Combined Treatment of Murine Fibrosarcoma with Chemotherapy (Paclitaxel), Radiotherapy, and Intratumoral Injection of Dendritic Cells

BACKGROUND: New antitumor therapeutic strategies aim to combine different approaches that are able to induce tumor-specific effector and memory T cell responses that might control tumor growth. Dendritic cells (DCs) have the capacity to induce antigen-specific cytotoxic T lymphocytes. We have previously shown that the combined treatment of paclitaxel chemotherapy (Chemo) and injection of DCs led to complete tumor regression. OBJECTIVE: The goal of this study was to evaluate synergistic antitumor effect of a triple combination treatment comprising radiotherapy, paclitaxel Chemo and intratumoral injection of syngeneic bone marrow-derived DCs on murine fibrosarcoma, compared to other single or double combination treatments. METHODS: For the murine fibrosarcoma model, naive C57BL/6 mice were inoculated intradermally with 2x10(3) MCA102 cells in the right upper flank. Mice were assigned to five groups (untreatedcontrol, RT alone, RT+Chemo, RT+DC, and RT+Chemo+DC), with eight mice in each group. In vitro cytotoxicity assays were performed to assess the immune activity. The persistence of tumor-specific immunity was determined by second tumor challenge in mice with complete tumor regression. RESULTS: The triple combination treatment showed a significantly enhanced therapeutic efficacy by decreasing tumor size and inducing complete tumor regression, resulting in a cure of 50% of mice. The results of in vitro cytotoxicity assays and the second tumor challenge experiment strongly indicated the induction of a tumor-specific cytotoxic T lymphocyte response and acquisition of prolonged tumor immunity. CONCLUSION: These findings suggest that the triple combination treatment can be a promising strategy for the treatment of murine fibrosarcoma.

Experience in 102 Non-melanoma Skin Cancer with Mohs Micrographic Surgery / 대한피부과학회지

BACKGROUND: Mohs micrographic surgery (MMS) is a specialized type of minimal marginal surgery, which offers superior cure rates to other options in the treatment of non-melanoma skin cancers. OBJECTIVE: The aim of this study is to investigate the clinical characteristics and recurrence rate of the non-melanoma skin cancer and to estimate the safeties of MMS. METHODS: We retrospectively evaluated 102 patients who had been diagnosed with non-melanoma skin cancer and treated by MMS from May 2008 to September 2011. RESULTS: The most common cancer was basal cell carcinoma (63.72%), followed by squamous cell carcinoma (31.38%). The local flap was the most common method to repair surgical defects (74.5%), followed by primary closure (17.64%). Cervical lymph node metastasis was confirmed in 1 case (0.98%). Recurrence after MMS was observed in 1 of 102 patients (0.98%). CONCLUSION: MMS is a safe method for the treatment of non-melanoma skin cancer.

Photodistributed Telangiectasia Induced by Amlodipine

Calcium channel blockers are widely used antihypertensive drugs, which are uncommonly associated with cutaneous reactions, such as pruritus, urticaria, or alopecia. Photosensitivity presenting with telangiectasia has rarely been described. We present here a case of photodistributed telangiectasia induced clinically by amlodipine and histologically by enlarged capillaries in the upper dermis without signs of vasculitis.

A Case of Neutrophilic Dermatosis of the Dorsal Hands with Concomitant Involvement of the Lips

Neutrophilic dermatosis of the dorsal hands (NDDH) is a localized, pustular variant of acute febrile neutrophilic dermatosis (Sweet syndrome). The lesions of NDDH clinically resemble those of Sweet syndrome (SS), but they differ from classic SS according to their locations (NDDH is predominantly restricted to the dorsal hands) and the smaller number of accompanying systemic symptoms. The histology of the NDDH lesion shows a dense dermal neutrophilic infiltration. The lesions rapidly resolve after systemic corticosteroid and/or dapsone therapy. We herein report on a case of neutrophilic dermatosis of the dorsal hands in a 34-year-old woman. The patient also had skin changes with erythematous plaque on the right lips.

Postpartum Depressive Score and Related Factors Pre- and Post-delivery / 여성건강간호학회지

PURPOSE: This study aimed to identify the scores of postpartum depression(PPD) on the first day, 1st week, and 6th week after the delivery and to explore their related factors before and after delivery in postpartum women. METHODS: With a survey design, 293 postpartum women were recruited from a postpartum unit, Ilsin Christian hospital in Pusan via convenience sampling and were followed at 1st week and 6th week in the outpatient clinic. RESULTS: Results showed that the scores of PPD(EPDS score) were low at postpartum 1st day, 1st week and 6th week but prevalence of PPD(EPDS > or =13) was 3.1% at 1st day, 8.2% at 1st week and 7.5% at 6th week, respectively. The pre-delivery factors were experience of depression, and the post-delivery factors were baby's sex(1st day), no caregiver for baby(1st week), and no help and concern for taking care of baby from husband and family(1st day and 6th week). The greater satisfaction with becoming a mother and her life, and greater maternal attachment were related to lower level of PPD at the three time points. CONCLUSION: Regular screening for postpartum depression and supportive and informative education is needed for postpartum women visiting the outpatient clinic for follow-up.

Surgical Treatment for Acquired Malalignment of the Toenail / 대한피부과학회지

Malalignment of the toenail is a rare deformity that is characterized by lateral deviation of the nail plate with respect to the longitudinal axis of the distal phalanx. The condition may be congenital or acquired. The acquired forms of malalignment may result from trauma or surgical intervention. However, there are only a few reports that have focused on surgical treatment for this condition. We present here a case of a 24-year-old woman who had this nail problem for 1 year and she was successfully treated with the surgical approach. We also discuss the probable mechanism of iatrogenic malalignment.

Two Cases of Pruritic Urticarial Papules and Plaques of Pregnancy in the Postpartum / 대한피부과학회지

Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as a polymorphic eruption of pregnancy, is the most common dermatosis of pregnancy. Typically, PUPPP starts with erythema and urticarial papular eruption in the abdominal striae and may extend to the buttocks and thighs. It usually evolves in the third trimester and resolves rapidly in the postpartum. It is not usually recurrent in subsequent pregnancies. We report herein two patients with postpartum PUPPP.

Isotretinoin Treatment for the Recalcitrant Acne on a Patient with Apert Syndrome / 대한피부과학회지

Apert syndrome is a rare genetic craniofacial disorder associated with premature fusion of multiple cranial sutures and syndactyly. It is caused by mutation in the fibroblast growth factor receptor 2 genes. The clinical findings are characterized by the typical dysmorphic facial features, including hypertelorism, proptosis and cleft palate. Most of these patients have widespread, severe acne involving the face, chest, back and forearms during puberty and the acne is unresponsive to conventional treatments. We report here on a patient with the recalcitrant acne of Apert syndrome and the patient had failed to respond to conventional acne treatment, but the acne was successfully treated with isotretinoin

A Case of Lichenoid Drug Eruption Caused by Allopurinol / 대한피부과학회지

Lichenoid drug eruption is a lichenoid skin eruption caused by certain drugs and compounds, and can be similar to lichen planus. A 51-year-old man who had taken antihypertensive drugs (enalapril, dilazep dihydrochloride) and cholesterol lowering drug (atorvastatin) for 4 years had received allopurinol for asymptomatic hyperuricemia for 4 months. He developed pruritic erythematous papules and plaques with silvery scales on the face, trunk and extremities after taking allopurinol for 3 months. He had no fever, no eosinophilia and no systemic abnormalities. Histopathologic findings showed hyperkeratosis, parakeratosis, hypergranulosis, band-like lymphohistiocytic infiltration and perivascular lymphohistiocytic infiltration in the dermis, which were compatible with lichenoid drug eruption. The skin rashes disappeared after he stopped taking allopurinol and was treated with steroids.

A Case of Scrub Typhys during Pregnancy Treated with Azithromycin / 대한피부과학회지

Scrub typhus (tsutusgamushi disease) is an acute febrile illness caused by Orientia tsutsugamushi, which is endemic in the Asia-Pacific area. Scrub typhus in pregnant woman is uncommon and some reports have suggested that this disease may be associated with increased fetal loss. An effective and safe treatment regime for scrub typhus on pregnancy has not been established and the clinical outcome on the pregnant woman and fetus is unclear. We report a case of scrub typhus during pregnancy treated with azithromycin, which showed no recurrence and no fetal and neonatal complications.

Three Cases of Digital Mucous Cyst Treated with Sodium Tetradecyl Sulfate Sclerotherapy / 대한피부과학회지

A digital mucous cyst is a benign, non-inflammatory disease frequently observed on the dorsal aspect of the fingers and toes. Multiple punctures with extraction of the cyst contents and intralesional steroid injections are the suggested treatments. However, this approach has shown a high failure and recurrence rate. Cryotherapy has had a better success rate but it is a more painful procedure. Surgical excision of the communicating tract between the cyst and joint has been reported to have the highest cure rate but it requires highly skilled surgery, and the surgery has the risk of severe complications including contractures of the joints and acquired nail deformity. We report three patients with digital mucous cysts treated by sclerotherapy without complications.

A Case of Cowden Syndrome / 대한피부과학회지

Cowden syndrome is a rare autosomal dominant disorder characterized by mucocutaneous alterations including multiple facial trichilemmomas, oral mucosal papillomatosis, and acral keratoses. Extracutaneous lesions include polyposis of the gastrointestinal tract, and other multiple hamartoma of the internal organs. A 39 year-old man presented with multiple verruca-like papules and lichenified patches on the face, one year ago. He had been treated for atopic dermatitis for more than 10 years. Although he had been treated in accordance with atopic dermatitis for 1 year, his skin lesions had not improved, so a skin biopsy was performed. The skin biopsy specimen revealed the typical finding of trichilemmoma. Colonoscopy diagnosed diffuse colorectal polyposis. The clinical and hisopathologic findings were consistent with Cowden syndrome. We, herein, report a case of Cowden syndrome with atopic dermatitis.

A Case of Dermatomyositis Associated with Scarring Alopecic Patches / 대한피부과학회지

Dermatomyositis is a rare disease of unknown origin that combines an inflammatory myopathy with characteristic cutaneous findings. Scalp disease has rarely been considered as a manifestation of dermatomyositis and is often misdiagnosed as being scalp paosiasis or seborrheic dermatitis. We report a case of 27-year-old woman who presented with brownish alopecic patches on the scalp, and chronic proximal muscle weakness.

Expression of Smad 2 and 3 on the Lesions of Leprosy / 대한피부과학회지

BACKGROUND: Leprosy is an infectious disease with two polar forms, tuberculoid leprosy (TT) and lepromatous leprosy (LL), that are characterized by strong cell-mediated immunity (CMI) and CMI anergy, respectively. Transforming growth factor-beta (TGF-beta) is a family of growth factors involved in essential physiological processes, including development, differentiation, tissue repair, cell growth control and inflammation. Cellular signaling by TGF-beta family members is initiated by the assembly of specific cell surface receptors that activate transcription factors of the Smad family. Deregulation of the TGF-beta-Smad signaling pathway has been implicated in developmental disorders and several human diseases. Recently, ELISA & immunohistochemistry revealed high expression of TGF-beta isoforms in LL. OBJECTIVE: The purpose of this study was to investigate TGF-beta-Smad signaling in various forms of leprosy. METHODS: We investigated the involvement of TGF-beta by immunohistochemical staining for Smad 2 and 3 in skin biopsies from six patients of BL and four patients of TT. RESULTS: The inflammatory cells, keratinocytes and fibroblasts in BL showed strong positivity for both Smad 2 and 3, whereas those in TT showed little positivity. CONCLUSION: The high expression of Smad 2/3 in BL could represent high expression of TGF-beta, which possibly contributes to local CMI anergy and other clinical characteristic features of leprosy.

Two Cases of Pilomatricoma with Bullous Appearance / 대한피부과학회지

Pilomatricoma is a common, benign, cutaneous neoplasm, differentiating towards elements of the hair matrix and shaft. It typically presents as a deep-seated, solitary, firm nodule with overlying normal epidermis. However, pilomatricoma with bullous appearance is very rare. We report two cases of pilomatricoma with bullous appearance. The first case was an 11-year-old male who presented with 6 month history of a soft, erythematous, translucent polypoid mass on the left upper arm. The other case was a 20-year-old female who presented with 12 month history of a soft, slightly-brownish, peduncluated mass with indurated nodules on the left upper arm. In both cases, the histopathologic findings revealed multiple islands of shadow cells, with small foci of basophilic cells at the periphery of the deep dermis. There was dilation of lymphatic vessels in the overlying dermis, which explained the clinical bullous appearance.

Two Cases of Pilomatricoma with Bullous Appearance / 대한피부과학회지

Pilomatricoma is a common, benign, cutaneous neoplasm, differentiating towards elements of the hair matrix and shaft. It typically presents as a deep-seated, solitary, firm nodule with overlying normal epidermis. However, pilomatricoma with bullous appearance is very rare. We report two cases of pilomatricoma with bullous appearance. The first case was an 11-year-old male who presented with 6 month history of a soft, erythematous, translucent polypoid mass on the left upper arm. The other case was a 20-year-old female who presented with 12 month history of a soft, slightly-brownish, peduncluated mass with indurated nodules on the left upper arm. In both cases, the histopathologic findings revealed multiple islands of shadow cells, with small foci of basophilic cells at the periphery of the deep dermis. There was dilation of lymphatic vessels in the overlying dermis, which explained the clinical bullous appearance.

A Case of Acrosyringeal Nevus / 대한피부과학회지

Acrosyringeal nevus is a rare condition, which includes proliferation of acrosyringeal keratinocytes, and the proliferation extends from the undersurface of the epidermis down into the dermis as thin anastomosing cords. It is, however, controversial whether acrosyringeal nevus is the same lesion as eccrine syringofibroadenoma, because of several clinicopathological differences. We report a case of benign tumor, consisting of eccrine structures, which occurred in a 60-year-old man. The histopathological features of the excisional biopsy were consistent with acrosyringeal nevus.

A Case of Acquired Digital Arteriovenous Malformation / 대한피부과학회지

Arteriovenous malformation (AVM) consists of an abnormal connection between artery and vein without any interposed capillary bed, and is usually congenital. However, acquired AVM is quite rare, and is usually caused by injury, which induces direct arteriovenous shunting. Acquired digital AVM is a distinct entity, which was first described by Kadono et al. in 2000, and was thought to result from shunts between an artery and a vein in a finger tip. We report a case of acquired digital AVM in a 44-year-old women. The patient showed punctate hyperketatotic ectasia on the pulp of the right thumb. Histological finding showed dilated venous and arterial vessels in upper and lower dermis, and shunts between arteriols and venules.

A Case of Dopa-Responsive Dystonia, Segawa Disease / 대한소아신경학회지

Segawa disease, hereditary progressive dystonia with marked diurnal fluctuations or defined dopa-responsive dystonia has age-dependent clinical courses, which are characterized with marked progression in the first one and half decades, its subsiding in the third decade and almost stationary courses after the fourth decade. Also, it has characteristic diurnally fluctuating symptoms, aggravated towards the evening and alleviated after sleep. This autosomally dominantly inherited dystonia is caused by abnormalities of the gene of GTP cyclohydrolase I. The heterozygotic gene's abnormality induces partial decrement of tetrahydrobiopterin and affects synthesis of tyrosine hydroxylase(TH) rather selectively. The reduction of TH induces decrement of dopamine and disfacilitates the D1 receptor-striatal direct pathway. The pathognomonic finding in biochemical examination is the decrease of neopterin in the cerebrospinal fluid(CSF). Levodopa, by replacing dopamine contents at the terminal, alleviates motor symptoms completely and the effects sustain without any side effects. We experienced a girl diagnosed as Segawa disease with typical clinical courses and a decrease of neopterin in the CSF.

A Study on the Development of the Korean Family Resilience Scale / 간호학회지

PURPOSE: The purpose of this study was to develop an instrument to measure family resilience for Korean families with a chronically ill child, and to test the validity and reliability of the instrument. METHOD: The items of instruments used based on the researchers' previous study of concept analysis of Korean family resilience. Nineteen item scales were developed with five domains. In order to test reliability and validity of the scale, data were collected from 231 families, who had a child with a chronic illness. Data was collected between August and September of 2001 in a 3rd level University Hospital in Seoul, Korea. RESULT: The results were as follows: As a result of the item analysis, 19 items were selected from the total of 37 items, excluding items with low correlation with the total scale. Five factors were evolved by factor analysis, which explained 56.4% of the total variance. The first factor 'Family strength' explained 28.5%, 2nd factor 'Family maturity' 8.7%, 3rd factor 'The ability to use of external resources' 7.0%, 4th factor 'Control' 6.6%, 5th factor 'The driving force for finance' 5.7%. The attributes in these factors were different with those identified by concept analysis of the family resilience in Korean families from the previous study. Cronbach's alphacoefficient of this scale was .8039 and Guttman spilt- half coefficient was .8184. CONCLUSION: The study support the reliability and validity of the scale. Because the main concept of family resilience was family strength, there were distinct differences in dimensions of family functioning scales.