Generalized granuloma annulare (GGA) is an uncommon type of granuloma annulare. It is frequently characterized by chronicity and unresponsiveness to a number of therapeutic modalities. A variety of systemic treatment modalities for GGA have been tried, including PUVA, dapsone, hydroxychloroquine, systemic corticosteroids, niacinamide, vitamin E and chlorambucil. However, their efficacy was not very encouraging. We present a case of GGA which showed a satisfactory response to isotretinoin. To conclude, isotretinoin may be considered as treatment for GGA in patients with unacceptable cosmetic disfigurements or symptoms.
Adrenal Cortex Hormones ; Chlorambucil ; Dapsone ; Granuloma Annulare* ; Granuloma* ; Humans ; Hydroxychloroquine ; Isotretinoin* ; Niacinamide ; Vitamin E ; Vitamins

Laugier-Hunziker syndrome (LHS) is a rare acquired benign macular hyperpigmentation of the lips and oral mucosa which is often associated with longitudinal melanonychia. LHS is known to be an entirely benign condition with no systemic manifestations, which requires patient reassurance as the only intervention. The significance of this condition is due to its inclusion in differential diagnoses of pigmentary disorders of the oral mucosa, especially Peutz-Jeghers syndrome. We report a case of Laugier-Hunziker syndrome in a 66-year-old woman who presented with longitudinal pigmented bands on her fingernails and multiple, pigmented macules on the lip and tongue.
Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperpigmentation ; Lip ; Mouth Mucosa ; Nails ; Peutz-Jeghers Syndrome ; Tongue

Implantable cardioverter-defibrillator (ICD) therapy is acknowledged as a valid treatment method for the effective prevention of sudden cardiac death, which is a major cause of mortality in adult congenital heart disease patients. But ICD implantation by the conventional transvascular approach is not always possible in patients who have undergone palliative surgery due to congenital and structural heart disease. Here, we report a case in which an ICD was transvascularly implanted in an arrhythmogenic right ventricular cardiomyopathy patient who had undergone a one-and-a-half ventricle repair.
Adult ; Arrhythmogenic Right Ventricular Dysplasia ; Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Fontan Procedure ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Mortality ; Palliative Care

OBJECTIVE: To investigate the relationship between respiratory muscle strength and cardiac function in patients with Duchenne muscular dystrophy (DMD). METHOD: This study included 37 patients with DMD. Cardiac function of patients was evaluated by thoracic echocardiography, which recorded left ventricular ejection fraction (LVEF). Maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) representing respiratory muscle strength and blood sampling for brain natriuretic peptide (BNP) were performed. RESULTS: LVEF did not show significant correlation with MIP, MEP or age. However, LVEF was negatively correlated with BNP level. CONCLUSION: Cardiac dysfunction of patients with DMD didn't correlate with age or respiratory muscle strength. Therefore, investigation of cardiac function itself is needed for patients with DMD irrespective of respiratory compromises.
Echocardiography ; Humans ; Muscular Dystrophy, Duchenne ; Natriuretic Peptide, Brain ; Respiratory Muscles ; Stroke Volume

Adult ; Bone Marrow ; Cambium ; Chondrocytes ; Female ; Hemorrhage ; Humans ; Jaw ; Mandible ; Mucous Membrane ; Osteoblasts ; Osteosarcoma ; Osteosarcoma, Juxtacortical

BACKGROUND/AIMS: Early tumor detection is crucial for the prevention of colon cancer. Near-infrared fluorescence (NIRF) imaging using a target-activatable probe may permit earlier disease detection. Matrix metalloproteinases (MMPs) participate in tumorigenesis and tumor growth. The aim of this study was to determine whether NIRF imaging using an MMP-activatable probe can detect colon tumors at early stages. METHODS: We utilized two murine colon cancer models: a sporadic colon cancer model induced by azoxymethane (AOM), and a colitis-associated cancer model induced by a combination of AOM and dextran sodium sulfate (DSS). Colonic lesions were analyzed by histologic examination, Western blotting, immunohistochemical staining, and NIRF imaging using an MMP-activatable probe. RESULTS: Multiple variable-sized tumors developed in both models and progressed from adenomas to adenocarcinomas over time. At the early stage of the AOM/DSS model, diffuse inflammation was observed within the tumors. MMP expression increased progressively through normal, inflammation, adenoma, and adenocarcionoma stages. NIRF signal intensities were strongly correlated with each tumor stage from adenoma to adenocarcinoma. NIRF imaging also distinguished tumors from inflamed mucosa. CONCLUSIONS: NIRF imaging using a protease-activatable probe may be a useful tool for early tumor detection. This approach could translate to improve the endoscopic detection of colon tumors, especially in patients with inflammatory bowel disease.
Adenocarcinoma ; Adenoma ; Azoxymethane ; Blotting, Western ; Cell Transformation, Neoplastic ; Colon ; Colonic Neoplasms ; Dextrans ; Fluorescence ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Matrix Metalloproteinases ; Optical Imaging ; Sodium ; Sulfates

BACKGROUND/AIMS: Advances in endoscopic technology seek to improve the accuracy of neoplastic tumor detection. Recently developed endoscopy devices such as narrow-band imaging (NBI) nevertheless have limitations in morphologic diagnosis. The purpose of this study was to investigate whether a novel imaging technique-near-infrared fluorescence (NIRF) imaging using a protease-activatable nanoprobe-could provide more accurate neoplastic tumor detection, compared to NBI. METHODS: Images of the intestines of Apc(Min/+) mice were obtained by NIRF using a matrix metalloproteinase (MMP)-sensing probe, which was based on a nanoparticle platform. Immediately after imaging, endoscopy with NBI capability was performed on the same excised intestine. Macroscopic and microscopic findings in the intestines were assessed, and MMP expression was analyzed by Western blotting and real-time polymerase chain reaction. RESULTS: Numerous tiny polypoid lesions were present in the intestines of aged Apc(Min/+) mice. These lesions included adenomas, lymphoid follicles, and protruding normal tissues. When using NIRF imaging with an MMP-activatable nanoprobe, adenomatous polyps showed higher fluorescence, compared to lymphoid follicles or adjacent normal tissues. The expression of MMP was higher in the adenomatous tissue than in the other tissues. The sensitivity and specificity for adenoma detection were 88.9% and 82.2%, respectively, when using NIRF imaging with a MMP-nanoprobe, compared to 77.8% and 66.7%, respectively, when using NBI (P<0.05). CONCLUSIONS: Near-infrared fluorescence imaging with a protease-activatable nanoprobe could aid in the differentiation of tumor characteristics. Clinical application of this approach may improve the endoscopic detection of neoplastic tumors.
Adenoma ; Adenomatous Polyps ; Animals ; Blotting, Western ; Endoscopy ; Fluorescence* ; Intestines ; Mice ; Molecular Imaging ; Nanoparticles ; Narrow Band Imaging ; Optical Imaging* ; Sensitivity and Specificity

The 23 open reading frame (ORF) 5 sequences of Korean type II porcine reproductive and respiratory syndrome virus (PRRSV) were collected from viremic sera from the (modified live vaccine) MLV-vaccinating and non-vaccinating farms from 2007 to 2008. The samples were phylogenetically analyzed with previous ORF5 sequences, including type I Korean PRRSV, and previously reported or collected sequences from 1997 to 2008. A MN184-like subgroup of type II Korean PRRSV was newly identified in the viremic sera collected from 2007 to 2008. And of the type I PRRSVs, one subgroup had 87.2~88.9% similarity with the Lelystad virus, showing a close relationship with the 27~2003 strain of Spain. The maximum parsimony tree of type II PRRSV from 1997 to 2008 showed that they had evolved to four lineages, subgroups 1, 2, 3 and 4. Most of the recently collected type II PRRSVs belonged to subgroup 4 (48%). The region of three B-cell epitopes and two T-cell epitopes of ORF5 amino acids sequences was considerably different from the MLV in subgroups 3 and 4. In conclusion, the existence of type I PRRSV, which was genetically different from Lelystad virus (Prototype of type I PRRSV), and heterologous type II PRRSVs of viremic pigs detected even in the MLV-vaccinating farms indicated the need for new vaccine approaches for the control of PRRSV in Korea.
Animals ; Epitopes, B-Lymphocyte/immunology ; Epitopes, T-Lymphocyte/immunology ; Evolution, Molecular ; Korea ; *Open Reading Frames ; Phylogeny ; Pilot Projects ; Porcine Reproductive and Respiratory Syndrome/blood/genetics/immunology/*virology ; Porcine respiratory and reproductive syndrome virus/*genetics/immunology ; RNA, Viral/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Swine ; Viral Vaccines/immunology/standards ; Viremia/genetics/immunology/virology

The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the ‘Return home’ group and 99 subjects in the ‘Rehabilitation hospitalization’ group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be considered as basic data for establishing rehabilitation goals and treatment plans.
Activities of Daily Living ; Aphasia ; Cognition ; Cohort Studies ; Depression ; Diagnosis ; Housing ; Humans ; Korea ; Mass Screening ; Patient Discharge ; Psychology ; Quality of Life ; Rehabilitation ; Stroke ; Walking

The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the ‘Return home’ group and 99 subjects in the ‘Rehabilitation hospitalization’ group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be considered as basic data for establishing rehabilitation goals and treatment plans.