Higher Serum Calcium Levels Are Associated with Preclinical Peripheral Arterial Disease among the Apparently Healthy Individuals / 가정의학회지

BACKGROUND: Epidemiological studies suggest that serum calcium levels correlate with cardiovascular events. An ankle-brachial index (ABI) between 0.9 and 1.00 is a surrogate estimation of preclinical peripheral arterial disease (PAD). Prior studies have shown that an ABI of 0.9–1.0 is also associated with endothelial dysfunction. Therefore, we sought to investigate the relationship between serum calcium levels and preclinical PAD in apparently healthy Korean individuals. METHODS: We evaluated the association between serum calcium levels and preclinical PAD in 596 participants (334 males, 262 females) in a health examination program. Preclinical PAD was defined by an ABI of 0.9–1.0. Multiple logistic regression analysis was used to determine whether the serum calcium level was an independent determinant of preclinical PAD. RESULTS: The overall prevalence of preclinical PAD was 14.3%. The mean age was 44.0±12.5 years in the non-PAD group and 48.3±11.4 years in the preclinical PAD group (P=0.001). After adjusting for age, gender, systolic blood pressure, fasting plasma glucose, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, g-glutamyltransferase, uric acid, hypertension medication, diabetes medication, and hyperlipidemia medication, the odds ratio (95% confidence intervals) for preclinical PAD was 2.28 (1.02–5.11) with a 1-mg/dL increase in the serum calcium. CONCLUSION: These findings suggest that increased serum calcium is independently and positively associated with preclinical PAD regardless of the presence of classic cardiovascular risk factors.

Vulvar Vestibular Papillomatosis Misdiagnosed as Condyloma Acuminata / 대한피부과학회지

No abstract available.

Tick Bite by Male Amblyomma testudinarium in a Korean Woman / 대한피부과학회지

A 53-year-old woman presented with asymptomatic pedunculated mass on her buttock. She was attacked by the tick while climbing the Jungbyung mountain located in Changwon City, the southern coastal area of the Korean Peninsula. It was identified as male Amblyomma testudinarium according to its morphological characteristics. Histological examination showed dense inflammatory infiltration of neutrophils and eosinophils, and dilated vessels on the dermis beneath the biting site of the tick. There have been only few reports of the tick bite by A. testudinarium in the Korean literature. To the best of our knowledge, our patient is the second case of tick bite from this species and the first tick bite from the male tick recorded in Korea. Here, we report a case of tick bite by male A. testudinarium in a woman, including a review of relevant literature.

Onychomatricoma: A Rare Tumor of Nail Matrix

Onychomatricoma is a rare tumor of the nail matrix. Until now, few cases of onychomatricoma have been reported in the literature. Immunohistochemically, CD10, a marker of the onychodermis, is expressed in the stroma of the onychomatricoma. In the present case, a 27-year-old woman presented with an 8-year history of a yellowish, thickened, and overcurved nail plate of the right index finger, mimicking onychomycosis. She had been treated for 4 years with antifungal agents by general physicians, without improvement. The nail was surgically removed, and the tumor at the nail matrix was excised. The nail plate continued to grow in the 2 months after the excision. This is a case of onychomatricoma in South Korea, which was initially misdiagnosed as onychomycosis. In addition, we present a review of the literature regarding clinical, sonographic, and histological features, differential diagnoses, and treatment of onychomatricoma.

Onychomatricoma: A Rare Tumor of Nail Matrix

Onychomatricoma is a rare tumor of the nail matrix. Until now, few cases of onychomatricoma have been reported in the literature. Immunohistochemically, CD10, a marker of the onychodermis, is expressed in the stroma of the onychomatricoma. In the present case, a 27-year-old woman presented with an 8-year history of a yellowish, thickened, and overcurved nail plate of the right index finger, mimicking onychomycosis. She had been treated for 4 years with antifungal agents by general physicians, without improvement. The nail was surgically removed, and the tumor at the nail matrix was excised. The nail plate continued to grow in the 2 months after the excision. This is a case of onychomatricoma in South Korea, which was initially misdiagnosed as onychomycosis. In addition, we present a review of the literature regarding clinical, sonographic, and histological features, differential diagnoses, and treatment of onychomatricoma.

Tick Bite by Larval Hemaphysalislongicornis / 대한피부과학회지

No abstract available.

Examination of Burrows in a Norwegian Scabies Patient / 대한피부과학회지

No abstract available.

Insect Bite by Cephalonomia gallicola / 대한피부과학회지

No abstract available.

Unusual Manifestation of Molluscum Contagiosum: Eruptive Papules on the Face and Neck of an Immunocompetent Patient

No abstract available.

Evaluation of the rat tissue reaction to experimental new resin cement and mineral trioxide aggregate cement

OBJECTIVES: New resin cement (NRC) has been developed as a root repairing material and the material is composed of organic resin matrix and inorganic powders. The aim of this study was to compare the rat subcutaneous tissue response to NRC and mineral trioxide aggregate (MTA) cement and to investigate the tissue toxicity of both materials. MATERIALS AND METHODS: Sixty rats received two polyethylene tube-implants in dorsal subcutaneous regions, MTA and NRC specimens. Twenty rats were sacrificed respectively at 1, 4 and 8 wk after implantation and sectioned to 5 microm thickness and stained with Hematoxylin-Eosin (H-E) or von-Kossa staining. The condition of tissue adjacent to the implanted materials and the extent of inflammation to each implant were evaluated by two examiners who were unaware of the type of implanted materials in the tissues. Data were statistically analyzed with paired t-test (p < 0.05). RESULTS: In specimens implanted with both NRC and MTA, severe inflammatory reactions were present at one wk, which decreased with time. At eighth wk, MTA implanted tissue showed mild inflammatory reaction, while there were moderate inflammatory reactions in NRC implanted tissue, respectively. In NRC group, von-Kossa staining showed more calcification materials than MTA group at eighth wk. CONCLUSIONS: It was concluded that the calcium reservoir capability of NRC may contribute to mineralization of the tissues.

Dermoscopy: A Useful Tool for the Diagnosis of Angiokeratoma

Angiokeratoma is a rare vascular malformation of the upper dermis that presents clinically as deep red to blue-black in color and tends to take a diverse configuration without self-limiting. Here, we reported dermoscopic findings by two cases of angiokeratoma; solitary angiokeratoma and angiokeratoma circumscriptum. A 24-year-old male presented with a 2-months history of 5 mm sized black colored papule on the right buttock. A dermoscopic pattern characterized by red and dark lacunae, whitish veil covered with scale. A 26-year-old woman presented with multiple, 2~10 mm, dark colored papules on the anterior neck with zosteriform fashion since childhood. A dermoscopic pattern presented by red lacunae intermingled with whitish veil. As a previous report, our two cases was the most common dermoscopic pattern of angiokeratoma; red lacunae and whitish veil. Angiokeratoma is often diagnosed as melanocytic nevi, Spitz nevi, malignant melanomas, pigmented basal cell carcinomas, seborrheic keratoses, dermatofibromas and other vascular lesions including hemangiomas and pyogenic granulomas. However, in the dermoscopic view, these above lesions hardly show red lacunae with whitish veils. Therefore, the dermscopic view is a useful differential method of angiokeratoma.

A Case of Cutaneous Pseudolymphoma in a Clinical Appearance of Keloid / 대한피부과학회지

Cutaneous pseudolymphoma is a heterogeneous group of benign reactive T-cell or B-cell lymphoproliferative process, which clinically and histologically simulates cutaneous lymphomas. A few cases of pseudolymphomas, showing atypical clinical forms, have been reported previously in the literature, but are rare. A 23-year old male was presented with 4-year duration of cutaneous lesion on the right retroauricular area. On physical examination, about a 2x1 cm sized erythematous, elevated and protruded, firm nodule was seen. The cutaneous lesion resembled the appearance of keloid, but the patient did not have any obvious history of trauma. A punch biopsy was performed, and histologically, the lesion was diagnosed as cutaneous pseudolymphoma. After a single treatment of triamcinolone acetonide intralesional injection, the lesion was almost cleared. In this report, we present an interesting case of pseudolymphoma with a clinical finding resembling the appearance of keloid in a patient without any traumatic history.

Accuracy of Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigant

OBJECTIVES: To evaluate the accuracy of the Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigants, such as saline, 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine liquid, 2% chlorhexidine gel, and RC-Prep, and also to determine the electrical conductivities of these endodontic irrigants. MATERIALS AND METHODS: A root perforation was simulated on twenty freshly extracted teeth by means of a small perforation made on the proximal surface of the root at 4 mm from the anatomic apex. Root ZX was used to locate root perforation and measure the electronic working lengths. The results obtained were compared with the actual working length (AWL) and the actual location of perforations (AP), allowing tolerances of 0.5 or 1.0 mm. Measurements within these limits were considered as acceptable. Chi-square test or the Fisher's exact test was used to evaluate significance. Electrical conductivities of each irrigant were also measured with an electrical conductivity tester. RESULTS: The accuracies of the Root ZX in perforated teeth were significantly different between liquid types (saline, NaOCl) and gel types (chlorhexidine gel, RC-Prep). The accuracies of electronic working lengths in perforated teeth were higher in gel types than in liquid types. The accuracy in locating root perforation was higher in liquid types than gel types. 5.25% NaOCl had the highest electrical conductivity, whereas 2% chlorhexidine gel and RC-Prep gel had the lowest electrical conductivities among the five irrigants. CONCLUSIONS: Different canal irrigants with different electrical conductivities may affect the accuracy of the Root ZX in perforated teeth.

LEOPARD Syndrome with PTPN11 Gene Mutation Showing Six Cardinal Symptoms of LEOPARD

LEOPARD multiple congenital anomaly syndrome inherited in an autosomal dominant manner. LEOPARD is an acronym for Lentigines, Eletrocardiographic conduction defects, Ocular hypertelorism, Pulmonary valve stenosis, Abnormalities of the genitalia, Retardation of growth, and Deafness. Clinical diagnosis is primarily based on multiple lentigines, typical facial features, and the presence of hypertrophic cardiomyopathy and/or cafe-au-lait macules. We report a typical case of LEOPARD syndrome with PTPN11 gene mutation associated with lentigines, electrocardiograph abnormality, ocular hypertelorism, pulmonary valve stenosis, growth retardation, and sensorineural hearing loss.

Acral Pigmented Spitz Nevus That Clinically Mimicked Acral Lentiginous Malignant Melanoma

Pigmented Spitz nevus is a benign melanocytic skin lesion with distinct clinical features and it is frequently found on the extremities. However, it rarely occurs on acral area of the body, and such a case has not yet been fully documented. We present a case of acral pigmented Spitz nevus occurring on the foot, and this mimicked acral lentiginous malignant melanoma. Clinicians should be well aware of this entity and its possible clinical presentations. Since acral pigmented Spitz nevus is benign in nature, making the correct diagnosis is important to avoid unnecessary mutilating or excessive surgery.

Localized Bullous Pemphigoid Following Acupuncture / 대한피부과학회지

A 60-year-old man presented with a 3-week history of pruritic bullae and erosions located within an acupuncture site on the right lower leg. Ten days prior to the development of these bullae, he had been treated with acupuncture to the right calf due to Achilles tendonitis which had developed 1 year earlier. The diagnosis of bullous pemphigoid was confirmed by histologic findings and salt-split direct immunofluorescence study performed on the perilesional skin. To our knowledge, this is the first case of localized bullous pemphigoid following acupuncture.

Diffuse Cutaneous Mastocytosis with Generalized Bullae

We report on a 9-month-old female infant with multiple tense bullae and erosions covering the entire body, including the face, scalp, and trunk. The histopathological examination revealed sub-epidermal bullae with a dense dermal cellular infiltrate. The infiltrate was identified as a collection of mast cells using toluidine blue and Giemsa stains. The direct immunofluorscence was negative. A diagnosis of cutaneous diffuse mastocytosis with generalized bullae was made based on these clinical and histopathological findings. In cases with diffuse cutaneous mastocytosis with generalized bullae, systemic involvement is more frequent and more severe compared to other types of cutaneous mastocytosis. Some lethal outcomes have been reported. This is the first reported case of diffuse cutaneous mastocytosis in the Korean literature.

A Case of Chondroid Syringoma with Small Tubular Lumina / 대한피부과학회지

Chondroid syringoma is a rare epithelial tumor with an adnexal gland origin, and it clinically presents as a slowly growing benign nodule. A 57-year-old woman presented with a 1-year history of 1x1 cm subcutaneous firm nodule on her scalp. The biopsy specimen showed a basophilic stroma and small tubular structures that were lined by a single layer of epithelium, small groups of epithelial cells and solitary epithelial cells. The tumor cells showed positive immunoreactivity for S-100. Herein, we report on a case of chondroid syringoma that histopathologically presented with small tubular lumina.

Successful Treatment of Localized Epidermolysis Bullosa Acquisita with Low-dose Dapsone and Topical Tacrolimus / 대한피부과학회지

A 52-year-old man had a twenty-five year history of recurrent bullous eruption that was localized to both cheeks. The diagnosis of epidermolysis bullosa acquisita was confirmed by means of direct immunofluorescence and salt-split direct immunofluorescence studies that were performed on the perilesional skin. The patient has been in partial remission state with the treatment of low dose dapsone (12.5~25 mg) and topical tacrolimus. Herein, we report on a case of EBA localized to the face, and it showed a favorable response to treatment with low-dose dapsone and topical tacrolimus.

Apical microleakage of MTA with 4-META/MMA & TBB resin as a root-end filling material / 대한치과보존학회지

We evaluated in vitro microleakage of Mineral Trioxide Aggregate (MTA) powder with 4-methacryloxyethyl trimellitate anhydride (4-META) / methyl methacrylate (MMA) & tri-n-butylborane (TBB) resin as a retrograde filling material by using methylene blue dye method. Fifty-two single rooted, extracted teeth were instrumented and obturated with gutta percha and AH plus sealer. The apical 3mm of each root was resected and 3mm deep ultrasonic root end preparation was done. External surface of roots was coated with nail varnish. Prepared teeth were randomly divided into five groups; Negative control: completely covered with nail varnish; Positive control: coated with nail varnish except for apical foramen; Group 1 (retrofilled with Portland cement); Group 2 (retrofilled with MTA); Group 3 (retrofilled with MTA powder mixed with 4-META/MMA & TBB resin). Immediately after completion of root-end filling, all specimens were submerged in methylene blue dye for 72 hours in 37degrees C incubator. The roots were longitudinally sectioned and measured for extent of dye penetration by three different examiners under microscope (x10). The results were statistically analyzed using one way ANOVA and Turkey's HSD test. No leakage was evident in negative control and complete leakage in positive control group. Group 3 showed significantly less leakage than group 1 and 2 (p 0.01). It was concluded that MTA powder with 4-META/MMA & TBB resin was excellent in reducing initial apical microleakage.