A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy / 대한내과학회지

The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.

A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy / 대한내과학회지

The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.

Clinical, Histopathological and Immunohistochemical Study / 대한피부과학회지

No Abstract Available.

A Case of Lichenoid Contact Dermatitis Caused by a Color Developing Agent / 대한피부과학회지

Color developing agents which are derivatives of p-phenylenediamine, e.g. KODAK CD-2(2- amino-5 diethylaminotoluene) and CD-3(4-amino-N-ethylN beta m-toluidine sesquisulfate monohydrate), are known to cause contact allergy. There are two types of reactions to these chemicals. The first one is an acute eczematous lesion, and the other is a lichenoid lesion. A 33-year-old man developed a lichenoid contact dermatitis on both forearms and posterior neck after exposure to a color developing agent. Patch test revealed positive reaction to CD-2. Histopathologic finding from the skin lesion showed a lichen planus-like appearance.

A Case of Crohn's Disease Showing a Skin Lesion with a Cobblestone-like Appearance in the Perianal Region

Crohn's disease, a chronic relapsing, multisystemic, inflammatory disorder, may involve any part of the gastrointestinal tract and shows a cobblestone-like appearance on intestinal mucosa. There are also extraintestinal features, including lesions of the skin, eye, and joints. Ulcers, fissures, sinus tracts, abscesses, and vegetant plaques have been reported for the perianal skin lesions of Crohn's disease. We experienced a case of Crohn's disease in a 21-year-old Korean female showing a skin lesion with a cobblestone-like appearance in the perianal region.

Two Cases of Multiple Lichen Striatus / 대한피부과학회지

Lichen striatus usually occurs in a solitary and unilateral fashion. Its multiple and bilateral distribution is a very rare finding. We report two cases of multiple lichen striatus. The first case is a 3 year-old boy, whose skin lesions were distributed bilaterally on both upper arms and buttock. The second case is a 6 year-old girl whose skin lesions were two separated linear lesions from left chest and left upper back to left arm.

Effect of Insulin on the Cell Proliferation and Cell Cycle Progression in Fibroblasts / 대한피부과학회지

BACKGROUND: Insulin exerts an effect on cell proliferation and inhibition of apoptosis. However, the actions of insulin on cell cycle progression and signal transduction pathway are not well understood and insulin shows diverse effects on cell proliferation depending on cell types. OBJECTIVE: We attempted to understand the underlying mechanism by which insulin exerts this proliferative effect on 3T3 L1 fibroblasts by various markers of cell proliferation. METHOD: We investigated the effect of insulin on cell proliferation by [3H]thymidine incorporation, analyzing the cell cycle stages by flow cytometric measurement of DNA content per cell, cell counting, analysing cell division as well as the signal transduction pathway of insulin by measuring of phosphatidylinositol 3-kinase(PI3-kinase) and p44/42 mitogen-activated protein kinase (p44/42 MAPK/ERK) activity. RESULTS: The results were as follows: 1. Total accumulated [3H]thymidine incorporation increased approximately two-fold with insulin over the 0.5% serum control at 48 h incubation, and the maximal rate of DNA synthesis was observed during 8-12 h incubation and continuously declined until 48 h without a second increase in DNA synthnesis.. 2. The flow cytometric analysis of cell population distribution showed that insulin increased the cell population in S phase. 3. After insulin treatment for 48 h, cell number was increased approximately 45% in comparison with 0.5% serum control. 4. The cell division analysed after staining 3T3 L1 fibroblasts with carboxyfluorescein diacetate succinimidyl ester (CFSE). Cell division occured only once in 24h after insulin treatment.. 5. Insulin stimulated PI3-kinase and p44/42 MAPK/ERK activity about three- and two-folds, respectively. CONCLUSION: Taken together, this data indicates that insulin stimulated the transit from G0/G1 to S phase, progressed cell cycle through G2/M phase, increased the cell number and PI3-kinase, p44/42 MAPK/ERK stimulate cell proliferation. However, under our experimental conditions, insulin has a limited efficacy for late cell cycle events required for completion of miosis and cell cycle progression into the second round and the increase of the cell number by insulin was much less than the increase of the PI3-kinase and p44/42 MAPK/ERK activity. Therefore, the authors think that another pathways other than PI3-kinase or p44/42 MAPK/ERK might be involved in the effect of insulin on cell proliferation.

Two Cases of Kyrle's Disease / 대한피부과학회지

Kyrle's disease is a rare disorder characterized by hyperkeratotic papules containing a central, cone-shaped plug on the extensor surface of the extremites. We describe two cases of Kyrle's disease. The first case is 65-year-old male patient. He had multiple pruritic hyperkeratotic papules with a central plug on both lower extremities. He has suffered from Diabetes mellitus for 20 years. The second case is 54-year-old male patient. He had multiple pruritic hyperkeratotic papules with a central plug on the back, upper and lower extremities. He has been suffered from Diabetes mellitus for 20 years and chronic renal failure for 6 months. Histopathologic findings showed central epidermal invagination filled with heavy keratotic, partly parakeratotic plug and basophilic debries. Many vacuolated cells and a few dyskeratotic cells were seen below the keratotic plug.

Effects of Vaseular Endothelial Growth Factors on Hair Growth in Vitro / 대한피부과학회지

BACKGROUND: It has been suggested that the regulation of hair growth might involve complex interaction between dermal papilla cells and hair matrix cells. Dermal papilla cells secrete diffusible factors that would act an hair matrix cells. During anagen the papilla appears to have prominent capillary loop, whereas in telogen it is nonvascularized. Vascular endothelial growth factor(VEGF) was recently reported to be produced by dermal papilla cells in rats. OBJECTIVES: We performed this study in order to evaluate the effect of VEGF on human hair growth in vitro and on the proliferation of dermal papilla cells and to define the splice forms of VEGF. METHODS: To detect the isoforms of VEGF, RT-PCR was performed on RNA isolated from dermal papilla cells and RT-PCR products were hybridized with VEGF-specific oligonucleotide probe located in exon 4. Isolated human hair follicles were cultured with various concentrations of VEGF165 and VEGF121. Hair follicle growth was measured by an Olympus inverted microscope with an eyepiece measuring graticule. RESULTS: The following results were obtained from this study. 1. Southern hybridization and size calculation of RT-PCR products revealed that mRNA species corresponding to 121, 165, 189, and 206 amino-acid forms of VEGF were praduced by cultured human dermal papilla cells. 2. 10 ng/ml of rhVEGF165, 0.1 ng/ml of rhVEGF165 and 10 ng/ml of rhVEGF121 stimulated follicle elongation in vitro(p < 0.05). 3. rhVEGF165 and rhVEGF121 had no effect on the numbers and thymidine incorporation of dermal papilla cells. CONCLUSION: These results suggest that VEGF is produced by dermal papilla cells and is able to promote hair growth in vitro. Increased hair growth by VEGF might occur other than by proliferation of dermal papilia cells.