Onychomycosis is not uncommon among nail diseases. A review of the reports between 1985 and December 2004 found it to be increasing (0.86%) until 1988 among the outpatients in the department of dermatology, but it decreased thereafter to the current average of 0.48% (0.43~0.53%). No difference was found in the occurrence between the genders. It was most frequently seen in patients aged 40~49 (22%) followed by those aged 50~59 (19.6%), 30~39 (19.3%) and 20~29 (13.6%) respectively, although some discrepancies were shown among the investigators. A new classification of onychomycosis was reported by Baran et al in 1998, approximately 25 years after the first classification of four types published by Zaias in 1972. They suggested onychomycosis should be categorized into five clinical types: distal and lateral (DLSO), superficial, proximal subungual (PSO), endonyx, and total dystrophic (TDO). The basis of the new classification was the pattern of nail plate involvement by mode and site invasion, rather than fungal etiology; therefore, Candida onychomycosis is not a separate category in the new classification. Nail growth rate can be an important factor that determines the initiation of the infection, the treatment periods or results in onychomycosis. It depends mainly on the turnover rate of the nail matrix cells, but is influenced by numerous environmental, physiological, and pathological factors.
Candida ; Classification ; Dermatology ; Humans ; Nail Diseases ; Onychomycosis* ; Outpatients ; Research Personnel

The testicular feminization is the most common type of male pseudohermaphroditism. Mutation of androgen receptor gene impairs normal sexual differentiation in genetic male (46, XY) and subsequently develops secondary female characteristics. We report three cases of complete testicular feminization syndrome with normal development of female external genitalia, but with blindly ended vagina and inguinal or pelvic masses. Microscopic examination of the testes and their adnexa had three components: 1) A testis composed of immature tubules, prominent Leydig cells and a spindle cell stroma resembling ovarian stroma with hamartomatous nodule or Sertoli cell adenoma, 2) a white, whorled, firm, smooth muscle body in the medial pole of the testis, and 3) a lateral adnexal cysts of varying sizes.
46, XY Disorders of Sex Development ; Adenoma ; Androgen-Insensitivity Syndrome* ; Cryptorchidism* ; Disorders of Sex Development ; Female ; Genitalia ; Humans ; Leydig Cells ; Male ; Muscle, Smooth ; Receptors, Androgen ; Sex Differentiation ; Testis ; Vagina

PURPOSE: Matrix metalloproteinases (MMPs) have been reported to play critical roles in the endothelial cell migration and matrix remodeling during angiogenic process. To investigate the roles of the membrane type MMP (MT1-MMP) by the matrix remodeling of endothelial cells, MT1-MMP expression vector was transfected into bovine aortic endothelial cells (BAECs). Increased ex+pression of MT1-MMP in BAECs enhanced the activation of MMP-2, invasion and migration of BAECs. Moreover, the capacity of tube formation was increased by MT1-MMP transfectants. These observations indicate that MT1-MMP is involved in the angiogenic process of endothelial cells in vitro. In this study, we attempted these effects were confirmed in vivo system. MATERIALS AND METHODS: In this study, we used MT1- MMP or Antisense MT1-MMP stable transfectants in HT1080 human fibrosarcoma cells. Chorioallantoic membrane (CAM) assay was used for the detection of angiogenesis in vivo and modified CAM assay for quantification of invasion of MT1-MMP transfected cells. RESULTS: In CAM assay, the formation of microvessels was stimulated by MT1-MMP transfectants. Invasive capacity of HT1080 cells was also increased in a novel in vivo metastasis model, PCR based CAM assay. CONCLUSION: These results identify the function of MT1- MMP during the neovascularization process.
Chorioallantoic Membrane* ; Endothelial Cells ; Fibrosarcoma ; Humans ; Matrix Metalloproteinase 1* ; Matrix Metalloproteinase 14 ; Matrix Metalloproteinases ; Membranes ; Microvessels ; Neoplasm Metastasis ; Polymerase Chain Reaction

The gene product of bcl-2 (B-cell leukemia/lymphoma-2) was suggested to suppress programmed cell death (apoptosis) of tumor cells and be involved in the development of multiple myeloma. However, the normal plasma cells also express the protein. It is unclear whether the expression of bcl-2 in multiple myeloma is of normal character or of regulatory adaptation in association with neoplastic transformation. p53 was also suggested to be involved in tumor progression since mutations on p53 were found in multiple myeloma. In order to find the relationship between the expression patterns of bcl-2 and p53 in tumor cells of multiple myeloma and non-neoplastic plasma cells, we examined 38 cases of multiple myeloma and 10 cases of nasal polyp immunohistochemically. Furthermore, expression of bcl-2 and p53, mitosis, clinical stage and infiltrative pattern of tumor cells in bone marrow were also evaluated in association with the survival of patients. By immunostaining with anti-bcl-2 and p53 monoclonal antibody, 37 out of 38 cases of multiple myeloma and all of 10 cases of nasal polyp were positive for bcl-2 but only 7 cases of multiple myeloma were positive for p53. Marked dysplasia, low percentage of bcl-2 expression, and increased mitoses were correlated with poor prognosis. Based on these observations, we suggest that bcl-2 and p53 are involved in tumorigenesis of multiple myeloma and the survival of patients would be influenced by dysplastic change, mitosis and degree of bcl-2 expression.
Bone Marrow ; Carcinogenesis ; Cell Death ; Humans ; Mitosis ; Multiple Myeloma* ; Nasal Polyps ; Plasma Cells* ; Plasma* ; Prognosis

BACKGROUND: Although an oxidants and antioxidants imbalane has been considered in the pathogenesis of chronic obstructive pulmonary disease (COPD), there is a paucity of reports focussing on the smoking-induced changes of oxidants and antioxidants in COPD. METHOD: The concentration of antioxidants (ascorbic acid, uric acid, retinol, and α- &γ-tocopherol) was measured in the serum and induced sputum of 30 healthy controls and 34 stable COPD patients using high performance liquid chromatography (HPLC). The inhibition of lipid peroxidation as an index of antioxidant capacity was measured in the serum by a TBA assay. RESULTS: The serum concentration of ascorbic acid, α-tocopherol, and retinol were significantly lower in the patients with COPD than in healthy controls (484.8±473.3 vs 1497.8±819.2 pmol/L, p<0.001, 48.38±17.34 vs 73.96±26.29 pmol/L, p<0.001, and 9.51±8.33 vs 15.01±5.88 pmol/L, p<0.05, respectively, mean±SD). However, there were little differences in the ascorbic acid and uric acid concentrations in the induced sputum between the COPD patients and the controls. The induced sputum to serum ratio of ascorbic acid was significantly higher in COPD patients compared with healthy control (0.375 vs 0.085, p<0.05). In the normal controls, the serum ascorbic acid concentration was lower in smokers than in nonsmokers (1073±536 vs 1757±845 pmol/L, p<0.05), but the level was still higher than that of the COPD patients (p<0.05). The serum retinol levels were correlated with FEV1 in COPD patients (r=0.58, p<0.05). The products of lipid peroxidation were increased in normal smokers and COPD compared with normal nonsmokers (115.56±19.93 and 120.02±24.56 vs 91.87±20.71 µmol/µmol Pi of liposome, p<0.05). CONCLUSION: Cigarette smoking may induce the depletion of serum antioxidants and this depletion of antioxidants is suggested to play a role in the pathogenesis of COPD.
Antioxidants* ; Ascorbic Acid ; Chromatography, Liquid ; Humans ; Lipid Peroxidation ; Liposomes ; Oxidants ; Pulmonary Disease, Chronic Obstructive* ; Smoking ; Sputum* ; Uric Acid ; Vitamin A

Hypomelanosis of Ito (HI) is a neurocutaneous disorder, also known as incontinentia pigmenti achromians. HI has been associated with chromosomal abnormalities, especially mosaicism. Herein, we report a case of HI with multiple congenital anomalies. A 2-month-old girl presented with multiple linear and whorling hypopigmentation on the face, trunk, and both extremities and patch alopecia on the scalp. Moreover, she had conical teeth, aniridia of the both eyes, and multiple musculoskeletal problems, including syndactyly and coccyx deviation. Cytogenetic analysis on peripheral blood was normal 46, XX, and no mutation was found in IKBKG gene test.
Alopecia ; Aniridia ; Chromosome Aberrations ; Coccyx ; Cytogenetic Analysis ; Extremities ; Female ; Humans ; Hypopigmentation ; Infant ; Karyotype ; Mosaicism ; Neurocutaneous Syndromes ; Pigmentation Disorders ; Scalp ; Syndactyly ; Tooth

Background: Lichen striatus (LS) is a linear, inflammatory dermatosis that mainly affects children. To date, there are limited data comparing treatment outcomes between topical agents for pediatric LS. Objective: To investigate the clinical features and treatment outcomes associated with the use of topical agents for pediatric LS. Methods: We retrospectively reviewed the medical records and clinical photographs of 60 pediatric patients classified into three groups according to the topical agent used. Treatment response was evaluated by comparing subjective symptoms and clinical photographs obtained at each visit. Results: A good response (＞75% clinical improvement from baseline) was achieved in 55%, 46.2%, and 42.9% of patients from the calcipotriol, corticosteroid, and calcineurin inhibitor groups, respectively. There were no statistically significant differences in treatment duration among groups. However, when compared to other drugs, calcipotriol showed a trend towards shortening the disease course duration. Conclusion Topical use of calcipotriol, as well as corticosteroids and calcineurin inhibitors, may represent useful treatment options for pediatric LS, although further studies are required to confirm their efficacy and long-term safety.

BACKGROUND: To observe the immediate and long-term results of bronchial artery embolization(BAE) for hemoptysis and the factors influencing the recurrences. METHODS: This study involved 75 patients with massive, or moderate and recurrent hemoptysis, who underwent bronchial artery embolization(BAE) from 1994 to 1999. The underlying diseases included pulmonary tuberculosis in 35, bronchiectasis in 22, aspergilloma in 12, lung cancer in 3, and 3 with other diseases. RESULTS: After BAE, bleeding was controlled immediately in 61 patients(82.7%). One patient died of another medical problem, 3 patients were referred to surgery and 5 patients could not be followed-up. In the remaining 66 patients who were followed for more than one-year after BAE, 37(56.1%) patients had another hemorrhage(26 hemoptysis, 11 minor hemosputa). Among the recurred 37 subjects, 19(51.4%) experienced hemorrhage within 1 month after BAE, 31(83.8%) within 1 year, and 36(94.1%) within 3 years. The underlying lung diseases, the amount of bleeding and the extent of the involved lungs were factors affecting the outcome, especially blood loss >500cc was an important factor affecting the recurrence. BAE for two cases with lung malignancy was ineffective. Long-term control of bleeding (3-year cumulative non-recurrence) was achieved in 30 subjects(45.5%). CONCLUSION: Bronchial artery embolization(BAE) is effective as an initial treatment for moderate to massive hemoptysis. Because most of the recurrences occurred within 3 years, it is important to follow-up such patients for at least 3 years after BAE and the most significant factor affecting the prognosis was amount of blood loss.
Bronchial Arteries* ; Bronchiectasis ; Follow-Up Studies ; Hemoptysis* ; Hemorrhage ; Humans ; Lung ; Lung Diseases ; Lung Neoplasms ; Prognosis ; Recurrence ; Tuberculosis, Pulmonary

Primary colorectal lymphoma accounts for only 0.2~.65% of large intestinal malignancies. Mucosa-associated lymphoid tissue lymphoma in the rectum is very rare. We report the case of a 73-year-old woman with morphologic and immunophenotypic findings consistent with mucosa-associated lymphoid tissue lymphoma of the rectum. The woman complained of consistent bloody diarrhea and recently developed abdominal pain, febrile and chilling sensation. Ultrasonography of upper abdomen detected multiple stones within the gallbladder and the gallbladder was resected using laparoscopic surgery. An ulcerative polypoid mass in the rectum was detected by colonoscopy and computerized tomography of abdomen. Microscopic and immunohistochemical studies showed a diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma. This patient was consulted to the department of radiotherapy because of poor general condition and old age. Chemotherapy was not performed. She was followed up with no relapse of the lesions during 7 months after the diagnosis.
Abdomen ; Abdominal Pain ; Aged ; Colonoscopy ; Diagnosis ; Diarrhea ; Drug Therapy ; Female ; Gallbladder ; Humans ; Laparoscopy ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiotherapy ; Rectum* ; Recurrence ; Sensation ; Ulcer ; Ultrasonography

PURPOSE: Despite an increasing usage of old or marginal donor kidneys in renal transplantation, little attention has been directed to the structural and functional changes occurring in the remnant kidney of old donor. In this study, the functional and structural changes were assessed in the remnant rat kidneys of early stages of aging after uninephrectomy (UNx) and compared with that of young rats. METHODS: Twelve month-old and 7~9 week-old Sprague- Dawley (SD) male rats underwent UNx and were sacrificed following 1, 3, and 5 weeks after UNx. Extract and Sham- operated kidneys were used as control. Serum creatinine, 24hr urinary protein excretion, and urinary nitric oxide (NO) were measured. The extract kidneys were examined for routine histology and also for immunohistochemical stains for ED-1, inducible NO synthase (iNOS), and PCNA and TUNEL assay. RESULTS: In control rats, there was no difference in 24hr urine protein excretion and urinary NO level between old and young rats. However, the mean serum creatinine level was higher in old rats than that of young rats. After UNx, urinary NO level was significantly increased in old but not in young rats, without accompanying a significant increase of proteinuria or serum creatinine level. Histological injuries of remnant kidneys were not significantly increased after 5 weeks in old rats. However, TUNEL indices were persistently increased at 5 weeks with a return of PCNA indices to a basal level, The number of ED-1 positive cells and interstitial iNOS expression were also increased in remnant kidney of old rats, however, they were not statistically significant. CONCLUSION: UNx does not seem to affect the short-term renal function or histology in 12-month-old rats. However, persistent increase of TUNEL indices at 5 weeks may suggest parenchymal atrophy and a functional decrease in the long-run. A longer observation may be necessary to predict long-term sequelae of UNx in old rats.
Aging* ; Animals ; Apoptosis ; Atrophy ; Coloring Agents ; Creatinine ; Humans ; In Situ Nick-End Labeling ; Infant ; Kidney Transplantation ; Kidney* ; Male ; Nephrectomy* ; Nitric Oxide ; Nitric Oxide Synthase ; Proliferating Cell Nuclear Antigen ; Proteinuria ; Rats* ; Tissue Donors