Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture.

Despite its high incidence rate, vertebral fragility fracture (VFF) is frequently underdiagnosed due to the absence of marked symptoms. This study evaluated the diagnostic accuracy of our suggested physical examinations and compared them with that of plain radiographs. Patients over 65 years of age with sudden back pain within the preceding 3 weeks were enrolled. Physical examinations in three different positions and a closed-fist percussion test were performed, and the presence of VFF was evaluated through confirmatory radiographic tools. We assessed the diagnostic accuracy of each physical examination and compared them with the interpretation of plain radiographs and examined the patient-reported pain locations based on the VFF level. A total of 179 patients were enrolled. The forward bending in supine (FB-SU) test demonstrated superior diagnostic values (sensitivity: 90.6%, specificity: 71.2%), which outperformed those of plain radiographs (sensitivity: 68.9%, specificity: 71.9%). The location of patient-reported pain was generally close to or lower than the index fracture level. FB-SU showed the highest diagnostic accuracy and was more valuable than plain radiographs in diagnosing acute VFF. FB-SU is a simple and affordable screening test. If positive, physicians should highly suspect VFF even when based on vague evidence of acute fracture provided by plain radiographs.

Innovative Use of Negative Air Ions As an Alternative Therapy for Acne Vulgaris: A Report of Three Cases.

Acne vulgaris is a universal skin disease with multifactorial pathogenesis. Although an extensive range of treatment options exist for acne, a substantial number of patients are still struggling for an optimal treatment option due to the side effects or contraindications to the conventional acne treatment. Negative air ions (NAIs) are electrically charged molecules that naturally exist in the atmosphere. Since they are natural component of air, there are no known side effects and contraindications to their application. Furthermore, among the identified benefits of NAIs, certain mechanisms are related to acne pathogenesis, allowing them to be attractive candidates for acne treatment. Here, we describe three patients with acne who showed considerable clinical improvement after NAI therapy. All of the patients had failed to tolerate traditional acne treatment options. In all three cases, considerable improvement was observed in acne severity and the number of total lesions. Based on the three cases and a review of literature underlying the effects of NAIs, we suggest that NAIs may be a safe and effective alternative therapeutic option for acne vulgaris.

Eccrine Syringofibroadenoma in a Patient with Long-Standing Exfoliative Dermatitis.

Eccrine syringofibroadenoma (ESFA) is a rare benign cutaneous adnexal lesion characterized by a hyperplastic epithelium and eccrine ductal differentiation. In the present case, a 73-year-old Korean male presented with symmetrical numerous widespread, pinkish nodules with a cobblestone appearance over both legs for 2 years. He had a history of generalized erythematous scaly patches over his entire body for 20 years. On histopathologic findings, diagnosis of ESFA was confirmed. Our unusual and interesting case emphasizes the first report described one case in which multiple cobblestone like ESFAs arising from long-standing exfoliative dermatitis.

Squamous Cell Carcinoma and Multiple Bowen's Disease in a Patient with a History of Consumption of Traditional Chinese Herbal Balls.

Arsenic has been classified as a class I human carcinogen, meaning that there is sufficient evidence of carcinogenicity to humans. Arsenic, however, remains a common contaminant in a number of traditional Chinese herbal balls. A 64-year-old man presented with an erythematous erosive patch on the left palm, multiple yellowish scaly patches on the right palm and an erythematous hyperkeratotic patch with bleeding on the left foot dorsum. He also had similar skin lesions on the back and buttock. He had a past medical history of chronic exposure to arsenic through consumption of traditional Chinese herbal balls. Skin biopsy revealed Bowen's disease on the left palm and squamous cell carcinoma on left foot dorsum. We report this case to emphasize that we should investigate patient's history thoroughly, including the use of Chinese herbal balls to find out arsenicism.

Involvement of progranulin in the enhancement of hippocampal neurogenesis by voluntary exercise.

We have previously suggested that progranulin mediates the stimulatory effects of estrogen on adult neurogenesis in the hippocampus. Neurogenesis in mature animals is enhanced by growth factors, environmental enrichment, and voluntary exercise. In this study, we investigated the role of progranulin in voluntary running-induced hippocampal neurogenesis. In the hippocampus of wild-type mice, the pyramidal neurons in the CA1 and CA3 regions and interneurons in the hilus were mainly immunoreactive for progranulin, and wheel running increased progranulin expression in these neurons. Wheel running also increased the number of proliferating cells in the hippocampus in wild-type mice, but not in progranulin-deficient mice. These results suggest that progranulin plays an indispensable role in enhancing the hippocampal neurogenesis induced by voluntary exercise.

Osmolarity at early culture stage affects development and expression of apoptosis related genes (Bax-alpha and Bcl-xl) in pre-implantation porcine NT embryos.

This study examined whether high osmolarity of culture medium at the early culture stage affects development and expression of apoptosis related genes (Bax-alpha and Bcl-xl) of porcine nuclear transfer (NT) and in vitro fertilization (IVF) embryos. NT and IVF embryos were divided into three groups and the basic medium was PZM-3 (260-270 mOsmol, control group). The control group of embryos was cultured in PZM-3 for whole culture period. Other two groups of embryos were cultured in a modified PZM-3 with 0.05 M sucrose (300-320 mOsmol, sucrose group) or increased NaCl to 138 mM (300-320 mOsmol, NaCl group) for the first 2 days, and then cultured in PZM-3 for 4 days. NT embryos cultured in NaCl group showed a significantly higher developmental rate to the blastocyst stage with a decreased apoptosis rate compared to the control (P < 0.05). There was no difference in blastocyst formation and apoptosis incidence among the three culture treatments for IVF-derived embryos. Bax-alpha mRNA expression was significantly higher in the control than sucrose or NaCl group for both NT and IVF embryos (P < 0.05). Moreover, the relative abundance of Bax-alpha/Bcl-xl was higher in the control than the treatment groups. These results indicate that the higher osmolarity at the early embryonic stage of porcine NT and IVF embryos can improve the in vitro development with reduced apoptosis through regulating the Bax-alpha/Bcl-xl gene expression.

[A case of intestinal tuberculosis presenting massive hematochezia controlled by endoscopic coagulation therapy].

The clinical manifestations of intestinal tuberculosis are non-specific. But, abdominal pain, low grade fever, weight loss, anorexia, and diarrhea are major symptoms of intestinal tuberculosis. Massive bleeding has been reported as a rare manifestation of intestinal tuberculosis. Massive hematochezia from intestinal tuberculosis has rarely been reported in the medical literature. Also, most of them were treated with anti-tuberculosis medication only or with surgery. We treated a case of intestinal tuberculosis presenting massive hematochezia with colonoscopic coagulation therapy and anti-tuberculosis medication. Here, we report a Korean man who presented with massive hematochezia from ileal tuberculosis and treated by endoscopic coagulation therapy.

Development of multiple pigmented nevi within segmental nevus depigmentosus.

Nevus depigmentosus is a stable and well-circumscribed congenital hypomelanosis that may be in an isolated, dermatomal or systemic form. An 18-yr-old Korean man with segmental nevus depigmentosus developed multiple pigmented nevi which were present only within the confines of the leukoderma. Histologic and electron microscopic studies rendered a diagnosis of nevus depigmentosus with dysplastic nevus to the patient. The genetic alteration of melanocytes in the hypopigmented lesion is assumed to have resulted in the development of multiple pigmented nevi.

A Case of Lentigo Maligna Arising from Nevocytic Nevus / 대한피부과학회지

Lentigo maligna(LM) is a pigmented lesion that occurs on the sun-exposed skin of an older patients and may become lentigo maligna melanoma(LMM). Currently the percentage of LM type melanoma appears to be increasing, and this rise has been attributed to increasing UV radiation exposure. In addition to UV radiation, estrogen and progesterone, and nonpermanent hair dyes have been proposed as risk factors. A case is a 66-year-old female with a 3 years history of pigmented patch. She had a gradually enlarging irregular bordered brown to black mottled patch on the right temple area. Histologic examination revealed atypical melanocytes along the basal layer of atrophic epidermis, arranged in solitary units and small nests. Perilesional skin showed many scattered melanophages and regressing nevus cell nests which suggested preexisting nevus underwent regressive change. On the basis of clinicopathologic examination we diagnosed this case as lenigo maligna arising from nevocytic nevus and then we removed the lesion by wide surgical excision and could not find any recurrence until now.