Clindamycin Mono-Therapy of Hidradenitis Suppurativa Patients: A Single-Center Retrospective Study.

BACKGROUND: A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy. OBJECTIVE: To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients. METHODS: A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and comparing HS Physician's Global Assessment (HS-PGA) before (W0) and after (W8) the treatment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures. RESULTS: Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twenty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 (p=0.001). The prevalence of CL resistance was 15.00%. No significant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed (p=0.906). Adverse events occurred in 26.42% of patients. CONCLUSION: Systemic CL mono-therapy may be a safe and useful alternative to RF-CL combination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.

Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2-stage as an ancillary finding for predicting pathologic complete response.

INTRODUCTION: This study sought to assess preoperative concurrent chemoradiotherapy (CRT) magnetic resonance imaging (MRI)-based findings according to a structured MRI report template for primary staging of rectal cancer, and to evaluate the prognostic relevance of the pre-CRT MRI-based findings in patients with rectal cancer after CRT. METHODS: We retrospectively evaluated pre- and post-CRT MRI data of patients with pathologically proven rectal adenocarcinoma, between January 2008 and October 2019. Image interpretation was performed independently by two radiologists and each reviewer assessed the cancer characteristics on MRI, based on the structured MRI report for primary staging. MRI-based findings associated with pathologic complete tumour regression grade (TRG) after CRT were analysed by univariate and multivariate analysis. Significant factors from pre-CRT MRI were weighted to score mrTRG in post-CRT MRI. RESULTS: On univariate analysis, MR T-stage, tumour infiltration, mesorectal fascia involvement, extramural vascular invasion and serum carcinoembryonic antigen level correlated significantly with pathologic complete response (pCR). Multivariate analysis identified that only MR T-stage was independently associated with pCR (odds ratio, 3.89, 95% confidence interval, 1.18-12.84; P = 0.0278). Adding MRI-based T2-stage as an ancillary finding to mrTRG statistically significantly improved the sensitivity as compared to using only mrTRG for considering a CR. T2_mrTRG was significantly different in terms of the time to tumour progression between the CR and non-CR group. CONCLUSIONS: The MR T2-stage was independently associated with pCR after CRT in patients with rectal cancer and was helpful as ancillary predictive factor, adding to mrTRG for prediction of pCR.

The local hypothalamic-pituitary-adrenal axis in cultured human dermal papilla cells.

BACKGROUND: Stress is an important cause of skin disease, including hair loss. The hormonal response to stress is due to the HPA axis, which comprises hormones such as corticotropin releasing factor (CRF), adrenocorticotropic hormone (ACTH), and cortisol. Many reports have shown that CRF, a crucial stress hormone, inhibits hair growth and induces hair loss. However, the underlying mechanisms are still unclear. The aim of this study was to examine the effect of CRF on human dermal papilla cells (DPCs) as well as hair follicles and to investigate whether the HPA axis was established in cultured human DPCs. RESULTS: CRF inhibited hair shaft elongation and induced early catagen transition in human hair follicles. Hair follicle cells, both human DPCs and human ORSCs, expressed CRF and its receptors and responded to CRF. CRF inhibited the proliferation of human DPCs through cell cycle arrest at G2/M phase and induced the accumulation of reactive oxygen species (ROS). Anagen-related cytokine levels were downregulated in CRF-treated human DPCs. Interestingly, increases in proopiomelanocortin (POMC), ACTH, and cortisol were induced by CRF in human DPCs, and antagonists for the CRF receptor blocked the effects of this hormone. CONCLUSION: The results of this study showed that stress can cause hair loss by acting through stress hormones. Additionally, these results suggested that a fully functional HPA axis exists in human DPCs and that CRF directly affects human DPCs as well as human hair follicles under stress conditions.

Chronic inflammation-related radiological findings of gallbladder adenomyomatosis.

PURPOSE: This study aimed to assess radiological findings of adenomyomatosis advancing to chronic inflammation to differentiate between adenomyomatosis with and without chronic inflammation. MATERIALS AND METHODS: We retrospectively identified 79 patients with pathologically proven adenomyomatosis without (n = 10) or with chronic inflammation (n = 69), who underwent computed tomography (CT) and magnetic resonance imaging (MRI) followed by surgery. MRI analysis included evaluation of GB wall-thickening type, presence and location of intramural cysts, and presence of stones. CT analysis included GB wall-thickening type only. Multivariate logistic regression analysis was used to identify the image-based findings of adenomyomatosis associated with chronic inflammation. RESULTS: On univariate analysis, MRI-based GB wall-thickening type and presence of stones, and CT-based GB wall-thickening type were significantly different between adenomyomatosis with and without chronic inflammation. On multivariate analysis, only the absence of stones was identified as a significant predictor of adenomyomatosis without chronic inflammation (odds ratio 5.58; 95% confidence interval 1.20-26.01; p = 0.029). There was no significant difference in other MRI- and CT-based findings between adenomyomatosis with and without chronic inflammation. CONCLUSION: In patients with adenomyomatosis, the presence of stones was independently associated with chronic inflammation.

CRH receptor antagonists from Pulsatilla chinensis prevent CRH-induced premature catagen transition in human hair follicles.

BACKGROUND: There is a growing interest in the relationship among stress hormones, neuroendocrine signaling, and skin diseases, including hair loss. Previous reports showed that stress hormones inhibit human hair growth and induce early catagen transition. Moreover, a CRH receptor antagonist reversed CRH-induced alopecia in a mouse model, suggesting that antagonization of the CRH receptor is a key clinical strategy to treat stress-induced hair loss. OBJECTIVES: The aim of this study was to investigate the protective effect of CRH receptor antagonists from Pulsatilla chinensis on human hair follicles (hHFs) and human dermal papilla cells (hDPCs). METHODS: hHFs were observed and scored by hair cycle. The levels of cAMP, a second messenger, were measured in each group. In addition, the mRNA and protein levels of factors related to the hair cycle were measured. Furthermore, the expression levels of various members of the mitogen-activated protein kinase (MAPK) signaling pathway related to stress were measured. RESULTS: CRH induced early catagen transition in an ex vivo hair organ culture model. In addition, CRH downregulated the levels of alkaline phosphatase (ALP) and hair anagen-related cytokines in cultured hDPCs. Moreover, CRH induced the phosphorylation of JNK, c-Jun, p38, ERK, and Akt in cultured hDPCs. CRH receptor antagonists isolated from P chinensis reversed these CRH-induced modulations in both ex vivo hair follicles (HFs) and cultured hDPCs. CONCLUSIONS: These results indicate that P chinensis effectively blocks CRH receptor function and that saponin derivatives from P chinensis could be a pharmaceutical and cosmetic approach to treat stress-induced hair loss.

Comparison of the Treatment Outcomes of Photodynamic Therapy and Ingenol Mebutate in Bowen's Disease: A Retrospective Observational Study.

BACKGROUND: Bowen's disease (BD) is treated by multiple treatment modalities. OBJECTIVE: To assess the effectiveness of photodynamic therapy (PDT) and ingenol mebutate (IMB) in treating BD and determine the factors affecting the treatment outcome. METHODS: Patients with histologically confirmed BD from January 1, 2006, to December 31, 2017, were identified from the database of CHA Bundang Medical Center. Those treated with PDT or IMB were included. Patient, tumor characteristics, and treatment response data were retrospectively collected from the database. RESULTS: Overall, 44 and 24 BD were treated with PDT and IMB, respectively. Mean time to the first follow-up visit was 1.2 (0.5~4) months. Mean follow-up duration was 7.6 (1~36) months. The mean number of treatment sessions for PDT is 2 sessions (1~5), while that of IMB was equally 1 session. The complete response rates at the first follow-up visit were 66.7% and 53.0% and recurrence rates were 10.3% and 15.3% for PDT and IMB, respectively. However, the treatment outcome and recurrence rate between both treatment modalities were not significantly different (p=0.349 and p=0.993, respectively). In factor analysis, the complete response rate significantly decreased with older patients in IMB (p=0.012). Adverse events, occurred in 20.5% and 45.8% of patients treated with PDT and IMB, respectively. CONCLUSION: PDT and IMB are effective noninvasive treatment modalities for BD. However, PDT is a safer treatment modality, considering its fewer adverse events. Particularly, with age being a factor that reduces IMB outcome, in older patients, PDT can be considered as preferred treatments over IMB.

Usefulness of histologic differences and perivascular infiltration for preoperative T staging of advanced gastric cancer using computed tomography.

PURPOSE: This study aimed to determine whether histologic differences and perivascular infiltration are useful for clinical T staging of advanced gastric cancer (AGC). MATERIALS AND METHODS: This retrospective study included 160 patients with pathologically confirmed AGC who had available preoperative stomach computed tomography (CT). Using stomach CT, they were classified according to standard T stage, histologic T stage, and perivascular T stage. Accuracy of each T stage criteria was analyzed. Perivascular infiltrations for the evaluation of prognosis were correlated with time to tumor progression by log-rank test. RESULTS: There was a significant difference between the accuracies of the standard and histologic T stages (p < 0.001), whereas there was no significant difference between the standard and perivascular T stages (p = 0.07). In 121 patients who were pathologically confirmed as having T3 or T4a tumor, there was a significant difference between the standard and perivascular T stage (p < 0.001). In patients having T3 or T4a tumor, time to tumor progression of the negative perivascular infiltration subgroup was significantly longer than the positive subgroup. CONCLUSION: Consideration of histologic differences and perivascular infiltration may be useful for clinical T staging of AGC.

Anti-Wrinkle Efficacy of Cross-Linked Hyaluronic Acid-Based Microneedle Patch with Acetyl Hexapeptide-8 and Epidermal Growth Factor on Korean Skin.

BACKGROUND: Hyaluronic acid (HA)-based microneedle patch has recently been studied for wrinkle improvement. Cross-linked HA (CLHA) is widely used in dermal fillers. Acetyl hexapeptide-8 (AHP-8) and epidermal growth factor (EGF) are used for cosmetic ingredients. OBJECTIVE: This study aimed to verify the efficacy of the CLHA/HA-based patch with microstructure (microneedle patch) containing AHP-8 or EGF. METHODS: A total of 52 Korean females were enrolled in a double-blind, randomized, controlled, split-face trial. The subjects were divided into 3 groups: (1) microneedle patch alone, (2) microneedle patch/AHP-8, and (3) microneedle patch/EGF. The treatment was applied on the periorbital and nasolabial fold area for 4 hours to completely dissolve the microstructures once per week for 29 days. Evaluations, including photodamage scoring, image analysis with Antera 3D® (Miravex, Ireland), skin hydration measurement, and adverse effect assessments, were performed at each visit. RESULTS: Fifty subjects (96.2%) completed this clinical study. On day 29 after application, statistically significant improvements in wrinkle and skin hydration were observed in all groups (p<0.01). Treatment with microneedle patch/AHP-8 and microneedle patch/EGF showed statistically significant improvements in wrinkle compared with microneedle patch alone (p<0.05). No serious adverse effects were noted. CONCLUSION: Combination of CLHA-based microneedle patch and functional cosmetic ingredients can improve wrinkle with minimal discomfort.

Characterizations of Bone-Like Apatite Powder Fabricated Using Modified Simulated Body Fluid.

The objective of this study is to fabricate bone-like apatite (BLAp) powder using the modified simulated body fluid (SBF). The SBF2X and SBF4X groups were prepared by increasing the concentration of inorganic ions by two and four times, respectively, to that of the standard SBF. The mSBF4X group was prepared by particularly increasing the concentrations of calcium and phosphate ions in SBF. Bovine serum albumin (BSA) was added for SBF2X-BSA, SBF4X-BSA, and mSBF4X-BSA groups. BLAp powders were precipitated in these SBFs while being kept at 60 °C. Micro-morphology of BLAp powders showed tens of micrometers-sized rounded clusters which composed with sheet-like nano crystallites. The radius of BLAp clusters were decreased by increasing the concentration of inorganic ions and by incorporating the BSA. The hydroxyapatite crystalline structure was dominant for all sample groups. Further, octacalcium phosphate structure was detected in the mSBF4X group. However, these peaks were decreased in mSBF4X-BSA. FT-IR spectra demonstrated that BSA was co-precipitated in BLAp crystallites, and the amount of BSA was higher in the mSBF4X-BSA group than in the SBF4X-BSA group.

Osteoblast cell adhesion and viability on nanostructured surfaces of porous titanium oxide layer.

Surface characteristics and osteoblast cell functions were investigated for the nano-structured oxide layer on commercially pure titanium (CP-Ti) fabricated using microarc oxidation (MAO) and hydrothermal treatment (HT) methods. Ti-MAO-135HT, Ti-MAO-150HT, and Ti-MAO-175HT groups were fabricated by hydrothermally treating the MAO-treated specimens (Ti-MAO) in phosphorus-containing alkaline solution at temperatures of 135, 150, or 175 °C, respectively. After hydrothermal treatment, a nanosheet-shaped morphology, nano-needles and nanorods were observed on the porous surface of the Ti-MAO-135HT, Ti-MAO-150HT and Ti-MAO-175HT groups, respectively. The roughness was not significantly different for all groups. However the contact angle decreased dramatically as the hydrothermal temperature increased. The osteoblastic cell adhesion and viability of the Ti-MAO-150HT and Ti-MAO-175HT groups were significantly lower compared to those of the Ti-MAO group. This study showed that nano-topology formed on micro porous oxide layer was more important than hydrophilicity in its effect upon initial osteoblastic cell functions.

Cytocompatibility of pure metals and experimental binary titanium alloys for implant materials.

OBJECTIVE: This study was performed to evaluate the biocompatibility of nine types of pure metal ingots (Ag, Al, Cr, Cu, Mn, Mo, Nb, V, Zr) and 36 experimental titanium (Ti) alloys containing 5, 10, 15, and 20 wt% of each alloying element. METHODS: The cell viabilities for each test group were compared with that of CP-Ti using the WST-1 test and agar overlay test. RESULTS: The ranking of pure metal cytotoxicity from most potent to least potent was as follows: Cu>Al>Ag>V>Mn>Cr>Zr>Nb>Mo>CP-Ti. The mean cell viabilities for pure Cu, Al, Ag, V, and Mn were 21.6%, 25.3%, 31.7%, 31.7%, and 32.7%, respectively, which were significantly lower than that for the control group (p<0.05). The mean cell viabilities for pure Zr and Cr were 74.1% and 60.6%, respectively (p<0.05). Pure Mo and Nb demonstrated good biocompatibility with mean cell viabilities of 93.3% and 93.0%, respectively. The mean cell viabilities for all the Ti-based alloy groups were higher than 80% except for Ti-20 Nb (79.6%) and Ti-10 V (66.9%). The Ti-10 Nb alloy exhibited the highest cell viability (124.8%), which was higher than that of CP-Ti. Based on agar overlay test, pure Ag, Cr, Cu, Mn, and V were ranked as 'moderately cytotoxic', whereas the rest of the tested pure metals and all Ti alloys, except Ti-10 V (mild cytotoxicity), were ranked as 'noncytotoxic'. SIGNIFICANCE: The results obtained in this study can serve as a guide for the development of new Ti-based alloy implant systems.

Effect of laser irradiation on crystalline structure of enamel surface during whitening treatment with hydrogen peroxide.

OBJECTIVE: This study is to evaluate the effect of laser activation on the whitening and crystalline structure of enamel surface during whitening treatment with hydrogen peroxide. METHODS: Bovine teeth were treated with whitening gel containing 35% hydrogen peroxide. A whitening gel was applied on the enamel surface for a period of 5 min, and then irradiated using a diode laser (740 nm) during whitening treatment for 0, 30, 60, 120 and 180s for the GL0-W, GL30-W, GL60-W, GL120-W and GL180-W groups, respectively. The total whitening application time was 30 min for all groups. RESULTS: Laser-irradiated enamel groups showed a similar lightness compared to the GL0-W group. The thickness of porous layer observed on the enamel surface of GL0-W group was decreased by increasing the laser irradiation time. While the Ca and P contents of the GL0-W group were lower than those of the non-whitening treated group (GL0-C), the Ca and P contents of the GL180-W group were similar to those of the GL180-C group. The enamel crystallinity was dramatically decreased by whitening treatment without laser irradiation. However, the decrease of crystallinity was protected by laser irradiation during whitening treatment. Raman measurement verified that laser irradiation could prevent the loss of mineral compositions on enamel and maintain its crystalline structure. SIGNIFICANCE: The professional whitening treatment with hydrogen peroxide and diode laser activation improves not only the whitening effect but also protects the change of enamel structure compared to the treatment with only gel.