We describe a case of idiopathic CD4+ T-lymphocytopenia (ICL) in a 59-year-old patient who presented with various opportunistic infections. The patient was diagnosed with disseminated Mycobacterium avium infection, cytomegalovirus colitis and retinitis, and esophageal candidiasis. He was successfully treated with anti-mycobacterial drugs, ganciclovir, and fluconazole, respectively. However, the patient was diagnosed with primary central nervous system lymphoma, and then died of a Trichosporon beigelii sepsis during the 2nd cycle of systemic chemotherapy.
Candidiasis ; Central Nervous System ; Colitis ; Cytomegalovirus Infections ; Fluconazole ; Ganciclovir ; Humans ; Lymphoma ; Lymphopenia ; Middle Aged ; Mycobacterium avium ; Opportunistic Infections ; Retinitis ; Sepsis ; T-Lymphocytopenia, Idiopathic CD4-Positive ; Trichosporon

BACKGROUND: Scutellaria baicalensis Georgi extract is used as a traditional herbal medicine. The efficacy of Scutellaria baicalensis Georgi extract is known for antioxidative activity, antiinflammation effect, antibacterial effect, inhibitory effect of melanin synthesis, sun protection effect, antiallergy effect, and etc. OBJECTIVE: We confirmed the cell viability or inhibitory effect of melanin synthesis in HaCaT (human keratinocyte cell line) and B16F10 (murine melanoma cell line) cells and the skin safety test through a clinical test (dermal irritation study) for Scutellaria baicalensis Georgi extract, according to the extraction methods. METHODS: We checked the cell viability, using MTT assay and inhibitory effect of melanin synthesis in B16F10 cells or HaCaT cells for thirty one Scutellaria baicalensis Georgi extract, according to the extraction methods. Then, we evaluated the skin safety for selected eight Scutellaria baicalensis Georgi extract through a primary dermal irritation test. RESULTS: Among the thirty one Scutellaria baicalensis Georgi extracts, according to the extraction methods, we selected eight Scutellaria baicalensis Georgi extracts that were not detected with cell toxicity in HaCaT cells and B16F10 cells, and could have inhibited the melanin synthesis in B16F10 cells. The selected eight Scutellaria baicalensis Georgi extracts identified the skin safety through a primary dermal irritation test. CONCLUSION: We expect clinical trials for whitening efficacy based on inhibitory effect of melanin synthesis and human skin safety for Scutellaria baicalensis Georgi extracts.
Cell Survival ; Herbal Medicine ; Humans ; Keratinocytes ; Melanins ; Melanoma ; Scutellaria ; Scutellaria baicalensis ; Skin ; Solar System

BACKGROUND: Alopecia areata (AA) is believed to be an organ-specific autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no definitive therapy for AA. OBJECTIVE: We sought to determine whether the combination therapy of cyclosporine and psoralen plus ultraviolet A (PUVA) could be an effective treatment for severe AA. METHODS: A total of 41 patients with severe AA were treated with oral cyclosporine and topical PUVA. Cyclosporine was given at an initial daily dose of 200 mg for adult and 100 mg for children for periods of up to 16 weeks. Eight-methoxypsoralen (Methoxsalen) was applied topically 20 minutes prior to ultraviolet A (UVA) exposure, and the patients were irradiated with UVA twice a week for 16 weeks. RESULTS: Of the total 41 patients, 2 (7.3%) patients were lost to follow-up, and 1 (2.4%) patient discontinued the treatment due to abdominal discomfort. Six (14.6%) patients were treated for less than 12 weeks. Of remaining 32 patients, 3 (9.4%) showed excellent response, 3 (9.4%) showed good response, 12 (37.5%) showed fair response, and 14 (43.7%) showed poor response. CONCLUSION: Although limited by its uncontrolled character, this study shows that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA.
Adult ; Alopecia ; Alopecia Areata ; Autoimmune Diseases ; Child ; Cyclosporine ; Ficusin ; Hair Follicle ; Humans ; Lost to Follow-Up ; PUVA Therapy ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Staphylococcus Aureus (S. Aureus) is one of the most common and predominant form of bacteria in the nasal airway that roduces toxin. Alpha toxin from S. Aureus, also known as alpha-hemolysin, causes damage to the membrane in many types of cells. The purpose of this study is to develop a rat model of rhinosinusitis induced by the intra-nasally applied alpha-toxin of S. Aureus. MATERIAL AND METHODS: Forty micro-liters of 100 microgram/ml of alpha-toxin was applied intra-nasally to 4-6 weeks-old Sprague-Dawley rats and the same amount of vehicle was applied to control rats. At days 1, 5 and 14 the rats were sacrificed and their nasal cavity prepared for histological investigation. RESULTS: Inflammatory cell clusters were observed in the alpha-toxin applied rats. The number of sinus air spaces occupied by inflammatory cell clusters increased significantly at days 1 and 5 compared with the control rats. Comparisons across the time interval demonstrated statistically significant changes, showing a peak at day 1 among alpha-toxin applied rats. CONCLUSION: Intra-nasally applied alpha-toxin induces acute rhinosinusitis in the rats. The histological evidence of rhinosinusitis revealed the appearance of inflammatory cell clusters in the sinonasal air spaces. These findings indicate that this rat model of alpha-toxin induced rhinosinusitis may be applied for better understanding of the role of bacterial toxin in the pathogenesis of rhinosinusitis.
Animals ; Bacteria ; Membranes ; Models, Animal* ; Nasal Cavity ; Rats* ; Rats, Sprague-Dawley ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: Primary hyperhidrosis (PHH) is the disease of production of excessive sweat mainly localized in palm, sole, and craniofacial area. The characteristics of the lesional skin and the relationship with fungal infection in patients with PHH are still not known in Korean literature. OBJECTIVE: The aim of the present study was to compare the skin hydration and transepidermal water loss (TEWL) in patients with PHH with those in control group and to determine the relation of PPH to tinea pedis. METHODS: A prospective case-control study of patients with PHH was conducted. We have measured the skin hydration and TEWL on the skin of palm, sole and forehead in patients with PPH and those in control group. A total of 67 patients with PHH and 50 volunteers of control group were examined for the presence of tinea pedis. Information on the treatment history of tinea pedis were provided by means of reviewing the medical records. RESULTS: Of 67 patients with PHH included, mean age was 28.1 years. Distributional patterns of PHH were palmoplantar (50.7%), isolated palmar (19.4%), isolated plantar (7.5%), and craniofacial (22.4%). Age at onset for palmoplantar HH (12.9+/-7.5 years) was significantly younger than that of craniofacial HH (26.8+/-10.5 years) (p < 0.05). Compared with the skin of those in control group, the values of the skin hydration and TEWL were significantly higher in the skin of patients with PHH. The risk of tinea pedis were increased in patients with primary palmoplantar hyperhidrosis compared with controls (Odds ratio: 2.44). CONCLUSION: Skin physiological parameters of patients with PHH and normal subjects were evaluated by non-invasive skin bioengineering methods which show quantitative modifications in physiological conditions. On the basis of current data, we can expect great advances in the curative value for treatment in patients with PHH.
Bioengineering ; Case-Control Studies ; Forehead ; Humans ; Hyperhidrosis ; Prospective Studies ; Skin ; Sweat ; Tinea ; Tinea Pedis

BACKGROUND: Androgenetic alopecia (AGA) is characterized by the local and gradual transformation of terminal scalp hair into vellus hair, which has a shorter and thinner shaft. There are no studies that analyze annual changes in age, patterns, family history, and associated disease. OBJECTIVE: We investigated the severity of hair loss, age of onset, the frequency of family history, and past medical histories in Korean patients with AGA. METHODS: A retrospective chart review was performed to identify all patients with AGA referred to the Dermatology Clinic at Chung-Ang University Hospital from January 2006 to December 2010. RESULTS: The age of onset was also gradually decreased from 34.1+/-10.1 years to 31.6+/-10.9 years between 2006 and 2010. In female patients, specific annual changes were not observed. Hamilton-Norwood Type IIIv AGA was most common in male patients and Ludwig Type I AGA was most common in female patients at all times between 2006 and 2010. The majority of patients with AGA had a family history of baldness and was most commonly associated with a paternal pattern of inheritance. Seborrheic dermatitis was the most common associated disease in male and female patients. CONCLUSION: Our results show the possibilities that the average age of onset is decreasing. The period of the present study was only 5 years, which is not sufficient for the precise determination of onset age for AGA. Clearly, a long-term study is needed.
Age of Onset ; Alopecia ; Dermatitis, Seborrheic ; Dermatology ; Female ; Hair ; Humans ; Male ; Retrospective Studies ; Scalp ; Wills

BACKGROUND: Hyaluronic acid (HA) is a carbohydrate, occurring naturally throughout the human body. With linear polysaccharide structure, it is (HA) found in soft connective tissues, cartilage and joinfluids. Hyaluronic acid filler is used for treatment of depth of the fold or volume of filler needed and performed for wrinkle improvement and cosmetic. We did property of matter for the Perfectha(R) fillers. OBJECTIVE: Our purpose is to describe and comment on our experiences with two kinds of Perfectha(R) fillers. METHODS: We obtained image of the shape of fillers using a folliscope, VC98 and particle size using the Scanning electron microscope (SEM). We tested to make sure that affinity both fillers with water. We mixed the fillers and distilled water. We the PARKER ink added to the mixture. Viscosity and elasticity were measured using a rheometer. RESULTS: The test revealed that a particle sized Perfectha(R) derm deep is bigger than a Perfectha(R) derm. We were confirmed as hydrophile. While Perfectha(R) derm deep filler has high viscosity and elasticity, Perfectha(R) derm filler has high viscosity only, not elasticity. CONCLUSION: Two kinds of Perfectha(R) fillers act as space filler by binding to water and thus keeping the skin wrinkle-free.
Cartilage ; Connective Tissue ; Elasticity ; Human Body ; Hyaluronic Acid ; Ink ; Particle Size ; Skin ; Viscosity ; Water

BACKGROUND: Hyaluronic acid (HA) is a mucopolysaccharide that occurs naturally throughout the human body, where it attaches to collagen and elastin to form cartilage, and also helps maintain the strength and flexibility of the cartilage that cushions joints. A decline in HA synthesis may lead to a variety of symptoms, ranging from joint discomfort, to wrinkles. Cross-linked HA is a viscoelastic solid that resists in vivo degradation by hyaluronidase for much longer than endogenous HA, and which is also a key ingredient in various cosmetics. OBJECTIVE: To describe our experience with three kinds of Elravie(R) fillers. METHODS: We obtained images of filler shape using a folliscope. Scanning electron microscopy (SEM) was used to compare particle sizes. Hydrophilic filler is a hydroxyl, and for this reason, we mixed the filler with water. Next, PARKER ink was added to the mixture, and viscosity and elasticity were measured using a rheometer. RESULTS: Among the tested fillers, particle size was largest in the Restylane(R) SubQ. Elravie(R) ultra volume filler was greater in volume than Elravie(R) deep line, and Elravie(R) light fillers. We confirmed Elravie(R) fillers to be hydrophilic. Elravie(R) ultra volume filler was found to have the highest viscosity and elasticity, whilst Elravie(R) light filler had the lowest. CONCLUSION: All three kinds of Elravie(R) fillers were found to be suitable for human cosmetic use.
Cartilage ; Collagen ; Elasticity ; Elastin ; Human Body ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Ink ; Joints ; Microscopy, Electron, Scanning ; Particle Size ; Pliability ; Viscosity ; Water

BACKGROUND AND OBJECTIVES: Laryngeal trauma occurs uncommonly, but when it does, it can cause acute airway obstruction and longterm voice and airway problems. The purpose of this study was to analyze the clinical presentation of larynx trauma and to assess the outcome of the treatment. MATERIALS AND METHOD: We analyzed the medical records of 32 patients with acute laryngeal trauma from 1992 to 2006, retrospectively. RESULTS: The most common cause of injury was traffic accident. Voice change was the most common symptom. Vocal cord palsy in patients with redistributed in minor injury was improved in all of the group that received conservative management. If there are significant endolaryngeal laceration or arytenoid disruption, which can occur with major trauma, consideration should be given to placing an endolaryngeal stent. But there was no difference in improvement rates between those receiving treatment with stent and those without stent. Thus, consider severity, treatment with stent is likely to yield to significant benefit. CONCLUSION: Vocal cord palsy in patients with redistributed in minor trauma may be managed conservatively. We conclude that patients with major trauma of endolaryngeal mucosa should use a stent in their treatment.
Accidents, Traffic ; Airway Obstruction ; Humans ; Lacerations ; Larynx ; Medical Records ; Mucous Membrane ; Retrospective Studies ; Stents ; Vocal Cord Paralysis ; Voice

BACKGROUND AND OBJECTIVES: Endoscopically guided middle meatal culture is recommended to determine organ-specific antibiotic therapy in sinusitis. This study was designed to decrease the chance of contamination in endoscopically guided middle meatal swab through a shielded pathway using a sterile straw to bypass the contaminated area in the nose from the vestibule to the middle meatus. SUBJECTS AND METHOD: Seventeen healthy volunteers underwent endoscopically guided middle meatal culture. With or without the sterilization of the nasal vestibule, endoscopically guided middle meatal culture was performed by using a sterile cotton swab (routine swab) and using a sterile cotton swab through a sterile straw (shielded swab). We compared the contamination rates between the routine swab versus shielded swab. RESULTS: With and without the sterilization of the nasal vestibule, the contamination rates of the routine swab was 11.7% and 64.7%, respectively and the contamination rates of the shielded swab was 5.8% in both. CONCLUSION: In endoscopically guided middle meatal culture, the contamination rates was significantly decreased by using the shielded swab without sterilization of the nasal vestibule. This study suggests that the shielded swab is a new and reliable swab method that can be used easily and simply at the office.
Nose ; Sinusitis ; Sterilization