Use of Cream Containing Mucus Secreted by Snails Has an Anti-aging Effect on Skin / 대한피부과학회지

BACKGROUND: A cream made from mucus secreted by snails contains 80% mucin, as well as glycosaminoglycan, allantoin for skin rejuvenation, glycolic acid for keratin removal, and collagen and elastin, which are components of dermis. OBJECTIVE: The goal of the present study was to evaluate the efficacy of using cream containing mucus secreted by snails to reduce wrinkles, improve skin elasticity, restore dermal density, and lift the skin. METHODS: Cream containing mucus secreted by snails was applied to the lateral epicanthal areas and the left cheek of 10 subjects for 4 weeks twice per day. Wrinkles, skin elasticity, dermal density, and skin tightening were evaluated at baseline and 2 and 4 weeks. A patient survey was conducted at 4 weeks. RESULTS: There were statistically significant differences between baseline and 4 weeks after applying the cream in terms of wrinkles, skin elasticity, dermal density, and skin tightening (p<0.05). CONCLUSION: Use of cream containing mucus secreted by snails seems to be effective for anti-aging of the skin. Long term follow up studies, such as 3 or 6 months, to confirm the efficacy of the cream should be conducted involving a larger number of patients.

Comparative Study of 20% Aluminum Chloride Solution and Botulinum Toxin A Injection in the Treatment of Patients with Primary Palmar Hyperhidrosis / 대한피부과학회지

BACKGROUND: Primary hyperhidrosis carries a substantial psychological and social burden. Early detection and management can significantly improve a patient's quality of life. A large number of therapeutic options are used, such as the application of topical agents, iontophoresis, sympathectomy, and botulinum toxin injection. OBJECTIVE: We aim to comprehensively evaluate the effects of botulinum toxin type A and 20% aluminum chloride on primary palmar hyperhidrosis. METHODS: A total of 55 patients with clinical diagnosis of primary hyperhidrosis were treated by botulinum toxin type A and 20% aluminum chloride solution. To prospectively assess the effects on primary palmar hyperhidrosis, we checked corneometer at baseline, 2 and 4 months later. By regular meetings with patients, including telephone interviews, we analyzed patients' subjective satisfaction scores and complaints during the follow=up periods. RESULTS: During the 2-month period, as compared with that of the control group, the level of corneometer of both groups declined. In the 4-month period, the group treated with 20% aluminum chloride sustained a lower level of corneometer. In the questionnaire, in the 2-month period, the group treated with botulinum toxin resulted in a lower level of overall treatment scores than that of the group treated with 20% aluminum chloride. However, in the 4-month period, the group treated with aluminum chloride showed lower scores. CONCLUSION: Both botulinum toxin type A and aluminum chloride solution were safe and well tolerated, producing high levels of patient satisfaction. However, considering the long-term efficacy of treatment, aluminum chloride may be a more suitable mode of treatment for primary palmar hyperhidrosis.

Clinical Results and Histologic Change on Animal Model with Modified Uncut Roux Reconstruction after Gastrectomy

PURPOSE: The uncut Roux operation prevents the Roux stasis syndrome by preserving neuromuscular continuity between the proximal jejunum and the Roux limb, but this technique has an unacceptably high incidence of dehiscence of the staple lines with subsequent reflux gastritis or esophagitis. The authors designed a modified uncut procedure to avoid dehiscence of the staple lines. The aim of this study was to review whether this technique might be useful by examining the histologic change on animal study and the postoperative radiologic study of patients with modified uncut reconstruction. METHODS: Between February 1997 and December 2000, the UGI study was reviewed in 213 patients undergoing the modified uncut Roux reconstruction at Soonchunhyang University Hospital, Chunan, Korea, at 2 and 8 weeks after operation, to evaluate the incidence of dehiscence and the leakage of staple lines. Animal study included ten pigs, 5 underwent conventional uncut Roux procedure with staple, while the other 5 received reinforcing whole layer suture with black silk on the staple lines. The animals then underwent a second operation at 15 days after operation to evaluate histologic change and dehiscence of staple lines. RESULTS: Dehiscence and leakage were not found in any of the 213 patients undergoing modified uncut Roux reconstruction. In the animal study, 2 of 5 cases (40%) receiving conventional uncut Roux reconstruction had dehiscence, whereas dehiscence was absent in all 5 cases receiving modified uncut Roux reconstruction and these 5 animals showed more marked infiltration of inflammatory cells, vascular formation and more severe fibrosis on histologic examination. CONCLUSION: The conventional uncut Roux procedure suffer dehiscence of the staple lines with subsequent reflux gastritis or esophagitis. Therefore, modified uncut Roux reconstruction might prevent a jejunal leakage in the case of staple line dehiscence and might prevent dehiscence of staple lines.

Activation of Mouse Dendritic Epidermal T Cells(Vgamma5/Vdelta1 TCR+ T Lymphocytes) by Transformed Keratinocyte Cell Lines / 대한피부과학회지

BACKGROUND: Dendritic epidermal T cells(DETC) are skin specific members of the epithelial gammadelta-T cell family that reside normally in mouse epidermis. Although the mechanisms of antigen recognition by alpabeta-T cells have become better defined, the physiological role of the gammadelta-T cells and ligands they recognize are still poorly understood. OBJECT: In the present study we sought to elucidate the antigen specificity and whether the DETC recognize transformed keratinocyte derived antigen. METHOD: We used a DETC and TCR(-) DETC which were obtained by 1600R gamma-irradiation and sorting, in addition to transformed keratinocyte cell lines. We performed coculture experiments of DETC/transformed keratinocyte cell lines to detect direct evidence that DETC recognize the keratinocyte-derived antigen. RESULT: 1. TCR negative variants of DETC do not respond to concanavalin(Con)-A, but respond to phobol myristate acetate(PMA)/ionomycin. 2. PAM 212, UV-irradiated PAM 212 and heat shocked PAM 212 cells stimulate DETC. PAM 212 cells could perform as stimulator of DETC even in the absence of stress signal. 3. UV irradiated XB2 cells stimulate DETC, but XB2 and heat shocked XB2 cells could not stimulate DETC. 4. DETC do not respond to fibroblast, UV-irradiated fibroblast and heat shocked fibroblast 5. TCR negative variants of DETC are no longer stimulated by PAM 212 cells, suggests that PAM 212 cells mediate their effects through the TCR CONCLUSION: The above results strongly suggest that DETC recognize specific, transformed and stressed keratinocyte-derived antigens and may play a role as an immune surveillant for cellular damage. Therfore, DETC may play critical roles during the induction of immune reaction in the skin.

A Comparison Study of Prick Test and Chemiluminescent Assay / 대한피부과학회지

BACKGROUND: Prick test is most frequently used in clinical procedures because its simplicity and safety of application and better correlation with clinical history as well as specificity and high reproducibility. The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of radioallergosorbent test(RAST). The CLA permits quick, simultaneous detection of total and specific IgE in human serum. The CLA has shown good sensitivity, specificity, and a good correlation with the RAST and skin prick test. OBJECTIVE: The purpose of this study was to find causative allergens and to evaluate the clinical significance of CLA comparing the results of the CLA with those of the prick test in dermatologic outpatients. METHODS: We performed the prick test with 51 allergens(Bencard Ltd. Brentford, England) in 448 patients, and CLA with 35 allergens(Boehringer mannheim Korea. green cross inc.) in 280 patients with dermatologic diseases. RESULTS: 1. The positive reaction rate was highest in third decade and decreased over the age of 40 in prick and CLA. 2. The positive reaction rate of prick test(52.8%) was higher than that of CLA(25.0%). 3. The positive reaction rate to single allergens and compound allergens was 14.2% and 38.6% in the prick test and 2.5% and 22.5% in the CLA respectively. 4. In the prick test, the positive allergens, in descending order, were House dust 114(25.4%), D. farinae 88(19.6%), D. pteronyssinus 79(17.6%), Mixed inhalants 61(13.6%), and Threshing 47(10.5%). In the CLA Thistle 35(12.5%), Dandelion 31(11.1%), D. farinae 30(10.7%), D. pteronyssinus 29(10.4%), and Cat fur 12(4.3%). 5. The results of the CLA to common 2 allergens showed a concordance rate of 84.6%, sensitivity of 58.9%, and specificity of 86.1% compared with those of prick test. CONCLUSION: CLA may be a useful alternative method and shows a good correlation with the prick test. Combination of the two method results in a high diagnostic accuracy for the cause of allergic diseases.

A Case of Acquired Digital Fibrokeratoma Occurring on the Sole / 대한피부과학회지

Acquired digital fibrokeratomas are unusual benign solitary tumors of fibrous tissue that usually occur on the fingers and toes. We report a case of acquired digital fibrokeratoma with unusual involvement of the sole, a previously traumatic site, in a 57-year-old male. We treated it with a total surgical excision.

A Case of Cavernous Angioleiomyoma / 대한피부과학회지

Angioleiomyoma is a solitary subcutaneous tumor characterized by proliferation of vascular smooth muscle cells. Angioleiomyoma is classified into three histological subtypes; solid, venous and cavernous according to its dominant feature. The solid type is most common but the cavernous type is very rare. We report a case of cavernous angioleiomyoma in a 58-year-old male who complained of a tender tumor on the dorsum of his left hand.

A Case of Subacute Cutaneous Lupus Erythematosus / 대한피부과학회지

We present a case of subacute cutaneous lupus erythematosus which fulfilled the criteria of systemic lupus erythematosus in a 52-year-old woman with annular and polycyclic erythematous patches on the neck and upper part of the anterior chest. She complained malar of resh, arthralgia, general weakness, and severe headache. Laboratory findings showed hematologic, serologic, central nervous system, and nephrologic abnormalities. Serologic abnormalities of this patient were positive anti-nuclear antibody, anti-La antibody, rhematoid factor, anti-RNP antibody and anti-platelet antibody, but anti-dsDNA and anti-Ro antibody test were negative. She was treated with oral prednisolone and intravenous cyclophosphamide. In the course of treatment, sepsis developed and she died from multi-organ system failure.

A clicical study for alopecia totalis and alopecia universalis / 대한피부과학회지

BACKGROUND: Alopecia totalis and alopecia universalis are uncomman and developed from 5-10% of the patients with alopecia areata. OBJECTIVE: The authors perfcirmed a study for clinical obervations and the effects of treatments of alopecia totalis and alopecia universalis in order that this study may cointribute to further studies and treatments of them. MEHTODS: The author performed a clinical study of 42 patients with alopecia totalis and alopecia universalis retrospectively in order to evaluate the clinical manifestation. and the effects of treatments from January 1984 to March 1992 at the department of Dermatology, College of Medicine, Chung Ang University. RESULTS: 1. The incidence of alopecia totalis and alopecia universalis was 6.7% (42/623) among the alopecia patients who were occtipied 1.4% (623/44,839) among the all new dermatologic out patients. 2. The age distributions at the onset of disease showed a peak incidenced an age of less than 15 years (52.4%, 22/42) and the average age was 19.7 years. 3. The laboratory fi ndings showed decreased total T cell count in 1 case(1/10), inversed T/T ratio in 6 cases(6/10), poisitive anti-thyroglobulin anti-body in 3 cases(3/11), and abnormal serum levels of testosterone, esradiol and progesterone in 5 cases(5/22), 2 cases(2/14) and 8 cases(8/13), respectively. 4. The effects in the group treated with topical immunotherapy with DPCP(2,3-diphenylcyclopropenone) or DI CB(2,4-dinitrochlorobenzene) revealed no significant difference from those in the group treated with an intralesional injection of triamcinolone acetonide. 5. The response rates to treatment were make ily higher in the patients with alopecia totalis than alopecia uriiversalis, in cases where the duration of disease was less than 5 years, and in the patients associated with psychologic stress. CONCLUSION: These results suggested that alopecia totalis and alopepia aniversalis frequently occur in children, and some of them we eassociated with cell mediated immunity defects, autoantibody and endocrine factors. The patients with alopecia totalis, with short duration if disease and associated with emotional stress showed better therapeutic responses.