Burn and Scar after Using Medical Devices in Beauty Shop / 대한피부과학회지

No abstract available.

The Use of Medical Devices for Medical Skin Care and the Legal Issues / 대한피부과학회지

BACKGROUND: Medical skin care is essential for the treatment of skin diseases all over the world. Medical skin care is also part of medical practice and this must be differentiated from the simple skin care that is given for normal healthy skin. OBJECTIVE: We wanted to discuss medical skin care and the related medical devices and legal issues. METHODS: We reviewed the related laws and regulations, we consulted experts and associations and we analyzed the result of the survey. RESULTS: Legally, medical skin care and simple skin care are well classified. However, many illegal procedures are still performed by non-medical personnel and many adverse effects have been reported as a result. Furthermore, there are no legal restrictions for the performer based on the grade of each medical skin care procedure. CONCLUSION: For the best results and safe procedures, medical skin care must be performed by approved medical equipment under the supervision of a physician or medical personnel. Continuous control and guidance by the government is strongly needed.

Effectiveness of Endoscopic Management in Recurrent Hematospermia / 대한비뇨기과학회지

PURPOSE: To evaluate the usefulness and effectiveness of endoscopic management for recurrent hematospermia, we performed transurethral endoscopy of the seminal vesicles in patients with recurrent hematospermia, despite the administration of oral medication. MATERIALS AND METHODS: Sixteen patients were enrolled this study. Initially, all patients were treated with oral antibiotics for 6-8 weeks. Transrectal ultrasound (TRUS) and/or MRI were performed to find the anatomic abnormality and its relation with pelvic organs. The mean patient age and duration of symptoms were 43.9 years (range 24-64 years) and 21.3 months (range 1-108), respectively. We used a 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments for the seminal vesiculoscopic examination. Patients were followed for more than 12 months after the procedures. RESULTS: An endoscopic seminal vesicle examination was able to be successfully performed in all patients. A midline cyst was found at 10 cases, which were fulgurated. Endoscopic incisions or dilation of the ejaculatory duct were performed in all patients. An ejaculatory duct stone was found at 5 cases, and removed endoscopically. All patients reported improvement of hematospermia after the procedure, and 3 with perineal discomfort became symptom free. Postoperative complications, such as epididymitis, orchitis and ejaculatory abnormalities, were not observed in any patient. CONCLUSIONS: Transurethral endoscopic interventions of the seminal vesicles can be performed easily with a conventional 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments. Transurethral endoscopic managements were effective and safe treatment options in recurrent hematospermia patients.

Two Cases of Generalized Vitiligo after Allogeneic Stem Cell Transplantation / 대한피부과학회지

Generalized vitiligo associated with allogeneic bone marrow or stem cell transplantation has rarely been reported. We experienced two cases of generalized vitiligo after allogeneic bone marrow and stem cell transplantation. The first patient was received an allogeneic bone marrow transplantation and subsequent allogeneic peripheral blood stem cell transplantation for severe aplastic anemia from his sister. The second patient underwent allogeneic bone marrow transplantation for acute myelogeneous leukemia from his sister. Generalized vitiligo developed after transplantation. Neither vitiligo nor evidences of autoimmune diseases were found in their stem cell donors. Vitiligo was effectively treated with narrow band UVB irradiation.

Effects of Connexin Expression on Detrusor Overactivity in Male Patients with Bladder Outlet Obstruction Caused by Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Detrusor overactivity is frequently associated with bladder outlet obstruction, which may be related with increased electrical coupling. The effects of connexin 43(Cx43) and connexin 26(Cx26) mRNA expressions on the detrusor over activity were studied. MATERIALS AND METHODS: 36 male patients, with a bladder outlet obstruction due to benign prostatic hyperplasia(BPH), were subdivided into those with and without detrusor overactivity(DO) based on urodynamic studies: DO(+) and DO(-) group. All patients underwent a bladder biopsy during TUR-P. The symptoms, International Prostate Symptom Score (IPSS), prostate size, serum prostatic specific antigen(PSA) value and urodynamic parameters were compared between the two groups. The expressions of Cx43 and Cx26 mRNA in each group were analyzed by a reverse transcriptase polymerase chain reaction(RT-PCR). RESULTS: There were no differences in age, IPSS score, prostate volume, PSA and free Qmax between the DO(+) and DO(-) groups. The expressions of Cx43 and Cx26 mRNA in the DO(+) group were significantly increased compared with those in the DO(-) group. CONCLUSIONS: Our results show there is a change in the expressions of the Cx43 and Cx26 according to the bladder function, which may be related to detrusor overactivity in patients with a bladder outlet obstruction.

Changes of Urinary Prostaglandin in Male Patients with Lower Urinary Tract Symptoms

PURPOSE: Prostaglandin in the urinary bladder could be changed due to pathology of bladder and this change could be noted in the urine. This study was performed to investigate the changes in urinary prostaglandins in male patient with lower urinary tract symptom (LUTS). MATERIALS AND METHODS: The study groups included 60 male LUTS patients and 15 healthy male patients were used as the reference controls. Evaluation included history taking, urinalysis, IPSS and urodynamic study. The urinary concentration of prostaglandin E2 (PGE2) and prostaglandin F2alpha (PGF2alpha) in voided urine were analyzed by enzyme linked immunosorbent assay (ELISA) and these results were compared with control group. RESULTS: The IPSS scores of LUTS patients were higher than those of control patients. Also, detrusor overactivity was found in 30 patients and bladder outlet obstruction was found in 38 patients from urodynamic study. The urinary concentration of PGE2 was significantly increased in LUTS patients compared with control patients. The urinary concentration of PGF2alpha was not statistically significant between LUTS patients and control patients. The urinary concentration of PGE2 was decreased in LUTS patients with detrusor underactivity and negatively correlated to maximal bladder capacity. However, The urinary concentration of PGF2alpha was not correlated with IPSS and urodynamic parameters. CONCLUSION: Prostaglandins may play a role in lower urinary tract symptoms, and these changes can be detected in urine sample. Therefore, urinary PG may be used as a marker to evaluate lower urinary tract symptoms.

Malassezia Yeasts in Acne Vulgaris / 대한피부과학회지

BACKGROUND: Acne is a common follicular inflammatory dermatoses affecting sebaceous glands. It has been known that Malassezia, the lipophilic normal human skin flora, contribute to the development of acne lesion, but the detailed clinical features and effective treatment methods are lacking. OBJECTIVE: In order to elucidate clinical features and efficacy of antifungal treatment in acne associated with Malassezia, we conducted a prospective clinical study with mild to moderate acne patients. METHODS: Twenty eight patients (13 men and 15 women, mean age 19.1+/-4.4 years) with the acneiform eruptions on their face and upper trunk who showed Malassezia from comedo on the KOH/Parker ink examination (spore load 3+ over) were included in this study. Oral itraconazole, 200mg/day, was given at the beginning of treatment for one week. Clinical assessment for the acne lesions(Cunliffe score by Leeds technique and Global acne grading system) and mycological examination were done at the beginning, 2 and 4 weeks of treatment. RESULTS: Acne associated with Malassezia showed polymorphous eruption composed of open and closed comedo, inflammatory papules and pustules. Acneiform eruptions were found on the forehead(67%), cheek(64%), submental(60%) and temple area of the face. Among the patients, seborrhea(21%) and seborrheic dermatitis(14%) were accompanied. The acneiform eruption was aggravated during the summer season(18%). Systemic corticosteroids(14%) and menstruation(27% in women) were also mentioned as the aggravating factors. Systemic itraconazole significantly improved acne lesions from 2 weeks after treatment. CONCLUSION: The results imply that Malassezia should be examined in patients with mild to moderate acne on the face and upper trunk, simultaneously. Use of anti-Malassezia agent such as itraconazole can be considered as an initial treatment in those patients.

Three Cases of Earlobe Keloids Treated with Carbon Dioxide Laser Vaporization and Pressure Earring after Partial Keloidectomy / 대한피부과학회지

Keloid is proliferative fibrous growths that result from an excessive tissue response to trauma. The earlobe is a common site for the formation of keloid and the frequent cause is ear piercing. Many modalities are available for the treatment of earlobe keloid. Surgical excision has been the most commonly used therapeutic modality but recurrence following excision is common. Intralesional triamcinolon, radiation therapy, compression device, cryosurgery, D-penicillamine or any combination of them were reported to be successful in the treatment of earlobe keloid. We report three cases of earlobe keloid treated with partial surgical keloidectomy of upper part and carbon dioxide laser vaporizing the residual keloid tissue. And then the defect was covered with a primary closure with flap. Pressure earrings were fitted 2 weeks after surgery, and were maintained for 3 months. There was no recurrence of keloid for follow-up period at least 9 months. We suggest that combined modality of CO2 laser vaporization and pressure earring after surgical keloidectomy may offer a better cosmetic and functional improvement in the treatment of primary and recurrent earlobe keloid.

Low-dose UVA1 Phototherapy for Localized Scleroderma / 대한피부과학회지

Localized scleroderma(LS) is sclerosis of the skin characterized by one or multiple circumscribed ivory-white, indurated, sometimes confluent plaques. It has been reported that LS might result from the unbalance between synthesis and degradation of collagen in the dermis. Recently, treatment of LS with long wave UVA1, which can induce mRNA of matrix metalloproteinase-1 from dermal fibroblast and can cause apoptosis of infiltrating T lymphocytes, showed promising results. In this case, a 14-year-old girl had a 6 month history of linear, brown colored, indurated plaque on her left thigh compatible with LS histopathologically. UVA1(2.4-10.8J/cm2) was irradiated to the skin lesion at each visit, a total of 68 times for 18 months with the cumulative dose of 533J/cm2 UVA1. Her fibrotic skin lesion was resolved during treatment, but became hardened with cessation of phototherapy. She remains disease free for 11 months. We report a case of LS with improvement with low-dose UVA1 phototherapy.

Laparoscopic Radical Prostatectomy / 대한비뇨기과학회지

We report our initial experiences of a laparoscopic radical prostatectomy through an intraperitoneal approach. Two patients with an adenocarcinoma of the prostate underwent operations. The procedures for achieving a complete removal, vesicourethral anastomosis, operative time, blood loss, hospital stay, pathologic findings, continence, and potency were evaluated in both cases. Complete removals of the prostates and seminal vesicles were achieved in both cases. Reconstructions of the bladder neck with a watertight anastomosis were successful. The surgery time was 9 hours and 5 minutes, 6 hours and 30 minutes in each, with an estimated blood loss of approximately 800 and 400cc. The hospital stay was 15 days and 12 days. The final pathologic evaluation was a stage T3a (Gleason score; 7) and stage T2a (Gleason score; 6) disease with a negative margin. A laparoscopic radical prostatectomy is feasible and offers an advantage over open surgery with regard to the length of stay, convalescence time, cosmetic results, continence, and potency.

Laparoscopic Radical Prostatectomy / 대한비뇨기과학회지

We report our initial experiences of a laparoscopic radical prostatectomy through an intraperitoneal approach. Two patients with an adenocarcinoma of the prostate underwent operations. The procedures for achieving a complete removal, vesicourethral anastomosis, operative time, blood loss, hospital stay, pathologic findings, continence, and potency were evaluated in both cases. Complete removals of the prostates and seminal vesicles were achieved in both cases. Reconstructions of the bladder neck with a watertight anastomosis were successful. The surgery time was 9 hours and 5 minutes, 6 hours and 30 minutes in each, with an estimated blood loss of approximately 800 and 400cc. The hospital stay was 15 days and 12 days. The final pathologic evaluation was a stage T3a (Gleason score; 7) and stage T2a (Gleason score; 6) disease with a negative margin. A laparoscopic radical prostatectomy is feasible and offers an advantage over open surgery with regard to the length of stay, convalescence time, cosmetic results, continence, and potency.

Contact Dermatitis due to Ketoprofen Patch(Ketotop(R)) / 대한피부과학회지

Ketoprofen is an nonsteroidal anti-inflammatory drug derived from propionic acid. It has been widely used as topical preparations, as gel or patch. It has been reported that topical ketoprofen can cause contact dermatitis and photocontact dermatitis. We experienced five cases of contact dermatitis, developed after applying ketoprofen patch(Ketotop(R), Pacific pharmaceutical Co., Korea) for the control of oste omuscular or joint pain. While one patient had generalized urticarial eruption, the rest of patents showed localized erythematous pruritic eczematous skin eruptions. It was verified through intradermal skin test and pin prick test that ketoprofen itself was not the causative drug for the skin eruption. Patch test excluded the possibility of allergic skin reaction to rubber compounds. It should be elucidated which compounds are allergic or toxic to the skin, contained in woven fabrics.

Significance of Blood TNF-alpha and Interleukin 10 Levels in Vibrio Vulnificus Cytolysin Toxemia / 대한피부과학회지

BACKGROUND: Pro-inflammatory cytokines, such as tumor necrosis factor(TNF)-alpha and interleukin (IL)-1, have been incriminated in the pathogenesis of septic shock in animals and humans. IL-10 reduces the release of pro-inflammatory cytokines, nitric oxide and reactive oxygen species. IL-10 prevents endotoxin-induced toxicity. OBJECTIVE: The aim of this study was to investigate the relation between IL-10 and TNF-alpha in toxemic mice according to concentrations of V. vulnificus cytolysin. METHODS: First, after administration of V.vulnificus cytolysin(2, 4, 6, 8, 10 hemolytic units; HU) and physiologic saline through a mouse tail vein, we obtained blood samples from the heart at 60 minutes which was a peak time of IL-10 and TNF-alpha release. We measured serum concentration of circulating TNF-alpha and IL-10 using commercially available enzyme-linked immunosorbent assay methods. Second, after administration of 1,000U recombinant mouse IL-10 through a mouse tail vein 30 min before infusion of the lethal dose(8HU) of V. vulnificus cytolysin. We obtained blood samples from the heart at 60 minutes and measured serum concentration of circulating TNF-alpha level. RESULTS: Both IL-10 and TNF-alpha levels were significantly correlated with V. vulnificus cytolysin concentration(P=0.002). TNF-alpha levels were 76.9+/-9.5 pg/ml in 2HU, 315.8+/-39.8 pg/ml in 4HU, 426.1+/-27.9 pg/ml in 6HU, 931.3+/-22.3 pg/ml in 8HU, 1825.2+/-18.8 pg/ml in 10HU and 23.6+/-5.1 pg/ml in physiologic saline. IL-10 levels were 80.2+/-21.5 pg/ml in 2HU, 244.4+/-35.4 pg/ml in 4HU, 382.2+/-22.6 pg/ml in 6HU, 740.1+/-33.0 pg/ml in 8HU, 997.3+/-16.8 pg/ml in 10HU and 35.8+/-15.0 pg/ml in physiologic saline. After administration of 1,000U recombinant mouse IL-10, comparing to control group(931.3+/-22.3 pg/ml), TNF-alpha level was reduced to 307.2+/-23.9 pg/ml(P=0.003). CONCLUSION: IL-10 has an inhibitory effect on the production of TNF-alpha although it is released together with TNF-alpha in toxemic mice. IL-10 blood levels are directly related to the severity of toxemia. We conclude that IL-10 is a prognostic factor for the development of sepsis and might be used for the treatment of sepsis.

A case of Human Herpesvirus 8 Related Kaposi's Sarcoma in a Patient with Iatrogenic Cushing's Syndrome / 대한피부과학회지

Kaposi's sarcoma(KS) is a multicentric proliferative vascular tumor involving cutaneous and visceral tissues. KS was one of the first recognized manifestations of AIDS. A 71-year-old woman was seen with multiple violaceous nodules and painful erythematous cellulitis-like swelling on both lower legs. Easy bruising and senile purpura was also noted on her forearms. She had been suffered from lower back pain for 7 years, and had been treated with corticosteroids. Clinical picture and hormonal study revealed that she had iatrogenic Cushing's syndrome. The histopathologic study from skin lesion showed abnormally proliferated and dilated vessels, vascular slits, spindle shaped cells in the entire dermis. Human herpesvirus 8(HHV-8) was detected by nested polymerase chain reaction(PCR) using the paraffin-embedded skin tissue. She received localized radiotherapy(50 Gray) to both lower legs with favorable response. But five months later, her skin lesions had recurred and progressed into more aggressive pattern mainly on her left lower leg. We report a rare case of human herpesvirus 8 related KS in iatrogenic Cushing's syndrome.

The Role of the Cytokines (IL-12, IFN-gamma) in the Generalized Shwartzman Reaction Induced by Vibrio Vulnificus Cytolysin / 대한피부과학회지

No Abstract Available.

Finger-Tip Unit in Korean Adults and It's Clinical Application According to Anatomical Sites / 대한피부과학회지

BACKGROUND: Dermatologic patients need advice on how much ointment or cream to apply, in particular topical corticosteroids. The instructions given to patients concerning topical therapy are frequently vague. OBJECTIVE: The aims of this study are to make simple guidelines on the topical application of ointments or creams for patients, parents, doctors and nurses, and to check the accuracy of these guidelines in practice. METHODS: The average height and weight according to the different age groups and sex were measured from Korean standard growth and developement chart. From this chart, their total body surface areas(BSA) were calculated using a standard nomogram. The length of the tips of their index fingers was measured; measuring from the distal skin-crease to the end of the finger. One finger-tip unit(FTU) was defined as the amount of ointment expressed from a tube nozzle with a 5 mm in diameter, covering from the distal skin-crease to the tip of the palmar aspect of the index finger. The average area of abdominal skin covered by one finger-tip unit, and that of one palm were measured by computer scanner(Hurapack scanner, 4C) and image analyzed program(Image Pro. Plus(R) V. 3.0, Micromedical). Each patient then placed his or her right hand lightly, palm side down with the fingers and thumb closed, onto Hurapack scanner 4C. A tracing of the outer edge of the hand was made from the ulnar to radial styloid by photoshop program. The outlined area and enclosed area were measured by an image analyzer. RESULTS: 1. The average length of each finger-tip was 2.48+/-0.2cm in males and 2.24+/-0.13cm in females. 2. The average weight of one FTU was 0.46+/-0.03g in males and 0.40+/-0.02g in females. 3. The average area of palm was 145+/-12.4cm2 in males and 115.9+/-10.1cm2 in females. 4. The average area of abdominal skin covered by one FTU was 278+/-34.4cm2; The average area was 303+/-24.3cm2 in males and 253+/-21.9cm2 in females. 5. The number of FTU of adult male required to treat various anatomical sites was : face and neck, 2.6; trunk and buttock, 10.5; arm and hand, 5; leg and foot, 10. The number of FTU of adult female was : face and neck, 2.8; trunk and buttock, 11; arm and hand, 5.5; leg and foot 11. 6. The number of FTU of children required to treat each anatomical site was variable because of differential growth according to different age. CONCLUSION: The concept of FTU provides convenient means of rapidly assessing the approximate amount of ointment or cream required for the treatment of patients.

A Case of Angiocentric T-cell Lymphoma / 대한피부과학회지

A 40-year-old female patient, known angiocenteric T-cell lymphoma on nasal cavity, was transfered from the department of hemato-oncology for the evaluation of egg sized pinkish-yellow indurated mass with central necrotic tissue on the left medial elbow. Histopathologic findings revealed angiocentric, angioinvasive, and angiodestructive infiltrate containing atypical lymphocytes. The infiltrative cells were positivly stained with antibody to CD45RO, LCA, but not with antibody CD20. The atypical infiltrated perivascular lymphoid cells were positive to Epstein-Barr virus in situ polymerase chain reaction. She was treated with combined chemotherapy and radiation therapy, but she died due to sepsis. We herein report a rare case of angiocentric T-cell lymphoma on the nasal cavity and skin associated with Epstein-Barr virus.

Three Cases of Iinear Focal Elastosis / 대한피부과학회지

Linear focal elastosis is a new disease that clinically shows asymptomatic, palpable, striae-like lines extending horizontally across the middle and lower back and histologically a focal increase in elastic fibers separating the dermal collagen bundles. We report typical cases of linear focal elastosis clinically and histologically in three teenaged males.

A Case of Cervical Tab / 대한피부과학회지

Cervical tab is one of rare developmental anomalies of the brachial apparatus which appears as firm, protruding papule or nodule on the neck along the line of anterior border of the sternocleidomastoid muscle. A 5 year-old male patient developed a pea sized, movable, semi-solid mass on the lower portion of right sternocleidomastoid muscle area. On microscopic examination, well-marginated oval shaped cartilage was present. Individual cells in the lacunae had ample cytoplasm and eccentric nucleus. Verhoeff-van Gieson stained section of the mass showed cartilage with a rich elastic network in the matrix, most heavily concentrated about the chondrocyte. We report a rare case of cervical tab manifesting as a skin-colored nodule on the sternocleidomastoid muscle area.

Changes of Whole Blood Glucose Level in Toxemic Mice Induced by Vibrio vulnificus Cytolysin / 대한피부과학회지

BACKGROUND: Vibrio(V.) vulnificus is a pathogenic, marine, halophilic, gram-negative bacillus which causes fulminant septic shock. Shock can be complicated by occurrence of hypoglycemia, which is caused by an unbalance between glucose production and consumption. Metabolic changes, especially glucose metabolism, in septic shock caused by V. vulnificus are not well clarified yet. OBJECTIVE: Our purpose was to investigate the changes of blood sugar level after intravenous administration of V. vulnificus cytolysin which is known to be a major virulent factor for elucidating pathogenesis of septic shock. METHODS: After administration of the lethal dose(8 hemolytic units)of V. vulnificus cytolysin through mouse tail vein in non-fasting and fasting group, we obtained blood samples from heart according to time courses of every thirty minutes. We measured whole blood glucose level using commercially available blood glucose meter. RESULTS: The level of blood glucose increased until 90 minutes, began to decrease at 120 minutes, and fell to baseline at 360 minutes in non-fasting mouse group. In fasting group, although elevation of blood glucose level was not observed in early stage of toxemia, hypoglycemia was nearly concordant with non-fasting group in late stage of toxemia. CONCLUSION: Hypoglycemia should be checked in patients with V. vulnificus sepsis. Failure to recognize and treat the hypoglycemia may contribute to the prognosis of these patients.