No abstract available.
Anemia, Aplastic* ; Hepatitis*

A case of infectious mononucleosis was presented. She was admitted to the hospital with the anterior cervical lymphadenopathy. Erythematous skin rashes on both low extermities, and splenomegaly. Her chief complaints were fever and sore throat. She showed atypical lymphocytes in peripheral blood smear with relative lymphocytosis. Mono-spot test was positive. She received symptomatic therapy and discharged without any complications. So, we report this case and review the brief literatures of infectious mononucleosis with the respect to etiology, clinical course, and histological characteristics of the disease.
Exanthema ; Fever ; Infectious Mononucleosis ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Pharyngitis ; Splenomegaly

BACKGROUND: Henna is a natural dye derived from the leaves of the tree Lawsonia inermis known for its very low allergic properties. Recently, however, cases of pigmented contact dermatitis after henna dyeing have been increasing. OBJECTIVE: To analyze the clinical and histologic features of pigmented contact dermatitis caused by henna dyeing. METHODS: We retrospectively reviewed the clinical and histopathologic features of patients diagnosed with pigmented contact dermatitis after henna dyeing from June 2014 to August 2017. RESULTS: A total of 22 patients with a history of henna dyeing were included. All patients were female, and mean age was 58.9±8.2 years. They presented with rapidly spreading dark brownish patches located mostly adjacent to the hairline, such as at the forehead, temple, and lateral cheek. The mean duration between symptom onset and henna dyeing was 4.52 months (0~15). Standard patch test and as is test using henna showed no significant results. There were 18 patients with pruritus, which was only present at the early stage. Histopathologic examinations showed lichenoid inflammation with dermal melanin incontinence, vacuolar alteration, epidermal apoptotic cells, and perivascular inflammation. CONCLUSION: These results suggest that pigmented contact dermatitis observed after henna dyeing was caused by the toxicity of henna itself, not by other additives. The active ingredient of henna is lawsone (2-hydroxy-1,4-naphthoquinone), which may have induced pigmented contact dermatitis by its own cellular toxicity. Dermatologists should consider henna dyeing as a potential cause of pigmentation of the face and neck.
Cheek ; Dermatitis, Contact* ; Female ; Forehead ; Humans ; Inflammation ; Lawsonia Plant ; Melanins ; Neck ; Patch Tests ; Pigmentation ; Pruritus ; Retrospective Studies ; Trees

BACKGROUND: Citron is well known for an abundance of antioxidative and anti-inflammatory ingredients such as vitamin C, polyphenol compounds, flavonoids, and limonoids. OBJECTIVE: In this study, we aimed to evaluate the effects of citron essential oils on rosacea mediators in activated keratinocytes in vitro. METHODS: Normal human epidermal keratinocytes (NHEKs) were stimulated with 1α, 25-dihydroxyvitamin D3 (VD3) and interleukin 33 (IL-33) with LL-37 to induce rosacea mediators such as kallikrein 5 (KLK5), cathelicidin, vascular endothelial growth factor (VEGF), and transient receptor potential vanilloid 1 (TRPV1). These mediators were analyzed by performing reverse-transcription polymerase chain reaction (PCR), quantitative real-time PCR, immunocytofluorescence and enzyme-linked immunosorbent assay after NHEKs were treated with citron seed and unripe citron essential oils. RESULTS: The messenger RNA (mRNA) and protein levels of KLK5 and LL-37 induced by VD3 were suppressed by citron seed and unripe citron essential oils. Furthermore, the mRNA and protein levels of VEGF and TRPV1 induced by IL-33 with LL-37 were also suppressed by citron essential oils. CONCLUSION: These results show that citron essential oils have suppressive effects on rosacea mediators in activated epidermal keratinocytes, which indicates that the citron essential oils may be valuable adjuvant therapeutic agents for rosacea.
Ascorbic Acid ; Enzyme-Linked Immunosorbent Assay ; Flavonoids ; Humans ; In Vitro Techniques ; Interleukin-33 ; Kallikreins ; Keratinocytes* ; Limonins ; Oils, Volatile* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Rosacea* ; Vascular Endothelial Growth Factor A

Interstitial lung disease (ILD) is often observed in connective tissue diseases (CTDs), frequently in rheumatoid arthritis, systemic sclerosis, primary Sjögren’s syndrome, and inflammatory myositis. Early detection of ILDs secondary to rheumatic diseases is important as timely initiation of proper management affects the prognosis. Among many imaging modalities, high-resuloution computed tomography (HRCT) serves the gold standard for finding early lung inflammatory and fibrotic changes as well as monitoring afterwards because of its superior spatial resolution. Additionally, lung ultrasound (LUS) and magnetic resonance imaging (MRI) are the rising free-radiation imaging tools that can get images of lungs of CTD-ILD. In this review article, we present the subtypes of ILD images found in each CTD acquired by HRCT as well as some images taken by LUS and MRI with comparative HRCT scans. It is expected that this discussion would be helpful in discussing recent advances in imaging modalities for CTDILD and raising critical points for diagnosis and tracing of the images from the perspective of rheumatologists.

Nevus sebaceus is a congenital hamartoma with epidermal, follicular, and apocrine elements. Several skin appendage tumors can evolve secondarily from nevus sebaceus. Two different tumors often develop simultaneously on a nevus sebaceus lesion, but the growth of more than two tumors is rare. Herein, we report a case of four appendage tumors including trichoblastoma, tumor of the follicular infundibulum, sebaceoma, and sebaceous hyperplasia within a single nevus sebaceus lesion on the face of a 76-year-old female.
Aged ; Female ; Hamartoma ; Humans ; Hyperplasia* ; Nevus* ; Pituitary Gland* ; Skin

OBJECTIVE: To evaluate the effectiveness of CC+FSH or CC+hMG in intrauterine insemination (IUI) cycles for the treatment of infertility. METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days followed by hMG or FSH. A single IUI was performed at 36 h after hCG. Clinical pregnancy was classified if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: The overall clinical pregnancy rate was 19.1% per cycle (17/89) and 21.5% per patient (17/79). More clinical pregnancies were recorded in CC+FSH (23.1%, 6/26) than CC+hMG cycles (17.5%, 11/63), but this difference was not statistically significant. No differences were found in age, duration of infertility, follicle size, levels of estradiol (E2) on the day of hCG injection and total motile sperm counts between pregnant and non-pregnant groups. However, more ampules of gonadotropins were used in pregnant group than non-pregnant group (p<0.05). CONCLUSION: Combination of CC and hMG may economically be more effective to induce ovulation for IUI compared to CC and FSH.
Clomiphene* ; Estradiol ; Female ; Gestational Sac ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Ovulation ; Pregnancy Rate* ; Pregnancy* ; Sperm Count ; Ultrasonography

OBJECTIVE: This study was designed to evaluate the effects of endogenous LH surge, GnRH agonist (GnRH-a) or human chorionic gonadotropin (hCG) as ovulation trigger on pregnancy rate by intrauterine insemination (IUI). METHOD: Patients received daily 100 mg of clomiphene citrate (CC) for 5 days stating on the third day of the menstrual cycle followed by human menopausal gonadotropin (hMG) for ovulation induction. Follicles larger than >16 mm in diameter were present in the ovary, frequent LH tests in urine were introduced to detect an endogenous LH surge. Final follicular maturation and ovulation were induced by GnRH-a 0.1 mg (s.c.) or hCG 5,000~10,000 IU (i.m.) administration except natural ovulation. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. RESULTS: There were no differences in age, duration of infertility and follicle size, but more ampules of hMG were used in GnRH-a group compared to hCG 10,000 IU treated group (p<0.05). Lower level of estradiol (E2) on the day of hCG or GnRH-a injection was observed in hCG 10,000 IU group than other treatment groups (p<0.01). The overall clinical pregnancy rate was 19.8% per cycle (32/162) and 22.2% per patient (32/144). Pregnancy rate was higher in natural-endogenous LH surge group (37.5%, 9/24) than GnRH-a (18.8%) or hCG treated group (20.9% & 13.9%), but this difference was not statistically significant. No patient developed ovarian hyperstimulation. Abortion rate was 22.2% (2/9) in hCG 5,000 IU group. Delivery or ongoing pregnancy rate was 37.5% (9/24), 18.8% (3/16), 16.3% (7/43) and 13.9% (11/79) in endogenous LH surge, GnRH-a, hCG 5,000 IU and hCG 10,000 IU treatment groups, respectively. CONCLUSION: These results support the concept that use of natural-endogenous LH surge in stimulated cycles may be more effective to obtain pregnancies by IUI than GnRH-a or hCG administration.
Abortion, Induced ; Chorionic Gonadotropin ; Clomiphene ; Estradiol ; Female ; Gestational Sac ; Gonadotropin-Releasing Hormone* ; Gonadotropins ; Humans ; Infertility ; Insemination* ; Menstrual Cycle ; Ovary ; Ovulation Induction ; Ovulation* ; Pregnancy Rate* ; Pregnancy* ; Ultrasonography

Premature ovarian failure (POF) is defined as the complete cessation of menses less than 40 years of age. The criteria are more than four months of amenorrhea, with serum follicle stimulating hormone value of >40 mIU/mL and the frequency of POF is about 1% of all women. Although the etiologies of POF remain unknown, suggested factors are genetic, autoimmune, chemotherapy, radiotherapy and environmental toxins. The cytogenetic abnormalities predominantly concern the X chromosome, including Turner syndrome, Fragile X syndrome and deletion, translocation, or duplication of X chromosome. We report a very rare case of premature ovarian failure with the following karyotype: 46,X,dup(Xq), and report it with a brief review of literature.
Amenorrhea ; Chromosome Aberrations ; Female ; Follicle Stimulating Hormone ; Fragile X Syndrome ; Humans ; Primary Ovarian Insufficiency ; Turner Syndrome ; X Chromosome

Diffuse malignant mesothelioma is a rare malignant tumor having poor prognosis. There is still no widely acceptable staging system of the disease and pathologic diagnosis is difficult. Although surgical treatment for diffuse malignant mesothelioma has been controversial, extrapleural peumonectomy in selected patients could prolong the survival when it was combined with adjuvant chemotherapy and radiation therapy. We experienced 4 cases of diffuse malignant mesothelioma for 7 years since 1992, they were treated with extrapleural pneumonectomy without early postoperative mortality. Three patients underwent adjuvant therapy after surgery; chemotherapy in two, and chemo-radiation therapy in one, but one patient could not receive adjuvant therapy because of postoperative complication of hypoxic brain damage due to cardiac torsion and empyema. In this article, we describe surgical experience of extrapleural pneumonectomy and discuss about the controversial points of the disease.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Empyema ; Humans ; Hypoxia, Brain ; Mesothelioma* ; Mortality ; Pneumonectomy* ; Postoperative Complications ; Prognosis