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Background and Objectives@#Studies evaluating the nature of ischemic burden of chronic total occlusion (CTO) vessels are still lacking. @*Methods@#A total of 165 patients with single vessel CTO >2.5 mm in an epicardial coronary artery who underwent single photon emission computed tomography (SPECT) were enrolled in the study. Ischemic burden was calculated with the use of semi-quantitative SPECT analysis, and was defined as the summed difference score (SDS) divided by the maximal limit of the score (=SDS/68). @*Results@#The mean age of the participants was 59.5 years and the CTO of the left anterior descending coronary artery (LAD), left circumplex coronary artery (LCX), and right coronary artery (RCA) accounted for 93 (56.4%), 18 (10.9%), and 54 (32.7%) patients, respectively. The median ischemic burden of the total population was 8.8%, and it was highest in the LAD CTO (10.3%) compared with the LCX (5.9%) and RCA CTO (5.9%, p10%) was observed in 66 patients (40.0%), and in 47 patients (50.5%) of the LAD CTO. Ischemic burden was different according to the CTO location only in LAD CTO. The statistically significant predictors for high-ischemic burden were hypertension, baseline ejection fraction >45%, LAD CTO, proximal CTO location, and de novo CTO. Japanese-CTO score and Rentrop scale collateral grade were not associated with high-ischemic burden. @*Conclusions@#Only 40% of patients with single vessel CTO had ischemic burden >10%. For CTO vessels, measurement of ischemic burden using SPECT prior to revascularization may be helpful in identifying beneficial subjects.
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14-3-3γ plays diverse roles in different aspects of cellular processes. Especially in the brain where 14-3-3γ is enriched, it has been reported to be involved in neurological and psychiatric diseases (e.g. Williams-Beuren syndrome and Creutzfeldt-Jakob disease). However, behavioral abnormalities related to 14-3-3γ deficiency are largely unknown. Here, by using 14-3-3γ deficient mice, we found that homozygous knockout mice were prenatally lethal, and heterozygous mice showed developmental delay relative to wild-type littermate mice. In addition, in behavioral analyses, we found that 14-3-3γ heterozygote mice display hyperactive and depressive-like behavior along with more sensitive responses to acute stress than littermate control mice. These results suggest that 14-3-3γ levels may be involved in the developmental manifestation of related neuropsychiatric diseases. In addition, 14-3-3γ heterozygote mice may be a potential model to study the molecular pathophysiology of neuropsychiatric symptoms.
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Animais , Camundongos , Ansiedade , Encéfalo , Heterozigoto , Camundongos Knockout , Síndrome de WilliamsRESUMO
Cutaneous lesions of leukemia cutis (LC) by chronic neutrophilic leukemia (CNL) have been merely reported due to the rare occurrences of CNL. Furthermore cutaneous lesions in relation to clinical severity have been far less studied. A 70-year-old man presented with multiple violaceous papules and excoriations on both lower extremities. The diagnosis was LC based on histologic and laboratory evaluation and the origin was elaborated as CNL with the confirmation of colony stimulating factor 3 receptor (CSF3R) mutation. Interestingly, the patient presented clinical severity in a parallel manner to the hematologic abnormality. To the best of our knowledge, there has been no reported case of CSF3R confirmed LC in CNL featuring explicit skin eruption in relation to laboratory findings.
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Idoso , Humanos , Fatores Estimuladores de Colônias , Diagnóstico , Leucemia , Leucemia Neutrofílica Crônica , Extremidade Inferior , PeleRESUMO
BACKGROUND: Bee venom (BV) has been widely investigated for potential medical uses. Recent inadvertent uses of BV based products have shown to mitigate signs of fungal infections. However, the component mediating the antifungal effect has not been identified. OBJECTIVE: This investigation compares bee venom in its whole and partial forms to evaluate the possible component responsible for the antifungal effect. METHODS: Forty-eight plates inoculated with Trichophyton rubrum were allocated into four groups. The groups were treated with raw BV (RBV), melittin, apamin and BV based mist (BBM) respectively and each group was further allocated accordingly to three different concentrations. The areas were measured every other day for 14 days to evaluate the kinetic changes of the colonies. RESULTS: The interactions of ratio differences over interval were confirmed in groups treated with RBV and BBM. In RBV, the level of differences were achieved in groups treated with 10 mg/100 µl (p=0.026) and 40 mg/100 µl (p=0.000). The mean difference of ratio in groups treated with RBV was evident in day 3 and day 5. The groups that were treated with melittin or apamin did not show any significant interaction. In BBM groups, the significant levels of ratio differences over time intervals were achieved in groups treated with 200 µl/100 µl (p=0.000) and 300 µl/100 µl (p=0.030). CONCLUSION: The the bee venom in its whole form delivered a significant level of inhibition and we concluded that the venom in separated forms are not effective. Moreover, BV based products may exert as potential antifungal therapeutics.
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Antifúngicos , Apamina , Venenos de Abelha , Abelhas , Meliteno , Negociação , Trichophyton , PeçonhasRESUMO
BACKGROUND/AIMS: Compared with metallic drug-eluting stents (DES), bioresorbable vascular scaffolds (BVS) may further improve long-term outcomes of percutaneous coronary intervention (PCI) in patients with coronary artery disease. We report our early experience with BVS in Korea. METHODS: We evaluated 105 consecutive patients with BVS implanted at Asan Medical Center, Korea between October 21, 2015 and June 3, 2016. Angiographic results, and in-hospital and 6-month clinical outcomes were assessed. RESULTS: A total of 134 BVS were implanted to treat 115 lesions. The mean age was 62 ± 10.5 years; 85 patients (81%) were males, 26 patients (25%) were presented with acute coronary syndrome. Among 115 lesions treated with BVS, 76 (66.1%) were B2/C type, 27 (23.5%) were bifurcation lesions, and four (3.5%) were chronic total occlusion. Pre-dilation and post-dilation using high-pressure non-compliant balloon was performed in 104 lesions (90.4%) and 113 lesions (98.2%), respectively. During the procedure, intravascular imaging was used for all patients (100%; intravascular ultrasound 89 and optical coherence tomography 40 patients). Device success rate was 100%. In-segment and in-scaffold acute again were 1.1 ± 0.6 and 1.3 ± 0.5 mm, respectively. Periprocedural myocardial infraction occurred in four patients (3.8%). No deaths, stent thrombosis, or urgent revascularizations occurred either during hospitalization or the follow-up period. CONCLUSIONS: In this single-center experience, implantation of BVS with intravascular imaging support was feasible and early clinical outcomes were excellent. Evaluation of long-term efficacy and safety of BVS and its feasibility in clinical use for a broader range of lesions is warranted.
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Humanos , Masculino , Implantes Absorvíveis , Síndrome Coronariana Aguda , Doença da Artéria Coronariana , Vasos Coronários , Stents Farmacológicos , Procedimentos Endovasculares , Seguimentos , Hospitalização , Coreia (Geográfico) , Intervenção Coronária Percutânea , Stents , Trombose , Tomografia de Coerência Óptica , UltrassonografiaRESUMO
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor that is highly aggressive in nature and indolent in progression. The common risk factors for MCC are senility, prolonged exposure to sunlight, and immune deficient states. Moreover, Merkel cell polyomavirus has recently been characterized to be significantly associated with pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20). Diagnosis is often difficult since histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies. A 67-year-old man presented with a solitary domeshaped erythematous round mass on the left upper arm for 2 months. Biopsy and IHC studies revealed findings consistent with Merkel Cell Carcinoma of neuroendocrine origin. Common IHC stains usually confirm positive findings for CK20, which is also recognized as the key component in making the diagnosis. We present a CK20 negative MCC in light of expanding the knowledge of unusually stained IHC results in MCC.
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Idoso , Humanos , Braço , Biópsia , Carcinoma de Célula de Merkel , Corantes , Diagnóstico , Diagnóstico Diferencial , Queratina-20 , Queratinas , Poliomavírus das Células de Merkel , Tumores Neuroendócrinos , Fatores de Risco , Luz SolarRESUMO
No abstract available.
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No abstract available.
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Punctate leukoderma is characterized of the destruction of melanocytes after chemical of physical damage. In addition, the term is broadly used to describe hypopigmented lesions induced in vitiligo patients after psolaren administration with ultraviolet A and in psoriasis patients with repetitive ultraviolet B phototherapy. The Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser in treating melasma is frequently reported to be associated with the cause. A 44-year-old woman presented to the department with numerous confetti-like hypopigmented macules on both cheeks for over a year. Weekly treatment of 1,064 nm Qswitched Nd:YAG laser (2.0–3.4 J, 8 mm spot-size) therapy at a non-dermatologic clinic had induced both hyperpigmentation and hypopigmentation lesions. Biopsy performed at both hyperpigmented and hypopigmented lesions revealed variable melanin pigmentation with segmental loss and infiltration of pigment incontinence. The patient was diagnosed with punctate leukoderma and was directed for narrow-band ultraviolet B phototherapy. Herein, we report a case of punctate leukoderma after inadvertent use of 1,064 nm Q-switched Nd:YAG laser.
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Adulto , Feminino , Humanos , Alumínio , Biópsia , Bochecha , Hiperpigmentação , Hipopigmentação , Melaninas , Melanócitos , Melanose , Fototerapia , Pigmentação , Psoríase , Vitiligo , ÍtrioRESUMO
BACKGROUND: Tinea capitis has been recognized as the most commonly misdiagnosed scalp disease. Inappropriate medication and delayed intervention leads to a broad array of complications from prolongation of treatment to scarring of the scalp. The financial deficits and problems imparted on patients continue to be a clinical and social burden. OBJECTIVE: The clinical and financial aspects between the initially misdiagnosed group and the properly diagnosed group were analyzed, to provide the epidemiologic basis and to address improvements for misdiagnoses of tinea capitis. METHODS: A retrospective review of electronic and written chart was performed on all patients diagnosed of tinea capitis at Daegu Catholic University Medical Center (DCUMC) from January 2006 to June 2016. A total of 100 patients were included in the study and an initially misdiagnosed group and initially diagnosed group were evaluated. RESULTS: Significant differences between the groups were not observed in variables including age, sex and occupation. The highest diagnostic precision was observed in dermatologists (78.4%) by using standard microscopic (31.0%) and culture studies (13.0%). Misdiagnosis rate was highest in pediatrics (34.9%) and erroneous examination such as laboratory test (48.4%) and Gram stain (19.4%) were countered in the misdiagnosed group. Additional clinic visits, prescriptions and extra trips to clinics resulted financial disadvantage in the misdiagnosed group. CONCLUSION: The misdiagnosed tinea capitis was found to arise from unawareness of the disease that leads to inappropriate approach and medication prescription. The duration, complications and financial loss were reported to be higher in misdiagnosed group based on the study.
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Humanos , Centros Médicos Acadêmicos , Assistência Ambulatorial , Cicatriz , Erros de Diagnóstico , Ocupações , Pediatria , Prescrições , Estudos Retrospectivos , Couro Cabeludo , Tinha do Couro Cabeludo , TinhaRESUMO
Halo nevus and vitiligo are known to be associated with immunologic defect that result in typical skin lesions. Random shapes and sizes of whitish patches, depending on the type, are featured in vitiligo. Halo, on the other hand, presents by surrounding the previous pigmented lesion leaving a whitish-halo-like appearance. The mechanisms underlying these entities remain to be elucidated. Various immunological responses along with biomechanical activities suggest causal relationship between the two diseases. A 6-year-old male patient was recently presented with multiple whitish patches on the various parts of the body in a Koebner phenomenon manner. A noticeable hairy congenital melanocytic nevus surrounded a well-demarcated halo of depigmentation was also observed. Clinical and pathological findings were conclusive of as halo nevus with multiple concurrent vitiligo. The pathogenic relationship between the two entities must be underlined since the nature of disease progression is associated and the respective management may also be altered accordingly.
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Criança , Humanos , Masculino , Progressão da Doença , Mãos , Nevo com Halo , Nevo Pigmentado , Pele , VitiligoRESUMO
Apocrine hidrocystoma is a benign tumor arising from apocrine sweat gland. It presents as a solitary translucent nodule, usually on the face, head, and neck. However it is extremely rare for the apocrine hidrocystoma to arise on the extremities, and no case of apocrine hidrocystoma on lower extremity has been reported in Korean dermatologic literature. Herein, we report a case of 63-year-old male apocrine hidrocystoma that developed in ankle area with a review of the literature.
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Humanos , Masculino , Pessoa de Meia-Idade , Tornozelo , Extremidades , Cabeça , Hidrocistoma , Extremidade Inferior , Pescoço , Glândulas SudoríparasRESUMO
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor that is highly aggressive in nature and indolent in progression. The common risk factors for MCC are senility, prolonged exposure to sunlight, and immune deficient states. Moreover, Merkel cell polyomavirus has recently been characterized to be significantly associated with pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20). Diagnosis is often difficult since histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies. A 67-year-old man presented with a solitary domeshaped erythematous round mass on the left upper arm for 2 months. Biopsy and IHC studies revealed findings consistent with Merkel Cell Carcinoma of neuroendocrine origin. Common IHC stains usually confirm positive findings for CK20, which is also recognized as the key component in making the diagnosis. We present a CK20 negative MCC in light of expanding the knowledge of unusually stained IHC results in MCC.
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Idoso , Humanos , Braço , Biópsia , Carcinoma de Célula de Merkel , Corantes , Diagnóstico , Diagnóstico Diferencial , Queratina-20 , Queratinas , Poliomavírus das Células de Merkel , Tumores Neuroendócrinos , Fatores de Risco , Luz SolarRESUMO
Dermatophytosis in children is relatively infrequent than adults. Dermatophytosis in children can be different clinically and mycologically from those in adults in that children experience rapid physical changes and they have different skin features and environments from those of adults. Microsoprum (M.) canis is one of the zoophilic dermatophytes responsible for 3~30% of tinea corporis and tinea capitis in children. It is most likely transmitted by contact with infected animals such as cats and dogs. Clinical manifestations were single or multiple annular shaped, erythematous scaly patches and sometimes hard to differentiate with other skin diseases. A 6-year-old girl presented with multiple, pruritic, erythematous scaly patches on cheek and buttock. The lesion started 3 weeks before visiting our skin clinic. There was no personal or family history of any skin disease but she had a history of contacting with a dog. A fungal culture from tissue of the lesions grown on potato dextrose agar-corn meal-tween 80 showed typical Microsporum canis. The skin lesions were clinically improved after topical treatment for 4 weeks.