BACKGROUND: It seems that herpes zoster is caused by reactivation of the varicella-zoster virus and its incidence is increasing. The reactivation of the varicella zoster virus is thought to be associated with the disturbance of the state of immunity in patients with herpes zoster. OBJECTIVE: The purpose of this study was to elucidate the state of immunity in patients with herpes zoster in its acute phase(less than 7 days). METHODS: 1. Thirty patients with acute phase herpes zoster matched by age and sex against a control group, were checked for Helper/Inducer T cell(CD4), Suppressor/Cytotoxic T cell(CD8), NK cell, B cell and activated T cell by three color flow cytometric analysis. 2. Forty patients with herpes zoster measured delayed cutaneous hypersensitivity by means of Multitest' CMI. 3. Thirty patients with herpes zoster measured Ig G, M, A by means of N-antisera method.
Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Hypersensitivity ; Immunity, Cellular ; Immunity, Humoral* ; Incidence ; Killer Cells, Natural

No abstract available.
Intercellular Adhesion Molecule-1* ; Interleukin-6* ; Keratinocytes*

No abstract available.
Myasthenia Gravis* ; Thymectomy*

PURPOSE: To evaluate the correlation between diabetic retinopathy (DR) and arteriolosclerosis in patients with NIDDM (non-insulin-dependent diabetes mellitus), to investigate the risk factors of DR, and to assess the change of the correlation according to the risk factors. METHODS: The study subjects were selected from consecutive routine clinical visits by random sampling from July 2002 to June 2003. The patients were divided into two groups according to the presence of DR, and the patients' charts, fundus examination and blood test were retrospectively reviewed. ETDRS (Early Treatment DR Study) classification for DR and Scheie classification for arteriolosclerosis were used. Statistical analysis was conducted with SPSS program (version 10.0). The confidence interval was set to 95%, and the level of significance was set at p=0.05. RESULTS: DR had a statistically significant correlation with arteriolosclerosis, especially according to duration of diabetes mellitus (p<0.05). Risk factors including diabetes mellitus duration, HgA1c level, and LDL (low-density lipoprotein) cholesterol level showed statistically significant difference (p<0.05). CONCLUSIONS: From the result of analysis, DR has a statistically significant correlation with arteriolosclerosis, especially according to the duration of diabetes mellitus. To prevent vision-threatening complications of DR, the degree of arteriolosclerosis as well as risk factors such as diabetes mellitus duration, serum HgA1c level, and LDL (low-density lipoprotein) cholesterol level should be carefully considered and monitored in the evaluation, progression, and treatment of DR.
Arteriolosclerosis* ; Cholesterol ; Classification ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Hematologic Tests ; Humans ; Retrospective Studies ; Risk Factors

We report a case of multiple agminated Spitz nevi in a 16-year-old boy who presented with multiple nodules on the right side of his face. His past history revealed that there had been erythematous and brown colored papules on the same site at the age of four. At that time one lesion was excised and histopathological findings showed fairly well circumscribed spindle and epithelioid cell nests consistent with a Spitz nevus. Twelve years later, he presented with multiple agminated brown to black colored nodules on the face. Microscopic evaluation revealed nevus cells diffusely distributed throughout the dermis showing no or little junctional activity. In addition, these cells were embedded in a strikingly desmoplastic stroma which consisted of acellular collagen fiber. Immunohistochemical staining for S-100 protein was positive. To our knowledge this is the first report of multiple agminated Spitz nevi in Korea.
Adolescent ; Collagen ; Dermis ; Epithelioid Cells ; Humans ; Korea ; Male ; Nevus* ; Nevus, Epithelioid and Spindle Cell ; S100 Proteins

PURPOSE: To report a case of severe vaso-occlusive retinopathy with significant decrease of bilateral visual acuity as the first manifestation associated with systemic lupus erythematosus (SLE). CASE SUMMARY: A 23-year-old man was referred to our clinic with bilateral visual impairment of hand motion (HH). Fundus examination revealed severe retinal hemorrhage, cotton-wool patch, occlusive retinal vasculitis with vascular engorgement, and diffuse retinal edema in both eyes. Because of a malar rash on both cheeks, generalized edema was observed on initial examination with hypertension, azotemia, anemia, and thrombocytopenia, The patient was diagnosed with SLE, strongly positive to antinuclear antibody (ANA), and received an intravitreal injection of Bevacizumab (Avastin, Genentech Inc., San Francisco, CA, USA) in the left eye in addition to hemodialysis, transfusion, systemic corticosteroid and immunosuppressant treatment due to lupus nephritis. Eighteen months later, the retinal edema, cotton-wool patch and hemorrhage resolved, leaving epiretinal membrane without traction in his left eye and diffuse degeneration of the right eye. Final visual acuity was HM in the right eye and 20/100 in the left eye. CONCLUSIONS: Vaso-occlusive retinopathy in SLE can result in permanent visual impairment. In a patient with a high possibility of SLE retinopathy, a periodic fundus examination and intensive management of systemic disease should be considered.
Anemia ; Antibodies, Antinuclear ; Antibodies, Monoclonal, Humanized ; Azotemia ; Cheek ; Edema ; Epiretinal Membrane ; Exanthema ; Eye ; Hand ; Hemorrhage ; Humans ; Hypertension ; Intravitreal Injections ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Papilledema ; Renal Dialysis ; Retinal Hemorrhage ; Retinal Vasculitis ; San Francisco ; Thrombocytopenia ; Traction ; Vision Disorders ; Visual Acuity ; Bevacizumab

PURPOSE: To investigate the clinical and social characteristics of non-penetrating ocular injuries and use the results for treatment and prevention. METHODS: A retrospective survey was performed on 468 eyes of 421 patients, who visited our clinic due to non-penetrating ocular injuries from January 2010 to December 2010. The incidence of ocular injuries, sex, age, monthly and seasonal distribution, side, cause, influence of alcohol, and change in visual acuity were reviewed statistically. RESULTS: The incidence of non-penetrating ocular injuries was 4.9%. The incidence was more common in males (82.9%), in the 3rd decade of life (23.5%) and in summer (30.8%). Minor injuries (36.1%) were the most common caused by scratches, finger pricks, nails, or small foreign bodies. The second common cause was violence (16.4%), followed by traffic accidents (14.7%). The injuries related to alcohol represented 12.6% of all cases. When considering initial diagnoses, periorbital contusion and corneal abrasion were the most common. The initial visual acuity was less than 20/200 in 9.4% of the eyes and the final acuity after a 6-months of treatment was less than 20/200 in 3.0% of the eyes. CONCLUSIONS: This survey gathered the clinical and social characteristics as well as new insights into non-penetrating ocular injuries which can be used for treatment and prevention.
Accidents, Traffic ; Contusions ; Eye ; Fingers ; Foreign Bodies ; Humans ; Incidence ; Male ; Nails ; Retrospective Studies ; Seasons ; Sociology ; Violence ; Visual Acuity

BACKGROUND: Pilomatricoma (PM) is benign follicular tumor composed of the basophilic cells, transitional cells, shadow cells, squamoid cells and keratin filaments/amorphous debris. At present, PM is assumed to differentiate toward hair-forming cells of hair follicles but definite direction is not clear. OBJECTIVES: This study was made in order to investigate the pathways of cell differentiation associated with sudden keratinization in PM. METHODS: In the present study, 19 cases of human PM was histopathologically examined and classified into 4 groups according to the chronological stages. RESULTS: In the chronological stages according to Kaddu's classification, there were 2 cases of early lesion, 6 cases of fully developed lesion, 7 cases of early regressive lesion and 4 cases of late regressive lesion. The basophilic cells changed into the shadow cells or amorphous debris through the transitional cells moving toward the exterior of the PM, as well as toward the interior. As keratinization occurs, some inner basophilic cells which had been located in marginal areas of keratinization lost their tight cell-cell bonding. These cells showed edematous/vesicular and squamoid changes. High molecular weight cytokeratin was expressed in a linear pattern in some early and fully developed lesions. There were fewer layers of basophilic cells between the stroma and squamoid cells/amorphous debris than between the stroma and shadow cells. Ki-67 was expressed strongly both basal and overlying basophilic cells. Apoptotic bodies were detected in most transitional cell layers and some amorphous debris zones. CONCLUSIONS: The present study suggests dual pathways of cell differentiation in PMs. In the sudden keratinization pathway, the basophilic cells, transtional cells, shadow cells, and squamoid cells are suddenly keratinized, and the basophilic cells become early the transitional cells or squamoid cells. Cytoplasmic expressions of Ki-67 and cytokeratin in the basophilic cells show that the basophilic cells differentiate toward the innermost layer of the outer root sheath cells.
Apoptosis ; Basophils ; Cell Differentiation ; Classification ; Cytoplasm ; Hair Follicle ; Humans ; Keratins* ; Molecular Weight ; Pilomatrixoma*

Anomalous origin of left coronary artery from pulmonary artery(ALCAPA) is a rare fatal congenital anormaly that needs early surgical intervention. Many reports say that the choice of operative procedure is reimplantation of the left coronary artery into the ascending aorta. We experienced the surgical management of a case of the ALCAPA. The patient was 44 days old and 3.45 kg weighed female baby who had a symptom of congestive heart failure. She underwent implantation of coronary artery on the aorta with cardiopulmonary bypass and recovered without any complications.
Aorta ; Bland White Garland Syndrome ; Cardiopulmonary Bypass ; Coronary Vessels* ; Female ; Heart Failure ; Humans ; Pulmonary Artery* ; Replantation ; Surgical Procedures, Operative

BACKGROUND: Trichotillomania appears as incomplete alopecia due to patients own repeated manipulations of the hair. But there are few available clinicopathologic data in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinicopathological feature of trichotillomania and the experimental pathologic findings after hair plucking in rabbits. METHOD: Through retrospective study on patients who were diagnosed as trichotillomania from 1988 to 1997 at the Department of Dermatology in Pusan National University Hospital, we observed the clinical and histopathological findings in 20 cases of trichotillomania as well as histopathologic changes of hair follicle and associated structure after hair plucking in rabbits with 4 days interval. RESULTS: 1. The mean age of onset was 15.7 years and female were 12 cases(60%). 2. The school age(between 7 and 18 years) was most common as 15cases(75%) 3. Among initial sites of involvement, parietal region was the most common(10 cases, 55%), followed by frontal(5 cases, 25%), temporal(2 cases, 10%), and occipital(2 cases, 10%) region. 4. Some patients complained pruritus(25%), chronic headache(10%) and had onychophagia (20%), trichophagia(5%) and thumb sucking(5%). 5. Many patients were not typical in history, and 14 cases(70%) denied hair-plucking history. 6. Results of twelve patients with psychiatric consultation revealed obsessive disorder(4 cases, 33%), social phobia(2 cases, 17%) and dysmorphic disorder(1 case, S%). 7. The most common presumptive triggering factor was mental stress related to school work(5 cases, 25%). 8. The characteristic findings of histopathologic examination in 20 cases were empty hair follicles without perifollicular infiltration(100%) and increased catagen hair(90%) with normal anagen hair(85%), trichomalacia(40%). 9. In experimental hair plucking of rabbit, soon after hair plucking, dilated empty root sheaths, perifollicular hemorrhage were observed. These findings are similar in trichotillomania. Catagen evolution, sebaceous proliferation and hyperplasia at 4th day, prominent bulge region at 8th day, growing epithelial sheaths into deep dermis at 12th day, many anagen hair at 20th day were observed. CONCLUSION: Trichotillomania was more frequent in young than adolescent and female than male. Histopathologically, the most characteristic finding was increased catagen hair without perifollicular inflammation. In hair follicle regeneration of rabbit after plucking, all hair follicles changed into catagen and telogen stage simultaneously and new hair growth was observed.
Adolescent ; Age of Onset ; Alopecia ; Busan ; Dermatology ; Dermis ; Female ; Hair Follicle ; Hair* ; Hemorrhage ; Humans ; Hyperplasia ; Inflammation ; Korea ; Male ; Nail Biting ; Rabbits* ; Rabeprazole ; Regeneration ; Retrospective Studies ; Thumb ; Trichotillomania*