Therapeutic Efficacy of Bone Marrow Derived Mesenchymal Stem Cells in Ototoxic Sensorineural Hearing Loss / 대한이비인후과학회지

Background and Objectives@#Ototoxic sensorineural hearing loss causes permanent hearing loss in most cases. Recently there have been many reports describing cell base therapy with stem cells that has some effect on hearing recovery. We evaluated the efficacy of clinical grade, pre-made, human bone marrow derived mesenchymal stem cells (BM-MSCs) in ototoxic deaf animal model.Materials and Method BM-MSCs were cultured in a clinical grade laboratory. The animals were divided into 2 groups as follows: a saline injected control group and a stem cell injected group (MSC-group). Cultured MSCs were transplanted into the brachial vein of the deaf mice model. We recorded auditory brainstem response (ABR) and conducted immunohistochemistry at 1, 3, and 5 weeks. @*Results@#After the transplantation of MSC, a significant improvement in the hearing threshold of ABR was observed in the MSC transplanted group. Five weeks after transplantation of MSCs, hair cell regeneration was confirmed from the basal to the apex of the cochlea in fluorescent dyed image under the microscope compared to the control group. @*Conclusion@#BM-MSCs were effective in an acute ototoxic deaf animal model. These results show that stem cell transplantation mediate inner ear regeneration.

Pyoderma Gangrenosum Associated with Idiopathic Myelofibrosis / 대한피부과학회지

Pyoderma gangrenosum is a rare, recurrent, painful and ulcerative skin disorder of unknown etiology, but is commonly associated with a variety of underlying systemic diseases of ulcerative colitis, rheumatoid arthritis, monoclonal gammopathies, Crohns disease, chronic active hepatitis and some hematologic diseases such as leukemia, thrombocythemia, dysglobulinemia and myeloma. We describe a 50 year-old woman who had pyoderma gangrenosum associated with idiopathic myelofibrosis. The findings of a bone marrow biopsy revealed proliferation of fibroblasts and a dense reticulin network, which were consistent with myelofibrosis. Steroid therapy resulted in a good response temporarily but, she died within a year after diagnosis. To our knowledge, our present case associated with idiopathic myelofibrosis is the first reported case in the Korean literature.

A Case of Herpes - Associated Erythema Multiforme Treated with Thymopentin / 대한피부과학회지

Herpes-associated erythema multiforme(HAEM) is a common subtype of erythema multiforme (EM) which usually develops 1-3 weeks after the recurrent herpetic episodes. The role of HSV in the pathogenesis of EM has not been fully defined. Recent studies, however, suggest that the host immune response to HSV, especially cell-mediated immune mechanism, is critical to the development of HAEM and, based on these findings, a variety of immunomodulating agents have been tried for the treatment of recurrent EM. Thymopentin, an immunomodulator that influences the maturation of thymocyte and mature T cell function, has been used as a therapeutic agent for various autoimmune diseases and recurrent HSV infection. A 37-year-old man with HAEM, who had failed to respond to intermittent acyclovir therapy for about 5 years, was treated with a subcutaneous injection of thymopentin 50mg three times a week for 6 consecutive weeks. The EM lesions were completely cleared 5 weeks after starting the treatment, without any sigrificant side effects. We herein, report a case of HAEM who has been treated with a 6-week schedule of thymopentin therapy and has showed no recurrence for the 6 months of follow-up period.

Two Cases of HPV 16 - positive Bowenoid Papulosis Treated with Diphenylcyclopropenone Immunotherapy / 대한피부과학회지

Bowenoid papulosis(BP) is characterized by multiple papules with a benign clinical course but having a histopathology of squamous cell carcinoma in situ on the external genitalia of sexually active men and women. It is well known that the Human papilloma virus(HPV) is connected with the development of BP. Out of these, HPV 16 which has been frequently found in the BP lesions is an oncogenic virus and the theory that BP might progress to intraepithelial neoplasia and advanced carcinoma has been postulated. Local destructive therapy including electrodessication, laser surgery, cryosurgery, and surgical excision is effective and produces a low recurrence rate. However, pain, bleeding, restriction in activity, and postoperative scars are inevitable with complete destruction of the multiple lesions. It has been suggested that diphenylcyclopropenone(DCP) might be a promising therapeutic agent for various viral diseases including HPV-related warts, It is a potent sensitizer which is not mutagenic and works by the induction of type IV hypersensitivity response in HPV infected tissue, leading to wart destruction. We herein, report 2 cases of HPV 16-positive BP treated with DCP immunotherapy.

The Significance of KONCPA Test in Onychomycosis / 대한피부과학회지

BACKGROUND: It has been reported that KONCPA(KOH+Nail clipping+PAS reaction) test might be a useful complementary method with a high positive rate and an exellent view for making the diagnosis of onychomycosis. OBJECTIVE: KONCPA test, Onyehomycosis This study was aimed to know whether KONCPA test would increase the diagnostic sensitivity of onychomycosis, and agree with the findings of fungus culture and whether KONCPA finding would be of help in diagnosing the causative fungi even in case that KOH smear and fungus culture fail to identify the causative fungi. METHODS: Using 95 onychomycotic nail samples obtained from 87 patients, the KONCPA findings were compared with those of KOH smear and fungus culture. RESULTS: The results were as follows ; 1. The positive rates for dtecting the causative fungi from KOH srnear, fungus culture and KONCPA test were 779%, 45.3% and 95.8% respectively. The time required for KONCPA test, showing the highest positive rate, was only about 2 to 3 hours. 2. The fungus culture identified the causative fungi from 43 samples, of which dermatophytes were found in 31 samples(72.1%), Candida spp. in 5 samples(11.6%) and molds in 7 samples(16. 3%). KOH smear revealed the causative fungi in 63 samples : dermatophytes 56(88.9%), Candida spp. 4(6.3%) and molds 3(4.8%). KONCPA yielded the highest positivity by detecting the pathogenic fungi in 86 samples(95.8%): dermatophytes 60(69.8%), Candida spp. 8(9.3%), molds 10 (11.6%) and mixed infections 8(9.3%). 3. Compared with the results of fungus culture, 3 groups of fungi showed morphologic differences on KONCPA test: dermatophyte showing septated long and thin hyphae and a few arthrospores, Candida sp. showing blastospores and/or grape-like clusters of regular spores and pseudohyphae, and mold showing irregular hyphae with variable width and aggregates of irregular spores. 4. Of the 52 samples which were negative in fungus culture, 33(63.5%) showed findings of dermatophyte, 2(3.8% ) of Candida sp., 2(3.8% ) of mold and the remaining 11 samples(21.2% ) were negative on KOH smear, Of these 52 samples, KONCPA diagnosed 34(65.4%) to be dermatophytes, 6(11.5%) Candida syp., 6(11.5%) molds, 1(1.9%) mixed infection and 2 samples(3.8%) to be negative. CONCLUSION: KONCPA test is useful in the diagnosis of onychomycosis because of its higher positive rate in detecting the causative fungi compared with fungus culture or KOH smear. It is also a timesaving and simple procedure Furthermore, in case that KOH smear and fungus culture fail to identify the causative fungi, it is possible to make a presumptive diagnosis by the findings of KONCPA test.

A Case of Acrodermatitis Enteropathica with a Normal Serum Zinc Level / 대한피부과학회지

Acrodermatitis enteropathica is a rare autosomal recessive disorder characterized by alopecia, acral and periorificial dermatitis and gastro-intestinal disturbances such as diarrhea. This syndrome is caused by malabsorption of zinc. The mean serum zinc level is usually low in untreated patients and the oral administration of zinc sulfate can clear the skin lesions and other symptoms. We report a three-month-old female baby with acrodermatitis enteropathica showing a normal serum zinc level in whom diapnosis was confirmed by typical skin lesions, clinical symptoms and response to oral zinc therapy.

A Case of Reiter' s Syndrome Combined with Lung Cancer / 대한피부과학회지

Reiters syndrome is an unusual disease characterized a triad of nongonococcal urethritis, conjunctivitis, and arthritis in association with the mircoutaneous lesions of keratoderma blenorrhagica and balarintis circinata. We present herein a case of Reiters syndome combined yiti lung cancer. A 39-year-old man has experienced naigrating polyarthralgia and high fever ilitermittently for about 20 years, Hyperkeratotic erythemnous patches and plaques, which dyeliped about 1 year ago, have aggravated and expanded to the whole body. Histopathologic sections from the plaque on the right forc ari showed characteristic findings including thickened parakeratotic horny layer and spongiform micropustules of Kogoji He was associated with HLA-B27. On the chest X-ray, a thumbtip size mass was incidently found. Chest CT and bone scan findings supported lung cancer and multiele metastases.