BACKGROUND: The current modality of choice for the treatment of Port-wine stains (PWS) is laser photocoagulation. Laser therapy for the treatment of PWS, especially with a pulsed dye laser (PDL), has been proven safe and effective; however, because penetration of the PDL is too shallow for an effective ablation of the blebs, treatment of blebbed PWS, using PDL, may be insufficient. OBJECTIVE: We demonstrated the clinical efficacy of a 1,064 nm long pulsed Nd:YAG laser with contact cooling device for blebbed PWS. METHODS: Twenty one patients with blebbed PWS (Fitzpatrick skin types II-V) underwent a treatment, using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device at 8-week intervals. Treatments were done using 5~6 mm spot sizes at 20~30 ms and 95~170 J/cm2. Laser parameters were adjusted in order to meet the needs of each individual patient's lesions. RESULTS: All subjects tolerated the treatments well, and showed clinical improvement from blebs. Of the 21 patients, 18 of them experienced either moderate or excellent response. CONCLUSION: Use of a 1,064 nm long pulsed Nd:YAG laser results in a greater depth of vascular coagulation. A 1,064 nm long pulsed Nd:YAG laser with contact cooling device may be regarded as a promising therapeutic option for the treatment of blebbed PWS.
Blister ; Humans ; Laser Therapy ; Lasers, Dye ; Light Coagulation ; Port-Wine Stain ; Skin

The energy spectra for electron beam of medical linear accelerator were calculated using a GEANT4 Medical Linac 2 example code. The incident electron mean energy were 6, 9, 12, 16, 20 MeV. This code was designed to calculate electron beam energy spectra according to material, thickness and location of electron scattering foil affecting electron beam characteristic. Lead, Copper, Aluminum and Gold were used for scattering foil. The energy distribution for electron and photon were analyzed by changing position of scattering foil in the head of linear accelerator. The effect of electron scattering foil on energy spectra which is basic data of simulation for medical linear accelerator were presented. The calculated results would be used in design of medical accelerator head.
Aluminum ; Copper ; Electrons ; Head ; Particle Accelerators

Port wine stains (PWS) are congenital capillary malformations consisting of ectasia of capillaries and venules. At birth,lesions are flat and relatively uniform in color, but evolve with age to become raised, thickened, irregularly surfaced, and deeply colored. Therefore, it is considered optimal to begin treatment of patients at an early age. Conventional treatment modalities, such as electrocautery or excision, require considerable effort and may be cosmetically unsatisfactory. We have performed treatment of blebbed PWS of four patients using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device. According to their size, most blebs required three or fewer treatment sessions at 8-week intervals. Treatments were well tolerated by all subjects and patients showed moderate to good improvement of blebs. A 1,064 nm long pulsed Nd:YAG laser with contact cooling may be considered as a promising therapeutic option for treatment of blebbed PWS.
Blister ; Capillaries ; Dilatation, Pathologic ; Electrocoagulation ; Humans ; Lasers, Dye ; Port-Wine Stain ; Vascular Malformations ; Venules

INTRODUCTION: As the number of diabetics increase with younger onset and longer duration, patients are confronted with higher incidence of diabetes related complications such as distal extremity vasculopathy, neuropathy and various infectious diseases. Such diabetics are more prone to a much higher rate of onychomycosis compared to normal subjects and because this could trigger irreversible consequences, confirmation of fungal involvement should be promptly taken care of. Itraconazole is a widely used drug nowadays and compared to drugs such as griseofulvin and ketoconazole, has many advantages in efficacy, cost, duration of therapy which eventually results in better patient compliance. OBJECTIVE: Our study was designed to better dictate the usage of itraconazole in diabetics so these patient can receive quality treatment when it is needed. METHOD: The study consisted of 101 patients with both onychomycosis and diabetes who were receiving treatment in Eulji hospital. They all received 3 pulses of itraconazole and were evaluated for efficacy and safety of their treatment. The patients were observed on routine examinations for 36 weeks and at their visits they were interviewed and received microscopic examinations. RESULT: Eighty four percent of the patients showed clinical and mycological improvement with 33% of them showing total clearance. There were no hypo- or hyperglycemic events and 17 patients complained of mostly mild side effects such as indigestion. Two patients dropped out of the study due to epigastric pain and peripheral extremity swelling. CONCLUSION: The use of itraconazole in the treatment of onychomycosis seemed to be effective and relatively safe for diabetics.
Communicable Diseases ; Diabetes Complications ; Dyspepsia ; Extremities ; Griseofulvin ; Humans ; Incidence ; Itraconazole* ; Ketoconazole ; Onychomycosis* ; Patient Compliance

The term, hyperkeratotic vascular stains is a peculiar form of capillary malformations commonly called as angiokeratoma or verrucous hemangioma. Hyperkeratotic vascular stains present at birth and consist of vascular dilatation and epidermal proliferation manifested as hyperkeratosis, acanthosis, and papillomatosis. Some authors insisted that angiokeratoma and verrucous hemangioma are not proper terms because they are not true tumors but malformations due to their lack of endothelial proliferation. Wide and deep excisions have been preferred as a curative therapy. The patient was a 9-year-old girl with multiple, linear, bluish black colored, hyperkeratotic plaques on her left lower leg. The red patches at birth had slowly enlarged and had become verrucous. Some satellite lesions had also developed. Histopathologic examination showed dilated capillaries filled with red blood cells in the papillary dermis and subcutaneous fat layer. The carbon dioxide laser was used to remove hyperkeratotic plaques. The flash-lamp pumped-pulsed dye laser and intense noncoherent pulsed light were used to remove satellite lesions and vascular lesions for a year. One of the lesions resistant to laser therapy was completely excised. Because multiple hyperkeratotic vascular stains are often impossible to be excised completely, laser therapy may be tried as the first choice.
Angiokeratoma ; Capillaries ; Child ; Coloring Agents* ; Dermis ; Dilatation ; Erythrocytes ; Female ; Hemangioma ; Humans ; Laser Therapy ; Lasers, Dye ; Lasers, Gas ; Leg ; Papilloma ; Parturition ; Subcutaneous Fat

Wet cement can cause caustic ulcers due to its alkalinity. Besides caustic ulcers frequently called cement burn, allergic and irritant contact dermatitides are common in cement workers. Alkalinity of calcium hydroxide in wet cement combined with the effect of pressure and occlusion against skin may result in cement burn. We report two cases of cement burn due to their occupational exposures.
Burns* ; Calcium Hydroxide ; Dermatitis, Contact ; Occupational Exposure ; Occupations ; Skin ; Ulcer

Nerve sheath myxoma(NSM) is a rare cutaneous neoplasm of uncertain histogenesis. NSM can be divided into two groups; NSM1 (a myxoid NSM) and NSM2 (a cellular neurothekeoma). NSMs are characterized histologically by well-defined, lobular or plexiform dermal proliferation of stellate, spindle-shaped cells embedded in abundant myxoid stroma. A variable amount of nerve fascicles are entrapped within and around the tumor. Two variants of NSM share the same features to a certain degree but differ in cellularity and mucin deposition. We report two cases of NSMs with different clinical and histopathologic features.
Mucins ; Neurothekeoma*

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure

There have been no known therapeutic modalities as effective as glucocorticoids for the treatment of chronic intractable atopic dermatitis. However, various attempts including phototherapy with UVB irradiation have been tried to avoid side effects from long term corticosteroids treatment. The therapeutic effect of UVB irradiation in the management of chronic atopic dermatitis was examined. Sixteen patients with atopic dermatitis showing severe itching and lichenified lesions, who were dependent on corticosteroids, were treated with UVB. After applying mineral oil or vaseline, patients received phototherapy. Intractable pruritus subsided or ameliorated after mean 5.2 times of treatments in 10 of 11 patients, and the skin lesions disappeared or improved after mean 13 times of treatments in 9 of 10 patients. No side effects were observed. UVB phototherapy could be avaluable alternate for the treatment of intractable atopic dermatitis.
Adrenal Cortex Hormones ; Dermatitis, Atopic* ; Glucocorticoids ; Humans ; Mineral Oil ; Petrolatum ; Phototherapy* ; Pruritus ; Skin

BACKGROUND: Defective adhesion and migration of melanocyte may be involved in pathogenesis of vitiligo. Tenascin, a glycoprotein of the extracellular matrix, has a role in cell adhesion and migration. It has been reported that abundant expression of tenascin in vitiligo lesion may inhibit melanocyte adhesion and migration. OBJECTIVE: To investigate the tenascin expression in vitiligo skin lesions and to compare with clinical findings. METHODS: We studied 9 patients with vitiligo. The expressions of tenascin were studied by immunahistochemieal techniques.
Cell Adhesion ; Extracellular Matrix ; Glycoproteins ; Humans ; Melanocytes ; Skin ; Tenascin* ; Vitiligo*