A Case of Breast Reduction with Pure Tumescent Liposuction / 대한피부과학회지

Patients with macromastia have physical discomfort including head, neck, and shoulder pain, wet skin fold/eczema, intractable mastalgia, and restricted exercise. They also have cosmetic problems and psychiatric discomfort. In Korea, excisional breast reduction is the main treatment option for macromastia, but breast reduction with pure tumescent liposuction is becoming a new treatment option in western society. Breast reduction with pure tumescent liposuction has multiple advantages including safety, no general anesthesia, outpatient procedure, minimal scaring, no loss of nipple sensation and the possibility of breast feeding. We report a case of macromastia treated by pure tumescent liposuction without any sedation. We hope that this article may help Korean dermatologists to understand about breast reduction using pure tumescent liposuction and expand the field of dermatologic surgery in Korean society.

Wall Structure and Composition Changes of Primary Varicose Veins of the Legs: A Histopathologic Study / 대한피부과학회지

BACKGROUND: Many factors have been implicated in the etiology of varicose veins. Among them, the most widely advanced are weakness of the vascular wall due to defective smooth muscle and connective tissue metabolism, dysfunction of the endothelium, valvular incompetence, and hemodynamic stress. However, the etiology remains unclear. OBJECTIVE: This study was performed to analyze the wall structure and composition changes of primary varicose veins of the legs. METHODS: Varicose vein samples were collected from 13 patients having primary varicose veins who underwent ambulatory phlebectomy. Control veins(below the age of 50 years) were collected from 2 patients with no history or clinical evidence of varicose vein. Samples were stained with hematoxylin and eosin, Masson's Trichrome, Van Gieson stains and immunohistochemical stains for collagen type IV, alpha-smooth muscle actin antigen were performed. Tissue samples were examined by light microscopy for comparative histological changes and different components of the varicose vein wall as compared to control veins. RESULTS: In the varicose vein, there was intimal hypertrophy in almost all the sections examined. The thickness of intima varied at different places. There were hyperplasia of smooth muscle cell and collagen in the varicose vein. Collagen type IV exhibited an accumulation especially in the subendothelial region of varicose vein. CONCLUSION: Dilatation and varicosities are not due to deficiency in the vein wall components, but rather to hemodynamic response. Modulation in the extracellular proteins may be the cause for the development of varices.

A Study On Prevalence of The Elevated Transaminase(AST, ALT) and Hepatitis B, C Viral Markers in Dermatologic Patients / 대한피부과학회지

BACKGROUND: Recently, in dermatologic area, the number of skin biopsy for diagnosis and treatment has been increased and the dermatosurgery which should give patients satisfaction developed widely. As the frequency of direct contact with patients increases, we must recognize and prevent infectious diseases such as hepatitis B and C. Also, because drugs which may affect function of liver were used in many medical clinics and shops, we have more chance of evaluating liver function before the treatment. OBJECTIVE: We investigated the prevalence and associated diseases of the patients with elevated transaminase (AST,ALT), positive of hepatitis B surface antigen and anti-HCV Ab. And we tried to study the causes of elevated transaminase. METHOD: All the 1704 outpatients who visited the dermatologic clinic of Pusan National University Hospital from March 1996 to February 1999 were enrolled. AST and ALT level were assessed by kinetic method and elevated group comprised the subjects with AST and ALT levels exceeding the upper limit of normal for our laboratories (AST >40IU/L or ALT >37IU/L). HBsAg and anti-HCV Ab were tested by enzymeimmunoassay(EIA) and medical records were reviewed. RESULTS: The prevalence of elevated transaminase was 13.6% and the peak age was the sixth decade. Most common associated disease categories were drug druption, eruption & urticaria. The prevalence of positive hepatitis B surface antigen was 9.7% and the peak age was the fourth decade (42.4%). Associated diseases of antigen positive patients were lichen planus, urticaria, cryoglobulinemia, etc. The prevalence of positive anti-HCV Ab was 3.4% and the sixth decade was the peak incidence of age distribution. The diseases such as urticaria, erythema nodosum, psoriasis, alopecia, and so on were investigated in the patients. Common suspected causes of elevated transaminase(AST, ALT) were hepatotoxic drug and viral hepatitis. Conclusion: Increased hepatic parenchymal enzyme was investigated in a high percentage of studied patients. Also, the prevalence of HBV and HCV infection in dermatologic patients were relatively higher than that of reported normal Korean people. Therefore dermatologists should recognize these facts and be careful in dermatologic procedure.