As chemicals become common in everyday life, serious burns are increasing due to chemicals. Chemical burns are characterized by continuous tissue destruction until the harmful substances are neutralized. The longer the skin is in contact with the chemical, the deeper the burn can be. In cases of chemical burns caused by glacial acetic acid, the burns were caused by a mixture of a small amount of glacial acetic acid and a large amount of flour. Despite the prolonged contact with the dough, tissue damage was managed through debridement and split thickness skin graft, leading to relatively good results.

Necrotizing fasciitis is a deep soft tissue infection that includes the muscle fascia and subcutaneous fat. It is rare, but it causes necrosis of the muscle, fascia, and subcutaneous tissues. It advances quickly and becomes a life-threatening bacterial infection with high morbidity and mortality. Alcoholics with diabetes are especially vulnerable to necrotizing fasciitis and at high risk of progression to severe sepsis and septic shock. In that sense, early diagnosis and prompt treatment are important in the management of necrotizing fasciitis, especially in diabetic alcoholics. We recently treated necrotizing fasciitis on the left lower leg of a 55-year-old diabetic alcoholic who had not controlled blood sugar for 4 years. In our case, a minor burn wound on the left lower leg caused by the hot ramen soup progressed to necrotizing fasciitis within ten days. The patient who was diagnosed with necrotizing fasciitis of the left lower leg was successfully managed with prompt diagnosis, serial debridement, and a split-thickness skin graft while controlling blood sugar levels.

We previously reported peritoneal innate-like integrin α4 (CD49d)highCD4+ T cells that provided help for B-1a cells. Here we analyzed the expression of various integrin chains on the peritoneal and pleural integrin α4highCD4+ T cells and investigated the functional heterogeneity of the subpopulations based on the integrin expression. Pleural cavity contained a lower ratio of integrin α4highCD4+ T cells to integrin α4lowCD4+ T cells than peritoneal cavity, but the pleural integrin α4highCD4+ T cells have the same characteristics of the peritoneal integrin α4highCD4+ T cells. Most of integrin α4highCD4+ T cells were integrin β1highβ7−, but a minor population of integrin α4highCD4+ T cells was integrin β1+β7+. Interestingly, the integrin α4highβ1highβ7− CD4+ T cells expressed high levels of integrin α4β1 and α6β1, whereas integrin α4highβ1+β7+ CD4+ T cells expressed high levels of integrin α4β1 and α4β7, suggesting an alternative expression of integrin α6β1 or α4β7 in combination with α4β1 in respective major and minor populations of integrin α4highCD4+ T cells. The minor population, integrin α4highβ1+β7+ CD4+ T cells, were different from the integrin α4highβ1highβ7− CD4+ T cells in that they secreted a smaller amount of Th1 cytokines upon stimulation and expressed lower levels of Th1-related chemokine receptors CCR5 and CXCR3 than the integrin α4highβ1 highβ7− CD4+ T cells. In summary, the innate-like integrin α4highCD4+ T cells could be divided into 2 populations, integrin α4β1+α6β1+α4β7− and α4β1+α6β1−α4β7+ cells. The functional significance of serosal integrin α4β7+ CD4+ T cells needed to be investigated especially in view of mucosal immunity.
CD4-Positive T-Lymphocytes ; Cytokines ; Immunity, Mucosal ; Integrin alpha4 ; Peritoneal Cavity ; Pleural Cavity ; Population Characteristics ; Receptors, CCR5 ; Receptors, Chemokine ; Receptors, CXCR3 ; T-Lymphocytes* ; Th1 Cells