In order to evaluate the effects of a topical application of homologous fibronectin on the healing of skin wounds, we made 2 excisional wounds on the back skin of each rat, applied ointment with or without fibronectin purified from citrated homologous plasma, and evaluated the effect according to wound size and microscopic findings. Excised lesions treated with carrier alone, but the difference was significant only in the early phase of wound healing, 2 and 3 days, according to wound size and microscopic changes. A significant decrease in wound size could be found in both groups, treated with ointment containing and not containing fibronectin, between day 4 and 9 when wound contraction was a major contributor to wound closure. Therefore it can be concluded that topical application of fibronectin has a beneficial effect on wound healing during its early phase, but no significant influence on wound contraction.
Administration, Topical ; Animals ; Fibronectins/blood/*therapeutic use ; Ointment Bases ; Rats ; Rats, Inbred Strains ; Skin/pathology ; Wound Healing/*drug effects

BACKGROUND: Vitiligo has been associated with various disorders including pernicious anemia, diabetes, hyperthyroidism, hypothyroidism, alopecia areata, Addison's disease, and so on. Autoantibodies against specific organs are also frequently found. However, the positive rates of these autoantibodies' detection by various reporters showed too much diversity to extrapolate a definitive conclusion. OBJECTIVE: The purpose of this study was to investigate the autoimmune aspects of vitiligo by evaluating the detection rates of various organ-specific autoantibodies. METHODS: We classified vitiligo patients into 2 groups(autoantibody positive group and autoantibody negative group) and 3 types(localized, generalized, and universalis). The overall detection rates of various autoimmune and endocrine diseases were also assessed in patients and the control, which was composed of 40 young healthy volunteers. RESULTS: There were 106 males(33.0%) and 215 females(67.0%) in total 321 vitiligo patients. 115 patients(35.8%) were determined to be autoanitibody positive, and 206 patients(64.2%) were negative. The most frequent type of vitiligo was generalized type in both autoantibody positive and negative group. Mean age of onset was 30.8 years. And there was a statistically significant difference between autoantibody positive(37.6 years) and negative(29.3 years) group(p < 0.05). Average disease duration was 6.5 years in autoantibody positive group and 4.3 years in autoantibody negative group. The positive rates of anti-nuclear, anti-microsomal. anti-smooth muscle antibody, and rheumatoid factor showed no significant differences between vitiligo patients and normal control group(p > 0.05). But the positive rate of antithyroid antibody was significantly higher in vitiligo patients than in normal control(kappa2 = 4.234, p = 0.040). The prevalence rates of autoimmune & endocrine disorders showed no significant differences between vitiligo patients and normal control(p>0.05). The prevalence rates of autoimmune and endocrine disorders were higher in autoantibody positive vitiligo group(33.0%) than in negative group(29.6%), although it was not statistically significant(p>0.05). However, the prevalence rate of thyroid disease itself was significantly higher in autoantibody positive group than in negative group(p = 0.004). Treatment response to PUVA therapy was better in autoantibody positive group than in negative group(p = 0.0003). CONCLUSION: With these results, we were able to conclude that anti-thyroglobulin antibody is more frequently found in vitiligo patients than in normal control. And autoantibody positive vitiligo patients showed higher prevalence rate of thyroid disease and better treatment response to PUVA therapy than in autoantibody negative vitiligo patients. Therefore, the presence of autoantibody in vitiligo patients seems to be related with a better treatment response for PUVA therapy.
Addison Disease ; Age of Onset ; Alopecia Areata ; Anemia, Pernicious ; Autoantibodies* ; Endocrine System Diseases ; Healthy Volunteers ; Humans ; Hyperthyroidism ; Hypothyroidism ; Prevalence ; PUVA Therapy ; Rheumatoid Factor ; Thyroid Diseases ; Vitiligo*

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of 26.3 kg/m2 and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range (23.1 kg/m2) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.
Adenoids ; Body Mass Index ; Child ; Diagnostic Errors ; Diet ; Fatty Liver ; Follow-Up Studies ; Humans ; Hypertrophy ; Liver ; Obesity ; Physical Examination ; Polysomnography ; Reference Values ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Sinusitis ; Sleep Apnea, Obstructive ; Snoring

Congenital middle ear cholesteatoma (CMEC) accounts for 2%-5% of all cases of middle ear cholesteatoma. CMEC is rare and diagnostically challenging; therefore, only a few cases are reported in the literature, and the pathophysiology of this condition remains largely unclear. Currently, epidermoid formation, amniotic fluid contamination, lack of the tympanic ring, and squamous metaplasia are among the mechanisms implicated in the pathogenesis of CMEC; however, no single theory satisfactorily explains the pathophysiology of this disorder. We report a case of CMEC in a young male patient, who showed a symmetric, binaural whitish mass posterior to the anterosuperior quadrant of the tympanic membrane. A few reports have described bilateral CMEC; however, no study has reported symmetrical CMEC as observed in this case. Bilateral tympanoplasty concomitant with cholesteatoma removal was performed, and histopathological evaluation of the resected specimen showed closed-type cholesteatoma. In this report, we describe a rare case of symmetric CMEC, which supports the epidermoid formation theory associated with CMEC, together with a literature review.

No abstract available.
Eyelids*

BACKGROUND: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. OBJECTIVE: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. METHODS: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImagePro®Plus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. RESULTS: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p<0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of “very satisfied” or “satisfied” responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. CONCLUSION: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.
Antifungal Agents ; Cybernetics ; Humans ; Lacquer* ; Laser Therapy ; Onychomycosis* ; Patient Satisfaction ; Therapeutic Uses ; Treatment Outcome ; Yttrium*

In order to elucidate the fungal diversity and community structure in freshwater environments, numerous fungal strains were isolated from freshwater, submerged soils, twigs, dead insects, etc. Among them, the present study has focused specifically on Aspergillus, Penicillium, and Talaromyces species, which produce diverse useful metabolites in general. Twelve strains of Aspergillus isolated were identified as A. japonicus (n = 5), A. tubingensis (3), A. niger (2), and A. flavus (2), 10 strains of which belong to Aspergillus section Nigri, named black Aspergillus. Eight strains of Penicillium were identified as P. brasilianim (n = 3), P. oxalicum (2), P. crustosum (1), P. expansum (1), and P. piscarium (1). Two different strains of Talaromyces were identified as T. pinophilus and T. versatilis. Thus far, Penicillium piscarium and Talaromyces versatilis have been unrecorded in Korea, for which we provide detailed morphological and molecular characteristics.
Aspergillus ; Fresh Water ; Insects ; Korea ; Niger ; Penicillium ; Soil ; Talaromyces

OBJECTIVE: Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. METHODS: Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. RESULTS: Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). CONCLUSION: Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of > or =70%.
Angiography ; Angioplasty ; Antibodies, Monoclonal ; Arteries ; Constriction, Pathologic ; Dissent and Disputes ; Follow-Up Studies ; Humans ; Immunoglobulin Fab Fragments ; Intracranial Arteriosclerosis ; Ischemic Attack, Transient ; Phenobarbital ; Retrospective Studies ; Stents ; Stroke ; Thrombosis

No abstract available.
Injections, Intralesional ; Isotretinoin ; Triamcinolone ; Triamcinolone Acetonide

Dorsal root ganglionotomy of the S5 nerve is useful for pain around the coccyx. The S5 dorsal root ganglion lies behind the sacrum at a level 1 cm caudal to the S2 foraminal opening and approximately 2 mm lateral to the midline of the sacrum. A small burr-hole was made through the plates of the posterior sacrum to approach the dorsal root ganglion of S5 nerve. Sensory stimulation was performed at 0.3 V, 50 Hz. No motor fasciculations was noted at 0.6 V, 2 Hz. A thermal lesion was created at 75oC for 60 sec. The patient whom we report now was a 67-year-old male who suffered from the pain around the coccyx due to rectal cancer metastasis. He failed to respond to other oral and invasive conventional therapy. We experienced a successful result in the treatment of his intractable pain after the S5 dorsal root ganglionotomy.
Aged ; Coccyx ; Fasciculation ; Ganglia, Spinal ; Humans ; Male ; Neoplasm Metastasis ; Pain, Intractable ; Rectal Neoplasms ; Sacrum ; Spinal Nerve Roots*