Histopathological and Immunohistochemical Differentiation between Psoriasis and Seborrheic Dermatitis of the Scalp: Based on Langerin and CD1a / 대한피부과학회지

Background@#Psoriasis and seborrheic dermatitis are difficult to distinguish if the lesion is localized to the scalp. @*Objective@#To validify the use of langerin and CD1a as markers of Langerhans cells to distinguish scalp psoriasis from seborrheic dermatitis. @*Methods@#We retrospectively evaluated 25 seborrheic dermatitis cases and 17 psoriasis cases diagnosed at a tertiary medical center in Korea from 2010 to 2019. The histopathological features and expression of CD1a and langerin were analyzed by dermato-pathologists. @*Results@#Hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound were observed more frequently in the psoriasis group than in the seborrheic dermatitis group (p=0.016, p=0.027, and p=0.021, respectively). Other features examined did not show statistically significant differences. Dermal expression of langerin occurred more frequently in the psoriasis group than in the seborrheic dermatitis group (76.5% vs. 36.0%, p=0.010). Additionally, stronger CD1a dermal expression was observed in the psoriasis group than in the seborrheic dermatitis group (p=0.049), although the difference in overall dermal CD1a expression regardless of strength was not significant. In contrast, the epidermal expressions of CD1a and langerin did not show significant differences. Similarly, the follicular expressions of CD1a and langerin did not demonstrate significant differences. @*Conclusion@#In this retrospective study, histopathological findings that favored psoriasis over seborrheic dermatitis included hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound. The use of Langerhans cells, CD1a, and langerin as markers could help distinguish scalp psoriasis from seborrheic dermatitis.

Histopathological and Immunohistochemical Differentiation between Psoriasis and Seborrheic Dermatitis of the Scalp: Based on Langerin and CD1a / 대한피부과학회지

Background@#Psoriasis and seborrheic dermatitis are difficult to distinguish if the lesion is localized to the scalp. @*Objective@#To validify the use of langerin and CD1a as markers of Langerhans cells to distinguish scalp psoriasis from seborrheic dermatitis. @*Methods@#We retrospectively evaluated 25 seborrheic dermatitis cases and 17 psoriasis cases diagnosed at a tertiary medical center in Korea from 2010 to 2019. The histopathological features and expression of CD1a and langerin were analyzed by dermato-pathologists. @*Results@#Hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound were observed more frequently in the psoriasis group than in the seborrheic dermatitis group (p=0.016, p=0.027, and p=0.021, respectively). Other features examined did not show statistically significant differences. Dermal expression of langerin occurred more frequently in the psoriasis group than in the seborrheic dermatitis group (76.5% vs. 36.0%, p=0.010). Additionally, stronger CD1a dermal expression was observed in the psoriasis group than in the seborrheic dermatitis group (p=0.049), although the difference in overall dermal CD1a expression regardless of strength was not significant. In contrast, the epidermal expressions of CD1a and langerin did not show significant differences. Similarly, the follicular expressions of CD1a and langerin did not demonstrate significant differences. @*Conclusion@#In this retrospective study, histopathological findings that favored psoriasis over seborrheic dermatitis included hyperkeratosis, parakeratosis, and the presence of neutrophils in the parakeratotic mound. The use of Langerhans cells, CD1a, and langerin as markers could help distinguish scalp psoriasis from seborrheic dermatitis.

Severe or Profound Sensorineural Hearing Loss Caused by Novel USH2A Variants in Korea: Potential Genotype-Phenotype Correlation

Objectives@#. We, herein, report two novel USH2A variants from two unrelated Korean families and their clinical phenotypes, with attention to severe or more than severe sensorineural hearing loss (SNHL). @*Methods@#. Two postlingually deafened subjects (SB237-461, M/46 and SB354-692, F/34) with more than severe SNHL and also with suspicion of Usher syndrome type II (USH2) were enrolled. A comprehensive audiological and ophthalmological assessments were evaluated. We conducted the whole exome sequencing and subsequent pathogenicity prediction analysis. @*Results@#. We identified the following variants of USH2A from the two probands manifesting more than severe SNHL and retinitis pigmentosa (RP): compound heterozygosity for a nonsense (c.8176C>T: p.R2723X) and a missense variant (c.1823G>A: p.C608Y) in SB237, and compound heterozygosity for two frameshift variants (c.14835delT: p.S4945fs & c.13112_13115delAAAT: p.G4371fs) in SB354. Based on the American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines, two novel variants, c.1823G>A: p.C608Y and c.14835delT: p.Ser4945fs, can be classified as “uncertain significance” and “pathogenic,” respectively. The audiogram exhibited more than severe SNHL and a down-sloping configuration, necessitating cochlear implantation. The ophthalmic examinations revealed typical features of RP. Interestingly, one proband (SB 354-692) carrying two truncating compound heterozygous variants exhibited more severe hearing loss than the other proband (SB 237-461), carrying one truncation with one missense variant. @*Conclusion@#. Our results provide insight on the expansion of audiological spectrum encompassing more than severe SNHL in Korean subjects harboring USH2A variants, suggesting that USH2A should also be included in the candidate gene of cochlear implantation. A specific combination of USH2A variants causing truncating proteins in both alleles could demonstrate more severe audiological phenotype than that of USH2A variants carrying one truncating mutation and one missense mutation, suggesting a possible genotype-phenotype correlation. The understanding of audiological complexity associated with USH2A will be helpful for genetic counseling and treatment starategy.

Comparison of outcomes of two methods of axillary osmidrosis surgery: Subdermal excision versus liposuction combined with diode laser ablation

Background@#Patients with axillary osmidrosis suffer from a foul odor due to the bacterial decomposition of apocrine gland secretions. This condition is stressful, especially for teenaged students and young working people in Korea, who seek a reliable method for reducing odor that allows them to quickly return to school or work after surgery. Thus, surgeons must seek ways to effectively remove sweat glands with minimal complications. The conventional subdermal excision method has been widely used for the removal of sweat glands, but it can have many complications. The purpose of this study is to determine whether liposuction combined with diode laser ablation is effective for sweat gland removal compared with the subdermal excision method. @*Methods@#From 2011 to 2017, we compared two surgical methods for osmidrosis: subdermal excision and liposuction combined with diode laser ablation. An objective analysis of sweat (apocrine) gland count, determined by histopathological examinations of preoperative and postoperative punch biopsy specimens, was combined with a subjective assessment of patients’ symptoms (malodor grade) preoperatively and postoperatively. @*Results@#A larger percentage of sweat glands were removed by subdermal excision than by liposuction with diode laser ablation. However, no statistically significant difference was found between the two methods with regard to the percentage of apocrine glands removed. Liposuction with diode laser ablation had fewer perioperative complications and higher patient postoperative satisfaction than subdermal excision. @*Conclusions@#Liposuction with diode laser ablation is a useful method for axillary osmidrosis surgery in teenaged students and young working people in Korea.

Curcumin Attenuates Acrolein-induced COX-2 Expression and Prostaglandin Production in Human Umbilical Vein Endothelial Cells

OBJECTIVE: Inflammation is crucial to limiting vascular disease. Previously we reported that acrolein, a known toxin in tobacco smoke, might play an important role in the progression of atherosclerosis via an inflammatory response involving cyclooxygenase-2 (COX-2) and prostaglandin production in human umbilical vein endothelial cells (HUVECs). Curcumin has been known to improve vascular function and have anti-inflammatory properties. In this study, we investigated whether curcumin prevents the induction of inflammatory response caused by acrolein.METHODS: Anti-inflammatory effects of curcumin were examined in acrolein-stimulated HUVECs. Induction of proteins, mRNA, prostaglandin and reactive oxygen species (ROS) were measured using immunoblot analysis, real-time reverse-transcription polymerase chain reaction, enzyme-linked immunosorbent assay and flow cytometry, respectively.RESULTS: Curcumin attenuates inflammatory response via inhibition of COX-2 expression and prostaglandin production in acrolein-induced human endothelial cells. This inhibition by curcumin results in the abolition of phosphorylation of protein kinase C, p38 mitogen-activated protein kinase, and cAMP response element-binding protein. Furthermore, curcumin suppresses the production of ROS and endoplasmic reticulum stress via phosphorylation of eukaryotic initiation factor-2α caused by acrolein.CONCLUSION: These results suggest that curcumin might be a useful agent against endothelial dysfunction caused by acrolein-induced inflammatory response.

Adenomyoepithelioma of the Breast: Which Mimicking Malignancy on Ultrasound Elastography

Adenomyoepithelioma (AME) is a rare breast lesion with balanced proliferation of both epithelial and myoepithelial cells. Patients usually present with a solitary mass without pain and nipple discharge. Although the tumor is generally considered benign, it has potential for local recurrence, metastasis, or malignant change. Approximately 150 cases have been reported in the medical literature, of which 40 cases were malignant or potentially malignant. But among them, elastographic findings have been reported in only two cases and still remain unclear. Herein, we now present a case of breast AME with emphasis on elastography.

The first case of vaginal angiomatoid Spitz nevus causing vaginal bleeding

Angiomatoid Spitz nevus is a variant of melanocytic nevus with prominent vasculature. Due to its pathologic features, angiomatoid Spitz nevus in the vaginal wall is extremely rare. A 42-year-old woman presented to the hospital with abnormal vaginal bleeding. Vaginal examination revealed a 2×2-cm well-demarcated tumor on the posterior wall of the vagina. The mass was successfully removed by complete excision and was diagnosed as angiomatoid Spitz nevus on pathologic examination. We present the first reported case of vaginal angiomatoid Spitz nevus, which caused vaginal bleeding. Although angiomatoid Spitz nevus has many histopathological similarities with malignant melanoma, precise histopathological diagnosis is important for preventing overtreatment.

Pulmonary Comorbidities of Lung Emphysema

Pulmonary emphysema is defined as the “abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of the alveolar wall and without obvious fibrosis.” Pulmonary emphysema could result in various complications or comorbidities, many of which are interrelated. Pulmonary emphysema can result in a number of interrelated complications and comorbidities. When pulmonary emphysema is accompanied by comorbidities, it may exhibit different and unique radiologic findings, depending on the underlying lung condition. The purpose of this article was to review radiologic findings that have been reported in patients with underlying emphysema, as well as localized pulmonary comorbidities including infection, fibrosis, primary lung cancer, hemorrhage, and other rare conditions.

Spectrum of Multi-Detector Computed Tomography Findings that Alter Pulmonary Artery Diameters in Adults

Abnormalities in the anatomy of pulmonary arteries may have heritable or environmental causes and involve a reduction or enlargement in transverse diameters of the blood vessels eg, congenital and developmental disorders, acquired intrinsic causes, extrinsic compression, and constriction. Pulmonary hypertension, pulmonary artery aneurysm and pseudoaneurysm, and idiopathic dilatation can also increase the diameter of a pulmonary artery. Multi-detector computed tomography (CT) is useful to evaluate each pulmonary artery and to diagnose the conditions that alter the diameter of the pulmonary artery. It is important to be familiar with the CT features of a variety of disorders to allow for accurate diagnoses and appropriate therapeutic management.

A Study on Vitamin D and Cathelicidin Status in Patients with Rosacea: Serum Level and Tissue Expression

BACKGROUND: Rosacea is a chronic inflammatory disease characterized by centrofacial erythema. Excess cathelicidin is suggested to be important to the pathophysiology of the disease. Recently, presence of a vitamin D response element was revealed in the cathelicidin gene promoter. OBJECTIVE: The aim of this study was to determine whether vitamin D and cathelicidin are associated with rosacea, both serologically and histopathologically. METHODS: Subjects with rosacea and without chronic skin disorders were enrolled in the patient and control groups, respectively. Serum 25-hydroxy-vitamin D and cathelicidin levels were measured. Tissue expression of cathelicidin and vitamin D receptor were measured with immunostaining-intensity-distribution index. RESULTS: The mean serum 25-hydroxyvitamin D level of patients with rosacea was 12.18±5.65 ng/ml, which is lower than that of the controls (17.41±6.75 ng/ml). Mean serum cathelicidin levels in patients with rosacea and the controls were 85.0±26.1 ng/ml and 55.0±23.3 ng/ml, respectively. Cathelicidin expression in rosacea tissue was significantly higher than that in control tissue (5.21 vs. 4.03). No significant difference was observed in vitamin D receptor expression. CONCLUSION: Higher cathelicidin expression in rosacea supports the hypothesis that an abnormal inflammatory response of the innate immune system is important in pathogenesis of rosacea, but the role of high cathelicidin serum levels is complicated. Serum vitamin D was lower in patients with rosacea, although serum cathelicidin was higher than that of the controls. This suggests that the role of vitamin D level in the pathogenesis of rosacea merits further investigation.

Knowledge and Practice of Fever Management by Mothers of Preschool Children at Home

PURPOSE: This study was done to identify the level and correlation of knowledge and practice of fever management at home and provide data for the development of an intervention program to improve the fever management ability of mothers of preschool age children. METHODS: Participants were 112 mothers with children between 1 and 6 years of age and attending one of three daycare centers located in J city. The participants had a history of using medication and tepid massage. Data were collected during April, 2016. RESULTS: The mean scores were 27.55 (correct answer rate 70.64%) of 39 for knowledge, and 75.93 of 92 for fever management practice. There were significant differences in scores for knowledge according to the number of children and number of visits to doctors for treatment of a fever. There were no differences in scores for practice. There was a positive correlation between knowledge and practice. CONCLUSION: Results indicate that mothers' knowledge and practice of childhood fever management were insufficient to provide accurate management of childhood fevers. Therefore, to improve the mothers' ability to provide appropriate fever management, educational strategies that focus on increasing knowledge need to be developed.

Mycoplasma Infection as a cause of Persistent Fever after Intravenous Immunoglobulin Treatment of Patients with Kawasaki Disease: Frequency and Clinical Impact / 감염과화학요법

BACKGROUND: Mycoplasma is a common cause of respiratory infections and may require differential diagnosis from Kawasaki disease (KD). In this study, we investigated the frequency and clinical manifestations of mycoplasma infection in patients with KD. MATERIALS AND METHODS: Medical records of 375 in-patients admitted for treatment during the acute stage of KD, were collected, and reviewed retrospectively. Of these patients, 152 (40.5%) were also tested for recent mycoplasma infection. Patients with positive results (anti-mycoplasma IgM Ab >1:640 or cold agglutinin >1:64) were designated as the case group (n = 37, 24.3%) whereas those with negative results were designated as the control group (n = 115, 75.7%). Clinical findings of the two groups were compared. RESULTS: Patients in the case group were older than those in the control group (mean age, 48.2 ± 32.1 months, vs. 31.7 ± 21.7 months; P = 0.001). There were significant differences between the case and control groups in the changes in the extremities (78.3% vs. 57.4%, respectively; P = 0.031), and in fever duration (6.5 ± 2.5 days vs. 5.4 ± 1.5 days; P = 0.047). Of the 37 patients with positive mycoplasma testing, 7 (18.9%) had persistent fever even after the symptoms and signs of systemic inflammation (acute phase of KD) had been resolved. These patients were positive for mycoplasma infection during further evaluation of persistent fever, and all of them responded to macrolide antibiotics. CONCLUSIONS: We found that mycoplasma infection is somewhat related to KD. When fever persists after resolution of the acute stage of KD, mycoplasma infection may be considered as a possible cause of fever in preschool-aged children.

Recurrent Gastric Perforation in a Neonate Recovered after Primary Surgical Repair and Percutaneous Peritoneal Drainage / 대한주산의학회잡지

Neonatal gastric perforation is a rare but fatal disease, occurred mainly in preterm infants. In general, primary surgical repair is the main treatment. To the best of our knowledge, there has been only one report of improvement of gastric perforation in neonates after percutaneous peritoneal drainage alone. We describe a case of gastric perforation in a premature extremely low-birth-weight infant girl of 25(+4) weeks gestational age. We present this case to emphasize that gastric perforation may improve with percutaneous peritoneal drainage.

P2X7 Receptor Expression in Coexistence of Papillary Thyroid Carcinoma with Hashimoto's Thyroiditis

BACKGROUND: This study was aimed at investigating the relation of P2X7 receptor (P2X7R) expression with the clinicopathological features of papillary thyroid carcinoma (PTC) coexisting with Hashimoto's thyroiditis (HT). METHODS: We examined 170 patients (84, PTC with HT; 86, PTC without HT). P2X7R expression was examined by immunohistochemical methods. The staining intensity and patterns were evaluated and scored using a semi-quantitative method. RESULTS: The PTC with HT group was more likely to contain women and had less extrathyroid extension, lymph node (LN) metastasis, lymphovascular invasion, and recurrence than the PTC without HT group. Patients positive for P2X7R had significantly higher frequencies of lymphovascular invasion, extrathyroid extension, LN metastasis, and absence of HT. As shown by multivariate analysis, the expression of P2X7R was significantly higher if HT was absent and extrathyroid extension was present. In the PTC with HT group, the expression of P2X7R was significantly higher in patients with tumor multifocality, lymphovascular invasion, and extrathyroid extension. In the PTC without HT group, the expression of P2X7R was significantly higher in women and those having tumor multifocality. CONCLUSIONS: Coexistence of PTC with HT is associated with good prognostic factors, and P2X7R expression in PTC was correlated with poor prognostic factors and the absence of HT.

Simultaneous Occurrence of Ductal Carcinoma In Situ within Juvenile Fibroadenoma in Both Breasts: A Brief Case Report

No abstract available.

Proteomics Analysis for Helicobacter pylori-infected Gastric Mucosa / 대한소화기학회지

BACKGROUND/AIMS: Helicobacter pylori infection is linked to the development of gastric cancer. H. pylori-associated gastric inflammation is considered to be the first important step in the histogenesis of such neoplasia. However, studies that compare proteome of gastric mucosa infected with or without H. pylori are lacking. METHODS: We employed proteomics analysis on the endoscopic biopsy specimens of gastric mucosa obtained from two groups (30 cases): healthy subjects without H. pylori infection (15 cases), and gastritis patients with H. pylori infection (15 cases). The pooled proteins obtained from gastric mucosa infected with or without H. pylori were separated by two-dimensional gel electrophoresis and analyzed by a computer-aided program. The altered protein expressions were then identified by mass spectrometry and validated by Western blotting and immunohistochemistry. RESULTS: On mass spectrometry using MALDI TOF(TM) Analyzer, the up-regulation of Keratin 1, ezrin, adenosine triphosphate (ATP) synthase subunit alpha mitochondrial isoform c, Keratin type I cytoskeletal 19, and Keratin type I cytoskeletal 9 were identified; in contrast, 71 kd heat shock cognate protein, ATP synthase subunit alpha mitochondrial precursor, and annexin IV were down-regulated. Among them, membrane cytoskeleton linker ezrin was validated using Western blot and immunohistochemistry. CONCLUSIONS: Expression of ezrin was significantly different between the gastric mucosa with and without H. pylori infection. Therefore, ezrin could be considered a promising potential molecular marker for detecting H. pylori infection in gastric mucosa.

Expression of Histone Deacetylases HDAC1, HDAC2, HDAC3, and HDAC6 in Invasive Ductal Carcinomas of the Breast / 한국유방암학회지

PURPOSE: DNA deacetylation by histone deacetylase (HDAC) is an important mechanism involved in the oncogenic tumorigenesis of breast cancer. Previous studies have reported an association of the estrogen receptor (ER) with HDACs and demonstrated the efficacy of HDAC inhibitors for the treatment of breast cancers via in vitro experiments. In this study, we examined the association of HDAC expression with clinicopathological parameters and disease-specific survival. METHODS: Immunohistochemical (IHC) analysis of HDAC1, HDAC2, HDAC3, and HDAC6 was performed using tissue microarrays in 300 invasive ductal carcinomas. IHC scoring was determined by multiplication of the intensity (0 to 3) and the proportion (0 to 4) of staining, and we classified tumors into low- and high-HDAC expression groups. RESULTS: High expression of HDAC1 was correlated with the molecular subtype (p=0.001) and human epidermal growth factor 2 (HER2) amplification (p=0.012). High expression of HDAC6 was correlated with a younger age (p<0.001), ER expression (p=0.025), progesterone receptor expression (p=0.034), molecular subtype (p=0.023), and HER2 amplification (p=0.011). High HDAC1 expression was correlated with luminal A tumors (p=0.001), while high HDAC6 expression was more common in luminal B tumors (p=0.023). Although the expression of HDACs did not exhibit prognostic significance in the entire cohort, high expression of HDAC1 and HDAC6 was associated with improved overall survival (OS) in patients with ER-positive tumors (p=0.017 and p=0.029, respectively), and high expression of HDAC2 was correlated with improved OS in ER-negative tumors (p=0.048) on univariate analysis. Furthermore, high HDAC6 expression was associated with improved disease-free survival (p=0.048) on multivariate analysis. CONCLUSION: HDAC1 expression is significantly correlated with the molecular subtypes of tumors, with the highest expression being observed in luminal A tumors. HDAC6 is a significantly correlated with ER expression and the molecular subtype, thereby supporting the estrogen regulatory property of HDAC6. HDAC1 and HDAC6 expression are good prognostic factors for ER-positive tumors.

Vasculitis as a Presenting Feature of Multiple Myeloma in a Patient with Rheumatoid Arthritis

Paraneoplastic vasculitis is a part of secondary vasculitis, the hematological neoplasm, such as lymphoma or myelodysplastic syndrome, which is most frequently observed. However, in multiple myeloma, cutaneous vasculitis is a rare complication, particularly as an initial clinical symptom. We report one case where a purplish reticulated patch on the lower extremity and an ear lobe skin necrotic change developed in a rheumatoid arthritis patient. He was diagnosed with multiple myeloma and cutaneous vasculitis.

Vasculitis as a Presenting Feature of Multiple Myeloma in a Patient with Rheumatoid Arthritis

Paraneoplastic vasculitis is a part of secondary vasculitis, the hematological neoplasm, such as lymphoma or myelodysplastic syndrome, which is most frequently observed. However, in multiple myeloma, cutaneous vasculitis is a rare complication, particularly as an initial clinical symptom. We report one case where a purplish reticulated patch on the lower extremity and an ear lobe skin necrotic change developed in a rheumatoid arthritis patient. He was diagnosed with multiple myeloma and cutaneous vasculitis.

Heterotopic Intestinal Cyst of the Submandibular Gland: A Case Study

Heterotopic gastrointestinal cysts are rarely found in the oral cavity. Most of these cysts are lined with gastric mucosa and involve the tongue. There have been no reported heterotopic intestinal cysts of the submandibular gland that are completely lined with colonic mucosa. An 8-year-old girl presented with an enlarging swelling in the left submandibular area, and a 4-cm unilocular cyst was fully excised. The cyst was completely lined with colonic mucosa that was surrounded by smooth muscle layer, and the lining cells were positive for CDX-2, an intestinal marker, indicating a high degree of differentiation. The pathogenesis remains unclear, but it may be related to the misplacement of embryonic rests within the oral cavity during early fetal development. Although heterotopic intestinal cysts rarely occur in the submandibular gland, they should be considered in the differential diagnosis of facial swellings in the pediatric population.