BACKGROUND: Androgenetic alopecia (AGA) is a common hair loss disease with genetic predisposition among men and women, and it may commence at any age after puberty. It may significantly affect a variety of psychological and social aspects of one's life and the individual's overall quality of life (QoL). OBJECTIVE: This study aimed to investigate the QoL of AGA patients and discover the factors that can influence the QoL of AGA patients, including previous experience in non-medical hair care, reasons for hospital visits, age, duration, and the severity of AGA. METHODS: A total of 998 male patients with AGA were interviewed, using the Hair Specific Skindex-29 to evaluate the QoL of AGA patients. RESULTS: The results of the Hair Specific Skindex-29 on patients with AGA were as follows: symptom scale: 26.3+/-19.5, function scale: 24.0+/-20.1, emotion scale: 32.1+/-21.8, and global score: 27.3+/-19.1. According to this assessment, QoL was more damaged if the patient had severe alopecia, a longer duration of AGA, younger age, had received previous non-medical hair care, and visited the hospital for AGA treatment. CONCLUSION: This study showed that AGA could harmfully affect the patients' QoL. These findings indicate that dermatologists should address these QoL issues when treating patients with alopecia.
Alopecia ; Female ; Genetic Predisposition to Disease ; Hair ; Humans ; Male ; Prospective Studies ; Puberty ; Quality of Life

BACKGROUND AND OBJECTIVES: Aspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). An elevated neutrophil count in STEMI is associated with microvascular dysfunction and adverse outcomes. We evaluated whether AT can improve microvascular dysfunction in patients with STEMI and an elevated neutrophil count. SUBJECTS AND METHODS: Seventy patients with STEMI undergoing primary PCI from August 2007 to February 2009 in our institution were classified by tertiles of neutrophil count on admission (<5,300/mm3, 5,300-7,600/mm3, and >7,600/mm3). The angiographic outcome was post-procedural thrombolysis in myocardial infarction (TIMI) flow grade. Microvascular dysfunction was assessed by TIMI myocardial perfusion (TMP) grade and ST-segment resolution on electrocardiography 90 minutes after PCI. The clinical outcome was major adverse cardiac event (MACE), defined as cardiac death, re-infarction, and target lesion revascularization at 9 months. RESULTS: There were no significant differences in the clinical characteristics and pre- and post-procedural TIMI flow grades between the neutrophil tertiles. As the neutrophil count increased, a lower tendency toward TMP grade 3 (83% vs. 52% vs. 54%, p=0.06) and more persistent residual ST-segment elevation (>4 mm: 13% vs. 26% vs. 58%, p=0.005) was observed. The 9-month MACE rate was similar between the groups. On subgroup analysis of AT patients (n=52) classified by neutrophil tertiles, the same tendency toward less frequent TMP grade 3 (77% vs. 56% vs. 47%, p=0.06) and persistent residual ST-segment elevation (>4 mm: 12% vs. 28% vs. 53%, p=0.05) was observed as neutrophil count increased. CONCLUSION: A higher neutrophil count at presentation in STEMI is associated with more severe microvascular dysfunction after primary PCI, which is not improved with AT.
Death ; Electrocardiography ; Humans ; Myocardial Infarction ; Neutrophils ; Percutaneous Coronary Intervention ; Perfusion ; Thrombectomy ; Thymidine Monophosphate

BACKGROUND AND OBJECTIVES: Aspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). An elevated neutrophil count in STEMI is associated with microvascular dysfunction and adverse outcomes. We evaluated whether AT can improve microvascular dysfunction in patients with STEMI and an elevated neutrophil count. SUBJECTS AND METHODS: Seventy patients with STEMI undergoing primary PCI from August 2007 to February 2009 in our institution were classified by tertiles of neutrophil count on admission (<5,300/mm3, 5,300-7,600/mm3, and >7,600/mm3). The angiographic outcome was post-procedural thrombolysis in myocardial infarction (TIMI) flow grade. Microvascular dysfunction was assessed by TIMI myocardial perfusion (TMP) grade and ST-segment resolution on electrocardiography 90 minutes after PCI. The clinical outcome was major adverse cardiac event (MACE), defined as cardiac death, re-infarction, and target lesion revascularization at 9 months. RESULTS: There were no significant differences in the clinical characteristics and pre- and post-procedural TIMI flow grades between the neutrophil tertiles. As the neutrophil count increased, a lower tendency toward TMP grade 3 (83% vs. 52% vs. 54%, p=0.06) and more persistent residual ST-segment elevation (>4 mm: 13% vs. 26% vs. 58%, p=0.005) was observed. The 9-month MACE rate was similar between the groups. On subgroup analysis of AT patients (n=52) classified by neutrophil tertiles, the same tendency toward less frequent TMP grade 3 (77% vs. 56% vs. 47%, p=0.06) and persistent residual ST-segment elevation (>4 mm: 12% vs. 28% vs. 53%, p=0.05) was observed as neutrophil count increased. CONCLUSION: A higher neutrophil count at presentation in STEMI is associated with more severe microvascular dysfunction after primary PCI, which is not improved with AT.
Death ; Electrocardiography ; Humans ; Myocardial Infarction ; Neutrophils ; Percutaneous Coronary Intervention ; Perfusion ; Thrombectomy ; Thymidine Monophosphate

Primary cardiac lymphomas (PCL) are extremely rare. Clinical manifestations may be variable and are attributed to location. Here, we report on a case of PCL presenting with atrioventricular (AV) block. A 55 year-old male had experienced chest discomfort with unexplained dyspnea and night sweating. His initial electrocardiogram (ECG) revealed a first degree AV block. Along with worsening chest discomfort and dyspnea, his ECG changed to show second degree AV block (Mobitz type I). Computed tomography (CT) scan showed a cardiac mass (about 7 cm) and biopsy was performed. Pathologic finding confirmed diffuse large B-cell lymphoma. The patient was treated with multi-drug combination chemotherapy (R-CHOP: Rituximab, cyclophoshamide, anthracycline, vincristine, and prednisone). After treatment, ECG changed to show normal sinus rhythm with complete remission on follow-up CT scan.
Antibodies, Monoclonal, Murine-Derived ; Atrioventricular Block ; Biopsy ; Drug Therapy, Combination ; Dyspnea ; Electrocardiography ; Follow-Up Studies ; Heart Neoplasms ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Male ; Sweat ; Sweating ; Thorax ; Vincristine ; Rituximab

PURPOSE: Febrile convulsions are a common pediatric neurological disease, and it is important to prevent such a disease by controlling the risk factors that may recur. A recent report states that influenza virus infections have a high probability of a relationship with febrile convulsions; therefore, it is necessary to identify the clinical properties of febrile convulsions in relation to domestic influenza virus infections. METHODS: Between November 2005 and February 2008, children hospitalized because of febrile convulsions and subsequently confirmed to have influenza infections were enrolled as subjects (patient group, n=11). The control subjects were those admitted with influenza virus infections but no febrile convulsions (control group 1, n=46) and those who developed febrile convulsions without influenza virus infection (control group 2, n=53). RESULTS: The patient group showed a higher maximum body temperature (39.3+/-0.5degrees C), more histories of past febrile convulsions (72.7%), and a shorter total duration of fever (2.9+/-1.2 days) than control group 1. When multivariate analysis was performed, the probability of febrile convulsions was found to be as high as 225.9 times in patients who had influenza virus infections with a past history of febrile convulsions (OR=225.9, 95% CI: 1.7-4780.0, P<0.05). When patients with febrile convulsions were compared based on the symptoms of influenza virus infections, the patient group showed a shorter duration of fever (0.9+/-0.7 days) before convulsion than control group 2; these convulsions were mostly a recurrence of febrile convulsions. When multivariate analysis was performed, the cases with a past history of febrile convulsions showed 5.5 times (OR=5.5, 95% CI: 1.2-25.1, P=0.03) the probability of convulsions when infected with the influenza virus, and this probabilit. decreased by 0.3 times over one-day increments of the febrile period until febrile convulsions (95% CI: 0.1-0.9, P=0.02). Maximum body temperature, total duration of fever, family history of febrile convulsions, and complex febrile convulsions did not show a statistical significance. CONCLUSION: In cases of pediatric influenza virus infection, the past history of febrile convulsions could be identified within the risk factor of recurrent febrile convulsions. Therefore, influenza vaccination of children having a past history of febrile convulsions will be helpful to avoid the recurrence of these convulsions.
Body Temperature ; Child ; Fever ; Humans ; Influenza, Human ; Multivariate Analysis ; Orthomyxoviridae ; Recurrence ; Risk Factors ; Seizures ; Seizures, Febrile ; Vaccination

OBJECTIVE: Low-dose aspirin have been proposed to improving endometrial receptivity and pregnancy rate in COH-IVF by increasing endometrial perfusion. However, the effect of low-dose aspirin in COH-IVF could be negligible because there have been large quantity of other important factors responsible for changing endometrial perfusion accompanied by COH procedure. In contrast, in frozen-thawed embryo transfer cycles which were not accompanied by COH procedure, the effects of low-dose aspirin in endometrial blood flow seems to be more certain than in COH-IVF cycles. In this study, we analyzed the effect of low-dose aspirin treatment on implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer METHODS: From January 2003 to December 2003, total 264 cycles from 264 patients who attended infertility clinic at Samsung Cheil Hospital were enrolled in this study. All cases included in this study, embryos were frozen and thawed at the pronuclear stage and three days after incubation, at least 2 or more good quality embryos were transferred into uterus. In study group, low dose aspirin (100 mg/day) was administrated from the first or second date of menstrual day to 9 days after embryo transfer. On the other hand, control group did not take any medicine except estradiol valerate for endometrial priming. Several variables including implantation and pregnancy rates were compared in both groups. After then, each groups were stratified by endometrial thickness checked at embryo transfer (ET) day such as (28 mm versus <8 mm) and same variables above described were compared between study and control groups. RESULTS: The mean age, infertility duration, endometrial thickness at embryo transfer day and mean number of transferred embryo were not significantly different in both groups. Also, implantation rates (study group: 15.8%, control group: 20.5%) and pregnancy rate (study group: 45.1%, control group: 43.5%) were not significantly different between two groups. (p>0.05) After we analyzed same variables stratified by endometrial thickness checked at embryo transfer day, we could not found any significant difference between study and control groups. CONCLUSIONS: Low-dose aspirin treatment seems to have no advantage of improving implantation and pregnancy rates in patients undergoing frozen-thawed embryo transfer.
Aspirin* ; Embryo Transfer* ; Embryonic Structures* ; Estradiol ; Hand ; Humans ; Infertility ; Perfusion ; Pregnancy Rate* ; Pregnancy* ; Uterus

OBJECTIVES: This study was performed to evaluate the pregnancy rate following the transfers of frozen- thawed embryos which was derived from intracytoplasmic sperm injection (ICSI) using sperm obtained by ejaculated, testicular sperm extraction (TESE), and frozen-thawed testicular sperm extraction (t-TESE). METHODS: Frozen-thawed embryos were successfully transferred to the patients in 664 cycles among 695 cycles from January 1998 to December 2002, where ICSI was done with various origins of sperm. Subjects were divided into three groups according to the origin of sperm; ejaculated sperm group as a control (n=535), TESE group (n=98) and t-TESE group (n=62). After conventional ICSI, the supernumerary PN stage or developing embryos were cryopreserved by slow freezing protocol with 1, 2-propanediol as cryoprotectant. RESULTS: The survival rate of frozen-thawed embryos was 77.7% (2515/3236) in ejaculated sperm group, 76.6% (441/576) in TESE group and 83.9% (292/348) in frozen-thawed TESE group, respectively. The difference of survival rate of between t-TESE group and other two groups was statistically significant (p<0.01). The good embryo formation rate and positive beta-hCG rate was 46.3% (1164/2515), 28.8% (148/513) in ejaculated sperm group, 49.2% (217/441), 36.6% (34/93) in TESE group and 46.2% (135/292), 34.9% (22/63) in frozen-thawed TESE group, respectively. CONCLUSION: This study demonstrates that comparable pregnancy rate and implantation rate could be achieved after the transfer of frozen-thawed embryos following ICSI using various sources of sperm. As there was no statistically significant difference in pregnacy rate between ICSI with fresh testicular sperm and with frozen-thawed testicular sperm, the sequential cryopreservation of supernumerary testicular sperm and embryos may be a useful method for increasing pregnancy outcome in infertile couples with male factor.
Cryopreservation ; Embryonic Structures* ; Family Characteristics ; Female ; Freezing ; Humans ; Male ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Rate ; Pregnancy* ; Sperm Injections, Intracytoplasmic* ; Spermatozoa* ; Survival Rate

OBJECT: The purpose of this study was to determine the prevalence of fungal infection and ulcer on the feet of diabetic patients and the existence of correlation between ulcer and fungal infection. METHODS: A total of 21, 693 outpatients diagnosed as diabetes mellitus at the department of endocrinology of 32 hospitals were examined. The diabetic patients with foot problems were consulted to the department of dermatology. Physical examination and KOH preparation were performed. RESULTS: 13, 271 patients had certain kinds of foot problem, accounting for 61.2% of 21, 693 diabetics examined. Of these, fungal foot disease were found in 10, 403 that constituted 78.4% (48.0% of the entire diabetic population). Tinea pedis was the diagnosis in 6, 496 (29.9%), onychomycosis in 7, 783 (35.9%), and coexistence was in 3, 883 (17.9%). Foot deformity was in 1, 346 (6.2% of diabetics; 10.1% of foot disease), non-palpable pulse in 1, 051 (4.8% ; 7.9%), and foot ulcer was in 425 (2.0% ; 3.2%), following in a descending order of frequency. Odds ratios for diabetic foot ulcer were 2.5 in patients with the foot deformity, 1.6 with fungal foot disease and 2.2 with non-palpable pulse. Conversely, Odds ratios for fungal foot disease were 2.5 with foot deformity, and 1.6 with foot ulcer. A total of 5, 486 patients paid a visit to the department of dermatology. Of these, 4, 519 patients were diagnosed with fungal infection through physical examination and KOH smear by dermatologists. The population comprised of 2, 272 males and 2, 247 females, showing similar prevalence between sexes. However, age did have positive correlation regarding prevalence of fungal foot disease. The number of diabetic patients with toenail problems was 3, 847 patients (70%) and onychomycosis was proven mycologically in 3, 276. Onychomycosis of distal subungal type was the most common clinical finding, most frequently involving the great toenails. Abnormal skin findings of the foot were seen in 3, 885(70.8%) and tinea pedis was found in 3, 209 (58.5%), most commonly involving the soles. CONCLUSION: This study showed that fungal infection might be regarded as a risk factor of foot ulcer. Treatment of fungal infection in diabetic patients might prevent diabetic foot disease such as ulcer and reduce the disability, morbidity and mortality in diabetic patients.
Dermatology ; Diabetes Mellitus ; Diabetic Foot ; Diagnosis ; Endocrinology ; Female ; Foot Deformities ; Foot Diseases ; Foot Ulcer ; Foot* ; Humans ; Male ; Mortality ; Nails ; Odds Ratio ; Onychomycosis ; Outpatients ; Physical Examination ; Prevalence* ; Risk Factors ; Skin ; Tinea Pedis ; Ulcer*

OBJECTIVE: To evaluate the difference of implantation rate (IR) and clinical pregnancy rate (CPR) between two protocols of endometrial preperation in women undergoing frozen-thawed embryo transfer (FET) cycles. METHODS: This study was performed during the different time periods: A retrospective study from January 2000 to June 2001 (phase I) and a prospective study from July 2001 to March 2002 (phase II). All the patients received estradiol valerate (6 mg p.o. daily) starting from day 1 or 2 of the menstrual cycle without pituitary down regulation. Progesterone was administered around day 14 after sonographic confirmation of endometrial thickness > or = 7 mm and no growing follicle. In Group A (n=88, 99 cycles) of phase I, progesterone was administered i.m. at a dose of 50 mg daily from one day prior to thawing of pronuclear (PN) stage frozen embryo or three days prior to thawing of 6-8 cell stage frozen embryo and then each stage embryos were trasnsferred 2 days or 1 day later after thawing. In Group B (n=246, 299 cycles) of phase I, patients recieved progesterone 100 mg i.m. from one day earlier than group A; two days prior to PN embryo thawing, four days prior to of 6-8 cell embryo thawing. During the phase II, to exclude any differences in embryo transfer procedures, in Group 1 (n=23, 28 cycles) of phase II embryo was transfered by one who have used the progesterone protocol since the phase I. In Group 2 (n=122, 139 cycles) of phase II embryo was transfered by one who use the progesterone protocol from the phase II. RESULTS: When compared across the phase and group, there were no significant differences in the characteristics. During the phase I, there were significant increase in IR (14.4% vs 5.9%, p=0.001) and CPR (28.3% vs 14.5%, p=0.000) in group A. During the phases II, IR (11.8% vs 10.6%) and CPR (27.6% vs 27.3%) show no differences between two groups. CONCLUSIONS: In FET cycles, IR and CPR are increased significantly by the change of dosage and timing of progesterone administraton. And the timing is considered to be more important factor because the dosage of progesterone did not affect implantation window in previous studies. Therefore, we suggest that progesterone administration in FET cycle should begin from one day prior to PN stage embryo thawing and three days prior to 6-8 cell stage embryo thawing.
Cardiopulmonary Resuscitation ; Down-Regulation ; Embryo Transfer* ; Embryonic Structures* ; Estradiol ; Female ; Humans ; Menstrual Cycle ; Pregnancy Rate* ; Pregnancy* ; Progesterone* ; Prospective Studies ; Retrospective Studies ; Ultrasonography

The salivary glands produce 1.5L of fluid per day. As in other exocrine organs, the general mechanism in the salivary glands is that water movement occurs secondary to osmotic driving forces created by active salt transport. Therefore, high water permeability in the salivary glands is expected to have a variety of aquaporin (AQP), a water channel. Although some AQPs have been known to be present in the salivary glands, roles of parasympathetic nerve in AQP expression have not yet been examined. This study was designed to examine the changes of AQPs and extracellular signal-regulated kinase (ERK) in the submandibular glands after parasympathetic denervation. Right chorda-lingual nerve was cut, and each right (experiment) and left (control) submandibular gland was excised at 1, 3, 7, 14, 30 days after denervation. The denervated right submandibular glands were resulted in weight loss and morphologic changes, including cell loss and atrophy, as the time elapsed after parasympathetic denervation increased, whereas there were no histologic alteration in control side. AQP5 which is known to reside in apical membrane and secretory caraliculi of the submandibular acini were gradually underexpressed according, as the time after denervation increased. Expression of AQP4 in submandibular ductal epithelium was down-regulated after denervation. Besides, AQP3 and 8, which is known to be present in basolateral membrane of the glandular acini, were gradually underexpressed after denervation, similar to the pattern of other types. Expression of ERK, a mitogen-activated protein kinase, was downregulated after parasympathetic denervation in the submandibular gland. These results suggest that parasympathetic nervous system regulates the expression of AQPs in salivary glands, and is in part mediated by ERK pathway.
Animals ; Aquaporins* ; Atrophy ; Denervation ; Epithelium ; MAP Kinase Signaling System ; Membranes ; Parasympathectomy* ; Parasympathetic Nervous System ; Permeability ; Phosphotransferases ; Protein Kinases ; Rats* ; Salivary Glands ; Submandibular Gland* ; Water ; Water Movements ; Weight Loss