclear A band and I band, myofibrillolysis, increased and dilated cistemae of sarcoplasmic reticulum and mitochondria with dilated cristae and electron lucent matrix were seen. 4 weeks after irradiation, lysis of sarcomere and increased cisternae of sarcoplasmic reticulum were seen. 3. The ultrastructural changes in the rectus femoris muscles of the rats were getting worse and worse after 3 days of irradiation with the pretreatment of SOD. 2 weeks after irradiation with the pretreatment of SOD, myofibrillolysis, increased and dilated cisternae of sarcoplasmic reticulum and damaged mitochondria were seen. 4 weeks after irradiation with the pretreatment of SOD, the ultrastructures of rectus femoris muscles were recovered to normal. Consequently, after irradiation of 30 Gy, the immunoreactivities of SOD are decreased and SOD attenuates the reversible changes of ultrastructures in muscles.
Animals ; Antibodies ; Citric Acid ; Humans ; Lower Extremity ; Male ; Metabolism ; Microcirculation ; Mitochondria ; Mortality ; Muscles ; Quadriceps Muscle* ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Sarcomeres ; Sarcoplasmic Reticulum ; Superoxide Dismutase ; Urethane

BACKGROUND AND PURPOSE: Valproic acid (2-propylpentanoic acid) which enhances GABA synthesis and blocks it's degradation has been useful treatment of migraine and may activate GABA receptors to modulate trigeminal nociceptive neurons innervating the meninges. But the mechanism and action of sodium valproate in headache is not clear. To investigate the mechanism of valproic acid action in headache model, we compared the change of dural plasma protein extravasation in both substance-P neurogenic inflammation rats with valproic acid pretreatment and without valproic acid pretreatment. METHOD: Sprague-Dawely rats were pretreated with valproate 30 minutes prior to substance-P administration in order to test the effects of sodium valproate on dural plasma protein extravasation by detecting the amount of extravasated Evans blue in the dura matter. To examine the abilities of either bicuculine (GABAA antagonist) and phaclofen (GABAB antagonist) to reverse the effect of valproate, they were administered 5 min before valproate administration. After then we also test the effect of muscimol (GABAA agonist) and bicuculine (GABAA antagonist) in substance-P induced neurogenic inflammation rats. RESULTS: Intraperitoneal injection of sodium valproate and muscimol reduced dural plasma protein extravasation after intravenous substance-P administration. The GABAA antagonist bicuculine completely reversed the effect of valproate and muscimol on plasma extravasation following substance-P administration, whereas the GABAB receptor antagonist, phaclofen, did not. CONCLUSION: We concluded that the attenuation of dural plasma protein extravasation by valproate and muscimol is mediated by via GABAA receptors within the meninges. Agonists and modulators at the GABAA receptor may become useful for the development of selective therapeutic agents for migraine headache.
Animals ; Evans Blue ; gamma-Aminobutyric Acid ; Headache* ; Injections, Intraperitoneal ; Meninges ; Migraine Disorders ; Muscimol ; Neurogenic Inflammation ; Nociceptors ; Plasma ; Rats* ; Receptors, GABA ; Sodium* ; Valproic Acid*

PURPOSE: MRI is known to be an effective imaging modality of the aorta and its role is steadily increasing in the evaluation of acquired aortic diseases including aortic dissections and aortic aneurysms. However, differentiation of the aortic dissections with thrombosed false lumen from the aortic aneurysm with mural thrombus in MRI has not been easy. Therefore, the authors tried to find the characteristic MR featrses which would to differentiate the two diseases. MATERIALS AND METHODS: MR images of 6 patients with thrombosed aortic dissection and 7 patients with thrombosed aortic aneurysms were reviewed retrospectively and compared in regand to shape and extent of thrombus, dimension of aorta, and luminal flow signal. RESULTS: Thrombosed aortic dissections showed sharply demarcated crescent shaped aortic wall thickening of even thickness involving long segment of the aorta, whereas thrombosed aortic aneurysms showed irregular aortic wall thickening of uneven thickness localized in the short dilated segment of the aorta. Characteristically aortic aneurysm with mural thrombus showed eccentric intraluminal slow flow signal. In contrast to the signal void of the true lumen in aortic dissections, the residual lumen of the aortic aneurysm with mural thrombus revealed intraluminal signal due to slow flow. CONCLUSION: Familiarity to these MRI findings of thrombosed aortic dissections and aortic aneurysms may lead to the accurate differential diagnosis in majority of cases.
Aorta ; Aortic Aneurysm* ; Aortic Diseases ; Diagnosis, Differential* ; Humans ; Magnetic Resonance Imaging* ; Phenobarbital ; Recognition (Psychology) ; Retrospective Studies ; Thrombosis

Most of the peripheral nerve injuries from crushing or compressive forces are accompanied by surrounding soft tissue injuries. As a result, poor vascularity due to fibrosis and sacr formation compromises regeneration of the grafted nerve. Vascularized nerve graft shows superior regeneration to that of a non-vascularized one. However, the human body provides few donor sites of vascularized nerve graft clinically. We presumed that the prefabricated myoneural or adiponeural flap, which include fabricated nerves wrapped with surrounding vascularized muscle or adipose tissue flap, influences superiorly on the regeneration of grafted nerve because that surrounding vasculatity indirectly enhances the vascularity of the grafted nerve itself. Thirty adult male Sprague-Dawley rats were divided into three groups: 1) conventional reversed autogenous graft of the femoral nerve alone(n=10); 2) nerve graft entubulated with abdominal adipose tissue flap with a pedicle of inferior epigastric artery(n=10); 3) nerve graft entubulated with adductor muscle flap with a pedicle of the first muscular branch of the femoral artery(n=10). At three months postoperatively, grafted nerves were examined by electrophysiologic study to check amplitudes and motor nerve conduction velocities, as well as histopathologic study for evaluation of regenerated nerve cells, fibrosis and neo-vascularization. Consquently, nerve regeneration was found in all three groups. Both the myoneural and adiponeural flap groups had better improved results of nerve regeneration compared to that of the conventional nerve graft group. The result of myoneural flap group was superior to that of the adiponeural flap group. The myoneural flap group showed minimal fibrosis and less prominent neovascularization around moderately regenerated nerves. The adiponeural flap group showed more severe perineural and endoneural fibrosis, as well as vascular proliferation around focal regenerated nerves. The results of myoneural flap group proved to be statistically significant. We concluded that it is possible to use nerve graft entubulated with a vascularized muscle flap (myoneural flap) as a substitute for vascularized nerve graft.
Abdominal Fat ; Adipose Tissue ; Adult ; Femoral Nerve ; Fibrosis ; Human Body ; Humans ; Male ; Nerve Regeneration* ; Neural Conduction ; Neurons ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Regeneration ; Soft Tissue Injuries ; Tissue Donors ; Transplants*

A case of transient neonatal diabetes mellitus combined with congenital adrenal hyperplasia(CAH) is described. A female infant was born by cesarean delivery due to fetal distress, she had sunken eyeball and anterior fontanelle, large protruded tongue and thin subcutaneous tissues. She had large clitoris and progressive pigmentation on whole body was observed since 10th day of birth. Hyperglycemia and glycosuria was noted at 3rd day of birth. Level of insulin and C-peptide was 3.0 mU/L and 0.35 ng/mL respectively. Serum ACTH was 870.4 pg/mL and 17-hydroxyprogesterone was increased to 20,000 ng/dL. Serum Na was 124 mEq/L, K 5.6 mEq/L. Abdominal MRI showed no abnormality. Chromosomal study showed 46,XX. Genetic analysis with polymorphic DNA markers for chromosome 6 showed paternal uniparental isodisomy at D6S276, D6S1704 and DNA analysis of CYP 21 gene showed mutation at P435S. She required insulin therapy for 8 months after birth. Hydrocortisone and florinef was needed for the control of CAH.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; C-Peptide ; Chromosomes, Human, Pair 6 ; Clitoris ; Cranial Fontanelles ; Diabetes Mellitus* ; DNA ; Female ; Fetal Distress ; Genetic Markers ; Glycosuria ; Humans ; Hydrocortisone ; Hyperglycemia ; Infant ; Insulin ; Magnetic Resonance Imaging ; Parturition ; Pigmentation ; Subcutaneous Tissue ; Tongue ; Uniparental Disomy

BACKGROUND: UVB is responsible for most of the carcinogenic effects of sun exposure. OBJECTIVE: Aim of this study was to investigate the regulation and intracellular redistribution of p53 protein after UVB irradiation. METHODS: Cultured normal human melanocytes and G361 melanoma cells were used for west-ern blotting and confocal microscopic examination for determining expression and distribution of p53. RESULTS: UVB irradiation increased p53 expression in cultured normal human melanocytes and G361 malignant melanoma cells according to increasing doses of UVB. Furthermore, p53 moved from cytosol to nucleus after UVB irradiation. CONCLUSIONS: UVB irradiation induced overexpression and redistribution of p53 in cultured normal human melanocytes and G361 malignant melanoma cells.
Cytosol ; Humans ; Melanocytes* ; Melanoma* ; Solar System

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis

BACKGROUND: As an antihypertensive drug, Nifedipine, a calcium channel blocker was introduced recently, which also has antianginal effect. But due to the relatively short duration of action, another antihypertensive agents having longer duration of action and stronger hypertensive effect were under investigation. Nilvadipine, a new calcium channel blocker, was introduced to have more prologned duration of action and to act more specifically on vascular smooth muscle. So the efficacy and safety of oral Nilvadipine on essestial hypertension was investigated and represented by our institute. METHODS: In order to investigate the efficacy and safety of oral Nilvadipine, daily doses of 4mg twice a day were administered in 30 hypertensive patients whose states were compatible to the criteria : 1) severity of hypertension rated in Stage I and Stage II according to the classification by WHO, 2) ages ranging from 30 to 74 years regardless of sex, 3) blood pressure with 95mmHg or higher but less than 115mmHg in diastolic pressure which was the mean in a sitting position at the last two out of not less three consultations in the 2 week observation period, 4) outpatients with informed consent for 6 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete with blood count with platelet, uronalysis and the electrocardiography were performed at the beginning period and the 6th weeks of therapy. And kinds of side effects were questioned by examining physicians. RESULTS: The following results were obtained : 1) Blood pressure fell significantly in 6 weeks of treatment with Nilvadipine(Mean pressure+/-S.D., 6.00mmHg vs 108.90+/-9.68mmHg p<0.05), 2) There was no significant change in EKG in 6 weeks of treatment with Nilvadipine, 3) Pulse rate was decreased in 6 weeks of treatment with Nilvadipine(80.14+/-11.90/min vs 75.39+/-6.47/min, p<0.05). 4) No significant chsange in body weight was observed(64.50+/-8.7kg vs 63.50+/-10.25kg, p<0.05). 5) There were no significant changes in blood chemistry including blood sugar, cholesterol, electrolytes, serum creatinine and alkaline phosphatase values, 6) Hematologic findings and urinalysis findings reamained unchanged, 7) Total 10 patients(33.30%) had various side effects;facial flushing 30.00%, palpitation 23.33%, headache 20.00%, nausea 10.00%, drowsiness 3.33%, heaviness 3.33% and indigestion 3.33%. But there was no serious side effect that requires to discontinue the medication of the test drug. And there was no need to reduce the dosage due to the side effect, 8) The antihypertensive effect was judged to decrease markedly in 76.70%, decrease 20.00%, unchange 3.30% and increase 0.00%, 9) The utility which was assessed with the data from the overall safety and antihypertensive effect, the drug was judged to be very useful in 60.00%, useful 33.30%, useless 6.67% and inhibited 0.00%. CONCLUSION: From the above results, Nilvadipine in doses of 4mg twice a day was effective and useful in most cases without severe side effects in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Glucose ; Blood Platelets ; Blood Pressure ; Body Weight ; Calcium Channels ; Chemistry ; Cholesterol ; Classification ; Creatinine ; Dyspepsia ; Electrocardiography ; Electrolytes ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Informed Consent ; Muscle, Smooth, Vascular ; Nausea ; Nifedipine ; Outpatients ; Referral and Consultation ; Sleep Stages ; Urinalysis