BACKGROUND: Monofunctional psoralens plus UVA radiation are not severely phototoxic and have less mutagenic activity than bifunctional psoralens plus UVA radiation. OBJECTIVE: The purpose of this study was to evaluate pigment producing effect using various concentrations(0.02%, 0.1%, 0.5%) of monofunctional psoralens such as angelicin, khellin and comparing it's effect with TMP in topical photochemotherapy. METHOD: Ninty three C57BL mice were painted with either angelicin, khellin or TMP solution in concentrations of 0.02%, 0.1% and 0.5% each and were UVA irradiated. Skin biopsies were performed at 1,3,5 weeks after UVA irradiation. The pigment producing effects were measured by the number, area and perimeter of the melanocytes after topical PUVA. RESULTS: The comparison of melanocyte numbers between different psoralens after five weeks of photochemotherapy showed a significant difference in decreasing order of TMP, khellin and angelicin. The area and perimeter of melanocytes were larger in the TMP group after five weeks photochemotherapy than the other group. However in the khellin and angelicin group, the area and perimeter of melanocytes were not increased by increasing the frequency of the UVA irradiation. CONCLUSION: The number, area and perimeter of melanocytes after topical PUVA increased in the TMP group compared to angelicin or khellin group. We expect the clinical application of angelicin and khellin in vitiligo is possible considering the result of the study of pigment producing effect with a higher concentration and higher dose of UVA.
Animals ; Biopsy ; Ficusin* ; Furocoumarins ; Khellin ; Melanocytes* ; Methods ; Mice* ; Mice, Inbred C57BL ; Paint ; Photochemotherapy* ; Skin ; Thymidine Monophosphate ; Vitiligo

The exact etiologies and mechanisms of ischemia in avascular necrosis of femoral head are still under investigation. But this condition seems to be increasing during a few decades with increasing use of steroid and alcohol abuse in Korea. The treatment modalities have been based on the stages of the disease by simple radiographic findings that do not describe the accurate pathological extent or localization. Therefore more sophisticated study is needed to treat the AVN of the femoral head well. Magnetic resonance images, simple radiographs, scintigraphs of 13 patients(22 femoral heads), who were admitted and treated at Seoul National University Hospital from April, 1989 to December, 1989 were correlated, to characterize the type of AVN by extent and location regardless of its stage and reveal the relationship between types and stages. It is the result of this study that the type of AVN as well as stage should be considered in determining the treatment modality.
Alcoholism ; Classification ; Head ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Seoul

BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

Several observation suggest that the antimelanocyte autoantibodies could play a role in melanocyte destruction. Some experiments indicate that melanocyte antibodies from patients with vitiligo can kill melanocyte in vitro. In these experiments, we demonstrated that vitiligo patient's sera containing antimelanocyte antibodies can lyse cultured human melanocytes by complement activation. Melanocyte cytotoxicity was measured using the ethidium bromide/ acridine orange viability assay. Significant melanocyte cytotoxicity was seen in sera from patients with both active and inactive vitiligo(p<0.01). Melanocyte cytotoxicity measured with complement-mediated cytotoxicity decreased after systemic steroid treatment(p<0.05) ; however melanocyte cytotoxicity showed no significant change with systemic PUVA therapy.
Acridine Orange ; Antibodies ; Autoantibodies* ; Complement Activation ; Ethidium ; Humans ; Melanocytes ; PUVA Therapy ; Vitiligo*

Congenital fibrosarcoma of neonate is a very rare malignant tumor prone to behave aggressively with a tendency to local recurrence without metastasis. It is characteristically composed of collagenous fibroblasts and herringbone pattern in histology. We experienced a case of congenital fibrosarcoma on the left thigh and report this case with some review in literature with 1½ year follow up.
Collagen ; Fibroblasts ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Infant, Newborn ; Neoplasm Metastasis ; Recurrence ; Thigh

BACKGROUND: Malpositioning of the endotracheal tube within airway after intubation may results in serious complications, such as accidental extubation and inadvertent endobronchial intubation. Therefore, early detection of malposioning of the endotracheal tube is very impotant for deciding patient's prognosis. METHODS: We assessed the distance from the tip of the endotracheal tube to the carina according to the patient's age, sex, and the time, the location, and the route of intubation. The chest x-ray was taken for 333 patients (men, 226: women, 107) who were admitted to the intensive care unit of Wonju Christian Hospital from march 1, 1995 to February 28, 1996. Chest x-ray was obtained after intubation to verify endotracheal tube position. Appropriate endotracheal tube position on chest x-ray was defined as between 2 and 6 cm above the carina. RESULTS: Of the 333 intubations, 106 (31.8%) endotracheal tubes were inappropriately placed according to the chest x-ray. The percentage of malpositioned endotracheal tubes (<2 cm) was higher in women than in men (11.2% vs. 5.3%, p<0.05), with higher in night (7 PM to 7 AM) than in day (7 AM to 7 PM) (42% vs. 24%, p<0.05). Distance from the carina to the tip of endotracheal tube is 4.34 +/- 1.77cm in women and 5.23 +/- 1.64cm in men. Thus, position of the endotracheal tube in women is deeper than men (p<0.001). CONCLUSIONS: We conclude that the chest x-ray for confirmation of endotracheal tube position after endotracheal intubation may remain the standard of practice. And endotracheal tube position should be carefully assessed immediately after tracheal intubation, particularly in women and at night.
Female ; Gangwon-do ; Humans ; Incidence* ; Intensive Care Units ; Intubation ; Intubation, Intratracheal* ; Male ; Prognosis ; Thorax*

Endoscopic injection sclerotherapy(EIS) has been widely used in treating and eradicating acutely bleeding esophageal varies, but may be associated with some undesirable local and systemic complications. Endoscopic variceal ligation(EVL), which consists of mechanicai ligation and thrombosis of varices using elastic o-band, has been recently developed as a non operative alternative to EIS. We performed EVL in 65 patients who had bled from esophageal varices between November 1991 and September 1993. Total 274 sessions were performed and 774 o-bands were used. Six patients were actively bleeding and all of them were successfully controlled by emergency EVL. During the follow-up period, five patients who had combined hepatoma died. Varices were eradicated or reduced grade I in 43(71.6%) of the 60 survivals by 8-36 ligations(mean 15.6 ligation) in 2-13 EVL sessions(mean 5.6 sessions). During follow up period, five patients had recurred from grade 0 to grade 2 or 3 in 106-260 days(mean 182.6 days), and then eradicated by repeated EVL. During or after EVL, there were no complications, except mild substernal distress and mild dysphagia in 17 and 7 patients respectively. These results showed that EVL is a safe and effective method for eradication of bleeding esophageal varices.
Carcinoma, Hepatocellular ; Deglutition Disorders ; Emergencies ; Esophageal and Gastric Varices* ; Follow-Up Studies ; Hemorrhage ; Humans ; Ligation* ; Thrombosis ; Varicose Veins

This study was undertaken to investigate the recovery of epidermal Langerhans cells in relation to time after UVA irradiation through different amounts and ways of exposure in CH mice. We irradiated the ears of C2H mice with UVA 200J/cm2 and 400J/cm2 in a single dose at one time or 5 fractionated doses for 5 days and performed biopsies on the ears of the control and experimental groups after 2, 7, 14, 21days of irradiation and stained them with immunoperoxidase method. The results are summarized as follows, l. We observed a significant decrease in the number of the Ia-positive epidermal Langerhans cells in the single-dose-exposed group compared to the fractionated- dose-exposed group on 7th and 14th days irradiated with UVA 200J/cm. 2. There was no significant difference in the change in the number of the Ia- positive epidermal Langerhans cells until 21 days of exposure between the single- dose-exposed group and the fractionated-dose-exposed group irradiated with UVA 400 J/cm 3. In the group irradiated with UVA 2003/cm, the reduced number of the Ia-positive epidermal Langerhans cells returned to normal on the 14th day after irradiation in the fractionated-dose-exposed group and on the 21st day in the single- dose-exposed group. In the group irradiated with 400J/cm, the number returned to normal on the 21st day of irradition both in the fractionated-dose-exposed group and in the single-dose-exposed group.
Animals ; Biopsy ; Ear ; Langerhans Cells* ; Mice ; Mice, Inbred C3H*

BACKGROUND: It is reported by rnany t,hat UVB and large coses of UVA damage epidermal Langerhans cells. UVA irradiated skin produces reactive oxygen soecies such as superoxide anion(O ), hydrogen peroxide(H O), hydroxyl radical( OH) and singlet oxigen(O ). Reactive oxygen species such as O are invnlved in the process of decreasing the number if epidermal Langerhans cells after irradiation with UVB. However, no well established studies have been carried out after irradiation with UVA. OBJECTIVES: We wished to find out whether the UVA-induced decrease in the number of Ia Langerhans cells would be protected by scavengers of reactive oxiygen species. METHODS: We irradiated 200J/cm and 400J/cm of UVA on thi ears of C3H mice with or without intravenous injectior. of SOD, catalase, and sodium azide which are the scavengers of O , HO and O, respectively. We biopsied the ears of mice 2 days after irradiaion, stained them with immunope-roxidase technique, and counted the number of Langerhans cells. RESULTS: 1, There was significant decrease in the number of Ia Langerhans cells in the 200J/cm or 400J/cm of UVA irradiated group compared to the normal control group. 2. The pretreatment groups with SOD, catalase, and sodium to before irradiation with 200J/cm or 400J/cm of UVA showed less decrease in the number of la Langerhans cells compared to the 200J/cm or 400J/cm irradiated group with UVA only. CONCLUSION: Frorn the above result, we can deduce that reactive oxygen species are involved in the decrease in the number of Ia Langerhans cells induced by 200J/cm. or 400J/cm of UVA irradiation.
Animals ; Catalase ; Ear ; Hydrogen ; Langerhans Cells* ; Mice ; Mice, Inbred C3H ; Oxygen ; Reactive Oxygen Species* ; Skin* ; Sodium ; Sodium Azide ; Superoxides

IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.
Anaphylaxis ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Delivery of Health Care ; Humans ; Hypersensitivity, Immediate ; Latex ; Latex Hypersensitivity ; Personnel, Hospital* ; Rubber ; Skin ; Urticaria