Objective: This study aimed to investigate the blood-brain barrier (BBB) disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and automatic whole brain segmentation. Materials and Methods: Forty-two consecutive mTBI patients with PCS who had undergone post-traumatic MR imaging, including DCE MR imaging, between October 2016 and April 2018, and 29 controls with DCE MR imaging were included in this retrospective study. After performing three-dimensional T1-based brain segmentation with FreeSurfer software (Laboratory for Computational Neuroimaging), the mean Ktrans and vp from DCE MR imaging (derived using the Patlak model and extended Tofts and Kermode model) were analyzed in the bilateral cerebral/cerebellar cortex, bilateral cerebral/cerebellar white matter (WM), and brainstem. Ktrans values of the mTBI patients and controls were calculated using both models to identify the model that better reflected the increased permeability owing to mTBI (tendency toward higher Ktrans values in mTBI patients than in controls). The Mann-Whitney U test and Spearman rank correlation test were performed to compare the mean Ktrans and vp between the two groups and correlate Ktrans and vp with neuropsychological tests for mTBI patients. Results: Increased permeability owing to mTBI was observed in the Patlak model but not in the extended Tofts and Kermode model. In the Patlak model, the mean Ktrans in the bilateral cerebral cortex was significantly higher in mTBI patients than in controls (p = 0.042). The mean vp values in the bilateral cerebellar WM and brainstem were significantly lower in mTBI patients than in controls (p = 0.009 and p = 0.011, respectively). The mean Ktrans of the bilateral cerebral cortex was significantly higher in patients with atypical performance in the auditory continuous performance test (commission errors) than in average or good performers (p = 0.041). Conclusion BBB disruption, as reflected by the increased Ktrans and decreased vp values from the Patlak model, was observed throughout the bilateral cerebral cortex, bilateral cerebellar WM, and brainstem in mTBI patients with PCS.

PURPOSE: Somatic mutations of the chromatin remodeling AT-rich interactive domain 1A (SWI-like) gene (ARID1A) have been identified in many human cancers, including breast cancer. The purpose of this study was to evaluate the nuclear expression of ARID1A in breast cancers by immunohistochemistry (IHC) and to correlate the findings to clinicopathologic variables including prognostic significance. METHODS: IHC was performed on tissue microarrays of 476 cases of breast cancer. Associations between ARID1A expression and clinicopathologic characteristics and molecular subtype were retrospectively analyzed. RESULTS: Low expression of ARID1A was found in 339 of 476 (71.2%) cases. Low expression of ARID1A significantly correlated with positive lymph node metastasis (p=0.027), advanced pathologic stage (p=0.001), low Ki-67 labeling index (p=0.003), and negative p53 expression (p=0.017). The ARID1A low expression group had significantly shorter disease-free and overall survival than the ARID1A high expression group (p<0.001 and p<0.001, respectively). Multivariate analysis demonstrated that low expression of ARID1A was a significant independent predictive factor for poor disease-free and overall survival in patients with breast cancer (disease-free survival: hazard ratio, 0.38, 95% confidence interval [CI], 0.20-0.73, p=0.004; overall survival: hazard ratio, 0.11, 95% CI, 0.03-0.46, p=0.003). In patients with luminal A type disease, patients with low ARID1A expression had significantly shorter disease-free and overall survival rates than patients with high ARID1A expression (p=0.022 and p=0.018, respectively). CONCLUSION: Low expression of ARID1A is an independent prognostic factor for disease-free and overall survival in breast cancer patients and may be associated with luminal A type disease. Although the biologic function of ARID1A in breast cancer remains unknown, low expression of ARID1A can provide valuable prognostic information.
Breast Neoplasms* ; Breast* ; Chromatin Assembly and Disassembly ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Phenobarbital ; Prognosis* ; Retrospective Studies ; Survival Rate

BACKGROUND/AIMS: This study was performed to investigate the correlation of sodium iodide symporter (NIS) expression with the functionality and loss of phosphatase and tensin homolog deleted on chromosome ten (PTEN) expression in human cholangiocarcinoma (CCA). METHODS: Immunohistochemistry for the expression of NIS and PTEN was performed in 60 biopsy specimens of CCA. The clinicopathological parameters were retrospectively identified from medical records. The expression pattern of NIS and loss of PTEN expression were analyzed in association with the clinicopathological characteristics, including survival. RESULTS: Normal biliary trees displayed NIS expression, but hepatocytes did not. NIS expression was divided into two patterns: cytoplasmic and membranous. Fifty-nine cases, all except for one case, displayed NIS expression in tumor cells. Twenty-two cases (33.3%) were mixed pattern, and 39 cases (65.05%) were cytoplasmic pattern; the pure membranous pattern was not noted. There was no association between the NIS expression pattern and clinicopathological parameters, including age, sex, differentiation grade, T stage and tumor, node, metastasis stage (p>0.05). The survival rates were similar among various NIS expression patterns. Normal hepatocytes and biliary trees exhibited PTEN expression in the nucleus and cytoplasm. CCA cells displayed nuclear staining. Thirty-six (60.0%) of 60 cases displayed a loss of PTEN expression. The loss of PTEN expression was observed in the advanced T-stage group (p=0.0036), but there was no association between the loss of PTEN expression and other clinicopathological parameters (p>0.05). No association between the loss of PTEN expression and survival was noted. CONCLUSIONS: NIS is expressed in most types of human CCA. The expression pattern suggests a role in cancer development. PTEN loss expression is common in the context of human CCA, especially in the advanced T stage.
Biopsy ; Cholangiocarcinoma ; Cytoplasm ; Hepatocytes ; Humans ; Immunohistochemistry ; Ion Transport ; Medical Records ; Microfilament Proteins ; Neoplasm Metastasis ; Retrospective Studies ; Sodium ; Sodium Iodide ; Survival Rate ; Symporters

A woman aged 40 years presented with symmetric band of depigmented patches on her hand dorsum and forearms. Under the diagnosis of focal vitiligo, we initially treated her with oral and topical steroids and local UVB irradiation. However, the wrist lesions were recalcitrant. Therefore, we tried a non-cultured epidermal cellular graft using autologous melanocyte-keratinocyte suspension. Twelve months after the procedure, higher than 70% of repigmentation was observed. This procedure seems to be an effective and practical treatment for recalcitrant vitiliginous lesions.
Aged ; Female ; Forearm ; Hand ; Humans ; Steroids ; Transplants ; Vitiligo ; Wrist

Lipomas are the most common benign mesenchymal tumors composed of mature fat cells. They can be classified into superficial lipoma (subcutaneous lipoma) or deep lipoma (subfascial lipoma) depending on the depth they develop. The latter is quite rare and tends to be less circumscribed and relatively fixed compared to the superficial ones. Therefore, it is initially misdiagnosed as other superficial lesions, and pre-operative awareness of deep tumors is important to differentiate them from other superficial lesions. Futhermore, the removal of the tumor also requires a detailed knowledge of the anatomy of the forehead, plus more sophisticated surgical skills so as not to damage important structures in the forehead such as vessels and nerves. Herein, we report 8 cases of deep lipoma on the forehead, demonstrating that it is not as rare as reported.
Adipocytes ; Forehead* ; Lipoma*

BACKGROUND: With the advance of socioeconomy and medical sciences, geriatric health care has become a world wide concern and disease of the skin is no exception. OBJECTIVE: The aim of this study was to investigate the epidemiology, past history and the prevalence of various skin disorders of the elderly. METHODS: In this trial, a total of 1082 new patients older than 65 years, who visited the Department of Dermatology, Kyungpook National University Hospital in Daegu, Korea in the last 3 years (2002~2004), were selected. The data was studied on the basis of a retrospective survey of hospital records. RESULTS: Of total patients who were seen at the dermatologic outpatient department, 10.1% were 65 years and older. The male to female ratio was 1 to 1.01. The patients between 65 and 74 years old compromised the majority (72.8%), and the patients older than 85 years old were 4.1%. They visited hospital most frequently in summer. Of the common complaints recorded, pruritic rash was the most frequent. The commonly diagnosed disorders were herpes zoster followed by senile pruritus, tinea/onychomycosis, and seborrheic dermatitis in decreasing order. The most common dermatologic disease was hespes zoster and postherpetic neuralgia for all three age groups : 65~74 years old, 75~84 years old, and over 85 years old. A total of 901 patients, which constituted 83.3% of the total patients, had at least more than one underlying disease, of which cardiovascular disease was the most common. CONCLUSION: This study is expected to be of help to understand the characteristics and the distribution of dermatologic diseases in the elderly.
Aged* ; Aged, 80 and over ; Cardiovascular Diseases ; Daegu ; Delivery of Health Care ; Dermatitis, Seborrheic ; Dermatology ; Epidemiology ; Exanthema ; Female ; Gyeongsangbuk-do ; Herpes Zoster ; Hospital Records ; Humans ; Korea ; Male ; Neuralgia, Postherpetic ; Outpatients ; Prevalence ; Pruritus ; Retrospective Studies ; Skin

Pyoderma-pyostomatitis vegetans (PD-PSV) is a rare, benign, eosinophilic pustular and vegetating mucocutaneous disease characterized by skin lesions which typically involve the axillary and genital regions, the face and the scalp. PD-PSV was at first regarded as a subtype of bullous disease. However, due to the lack of abnormality under a immunofluorescent microscope, it could be diffentiated from bullous disease. A 48-year woman presented with a 6-month history of sharply-outlined, exudative, papillomatous and vesiculopustular vegetating plaques on the perioral, umbilicus and nasal mucosa, tips of her fingers and toes and perianal region. A skin biopsy taken from the lip and umbilicus showed papillary dermal edema and focal inflammatory cell infiltration composed of many eosinophils, intraepithelial microabscesses, focal spongiosis, and exocytosis. No abnormalities were found during an immunofluorescence study. The lesions were almost cleared with 20 mg of triamcinolone and 200 mg of cyclosporin medication during a 3-month treatment period.
Biopsy ; Cyclosporine ; Edema ; Eosinophils ; Exocytosis ; Female ; Fingers ; Fluorescent Antibody Technique ; Humans ; Lip ; Nasal Mucosa ; Scalp ; Skin ; Toes ; Triamcinolone ; Umbilicus

No abstract available.

Infectious disease took the leading cause of death in patients with systemic lupus erythematosus (SLE). Especially Salmonella infection occurs more common in SLE patients. We report a case of thyroid abscess caused by Salmonella Group D in a patient with SLE. A patient, 29-year-old female, with SLE was admitted with a painful swelling of the left neck and diarrhea. The painful swelling of neck was revealed as an abscess of the thyroid and Salmonella Group D was isolated from the aspirated material of the thyroid abscess. The patient recovered after surgical drainage and administration of intravenous 3rd cephalosporin.
Abscess* ; Adult ; Cause of Death ; Communicable Diseases ; Diarrhea ; Drainage ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Neck ; Salmonella Infections ; Salmonella* ; Thyroid Gland*

BACKGROUND: There is no clear dermatologic definition to describe sensitive skin which usually includes subjective and psychological meanings. Some individuals exhibit exaggerated response, especially on the face, ranging from itching to intense adverse reaction like erythema, wheal, and eczema in comparison to normal ones when exposed to external irritants, allergens, environmental changes or internal stimulants. OBJECTIVE: To diagnose sensitive skin, lactic acid sting test is well known to represent a person who has subjective symptoms like itching, burning, prickling and stinging. We tried to compare several lactic acid sting tests to search for sensitive skin conveniently and rationally. METHODS: A total of 50 panelists (25 people of sensitive group and 25 people of control group, respectively) were selected by the method of self-assessment questionnaires related to sensitive skin. The panelists were tested on face, by conditioning 3 variances (5% or 10% Lactic acid, Hydration, Hilltop chamber), in 2 week intervals, 8 times totally. RESULTS: When lactic acid sting tests were performed using Hilltop chamber, there were more positive responders in sensitive group(p<0.05). There was statistically a significant difference between the 2 groups in the comparison of mean values of lactic acid sting scores (p<0.05). Sensitive group showed higher sting scores and exhibited much more difference with time (p<0.05). CONCLUSION: Our experiment showed that occlusive technique using Hilltop chamber was an inspiring and useful method of several lactic acid sting tests to find out sensitive skin.
Allergens ; Bites and Stings* ; Burns ; Eczema ; Erythema ; Humans ; Irritants ; Lactic Acid* ; Pruritus ; Self-Assessment ; Skin* ; Surveys and Questionnaires