A 25 year old man presinted with erythematous and inderated plaques on the upper and lower extermities that were preceded by insect bites while traveling in central Africa. The patient had a past histrory of Kimura's disease, asthma, and allergic rhinitis, Histologic examination revealed panniculitls showing massive eosinophilic infiltration. The dermis showed eosinopbilic infilreatiom without flame figyres. The patient responded well to oral conrticosteroids. This patient did not fit the diagnosis of eosinoplilic pannicylitis, eosinophilic cellylitis, hypereosinophilic syndrome or eosinophilic vascylitis.
Africa, Central ; Asthma ; Dermis ; Diagnosis ; Eosinophils* ; Humans ; Hypereosinophilic Syndrome ; Insect Bites and Stings ; Rhinitis, Allergic ; Skin*

Oil granuloma develops mainly after injection of oil substances such as paraffin, silicone, etc, but there have been reports of oil granuloma after topical application of lipid substance to the body. A 22-year-old woman developed oil granuloma after the application of squalene on both lower eye-lids. Histopathologic findings ahowed acanthosis and dyskeratosis of the hair follicles. Lipid suketances staining with oil-red-O stain were found mainly on the hair follicles. and partly on the epidermis. We report a case of oil grinulorna caused by squalerie that may have penetrated through the hair follicles and partly through the epidermis resulting in chronic granulous changes in the dermis.
Dermis ; Epidermis ; Eyelids* ; Female ; Granuloma* ; Hair Follicle ; Humans ; Paraffin ; Silicones ; Squalene* ; Young Adult

Reticulate acropigmentation of Kitamura, described first by Kitamura and Akam atsu in 1943, is a pigmentary disorder that may be determined by an autasomal dominant gene. Skin lesions are characterized clinically by depressed brownisL pigmented spots, in a reticulated pattern, on the extensor surface of the acral parts of the extremities. Most reported cases are confined to Japanese. We report herein a case of reticulate acropigmentation of Kitarnura in a 28- year-old woman, with a depressed brownish pigmented spots, in a reticulate pattern, on the dorsum of hands and left foot. The authors make the diagnosis of this case a reticulate acropigmentation of Kitamura for the clinical symptoms and histopathologic findings.
Asian Continental Ancestry Group ; Diagnosis ; Extremities ; Female ; Foot ; Genes, Dominant ; Hand ; Humans ; Skin

The small GTPase RhoA has been studied extensively for its role in actin dynamics. In this study, multiple bioinformatics tools were applied cooperatively to the microarray dataset GSE64714 to explore previously unidentified functions of RhoA. Comparative gene expression analysis revealed 545 differentially expressed genes in RhoA-null cells versus controls. Gene set enrichment analysis (GSEA) was conducted with three gene set collections: (1) the hallmark, (2) the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and (3) the Gene Ontology Biological Process. GSEA results showed that RhoA is related strongly to diverse pathways: cell cycle/growth, DNA repair, metabolism, keratinization, response to fungus, and vesicular transport. These functions were verified by heatmap analysis, KEGG pathway diagramming, and direct acyclic graphing. The use of multiple gene set collections restricted the leakage of information extracted. However, gene sets from individual collections are heterogenous in gene element composition, number, and the contextual meaning embraced in names. Indeed, there was a limit to deriving functions with high accuracy and reliability simply from gene set names. The comparison of multiple gene set collections showed that although the gene sets had similar names, the gene elements were extremely heterogeneous. Thus, the type of collection chosen and the analytical context influence the interpretation of GSEA results. Nonetheless, the analyses of multiple collections made it possible to derive robust and consistent function identifications. This study confirmed several well-described roles of RhoA and revealed less explored functions, suggesting future research directions.

OBJECTIVE: The purpose of this study was to evaluate the influence of intraoral temperature changes on the orthodontic force level of a superelastic nickel-titanium alloy wire. METHODS: Nickel-titanium archwires of 0.016" x 0.022" thickness were tested with a three point bending test setup, and temperature changes were applied. The force level changes according to temperature changes were measured at a 1.5 mm deflection during the loading phase and a 1.5 mm deflection during the unloading phase from a deflection to 3.1 mm. Ten cycles of thermal cycling from baseline (37 degrees C) to cold (20 degrees C) or hot (50 degrees C) temperature were applied. RESULTS: After thermal cycling, the force level during the loading phase decreased and the force level during the unloading phase increased even after the temperature was changed to the initial 37 degrees C. CONCLUSIONS: The results suggest that the orthodontic force level can not return to the initial force level after temperature changes. When applying superelastic nickel-titanium archwires, we must consider that a lighter force than the loading force and a heavier force than the unloading force will be applied after intraoral temperature changes caused by eating and drinking.
Alloys ; Drinking ; Eating

Mixed lineage leukemia proteins (MLL) are the key histone lysine methyltransferases that regulate expression of diverse genes. Aberrant activation of MLL promotes leukemia as well as solid tumors in humans, highlighting the urgent need for the development of an MLL inhibitor. We screened and isolated MLL1-binding ssRNAs using SELEX (Systemic Evolution of Ligands by Exponential enrichment) technology. When sequences in sub-libraries were obtained using next-generation sequencing (NGS), the most enriched aptamers—APT1 and APT2—represented about 30% and 26% of sub-library populations, respectively. Motif analysis of the top 50 sequences provided a highly conserved sequence: 5′-A[A/C][C/G][G/U][U/A]ACAGAGGG[U/A]GG[A/C] GAGUGGGU-3′. APT1, APT2, and APT5 embracing this motif generated secondary structures with similar topological characteristics. We found that APT1 and APT2 have a good binding activity and the analysis using mutated aptamer variants showed that the site information in the central region was critical for binding. In vitro enzyme activity assay showed that APT1 and APT2 had MLL1 inhibitory activity. Three-dimensional structure prediction of APT1-MLL1 complex indicates multiple weak interactions formed between MLL1 SET domain and APT1. Our study confirmed that NGS-assisted SELEX is an efficient tool for aptamer screening and that aptamers could be useful in diagnosis and treatment of MLL1-mediated diseases.
Aptamers, Nucleotide ; Conserved Sequence ; Diagnosis ; Histones ; Humans ; In Vitro Techniques ; Leukemia ; Ligands ; Lysine ; Mass Screening ; Methyltransferases ; Myeloid-Lymphoid Leukemia Protein ; RNA

Majocchi's granuloma is a well recognized but uncommon infection of dermal and subcutaneous tissue by fungal organisms usually limited to the superficial epidermis. The organism usually associated with Majocchi's granuloma is Trichophyton rubrum, however, other dermatophytes may be the causative agent. We presented a 29-year-old female, who underwent kidney transplantation for end stage renal disease 3 years earlier, had an erythematous nodule on her left lower leg for 6 months. Histology showed suppurative granulomatous inflammatory cellular infiltrates in the dermis. Many septate hyphae were noted within the granulomatous tissue stained with PAS. A fungal culture from biopsy specimen revealed T. rubrum. The cutaneous lesion treated with terbinafine 250 mg daily and 10 weeks later, there was a marked improvement in the lesion.
Adult ; Arthrodermataceae ; Biopsy ; Dermis ; Epidermis ; Female ; Granuloma* ; Humans ; Hyphae ; Kidney Failure, Chronic ; Kidney Transplantation ; Leg ; Subcutaneous Tissue ; Transplantation* ; Trichophyton

Purpose: The mortality of patients with Fournier's gangrene remains at 15-50%, despite the improvement in critical care, the liberal use of broad spectrum antibiotics and the emphasis on aggressive surgical debridement. Therefore, the factors impacting on the survival and necessity for aggressive management were evaluated by comparing the medical records of survivors and non-survivors of Fournier's gangrene. Material and Methods: The medical records of 20 patients with Fournier's gangrene treated over a 12-year period were reviewed. The patients' ages ranged between 20 and 90 years (mean 55). The predisposing factors and extended surface area of necrosis were analysed by outcome. The number of surgical debridements and their timing, with respect to initial presentation and diversions, were analysed according to the extended surface area (3%). The outcome of the surgical treatments of patients with fever or sepsis at the time of the initial hospital visit was analyzed. Results: The predisposing factors included diabetes mellitus (10 cases, 50%), general weakness (7 cases, 35%), alcohol abuse (5 cases, 25%), malignant disease (3 cases, 15%) and hemiplegia (2 cases, 10%). Of the 20 patients, 3 (15%) died and 17 (85%) survived. One patient died due to septic shock before undergoing surgical debridement. The mean surface area involved with the disease among the survivors and non survivors were 3.6 and 3.7%, respectively. The patients with an extended surface below 3% (n=10) had 1.5 times the mean number of debridements. Of these, diversion was performed in one patient, three patients had complications and one patient died. The patients with an extended surface over 3% (n=9) had 2.3 times the mean number of debridements. Of these, five patient was performed diversion, tree patients had complication and one patient died. Of the 11 patient with fever or sepsis, 2 that did not undergone first debridement within 24hr of presentation died. However, all the patients who underwent first debridement within 24hr of presentation survived. Conclusions: The patient's physiological status influenced by the predisposing factors played the important role in the outcome. With aggressive treatment, including early and repeat surgical intervention and diversion, the disease has a reduced mortality.
Alcoholism ; Anti-Bacterial Agents ; Causality ; Critical Care ; Debridement ; Diabetes Mellitus ; Fever ; Fournier Gangrene* ; Hemiplegia ; Humans ; Medical Records ; Mortality ; Necrosis ; Prognosis ; Sepsis ; Shock, Septic ; Survivors

Papular xanthoma is a normolipemic xanthomatosis, characterized by nonconfluent papular to papulonodular eruptions on the face, trunk, extremities and occasionally mucous membranes. Histologically, there was an infiltration of foamy histiocytes and Touton type giant cells in the dermis without inflammatory cells or a pure histiocytic component. But, occasional lymphocytes were interspersed between the foamy macrophage. No systemic involvement could be found and the blood lipid profiles were normal. We report a case of papular xanthoma in a 30-year-old man with typical clinical, histopathologic findings.
Adult ; Dermis ; Extremities ; Giant Cells ; Histiocytes ; Humans ; Lymphocytes ; Macrophages ; Mucous Membrane ; Xanthomatosis

PURPOSE: A ureter obstruction caused by a ureteral stone results in inflammatory changes in the proximal submucosal layer and prevents the spontaneous passage of the ureteral stone. Accordingly, we analyzed the relationship between the spontaneous passage rates of ureteral stones less than 8 mm in size and serum C-reactive protein (CRP) levels and neutrophil percentages. MATERIALS AND METHODS: A total of 187 patients who were diagnosed with ureteral stones less than 8 mm in size and were managed consecutively at Keimyung University Dongsan Medical Center from January 2001 to January 2011 were retrospectively analyzed. Ureteral stone removal was defined as no ureteral stone shown in an imaging test without any treatment for 8 weeks after diagnosis. The patients were divided into three groups according to the levels of serum CRP and into two groups according to neutrophil percentage. The associations between these factors and ureteral stone passage rates were then examined. RESULTS: The ureteral stone passage rates of the low serum CRP level group, the medium serum CRP level group, and the high serum CRP level group were 94.1% (159/169), 70% (7/10), and 50.0% (4/8), respectively. The passage rates of ureteral stones in the group with a normal neutrophil percentage and in the group with a higher neutrophil percentage were 94.5% (121/128) and 83.1% (49/59), respectively (p=0.011). CONCLUSIONS: Measuring serum CRP levels and neutrophil percentages in patients with small ureteral stones of less than 8 mm is useful in predicting whether the stone will be spontaneously passed. When the serum CRP level and neutrophil percentage of a patient are high, aggressive treatment such as extracorporeal shock wave lithotripsy should be considered.
C-Reactive Protein ; Humans ; Lithotripsy ; Neutrophils ; Retrospective Studies ; Ureter ; Ureterolithiasis