The pathogenesis of vitiligo has not been fully elucidated, but three different hypothese have been advanced to explain the cause of vitiligo. One is related to autoimmunity, another concerns neurohumoral factors and the third involves self-destruction of melanocytes. The autoimmune theory of vitiligo is further strengthened by the increased association of vitiligo with a nurnber of autoimmune disorders and by the increased prevalence of organ-specific autoantibodies in vitiligo. Also decreased T lymphocytes in vitiligo patients were reported. The present study was undertaken to evaluate the cell mediated immune status of patients with vitiligo using several in vitro and in vivo immune parameters. Thirty patients between the ages of 12 and 65 were observed at the Department of Dermatology of Ewha Womans University Hospital from Apri11981 through October 1981. Age matched 30 healthy persons comprised the control group. The results were summarized as follow: 1) The mean percentage of T lymphocytes in 30 vitiligo subjects and 30 control subjects were 55.3% and 67.4% respectively. There was a significant decrease of T lymphocytes in patients with vitiligo(p<0.05). 2) The percentage of subjects showing positive delayed hypersensitivity reactions to candidin, trichophytin and PPD were 33.3%, 43%, 50% respectively in 30 vitiligo patients and 60%, 75%, 80% respectively in 20 controls. A slight depression in delayed cutaneous hypersensitivity in gatients with vitiligo. (p<0.1). 3) The percentage of subjects showing positive sensitization with DNCB was 53% in 30 vitiligo patienta and 85% in 20 controls. A slight depression in DNCB sensitization was evident in vitiligo patients(p<0.1).
Autoantibodies ; Autoimmunity ; Depression ; Dermatology ; Dinitrochlorobenzene ; Female ; Humans ; Hypersensitivity ; Hypersensitivity, Delayed ; Immunity, Cellular* ; Melanocytes ; Prevalence ; T-Lymphocytes ; Trichophytin ; Vitiligo*

A 24-year-old man presented with a 1.5 × 0.5 cm-sized erythematous nodule with central crust on the forehead since 5 years ago. There was no history of trauma or previous skin disorders. Histopathologic examination showed a typical picture of osteoma cutis. In addition, transepidermal elimination of bony material was observed: red linear plate-like calcified lamella structures had extruded to the skin surface through the perforated epidermis. The perforating type of osteoma cutis was discussed.
Epidermis ; Forehead ; Humans ; Osteoma* ; Skin ; Young Adult

Housewife's eczema is not a specific disease but an inflammatory pattern of response to variety of stimuli: it is characterized by erythema, papules, vesicles, exudation, and scaling. Nickel is one of the most common causes of allergic contact dermatitis, particularly in women. The authors reported a case of housewife's eczema due to nickel sulfate occuring in a 30 year-old housewife for 3 years which was confirmed by patch test with 5% nickel sulfate and dimethyl glyoxime spot test on patients wedding ring and stainless bowels. Literature were reviewed briefly.
Adult ; Dermatitis, Allergic Contact ; Eczema* ; Erythema ; Female ; Humans ; Nickel* ; Patch Tests

A female newborn had the following characteristics; a congenital localized absence of skin over the lower extremities; blistering of the skin or mucous membrane, incited by trauma, which heals without scarring; and congenital absence or deformity of the nails. In respect to the characteristic manifestation, clinical course and electron microscopic features, our patient seems to fit well into Bart's syndrome. The inheritance pattern appears to be autosomal dominant but, as in this report, isolated cases have been recognized. As the review of the literatures, congenital localized absence of skin has been observed in various subsets of inherited E.B. But, we believe that the term Bart's syndrome should be used to identify patients with good prognosis as the Bart's initial description To the best of our knowedge, this is the first reported case of Bart's syndrome in the korean literature.
Blister ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Infant, Newborn ; Inheritance Patterns ; Lower Extremity ; Mucous Membrane ; Prognosis ; Skin

Immunosuppressive therapy based on the use of antilymphocyte globulin (ALG) has become standard therapy for patients with splastic anemia who are not eligible for bone marrow transplantation. In this study, T cell subsets before and after ALG therapy, hematologic responses, complications and prognostic factors were analysed. Eleven (42%) out of twenty-six patients treated with ALG showed response, but two patients showed relapse. Most of the response (9 cases) was noticed within 6 months after the initiation of ALG therapy (median: 3 months). The main complications of ALG therapy were fever (91%), thrombocytopenia (86%), neutropenia (63%), and serum sickness (56%). Four patients were died just ALG therapy because of serum sickness (2 cases), intracranial hemorrhage (1 case), and shock (1 case). Short interval from diagnosis to treatment suggested to show good response (P=0.0575), but it was not significant statistically. Lymphocyte subsets were measured in the blood of 23 patients. Helper T/suppressor T cell ratio (T4/T8 ratio) at the initiation of ALG therapy (day 0) was higher significantly in patients who were responded (P=0.0299). The patients who showed above 1.0 of T4/T8 ratio on day 0 might be speculated good response (P=0.032). More difference of T4/T8 ratio between day 14 after ALG therapy and day 0 might show good response (P=0.0673). Then the actuarial probability of survival at 3 years in patients treated with ALG was 77%. Our data suggest that ALG therapy may be used as an alternative treatment to bone marrow transplantation, and T4/T8 ration of peripheral blood at the initiation of therapy may be used as one of the prognostic factors.
Anemia ; Anemia, Aplastic* ; Antilymphocyte Serum* ; Bone Marrow Transplantation ; Child* ; Diagnosis ; Fever ; Humans ; Intracranial Hemorrhages ; Lymphocyte Subsets ; Neutropenia ; Recurrence ; Serum Sickness ; Shock ; T-Lymphocyte Subsets ; Thrombocytopenia

Edwards syndrome is first introduced by Edwards and characterized by facial anomalies, multiple cardiovascular, gastrointestinal, urogenital, and skeletal malformations. It results from triplication of part or all of chromosome 18 in some or all of the patient's cells. It has an incidence of 1 in 4,500 live births or less and short life expectancy. Recently we experienced a case of 3-day-old female new born infant with this syndrome. Post mortem examination showed progeric face with prominent occiput, large flabby ears, microphthalmia, and micrognathia, bilateral clenched hands with flexion contraction of middle fingers, and bilateral rockerbottom feet. Internal examination revealed horseshoe kidney, esophageal atresia with tracheoesophageal fistula, two accessory spleens, and multiple cardiac anomalies. A trisomy 18 was confirmed by the cytogenetic study.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Incidence

Small cell carcinoma of the ovary is rare malignancy occurring in women under 40 years of age(average, 23 years), which is associated with hypercalcemia in two thirds of cases. Its histogenesis is uncertain, but the possibilities of common epithelial, neuroendocrine, sex cord stromal and germ cell origin are suggested. All reported cases were proved to have rapid fatal course despite various therapy and 5 years suvival rate was only 10%. We report one case of a 20-year old woman with primary small cell carcinoma of the left ovary. The ovary was markedly enlarged and completely replaced by a mass, measuring 21x16x8 cm. Microscopic examination revealed dimorphic population of small and large malignant cell producing immature follicle-like structure which is characteristic of small cell carcinoma of the ovary. These pathological findings were similar to those of granulosa cell tumor, which is required to make differential diagnosis from small cell carcinoma. Immunohistochemical stains for cytokeratin and vimentin were positive, but those for S-100 protein and NSE were negative. One month after the initial operation, the tumor has recurred and the second and the second palliative operation followed by 3 cycles of chemotherapy was done. The patient showed disseminated metastasis at present time.
Female ; Humans ; Diagnosis, Differential ; Neoplasm Metastasis

Exercise induced asthma (EIA) is defined as acute, reversible, usually self-limiting airway obstruction which develop after strenous exercise in patients with asthma. EIA is a bigger problem in children than adults due to more active and smaller airways which obstruct more easily when bronchospasm develops. The exercise elicited many change in pulmonary function of asthmatic children. These change could be measured by measurements of PEFR, FEV1, FVC, or SRaw. The propose of this study is to determine the changes and sensitivity of different pulmonary function test in asthmatic children. 37 asthmatic children exercised on free running and pulmonary function tests were performed before and every 5 minutes during 15 minutes after exercise. The results were as follows. 1) In 37 asthmatic children, EIA developed in 23 children (62%) and did not developed in 14 children (38%). The difference in sex, height, weight, total eosinophil count, serum IgF and test between EIA and Non-EIA were not significant (P>0.05). 2) In EIA group, %PEFR was changed from 109.56% to 83.56%, But in Non-EIA group, %PEFR was not changed before and after exercise loading test. 3) In EIA group, %FEV1 was changed from 90.91% to 74.87%. But in Non-EIA group, %FEV1 was not changed before and after exercise loading test. 4) In EIA group, %FVC changed from 91.83% to 75.35%. But in Non-EIA group, %FVC was not change before and after exercise loading test. 5) There was significant difference in pre-exercise specific airway resistance between EIA (6.7+/-1.7) and normal children (5.8+/-2.2)(p<0.05). In EIA group, %SRaw was changed from 115.7% to 161.2%. But in Non-EIA group, %SRaw was not changed before and after exercise loading test. 6) During the post-exercise observation period, increasement of SRaw was greater than changes in any other pulmonary function test. SRaw is the most sensitive test for the ditection of exercise induced airway obstruction is asthmatic children.
Adult ; Airway Obstruction ; Airway Resistance* ; Asthma ; Asthma, Exercise-Induced ; Bronchial Spasm ; Child* ; Eosinophils ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Running

BACKGROUND: The activity of drug metabolizing enzymes and the modulation of their expression by inducers in the skin are the key factors for understanding of pharmacological and toxic effects of topically applied drugs. The role of these enzymes is of major importance, as they may contribute to determine the steady-state levels of biologically active substances. 3-Methylcholanthrene and all-trans- retinoic acid have been known to be inducers of the drug metabolizing enzymes. And all-trans- retinoic acid has many biological actions including anti-cancer effects. OBJECTIVE: The purpose of this study was to evaluate the effect of all-trans-retinoic acid on inducing the expression and modulation of genetic polymorphism of drug metabolizing enzymes as well as to estimate the role of all-trans-retinoic acid in carcinogenesis and drug interactions. METHODS: We analyzed the activities of CYP1A1(Cytochrome P450 1Al), NADPH cytochrome P450-reductase, UGT1 and GST after administration of 3-methylcholanthrene and all-trans-retinoic acid to the Sprague-Dawley male rats. We observed the inducible gene expression of CYP1A1, UGT1, GSTJt by RT-PCR and the genetic polymorphism of CYP1A1, UGT1, GSTK by PCR. RESULTS: 1. The expression of CYP1A1, NADPH cytochrome P450-reductase, UGT1 and GST was induced by 3-methylcholanthrene and all-trans-retinoic acid. That of NADPH cytochrome P450-reductase and UGT1 is pronouncedly enhanced by all-trans- retinoic acid. 2. The effects of 3-methylcholanthrene and all-trans-retinoic acid on inducing the expression of CYP1A1 and UGT1 correlated with an increase of mRNA expression levels of CYP1A1 and UGT1. The modulation of mRNA expression levels of GST was downregulated by all-trans-retinoic acid. 3. The genetic polymorphism of CYP1A1 was induced by 3-methylcholanthrene and all-trans- retinoic acid, and that of GSTM1 was not affected by the inducers. The induction of genetic polymorphism of GST was down regulated by all-trans-retinoic acid. CONCLUSION: 3-Methylcholanthrene and all-trans-retinoic acid modulate the inducible expression and genetic polymorphism of drug metabolizing enzymes differentially. All-trans-retinoic acid can modulate the metabolism of procarcinogen such as 3-methylcholanthrene by inducing drug metabolizing enzymes. Furthermore, the elucidation of the molecular mechanisms underlying the regulation of drug metabolizing enzymes by 3-methylcholanthrene, all-trans-retinoic acid and other drugs could help to understand their respective roles in drug interactions and carcinogenesis.
Animals ; Carcinogenesis ; Cytochrome P-450 CYP1A1 ; Cytochromes ; Drug Interactions ; Gene Expression* ; Humans ; Male ; Metabolism ; Methylcholanthrene ; NADP ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Skin* ; Tretinoin*

Pulmonary vein velocities have recently been estimated in conjunction with mitral flow velocities to increase our understanding o ventricular filling. The advent of transesophageal echocardiography with pulsed Doppler imaging capability has provided a method by which both the mitral valve and pulmonary vein velocities can be easily recorded because of the posterior approach providing unimpeded interrogation of cardiac structures. The purpose of this present study was to evaluate the normal pulmonary venous, mitral and aortic flow pattern by transthoracic echocardiography in neonate according to the postnatal age. The results were as follows. 1) With regard to the aortic flow, the early systolic was of pulmonary flow peaked after the onset of aortic flow and the late systolic wave occured consistently before aortic valve closure. 2) The peak velocities of early systolic, late systolic, late systolic, diastolic and atrial systolic in the pulmonary venous flow were 36.4 (13.2cm/sec, 45.3 (15.3cm/sec, 48.5 (14.1cm/sec and 16.6( 5.7cm/sec at 1 day old. the difference according to the postnatal age was not significant. 3) The ratio of peak systolic to peak distolic velocity of pulmonary venous flow was 1.0( 0.3 at 1 day o1, 1.1( 0.4 at 1 week old and 1.2 (0.3 at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). 4) The peak early diastolic velocity of mitral flow was 51.3 (15.2cm/sec at 1 day old, 54.7( 13.7cm/sec at 1 week old and 80.7 (16.6cm/sec at 1 month old. The difference between 1 week old and 1month old was statistically significant(p<0.01). 5) The peak late diastolic velocity of mitral flow was 48.3 (14.6cm/sec at 1 day old, 50.1( 9.9cm/sec at 1 week old and 71.8 (16.6cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 6) The ratio of peak mitral early diastolic to peak late diastolic velocity was 1.1( 0.2 at 1 day old, 1.1( 0.3 at 1 week old and 1.2( 0.7at 1 month old. The difference between 1 week old and 1 month old was statistically significant(p<0.01). 7) The peak aortic valve flow velocity was 62.1 (14.2cm/sec at 1 day old, 67.8 13.4cm/sec at 1 week old and 76.6 14.1cm/sec at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). In conclusion, improvement of left ventricular diastolic function was noted at 1 month old by echocardiography. These normal data will be useful in comprisons with the data, which obtained in newborn with various congenital heart disease that affects flow dynamics.
Aortic Valve ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Transesophageal ; Heart Defects, Congenital ; Humans ; Infant, Newborn* ; Mitral Valve ; Pulmonary Veins