Generalized granuloma annulare is a rare skin disease presenting generalized eruption with a distinctive histologic picture. The age of onset of generalized granuloma annulare differs from that of localized granuloma annulare. Most of the patients with generalized granuloma annulare were in the fifth to seventh decades and cases of generalized granuloma annulare in infancy or in early childhood have been rarely reported. We herein report two cases of generalized granuloma annulare in 45- and 18-month-old boys, who is the youngest patient yet reported in the Korean literature. The histopathologic findings were compatible with granuloma annulare and all lesions completely involuted in two months after administration of topical or systemic corticosteroids.
Adrenal Cortex Hormones ; Age of Onset ; Granuloma Annulare* ; Granuloma* ; Humans ; Infant ; Skin Diseases

Seventeen patients were treated for chronic bacterial prostitis by an injection of 2 gm fosfomycin sodium via perineal route directly into the prostate. Cure rate was 70% of the seven patients who allowed follow-up study at six months after Treatment with one injection. The pain, discomfortness, hematuria and hemospermia were improved except one case. Results demonstrated that direct injection into the prostate offers a new alternative method in the treatment of chronic bacterial prostatitis.
Follow-Up Studies ; Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostate* ; Prostatitis* ; Sodium*

Objective To evaluate the effectiveness and predictive value of high-resolution manometry(HRM) for POEM in treating achalasia. Methods A total of 84 achalasia patients categorized into subtypes by HRM, who also underwent POEM, were enrolled in our study. Eckardt score, Barium esophagogram and HRM were performed before, 6 months and 1 year after POEM. Results POEM was successfully performed in all 84 patients. No perforation occurred in any patient. The Eckardt scores and esophageal diameter after POEM significantly reduced compared with those before(P<0. 05). The 4s-IRP decreased from 33. 4±9. 0 mmHg (1 mmHg =0. 133 kPa) to 14. 6±3. 8 mmHg six months after POEM (P<0. 05) and to 16. 4±3. 9 mmHg one year after POEM (VS preoperate, P<0. 05). The LESP before treatment was 41. 8±15. 4 mmHg, decreasing to 18. 4±7. 1 mmHg six months after POEM (P<0. 05) and 20. 7±7. 6 mmHg one year after POEM (VS preoperate, P <0. 05) . When categorizing patients into 3 subtypes by HRM, 4s-IRP of type II showed the most dramatic decrease six months after POEM(62. 8%), followed by typeⅠ(53. 5%), while type III had the least decrease(41. 8%). The mean decreasing rate of LESP in type III was 42. 3% six months after POEM, followed by typeⅠ(55. 3%) , while type II showed the highest rate(57. 8%). Conclusion POEM is a safe treatment for achalasia and has significant short-term efficacy with Type II responding best to POEM. HRM plays a vital role in typing AC and predicting the effectiveness of POEM and can be useful in selecting an appropriate treatment.

Objective To investigate the protective effects of aspirin on hypoxic brain neural cells of rat and the effects of extracellular calcium on the neuroprotective effect of aspirin. Methods The hypoxic cell model was established by adding Na2S2O4 to the calcium or calcium free medium. Cultured primary cortical neurons of rat were pretreated with ASA in vitro. The change of intracellular free calcium and neuroglobin (NGB) were observed and analyzed by laser scanning confocal microscope. Results The expression level of [Ca2+]i and NGB increased significantly in the chemical hypoxia group(P

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

Objective Construct the lentiviral AQP1 vector and explore whether it can transfect the myocyte or not,then test the law of the AQP1 expression and the edema in the successfully transducted myocytes after cardiopulmonary bypass in sheeps.Methods Design cleavage primer according to ovine AQP1mRNA,clone it into expressing vector and transducated into the 293T cells with other packing vectors to produce the lentiviral AQP1 vector,then test the virus titer.36 adult healthy sheeps are randomly divided into blank or AQP1-lentiviral transfected group,blank or AQP1-lentiviral vector suspension was injected in the ventricle tissue of healthy adult sheeps during cardiopulmonary bypass and take specimen in different time points (2,6,12,24,48,72 h)after extracorporeal circulation,3 in each group.Realtime-PCR WesternBlot ELISA FACS immumofluorescent and Dry/Wet methods are emploied to detect the expression of AQP1 and the according degree of edema.Results lentiviral AQP1 vector was successfully construced and transducated into the myocytes.The tranducated groups have the same trend of AQP1 of expression and cardiac edema after cardiopulmonary bypass compared to the blank vector group,but the degree is heavier(P ＜ 0.05).Conclusion Lentivral AQP1 vector can successfully transfect the myoctyes,and the overexpressed myocardial tissue have the same trend of AQP1 expression and edema after cardiopulmonary bypass,but with a heaver degree.The expression of aquaporins was positively relevant to the edema.

Objective To evaluate the sunscreen application and the level of photoprotective knowledge in both dermatologists and photosensitive patients. Methods The style, sites and amount of the sunscreen applied were examined by 0. 05 % dipyridamole cream in 39 dermatologists and 41 photosensitive patients with Wood's light. The participants were asked to fill in a questionnaire about the photoprotective knowledge. Results Frequent mistakes made by participants in this study were as follow: (1) using an inadequate amount of sunscreen; (2) putting sunscreen in the palm of the hand and rubbing the hands together before application; (3) lacking a systematic approach to sunscreen application. The median quantity of individual sites ranged from 0. 5 mg/cm2 to 1 mg/cm2 except for the forehead of the female dermatologist that had a median thickness of 1. 5 mg/cm2. The questionnaire survey showed that dermatologists also had less knowledge on sun protection even though better than photosensitive patients. Conclusions Dermatologists and photosensitive patients always fail to apply sunscreen in some prominently exposed sites and to paint the average thickness of sunscreen used far less than that of experimentally measured dose (2 mg/cm2). Continuing education and training about pho-toprotection for dermatologists should be carried out to provide better education for the patients on sun protection.

Objective To study the expression of matrix metalloproteinase(MMP)-1,-3 and-9 in sun-exposed and-unexposed skin as weil as its significance in the mechanism of skin photoaging.Methods Skin samples were resected from the exmnsor side of forearm(sun-exposed area)and flexor side of upper arm(sun-unexposed area)of 23 healthy female volunteers.The expression of MMP-1,-3 and-9 was detected by immunohistochemical staining in 46 skin samples.Immunoreactive intensity distribution index (IRIDI)was calculated to assess the expression of MMP-1,-3 and-9.Wilcoxon signed ranks test,Mann-Whitney U-test and Spearman rank correlation analysis were performed.Results MMP-1,-3 and-9 were expressed in both sun-exposed and -unexposed skin.The average IRIDI value for MMP-1,-3 and-9 was 7.70(range,3 to 12).9.22(range,6 to 12),8.30(range,6 to 12)in sun-exposed skin,and 4.26 (range,2 to 6),5.39(range,2 to 9),4.04(range,1 to 6)in sun-unexposed skin,respectively;significant difierence existed between sun.exposed and-unexposed skin in the three parameters(all P＜0.01).A significant inerease was observed in the average IRIDI value for MMP-1,-3 and-9 in sun-exposed skin vs.sun-unexposed skin in women above 50 years of age (9.17 vs 4.75,10.58 vs 6.42,8.92 vs 4.33,respectively,all P＜0.05).In women younger than 50 years,the average IRIDI value for MMP-1,-3 and-9 was 6.09(range,3 to 8),7.73(range,6 to 9),7.64(range,6 to 12)in sun-exposed skin,significantly higher than that in sun-unexposed skin[3.73(range,2 to 6),4.27(range,2 to 8),3.73(range,1 to 6),all P＜0.05].Increased IRIDI scores of MMP-1,-3 and -9 were noticed in sun-exposed skin in women above 50 years of age vs.those younger than 50 years.but there was no statistical difrerence in MMP-I or MMP-9 between the two aged groups in sun-unexposed skin(all P＞0.05).The IRIDI scores of MMP-1,MMP-3 and MMP-9 were positively correlated with age(r=0.66,0.69,0.74,all P＜0.01)in sun-exposed skin,but the IRIDI scores of MMP-1 and MMP-9 uncorrelated with age in sun-unexposed skin.Conclusions There isan elevated expression of MMP-1,-3 and.9 in sun-exposed skin VS.SUn.unexposed skin.hinting that these three MMPs play a role in the occurrence and development of photoaging,but their biological mechanism may be different.

Nerve root compression due to ligamentum flavum hematoma is extremely rare, with less than 70 cases reported in the literature. The clinical presentation and images were similar to those of spinal epidural tumors. Herein, we reported a previously healthy 64-year-old female who presented with right radicular leg pain. Neurological examination was consistent with right L5 root compression. The magnetic resonance imaging revealed a mass posterior to the L5 thecal sac, appearing as high intensity on T1-weighted and T2-weighted images. During operation, the dark hematoma within the ligamentum flavum was found. The pathological examination confirmed the diagnosis of hemorrhage. Her prognosis following surgery was excellent.
Sciatica

Objective To study the precipitating factors, clinical features, histopathological changes and treatment in patients with localized and generalized granuloma annulare (GA). Methods Clinical data of 24 cases of localized GA and 19 cases of generalized GA were analyzed retrospectively. Results Some cases of GA were found to be related to the exposure of sunlight, especially in the generilized patients. In the patients with localized GA, lesions usually distributed on the dorsal surface of the hands, nape of the neck, dorsum of feet. Annular lesions with 1-2 centimeters in diameter were formed by small papules. The largest lesion was 7 centimeter in diameter. Generalized GA presented as a diffuse papular eruption, 0.5 ~ 1 cm in diameter, and the lesions favoured the trunk and four limbs. The histopathological study showed that palisading granuloma pattern accounted for 61.9% in all patients, and scattered histiocytic infiltration accounted for 38.1%. Ultraviolet light avoidance, topical steroids, cryotherapy, surgical excision, systemic vitamin E or nicotinamide were effective for localized lesions. Systemic administration of chloroquine in low dosage was an alternative way for the stubborn localized GA. Systemic chloroquine, dapsone, corticosteroids, isotretinoin were effective in most generalized GA cases, but some cases relapsed when treatment was stopped. Conclusions Ultraviolet may be associated with the development of generalized GA. The histopathological changes were variable, the palisading granuloma pattern is the most common pattern. Topical therapy is effective in localized GA, and systemic therapy is mainly used for generalized GA.