No abstract available.
Pityriasis Rubra Pilaris ; Pityriasis ; Ustekinumab

No abstract available.
Lichen Sclerosus et Atrophicus* ; Lichens*

Background: Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. Objective: The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. Methods: A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. Results: The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. Conclusion In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.

Background: Sweet syndrome is characterized by tender erythematous plaques and nodules with predominantly dermal neutrophilic infiltrates. Sweet syndrome is relatively rare in children and adolescents. To date, only a few cases have been reported in Korean literature. Objective: The aim of this study was to investigate the clinical and histopathological features of Sweet syndrome in Korean children and adolescents. Methods: A retrospective study was conducted on 15 pediatric patients (aged ＜18 years) who were diagnosed with Sweet syndrome between 1991 and 2019. We reviewed the clinical and histopathological features of Sweet syndrome. Results: The age of the 15 patients ranged from 4 months to 17 years. Among the 15 patients with Sweet syndrome, nine patients were females and six patients were males. Most patients (80%) had lesions on the upper extremities. Fever and tenderness (60%) were the most commonly associated symptoms. Transient infections such as upper respiratory infection or gastroenteritis were the most common identifiable cause, observed in 40% of patients. Histopathologically, dermal neutrophilic infiltration was observed in all patients. All patients were treated with systemic corticosteroids and showed a good response, although 26.7% of the patients experienced symptom recurrence.During the follow-up period, there were no incidences of any complications or extracutaneous manifestations in the patients. Conclusion In contrast to previous reports of pediatric Sweet syndrome, female predominance was observed in this study. Transient infection was the most common factor. All patients responded well to systemic corticosteroid therapy without complications or extracutaneous manifestations during the follow-up period.

BACKGROUND: The incidence of candidemia has increased, and an early differentiation of transient or central venous catheter (CVC)-related candidemia from deep-seated invasive candidiasis is often difficult. The Pastorex Candida antigen assay (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) is known to be an useful and specific tool for the diagnosis of invasive candidiasis. We assessed the clinical significance of Pastorex Candida antigen assay in patients with candidemia. METHODS: Eighty-five sera from 27 patients with candidemia and 42 control sera (32 patients with superficial Candida colonization and 10 healthy subjects) were tested. The Pastorex Candida latex agglutination test was performed to evaluate the presence of Candida mannan antigen. Candidemia was divided into 3 categories; (i) transient, (ii) CVC-related, and (iii) non-CVC-related persistent types. RESULTS: Thirty-two patients with superficial Candida colonization and 10 healthy subjects were negative for the Pastorex Candida antigen. Of the 85 sera from 27 patients with candidemia, 14 (16.4%) were positive for the Pastorex Candida antigen. The Pastorex Candida antigen was detected neither in 6 patients with transient candidemia nor 15 patients with CVC-related candidemia. Conversely, it was detected in at least one serum sample of 5 of the 6 (83.3%) patients with non-CVC-related persistent candidemia. Of the 24 sera from 6 patients with non-CVC-related persistent candidemia, 14 (58.3%) were positive for the Pastorex Candida antigen. Overall, the sensitivity and specificity of the Pastorex Candida antigen assay for the diagnosis of non-CVC-related persistent candidemia were 83.3% and 100%, respectively. CONCLUSIONS: Our data suggest that the Pastorex Candida antigen assay has a potential for the differential diagnosis of non-CVC-related persistent candidemia from transient or CVC-related candidemia.
Candida* ; Candidemia* ; Candidiasis, Invasive ; Central Venous Catheters ; Colon ; Diagnosis ; Diagnosis, Differential ; Humans ; Incidence ; Latex Fixation Tests ; Mannans ; Sensitivity and Specificity

Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Aging ; Animals ; Apoptosis ; Asian Continental Ancestry Group ; Blood Pressure ; Cell Line ; Cohort Studies ; Gene Expression ; Genome ; Heart ; Humans ; Kidney ; Mice ; Neuroblastoma ; RNA, Messenger ; RNA, Small Interfering ; Transcription Factors ; Veins ; Zinc Fingers

PURPOSE: To compare the ultrasonographic image quality of fundamental imaging (FI), tissue harmonic imaging (THI), fundamental compound imaging (FCI), and harmonic compound imaging (HCI) in the evaluation of focal hepatic lesions. MATERIALS AND METHODS: Ninety-four focal hepatic lesions (27 hemangiomas, 15 hepatocellular carcinomas, 14 metastases, and 38 cysts) in 74 patients [30 males and 44 females aged 33-82 (mean, 55) years] were included in our study. All patients underwent FI, THI, FCI, and HCI using an HDI 5000 Sono CT scanner (Advanced Technology Laboratories, Bothell, CA., U.S.A.) with a 2-5MHz convex transducer. Images were analysed by two abdominal radiologists who used a 4-point scale and reached a consensus. In the case of solid lesions, four parameters, as follows, were evaluated: lesion conspicuity, internal morphology, overall image quality, and peripheral halo. For cysts, three parameters (internal artifact, sharpness of margin, and posterior enhancement) were assessed. For statistical analysis, the Scheffe method (ANOVA test) was used. RESULTS: For solid lesions (hemangioma, hepatocellular carcinoma, and metastasis), THI, FCI and HCI were superior to FI in terms of lesion conspicuity, internal morphology and overall image quality (p<0.05), though for peripheral halo, the four imaging techniques were not statistically different. For cysts, THI, FCI and HCI revealed clearer internal artifact and better margin sharpness than FI (p<0.05), while in terms of posterior enhancement, THI was superior to both FI and FCI, and HCI was superior to FCI (p<0.05). CONCLUSION: For the evaluation of focal hepatic lesions, harmonic imaging techniques (i.e. THI and HCI) appear to provide better image quality than fundamental imaging techniques (i.e. FI and FCI). There is, however no significant difference in image quality between the two harmonic techniques.
Artifacts ; Carcinoma, Hepatocellular ; Consensus ; Female ; Hemangioma ; Humans ; Male ; Neoplasm Metastasis ; Transducers

BACKGROUND: BACTEC MGIT 960 system(Becton Dickinson, USA; MGIT 960) is a fully automated, noninvasive culture system for mycobacteria, which has been regarded as a sensitive and least labor-intensive method. This study was purposed to evaluate the performance of MGIT 960 compared to BACTEC 460 TB radiometric system(Becton Dickinson, USA; BACTEC 460) and Ogawa media. METHODS: A total of 1,067 clinical specimens submitted from April to June in 1999 was cultured for acid fast bacilli(AFB). All specimens were digested, decontaminated by the 6% sodium hydroxide(final concentration of 1.5%) and 0.5% N-acetyl-L-cysteine method. All specimens were inoculated into three kinds of media: a MGIT, a BACTEC 12B, and an Ogawa medium. The AFB recovered from cultures were identified to M. tuberculosis complex and MOTT by NAP test. RESULTS: Of 106 isolates of M. tuberculosis recovered from all culture systems, 101(95.3 %) were detected in the MGIT 960, 95(89.6%) in the BACTEC 460 and 76(71.7%) on Ogawa media. MGIT 960 plus Ogawa media detected 104(98.1%) isolates and BACTEC 460 plus Ogawa media recovered 96(90.6%) isolates. The mean time required for detection of M. tuberculosis was 12.7+/-5.8 days with MGIT 960, 16.2+/-7.7 days with BACTEC 460, and 22.8+/-9.5 days with Ogawa media. The contamination rate were 5.1% for MGIT 960, 2.7% for BACTEC 460, and 6.7% for Ogawa media. CONCLUSIONS: MGIT 960 is a sensitive and rapid method to isolate M. tuberculosis.
Acetylcysteine ; Mycobacterium tuberculosis* ; Mycobacterium* ; Sodium ; Tuberculosis

Metformin has been reported to increase the expression of the glucagon-like peptide-1 (GLP-1) receptor in pancreatic beta cells in a peroxisome proliferator-activated receptor (PPAR)-alpha-dependent manner. We investigated whether a PPARalpha agonist, fenofibrate, exhibits an additive or synergistic effect on glucose metabolism, independent of its lipid-lowering effect, when added to metformin. Non-obese diabetic Goto-Kakizaki (GK) rats were divided into four groups and treated for 28 days with metformin, fenofibrate, metformin plus fenofibrate or vehicle. The random blood glucose levels, body weights, food intake and serum lipid profiles were not significantly different among the groups. After 4 weeks, metformin, but not fenofibrate, markedly reduced the blood glucose levels during oral glucose tolerance tests, and this effect was attenuated by adding fenofibrate. Metformin increased the expression of the GLP-1 receptor in pancreatic islets, whereas fenofibrate did not. During the intraperitoneal glucose tolerance tests with the injection of a GLP-1 analog, metformin and/or fenofibrate did not alter the insulin secretory responses. In conclusion, fenofibrate did not confer any beneficial effect on glucose homeostasis but reduced metformin's glucose-lowering activity in GK rats, thus discouraging the addition of fenofibrate to metformin to improve glycemic control.
Animals ; Blood Glucose/metabolism ; Body Weight/drug effects ; Diabetes Mellitus, Experimental/*drug therapy/*metabolism ; Drug Therapy, Combination ; Feeding Behavior/drug effects ; Fenofibrate/*pharmacology/therapeutic use ; Glucagon-Like Peptide 1/agonists/metabolism ; Glucose/*metabolism ; Glucose Tolerance Test ; Homeostasis/*drug effects ; Immunohistochemistry ; Injections, Intraperitoneal ; Insulin-Secreting Cells/drug effects/metabolism/pathology ; Lipid Metabolism/drug effects ; Male ; Metformin/*pharmacology/therapeutic use ; Peptides/administration & dosage/pharmacology ; Rats ; Receptors, Glucagon/metabolism ; Venoms/administration & dosage/pharmacology

Perforating granuloma annulare (PGA), a rare variant of granuloma annulare, is characterized by transepidermal elimination of altered collagen that clinically manifests an umbilicated papule with a central crust. It can be confused with papulonecrotic tuberculid (PNT) because of their similar appearance. Unlike PGA, PNT is usually related to tuberculosis infection with a typical histologic finding of wedge-shaped dermal necrosis. Here, we report the first Korean case of PGA mimicking PNT both clinically and histologically. A 43-year-old Korean woman presented with erythematous papules localized on the extensor surface of her limbs for one year. Some of these papules had a central umbilication or a crust. Regarding comorbidity, she had latent tuberculosis diagnosed with QuantiFERON®-TB Gold test about five months ago. She was on antituberculous medication. Initially, a diagnosis of papulonecrotic tuberculid accompanied by latent tuberculosis was considered. However, despite taking the antituberculous medication for five months, her skin lesions were not improved. Biopsy specimen from her arm lesion showed wedge-shaped area of necrosis in the dermis. Additionally, there were multiple focal mucin depositions and palisading granulomatous inflammation throughout the dermis. A diagnosis of PGA was made and she was treated with topical corticosteroid. After two weeks of applying topical corticosteroid, most of her skin lesions disappeared, leaving some hyperpigmented scars.
Adult ; Arm ; Biopsy ; Cicatrix ; Collagen ; Comorbidity ; Dermis ; Diagnosis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Inflammation ; Latent Tuberculosis ; Mucins ; Necrosis ; Skin ; Tuberculosis ; Tuberculosis, Cutaneous*