BACKGROUND: The pathogenesis of melasma has not yet been clearly demonstrated. But, clinical manifestations such as remarkable lesional symmetry and the distribution related to trigeminal nerves, suggest that the neural system could play a pathogenic role in melasma. OBJECTIVE: This study was carried out to examine the expression of some neuropeptides and their receptors, which are well known to be major contributors of neuroinflammation in many dermatoses, in melasma lesions. METHODS: Skin biopsies were obtained from the lesional and non-lesional facial skin of 6 Korean women with melasma. Immunofluorecence staining and confocal laser scanning microscopy were performed. RESULTS: In our results, no difference could be detected with regard to the intensity of immunoreactivity for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), calcitonin gene-related peptide receptor (CGRPR), substance P (SP), substance P receptor (SPR), somatostatin (SOM), pituitary adenylate cyclase activating peptide (PACAP) and pituitary adenylate cyclase activating peptide receptor (PACAPR) in the lesional skins compared with the non-lesional skins. CONCLUSION: These results suggest that neuroinflammation induced by neuropeptides such as substance P, calcitonin gene-related peptide, vasoactive intestinal peptide, and somatostatin and their receptors included in this study, are not directly associated with melasma pathogenesis.
Adenylyl Cyclases ; Biopsy ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Melanosis ; Microscopy, Confocal ; Neuropeptides ; Receptors, Neurokinin-1 ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide ; Skin ; Skin Diseases ; Somatostatin ; Substance P ; Trigeminal Nerve ; Vasoactive Intestinal Peptide

BACKGROUND: Alcohol intake induces complex changes in the human body. However, there has not been much investigation on the interaction between alcohol and human skin. OBJECTIVE: The aim of this study is to investigate the effects of alcohol intake on the skin's physiology. METHODS: A total 16 Korean males was enrolled in this study and they were divided into two groups (group A and group B). Each group included 8 people. Group A drank alcohol (20.1%, 360 ml) for 90 min and Group B drank 360 ml of normal saline. The body temperature, the skin erythema index, the transepidermal water loss (TEWL), the skin hydration, the skin pH and skin sebum were measured before and 30 min and 120 min after alcohol intake. RESULTS: In group A, the skin erythema index, TEWL, skin hydration and skin pH significantly increased 30 min after alcohol intake, while the body temperature and sebum decreased. All the measurements except sebum recovered 120 min after alcohol intake. However, in group B, all the measurements were not significantly changed. CONCLUSION: Alcohol intake affects thermoregulation, the skin barrier function and the skin pH. This study showing that physiologic changes are induced by alcohol intake may help investigate the interaction between alcohol and skin disease.
Body Temperature ; Body Temperature Regulation ; Erythema ; Human Body ; Humans ; Hydrogen-Ion Concentration ; Male ; Sebum ; Skin ; Skin Diseases ; Skin Physiological Phenomena

Cistanche tubulosa and Laminaria japonica have been reported to have anti-oxidative, anticoagulant, anti-cancer and anti-inflammatory properties. They are expected to be a promising candidates for promoting hair growth and treating dandruff and scalp inflammation as a consequence. In this double-blinded, placebo-controlled clinical trial, we investigated the efficacy of Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) in promoting hair health in patients with mild to moderate patterned hair loss. Using phototrichogram (Folliscope 4.0, LeadM, Seoul, Korea), we compared the density and diameter of hairs in patients receiving a placebo or Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) at baseline, 8 and 16 weeks of the study. In order to determine the efficacy of treatment on dandruff and scalp inflammation, investigator's assessment score and patient's subjective score were also performed. We found a statistically significant increase in the hair density of the test group (n = 45, MK-R7 400 mg) after 16 weeks of consuming the MK-R7 (test group: 23.29 n/cm2 +/- 24.26, control: 10.35 n/cm2 +/- 20.08, p < 0.05). In addition, we found a statistically significant increase in hair diameter in the test group compared to control group at week 16 (test group: 0.018 mm +/- 0.015, control: 0.003 mm +/- 0.013, p < 0.05). There were also significant outcomes regarding the investigator's visual assessment and patient's subjective score of dandruff and scalp inflammation in the test group compared to those in control group. Based on the results of this clinical study, we conclude that Cistanche tubulosa extract and Laminaria japonica extract complex (MK-R7) are promising substances for promoting health of the scalp and hair.
Cistanche* ; Dandruff ; Hair* ; Humans ; Inflammation ; Laminaria* ; Scalp* ; Seoul

Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial septal defect (ASD). In our case, the patient had a right sided aortic arch and aberrant left subclavian artery, also she had ASD (ostium secundum) and moderate tricuspid regurgitation with pulmonary hypertension. The patient was successfully performed patch closure of ASD and tricuspid valve annuloplasty via midline sternotomy. The patient had uneventful postoperative course.
Aneurysm ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Deglutition Disorders ; Female ; Heart Diseases ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Sternotomy ; Subclavian Artery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

BACKGROUND: Microneedles provide a minimally invasive means to transport molecules into the skin. A number of specific strategies have been employed to use microneedles for transdermal delivery. OBJECTIVE: The purpose of this study was to investigate the safety of two new digital microneedle devices (Digital Hand(R) and Digital Pro(R); Bomtech Electronics Co., Ltd., Seoul, Korea) for the perforation of skin in skin-hairless-1 mice. This device replaces conventional needles and is designed specifically for intradermal delivery. METHODS: We used two newly developed digital microneedle devices to perforate the skin of skin-hairless-1 mice. We conducted a comparative study of the two digital microneedle devices and DTS(R) (Disk type-microneedle Therapy System; DTS lab., Seoul, Korea). To evaluate skin stability, we performed visual and dermatoscopic inspections, measurements of transepidermal water loss, and biopsies. RESULTS: The two novel digital microneedle devices did not induce significant abnormalities of the skin on visual or dermatoscopic inspection, regardless of needle size (0.25~2.0 mm). No significant histopathological changes, such as inflammatory cell infiltration, desquamation of the stratum corneum, or disruption of the basal layer, were observed. The digital microneedle devices and microneedle therapy system produced similar results on measures of skin stability. CONCLUSION: These two novel digital microneedle devices are safe transdermal drug delivery systems.
Animals ; Drug Delivery Systems ; Electronics ; Electrons ; Mesotherapy ; Mice ; Mice, Hairless ; Needles ; Pyridines ; Skin ; Thiazoles ; Water Loss, Insensible

BACKGROUND: Malassezia is considered as major factor in dandruff of human scalp. OBJECTIVE: In order to develop an antimicrobial agent, bamboo oil was extracted by high temperture suction from dried bamboo truk abd then antimicrobial activities against Malassezia are investigated. METHODS: Minimum inhibitory concentration and antimicrobial activity were measured in Malassezia species. RESULTS: 1. Minimum inhibitory concentration of the Bamboo (Phyllosrachys bambusoides) Essential Oil Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standard, Malassezia dermatis patient were 10 microliter/ml, 5 microliter/ml, 5 microliter/ml, 10 microliter/ml, 5 microliter/ml and 10 microliter/ml respectively. 2. Minimum inhibitory concentration of the Itraconazole Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standardntia, Malassezia dermatis patient were 10 microgram/ml, 10 microgram/ml, 10 microgram/ml, 0.1 microgram/ml, 1 microgram/ml, and 0.01 microgram/ml, respectively. 3. Minimum inhibitory concentration of the ketoconazole Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis standard, Malassezia sympodialis patient, Malassezia dermatis standard, Malassezia dermatis patient were 0.01 microgram/ml, 10 microgram/ml, 10 microgram/ml, 0.1 microgram/ml, 0.01 microgram/ml, and 0.01 microgram/ml, respectively. 4. Malassezia furfur standard, Malassezia furfur patient, Malassezia sympodialis patient and Malassezia dermatis patient showed the strongest antimicrobial effect on bamboo oil > ketoconazole > itraconazole. 5. Malassezia sympodialis standard, Malassezia sympodialis patient and Malassezia dermatis standard strongest antimicrobial effect on ketoconazole > bamboo oil > itraconazole. CONCLUSION: Bamboo oil might be applied as antidandruff treatment modality by its anti-malassezial effect.
Humans ; Itraconazole ; Ketoconazole ; Malassezia ; Microbial Sensitivity Tests ; Scalp ; Suction

BACKGROUND: Angioimmunoblastic T-cell lymphoma (AITL) is a complex lymphoproliferative disorder and often mimics a viral infection with frequent skin involvement. Epstein-Barr virus (EBV) and human herpes virus (HHV)-6 are reported to be associated with AITL, but there are conflicting results. OBJECTIVE: We evaluated the association of EBV and HHV-6 with AITL. METHODS: We reviewed the clinical, histological and immunophenotypical features of 19 cases of AITL. Among them, 11 lymph node biopsies of AITL were examined for HHV-6, -7, and -8 by polymerase chain reaction (PCR) using virus-specific primers. In situ hybridization of EBV early region RNA (EBER) was performed and T cell receptor (TCR) gene rearrangement was also investigated in some cases. RESULTS: Among these 19 cases, maculopapular, plaque or nodular skin lesions accompanied AITL in 12 cases. Clonal TCR gene rearrangement was seen in 8/9 cases tested. EBER in situ hybridization was positive in 8 cases (57.1%). Among 7 cases with skin biopsies, five cases were consistent with cutaneous involvement of AITL, 1 case was a drug eruption, and the other case was Kaposi's sarcoma. Except a HHV-8 (+) case who also had Kaposi's sarcoma, all of these cases were negative for HHV-6, -7 and -8. CONCLUSION: Skin manifestation seems to be a cardinal component of AITL, be it in the context of presentation, progression or recurrent disease. Recognition of clinicopathological features of skin lesions in AITL as diagnostic clues should be stressed among dermatologists. The lack of HHV-6, -7 and -8 in lymph node biopsy of AITL argues against a pathogenic role for HHVs in AITL.
Biopsy ; Drug Eruptions ; Gene Rearrangement ; Genes, T-Cell Receptor ; Herpesvirus 4, Human ; Herpesvirus 6, Human ; Herpesvirus 8, Human ; Humans ; In Situ Hybridization ; Lymph Nodes ; Lymphoma, T-Cell ; Lymphoproliferative Disorders ; Polymerase Chain Reaction ; Receptors, Antigen, T-Cell ; RNA ; Sarcoma, Kaposi ; Skin ; Skin Manifestations ; Viruses

Chylothorax charaterized by milky, opalescent fluid in the pleural space has variety causes, including trauma, lymphoma and carcinoma. The nephrotic syndrome is not recognized as a cause of chylothorax. We report a case of nephrotic syndrome and chylothorax that was secondary to the transdiaphragmatic movement of chyloascites and was treated with chest tube drainage and total parenteral nutrition.
Adult* ; Chest Tubes ; Chylothorax* ; Drainage ; Humans ; Lymphoma ; Nephrotic Syndrome* ; Parenteral Nutrition, Total

There is increasing attention to medical problems of musicians. Many studies find a high prevalence of work-related musculoskeletal disorders in musicians, ranging from 73.4% to 87.7%, and string players have the highest prevalence of musculoskeletal problems. This paper examines the various positions and movements of the upper extremities in string players: 1) basic postures for holding instruments, 2) movements of left upper extremity: fingering, forearm posture, high position and vibrato, 3) movements of right upper extremity: bowing, bow angles, pizzicato and other bowing techniques. These isotonic and isometric movements can lead to musculoskeletal problems in musicians. We reviewed orthopedic disorders that are specific to string players: overuse syndrome, muscle-tendon syndrome, focal dystonia, hypermobility syndrome, and compressive neuropathy. Symptoms, interrelationships with musical performances, diagnosis and treatment of these problems were then discussed.
Cumulative Trauma Disorders/*etiology ; Humans ; Musculoskeletal Diseases/*etiology ; *Music ; Neuromuscular Diseases ; Occupational Diseases/*etiology

BACKGROUND: Ramsay Hunt syndrome (herpes zoster oticus) is characterized by vesicles on the pinna, otalgia, facial nerve palsy and sensorineural hearing loss. It is not such a common dermatological disease like herpes zoster. However, reactivation of the latent varicella zoster virus causes facial palsy and therapeutic onset is one of the prognostic factors in Ramsay Hunt syndrome. OBJECTIVE: The aim of this study was to elucidate the epidemiology, the clinical characteristics of Ramsay Hunt syndrome and prognosis according to therapeutic ways. METHODS: The 84 cases diagnosed as Ramsay Hunt syndrome from January 2000 to July 2007 were assessed in regard to age, sex, clinical characteristics, electromyography (EMG) results, onset of neurological recovery according to medication and onset of rehabilitation therapy by review of medical records. RESULTS: Ramsay Hunt syndrome consisted 4.7% (84 cases of 1787) of total herpes zoster patients. The ratio of male to female patients was 37:47. Frequency was slightly higher in female patients. The mean age was 62+/-14.7 and the age distribution was in the range of 26~87 years. The most common clinical appearance was vesicular eruptions and facical nerve palsy including change in nasolabial fold and location of the lip (73.8%), followed by vesicular eruptions and vestibulocochlear symptoms like tinnitus and vertigo (16.7%), facial nerve palsy and vestibulocochlear symptoms appearing together (9.5%). EMG showed abnormal results in 67.9%. More than one kind of abnormality was commonly observed. The most common abnormal EMG result was fibrillation potential (42.2%), followed by positive sharp wave (31.3%), polyphasia (10.8%), high frequency discharge (8.4%), increased insertional activity (4.8%) and fasciculation (2.5%). There was no significant difference in onset of neurological recovery between acyclovir injections and oral famciclovir or valaciclovir treatment. The patients who had received physical therapy a week after the symptoms had developed, had a faster onset of recovery (2.8 week Vs 4.1 week, p<0.05). CONCLUSION: This study suggests that antiviral agents of a different kind may not affect recovery onset and earlier rehabilitation therapy seems to be effective in neurological recovery in Ramsay Hunt syndrome.
Acyclovir ; Age Distribution ; Antiviral Agents ; Earache ; Electromyography ; Epidemiology ; Facial Nerve ; Facial Paralysis ; Fasciculation ; Female ; Hearing Loss, Sensorineural ; Herpes Zoster ; Herpes Zoster Oticus* ; Herpesvirus 3, Human ; Humans ; Lip ; Male ; Medical Records ; Nasolabial Fold ; Paralysis ; Prognosis ; Rehabilitation ; Tinnitus ; Vertigo