A Review on the Clinical Characteristics and Outcomes from Spontaneous Intestinal Intramural Hematoma

PURPOSE: Spontaneous intestinal intramural hematoma (SIMH) is a very rare complication of anticoagulation. Most reports on SIMH have been case reports and case series, not well-established clinical studies. Therefore, the aim of this study was to evaluate the clinical characteristics and outcomes from SIMH. METHODS: A retrospective review of the records of 48 patients with non-traumatic SIMH was performed at an urban academic tertiary hospital between January 2001 and December 2012. These patients were diagnosed with SIMH by computed tomography and confirmed by a radiology specialist. Their clinical characteristics and outcomes from SIMH were determined. RESULTS: Among all SIMH cases, the percentage of warfarin users was 70.8%. The median age at presentation was 66.5 years, whereas warfarin users were older (68.0 years) than non-users (55.0 years) (p<0.01). SIMH patients had abdominal pain (81.3%), nausea and vomiting (50.0%) and 62.5% of them had abdominal tenderness. The most frequently involved site was the small bowel (85.4%) and there was only one patient with bowel obstruction from SIMH. A total of 33(68.6%) patients were admitted for 9.3 days for conservative treatment, including transfusion. On the other hand, two patients had surgical intervention. There were no mortality cases from SIMH during the study period. CONCLUSION: SIMH is rare disease which can treated with supportive care. However, it can cause severe complications, such as bowel obstruction and perforation, requiring surgical intervention. Therefore, emergency physicians have to consider SIMH carefully, especially in patients treated with an anticoagulation agent.

The Bacterial Protein Azurin Enhances Sensitivity of Oral Squamous Carcinoma Cells to Anticancer Drugs

PURPOSE: Surgical therapy is the primary treatment for oral cancer, but it can cause facial distortion. Therefore, if anticancer drugs are effective against oral cancer, they may be used preferentially. However, oral squamous carcinoma cells (OSCCs) are resistant to these drugs, so finding a way to enhance the sensitivity of these cells to anticancer drugs is important. The bacterial protein azurin is known to selectively enter cancer cells and induce apoptosis. In this study, we show the anticancer effect of azurin in OSCC. MATERIALS AND METHODS: OSCC cell line (YD-9) was subjected to azurin treatment. Cell viability, morphology and protein expression levels were monitored after treatment of azurin. Cells were also subjected to combination treatment of azurin with either 5-fluorouracil or etopside. RESULTS: Azurin-treated cells showed decreased cell viability accompanied by apoptotic phenotypes including morphological change, DNA breakage, and increases in p53 and cyclin B1 protein levels. Combination treatment of azurin with other anti-tumor agents caused an increase in sensitivity to anticancer drugs in azurin-treated YD-9 cells. CONCLUSION: Azurin has a strong synergistic anticancer effect on oral cancer cells when it is used along with anticancer drugs.

Dermatologic Diseases Associated with Atopic Dermatitis in Koreans: Multicenter Study / 대한피부과학회지

BACKGROUND: Dermatological diseases can occur with atopic dermatitis. OBJECTIVE: The purpose of this study was to analyze diseases associated with atopic dermatitis in Koreans. METHODS: From November, 2007, to May, 2008, 948 patients with atopic dermatitis who visited the department of dermatology at 19 hospitals were evaluated for associated diseases. RESULTS: Of 948 patients, 53.8% (510) had symptoms associated with other dermatological diseases. In order of frequency, diseases associated with atopic dermatitis included acne, hand/foot eczema, seborrheic dermatitis, urticaria, warts, and recurrent herpes simplex. The number of associated diseases did not change significantly with the severity of atopic dermatitis. However, the incidence of hand/foot eczema and eczema herpeticum correlated significantly with the severity of atopic dermatitis. CONCLUSION: There is a distinct pattern of diseases associated with atopic dermatitis in Koreans.

Recombinant Azurin from Pseudomonas aeruginosa Induces Apoptotic Cell Death in Oral Squamous Carcinoma Cells

The use of bacteria in the treatment of cancer has a long and interesting history. The use of live bacteria in this way however has a number of potential problems including toxicity. Purified low molecular weight bacterial proteins have therefore been tested as anticancer agents to avoid such complications. Oral cancer is a widely occurring disease around the world and these lesions are typically very resistant to anticancer agents. In our present study we investigated the effects of purified recombinant azurin from Pseudomonas (P.) aeruginosa against YD-9 (p53-positive) human oral squamous carcinoma cells. Azurin showed cytotoxic effects against these cells in a dose dependent manner. The cell death accompanied by this treatment was found to be characterized by chromatin condensation and apoptotic bodies. Azurin treatment was further found to increase the expression of p53 The stabilization of p53 and induction of apoptosis in YD-9 cells by azurin suggests that it has potentially very strong anticancer properties in oral squamous carcinoma.

Recombinant Azurin from Pseudomonas aeruginosa Induces Apoptotic Cell Death in Oral Squamous Carcinoma Cells

The use of bacteria in the treatment of cancer has a long and interesting history. The use of live bacteria in this way however has a number of potential problems including toxicity. Purified low molecular weight bacterial proteins have therefore been tested as anticancer agents to avoid such complications. Oral cancer is a widely occurring disease around the world and these lesions are typically very resistant to anticancer agents. In our present study we investigated the effects of purified recombinant azurin from Pseudomonas (P.) aeruginosa against YD-9 (p53-positive) human oral squamous carcinoma cells. Azurin showed cytotoxic effects against these cells in a dose dependent manner. The cell death accompanied by this treatment was found to be characterized by chromatin condensation and apoptotic bodies. Azurin treatment was further found to increase the expression of p53 The stabilization of p53 and induction of apoptosis in YD-9 cells by azurin suggests that it has potentially very strong anticancer properties in oral squamous carcinoma.

Apoptotic Effect of Combination Treatment with a Proteasome Inhibitor, Lactacystin, and a Histone Deacetylase Inhibitor, Trichostatin A, on MCF-7 Cells / 대한해부학회지

Although much information has been accumulated about the synergistic interaction of proteasome inhibitors and HDAC inhibitors to induce apoptosis in a certain type of cells, much less is known currently about the underlying mechanism. This study was undertaken to explore the combination effect of a histone deacetylase inhibitor, TSA, and a proteasome inhibitor, lactacystin, on the induction of apoptosis. Pretreatment of TSA and subsequent treatment of lactacystin showed the strong antitumor activity and nuclear condensation. Western blot assay showed that combination treatment of TSA and lactacystin increased Bax/Bcl-2 ratio and decreased level of XIAP. Activation of caspase-7 and cleavage of PARP were demonstrated after the combination treatment. In combination treatment group, cell cycle arrest was induced at G2/M phase and abolished increase in proteasome activity. This study is elucidating the mechanims whereby targeting apoptotic machineries may help in directing therapeutic strategies.

Caspases-dependent Apoptosis in Human Melanoma Cell by Eugenol / 대한해부학회지

Malignant melanoma is a highly metastatic tumor, resistant to chemotherapy and radiotherapy. Recent studies have suggested that many therapeutic agents used against cancer mediate their effects by induction of apoptosis of the cancer cells. Eugenol enhances the generation of tissue-damaging free radicals and inflammation or allergic reactions. In particular, it is more cytotoxic against cancer cells compared with normal fibroblasts. This study was performed to investigate whether the cytotoxic effect of eugenol is associated with the induction of apoptosis and involves activation of caspase in the human melanoma G361 cells. Eugenol-induced apoptosis was confirmed by MTT assay, Hemacolor stain, Hoechst stain, DNA electrophoresis, and Western blot analysis. Eugenol had a significant dose- and time-dependent inhibitory effect on the viability of G361 cells. Eugenol treatment induced caspase-3 and -6 cleavage, and activation. The caspase-3 substrates PARP and DFF45 are cleaved during eugenol-induced apoptosis. It was found that the casapase-6 substrate lamin A was cleaved, whose cleavage has been reported to be necessary for complete condesation of DNA during apoptosis. These results suggest that eugenol may constitute a potential antitumor compound against melanoma occurring in the skin and oral mucosa.

Induction of Apoptosis in Human Oral Squamous Carcinoma Cells by Extracellular Products from Pseudomonas aeruginosa / 대한해부학회지

It was reported that cancer in humans and animals infected with microbial pathogens was regressed about 100 years ago. Bacteria are able to trigger apoptosis by a variety of mechanisms including the secretion of protein synthesis inhibitors, pore forming proteins, molecules activating the endogenous death machinery in the infected cell. This study was conducted in order to investigate whether extracellular products of Psuedomonas aeruginosa (EPPA) induce apoptosis in human oral carcinoma cells (OSC9). The EPPA showed cytotoxic effect on OSC9 cells in dose and time-dependent manner. The cell death was demonstrated to be due to apoptosis characterized by chromatin condensation and nuclear fragment. EPPA treatment induced cleavage of caspase-3 and caspase-6. The caspase substrates, PARP, DFF45 and lamin A were cleaved during EPPA-induced apoptosis. Taken together, EPPA induces apoptosis on human oral squamous carcinoma cells in caspase-dependent manner. Our data therefore provide that EPPA contains a novel antitumor agent for human oral squamous carcinoma.

Cytoplasmic Domain of Intercellular Adhesion Molecule-1(ICAM-1)is Important for the ICAM-1 Mediated Membrane Projection of Endothelial Cells / 대한해부학회지

Intercellular adhesion molecule-1 (ICAM-1)has been shown to enhance leukocyte adhesion, thereby inducing migration through blood endothelial cells. However, the molecular event during the process of adhesion is largely unknown. To examine the role of ICAM-1 cytoplasmic domain in SDF-1 alpha-induced T lymphocyte migration and adhesion, mutant human ICAM-1 molecules were expressed in COS-7 cell line. COS-7 cells expressing ICAM-1_GFP mutant without alpha-actinin revealed no association with the actin cytoskeleton, while wild-type ICAM-showed clear association with the actin, as observed by confocal microscopy, suggesting that actinin binding motif in the cytoplasmic domain of ICAM-1 is important for the proper localization of ICAM-1 on the cell membrane. However, based on adhesion assay, we found that the cytoplasmic domain of ICAM-1 is not essential for the binding of lymphocytes which were activated by SDF-1alpha. On the other hand, ICAM-1-mediated receptor-ligand clustering event was significantly inhibited in the cells expressing ICAM-1 mutants without alpha-actinin or whole cytoplasmic domain. Taken together, these results suggest that ICAM-1 cytoplasmic domain is not essential for the adhesion but important for the ligand-receptor-mediated membrane projection of endothelial cells before trans-endothelial migration of lymphocytes.

Iron chelator inducesMIP-3alpha/CCL20 in human intestinal epithelial cells: implication for triggeringmucosal adaptive immunity

A previous report by this laboratory demonstrated that bacterial iron chelator (siderophore) triggers inflammatory signals, including the production of CXC chemokine IL-8, in human intestinal epithelial cells (IECs). Microarray-based gene expression profiling revealed that iron chelator also induces macrophage inflammatory protein 3 alpha (MIP-3alpha)/ CC chemokine-ligand 20 (CCL20). As CCL20 is chemotactic for the cells involved in host adaptive immunity, this suggests that iron chelator may stimulate IECs to have the capacity to link mucosal innate and adaptive immunity. The basal medium from iron chelator deferoxamine (DFO)-treated HT-29 monolayers was as chemotactic as recombinant human CCL20 at equivalent concentrations to attract CCR6+ cells. The increase of CCL20 protein secretion appeared to correspond to that of CCL20 mRNA levels, as determined by real-time quantitative RT-PCR. The efficacy of DFO at inducing CCL20 mRNA was also observed in human PBMCs and in THP-1 cells, but not in human umbilical vein endothelial cells. Interestingly, unlike other proinflammatory cytokines, such as TNF-alpha and IL-1beta, a time-dependent experiment revealed that DFO slowly induces CCL20, suggesting a novel mechanism of action. A pharmacologic study also revealed that multiple signaling pathways are differentially involved in CCL20 production by DFO, while some of those pathways are not involved in TNF-alpha-induced CCL20 production. Collectively, these results demonstrate that, in addition to some bacterial products known to induce host adaptive immune responses, direct chelation of host iron by infected bacteria may also contribute to the initiation of host adaptive immunity in the intestinal mucosa.

Soluble glucocorticoid-induced TNF receptor (sGITR) induces inflammation in mice

Glucocorticoid-induced TNF receptor (GITR) was a new member of the TNF/nerve growth factor receptor (TNFR/ NGFR) family and induced in murine T cells by dexamathasone. Recombinant soluble GITR (sGITR) induced an inflammation in peritoneal membrane and changes in spleen after i.p. injection of 3 mg/kg in C57BL/6 mice. Spleen was enlarged and percentage of neutrophils and monocytes were increased. The area of red pulp in spleen was increased, while that of white pulp was decreased after GITR injection. The thickening of membrane and neutrophil infiltration was observed in peritoneal membrane with increased myeloperoxidase activity. At later time, neutrophil infiltration moved to inside the tissue with tissue damage. GITR ligand and GITR were expressed constitutively on the surface of spleen cells and cells from peritoneal fluid. In contrast, no significant change in the spleen and in peritoneal membrane was observed in mice treated with LPS. GITR may play a role in body's inflammatory processes.

Therapeutic efficacy of orally administration itraconazole in onychomycosis / 대한피부과학회지

Botween April 1991 and March 1992, a multicenter open trial was done to evaluate the therapeutic efficacy of itraconazole in the treatment of onychomycosis, 116 patients with onychomycosis diagnosed by clinical and mycological finding were recruited from the 24 university hospitals in Korea. They received 100mg of oral itraconazole once a day until clinical improvement was evident or until 12 months. Response to treatment was evaluated clinically and mycologically. Cure was complete absence of clinical lesions and negative mycological results. Marked improvment was minimal clinical lesions with negative mycology. Moderate improvement was some residual clinical lesions with positive mycology. Unchanged was no clinical response until 4 months after therapy. Obtained results were as follows. 1. Mean duration of treatment was 6.3+/-2.0 months (2-12), and 83 (70.7%) were cured, 27 (23.3%) showed marked improvement, 2 (1.7%) were moderately improved, 3 (2.6%) were unchanged, and 2 (1.7%) were excluded due to the possible side effect of the medication, although they showed moderate improvement. 2. When only fingernails were involved, mean duration of treatment was 5.3+/-2.0 months with cure rate of 81.8%. when toenails were involved, mean duration of treatment was 6.5+/-2.0 months, which was significantly longer than that in fingernail, however cure rate was 66.7%, which was not different from that in fingernail. 3. In cases that Candida spp. were causative organism, 91.7% were cured with marked improvement in another 8.3%. Onychomycosis due to dermatophytes were cured in 72.9%. However, when moulds or T. beigelii were isolated, only one out of six was cured. 4. 9 out of the 116 subjects showed possible side effects during itraconazole treatment. Gastrointestinal troubles were noted in seven, whicn were mostly mild and self-limited, however, in one patient, medications were withdrawn due to continuing gastric upset. In another patient, transient visual disturbance was noted and medications were also withdrawn. However, this patient was already suffereing from glaucoma and causal relationshiop was not established. Shoulder pain was noted in another one, however it was regarded probably unrelated to the drug, and medications were contiued without aggravation of the symptoms. 5. 88 patients were followed with serial biochemical liver function tests for two month interval. None of them showed evidence of hepatic injury during the entire observation period. From the above findings, oral itraconazole was regarded as more effective than the preexisting drugs in the treatment of onychomycosis, and also it was regarded safe in long term therapy.

A Study on Plasma Levels of Testosterone and Dehydroepiandrosterone - sulfate ( DHEA - S ) in the Patients with Acne Vulgaris / 대한피부과학회지

This study was performed to detect the hormonal abnormalities and to investigate the relationship between the levels of plasma testosterone and DHEA-S in 21 female patients with acne vulgaris using radioimmunoassay. The results were as follows : 1. The levels of plasma testosterone in patients group and control group(n=9) were 352+/-11.8 ng/dl, 223+/-9.7 ng/dl, respectively, and significantly elevated in patient group(p < 0.01), 2. The levels of plasma DHEA-S in patient group and control group were 286.6+/-126.8 pg/dl, 238.6+/-60.0 pg/dl, respectively, and did not show statistical significance. 3. The levels of plasma testosterones in patient subgroups classified by modified Pillsbury method were as follows minor group 32.6+5.3 ng/dl, mild group 33.4+/-15,5 ng/dl, moderate group 39.6+/-12.6 ng/dl. The testosterone levels in all the subgroups increased significantly than those in control group(352-t11.8 ng/dl) (p<0.05, p<0.05 p < 0.01) 4. The levels of plasrna DHEA-S in patient subgroups were follows minor group 242.5+/-412 pg/dl, mild group 263.9+/-166.1 pg/dl, moderate group 353.4+/-1273 pg/dl. The DE3EA-S levels in moderate group increased significantly than those in cotrol (238,6+/-60,0 pg/dl) and minor group(p<0.05). 5. There was no correlation between the plasma testosterone levels and the plasma DHEA-S levels in the acne patients.

A Case of Tinea Incognito / 대한피부과학회지

We report a case of tinea incognito occurring in a 47-year-old woman who deveoped erythematous papules and scaly patches on whole body after taking corticosteroid therapy intermittently over a period of 3 months. Direct smear and culture for fungus of the lesions demonstrated hyphae and C. albicans and T. mentagrophytes, which confirms the diagnosis. The lesions disappeared three months after systemic and topical antifungal therapy.

A Study of Natural Killer Cell Activities , T Cells and T Cell Subsets in Vitiligo / 대한피부과학회지

The pathogenesis of vitiligo is still unresolved. The three classically held theories are the immune hypothesis, neural hypothesis, and self destruct hypothesis. Recently the immunologic hypothesis is the most important. We analysed natural killer cell activities of 30 cases of vitiligo by Cr release assay, also analysed T cells and T cell subsets of 7 cases of vitiligo in peripheral blood by monoclonal antibody. The result were as follows l. A statistically significant increase of natural killer cell activity was observed in patients with vitiligo(67.5+/-19.2%) in comparison with control subjects(54.7+/-14.7%) 2. 5lo significant difference of natural killer cell activity was observed in patients whose onset of disease was less than 1 year(66.2+/-19.6%) in comparison with more than 1 year(72.0+/-18.4%) 3. No significant difference of natural killer cell activity was observed in patients with vitiligo between generalized(68.3+/-20.6) and localized type(70.3+/-18.0%). 4. The mean value of T cell, T cell subsets(T3, T4, TS) in patients with vitiligo(78. 8+/-10.8, 42.4+/-6.1, 26.46.8%) showed no significant difference in comparison with control subjects(75.3+/-6.3, 43.5+/-8.7, 26.1+/-6.69).

A Case of Pseudoxanthomatous Mastocytosis / 대한피부과학회지

We report a case of pseudoxanthomatous mastocytosis that is an uncommon variant of urticaria pigmentosa. A 3 month-old boy visited our hospital with yellowish cutaneous nodules At the age of 2 months, small yellowish macule developed on the posterior neek, and during the following months, lesions spread to trunk, upper extremities, face, and scalp, most of them became gradually to the nodules. Darier's sign could be elicited easily. A biopsy of one. of the nodules or the back showed a very dense oval or cuboidal cells infiltrate in the dermis. Special stain with toluiddine blue showed this to he composed of mast cells. Electron microscopic examination revealed crowded mast. cells which was showing numerous cytoplasmic granules and long, thin villi. The patient: was managed symptomaticvlly and recommended to avoid mechanical or chemical irritation to the lesions.

A Case of Sebaceous Epithelioma / 대한피부과학회지

Sebaceous epithelioma is an uncommon and primary neoplasm of sebaceous gland. We report herein a case of sebaceous epithelioma in an 85-year-old female. Physical examination showed a solitary, 2.5 x 3.5cm sized, reddish. irregularly surfaced, and well defined tumor on the intercanthal area. Histopathological findings showed tumor parenchyma. romprised of several large nests of three kinds of epithelial cells, mature sebaceous cells, undifferentiated cells arranged in pa1isade fashion at the periphery of a cell nest, and transitional cells showing beginning fatty vacuolizatiorn of the cytoplasm. Electron micocopy revealed immature dark cells, transitional cells, and mature sebaceous cell which showed many scattered foci of sebaceous ditferentiation characterized by intracytoplasmic lipid droplets and glycogen particls.

A Case of Darier' s Disease Improved with Oral Etretinate / 대한피부과학회지

We report a case of Darier's disease occuring in 49-year-old female patient. She had hyperkeratotic crusted eruptions on her forehead, neck and posterior auricular area. The skin lesions aggravated in summer and improved in winter, but never been healed completely. Histopathologic features from neck lesions revealed hyperkeratosis with corps ronds and grains as well as formation of villi and laeunae. We treated her with oral etretinate, and she was almost completely free of disease after 3 months treatment. We suggested that etretinate is an importnat advance in the treatment of Darier's disease.

A Study of Natural Killer Cell Activities in Patients with Behcet's Disease / 대한피부과학회지

Recently, many investigators demonstrate that immunologic mechanisms seem to play an important role in the pathogenesis of Behcet's disease. The present study was undertaken to see the possible roles of NK cell activity in the pathogenesis of Behcet's disease and relationship among NK cell and T-cell and T-subsets. Authors evaluated NK cell activities in 14 patients and T cell, t-subsets in 7 patients. The results were as follows ; 1. The mean value of NK cell activities showed no statistically significant difference between patients group(57.1+/-15.8) and normal healthy control group(56.1+/-16.2). 2. The mean value of T cell(T), T-subsets(T,T)in 7 patients group 74.4+/-9.8, 41. 6+/-8.0, 24.4+/-10.1 showed no statistically significance compared with the mean value of normal healthy control group 67.5+/-4.3, 39.7+/-5.6,26.3+/-6.0 respectively. 3. The mean value of NK cell activities showed no statistically significant difference between 7 complete type patients' group(49.6+13.1) and 7 incomplete type patients' group(64.4+15.6)

A Case of Pityriasis Rubra Pilaris Treated with Etretinate / 대한피부과학회지

We report herein a case of pityriasis rubra pilaris in a 39-year-old male, who had erythematous scaly patches on the face, trunk and extremities for one year. The skin lesion showed well defined plaques on the elbow and knee joint areas, and exfoliative hyperkeratotic sheets with fissures on the palms and soles. He had no family and past history of such skin lesion. He was treated with etretinate lmg/kg/day for 1 week initially, and then tapered off 0.5mg/kg/day for 5 weeks with marked improvement. There was no exacerbation and recurrence of the skin lesion for about 1 year.