Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder that leads to a progressive muscle wasting and paralysis. The pathological phenotypes are featured by severe motor neuron death and glial activation in the lumbar spinal cord. Proposed ALS pathogenic mechanisms include glutamate cytotoxicity, inflammatory pathway, oxidative stress, and protein aggregation. However, the exact mechanisms of ALS pathogenesis are not fully understood yet. Recently, a growing body of evidence provides a novel insight on the importance of glial cells in relation to the motor neuronal damage via the non-cell autonomous pathway. Accordingly, the aim of the current paper is to overview the role of astrocytes and microglia in the pathogenesis of ALS and to better understand the disease mechanism of ALS.
Amyotrophic Lateral Sclerosis ; Astrocytes* ; Glutamic Acid ; Microglia* ; Motor Neurons ; Neurodegenerative Diseases ; Neuroglia ; Oxidative Stress ; Paralysis ; Phenotype ; Spinal Cord

Percutaneous needle aspiration biopsy is a reliable and useful procedure for diagnosing tumor with a low rate of complications and high diagnostic reliability. Subcutaneous malignant seeding of the needle tract is a well-known complication of percutaneous needle aspiration biopsy. Implantation metastases of the abdominal and chest walls have been reported after puncturing the tumor lesions of the liver, kidney, adrenal gland, lung and pleura. We report here on a case of subcutaneous seeding of hepatoid thymic carcinoma on the right upper back after a percutaneous needle aspiration biopsy.
Adrenal Glands ; Biopsy, Needle ; Kidney ; Liver ; Lung ; Needles ; Neoplasm Metastasis ; Pleura ; Seeds ; Thorax ; Thymoma

BACKGROUND: Imiquimod is an immune response modifier that shows antiproliferative and antiviral characteristics through synthesis of multiple cytokines. Although it was originally approved by the Food and Drug Administration for the treatment of anogenital warts, it has also been successfully used to treat various skin conditions. OBJECTIVE: The aim of this study was to evaluate the current usage of 5% imiquimod cream for the treatment of various skin conditions in dermatologic clinics. METHODS: We reviewed the records of 270 patients with various skin conditions who were treated with 5% imiquimod cream. Data was collected through medical records, clinical photographs, and biopsy specimens. RESULTS: Besides anogenital warts, 5% imiquimod cream has been prescribed in more than 20 skin conditions. The most common skin disease was verruca vulgaris. Others, in order of prevalence, were molluscum contagiosum, actinic keratosis, condyloma accuminatum, and verruca plana. Among the 270 patients who were treated with 5% imiquimod cream, more than two-thirds showed clinical response, but only 26 patients (9.7%) achieved clinical complete remission with median clearing time of 7.3 weeks. While applying 5% imiquimod cream, 82 patients (30.4%) experienced local side effects that were generally mild and generally well-tolerated. The most common side effect was erythema and the others, in order of prevalence, were oozing, itching sensation, burning sensation, scabbing, erosion and pain. No systemic side effects were found. CONCLUSION: Although 5% imiquimod cream is licensed in Korea only for treatment of adult anogenital warts, other skin diseases such as verruca vulgaris are more commonly the treatment target in dermatologic clinics. As the reported therapeutic effects are various, more clinical studies are required to assess the safety and efficacy of imiquimod for the treatment of various skin conditions.
Adult ; Aminoquinolines ; Biopsy ; Burns ; Cytokines ; Erythema ; Humans ; Keratosis, Actinic ; Korea ; Medical Records ; Molluscum Contagiosum ; Prevalence ; Pruritus ; Sensation ; Skin ; Skin Diseases ; United States Food and Drug Administration ; Warts

The second-generation oral anticancer agent UFT is a combination of uracil, which has fluorouracil's (5-FU) degradation-inhibitory effect, and tegafur, which is slowly converted to 5-FU in vivo, and UFT shows a higher 5-FU concentration in the tumor tissues than is achieved by tegafur alone or with comparable doses of intravenous 5-FU. Mucocutaneous side reactions induced by UFT are rare and these include photosensitivity of the lichenoid and eczematous types, acral erythema, hyperpigmentation, palmoplantar keratoderma and scleroderma-like reactions, and discoid lupus erythematosus (DLE)-like eruption. However, there has been no report in the Korean medical literature on patients presenting with a DLE-like eruption associated with UFT. So, we report here a case of DLE-like eruption induced by oral UFT.
Erythema ; Fluorouracil ; Humans ; Hyperpigmentation ; Keratoderma, Palmoplantar ; Lupus Erythematosus, Discoid ; Tegafur ; Uracil

Objectives: We aimed to describe the epidemiological characteristics of carbapenemaseproducing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022. Methods: Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022. Results: Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p < 0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p < 0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p < 0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p = 0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p = 0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks. Conclusion In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.

Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder that results from a germline mutation of the VHL gene. The affected individuals might develop several benign or malignant tumors such as central nervous system or retinal haemangioblastomas, endolymphatic sac tumors, renal cell carcinomas, pheochromocytomas or pancreatic cysts and neuroendocrine tumors. We report here on a case of a 21 year old female with von Hippel-Lindau disease and she presented with only pancreatic neuroendocrine tumor and no evidence of haemangioblastomas or other visceral complications. Further, direct sequencing of the VHL gene reveals a novel germline frameshift mutation of codon 198 from the deletion of nucleotide 592 (cytosine), leading to truncation of the VHL protein.
Carcinoma, Renal Cell ; Central Nervous System ; Codon ; Endolymphatic Sac ; Female ; Frameshift Mutation ; Germ-Line Mutation ; Humans ; Neuroendocrine Tumors ; Pancreas ; Pancreatic Cyst ; Pheochromocytoma ; Retinaldehyde ; von Hippel-Lindau Disease

Small-breed dogs (n = 168; weight < 15 kg) diagnosed with myxomatous mitral valve degeneration based on a routine clinical examination, radiology, electrocardiography, and echocardiography at the Seoul National University Veterinary Medical Teaching Hospital were included in this study. Survival periods were determined, and there were significant differences in survival rates among the three International Small Animal Cardiac Health Council classes. The mean follow-up period was 14.3 ± 12.1 months. Univariate analysis revealed that dyspnea, pulmonary edema, and vertebral heart score were significantly associated with survival time (p < 0.05). Additionally, age, left atrial-to-aortic root ratio, ejection fraction, and left ventricular end diastolic volume were associated with an increased risk of death (p < 0.1), while body weight, body condition score, systolic blood pressure, arrhythmia, syncope, fractional shortening, and end systolic volume were not associated with an increased risk of death. These results suggest that among the assessed variables dyspnea, pulmonary edema, and vertebral heart score could be useful prognostic factors for providing patient information to owners.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Body Weight ; Dogs* ; Dyspnea ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart ; Heart Failure ; Hospitals, Teaching ; Humans ; Mitral Valve* ; Prognosis ; Pulmonary Edema ; Retrospective Studies* ; Seoul ; Stroke Volume ; Survival Rate ; Syncope

BACKGROUND: Hypotension is a common complication of spinal anesthesia for cesarean delivery. The incidence and severity of hypotension is reported higher compared with other surgeries due to aortocaval compression. We evaluated whether body weight, body height, body mass index (BMI) and abdominal circumference effected on the incidence of hypotension and ephedrine requirement. METHODS: A total of 55 parturients undergoing elective cesarean delivery were enrolled in this prospective observational study. Preeclampsia or eclampsia was excluded. Abdominal circumference, body weight, body height were assessed before anesthesia. Spinal anesthesia was conducted in the right lateral position using 8 mg of 0.5% hyperbaric bupivacaine and 15 microg of fentanyl. Blood pressure was measured before anesthesia and at 1 min interval after intrathecal injection. Nausea was assessed during spinal anesthesia. Hypotension was defined that blood pressure decreased below 80% of baseline value and ephedrine was given if blood pressure dropped below 70% (severe hypotension). RESULTS: The total incidence of hypotension was 65% (36/55) and ephedrine was administered in 38% (21/55) of parturients. Except height, abdominal circumference, body weight and body mass index were associated with the incidence of hypotension (P < 0.05). However, severe hypotension requiring ephedrine (P = 0.001, OR = 1.16, [95% CI 1.04-1.30]), ephedrine requirement (P = 0.001, R = 0.43) and nausea (P = 0.026, R = 0.31) were significantly related only with abdominal circumference. CONCLUSIONS: Abdominal circumference of parturients may be a good parameter to predict both of the incidence and the severity of hypotension during spinal anesthesia for cesarean delivery.
Anesthesia ; Anesthesia, Spinal ; Blood Pressure ; Body Height ; Body Mass Index ; Body Weight ; Bupivacaine ; Cesarean Section ; Eclampsia ; Ephedrine ; Female ; Fentanyl ; Hypotension ; Incidence ; Injections, Spinal ; Nausea ; Pre-Eclampsia ; Pregnancy ; Prospective Studies

We present the case of a 57-year-old man who developed retroperitoneal hemorrhage due to unintentional arterial puncture during femoral artery cannulation for Guglielmi detachable coil embolization. On emergence from anesthesia, he developed severe hypotension. Computed tomographic angiogram of the abdomen showed retroperitoneal hematomas around the urinary bladder, liver, and spleen. Because femoral artery cannulation is a common procedure for intravascular embolization in neuroradiologic procedures, Clinicians should be aware of the development of severe hematomas as a consequence of femoral artery puncture.
Abdomen ; Anesthesia ; Catheterization ; Femoral Artery ; Hematoma ; Hemorrhage ; Humans ; Hypotension ; Intracranial Aneurysm ; Liver ; Middle Aged ; Punctures ; Spleen ; Urinary Bladder