Urinary exosomal microRNA profiling in type 2 diabetes patients taking dipeptidyl peptidase-4 inhibitor compared with sulfonylurea

Background@#Dipeptidyl peptidase-4 (DPP-4) inhibitor has been reported to have kidney-protective benefits. To elucidate how antidiabetic agents prevent diabetic kidney disease progression, it is important to investigate their effect on the kidney environment in type 2 diabetes mellitus (DM) patients. Herein, we investigated the expression pattern of urinary exosome-derived microRNA (miRNA) in patients taking a combination of DPP-4 inhibitor and metformin (DPP-4 inhibitor group) and compared them with patients taking a combination of sulfonylurea and metformin (sulfonylurea group). @*Methods@#This was a prospective study involving 57 patients with type 2 DM (DPP-4 inhibitor group, n = 34; sulfonylurea group, n = 23) and healthy volunteers (n = 7). We measured urinary exosomal miRNA using the NanoString nCounter miRNA array (NanoString Technologies) across the three groups (n = 4 per each group) and validated findings using real-time polymerase chain reaction. @*Results@#Twenty-one differentially expressed candidate miRNAs were identified, and six (let-7c-5p, miR-23a-3p, miR-26a-3p, miR-30d, miR-205, and miR-200a) were selected for validation. Validation showed no significant difference in miRNA expression between the DPP-4 inhibitor and sulfonylurea groups. Only miR-23a-3p was significantly overexpressed in the diabetes group compared with the control group (DPP-4 inhibitor vs. control, p = 0.01; sulfonylurea vs. control, p = 0.007). This trend was consistent even after adjusting for age, sex, and body mass index. @*Conclusion@#There was no significant difference in urine exosome miRNA expression between diabetic participants taking DPP-4 inhibitor and those taking sulfonylurea. The miR-23a levels were higher in diabetic participants than in nondiabetic controls.

MiR-9 Controls Chemotactic Activity of Cord Blood CD34⁺ Cells by Repressing CXCR4 Expression

Improved approaches for promoting umbilical cord blood (CB) hematopoietic stem cell (HSC) homing are clinically important to enhance engraftment of CB-HSCs. Clinical transplantation of CB-HSCs is used to treat a wide range of disorders. However, an improved understanding of HSC chemotaxis is needed for facilitation of the engraftment process. We found that ectopic overexpression of miR-9 and antisense-miR-9 respectively down- and up-regulated C-X-C chemokine receptor type 4 (CXCR4) expression in CB-CD34⁺ cells as well as in 293T and TF-1 cell lines. Since CXCR4 is a specific receptor for the stromal cell derived factor-1 (SDF-1) chemotactic factor, we investigated whether sense miR-9 and antisense miR-9 influenced CXCR4-mediated chemotactic mobility of primary CB CD34⁺ cells and TF-1 cells. Ectopic overexpression of sense miR-9 and antisense miR-9 respectively down- and up-regulated SDF-1-mediated chemotactic cell mobility. To our knowledge, this study is the first to report that miR-9 may play a role in regulating CXCR4 expression and SDF-1-mediated chemotactic activity of CB CD34⁺ cells.

Carbohydrate Composition Associated with the 2-Year Incidence of Metabolic Syndrome in Korean Adults

The aim of this study was to investigate the association between macronutrient composition and metabolic syndrome (MetS) incidence in Korean adults. Data were obtained from a cohort of 10,030 members aged 40 to 69 years who were enrolled from the 2 cities (Ansung and Ansan) between 2001 and 2002 to participate in the Korean Genome Epidemiology Study. Of these members, 5,565 participants, who were free of MetS and reported no diagnosis of cardiovascular disease at baseline, were included in this study. MetS was defined using the criteria of the National Cholesterol Education Program-Adult Treatment Panel III and Asia-Pacific criteria for waist circumference. MetS incidence rate were identified during a 2-year follow-up period. Baseline dietary information was obtained using a semi-quantitative food frequency questionnaire. Multivariate logistic regression analysis was used to evaluate the association between the quartiles of percentages of total calorie from macronutrients consumed and MetS incidence. In analyses, baseline information, including age, sex, body mass index, income status, educational status, smoking status, alcohol drinking status, and physical activity level was considered as confounding variables. Participants with the second quartile of the percentages of carbohydrate calorie (67%–70%) had a 23% reduced odds ratio (95% confidence interval, 0.61–0.97) for MetS incidence compared with those with the fourth quartile after adjusting for confounding variables. The findings suggest that middle aged or elderly Korean adults who consume approximately 67%–70% of calorie from carbohydrate have a reduced risk of MetS.

Overall Incidence of Posttransplant Malignancies and Clinicopathologic Features of Thyroid Cancer in Renal Allograft Recipients; 40-years Single Center's Experience / 대한내분비외과학회지

PURPOSE: Prolonged immunosuppression after kidney transplantation (KT) is known to increase the risk of various cancers; however, few studies on posttransplant thyroid carcinoma (TC) have been reported in the literature. We investigated the incidence of posttransplant malignancies (PTMs) and the clinicopathological features of postransplant TC. METHODS: We conducted a retrospective study of 1,622 patients who underwent KT from Mar. 1969 to Dec. 2008. Overall incidence and the standardized incidence ratio (SIR) of posttransplant TC according to the 2007 annual report of the Korea Cancer Center Registry were calculated. RESULTS: During the mean follow-up period of 109 months, 137 (8.4%) recipients were identified as having PTM, including five males and seven females with papillary TC. (0.74%) SIR of the TC was 12.4 in males and 0.5 in females. During the mean follow-up period of 69.1 months, three (25.0%) patients with TC developed loco-regional recurrence. CONCLUSION: Overall incidence of TC was higher compared to the general Korean population (0.74% vs 0.04%) without differences in gender distribution (P=0.086) and higher tendency of locoregional recurrence in clinical carcinoma (P=0.0512). Therefore, to ensure early detection and favorable outcome of posttransplant TC, frequent surveillance using ultrasonography and prophylactic central neck dissection should be considered.

Rare Manifestation of Giant Molluscum Contagiosum on the Scalp in Old Age

No abstract available.

Rare Manifestation of Giant Molluscum Contagiosum on the Scalp in Old Age

No abstract available.

Treatment of Atopic Dermatitis Associated with Malassezia sympodialis by Green Tea Extracts Bath Therapy: A Pilot Study

Multiple treatment modalities, including topical and systemic corticosteroid and phototherapy, have been used in treatment of patients with atopic dermatitis. However, long-term corticosteroid therapy may have various adverse effects. The purpose of this study was to investigate the therapeutic efficacy and safety of bath therapy using green tea extracts for treatment of patients with atopic dermatitis. A total of four patients with atopic dermatitis were enrolled in this study. A Malassezia multiplex detection kit was used in performance of multiplex PCR on clinical isolates, which confirmed Malassezia sympodialis. Subjects underwent treatment with bath therapy using green tea extracts three times per wk for a period of 4 wk. Assessment using the scoring atopic dermatitis (SCORAD) index, the visual analogue scale for pruritus, and transepidermal water loss was performed weekly. Laboratory tests were performed before and after treatment. All patients showed marked improvement on the mean SCORAD and visual analogue scale, and a significant decrease in the mean values of serum eosinophil counts was observed after treatment. Bath therapy with green tea extract is an effective, safe, and nonsteroidal therapy for treatment of patients with atopic dermatitis associated with Malassezia sympodialis.

Human Skin Safety Test of Green Tea Cell Extracts in Condition of Allergic Contact Dermatitis

Various kinds of positive effects of green tea extracts had been studied for long time which included anti-inflammation, anti-aging, and cardiometabolic effects. Although topical steroid and non-steroidal calcineurin inhibitors may control clinical symptoms of allergic contact dermatitis, some of patients also present allergic reaction to these topical agents. Therefore, we have tried green tea extracts for managing this skin disorder with expectation of anti-inflammatory effect without potential side effects including skin irritation and toxic responses. The toxicity test of green tea extract also did not show any sign of irritation in the skin throughout the test period. Moderate severity of allergic contact dermatitis presented satisfactory clinical outcome at second week follow-up which was final visit of outpatient. This result mean that green tea extract has a positive effect for managing allergic contact dermatitis but its potency and efficacy seem to be so not strong enough to control moderate severity allergy skin lesion. In this pilot study, we were able to conclude that green tea cell extracts might be applied for potential anti-inflammatory soaking without skin toxicity.

Anti-inflammatory effects of Houttuynia cordata supercritical extract in carrageenan-air pouch inflammation model / 한국실험동물학회지

Anti-inflammatory effects of Houttuynia cordata supercritical extract (HSE) were investigated in rat carrageenan-air pouch model. Oral administration of HSE (50-200 mg/kg) suppressed carrageenan-induced exudation and albumin leakage, as well as inflammatory cell infiltration at a high dose (200 mg/kg). Intraperitoneal injection of dexamethasone (2 mg/kg) only decreased exudation and cell infiltration, while indomethacin (2 mg/kg, i.p.) reduced exudate volume and albumin content without influence on the cell number. HSE lowered tumor-necrosis factor-alpha (TNF-alpha) and nitric oxide (NO), as well as prostaglandin E2 (PGE2). Dexamethasone only reduced TNF-alpha and NO, while indomethacin decreased PGE2. The results indicate that HSE exhibits anti-inflammatory effects by inhibiting both TNF-alpha-NO and cyclooxygenase-2-PGE2 pathways.

Necrobiotic Xanthogranuloma with Monoclonal Gammopathy / 대한피부과학회지

Necrobiotic xanthogranuloma (NXG) is a rare, progressive, histiocytic disease characterized by destructive cutaneous lesions, a close association with paraproteinemia, multiple myeloma, hypertension, and multiple extracutaneous manifestations. Multiple indurated yellow-red plaques or nodules are commonly present in this disorder. The pathogenesis of NXG is poorly understood. Histopathologically, NXG features with hyaline necrosis or necrobiosis are present. We describe a patient with typical cutaneous and histologic findings of NXG with an associated monoclonal gammopathy.

Oral Lichen Planus for Whom Dermoscopy Was Used as an Adjuvant Diagnostic Tool / 대한피부과학회지

Lichen planus is a relatively common chronic inflammatory disease of the skin, mucous membranes, and hair follicles. Oral lichen planus develops in any area of the oral mucosa, especially in the buccal mucosa, tongue, gingiva and lip. The cutaneous lesions of lichen planus are characterized with gray or white punta or streaks, referred to as Wickham striae. We report 53-year-old woman with lichen planus on the lower lip diagnosed by dermoscopy.

Clinical Study of StoneTouch(R) Far-infrared Device on Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.

Clinical Study of StoneTouch(R) Far-infrared Device on Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.

A Case of Cutaneous Bronchogenic Cyst Presenting with Lymphoid Follicles

Cutaneous bronchogenic cysts are rare, and stem from developmental abnormalities of the tracheobronchial tree. The condition is often misdiagnosed clinically, with the correct diagnosis usually established by histopathologic examination. Published reports of bronchogenic or branchial anomalies are increasing, and the traditional defining characteristics of location and histopathology are proving to be less reliable for the identification of cutaneous bronchogenic cysts. In this report, we describe a case of a cutaneous bronchogenic cyst that presented with unusual histologic features, and was associated with several lymphoid follicles.

Complications Following BellaGen(TM) Injection

BellaGen(TM) is an injectable acellular dermal matrix granule derived from donated human skin tissue that was recently developed for soft tissue augmentation. Its use has been sporadically reported in penile girth enhancement procedures. Many cases of complications have been reported after injecting acellular dermal matrices like AlloDerm or SureDerm(TM) but few reports on complications associated with BellaGen(TM) injection. We report here on penile skin inflammation and necrosis following augmentation phalloplasty with BellaGen(TM), which developed 3 days after the injection and persisted for more than 2 weeks. The patient had a 15 year history of type 2 diabetes mellitus, and he was treated with oral antibiotics and wet dressings with KMNO4 solution to combine preservation of the remaining penile soft tissue with debridement of avascular tissue. The lesion improved with this treatment, but the patient experienced pain for about 2 weeks. All patients should be informed of the potential complications with the use of injectable acellular dermal matrices before treatment. Patient selection for augmentation is also important to have the most desirable results.

Adult Intussusception Caused by an Appendiceal Mucocele and Reduced by Colonoscopy

Appendiceal intussusception is a very rare disease that is found in only 0.01% of patients who have undergone an appendectomy. Clinical symptoms vary but include acute appendicitis symptoms such as right lower quadrant abdominal pain or repetitive right lower quadrant crampy pain. Some patients are asymptomatic. Operative treatment is necessary to reduce an appendiceal intussusception in adults, but there is a debate about how to perform the reduction. Successful colonoscopic reductions have been recently reported for some cases. We report a case of appendiceal intussusception that was diagnosed, reduced by colonoscopy, and histologically confirmed as a mucinous cystadenoma after the operation.

Childhood Granulomatous Periorificial Dermatitis Treated with Topical Tacrolimus / 대한피부과학회지

Childhood granulomatous periorificial dermatitis (CGPD) is a benign facial eruption of unknown etiology characterized by a monomorphic papular eruption occurring in the perinasal, perioral, and periocular areas. We report an 11-year-old boy with characteristic features of CGPD. He presented with a 4-month history of non-pruritic, papular eruptions on the face. The histopathologic exam revealed an upper dermal granuloma with surrounding lymphocytes. Treatment was initiated with tetracycline 500 mg/day, but there was no response for 3 weeks. We tried 0.03% topical tacrolimus to treat recalcitrant skin lesions. After 10 weeks of treatment, the lesions resolved without scarring.

A Case of Lupus Panniculitis-Misdiagnosed as Alopecia Areata

We present a 24-year-old woman with systemic lupus erythematosus presented with multiple patches of non-scarring alopecia closely resembling alopecia areata. Scalp biopsy showed a predominantly subcutaneous and dermal lymphocytic infiltrate that surrounded the deep follicular segments and hair bulb. This pattern is capable of producing a temporary hair loss, clinically misdiagnosed as alopecia areata. The clinical history, presence of erythema on bald patches and scalp tenderness as well as the biopsy findings were important clues in diagnosis of lupus erythematosus. We report here a case of lupus panniculitis that presented as multiple bald patches misdiagnosed as alopecia areata.

A Case of Ingrown Toenail Associated with Tinea Unguium Treated with K-D(R) Wire / 대한의진균학회지

Ingrown toenail is a common disorder resulting from various etiologies including excessive external pressure, ill-fitting footwear, and improper nail-trimming techniques. Patients commonly present with pain in the affected nail but with progression, drainage, infection and difficulty walking occur. It is often difficult to manage and frequently recurs, despite the multitude of treatment techniques that have been reported. Conservative therapy is a reasonable approach in patients with a mild to moderate ingrown toenail that do not have significant pain, substantial erythema, or purulent drainage from the lateral nail edge. We report a case of ingrown toenail in a 45-year-old female treated with K-D(R) wire, a corrective device. After application of K-D(R) wire for 3 weeks, ingrown toenail healed and the nail deformity was corrected.

Left mainstem bronchial rupture during one-lung ventilation with Robertshaw double lumen endobronchial tube: A case report / 대한마취과학회지

Lung separation using a double-lumen endobronchial tube is necessary for video assisted thoracoscopy (VATs). Bronchial rupture after intubation with a double-lumen endobronchial tube has been rarely reported. We report a case of a 70-year-old man who had solitary pulmonary nodule in his right upper lobe. He was intubated with a left-sided Robertshaw double-lumen endobronchial tube. He underwent a VATs right upper lobectomy with the one-lung ventilation of left lung. During the operation, the rupture of the left mainstem bronchus was detected. Immediately, the thoracotomy was performed and the ruptured left mainstem bronchus was repaired with absorbable sutures (vicryl). Seven days later he had a bronchoscopy to examine the left mainstem bronchus. There was no evidence of the bleeding, leakage and inflammation. Subsequent course was uneventful. Tracheobronchial injuries related to the double-lumen endobronchial tube are discussed.