Role of TGFBIp in Wound Healing and Mucin Expression in Corneal Epithelial Cells

PURPOSE: Transforming growth factor-β-induced protein (TGFBIp) is highly expressed in the cornea, and mutant TGFBIp induces corneal diseases. However, the function of TGFBIp in cornea epithelium is not fully investigated. Here, we tested the importance of TGFBIp in regulation of gene expression and corneal epithelial cell (CEC) activity. MATERIALS AND METHODS: The effect of TGFBIp on CEC activity was analyzed by cell migration, adhesion, proliferation and wound healing assay. Analysis of gene expression was examined by western blot and quantitative reverse transcription PCR. RESULTS: The results demonstrated that TGFBIp increased adhesion, migration, proliferation, and wound healing of CECs. Analysis of gene expression presented that TGFBIp-stimulated CECs exhibited increased expression of mucin family genes, such as MUC1, -4, -5AC, and -16. Furthermore, TGFBIp treatment increased the expression of MUC1, -4, -5AC, -7, and -16 in conjunctival epithelial cells. TGFBIp also increased the activity of intracellular signaling molecules ERK and AKT in CECs. Using pharmacologic inhibitors of ERK and AKT, we showed that the expression of mucin genes by TGFBIp is mediated by the activation of ERK and AKT signaling. CONCLUSION: Our findings demonstrate that the locally generated TGFBIp in the cornea may contribute to wound healing of CECs by enhancing the migration, adhesion, and proliferation of CECs. In addition, our results suggest that TGFBIp has a protective effect on ocular surfaces by inducing the expression of mucin genes in corneal and conjunctival epithelial cells. These data suggest that TGFBIp is a useful therapeutic target for patients with corneal wounds.

Cutaneous Manifestations in End-stage Renal Disease on Hemodialysis and Peritoneal Dialysis / 대한피부과학회지

BACKGROUND: End-stage renal disease (ESRD) is accompanied by various skin manifestations, and recently, the survival time of patients is increasing owing to the development of dialysis treatment, and skin manifestations are on the rise. OBJECTIVE: The objective of this study is to investigate the differences in skin changes, according to the dialysis method and period in ESRD patients, and to verify whether a correlation exists between the factors that affect pruritus. METHODS: Various kinds of skin manifestations were identified by examining and asking 80 outpatients detailed questions and the difference was examined by classifying them into groups, according to the dialysis method and period. RESULTS: The most common symptoms were xerosis (91%) and pruritus (85%). The study showed that most symptoms occurred more frequently in the peritoneal dialysis group than the hemodialysis, and among these, the change of sweating had a significant difference (p=0.043). As the dialysis period got longer, skin manifestation generally showed a higher frequency, and the particular bleeding tendencies and nail abnormalities showed an obvious difference. Results considering the relation of severity of pruritus and xerosis with the dialysis method and period showed a significant increase only in pruritus, according to the dialysis period (p=0.003). CONCLUSION: Skin changes showed a high frequency in peritoneal dialysis, but it didn't show a significant difference. Bleeding tendencies, changes of sweating, and nail abnormalities, according to the dialysis period, showed a significant difference. Factors causing pruritus were more related with xerosis than blood levels showing a renal function.

Cutaneous Manifestations in End-stage Renal Disease on Hemodialysis and Peritoneal Dialysis / 대한피부과학회지

BACKGROUND: End-stage renal disease (ESRD) is accompanied by various skin manifestations, and recently, the survival time of patients is increasing owing to the development of dialysis treatment, and skin manifestations are on the rise. OBJECTIVE: The objective of this study is to investigate the differences in skin changes, according to the dialysis method and period in ESRD patients, and to verify whether a correlation exists between the factors that affect pruritus. METHODS: Various kinds of skin manifestations were identified by examining and asking 80 outpatients detailed questions and the difference was examined by classifying them into groups, according to the dialysis method and period. RESULTS: The most common symptoms were xerosis (91%) and pruritus (85%). The study showed that most symptoms occurred more frequently in the peritoneal dialysis group than the hemodialysis, and among these, the change of sweating had a significant difference (p=0.043). As the dialysis period got longer, skin manifestation generally showed a higher frequency, and the particular bleeding tendencies and nail abnormalities showed an obvious difference. Results considering the relation of severity of pruritus and xerosis with the dialysis method and period showed a significant increase only in pruritus, according to the dialysis period (p=0.003). CONCLUSION: Skin changes showed a high frequency in peritoneal dialysis, but it didn't show a significant difference. Bleeding tendencies, changes of sweating, and nail abnormalities, according to the dialysis period, showed a significant difference. Factors causing pruritus were more related with xerosis than blood levels showing a renal function.

Parry-Romberg Syndrome with Band-like Linear Alopecia / 대한피부과학회지

Parry and Romberg described progressive facial hemiatrophy, characterized by progressive unilateral wasting of the skin, fat, muscle and bone in 1825 and 1846, respectively. Involvement of the central nervous system, with impairment of neurologic function, occurs infrequently. Linear scleroderma on frontal and parietal scalp, named 'en coup de sabre', is considered an overlapping condition. An 11 year-old girl was presented to our office with left facial hemiatrophy and transverse linear band-like alopecia on her posterior parietal scalp. Histopathologically, there was a sclerotic change of the collagen fibers and dermal lymphocytic infiltrations around the skin appendages. Her skin lesion has improved by intralesional corticosteroid injection. Linear scleroderma frequently coexists with Parry-Romberg syndrome. But in this case, she had a unique pattern of scleroderma, which is distinct from the previously reported cases.

An Unusual Case of Korean Brother and Sister with Woolly Hair

No abstract available.

Pachyonychia Congenita Affecting the Nails Only in the Mother and Son / 대한피부과학회지

Pachyonychia congenita (PC) is a rare autosomal-dominant ectodermal dysplasia, which is characterized by hypertrophic nail dystrophy, diffuse or focal symmetrical hyperkeratosis of the palms and soles, oral leukokeratosis, follicular keratosis on the extensor surfaces of the extremities, and other ectodermal defects. However, the variable degree of gene mutation may result in nail abnormalities alone. The nail changes presented in our patient are the only clinical manifestation. Hypertrophic nail dystrophy and yellowish discoloration, without involving any other organs, were shown in both mother and baby since birth. To the best of our knowledge, the case of PC affecting only the nails has never been reported in Korea before. Herein, we report monosymptomatic form of PC, which is notable for its rareness and unique pattern, distinct from previously reported cases.

Primary Cutaneous Follicular B Cell Lymphoma That Arose on the Scalp / 대한피부과학회지

Primary cutaneous follicular B cell lymphomas are rare entities of an unknown cause, except for those induced by Epstein-Barr virus (EBV) or Borrelia burgdorferi. Follicular B cell lymphoma has been thought to rarely occur primarily in the skin. The lesions are generally solitary plaques or nodules that are localized on the head and neck. It shows considerable variation in the clinical presentation, the histological features, the immunophenotype and the prognosis. In this case, a 79-year-old man presented with a 3-month history of lesions on his head. Clinical examination revealed two deep-seated subcutaneous tumors with uneven surfaces located on the both sides of the frontoparietal area of the scalp. Biopsy of the skin lesion disclosed a massive dermal lymphocytic infiltrate with a follicular pattern. On immunohistochemical staining, the lymphocytes strongly expressed CD20 and Ki-67, but not Bcl-2. He was diagnosed with primary cutaneous follicular B cell lymphoma. This case illustrates a rarely reported example of primary cutaneous follicular B cell lymphoma that arose on the scalp.

Habitual Thumbsucking-induced Koilonychia in Infancy / 대한피부과학회지

Koilonychia is dystrophy characterized by eversion of the marginal portion of the nail. As a result, the central portion of the nail is concave. It has been associated with systemic or skin-related conditions. Hereditary koilonychia is inherited as an autosomal dominant trait. Koilonychia can also be caused by exogenous factors such as certain toxic chemicals or repeated mechanical trauma. In this case, koilonychia on the fingernail of the left thumb was caused by repeated trauma resulting from continuous suction since birth. Herein, we report a rare case of koilonychia induced by habitual thumbsucking.

Subungual Squamous Cell Carcinoma of the Left Fourth Finger: A Case Report / 대한피부과학회지

Subungual squamous cell carcinoma is a rare malignant tumor. It may clinically mimic a variety of benign inflammatory lesions and this frequently misdirects the clinician toward delaying proper treatment. In this article, a 62-year-old woman presented with a 2-year history of repeat swelling, erythema and severe pain on the left fourth fingernail. She had been frequently treated under the clinical impression of paronychia or onychomycosis. Despite the treatment, no improvement was noted. She had an incisional biopsy of the perionychium. The histologic diagnosis was revealed invasive, well-differentiated squamous cell carcinoma. On the whole body PET-CT, hypermetabolic lesion was found in the distal phalanx of the left fourth finger. She underwent amputation at the distal phalangeal joint. There has been no recurrence of tumor for one year after surgery. In conclusion, subungual squamous cell carcinoma is often mistaken for chronic inflammation. When resistance to treatments is observed, the possibility of malignancy must be considered and early biopsy is recommended.

Development of Policy and Strategy for the Control of Creutzfeldt-Jakob Disease in Korea / 한국역학회지

PURPOSE: Through the understanding of the current status of transmissible spongiform encephalopathy(TSE), this study was conducted to contribute to the development of policy and strategy for the control of TSE in Korea in order to keep Korea as a bovine spongiform encephalopathy(BSE)- and variant Creutzfeldt-Jakob disease(vCJD)-free country. BSE and vCJD cases have not been found in Korea. During 2001-2004, the number of patients who have been diagnosed as a definite or probable CJD was 121, which are consisted of 62 male and 59 female(average age: 63 years old). The occurrence of the patients was 5-59 people per year until 2003 and has been gradually increasing due to the recent increase in the diagnostic rate rather than the increase of the incidence. In 2004, the annual occurrence of sporadic CJD(sCJD) in Korea was 1 people per million, which is similar to the average occurrence rate of the world. Two cases of chronic wasting disease(CWD) in deer were found in Chungcheongbuk-do, one in August 2001 and one in October 2001. After that, 4 more CWD-affected deer have been reported in Kyungsangnam-do area in November 2004. We have also examined the possibility that Korean CJD occurred as a result of dietary exposure to BSE. Fortunately, all of Korean CJD patients were not vCJD cases. However, if BSE occurs in Korea, there is a great potential for most of the Korean population to be easily infected with BSE due to their highly susceptible genotype to BSE infection as well as their traditional food habit. In 2003, the total number of people who left Korea was almost identical with the total number of people who entered Korea. However, we could not analyze the number of people who visited or stayed in the UK and Europe during 1980s~1990s, in which BSE was prevalent in Europe, because there was no statistical data available.

A Case of Bacterial Endophthalmitis Following Penetrating Keratoplasty

Endophthalmitis is an intraocular inflammation caused by bacteria or fungus. Although endophthalmitis may result from an endogenous source elsewhere in the body, it most commonly occurs following intraocular surgery or penetrating ocular injury. But endophthalmitis following penetrating keratoplasty reveals the significantly lower incidence than by other causes. We have experienced one case of bacterial endophthalmitis following penetrating keratoplasty which was proved to be Pseudomonas aeruginosa by bacterial culture. In spite of two intravitreal injection of proper antibiotics, his clinical symptoms and signs did not improve and his visual acuity decreased to hand movement. So, we performed pars plana vitrectomy and third intravitreal injection of antibiotic and achieved a successful results with final visual acuity of 6/20. We report a case of endophthalmitis following penetrating keratoplasty and with the review of literature.

Corneal Sensation after Phacoemulsification Versus Planned Extracapsular Cataract Extraction

In order to compare the corneal sensation after phacoemulsification and the planned extracapsular cataract extraction(p-ECCE), we studied 40 eyes of 31 patients prospetively. A Cochet-Bonnet esthesiometer was used to measure corneal sensitivity preoperatively and at one day, three day, one week, one month, and two months postoperatively, by the same surgeon using the same technique. There was no difference in corneal sensation between phacoemulsification and p-ECCE group preoperatively. The mean corneal sensitivity at 10:00(2:00) o`clock in phacoemulsificantion/p-ECCE was 17.3+/-7.0(18.2+/-6.7)/9.9+/-1.5(10.3+1.9), 22.1+/-6.9 (23.2+/-6.3)/14.1+/-2.3(14.3+/-2.3), 29.4+/-7.7(30.6+/-7.2)/17.7+2.2(18.7+/-2.2), 37.7+/-9.3(37.8+/-9.4)/26.3+/-7.9(27.7+/-8.4), 56.3+/-7.6(56.3+7.9)/59.2+/-3.8(59.4+/-2.7)mm after 1, 3, 7, 30, 60 days, respectively. Corneal sensation at the center and the 3, 6, and 9 o`clock positions was not changed in all eyes. Corenal sensitivity was significantly more recovered in phacoemulsification group than the p-ECCE group at postoperative onemonth(p<0.05). However, there were no statistically significant difference in recovery of corneal sensation between phacoemulsification group and p-ECCE group at postoperative two months. Conclusively corneal sensation returned to peroperative level at two months postoperatively in both groups.