BACKGROUND: Primary targit injured from the immunologic mechanism of alopecia areata is not definitely confirmed although alopecia areata is regarded as a disease occuring from certain im munologic process. Recently, par ticular interest has been focused on the follicular keratinocytes which show morphologic and anigenic alterations in active lesions. Another important point is the subclinical state hypothesi. It is based upon the observation that the patterns of T lymphocytes infiltration and ultrastructural changes of dermal papilla cells are nearly identical in active lesions and in non-lesional areas of alopecia areata. OBJECTIVE: The purpose of this study is to determine and to compare the aberrant expression of HLA-DR, CD1 and ICAM-1 on the follicular keratinocytes from the active alopecia areata lesion, stationary lesion and non-lesional scalp. METHODS: We performed a n immunohistochemical study, using the streptavidin system to compare the patterns of HLA-DR, CD1 and ICAM-1 immunoreactivity in the follicular keratinocytes in five active alopecia lesions two stationary lesions and non-lesional scalp specimens among four active and two stationary patients, and two normal control scalp specimens. RESULTS: In the active aloecia lesions, the HLA-DR and ICAM-1 immunoreactivity was observed in some patients while CD1 immunoreactivity was observed in all the patients. In the sta tionary alopecia lesions, none of the HLA-DR or CD1 or ICAM-1 immunoreactivity was observed as was the case in the norrial control scalp specimens. In the non-lesional normal scalp specimens, the HLA-DR, CD1 and ICAM-1 immunoreactivity showed nearly the same patterns as those in the acute alopecia leions. CONCLUSION: The aberrant antigenic alterations, especially CD1 expression of follicular keratinocytes are likely to be asociated with the active progress of alopecia areata lesions. These antigenic alterations were also observed in non-lesional scalp as well as alopecia areata lesions in the very similar patterns.
Alopecia Areata* ; Alopecia* ; HLA-DR Antigens ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Scalp* ; Streptavidin ; T-Lymphocytes

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

Verapamil is highly effective in terminating paroxysmal supraventricular tachycardia(PSVT) by its depressive action on the AV node. In other countries it is already the drug of choice if vagal manevers fail for conversion of PSVT. We evaluated therapeutic efficacy of intravenous verapamil in 30 patients with PSVT who visited Severance Hospital from november 1978 to November 1984. Twenty six of 30 patients(86.7%) had a restoration of normal sinus rhythm by intravenous verapamil without significant side effects. Thus intravenous verapamil is safe and extremely effective in terminating most PSVT.
Atrioventricular Node ; Humans ; Tachycardia, Supraventricular* ; Verapamil*

Coronary arterivenous fistula(CAVF) is an uncommon congenital coronary anomaly-Bilateral CAVFs that originate from both coronary arteries are very rare. Coronary arteriography performed in recent years has clarified the incidence and various features of this lesion. Baim et al.1) reported that only 5% of the coronary artery fistulas arose from bilateral coronary arteries. In this report, we present a case of bilateral coronary artery pulmonary artery fistulas associated with atypical chest pain.
Angiography ; Arteries* ; Chest Pain ; Coronary Vessels ; Fistula* ; Incidence ; Pulmonary Artery

Conventional dual chamber pacing (DDD) preserves atrioventricular synchrony but depend on appropriate sinus node function to achieve physiological heart rate with exercise by atrial tracking. Other indirect indicators of metabolic demand have been used to modulate pacing rate increases with exercise including sensing of pH, respiratory rate, ventricular repolarization and oxygen saturation. The activity sensing approach is unique in that noise generated by activity modulates the response and empirical programming of the unit allows for attaining the desired rate for a given level of activity. Physiologic rate increases can be obtained in patients with sinus node dysfunction or even atrial fibrillation. The lead can either be positoned in the atria for patients without atrial fibrillation or AV conduction disturbance or in the ventricle. We present two cases of rate responsive pacing using the Activitrax.
Atrial Fibrillation ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Noise ; Oxygen ; Respiratory Rate ; Sick Sinus Syndrome ; Sinoatrial Node

We reviewed 50 skin biopsies obtained from 40 patients with cutaneous leiomyoma during a 10 year period from January 1980 to December 1989. The result.s were summarized as follows: 1) Sex distribution showed a female preponderance with male.female ratio of 1: 1.9. 2) The age distribution was relatively even from childhood to old age. The mean age was 47,8 years, 3) The most common site of lesion was lower leg(34%) followed by hand(24%), foot(12% ), anterior chest(8% ), face(6% ), neck(4%), upper arm(4% ), labia major(2 %) and nipple(2%). 4) The lesions were relatively well circumscribed subcutaneous nodule, papule, plaque and nodule which measured between 0.3cm to 5cm in size and their colors were erythematous to light brown. 5) The most common clinical and histopathologic type was angioleiomyoma(75%) followed by solitary piloleiomyoma(12.5%), multiple piloleiomyoma(7,5%) and solitary genital leiomyoma(5% ). Angioleiomyomas were clincally associated with cavernous hemangioma, myoma of uterus and systemic lupus erythematosus. 7) The clinical diagnoses were mass(30% ), epidermal cyst(20%), dermatofibroma (12.5% ), leiomyoma(12,5%), neurilemmoma(5%), lipoma(5%), calcifying epithelioma(2.5%), metastatic carcinoma(2.5%), morphea(2.5% ), fibrocystic disease(2.5%), glomus tumor(2.5 % ) and Dupuytrens contracuture(2..5%).
Age Distribution ; Angiomyoma ; Biopsy ; Diagnosis ; Female ; Hemangioma, Cavernous ; Histiocytoma, Benign Fibrous ; Humans ; Leiomyoma ; Lupus Erythematosus, Systemic ; Myoma ; Sex Distribution ; Skin ; Uterus

Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

17,966 new outpatients who visited the Department of Dermatology of Wonju Christian Hospital from 1985 to 1989 were analyzed statistically. The study results are summarized as follws : 1. Among the 17,966 outpatients, the total number of male patients were 8358 (46.5%) and female patients were 9608 (53.5%). 2. In age distribution, the most frequent age groups were lst decade (24.0), 2nd decade (16.5), and 3 rd decade (25.5) amounting to 66% of the total outpatients. 3. The 15 most common dermatoses were dermatophytosis, atopic dermatitis, urticaria, acne, seborrheic dermatitis, allergic contact dermatitis, other eczema, hypopigmentary disorder, bacterial infection, psoriasis, insect bites, and herpes zoster. 4. Those dermatoses which showed increasing tendency were other eczema, hypopigmentary disorder, herpes zoster, and those of decreasing tendency were scabies, bacterial infection. psoriasis, insect bites. 5. Seasonal distribution. showed those diseases occurring most frequently during the summer season were dermatophytosis, insect bites. urticaria, acne, eczema, contact dermatitis. hypopigmentary disorder, bacterial infection. and herpes zoster. The incidence of atopic deratitis. and psoriasis were incfreased during the winter season. 6. In sexual distribution sebourrheic dermatitis. and scabies were more frequent in the males. whereas with urticaria. acne, contact dermatitis, and other eczema the females were more commonly affected. 7. In age distribution, atopic dermatitis, bacterial infection, and insect bites were the most frequent in the Ist decade. Dermatophytosis. urticaria, acne, seborrheic dermatitis, contact dermatitis, other eczema, hypopigmentary disorder, drug eruption, and psoriasis were most frequent in the 3 rd decade, with scabies in the 2nd decade, and herpes zoster in the 6th decade. 8. The distributions of dermatoses as disease groups, were eczema (23.8%), dermatophytosis (13.9%), urticaria-drug eruption (12.2%), skin appendage disorder (11.2%), and viral infection (8.1%), which constituted 69.2% of the total.
Acne Vulgaris ; Age Distribution ; Bacterial Infections ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Drug Eruptions ; Eczema ; Epidemiology ; Female ; Gangwon-do* ; Herpes Zoster ; Humans ; Incidence ; Insect Bites and Stings ; Male ; Outpatients ; Psoriasis ; Scabies ; Seasons ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria

No abstract available.
Purpura, Thrombocytopenic* ; Rifampin*

In a previous communication, we described a relatively simpli. method for assaying quantities of sweat using the skin surface hydrometer. In order to evaluate the pharmacologic response of weat glands in psoriasis, vitiligo and loalized scleroderma, we measured the basal skin conductance and the quantity of sweat induced by intradermal injections of pilocarpine nitrate in the lesional and per ilesional skin. The results were as follows : 1. In psoriatic plaques, based skin surface hydration and the sweat response to pilocarpine was markedly reduced (p<0.05), but there were no significant differences in normal perilesional skin. 2. In generalized vitiligo, basal skin surface hydration and the sweat gland response was normal. In the case of the segmental type, there was a slightly decreased sweat response in the lesion but, not significant statistically. 3. In the morphea plaque, basal skin surface hydration and the sw.at response to pilocarpine was markedly reduced but was normal in perilesional skin. This study presents evidence of the functional changes in the development of sweat secretion and surface hydration in the lesions of psoriasis, morphec and segmental type of vitiligo. The demonstration of ahnormalities in the pharmacolopic response to pilocarpine induction led us to suggest the possibility that some degree of sweat gland involvement is induced by the pathogenetic mechanisms of these diseases.
Injections, Intradermal ; Pilocarpine ; Psoriasis* ; Scleroderma, Localized ; Skin ; Sweat Glands* ; Sweat* ; Vitiligo*