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Background@#The relationship between latent tuberculosis and the use of certain biologics is well known, but the relationship between the test for latent tuberculosis results and psoriasis itself or systemic anti-psoriatic treatment (cyclosporine and methotrexate) has not been elucidated to date. @*Objective@#To assess the influence of psoriasis and systemic anti-psoriatic treatment on results of the interferon-gamma release assay. @*Methods@#A retrospective study was conducted on 353 patients who were screened for latent tuberculosis before the use of medicines for moderate to severe psoriasis. The screening was based on results of the interferon-gamma release assay. The control group included 2,025 health care workers who were screened for latent tuberculosis during a general medical examination. @*Results@#Interferon-gamma release assay was positive in 35.4% of the patients and 11.6% of the subjects from the control group. There was a statistically significant correlation between psoriasis and assay positivity (p＜0.05). Among the patients, no statistically-relevant association regarding previous use of cyclosporine or methotrexate was found (cyclosporine: p=0.284, methotrexate: p=0.231). Furthermore, patients were divided into two groups according to treatment duration, i.e., shorter or longer than 6 months. There were no relevant differences in treatment duration cyclosporine: p=0.243, methotrexate: p=0.743). @*Conclusion@#This study revealed a higher prevalence of interferon-gamma release assay positivity in patients with psoriasis. However, conventional anti-psoriatic drugs, such as cyclosporine and methotrexate, showed no significant difference regarding the assay positivity.
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Objective@#The objective of this study was to compare and evaluate the diagnostic value of serum carbohydrate antigen 125 (CA125) and/or human epididymis protein 4 (HE4) and a panel of novel multiple biomarkers in patients with ovarian tumors to identify more accurate and effective markers for screening ovarian cancer. @*Methods@#Candidate ovarian cancer biomarkers were selected based on a literature search. Dozens of candidate biomarkers were examined using 143 serum samples from patients with ovarian cancer and 157 healthy serum samples as noncancer controls. To select the optimal marker panel for an ovarian cancer classification model, a set of biomarker panels was created with the number of possible combinations of eight biomarkers. Using the set of biomarkers as an input variable, the optimal biomarker panel was selected by examining the performance of the biomarker panel set using the Random Forest algorithm as a non-linear classification method and a 10-fold cross-validation technique. @*Results@#The final selected optimal combination of five biomarkers (CA125, HE4, cancer antigen 15-3, apolipoprotein [Apo] A1, and ApoA2) exhibited a sensitivity of 93.71% and specificity of 93.63% for ovarian cancer detection during validation. @*Conclusion@#Combining multiple biomarkers is a valid strategy for ovarian cancer diagnosis and can be used as a minimally invasive screening method for early ovarian cancer. A panel of five optimal biomarkers, including CA125 and HE4, was verified in this study. These can potentially be used as clinical biomarkers for early detection of ovarian cancer.
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Purpose@#To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. @*Conclusions@#Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.
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Background@#While microscopy (MS) evaluation of skin scrapings has a 100% positive predictive value and specificity by definition for scabies diagnosis, it has low sensitivity. Dermoscopy (DS) has not yet been widely accepted for diagnosis, and long-term clinician training is required. @*Objective@#To evaluate the diagnostic validity of cytochrome c oxidase subunit 1 (cox1) gene nested polymerase chain reaction (PCR) as an adjunctive method for diagnosing scabies. @*Methods@#This was a prospective, single institution study, conducted on a total of 302 skin lesions from 50 patients suspected of scabies at Kangdong Sacred Heart Hospital in Seoul, Korea. DS, MS, and cox1 nested PCR were performed on all patients. @*Results@#Of the 302 lesions, 145 (48.0%) were obtained at first visit and 157 (52.0%) were identified in the course of follow-up visits after treatment. For all lesions, DS and MS sensitivity levels were 55.9% (73/136) and 55.2% (75/136), respectively, with cox1 gene nested PCR considered as 100%. The results of DS and MS identification showed no difference between each other and showed significant difference from that of cox1 gene nested PCR. @*Conclusion@#Nested PCR detecting cox1 may be prospectively used to comprehensively diagnose lesions of scabies in clinical practice.
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Purpose@#To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. @*Conclusions@#Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.
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Background@#While microscopy (MS) evaluation of skin scrapings has a 100% positive predictive value and specificity by definition for scabies diagnosis, it has low sensitivity. Dermoscopy (DS) has not yet been widely accepted for diagnosis, and long-term clinician training is required. @*Objective@#To evaluate the diagnostic validity of cytochrome c oxidase subunit 1 (cox1) gene nested polymerase chain reaction (PCR) as an adjunctive method for diagnosing scabies. @*Methods@#This was a prospective, single institution study, conducted on a total of 302 skin lesions from 50 patients suspected of scabies at Kangdong Sacred Heart Hospital in Seoul, Korea. DS, MS, and cox1 nested PCR were performed on all patients. @*Results@#Of the 302 lesions, 145 (48.0%) were obtained at first visit and 157 (52.0%) were identified in the course of follow-up visits after treatment. For all lesions, DS and MS sensitivity levels were 55.9% (73/136) and 55.2% (75/136), respectively, with cox1 gene nested PCR considered as 100%. The results of DS and MS identification showed no difference between each other and showed significant difference from that of cox1 gene nested PCR. @*Conclusion@#Nested PCR detecting cox1 may be prospectively used to comprehensively diagnose lesions of scabies in clinical practice.
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This study was conducted to confirm the performance of the microRNA (miRNA) biomarker combination as a new breast cancer screening method in Korean women under the age of 50 with a high percentage of dense breasts. To determine the classification performance of a set of miRNA biomarkers (miR-1246, 202, 21, and 219B) useful for breast cancer screening, we determined whether there was a significant difference between the breast cancer and healthy control groups through box plots and the Mann– Whitney U-test, which was further examined in detail by age group. To verify the classification performance of the 4 miRNA biomarker set, 4 classification methods (logistic regression, random forest, XGBoost, and generalized linear model plus random forest) were applied, and 10-fold cross-validation was used as a validation method to improve performance stability. We confirmed that the best breast cancer detection performance was achievable in patients under 50 years of age when the set of 4 miRNAs were used. Under the age of 50, the 4 miRNA biomarkers showed the highest performance with a sensitivity of 85.29%, specificity of 93.33%, and area under the curve (AUC) of 0.961. Examining the results of 4 miRNA biomarkers was found to be an effective strategy for diagnosing breast cancer in Korean women under 50 years of age with dense breasts, and hence has the potential as a new breast cancer screening tool. Further validation in an appropriate screening population with large-scale clinical trials is required.
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Purpose@#To evaluate the effect of orthokeratology lenses on axial length elongation and associated factors in eyes treated withorthokeratology lenses for 2-3 years. @*Methods@#Thirty-four eyes of 20 patients treated with orthokeratology lenses for more than 22 months were enrolled into the orthokeratology(OK) group. Uncorrected distant visual acuity, spherical equivalent, axial length, and high-order aberrations of theanterior cornea at baseline and during the follow-up period were analyzed retrospectively. Spectacle-wearing patients matchedwith the OK group patients by sex, age, refractive error and follow-up period were selected as a control group. To adjust for follow-upperiod differences, the 24-month conversion axial length changes were calculated and compared between the two groups. @*Results@#The 24-month conversion mean axial length change showed significant differences (0.50 ± 0.23 mm in the OK groupversus 1.00 ± 0.28 mm in the control group; p< 0.001). For the OK group, the age at starting OK lens (r = -0.572, p= 0.001)showed statistically significant correlation with axial elongation. The anterior corneal spherical aberrations (SA) and coma with 6mm pupil at last follow-up (SA: r = 0.543, p= 0.001; coma: r = 0.420, p= 0.017) and the total SA and total coma changes (ㅿSA:r = 0.518, p= 0.002; ㅿcoma: r = 0.420, p= 0.017) also showed a statistically significant correlation. The initial age and axiallength, the anterior corneal SA and ㅿSA values were identified as factors significantly correlated with axial length elongation bymultiple regression analysis. @*Conclusions@#The OK lens effectively suppressed axial length elongation during a 2-3 years treatment period. However, whenthe age of starting OK lens was younger and the anterior corneal spherical aberration during the follow-up period was larger, therisk of axial elongation was higher.
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Background@#Erythema nodosum (EN) and erythema induratum (EI) are similar inflammatory diseases of the lower extremities. Several factors (infections, drug hypersensitivity, inflammatory diseases, etc.) have been suggested as the cause of these diseases. Among them is Mycobacterium tuberculosis (MTB) infection. However, there is still a lack of evidence supporting this finding. @*Objective@#This study aimed to confirm whether Korean patients with EN/EI will exhibit positive interferon-gamma release assay (IGRA) results and determine the association of these disease with tuberculosis. @*Methods@#We retrospectively analyzed the clinical characteristics and IGRA test results of 62 patients (46 with EN and 16 with EI). @*Results@#A total of 22 of 44 EN patients (50%) had positive IGRA test results, except for two with “undetermined” results, and 12 of 16 EI patients (75%) had positive test results. This result was higher than that of the control group (15.5%, 292/1887) and showed a statistically significant difference (each p=0.000). Moreover, the proportion of EI patients with positive test results was higher than that of patients with severe psoriasis (35.6%, 112/315; p=0.001). Among EN/EI patients with positive IGRA test results, those treated with antituberculosis therapy (HREZ) showed good response rate. The response rate was 85.7% (6/7) for patients with EN and 90% (9/10) for those with EI. @*Conclusion@#High IGRA positivity was found in Korean EN/EI patients. This finding suggests a significant association between these diseases and tuberculosis.
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No abstract available.
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DNA , Mycobacterium tuberculosis , Mycobacterium , Reação em Cadeia da Polimerase , Tuberculose , Tuberculose CutâneaRESUMO
BACKGROUND/AIMS@#This study was to evaluate the clinical significance of infusion-related reaction (IRR) of rituximab in diffuse large B-cell lymphoma (DLBCL) patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) as a first-line chemotherapy.@*METHODS@#The medical records of 326 patients diagnosed with DLBCL were re trospectively analyzed. Both doctor's progress records and nursing records were reviewed. IRR was graded according to the National Cancer Institute Common Terminology Criteria.@*RESULTS@#IRR was not associated with overall survival (OS) or progression-free survival (PFS) of DLBCL patients as compared to those who did not have IRR (OS: median 78.0 months vs. 69.0 months, p = 0.700; PFS: median 65.4 months vs. 64.0 months, p = 0.901). IRR grade did not affect OS or PFS. B symptoms was independently associated with IRR (hazard ratio [HR], 1.850; 95% confidence interval [CI], 1.041 to 3.290; p = 0.036). Further, bone marrow involvement was independently associated with re-IRR (HR, 4.904; 95% CI, 0.767 to 3.118; p = 0.029).@*CONCLUSIONS@#Our study shows that IRR of rituximab is not associated with OS or PFS of DLBCL patients who received R-CHOP. Furthermore, our study suggests a need for more careful observation for IRR in patients with B symptoms or bone marrow involvement.
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BACKGROUND: Herpes zoster is characterized by unilateral grouped vesicles along the distribution of a dermatome. A global recurrence rate as low as 0.5%∼6.2% has been reported for herpes zoster. The recurrence of herpes zoster is higher in immunocompromised patients and older patients. OBJECTIVE: The purpose of this study is to assess the frequency of herpes zoster recurrence and factors that can influence its recurrence. METHODS: From January 2005 to December 2015, 14,343 patients with herpes zoster were enrolled in this study. The patients were diagnosed at Hallym University Medical Centers and Kangwon National University Hospital in Seoul, Gyeonggi, and Gangwon. Herpes zoster recurrence and patient characteristics were surveyed by medical record review and a telephonic survey. RESULTS: The overall frequency of herpes zoster recurrence was 1.18%. The frequency of recurrence was higher in women than in men. It was also higher in patients aged 50∼70 years than in patients who were younger or older than this. Additionally, we assessed that the frequency of recurrence was statistically higher in patients with a compromised immune system and in patients who experienced longer lasting pain during their first episode. CONCLUSION: The frequency of herpes zoster recurrence is more common in women, older age, patient with longer pain duration and immunocompromised patients.
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Feminino , Humanos , Masculino , Centros Médicos Acadêmicos , Herpes Zoster , Sistema Imunitário , Hospedeiro Imunocomprometido , Coreia (Geográfico) , Prontuários Médicos , Recidiva , SeulRESUMO
BACKGROUND: Plasma cell cheilitis is an unusual benign plasma cell proliferative disease of an unknown etiology that typically presents on the lip. OBJECTIVE: The aim of this study was to investigate the clinicopathological characteristics of 13 cases of plasma cell cheilitis. METHODS: The present study investigated the clinical manifestations, treatment modalities, and outcome of 13 patients diagnosed with plasma cell cheilitis from 2011 to 2016 at Kangdong Sacred Heart Hospital and Hallym University Sacred Heart Hospital. Biopsy specimens of the all cases were evaluated using conventional hematoxylin and eosin staining with kappa and lambda immunoglobulin light chain immunohistochemistry. RESULTS: The age of the patients ranged from 39 to 86 years (mean, 64.7 years), with male predominance. Histopathologically, 61.5% and 38.5% of patients showed band-like and pan dermal plasmacytic infiltrates, respectively. Eosinophilic infiltration was noted in 69.2% of patients. All cases showed both kappa and lambda immunoglobulin light chain reactivities, and kappa predominance was confirmed in 9 patients (69.2%). A majority of the patients was treated with local therapy, such as intralesional steroid injection with topical tacrolimus. Among the 13 patients, plasma cell cheilitis completely resolved, partially resolved, and recurred in 3 (23.1%), 5 (38.5%), and 5 patients (38.5%), respectively. CONCLUSION: Plasma cell cheilitis presented as erosive edematous circumscribed patches or plaques affecting mainly the lower lip of elderly male patients. The majority of histopathology cases showed characteristic plasma cell aggregation on the upper dermis that was immunopositive for immunoglobulin light chain, with kappa predominance.
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Idoso , Humanos , Masculino , Biópsia , Queilite , Derme , Amarelo de Eosina-(YS) , Eosinófilos , Coração , Hematoxilina , Cadeias lambda de Imunoglobulina , Cadeias Leves de Imunoglobulina , Imuno-Histoquímica , Lábio , Plasmócitos , Plasma , TacrolimoRESUMO
BACKGROUND: Despite major advances in lung cancer treatment, early detection remains the most promising way of improving outcomes. To detect lung cancer in earlier stages, many serum biomarkers have been tested. Unfortunately, no single biomarker can reliably detect lung cancer. We combined a set of 2 tumor markers and 4 inflammatory or metabolic markers and tried to validate the diagnostic performance in lung cancer. METHODS: We collected serum samples from 355 lung cancer patients and 590 control subjects and divided them into training and validation datasets. After measuring serum levels of 6 biomarkers (human epididymis secretory protein 4 [HE4], carcinoembryonic antigen [CEA], regulated on activation, normal T cell expressed and secreted [RANTES], apolipoprotein A2 [ApoA2], transthyretin [TTR], and secretory vascular cell adhesion molecule-1 [sVCAM-1]), we tested various sets of biomarkers for their diagnostic performance in lung cancer. RESULTS: In a training dataset, the area under the curve (AUC) values were 0.821 for HE4, 0.753 for CEA, 0.858 for RANTES, 0.867 for ApoA2, 0.830 for TTR, and 0.552 for sVCAM-1. A model using all 6 biomarkers and age yielded an AUC value of 0.986 and sensitivity of 93.2% (cutoff at specificity 94%). Applying this model to the validation dataset showed similar results. The AUC value of the model was 0.988, with sensitivity of 93.33% and specificity of 92.00% at the same cutoff point used in the validation dataset. Analyses by stages and histologic subtypes all yielded similar results. CONCLUSIONS: Combining multiple tumor and systemic inflammatory markers proved to be a valid strategy in the diagnosis of lung cancer.