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1.
Article in English | WPRIM | ID: wpr-811442

ABSTRACT

Duodenal leiomyosarcoma is a rare condition with a poor prognosis. Early diagnosis of duodenal leiomyosarcoma is challenging because it presents with nonspecific symptoms and endoscopic biopsies usually do not enable a definitive diagnosis. Duodenal leiomyosarcomas are diagnosed on the basis of the histopathological identification of a mesenchymal lesion composed of malignant tumor cells that on immunohistochemical examination is positive for smooth muscle actin and desmin. We report the case of a 38-year-old man who presented with gastrointestinal bleeding and obstruction who was diagnosed with duodenal leiomyosarcoma after surgical resection.


Subject(s)
Actins , Adult , Biopsy , Desmin , Diagnosis , Duodenal Obstruction , Early Diagnosis , Gastrointestinal Hemorrhage , Hemorrhage , Humans , Leiomyosarcoma , Muscle, Smooth , Prognosis
2.
Article in English | WPRIM | ID: wpr-810950

ABSTRACT

BACKGROUND: Immune cells express the vitamin (vit) D receptor, and vit D is a potent immune-modulator. A negative correlation between serum vit D levels and rheumatoid arthritis (RA) disease activity has been reported. Therefore, we aimed to investigate if the sufficient serum vit D level is helpful to control disease activity in RA patients treated with interleukin (IL)-6 receptor antibody tocilizumab.METHODS: RA patients taking tocilizumab were enrolled, and data were collected retrospectively. Disease activity scores (DAS) 28, serum vit D levels, modified Sharp scores of hand X-ray at the time of tocilizumab initiation, and follow-up data were analysed. Peripheral blood mononuclear cells were differentiated into T-helper (Th) 17 or osteoclasts in the presence of various concentrations of tocilizumab and/or 1,25(OH)₂D. Th17 proportions were analysed by fluorescence-activated cell sorting. Supernatant cytokine levels were determined by enzyme-linked immunosorbent assay.RESULTS: Among 98 RA patients taking tocilizumab, 34 (34.7%) had sufficient serum 25(OH)D levels (≥ 30 ng/mL) when tocilizumab was initiated. At 24 weeks, vit D sufficient patients had greater DAS28 reduction (64.6% ± 15.5% vs. 52.7% ± 20.7%, P = 0.004), and lower disease activity (91.2% vs. 70.3%, P = 0.018) or remission (82.4% vs. 57.8%, P = 0.014). These differences in DAS28 reduction and the proportion of patients with remission persisted at 48 weeks. However, there was no significant difference in hand and wrist erosion progression. In vitro, tocilizumab and 1,25(OH)₂D treatment synergistically suppressed IL-17 production and osteoclastogenesis.CONCLUSION: RA patients treated with IL-6 antibody show a better response when they have sufficient serum vit D. Tocilizumab and 1,25(OH)₂D synergistically suppress IL-17 production and osteoclast differentiation in RA patients.


Subject(s)
Arthritis, Rheumatoid , Cholecalciferol , Enzyme-Linked Immunosorbent Assay , Flow Cytometry , Follow-Up Studies , Hand , Humans , In Vitro Techniques , Interleukin-17 , Interleukin-6 , Interleukins , Osteoclasts , Retrospective Studies , Vitamin D , Vitamins , Wrist
3.
Immune Network ; : e26-2019.
Article in English | WPRIM | ID: wpr-764020

ABSTRACT

Since primary Sjögren's syndrome (pSS) is an autoummune disease of B cell hyperactivity and pathologic autoantibody response, follicular helper T (Tfh) cells and follicular regulatory T (Tfr) cells are suggested to be key players in pSS. We examined subsets of Tfh and Tfr cells from the blood in pSS patients, and whether these subsets represent disease activity, glandular inflammation, or autoantibody responses in pSS. Circulating Tfh and Tfr cells, along with their specific subsets, were identified from the peripheral blood of 18 pSS patients and 14 age- and sex-matched healthy controls (HCs) using flow cytometry analysis. Blood Tfr and Tfh cell ratios were increased in pSS patients compared with HCs. The CCR7(lo)PD-1(hi) subset of circulating Tfh cells was increased in pSS patients with high degree of focal lymphocytic sialadenitis; whereas circulating Tfh cells did not differ between pSS patients and HCs. The frequency of CCR7(lo)PD-1(hi) Tfh cells was significantly correlated with disease activity scores and differentiated B cells. PD-1 expression on blood Tfh and Tfr cells showed positive correlations with IL-21 in pSS. Increasing trend of blood Tfr cells was observed in pSS patients, and blood Tfr cells (particularly Th1 and Th17 subsets) represented hypergammaglobulinemia in pSS. In summary, circulating CCR7(lo)PD-1(hi) Tfh cells indicated disease activity and glandular inflammation in pSS. Circulating Tfr cells, shifted toward Th1 and Th17 subsets, indicated ongoing IgG production in pSS. Subsets of circulating Tfh or Tfr cells could be biomarkers for disease monitoring and patient stratification in pSS.


Subject(s)
Autoantibodies , B-Lymphocytes , Biomarkers , Flow Cytometry , Humans , Hypergammaglobulinemia , Immunoglobulin G , Inflammation , Sialadenitis , T-Lymphocyte Subsets , T-Lymphocytes , T-Lymphocytes, Helper-Inducer , T-Lymphocytes, Regulatory
4.
Article in English | WPRIM | ID: wpr-206186

ABSTRACT

The circulation and infection of avian influenza virus (AIV) in zoos and backyard flocks has not been systematically investigated. In the present study, we surveyed the birds including those in live bird markets (LBMs) and evaluated co-circulation of AIVs among them. Overall, 26 H9N2 AIVs and one H6N2 AIV were isolated from backyard flocks and LBMs, but no AIVs were isolated from zoo birds. Genetic analysis of the HA and NA genes indicated that most of the H9N2 AIVs showed higher similarities to AIVs circulating in domestic poultry than to those in wild birds, while the H6N2 AIV isolate from an LBM did to AIVs circulating in migratory wild birds. In serological tests, 15% (391/2619) of the collected sera tested positive for AIVs by competitive-ELISA. Among them, 34% (131/391) of the sera tested positive for AIV H9 antigen by HI test, but only one zoo sample was H9 positive. Although AIVs were not isolated from zoo birds, the serological results indicated that infection of AIVs might occur in zoos. It was also confirmed that H9N2 AIVs continue to circulate and evolve between backyard flocks and LBMs. Therefore, continuous surveillance and monitoring of these flocks should be conducted to control further epidemics.


Subject(s)
Animals , Birds , Influenza in Birds , Korea , Molecular Epidemiology , Poultry , Serologic Tests , Viruses
5.
Article in Korean | WPRIM | ID: wpr-41949

ABSTRACT

It is difficult to distinguish between circulating lymphoma cells and non-lymphoma cells which are lymphocytes, activated lymphocytes, monocytes, and leukemic cells. The presence of circulating lymphoma cells in the peripheral blood is infrequent but the incidence is probably significantly higher than has been reported in morphologic studies of peripheral blood smears. So the morphologic evaluations of the circulating lymphoma cells and non-lymphoma cells are needed. We experienced that circulating lymphoma cells were found in the peripheral blood smears in the 4 cases of non-Hodgkin's lymphomas. They were consisted of mantle cell lymphoma (1 case), peripheral T cell lymphoma (1 case), adult T cell leukemia/lymphoma (1 case), cutaneous T cell lymphoma (1 case) and diagnosed from their lymph node biopsies. Those circulating lymphoma cells were morphologically observed by light and electron microscopic methods. Using those morphological features, we think that detection rate of circulating lymphoma cells can be improved in the patient with lymphoma.


Subject(s)
Adult , Biopsy , Humans , Incidence , Leukemia , Lymph Nodes , Lymphocytes , Lymphoma , Lymphoma, Mantle-Cell , Lymphoma, Non-Hodgkin , Lymphoma, T-Cell, Cutaneous , Lymphoma, T-Cell, Peripheral , Monocytes
6.
Article in Korean | WPRIM | ID: wpr-177891

ABSTRACT

BACKGROUND: Because moving means can be easily shiftable according to their crude data, we made a selective expected ranges to calculate the moving means. Bull's mean (exponential factor, P=0.50) and Exponentially Adjusted Moving Mean (EAMM, P=0.66) were assessed. we studied to determine appropriately expected range and exponential factor. METHODS: We made the target values from RBC indices being measured with H-2 hematology autoanalyzer from 800 patients and the expected range from red cell indices data of additional 600 patients. Both moving means using this expected ranges were calculated. The % difference of Bull's mean and EAMM was compared and total mean of (deltaBull's mean/deltaBatch mean) and (deltaEAMM/deltaBatch mean) was compared. RESULTS: The target values were MCV: 90.6 fL, MCH: 29.8 pg. MCHC: 32.8 g/dL. The expected ranges were within +/-6% of their target values. Among the 20 batches obtained from expected range, there were no above +/-3% difference of red cell indices in both moving means. The comparison between % difference of Bull's mean and that of EAMM showed no difference. Total mean of (deltaEAMM/deltaBatch mean) was higher than that of (deltaBull's mean/deltaBatch mean). CONCLUSIONS: The % difference results of Bull's mean and EAMM were basically similiar within the expected range but EAMM method was more sensitive than Bull's mean method under the aspect of specimen effects, so EAMM was more detectable than Bull's mean on the quality control of red cell indices.


Subject(s)
Erythrocyte Indices , Hematology , Humans , Quality Control
7.
Article in Korean | WPRIM | ID: wpr-116638

ABSTRACT

BACKGROUND: For the early diagnosis of tsutsugamushi disease, polymerase chain reaction (PCR) using skin specimen might be a precise and useful diagnostic tool. The purpose of this study is to detect and identify the serotype of the Orientia tsutsugamushi from the skin lesions of the patients with tsutsugamushi disease by nested PCR. METHODS: Nested PCR was used to diagnose tsutsugamushi disease and identify the serotype of the O. tsutsugamushi; Karp, Kato, Gilliam or Boryong/Kuroki. The primer sets were derived from serotype-specific DNA sequences encoding the 56kDa antigen of O. tsutsugamushi. The PCR products were analyzed by using direct cyclic sequencing. RESULTS: The serotype-specific DNA bands with 1% agarose gel electrophoresis of amplified DNAs by nested PCR were observed in all 11 skin biopsy specimens from 8 patients with tsutsugamushi disease. Among 8 patients, 7 were proved to be infected with Boryong/Kuroki strains and one with Karp. One Karp strain showed one base mutation with amino acid sequence variation, but all the Boryong/ Kuroki strains showed no mutation. CONCLUSION: We suggest that serotype-specific nested PCR is a simple, rapid and precise diagnostic method, and useful for early diagnosis of tsutsugamushi disease. Furthermore, we might detect the sequence variations of serotype-specific DNA sequences encoding 56-kDa antigen among strains.


Subject(s)
Amino Acid Sequence , Base Sequence , Biopsy , DNA , Early Diagnosis , Electrophoresis, Agar Gel , Humans , Orientia tsutsugamushi , Polymerase Chain Reaction , Scrub Typhus , Skin
8.
Article in Korean | WPRIM | ID: wpr-117220

ABSTRACT

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.


Subject(s)
Ankle , Basophils , Cytoplasm , Female , Foot , Humans , Radiotherapy , Recurrence , Sarcoma, Clear Cell , Skin , Tendons , Thorax , Young Adult
9.
Article in Korean | WPRIM | ID: wpr-81130

ABSTRACT

We experienced a case of scrotal calcinosis which was considered to be developed from the trichilemmal cysts of the scrotum. This 22 year-old male patient has been suffered from pea-sized hard muliple yellowish nodules of the scrotum since. about 5 years ago. Histopathologic findings revealed multiple cysts or calcium lumps surrounded by variable a.mounts of granulomatous inflammatory infiltrations in the dermis. The cysts were lined by stratified squamous epithelium without intercellular bridge and surrounded by scanty inflammatory cells. Several cysts contained homogenous keratinous material but most cysts contained calcium deposits within the homogenous keratinous materials or only the calcium lumps in the intact epithelial linings. Most of calcium lumps which had partially or completely disintegrated epithelial linings were surrounded by active granulomatous inflammatory infiltrations and a few calrium lumps with completely disintegrated epithelial linings had no surrounding inflammatory cells. Observing the above histopathologic features, we could consider that this case of scrotal calcinosis was developed from the scrotal trichilemmal cyst and some cases of idiopathic scrotal calcinosis, previousely reported, were the end stage of the above process.


Subject(s)
Calcinosis , Calcium , Dermis , Epithelium , Humans , Male , Scrotum , Young Adult
10.
Article in Korean | WPRIM | ID: wpr-81121

ABSTRACT

We present a case of acquired, bilateral nevus of Ota-like macules in 50-year-old women, She had deeply brownish, confluent or solitary macules and patches distributed symmetrically on the both side of the forehead and temple, since years ago. But there was no involvement (of ocular and oral mucosa. Histopathologic findings showed flattening of the rete ridges and elongated or irregular shaped melanocytes containing many melaiiin granules, in upper-and mid-dermis. And most of melanocytes showed positive reactions on Dopa stain.


Subject(s)
Dihydroxyphenylalanine , Female , Forehead , Humans , Melanocytes , Middle Aged , Mouth Mucosa , Nevus
11.
Article in Korean | WPRIM | ID: wpr-106127

ABSTRACT

A clinical and histopathologic study was done on 48 cases of cutaneous tuberculosis among 43, 209 out-patients in Dermatologic department of Korea t.Jniversity Hospital during the period of 15 years and 9 mont4s from January, 1969 to September, 1984. These 48 cases were consistent with skin tuberculosis in histologic and clinicalI finc1ings, The result were summarized as follows: ]. The incidence of skin tuberculosis was 0 I 1 g among 43, 209 cases of outpatients. 2. Localized type of skin tuberculosis was 3. 2 times more frequent than disseminated type. Frequent skin tuberculosis was lupus vulgaris (57 3%), erythema induratum (12, 5%), tuberculosis verrucosa cutis(8.3%) and lupus milaris disseminatus faciei (8. 3%). 4, The ratio between male and fenmle was 1: l. 1. 5 The ages of onset were variable according to the types of skin tuberculosis. but 45 8% of all cases developed in the age group between 10 and 29 years. Seasonal incidences of skin tuberculosis were 52. 1% in spring, 85%, in winter, 18. 8% in summer, 4, 2%, in autumn. 7 In histopathologic findings, there were tubercle or tubrculoid structures in all cases and typical tubercle structures were observed in 18.8% The ratio of accordance between the histopathologic diagnosis and clinicopa thologic diagnosis was 81.3%.


Subject(s)
Diagnosis , Erythema Induratum , Humans , Incidence , Korea , Lupus Vulgaris , Male , Outpatients , Seasons , Skin , Tuberculosis , Tuberculosis, Cutaneous
12.
Article in Korean | WPRIM | ID: wpr-178175

ABSTRACT

A case of cutaneous cartilaginous tumor was diagnosed from solitary nadular skin lesion on a toe of 59-year old female. Lack of information about cartilage tumors in the dermatologic literature suggest that they rarely develop as supeficial lesions. General clinico-pathologic feature of the tumor is reviewed.


Subject(s)
Cartilage , Chondroma , Female , Humans , Middle Aged , Skin , Toes
13.
Article in Korean | WPRIM | ID: wpr-179088

ABSTRACT

Clear cell sarcoma of tendon and aponeuroses is slow growing and painless. It occur chiefIy in young adults, predominates in women and is most common in the region of the foot and knee. It is intimately bound to tendons or aponeuroses and is composed of srnall nest or aggregates of round or fusiform, pale staining cells showing prominent nucleoli. And it is tend to recur and to resuIt in eventual development of metastatic growth after a protracted clinical ccurs. Herein, we report a case of clear cell sarcorna of tendon anu aponeuross of metatarsophalangeal joint area between 2nd and 3rd light of left foot. The patient, 50-year-old female had a slow groving, asymptomatic, slightly eevated, emooth surfaced and normal skin colored mass for 2 years. Histopatholcigic tindings in dermis revealed nests of atypical polygonal or monotonous cells. Each cell had vesicular or hyperchrornatic nucleus with prominent nucleoli, occcasionally mitotic figure and abundant eosinophilic cytoplasm. For. treatment, transmetatarsal amputation was done.


Subject(s)
Amputation , Cytoplasm , Dermis , Eosinophils , Female , Foot , Humans , Knee , Metatarsophalangeal Joint , Middle Aged , Sarcoma, Clear Cell , Skin , Tendons , Young Adult
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