BACKGROUND: The endothelial expresson and upregulation of ICAM-1 and epidermal keratinocyte expression of ICAM-1 are well documented in psoriasis. ICAM-1 mediates the adhesion and trafficking of circulating activated skin-seeking CD45RO+ memory CD4+ T lymphocytes from the vessel into the dermis and epidermis of psoriatic skin by binding to its ligand LFA-1(lymphocyte function-associated antigen-1) expressed on lymphocyte membranes. OBJECTIVE: The purpose of this study was to investigate the expression of ICAM-1 in vascular endothelium and keratinocyte of psoriatic skin and the difference of ICAM-1 expression between early and fully developed psoriatic lesions. METHODS: We have studied the expression of ICAM-1 in twelve psoriatic patients who had not been treated for psoriatic lesions for 1 month and three normal human skin samples by immunohistochemical staining using monoclonal antibody against ICAM-1. RESULTS: Immunohistochemical staining revealed anti-ICAM-1 antibody positively stained only in the subpapillary endothelial cells of normal skin. But in all psoriatic lesions studied, anti- ICAM-1 antibody was stained positively in the endothelium of papillary and subpapillary plexus, and in fully developed psoriatic lesions, anti-ICAM-1 antibody was stained focally in epidermal keratinocytes. CONCLUSION: The results suggest that ICAM-1 expression on papillary microvessels and keratinocytes may play an important role in the transendothelial and transepidermal migration of lymphocytes from the vessel into the dermis and epidermis of psoriatic skin.
Dermis ; Endothelial Cells ; Endothelium ; Endothelium, Vascular* ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes* ; Lymphocytes ; Membranes ; Memory ; Microvessels ; Psoriasis ; Skin* ; T-Lymphocytes ; Up-Regulation

BACKGROUND: The bioactive sphingolipid metabolite sphingosine 1-phosphate (S1P), was reported to induce apoptosis of some cancer cells and neurons, although it is generally known to exert mitogenic and antiapoptotic effects. Recently, it was described that S1P induced time- and dose-dependent apoptosis in B16 melanoma cells, that was not associated with cell membrane receptors for S1P but ERK and caspase-3 activation. OBJECTIVE: In this study, we aimed to investigate the exact mechanism of apoptosis by S1P using cultured B16 melanoma cells with caspase activity assay and Western blot assays for p-ERK, Fas, Bcl-2 family and cytochrome C proteins. METHODS: We cultured B16 melanoma cells and treated S1P with various concentrations and time. Caspases (3, 8, and 9) activity assay and Western blot assays for phosphor-ERK, Fas, Bcl-2 family and cytochrome C proteins were performed. RESULTS: We observed S1P induced caspase-3, -8, and -9 activations in our results. S1P also induced prolonged activation of ERK in 72 hours. S1P concomitantly increased Bcl-2 protein expression in the early 12 hours of the treatment. Neither fas nor cytochrome C were affected by S1P. CONCLUSION: In conclusion, we propose that S1P may induce apoptotic signal on B16 melanoma cells by prolonged ERK activation and caspase-8, -9, -3 activations. S1P also appears to exert antiapoptotic signal by increasing Bcl-2 protein.
Apoptosis ; Blotting, Western ; Caspase 3 ; Caspase 8 ; Caspases ; Cell Membrane ; Cytochromes c ; Humans ; Lysophospholipids ; Melanoma ; Melanoma, Experimental ; Neurons ; Proteins ; Sphingosine

Interferon-gamma has been suggested as a cytokine of connective tissue stabilizer. In addition, it has also been demonstrated that this cytokine inhibited bone remodeling activities of the bone derived cells. In order to illuminate the effects of this cytokine in orthodontic force induced bone remodeling, it was administered to primary cultured periodontal ligament cells which have been known to have some osteoblast like characteristics. Interferon-gamma slightly decreased [3H]thymidine incorporation rate without a significant change in the total cellular DNA content up to 1000 U/ml, which meant these doses were not cytotoxic to the cell. Total protein synthesis was not influenced by various concentration of interferon-gamma whether it was determined by the [3H]proline incorporation rate or by the Lowry smethod. The effect of interferon-gamma on the individual protein was, however, differential, ie, it increased [3H]proline incorporation into the noncollagenous protein marginally, while it decreased [3H]proline incorporation into the collagen, so that it caused dose-dependent suppression of the relative collagen synthesis. On the contrary, the fibronectin synthesis determined by the ELISA was increased by 1000 U/ml of interferon-gamma. The differential effects of the interferon-gamma on the collagen and fibronectin synthesis exhibited not only their protein level but also the steady state mRNA level. Interferon-gamma decreased steady state level of alpha1(I) procollagen mRNA significantly, while showing no significant changes in the fibronectin mRNA level. In addition to this, it was also found that indomethacin did not affect on the interferon-gamma induced collagen decrease in this cell, which meant prostaglandins were not involved in the process of interferon-gamma induced collagen decrease. So it can be concluded that the incubation of periodontal ligament cells with 1000 U/ml of interferon-gamma for 24 hr showed differential effects on the type I collagen and fibronectin gene expression. The decrease in relative collagen synthesis in the protein level was related with decrease in the steady state level of mRNA, while the increase in the fibronectin synthesis in the protein level was not correlated with the mRNA level.
Alkaline Phosphatase ; Bone Remodeling ; Collagen Type I ; Collagen* ; Connective Tissue ; DNA ; Enzyme-Linked Immunosorbent Assay ; Fibronectins* ; Gene Expression ; Indomethacin ; Interferon-gamma* ; Osteoblasts ; Periodontal Ligament* ; Procollagen ; Prostaglandins ; RNA, Messenger

BACKGROUND: Alopecia areata (AA) is a common dermatologic disorder and the course is so variable that some patients undergo spontaneous remission and others undergo total hair loss. There is no clearly superior therapy for the treatment of alopecia areata. Currently, topical immunotherapy with DPCP represents the most accepted therapeutic modality for the treatment of extensive alopecia areata, but their response rates have varied in the literature. OBJECTIVE: We evaluated the efficacy, prognostic factors, and side effects of DPCP in the treatment of extensive AA. METHOD: Thirty nine patients with extensive AA (>50 % scalp hair loss), treated for at least 6 months at the Department of Dermatology of Inha University Hospital between March 2000 and April 2003 participated in the study. After sensitization with 1% DPCP, progressively higher concentrations beginning from 0.001% were applied weekly onto the entire scalp. The primary study end point, i.e. clinically significant regrowth with DPCP therapy, was defined as a cosmetically acceptable response (as judged by the patient) or significant regrowth resulting in greater than 90% of the scalp being covered with terminal hair (as determined by the investigators) RESULT: A clinically significant regrowth was obtained in 91.3% of the patients with 50% to 99% AA and 50.0% with alopecia totalis/universalis. The overall clinically significant regrowth rate was 74% (29 of 39 patients). Variables associated with clinically significant regrowth were the beginning age of DPCP therapy and the extent of AA. Relapse was observed in 56.3% of the patients who achieved significant hair regrowth after 6 months of follow-up. The Clinically significant adverse effects observed were eczematous reaction with blistering, swelling of cervical lymph nodes, urticaria, and erythema multiforme. CONCLUSION: Treatment with DPCP for extensive AA is very effective. Response of AA patients to DPCP treatment is affected by the beginning age of DPDP therapy and the extent of AA.
Alopecia Areata* ; Alopecia* ; Blister ; Dermatology ; Erythema Multiforme ; Follow-Up Studies ; Hair ; Humans ; Immunotherapy ; Lymph Nodes ; Recurrence ; Remission, Spontaneous ; Scalp ; Urticaria

PURPOSE: To evaluate the efficacy of pars plana vitrectomy on the retinal reattachment for the patients who have suffered from recurrent or remained retinal detachment (RD) although they had undergone scleral buckling procedures for their rhegmatogenous retinal detachment. METHODS: With retrospective chart review of 14 patients with recurrent or persisted RD who underwent pars plana vitrectomy, the authors checked the reattachment rate, their visual recovery state, and complicated disorders during and after the surgeries. All eyes had undergone scleral buckling procedure during primary repair. RESULTS: Anatomic success was achieved after the initial reoperation in 10 (71.5%) eyes. With further surgery, the overall success rate was 85.1% (12 eyes). Visual acuity was improved in 4 eyes, worse in 8 eyes. CONCLUSIONS: These results suggest that pars plana vitrectomy may be an efficient surgical procedure for retinal reattachment in cases of recurrent or persisted RD after primary scleral buckle.
Humans ; Reoperation ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Visual Acuity ; Vitrectomy*

PURPOSE: To report a case of a macular hole resulting from accidental exposure to tattoo removal by the Q-Switched Nd:YAG laser, which was treated successfully by vitrectomy and silicone oil infusion. CASE SUMMARY: A 33-year-old man presented with decreased visual acuity after accidental exposure to a Q-Switched Nd:YAG laser. According to fundus examination, vitreous hemorrhage and macular edema were observed. After 21 days, a macular hole had developed which was treated by standard pars plana vitrectomy and gas tamponade. Unfortunately, closure was not obtained on the first attempt. Therefore, a second attempt using silicone oil infusion was performed. Four months after the initial visit, BCVA had increased to 20/50, and anatomical occlusion was achieved. CONCLUSIONS: The authors of the present study experienced an unusual case of macular hole developed from the Q-Switched Nd:YAG laser used to remove a tattoo. A satisfactory visual acuity was achieved after silicone oil infusion despite failure in the first surgery.
Adult ; Humans ; Macular Edema ; Retinal Perforations ; Silicone Oils ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

BACKGROUND: Extensive alopecia areata (EAA) is resistant to multiple individual treatment modalities and has poor prognosis for cosmetically adequate regrowth. Anthralin is a widely used topical anti-psoriatic drug that may have an immunomodulating effect on AA as is does in psoriasis. But, there has only been small number of clinical trials of anthralin in the treatment of AA. OBJECTIVE: The purposes of the study were to evaluate the efficacy, prognostic factor, side effects and recurrence rate of topical anthralin therapy in treatment-resistant EAA. METHODS: A total of 16 cases of EAA (>50% scalp hair loss) who had failed in previous treatments were subjected in this study. Anthralin in 0.5% concentrations was applied to alopectic lesions for 1 hour daily over 4 weeks, gradually increasing anthralin concentration until low-grade erythema and pruritus develops. Treatment was withdrawn after complete response or if there were no signs of improvement at 6 months. Responders were followed up for 6 months after discontinuation of therapy. RESULTS: The overall response rate was 62.5%, complete response (>90% regrowth or cosmetically acceptable appearance) was obtained in 25% of cases and, good response (50~99% regrowth) in 39.5% of cases. In this study, among the investigated prognostic factors, there were no statistically significant factors (p<0.05, Fisher exact test). The most frequent side effects were therapeutically induced mild pruritus (93.8%), erythema (93.8%) and scale (56.3%). Other side-effects were transient folliculitis (31.3%) and regional lymph adenopathy (12.5%). Relapse was observed in 60% of responders after 6 month of follow up. CONCLUSION: Topical anthralin for treatment-resistant EAA is an effective therapy with tolerable side effects. Therefore, we propose the topical anthralin as a reasonable therapeutic option for treatment-resistant EAA.
Alopecia ; Alopecia Areata ; Anthralin ; Erythema ; Folliculitis ; Hair ; Prognosis ; Pruritus ; Psoriasis ; Recurrence ; Scalp

PURPOSE: To report the first domestic case of choroidal neovascularization in a choroideremia patient treated with intravitreal bevacizumab injection. CASE SUMMARY: A 29-year-old male presented with a sudden decline in vision in the left eye. Fundus examination revealed areas of choriocapillaries and retinal pigment epithelium atrophy with macular hemorrhage. Fluorescein angiogram revealed vascular hyperfluorescence in the juxtafoveal area. Neurosensory detachment around the macula and increased central macular thickness was also observed using optical coherence tomography. Upon the diagnosis of choroideremia with choroidal neovascularization, the patient was treated with 1.25 mg intravitreal bevacizumab. Visual acuity improved after four injections of intravitreal Bevacizumab with improvement in both detachment and fluorescein leakage. CONCLUSIONS: In patients with choroideremia presenting sudden decline in vision, ophthalmologists should detect for possible choroidal neovascularization. The results from the present study show that judicious use of intravitreal Bevacizumab may be effective in such cases. Further studies with a large sample size and sufficiently long follow-up periods are required.
Adult ; Antibodies, Monoclonal, Humanized ; Atrophy ; Choroid ; Choroidal Neovascularization ; Choroideremia ; Eye ; Fluorescein ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Retinal Pigment Epithelium ; Sample Size ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Bevacizumab

Bullous pemphigoid(BP) is a bullous disease in elderly people characterized by subepidermal bullae on erythematous and normal skin. Peripheral blood easinophilia have been reported in the patients with BP, and blood eosinophilia may be related to disease activity and severity in BP. We report a 70-year old man BP. He showed peripheral blood eosinophilia, and was treated successfully with a combination of low dose steroids & tetracycline-niacinamide(T-N) therapy. The eosinophil counts fell to normal levels as the skin lesion cleared.
Aged ; Eosinophilia ; Eosinophils ; Humans ; Pemphigoid, Bullous* ; Skin ; Steroids

The bioactive sphingolipid metabolite sphingosine 1-phosphate (S1P), recently was reported to induce apoptosis of some cancer cells and neurons, although it generally known to exert mitogenic and antiapoptotic effects. In this study, we investigated the effects of S1P on the cell growth, melanogenesis, and apoptosis of cultured B16 mouse melanoma cells. In results, S1P was found to induce apoptosis in B16 melanoma cells in a dose- and time-dependent manner, but exerted minimal effects on melanogenesis. Although receptors of sphingosine 1-phosphate (endothelial differentiation gene 1 [Edg]/S1P1, Edg5/S1P2, Edg3/S1P3) were expressed in B16 melanoma cells, they were shown not to be associated with S1P-induced apoptosis. In addition, pertussis toxin did not block the apoptotic effects of S1P on B16 melanoma cells. S1P induced caspase-3 activation and the extracellular signal-regulated kinase (ERK) activation. Interestingly, the ERK pathway inhibitor, UO126, reversed the apoptotic effects of S1P on B16 melanoma cells. These results suggest that S1P induced apoptosis of B16 melanoma cells via an Edg receptor-independent, pertussis toxin-insensitive pathway, and appears to be associated with the ERK and caspase-3 activation.
Sphingosine/administration & dosage/*analogs & derivatives ; Signal Transduction/drug effects ; Mice ; Melanoma/*enzymology/*pathology ; Lysophospholipids/*administration & dosage ; Extracellular Signal-Regulated MAP Kinases/*metabolism ; Enzyme Activation/drug effects ; Cell Line ; Caspase 3/*metabolism ; Apoptosis/*drug effects ; Animals