BACKGROUND: Staphylococcus aureus frequently colonizes and infects hospitalized patients. Respiratory infections with Staphylococcus aureus are common in patients with compromised airway defenses. However the mechanisms of S. aureus invasion from colonization to the epithelium are unclear. Cell invasion by S. aureus would require destruction of the extracellular matrix, which is believed to be the result of increased matrix metalloproteinases (MMP) activity. METHODS: In this study, respiratory epithelial cells were infected with S. aureus. After removing the extracellular bacteria by washing, the internalized bacteria in the cells were assessed by counting the colonized forming units (CFUs). The cell adhesion proteins, dysadherin and E-cadherin, were evaluated by Western blotting. The MMPs in the bacterial invasion were evaluated by pretreating the cells with GM6001, a MMP inhibitor. RESULTS: The internalization of S. aureus was found to be both time and dose dependent, and the increase in MMP 2 and 9 activity was also dependent on the incubation time and the initial amount of bacterial inoculation. The invasion of S. aureus was attenuated by GM6001 after 12 hours incubation with a multiply of infection (MOI)=50. The expression of dysadherin, a membrane protein, was increased in a time and dose dependent manner, while the expression of E-cadherin was decreased. CONCLUSION: MMPs may mediate the invasion of S. aureus into epithelial cells.
Bacteria ; Blotting, Western ; Cadherins ; Cell Adhesion ; Colon ; Dipeptides ; Epithelial Cells ; Epithelium ; Extracellular Matrix ; Humans ; Matrix Metalloproteinases ; Membrane Proteins ; Proteins ; Respiratory Tract Infections ; Staphylococcus ; Staphylococcus aureus

PURPOSE: To report a case of meibomian gland dysfunction as a chronic complication of eyelid tattooing and the corneal epithelial defect as an acute complication of eyelid tattooing well healed with proper treatment. CASE SUMMARY: A 31-year-old woman presented with severe eye pain, irritation and epiphora in both eyes. The patient underwent an eyelid tattooing procedure 2 hours before and dark pigments were placed on the inner eyelid margin. Slit lamp examination showed conjunctival injection and inferior corneal epithelial defect in both eyes. After 2 months, dry eye symptom still remained although the cornea was completely epithelialized. After 1 year, the patient improved completely, but still showed decreased tear film breakup time (TBUT). CONCLUSIONS: Due to the increased number of people who undergo cosmetic eyelid tattooing procedures, the number of reports associated with complications has increased and acute complications such as corneal epithelial defect can occur. Moreover, chronic discomfort associated with dry eye syndrome can occur when pigmentation is placed on the eyelid inner margin and lead to the destruction of meibomian glands. Thus, eyelid tattooing should be performed after careful consideration of possible complications.
Cornea ; Cosmetics ; Dry Eye Syndromes ; Eye ; Eye Pain ; Eyelids ; Female ; Humans ; Lacrimal Apparatus Diseases ; Meibomian Glands ; Pigmentation ; Tattooing ; Tears

BACKGROUND: By determining the reasons why patients with diabetes did not take diabetes educationand by analyzingthe characteristics of these patients, this study aimed to provide baseline data to improvediabetes education participation rates. METHODS: A survey was conducted in 56 patients who had been hospitalized for diabetes treatment and who had refused to take the prescribed diabetes education. The reasons for refusing diabetes education and the level of diabetes knowledge were evaluated. Medical records were also reviewed to determine the subjects' hemoglobin A1c test results. RESULTS: The most common reason for rejecting diabetes education was 'previous experiencewith diabetes education.' The subjects also refused diabetes educations due to cost and an impression that they already have sufficient diabetes knowledge. The patients who refused the education due to expenses were among the lower income group, and 80 percent of patients who had received diabetes educationin the past declined the education because of their previous experience. CONCLUSION: In order to increase the participation rates of diabetes education, it is important that patients recognize the significance of ongoing diabetes education. Furthermore, to eliminate the cost problems, national efforts are required such as promoting National Health Insurance coverage to includediabetes education as well as expanding the patients' opportunities for receiving qualified diabetes education with systematic and standardized education materials for free.
Academic Medical Centers* ; Compliance* ; Education* ; Humans ; Medical Records ; National Health Programs

Orofacial granulomatosis (OFG) is a rare chronic granulomatous disease of oral mucosa and maxillofacial region that clinically presents recurrent or persistent orofacial swelling. OFG may exist as an integration of the spectrum of various disorders, including Melkersson-Rosenthal syndrome, granulomatous cheilitis, Crohn’s disease, sarcoidosis, infectious diseases and delayed hypersensitivity reaction to food additives, dental materials. Precise etiology is not yet to be elucidated. Herein, we report two rare cases of orofacial granulomatosis who presented similar clinical manifestation of lip swelling but was diagnosed as a sarcoidosis and as a granulomatous cheilitis.

A 44-year-old male presented with 7 months history of nonpruritic round oozing plaques on the extremities and red papules on the trunk. The lesions were resistant to topical and oral steroid prescribed at the other local clinics. Histopathological examination showed parakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermal blisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemical analysis revealed the lymphocyte infiltrate to be predominantly CD4 + T cells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30 + were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides (MF). He was prescribed with narrow-band ultraviolet B twice per week and topical steroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantly faded and were flattened. Vesicular MF is associated with poor prognosis, but our patient was able to show benign course of disease thanks to timely diagnosis. One must consider vesicular MF as a differential for recalcitrant eczematous lesions.

We investigated the diffusion tensor image (DTI) parameters of superior longitudinal fasciculus (SLF) and inferior fronto-occipital fasciculus (IFOF), and their relationships with hemispatial neglect. Thirteen patients with first-ever ischemic stroke who had the right hemispheric lesion were included. Neglect was assessed using the Albert test and figure discrimination test of Motor-free Visual Perception Test 3 (MVPT-3). The SLF and IFOF were separated by diffusion tensor tractography (DTT) and tract volume (TV) was calculated. We measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the total area, seed region of interest (ROI), and target ROI, respectively. Among thirteen patients, seven demonstrated signs of hemispatial neglect on neglect test. Tractography reconstruction showed significantly low TV of the right IFOF in patients with hemispatial neglect. FA values of the right SLF and the right IFOF were significantly lower in neglect patients. ADC values were not significantly different in two groups. This study suggests that damage of SLF and IFOF is associated with hemispatial neglect in right hemispheric stroke patients. DTI may be useful for predicting the severities of hemispatial neglect using values such as TV and FA of each tract.

This study aims to investigate the relationship between ipsilesional upper extremity (UE) motor function and the integrity of the subregions of the corpus callosum in hemiparetic stroke patients with motor deficits of the dominant or non-dominant ipsilesional side.Twenty participants with unilateral UE deficits after stroke were included. Each of the 10 participants had lesions on the left and right sides. The ipsilesional UE function was assessed with the Jebsen-Taylor hand function test (JHFT), the 9-hole peg test (9HPT), and grip and pinch strength tests. Fractional anisotropy (FA) was calculated for the integrity of the 5 subregions of the corpus callosum. Pearson’s correlation analysis was conducted to investigate the relationship between UE function and the integrity of the callosal subregions.The results of JHFT and 9HPT showed a significant correlation with the FA value of the corpus callosum I projecting to the frontal lobe in the left lesion group (p < 0.05). There was no correlation between the ipsilesional UE motor function and the FA value of the ulnar subregion in the right lesion group (p > 0.05). These results showed that the motor deficits of the ipsilesional UE correlated with the integrity of callosal fiber projection to the prefrontal area when the ipsilesional side was non-dominant.

Primary endobronchial schwannomas are extremely rare tumors that originate from Schwann cells. We report a case of primary endobronchial schwannoma. A 44-year-old woman, without respiratory symptoms, was presented with a nodule in the left main bronchus on her chest computed tomography scan. The nodule was removed by a rigid bronchoscopy with argon plasma coagulation. Biopsy confirmed the diagnosis of schwannoma. There was no recurrence during her 4-month follow-up.
Adult ; Argon ; Argon Plasma Coagulation ; Biopsy ; Bronchi ; Bronchoscopy ; Female ; Follow-Up Studies ; Humans ; Neurilemmoma ; Recurrence ; Schwann Cells ; Thorax

We experienced a case of primary pulmonary biphasic synovial sarcoma, which was confirmed by immunohistochemistry and molecular testing of SYT-SSX2 fusion transcripts. The patient was a 61-year-old man who presented with a well-defined mass in the left upper lung field on chest radiography. Left upper lobectomy with lymph node dissection was performed. Histological and immunophenotypic features were consistent with biphasic synovial sarcoma. Reverse transcriptase polymerase chain reaction, performed using RNA extracted from frozen tumor samples for the detection of SYT-SSX fusion gene, amplified a single 331-bp fragment that was characteristic of the SYT-SSX2 fusion transcripts. We report a case of primary pulmonary biphasic synovial sarcoma, which was confirmed by SYT-SSX2 fusion transcripts, and present a brief review of the literature on Korean cases.
Base Sequence ; DNA Primers/genetics ; Humans ; Korea ; Lung Neoplasms/diagnosis/*genetics ; Male ; Middle Aged ; Oncogene Proteins, Fusion/*genetics ; Oncogenes ; Sarcoma, Synovial/diagnosis/*genetics

OBJECTIVES: Argon plasma coagulation (APC) is a noncontact form of electrocautery that utilizes ionized argon as the electrical current. A rigid bronchoscopic use of APC for the management of central airway obstruction could be safe and rapidly effective. This study evaluated the usefulness of rigid bronchoscopy with APC for the management of central airway obstructions due to benign or malignant tumors. METHODS: Twenty patients with obstructing central airway tumors were retrospectively reviewed from February 2008 to February 2013 at Chonnam National University Hospital. All patients received rigid bronchoscopic tumor removal under general anesthesia. APC was applied before and after tumor removal. RESULTS: The median age of patients was 59 years (interquartile range [IQR], 51 to 67 years) and 70% were female. The causes of airway obstruction included malignancy (n=8) and benign tumor (n=12). Airway tumors comprised intraluminal lesions (n=11, 55%) and mixed intraluminal/extraluminal lesions (n=9, 45%). The median tumor size was 15 mm (IQR, 10 to 18 mm). The median degree of airway obstruction was significantly reduced after intervention (90% [IQR, 88% to 96%] vs. 10% [IQR, 0% to 20%], P<0.001). The median American Thoracic Society dyspnea grade (3 [IQR, 1 to 4] vs. 1 [IQR, 0 to 1], P<0.001) and forced expiratory volume in one second (1.03 L [IQR, 0.52 to 1.36 L] vs. 1.98 L [IQR, 1.57 to 2.64 L], P=0.004) were significantly improved after intervention. There were no procedure-related acute complications and deaths. CONCLUSION: Rigid bronchoscopy with APC is an effective and safe procedure to alleviate central airway obstruction caused by tumors.
Airway Obstruction ; Anesthesia, General ; Argon Plasma Coagulation* ; Argon* ; Bronchoscopy ; Dyspnea ; Electrocoagulation ; Female ; Forced Expiratory Volume ; Humans ; Jeollanam-do ; Retrospective Studies