BACKGROUND: Alopecia totalis and alopecia universalis are uncomman and developed from 5-10% of the patients with alopecia areata. OBJECTIVE: The authors perfcirmed a study for clinical obervations and the effects of treatments of alopecia totalis and alopecia universalis in order that this study may cointribute to further studies and treatments of them. MEHTODS: The author performed a clinical study of 42 patients with alopecia totalis and alopecia universalis retrospectively in order to evaluate the clinical manifestation. and the effects of treatments from January 1984 to March 1992 at the department of Dermatology, College of Medicine, Chung Ang University. RESULTS: 1. The incidence of alopecia totalis and alopecia universalis was 6.7% (42/623) among the alopecia patients who were occtipied 1.4% (623/44,839) among the all new dermatologic out patients. 2. The age distributions at the onset of disease showed a peak incidenced an age of less than 15 years (52.4%, 22/42) and the average age was 19.7 years. 3. The laboratory fi ndings showed decreased total T cell count in 1 case(1/10), inversed T/T ratio in 6 cases(6/10), poisitive anti-thyroglobulin anti-body in 3 cases(3/11), and abnormal serum levels of testosterone, esradiol and progesterone in 5 cases(5/22), 2 cases(2/14) and 8 cases(8/13), respectively. 4. The effects in the group treated with topical immunotherapy with DPCP(2,3-diphenylcyclopropenone) or DI CB(2,4-dinitrochlorobenzene) revealed no significant difference from those in the group treated with an intralesional injection of triamcinolone acetonide. 5. The response rates to treatment were make ily higher in the patients with alopecia totalis than alopecia uriiversalis, in cases where the duration of disease was less than 5 years, and in the patients associated with psychologic stress. CONCLUSION: These results suggested that alopecia totalis and alopepia aniversalis frequently occur in children, and some of them we eassociated with cell mediated immunity defects, autoantibody and endocrine factors. The patients with alopecia totalis, with short duration if disease and associated with emotional stress showed better therapeutic responses.
Age Distribution ; Alopecia Areata ; Alopecia* ; Cell Count ; Child ; Dermatology ; Humans ; Immunity, Cellular ; Immunotherapy ; Incidence ; Injections, Intralesional ; Outpatients ; Progesterone ; Retrospective Studies ; Stress, Psychological ; Testosterone ; Triamcinolone Acetonide

Cutaneous metastases from internal malignancy are relatively rare. Three cases of cutaneous metastases, two from lung cancer and one from breast cancer are reported. Case 1-cutaneous metastasis from bronchioloalveolar carcinoma of the lung, where four erythematous to pinkish pea sized smooth surfaced nodules on the scalp were noticed for 2 years in a 48-year-old man. Case 2-cutaneous metastasis from adenocarcmoma of the lung, where two hard tender freely movable subcutaneous nodules, about 3 cm in diameter on the lateral chest wall were noticed for 6 months in a 61-year-old woman. Case 3-cutaneous metastasis from infiltrating ductal carcinoma of the right breast, where a hand, violaceous, non-tender plaque (8×6.5 cm) on the right areolar area was noticed for 4 months in a 47-year-old woman.
Adenocarcinoma, Bronchiolo-Alveolar ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Female ; Hand ; Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Neoplasm Metastasis ; Peas ; Scalp ; Thoracic Wall

PURPOSE: Generally, young age onset malignancies show worse prognosis. But is "young age onset" a single prognostic factor for breast cancer, has been controversial. The incidence of breast cancer according to age is different by region and races. This study purposed to know the incidence of breast cancer in younger or 35 year old (below Young age group) and its clinical characteristics, prognosis, and difference with older age onset breast cancer. METHODS: A retrospective study of consecutive 545 breast cancer patients who had been treated by our hospital from 1990 to 1999, was carried out. We investigated the ratio of 35 year old or younger breast cancer patients, age of menarche, TNM stage, histologic grades, hormone receptor status, survival rates. And compared it with counter age (>35) group's. The significances of differences were evaluated using Student's-t test or chi-square test by variable type. Analysis were performed using SPSS software. RESULTS: Younger age group patients were 62 (11.3%) among them, showed earlier menarche, worse histologic differentiation, and lower mammographic detection rate than counter group (p<0.05). There were no difference in TNM stage distribution, hormone receptor expression status according to age group (p>0.05). Young age group's 5 year overall and disease free survival rates were 83+/-5% and 58+/-8%, both were lower than counter group's 89+/-2% and 74+/-3% (p<0.05). Also age adjusted overall and disease free survival rates were worse than counter age group's. CONCLUSION:Younger age group shows worse survival rates, have poor prognostic factors and show early relapsing rate than older age group. So we can consider "young age onset" as a poor prognostic factor in breast cancer.
Adult ; Breast Neoplasms* ; Breast* ; Continental Population Groups ; Disease-Free Survival ; Female ; Humans ; Incidence ; Menarche ; Prognosis* ; Retrospective Studies ; Survival Rate

Objective: This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB. Methods: 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children’s personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245). Results: For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule-breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes (‘adaptiveness,’ ‘high reward dependence,’ ‘low self-directedness,’ and ‘maldaptiveness’). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated highest tendency for problematic behavior irrespective of the frequency of NB. Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with specific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accompanying personality profiles should be considered when assessing behavioral problems in children with NB.

OBJECTIVE: Patients with schizophrenia are at a higher risk for developing insulin resistance and type 2 diabetes mellitus (T2DM). However, few studies have examined abdominal fat and mid-thigh low-density muscle areas, which are known risk factors for insulin resistance and T2DM, in patients with schizophrenia. Therefore, we measured the abdominal fat and mid-thigh low-density muscle areas of schizophrenics and compared them with normal controls. METHODS: Nineteen (four men and 15 women) drug-naive or -free subjects who met the DSM IV criteria for schizophrenia and 19 age- and sex-matched controls were recruited. We measured weight, height, waist circumference, and percent body fat, and calculated the body mass index (BMI). Abdominal fat and mid-thigh low-density muscle areas were evaluated using computed tomography. RESULTS: There was no significant difference in terms of age and BMI between the two groups. The areas of abdominal fat (262.4+/-101.8 vs. 257.1+/-93.8 cm2 ; p=0.919), subcutaneous fat (182.4+/-72.8 vs. 180.5+/-75.1 cm2 ; p=0.988), visceral fat (79.9+/-47.2 vs. 76.6+/-49.3 cm2 ; p=0.872), and mid-thigh low-density muscle (15.0+/-9.9 vs. 15.4+/-5.2 cm2, p=0.373) did not differ between schizophrenics and controls. CONCLUSION: Abdominal obesity is a well-recognized risk factor for developing certain medical conditions such as insulin resistance and T2DM. We demonstrated that drug-naive or- free patients with schizophrenia do not have increased visceral fat or mid-thigh low-density muscle areas, which might have explained the higher prevalence of insulin resistance and T2DM in these patients.
Abdominal Fat* ; Adipose Tissue ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Male ; Obesity, Abdominal ; Prevalence ; Risk Factors ; Schizophrenia* ; Subcutaneous Fat ; Waist Circumference

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively.Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up- regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: This study was designed to elucidate the biology of cancer metastasis and differences in the biologic status between primary tumors and metastatic lymph nodes of invasive breast cancer by comparing the well known prognostic factors p53 gene mutation, p53 protein expression and the MIB-1 index. An additional goal was to investigate the p53 mutational pattern of breast cancer patients. METHODS: We used the PCR-SSCP method to detect p53 gene mutation and immunohistochemical staining to establish p53 protein expression and the MIB-1 labelling index in 25 primary tumors and metastatic lymph nodes from breast cancer patients. We then made a comparison the between primary tumors and the metastatic lymph nodes. RESULTS: The results indicated a correlation between histologic grade and p53 gene mutation as well as p53 protein expression, but showed no correlation to MIB-1 labelling index. The concordance rates of p53 gene mutation and p53 protein expression between the primary tumors and metastatic lymph nodes were 72% and 100%, respectively.Three cases showed a different mutated exon number between the primary tumors and the metastatic lymph nodes. Some cases showed p53 gene mutation only in the primary tumors, but while other cases only in the metastatic lymph nodes. The MIB-1 labelling index increased with tumor grade. The p53 altered group show a higher mean MIB-1 index than the non altered group's in both the primary tumors and metastatic lymph nodes. CONCLUSION: p53 gene mutation is not consistent with p53 protein expression and there are some differences in p53 gene mutation between primary tumors and metastatic lymph nodes in breast cancer. Therefore, metastatic tumor have different characteristics from those of primary tumors. In breast cancer, metastasis is regulated not only by an up- regulating mechanism but also by a down-regulating mechanism.
Biology ; Breast Neoplasms* ; Breast* ; Exons ; Genes, p53 ; Humans ; Lymph Nodes* ; Neoplasm Metastasis

PURPOSE: Hepatocellular carcinoma (HCC) patients are asymptomatic and the tumor remains in an unresectable state until the tumor progresses. Recently much efforts for elucidation of the early hepatocarcinogenesis have been made, and for this purpose it is very crucial to investigate the genetic abnormalities. We evaluated microsatellite alterations of five markers from chromosome 9, 13, 16 and investigated the relationships with the clinicopathological parameters in HCC. METHODS: The microsatellite alteration analysis was performed using polymerase chain reaction with five polymorphic microsatellite markers (D9S171, D9S1747, D13S156, D16S419, D16S3106) in 40 surgically resected HCCs and their respective non-tumorous counterparts. RESULTS: D9S171, D9S1747, D13S156, D16S419, D16S3106 abnormalities were detected in 20.0%, 14.3%, 50.0%, 32.4% and 22.6%, respectively. Loss of heterozygosity (LOH) of D9S171 correlated well with higher tumor histologic grade and LOH of D13S156, D16S419 and D16S3106 correlated well with increased tumor size. Microsatellite instability (MSI) was found in two markers, D13S156, D16S419. CONCLUSION: As a result, we concluded that alterations in microsatellites of various chromosomes may contribute to the hepatocarcinogenesis and tumor progression. Especially LOH of chromosome 13 and 16 are considered to correlate with tumor progression.
Carcinoma, Hepatocellular* ; Chromosomes, Human, Pair 13 ; Chromosomes, Human, Pair 9 ; Humans ; Loss of Heterozygosity ; Microsatellite Instability ; Microsatellite Repeats* ; Polymerase Chain Reaction

PURPOSE: Obesity has been shown to have important effects related to breast cancer. But there have been few data available on the distribution of body mass index (BMI) among Korean breast cancer patients and on the effects of this distribution on patient prognosis. Therefore we investigated the BMI distribution of Korean breast cancer patient's and its relationship with other tumor markers, in order to elucidate the relationship between BMI and patient prognosis. METHODS: We measured the BMI of 266 Korean adult women with breast carcinoma.and divided the subjects into the following subgroups according to BMI; low body weight (BMI<20), normal body weight (BMI; 20~25) and over weight (BMI> or25). We compared this distribution with that of the general Korean women's population. and investigated the correlation with other prognostic factors and tumor markers. The 5 year overall and disease free survival rates were evaluated for both the total breast cancer patients and the adjuvant hormone treated breast cancer patients, according to BMI subgroup, using the Kaplan-Meier method. RESULTS: Mean BMI for the breast patients was 23.4+/-3.1, and did not differ from that of the general Korean adult women's population ('1994 National Nutrition Survey Report).BMI increased with increasing age and was highest in the 60~69 yr age group. BMI was correlated with tumor size and stage. The survival rates were low in the high BMI group among both total and adjuvant hormone treated breast cancer patients, but in neither was any statistical difference found between BMI subgroups. CONCLUSION: Korean breast cancer patients are not obese as the general population and their BMI increases with increasing age and menopausal status. There was a tendency for higher BMI to be associated with poorer prognosis, although not to a statistically significant degree.
Adult ; Body Mass Index* ; Body Weight ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Female ; Humans ; Ideal Body Weight ; Nutrition Surveys ; Obesity ; Prognosis ; Survival Rate ; Biomarkers, Tumor

PURPOSE: Pancreatic cancer is a devastating disease and the complete resection is difficult due to its the aggressive histologic behavior. Among the possible treatments for the unresectable pancreatic cancer, intraoperative radiation therapy (IORT) has the several advantages. But the impacts of the IORT on survival and local control are not clear. We analyzed the effects of the IORT on pain control, survival duration and local control in patients with unresectable pancreatic cancer. METHODS: We reviewed 6 years of the medical records of 94 patients who had undergone operations involving the pancreatic adenocarcinoma (33 patient IORTs, 39 palliative surgerys only and 22 curative resections involving a curative resection). The clinicopathologic factors and outcomes of the 33 patients treated with the IORT were compared with those of the palliative surgery groups. RESULTS: The age and sex distribution and tumor stage were same for the two groups. The average tumor size in the IORT group was larger than those of the palliative surgery group. The preoperative serum CA19-9 level in the IORT group was higher than the other group. The most common reason for unresectability in the IORT group was local invasion to the adjacent organs including of the great vessels. On the contrary, distant metastasis was a more common cause unresectability in the palliative surgery group. The postoperative complications and operative times were similar in both groups. Pain relief after treatment was observed in 12 cases of the 26 patients in the IORT group, and 5 of 29 patients in the palliative surgery group (P<0.05). The cases of minor and partial remission were more common in the IORT group than the palliative surgery group. However, the survival rate of the IORT group was no better than the palliative surgery group. CONCLUSION: This study suggests that IORT may have an important palliative role especially in ameliorating visceral pain in patients with unresectable pancreatic cancer. However, IORT appears to have no significant effect on overall survival.
Adenocarcinoma ; Humans ; Medical Records ; Neoplasm Metastasis ; Operative Time ; Palliative Care ; Pancreatic Neoplasms* ; Postoperative Complications ; Sex Distribution ; Survival Rate ; Visceral Pain