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Background@#Primary cicatricial alopecia (PCA) is a rare disease that causes irreversible destruction of hair follicles and affects the quality of life (QOL). @*Objective@#We aimed to investigate the disease awareness, medical use behavior, QOL, and real-world diagnosis and treatment status of patients with PCA. @*Methods@#A self-administered questionnaire was administered to patients with PCA and their dermatologists. Patients aged between 19 and 75 years who visited one of 27 dermatology departments between September 2021 and September 2022 were included. @*Results@#In total, 274 patients were included. The male-to-female ratio was 1:1.47, with a mean age of 45.7 years. Patients with neutrophilic and mixed PCA were predominantly male and younger than those with lymphocytic PCA. Among patients with lymphocytic PCA, lichen planopilaris was the most common type, and among those with neutrophilic PCA, folliculitis decalvans was the most common type. Among the total patients, 28.8% were previously diagnosed with PCA, 47.0% were diagnosed with PCA at least 6 months after their first hospital visit, 20.0% received early treatment within 3 months of disease onset, and 54.4% received steady treatment. More than half of the patients had a moderate to severe impairment in QOL. Topical/intralesional steroid injections were the most common treatment. Systemic immunosuppressants were frequently prescribed to patients with lymphocytic PCA, and antibiotics were mostly prescribed to patients with neutrophilic PCA. @*Conclusion@#This study provides information on the disease awareness, medical use behavior, QOL, diagnosis, and treatment status of Korean patients with PCA. This can help dermatologists educate patients with PCA to understand the necessity for early diagnosis and steady treatment.
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Background and Objectives@#Human induced pluripotent stem cell (hiPSC)-derived cardiomyocyte (CM) hold greatpromise as a cellular source of CM for cardiac function restoration in ischemic heart disease. However, the use of animal-derived xenogeneic substances during the biomanufacturing of hiPSC-CM can induce inadvertent immune responses or chronic inflammation, followed by tumorigenicity. In this study, we aimed to reveal the effects of xenogeneic substances on the functional properties and potential immunogenicity of hiPSC-CM during differentiation, demonstrating the quality and safety of hiPSC-based cell therapy. @*Methods@#and Results: We successfully generated hiPSC-CM in the presence and absence of xenogeneic substances(xeno-containing (XC) and xeno-free (XF) conditions, respectively), and compared their characteristics, including the contractile functions and glycan profiles. Compared to XC-hiPSC-CM, XF-hiPSC-CM showed early onset of myocyte contractile beating and maturation, with a high expression of cardiac lineage-specific genes (ACTC1, TNNT2, and RYR2) by using MEA and RT-qPCR. We quantified N-glycolylneuraminic acid (Neu5Gc), a xenogeneic sialic acid, in hiPSC-CM using an indirect enzyme-linked immunosorbent assay and liquid chromatography-multiple reaction monitoring-mass spectrometry. Neu5Gc was incorporated into the glycans of hiPSC-CM during xeno-containing differentiation, whereas it was barely detected in XF-hiPSC-CM. @*Conclusions@#To the best of our knowledge, this is the first study to show that the electrophysiological function andglycan profiles of hiPSC-CM can be affected by the presence of xenogeneic substances during their differentiation and maturation. To ensure quality control and safety in hiPSC-based cell therapy, xenogeneic substances should be excluded from the biomanufacturing process.
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Objective@#Financial hardship influences depression risk, however, the pathway of the effect of financial hardship on depression and the role of self-esteem remain unclear. This study examined whether changes in financial hardship affected depression, and whether self-esteem mediated by this relationship. @*Methods@#Data from 99,588 observations of 15,331 individuals were extracted from 10 waves of the Korean Welfare Panel Study. The association between changes in financial hardship and depression was investigated using a generalized estimation equation, and the extent to which these associations were mediated by self-esteem was assessed. @*Results@#The results indicated that changes in financial hardship were associated with depression, with varying magnitude. Experiencing severe financial hardship over two consecutive years (odds ratio [OR]: 3.87, 95% confidence interval [CI]=3.09–4.85) or increased financial hardship over the previous year strongly influenced depression (e.g., OR: 3.88, 95% CI=3.09–4.86 for low financial hardship at t-1 year and high at t year). Self-esteem plays a mediating role in the relationship between changes in financial hardship and depression, where persistent financial hardship is associated with low self-esteem, leading to depression. @*Conclusion@#These findings highlighted the importance of monitoring and intervention for financial hardship and psychological problems to help manage depression.
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Insulin resistance is the pivotal pathogenic component of many metabolic diseases, including type 2 diabetes mellitus, and is defined as a state of reduced responsiveness of insulin-targeting tissues to physiological levels of insulin. Although the underlying mechanism of insulin resistance is not fully understood, several credible theories have been proposed. In this review, we summarize the functions of insulin in glucose metabolism in typical metabolic tissues and describe the mechanisms proposed to underlie insulin resistance, that is, ectopic lipid accumulation in liver and skeletal muscle, endoplasmic reticulum stress, and inflammation. In addition, we suggest potential therapeutic strategies for addressing insulin resistance.
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Spinal epidermoid cysts are extremely rare benign tumors and can be congenital or acquired.Acquired spinal epidermoid cysts are found in the lumbosacral region. To our knowledge, no case of epidermoid cyst related to spinal cord stimulator insertion has yet been reported. We report the MRI findings of a rare case of thoracic intradural epidermoid cyst acquired after spinal cord stimulator insertion in a 50-year-old female.
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Immune checkpoint inhibitor (ICI), including programmed cell death protein 1 and cytotoxic T-lymphocyte-associated protein 4 inhibitors, has emerged as a pillar in the management of advanced malignancies. A drug-induced sarcoidosis-like reaction (DISR) is a rare cutaneous adverse event of ICI. A 47-year-old male presented with one-month history of a solitary erythematous nodule on his forehead. He had been diagnosed with metastatic adenocarcinoma of the lung and was treated with nivolumab and ipilimumab for three months. Histological findings revealed multinucleated giant cells forming non-caseating granulomas with moderate peripheral lymphocyte infiltration in the dermis. Also, new hilar lymphadenopathy of the lung was identified in a systemic evaluation. Given the temporal relationship with ICI treatment, the final diagnosis was ICI-induced sarcoidosis-like reaction. To our knowledge, this is the first report of a case of DISR that developed following ICI treatment in the dermatologic literature in Korea.
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Objective@#: People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. @*Methods@#: We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). @*Results@#: This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. @*Conclusion@#: The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.
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Ascariasis is an intestinal disease caused by Ascaris lumbricoides. Most patients with ascariasis are asymptomatic; however, the presence of many larvae in the bowel can cause gastrointestinal complications, such as intestinal obstruction, obstructive jaundice, cholangitis, cholecystitis, and pancreatitis. Herein, we report a case of ascariasis presenting as hematoma and active bleeding in the sigmoid mesocolon of a 74-year-old man on computed tomography (CT). Sigmoid colon perforation was also detected on follow-up CT. Laparoscopic low anterior resection was performed; there was a large hematoma in the sigmoid mesocolon. Roundworms were microscopically identified in the mesenteric adipose tissue. The clinical and CT findings of this unusual presentation of ascariasis revealed serial complications during parasite migration from the intestinal lumen to the peritoneal cavity.
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Ascariasis is an intestinal disease caused by Ascaris lumbricoides. Most patients with ascariasis are asymptomatic; however, the presence of many larvae in the bowel can cause gastrointestinal complications, such as intestinal obstruction, obstructive jaundice, cholangitis, cholecystitis, and pancreatitis. Herein, we report a case of ascariasis presenting as hematoma and active bleeding in the sigmoid mesocolon of a 74-year-old man on computed tomography (CT). Sigmoid colon perforation was also detected on follow-up CT. Laparoscopic low anterior resection was performed; there was a large hematoma in the sigmoid mesocolon. Roundworms were microscopically identified in the mesenteric adipose tissue. The clinical and CT findings of this unusual presentation of ascariasis revealed serial complications during parasite migration from the intestinal lumen to the peritoneal cavity.
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Background@#Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. @*Objective@#We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. @*Methods@#An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). @*Results@#Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. @*Conclusion@#Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure.
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Human angiotensin-converting enzyme 2 (hACE2) has recently received a great attention due to it play a critical role as SARS-CoV receptor in the infection of human body. However, no further analysis for gene regulation has been performed in target tissues of model mice during hACE2 overproduction. To characterize changes in global gene expression in the hearts and kidneys of rtTA/hACE2 double transgenic (dTg) mice in response to hACE2 overexpression, total RNA extracted from these tissues from dTg mice after doxycycline (Dox) treatment was hybridized to oligonucleotide microarrays. Briefly, dTg mice were generated by cross-mating pα-MHC/rtTA Tg mice with pTRE/hACE2 Tg mice. The expression level of hACE2 protein was determined to be high in hearts, kidneys, and brains of dTg mice, whereas lung, liver, and testis tissues expressed low levels. The level of hACE2 was significantly enhanced in hearts and kidneys of the Dox+dTg group compared to that in Vehicle+dTg mice although consistent levels of mouse ACE2 (mACE2) remained in the same tissues. Based on the microarray analysis of heart tissue, 385 genes were differentially expressed, including 168 upregulated and 217 downregulated, when comparing non-Tg and Vehicle+dTg mice, whereas 216 genes were differentially expressed, including 136 upregulated and 80 downregulated, between Vehicle+dTg and Dox+dTg mice. In the kidneys, 402 genes were differentially expressed, including 159 upregulated and 243 downregulated, between non-Tg and Vehicle+dTg mice. Dox-treated dTg mice exhibited the differential expression of 4735 genes including 1636 upregulated and 3109 downregulated. Taken together, these findings suggested that several functional groups and individual genes can be considered biomarkers that respond to hACE2 overexpression in dTg mice. Moreover, our results provided a lot of useful information to predict physiological responses when these dTg mice are applied as a susceptible model for novel coronavirus (SARS-CoV, COVID-19) in both vaccine and drug development.
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Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
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Background@#In recent years, large amounts of data generated by patients have been accumulated on social media.We explored patients’ perspectives and experiences with vitiligo using web scraping data from the open internet community, NAVER Cafe. @*Objective@#To understand patients’ real concerns and thoughts about vitiligo. @*Methods@#Using vitiligo as a keyword, 1000 posts on NAVER Cafe were collected and categorized as follows: requests for recommendations for dermatology clinics; inquiries regarding vitiligo diagnosis, disease characteristics of vitiligo, and management of vitiligo; and advertisements. Essential contents were collected for each category to summarize patients’ perspectives and experiences. @*Results@#Of the 1000 posts, 284 were requests for clinical recommendations, 203 inquiries for diagnosis of their white spots, 132 inquiries regarding characteristics of vitiligo, 118 described experiences and emotions related to vitiligo, 105 inquiries regarding management of vitiligo, 103 advertisements, and 55 not related to vitiligo.Concerning the authors, 209 and 522 posts were written by patients and parents of children with vitiligo, respectively. @*Conclusion@#Patients with vitiligo have considerable concerns regarding their condition and actively communicate with each other through social media. Data mining on social media can provide a deeper understanding of patients’ thoughts and emotional distress with vitiligo as well as their families’.
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Primary breast carcinoma with neuroendocrine features is an extremely rare and underrecognized subtype of the breast carcinoma. And up to present, its biologic behavior, the most effective treatment, and prognosis are not well recognized. To diagnose this rare entity, special tumor stains of neuroendocrine markers are required, which are not routinely used. The imaging features of primary breast carcinoma with neuroendocrine features (BCNF) have not been accurately described due to the extreme rarity of this tumor type. We report the imaging features in a case of BCNF, with imaging findings different from the typical imaging findings of invasive breast carcinoma.
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PURPOSE: To introduce novel findings of polypoidal choroidal vasculopathy (PCV) via optical coherence tomography angiography (OCTA) METHODS: This study is a retrospective chart review of 16 patients (16 eyes) with PCV. OCTA (Avanti RTVue XR) findings were evaluated and selected for analysis after agreement by two retina specialists . RESULTS: Twenty one polyps in 16 eyes (16 patients) with PCV were included in this study. The mean patient age was 67 years (13 men and three women). The shape of polypoidal lesions on OCTA at initial were halo (five polyps), rosette (seven polyps), and vascular network (nine polyps). Eight months after anti-vascular endothelial growth factor treatment, in a total of four eyes, seven polyps could be followed up completely, the two halo type polypoidal lesions changed to rosette and vascular network type. The lesions of three rosette and two vascular network type lesions did not change in shape. In addition, the size of the polypoidal lesions (one among two halo types, two among three rosette types, and two among two vascular network types) decreased, but one halo type did not change and one rosette type increased in size on OCTA. CONCLUSIONS: En-face OCTA enabled us to categorize novel types of PCV with polypoidal lesions.
Subject(s)
Humans , Male , Angiography , Choroid , Endothelial Growth Factors , Polyps , Retina , Retrospective Studies , Specialization , Tomography, Optical CoherenceABSTRACT
In order to investigate the antioxidant effect of alkylhydroxide peroxidase (ahpC) of Helicobacter pylori (H. pylori) 26695, an ahpC-deficient mutant (H. pylori 26695 ahpC::cat) was generated. ahpC-deficient mutant was grown slowly at lower pressure of oxygen (5% oxygen) compared to the H. pylori 26695. Whole cell proteins isolated form H. pylori 26695 and H. pylori 26695 ahpC::cat were analyzed by MALDI-TOF and tandem-MS. The expression of 15 proteins, including Ppa, HypB, GrpE, Elp, RecA, GroES, Mda66, RibE, NapA, GlnA, BioB, TrxB, Tsf, FumC and Icd, was more than doubled in H. pylori 26695 ahpC::cat. Production of 10 proteins such as UreG, FabE, Adk, Pnp, OorC, AtpA, AtpD, Nqq3, Pfr, and TagD decreased below 50% in H. pylori 26695 ahpC::cat compared to the H. pylori 26695. In microarray analysis, 9 genes including sul1, amiE, frxA, fecA, hyuA, and katA increased in transcription level in H. pylori 26695 ahpC::cat compared to H. pylori 26695. A total of 24 genes, including flaB, protein kinase C inhibitor, cag16, pabC, and sabA, reduced in transcription. 27 genes, including HP0889, showed common expression changes in ahpC, katA, and sodB-deficient mutations. As a result of this study, there were not many genes whose expression was commonly changed by the deletion of each of the three major antioxidant enzymes of H. pylori. These results showed the functions and regulation of the three antioxidant enzymes were different in H. pylori.
Subject(s)
Antioxidants , Helicobacter pylori , Helicobacter , Microarray Analysis , Oxygen , Peroxidase , Protein Kinase C , Proteome , RibesABSTRACT
Myxoma is a benign mesenchymal neoplasm found in the heart, bone, and other soft tissues. However, myxoma of the external auditory canal is extremely rare. Since myxoma of the external auditory canal can be manifested as a part of the Carney complex, an autosomal dominant multiple familial neoplastic disorder, correct diagnosis and thorough investigation is important. We report a case of a 59-year-old man who presented to hospital with a complaint of growing mass within the right external auditory canal during one month. The surgical excision was done, and the histopathological examination revealed myxoma. In this article, we report the magnetic resonance imaging and computed tomography findings of the myxoma of the external auditory canal and correlate with the histopathological finding.
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Cavernous hemangioma of the breast is a rare benign vascular tumor. It is usually diagnosed as non-palpable mass during imaging examination, incidentally. Common sonographic finding of the breast hemangioma is a superficially located, oval shape, circumscribed margin mass. But the appearance of breast hemangioma is variable and it can be difficult to diagnose in preoperatively. Here, we report a 68-year-old female case with palpable breast mass and increased size on follow up ultrasonography.
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Retroperitoneal extraskeletal osteosarcoma is a rare tumor. Typical imaging findings include a soft tissue mass accompanied with internal calcifications. The authors encountered a case involving a 44-year-old woman with a large retroperitoneal extraskeletal osteosarcoma, without calcification, that mimicked a pancreatic tumor. The present report highlights computed tomography features of retroperitoneal extraskeletal osteosarcoma, followed by a brief literature review. It is challenging for radiologists to diagnose retroperitoneal masses. However, in patients who present with large retroperitoneal masses, combined with clinical information including the elevation of serum alkaline phosphatase levels, retroperitoneal extraskeletal osteosarcoma should be considered in the differential diagnosis, even if the mass does not exhibit a gross calcification on the imaging.
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A 52-year-old male complained of a painless, firm, and slow-growing mass in his right breast outer portion. The chest CT revealed a 3.3 cm-sized oval shaped, microlobulated, mild enhancing mass. Ultrasound showed a microlobulated marginated heterogeneous hypoechoic mass with internal vascularity and calcifications in the mass. On the ultrasound-guided core needle biopsy, the mass was confirmed as a benign granular cell tumor (GCT). The patient transferred to another hospital and underwent surgical removal of the lesion. GCT of the breast is uncommon and mostly benign neoplasm to originate from Schwann cell. Clinical and radiologic features of GCTs, including CT and ultrasound images, mimic malignancy and make diagnosis of GCT more difficult. The CT images of GCTs are much rarely reported. Physicians and radiologists must be aware of radiologic characteristics of this rare benign tumor for male breast, to avoid misdiagnosis this tumor for breast malignancy and overtreat.