Lichen planus and vitiligo are common skin disorders, which rarely coexist. We report a case of colocalization of lichen planus and vitiligo in a 42-year-old woman. Furthermore, herein, we discuss the possible mechanism of colocalization of lichen planus and vitiligo, including the role of actinic damage in the initiation of lymphocytic infiltrates of lichen planus in vitiliginous skin.
Actins ; Adult ; Female ; Humans ; Lichen Planus* ; Lichens* ; Skin ; Vitiligo*

BACKGROUND: Salmonella infections continue to cause gastrointestinal and systemic diseases throughout the world. S. Enteritidis and S. Typhimurium were traditionally known as typical food poisoning Salmonella agents, the isolation rate of which has been increased recently in Korea. S. Typhimurium phage type DT104 has become an important emerging pathogen. Isolates of this phage type often possess resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline (ACSSuT resistance). The mechanism by which DT104 has accumulated resistance genes is of interest, since these genes interfere with treatment of DT104 infections and might be horizontally transferred to other bacteria, even to unrelated organisms. METHODS: All the isolates included in this study were identified as S. enterica serovar Typhimurium according to the Kauffmann-White serotyping scheme and were definitive phage type DT104 according to the phage typing scheme described by Anderson, et al. A total of 63 isolates of S. enterica serovar Typhimurium DT104 were characterized by antimicrobial resistance analysis, pulsed-field gel electrophoresis (PFGE) with the restriction enzyme XbaI. RESULTS: Four hundred ninety six S. Typhimurium isolates were divided into 28 different phage types and DT104 was the second most common phage type in Korea. A total of 63 S. Typhimurium DT104 isolates were grouped into 7 resistance phenotypes. Fourty one (65.1%) isolates were resistant to the ACSSuTTic core alone or to additional drugs as well except twenty two (33.9%) isolates were resistant to the ASSuTeTic. Four PFGE subtypes A1, A2, B1, and B2 were observed among DT104 isolates and type A1 was prevalent. CONCLUSIONS: We concluded two distinct clones were present among Korea multidrug resistant S. enterica serotype Typhimurium DT104 and multidrug resistant S. Typhimurium phage type DT104 has been an important emerging pathogen in Korea.
Ampicillin ; Bacteria ; Bacteriophage Typing ; Bacteriophages ; Chloramphenicol ; Clone Cells ; Electrophoresis, Gel, Pulsed-Field ; Foodborne Diseases ; Korea* ; Phenotype ; Salmonella enterica* ; Salmonella Infections ; Salmonella* ; Serotyping ; Streptomycin ; Sulfonamides ; Tetracycline

OBJECTIVES: To evaluate the compatability of high school students' desks and chairs to the fittness of their physique, to examine the factors related the posture and pain while they use the classroom desks and chairs, and to analyze the curvature of spine in sitting position. METHOD: Measurements of the dimensions of desks and chairs and a written survey to question students' habits regarding to the usage of classroom desks and chairs along with the physical examinations of spine including the analysis of spine curvature in sitting position with an electrogoniometer. RESULTS: Seven hundred forty nine among 831 male students, and 1,017 among 1,074 female students, complained of discomforts associated with the usage of classroom desks and chiairs. An examination of spine in sitting position using an electrogoniometer showed that both male and female subjects displayed the spine curvatures in the order of thoracic kyphosis, lumbar lordosis, and scoliosis. All subjects displayed pain in the order of low back(38.8%), posterior neck(23.9%), shoulder and elbow joints(15.8%), and buttock(15.7%). CONCLUSION: The study revealed an urgent need for the adaptation of classroom desks and chairs according to the growing physique of the adolescents. A majority of the teenaged subjects experienced the discomfort from the use of improper funiture and a poor posture. Authors highly recommend a formal education to the students regarding the importance of proper posture and the usage of adjustable desks and chairs.
Adolescent* ; Animals ; Education ; Elbow ; Female ; Humans ; Kyphosis ; Lordosis ; Male ; Physical Examination ; Posture ; Scoliosis ; Shoulder ; Spine

OBJECTIVE: To investigate the efficacy of commonly available analgesics in the management of delayed-onset muscle soreness (DOMS) over an 8-day period, and to compare the efficacy between aspirin and acetaminophen. METHOD: Forty-two subjects were recruited. DOMS was induced by using the isokinetic dynamometer (KinCom(R)) in standardized fashion in the nondominant knee extensor with subjects seated at 30 degree-angle velocity. Subjects were asked to extend their non-dominant knee with concentric method and to hold the knee with eccentric flexion force at 30 degree-angle velocity, with maximal efforts. On this way, they did 10 repetitions, and then 3 cycles. We categorized four groups (n=10, for each group), that were control group with no medication, placebo group with placebo medication (antacid tablets), aspirin group with medication of 900 mg of aspirin, and acetaminophen group with medication with 3,900 mg of acetaminophen. Visual Analogue Scale (VAS: twice a day, until on day 8). and McGill Pain Questionnaire (MPQ: on day 1 and 3) were measured. RESULTS: We didn't find any significant difference of peak VAS score and relief time between four groups (P>0.05), The score of MPQ was not different between four groups (P>0.05). CONCLUSION: We concluded that the medication may not be beneficial, at least at the doses stated, in the management of DOMS.
2,5-Dimethoxy-4-Methylamphetamine ; Acetaminophen* ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Knee ; Myalgia* ; Pain Measurement

OBJECTIVE: The aim of this study was to investigate the prevalence of spinal deformities such as scoliosis, thoracic kyphosis and lumbar lordosis in Korean elementary school students. METHOD: Five hundred forty Korean elementary school students were preliminary screened for spinal deformities by physical examinations and the three dimensional skeletal analysis system. The study time and pain regions were investigated in sitting on chairs that commonly used in Korean elementary school. RESULTS: The prevalence of scoliosis, thoracic kyphosis and lumbar lordosis were 9.8%, 18.7% and 23.1%. There was a significant difference in study time between spinal deformity group and control group (p<0.01). In spinal deformity group, pain regions were low back (45%), posterior neck (23%), buttock (21%) and shoulder and elbow joints (11%). CONCLUSION: The spinal deformities showed high prevalence in elementary school students assessed by the three dimensional skeletal system analyser. The long term follow-up evaluation and confirmative radiographic study will be necessary to assess curve progression in spinal deformity group.
Animals ; Buttocks ; Congenital Abnormalities* ; Elbow Joint ; Humans ; Kyphosis ; Lordosis ; Neck ; Physical Examination ; Prevalence ; Scoliosis ; Shoulder

OBJECTIVE: Inappropriate neural control of the quadriceps femoris muscle group has been implicated in patellofemoral pain syndrome (PFPS) and the methods of biomechanical assessment of PFPS has been developed recently. The aims of the present investigation were to evaluate the effects of therapeutic exercise in the alleviation of PFPS and to develope objective clinical test for PFPS. METHOD: We investigated the onset time of the isometric contraction of vastus medialis oblique muscle (VMO) and the vastus lateralis muscle (VL) under four different conditions: knee flexion and extension in weight bearing (standing) and non-weight bearing (sitting on chair) situations. For each condition, onset times of EMG activities and onset times for VMO and VL were determined from five trials of isometric contraction. In addition, we compared knee flexor and extensor torques in control group and subjects with PFPS. To evaluate the effects of the exercise we compared the onset time difference (onset time of VL-onset time of VM) and quadriceps muscle torque at pre- and post- exercise in PFPS groups. RESULTS: In PFPS group, onset time of VMO during knee extension was significantly longer than the onset time of VL and the knee extensor torque was considerably weaker in comparison with normal group. Although onset time difference was not changed after exercise program, there were significant increase in knee extensor torque in subjects with PFPS. CONCLUSION: The role of exercise in the rehabilitation of quadriceps functions is to reduce the pain, to strengthen the knee extensor, and further accurate diagnostic tools and methods for the result of therapeutic exercise in PFPS are needed.
Isometric Contraction ; Knee ; Patellofemoral Pain Syndrome* ; Quadriceps Muscle ; Rehabilitation ; Torque ; Weight-Bearing

OBJECTIVE: To investigate the pathologic pulmonary mechanics and analyze the factors affecting cough ability in patients with Duchenne muscular dystrophy (DMD). METHOD: Thirty-one patients with DMD were investigated. The vital capacity (VC), maximum insufflation capacity (MIC), maximal inspiratory (MIP), and expiratory pressure (MEP) were measured. Unassisted peak cough flow (UPCF) and assisted PCF at three different conditions were evaluated. RESULTS: The mean value of MICs (1, 873 +/- 644 cc) was higher than that of VCs (1, 509 +/- 640 cc). MIP and MEP were 48.8 +/- 21.4% and 29.5 +/- 19.5% of predicted normal value respectively. MIP was correlated with UPCFs as well as MEP. All of three assisted cough methods showed significantly higher value than unassisted method (p<0.01). The manual assisted PCFs at MIC significantly exceeded those produced by manual assisted or PCFs at MIC. The positive correlation between the MIC-VC difference and PCF at MIC-UPCF difference was seen (p<0.01). CONCLUSION: Inspiratory muscle strength and the preservation of pulmonary compliance is important for the development of effective cough as well as expiratory muscle power. Thus, the clinical implication of the inspiratory phase in assisting a cough should be emphasized.
Compliance ; Cough* ; Humans ; Insufflation ; Mechanics* ; Muscle Strength ; Muscular Dystrophy, Duchenne* ; Reference Values ; Vital Capacity

OBJECTIVE: The usage of mechanical ventilator has been an issue in advanced stage of most neuromuscular diseases. The patients experience hypoventilation symptoms and usually die from pulmonary complications at last. Besides traditional invasive mechanical ventilation, non-invasive intermittent positive pressure ventilation (NIPPV) has provided an alternative treatment option. We evaluated the effects of NIPPV. METHOD: We applied NIPPV method to the patients with advanced neuromuscular disease who were hospitalized due to ventilatory failure, who visit our outpatient clinic due to hypercapnic symptoms, or who showed hypercapnia on a routine follow-up. To evaluate ventilatory status, blood gas tensions were analyzed by the arterial blood gas analysis and/or pulse-oxymeter and capnometer. Overnight pulse-oxymeter monitorings were done whenever necessary. RESULTS: Thirty patients were managed with NIPPV successfully. In five cases, invasive IPPV with tracheostomy at admission was switched to NIPPV. Three patients who had been intubated to receive IPPV were transferred to NIPPV without being tracheostomized. CONCLUSION: NIPPV can be used safely and effectively as an alternative method of ventilatory support for the patients with advanced neuromuscular disease who show ventilatory failure. It would relieve symptoms and signs of hypoventilation and prevent the acute respiratory muscle decompensation, if applied before overt ventilatory failure.
Ambulatory Care Facilities ; Blood Gas Analysis ; Follow-Up Studies ; Humans ; Hypercapnia ; Hypoventilation ; Intermittent Positive-Pressure Ventilation ; Neuromuscular Diseases* ; Respiration, Artificial ; Respiratory Muscles ; Tracheostomy ; Ventilators, Mechanical*

The aim of this study was to investigate the factors affecting cough ability, and to compare the assisted cough methods in patients with Duchenne muscular dystrophy (DMD). A total seventy-one male patients with DMD were included in the study. The vital capacity (VC) and maximum insufflation capacity (MIC) were measured. The unassisted peak cough flow (UPCF) and three different techniques of assisted peak cough flow were evaluated. UPCF measurements were possible for all 71 subjects. But when performing the three different assisted cough techniques, peak cough flows (PCFs) could be obtained from only 51 subjects. The mean value of MICs (1801+/-780cc) was higher than that of VCs (1502+/-765cc) (p< 0.01). All three assisted cough methods showed a significantly higher value than the unassisted method (F=80.92, p< 0.01). The manual assisted PCF under MIC (MPCFmic) significantly exceeded those produced by manual assisted PCF (MPCF) or PCF under MIC (PCFmic). The positive correlation between the MIC, VC difference (MIC-VC), and the difference between PCFmic and UPCF (PCFmic-UPCF) was seen (r= 0.572, p< 0.01). The preservation of pulmonary compliance is important for the development of an effective cough as well as assisting the compression and expulsive phases. Thus, the clinical importance of the inspiratory phase and pulmonary compliance in assisting a cough should be emphasized.
Adolescent ; Child ; Cough/*physiopathology ; Humans ; Inspiratory Capacity ; *Lung Compliance ; Male ; Muscular Dystrophy, Duchenne/*physiopathology/*therapy ; Pulmonary Ventilation ; *Respiratory Therapy ; Vital Capacity

The function of inspiratory muscles is crucial for effective cough as well as expiratory muscles in patients with Duchenne muscular dystrophy (DMD). However, there is no report on the correlation between cough and inspiratory muscle strength. To investigate the relationships of voluntary cough capacity, assisted cough techniques, and inspiratory muscle strength as well as expiratory muscle strength in patients with DMD (n=32). The vital capacity (VC), maximum insufflation capacity (MIC), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were measured. Unassisted peak cough flow (UPCF) and three different techniques of assisted PCF were evaluated. The mean value of MICs (1918 +/- 586 mL) was higher than that of VCs (1474 +/- 632 mL) (p < 0.001). All three assisted cough methods showed significantly higher value than unassisted method (212 +/- 52 L/min) (F = 66.13, p < 0.001). Combined assisted cough technique (both manual and volume assisted PCF; 286 +/- 41 L/min) significantly exceeded manual assisted PCF (MPCF; 246 +/- 49 L/ min) and volume assisted PCF (VPCF; 252 +/- 45 L/min) (F = 66.13, p < 0.001). MIP (34 +/- 13 cmH2O) correlated significantly with both UPCF and all three assisted PCFs as well as MEP (27 +/- 10 cmH2O) (p < 0.001). Both MEP and MIP, which are the markers of respiratory muscle weakness, should be taken into account in the study of cough effectiveness.
Respiratory Muscles/*pathology ; Pressure ; *Oxygen Consumption ; Muscular Dystrophy, Duchenne/*genetics ; Muscles/pathology ; Muscle Weakness/pathology ; Models, Statistical ; Male ; Inspiratory Capacity ; Humans ; Cough ; Biopsy ; Adult ; Adolescent