The Impact of Body Weight Change on Bone Mineral Density of the Lumbar Spine in Perimenopausal Women: A Retrospective, One-year Follow-up Study / 가정의학회지

BACKGROUND: Low body weight was one of the risk factors of osteoporosis. Little is known about the correlation between body weight change and bone mineral density (BMD) in Korean women. Therefore, this study was designed to reveal the impact of body weight change on BMD of the lumbar spine in perimenopausal women. METHODS: 105 healthy perimenopausal women aged between 44 and 50 years old were enrolled from August 2002 to March 2009. BMD was measured by dual energy X-ray absorptiometry. Partial correlation coefficients between body weight change and BMD change were calculated after the adjustments for several variables. BMD changes among groups based on BMI and the percentage change in body weight during 1-year follow-up period were compared. RESULTS: At both baseline and year 1, BMD of lumbar spine tended to be associated more with body weight. There was a significant association between body weight change and BMD change in lumbar spine during 1-year follow-up period. The weight gain group relatively showed an increase in BMD of lumbar spines than weight loss group. There was no BMD change in BMI less than 23 kg/m2 group, but in case of BMI more than 23 kg/m2 group, BMD in weight gain group increased more than the weight maintaining group. CONCLUSION: This study demonstrated that body weight change is associated with change in BMD of lumbar spine in perimenopausal women especially if they are overweight.

A Case of Acute Biphenotype Leukemia after Diagnosis of Pulmonary Alveolar Proteinosis

We present the case of a 34-year-old man with acute biphenotype leukemia that co-expressed B-lymphoid and myeloid antigen after the diagnosis of pulmonary alveolar proteinosis (PAP). The diagnosis of PAP was established by Periodic Acid-Schiff reaction staining on the Video Associated Thoracoscope guided lung biopsy and biphenotype leukemia was revealed by immunohistochemical stains of the blasts harvested from the bone marrow biopsy. Supposedly, PAP follows a hematologic malignancy, yet this case shows the reverse sequence.

Effects of Lactic Acid and Sodium Pyrrolidone Carboxylic Acid on the Irritated Skin Reaction Induced by Sodium Lauryl Sulphate Patch Testing of Normal Persons and Atopic Dermatitis Patients / 대한피부과학회지

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.

A Case of Acquired Perforating Dermatosis Associated with Hepatocellular Carcinoma and Diabetic Nephropathy / 대한피부과학회지

Acquired perforating dermatosis is a perforating disorder associated with diabetic mellitus or renal failure, which is characterized by transepidermal elimination of altered collagen and by its occurrence in adult life. We present a case of acquired perforating dermatosis associated with hepatocellular carcinoma and diabetic nephropathy, who had multiple pruritic brownish papules and nodules on trunk and extremities for 2 months. Histological findings showed transepidermal channel containing fragmented collagen and elastic fibers. The skin lesions were disappeared one month after hepatic lobetomy. It indicates that hepatocellular carcinoma can be one of the etiological factors in the development of acquired perforating dermatosis.

The Study of Irritancy of Surfactants with Low Concentrations by Non-invasive Bioengineering Methods / 대한피부과학회지

BACKGROUND: The bioengineering methods for investigating irritant skin reaction have been developed for several decades to evaluate the irritation potential more objectively and quantitatively and obtain the information which is not obvious by the visual examination. OBJECTIVE: The purpose of this study was to compare the irritant skin reaction of three kinds of surfactants with various low concentrations which produce little reaction visually and investigative the threshold concentration that is reliable for a patch test. Also we investigated the sensitivity and the correlation between visual examination and bioengineering methods in four different concentrations of surfactants METHODS: Twenty healthy volunteers were patch tested with 0.01%, 0.05%, 0.1%, 1.0% of sodium lauryl sulfate(SLS), cetyl trimethyl ammonium chloride(CETAC), POE(20) sorbitan monolaurate (Tween-20) on the flexor side of the Lt. forearm. The result of patch test was evaluated by visual scoring, evaporimeter, colorimeter, and corneometer until 72 hours. RESULTS: 1. SLS, anionic surfactant, showed the highest irritation potential in visual scoring, TEWL, and skin color measurement. And CETAC, cationic surfactant, showed the greatest irritation in corneometer measurements than other surfactants. 2. TEWL was the most sensitive method for evaluation of skin irritation and correlated most closely with visual examination. 3. Concentration of surfactant higher than 0.1% showed to produce reliable and constant result of skin irritation as the experimental primary irritant. CONCLUSION: SLS is proved to be the most appropriate primary irritant for studying irritant contact dermatitis, and the degree and mode of skin irritation is different according to the concentration and kinds of surfactants. TEWL measurement is the most sensitive bioengineering method, which could detect early stages of irritation and correlate well with visual examination.

A Case of Contact Urticaria from a Latex Glove Occurred to an Operationg Room Nurse

The prevalence of latex allergies has been on the increase along with the greater use of rubber products in daily life, medical, dental and occupational settings. Allergic reactions to latex can take two clinical forms of either contact dermatitis or immediate hypersensitivity reactions, which are provoked by the natural latex proteins or chemical additives used in the manufacturing process, respectively. A 25-year-old female, an operating room nurse, complained of recurrent pruritic erythematous wheals on both hands after the wearing of latex rubber gloves. The prick test and the usage Mlit't to the latex gloves were positive, and the RAST was class 3. To the best of our knowledge, is the first case report of contact urticaria from latex rubber gloves in Korean dermatologic literature.

A Case of Malignant Melanoma Developed in Atypical Melanocytic Hyperplasia / 대한피부과학회지

No abstract available.

The Effect of All-Trans-Retinoic Acid on the Activity and the Gene Expression of Drug Metabolizing Enzymes in Rat Skin / 대한피부과학회지

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.

UVA Blocking Effect of Epidermal Melanin in Patients with Vitiligo

BACKGROUND: Ultraviolet light induces sunburn, aging of the skin, disorders of pigment and even promotes skin cancers. Melanin is known to have a protecting role in the skin by blocking ultraviolet light. OBJECTIVE: The purpose of this study was to evaluate UVA blocking effect of epidermal melanin and to compare UVA blocking effect among different anatomical sites. METHODS: From 20 vitiligo patients who had undergone an epidermal graft, we obtained epidermis of normal and vitiliginous skin and measured transmitted UVA energy density. RESULTS: The vitiliginous epidermis, devoid of melanin, blocked lower amount of UVA energy than the normal epidermis. 11.6% of irradiated UVA energy was blocked by epidermal melanin. No significant differences were observed in UVA blocking effect among different anatomical sites in normal and vitiliginous epidermis. CONCLUSION: Epidermal melanin has some UVA blocking effect. No significant differences were found in UVA blocking effect among different anatomical sites despite the differences in the density of melanin pigment among different sites of the body.