BACKGROUND: The pathogenesis of confluent and reticulated papillomatosis(CRP) is still unknown, although many theories have been suggested. It is stressed that abnormal host response to colonization of pityrosporum orbiculare might play a role in the pathogenesis of CRP, but is not completely understood. Frequently, we have observed bacterial colonies in the stratum corneum and, especially, within the hair follicles from biopsy specimens of patients with CRP. In addition, successful treatment for CRP with minocycline, a derivative of tetracyclines, has been reported continuously. OBJECTIVE: The purpose of this study was to document the possible association of bacterial factors in the pathogenesis of CRP and to elucidate the effectiveness of minocycline. METHODS: We performed Brown and Brenn gram staining in 12 biopsy specimens, bacterial cultures, identification of microorganisms and antibiotics sensitivity testing including minocycline. We administered oral minocycline with an initial dose of 100mg per day for 1 to 3 months and a maintenance dose 50mg per day for I to 2 months, then evaluated the response of treatment. RESULTS: 1. On Brown and Brenn staining, the gram positive bacterial colonies that stained dark bluish or nearly black were observed within the infundibulum of hair follicles in 10 out of 12 biopsy specimens(83.3%) and on the keratotic invagination of stratum corneum in 11 out of 12 biopsy specimens(91.7%). 2. Histological features of regions where bacterial colonies were observed showed, hyperkeratosis and keratotic invagination on the stratum corneum in all cases. Hyperkeratosis(66.7%), parakeratosis(16.7%), inflammatory cell infiltration(25.0%), perifollicular fibrosis(33.3%), and abnormal keratin in sebaceous ducts(50.0%) were shown in hair follicles. 3. In anaerobic cultures, no bacteria was grown. In aerobic cultures, staphylococcus species were identified in 6 cases, streptococcus viridans in one case, sternotrophomonas maltophilia in one case. In the susceptibiliity test, minocycline was sensitive in 7 from 8 cases. 4. The therapeutic response to minocycline was observed within one month in all cases, and the time to clear the lesions was 1/2 month in 2 cases, 1 month in 4 cases, 2 months in 5 cases, 3 months in one case, respectively. CONCLUSION: Form these results, we suggest that bacterial factors may play an important role in the pathogenesis of CRP and that the action mechanism of minocycline in the treatment of CRP may be due to antibacterial effects.
Anti-Bacterial Agents ; Bacteria* ; Biopsy ; Colon ; Hair Follicle ; Humans ; Malassezia ; Minocycline ; Papilloma* ; Staphylococcus ; Tetracyclines ; Viridans Streptococci

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

We report the clinical evolution of two male patients with generalized granulama annulare(GGA) who were controlled with hydroxychloroquine. In the first case, a 3-year-old boy was treated with systemic steroid, and in the second case, a 68-year-old man was treated with prednisolone, niacin, and retinoic acid. But, remission and recurrence of the skin lesions were repeated. A good clinieal response was achieved in both cases after administration of hydroxychloroquine without side effects or any signs of recurrence. Hydroxychloroquine may be helpful to treat the GGA that have side effects to the systemic corticosteroid or resistence to other therapeutic modalities.
Aged ; Child, Preschool ; Granuloma Annulare* ; Granuloma* ; Humans ; Hydroxychloroquine* ; Male ; Niacin ; Prednisolone ; Recurrence ; Skin ; Tretinoin

No abstract available.
Infectious bursal disease virus*

Multiple endocrine neoplasi~a type 3 is a rare, heritable or sporadic, multiple neoplastic disorder that is charracterized by thyroid medullary careinoma, pheochromocytoma, multiple mucosal neuroma, and marfanoid habitus. The most important disorder of the syndrome is mucosal neuroma that is an early diagnostic sign of multiple endocrine neoplasia type 3. Early diagnosis of MEN type 3 determines prognosis of the disease. We present a case of multiple endocrine neoplasia type 3 of the sporadic pattern in a 27-year-old man who had typical medullary thyroid carcinoma, mucosal neuroma, marfanoid habitus, and megacolon.
Adult ; Early Diagnosis ; Humans ; Male ; Megacolon ; Multiple Endocrine Neoplasia* ; Neuroma* ; Pheochromocytoma ; Prognosis ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: We designed the aft-multiple-slit (AMS) system to reduce scatter in cone-beam computed tomography (CBCT). As a preliminary study, we performed a Monte Carlo N-Particle Transport Code (MCNP) simulation to verify the effectiveness of this system. MATERIALS AND METHODS: The MCNPX code was used to build the AMS geometry. An AMS is an equi-angled arc to consider beam divergence. The scatter-reduced projection images were compared with the primary images only and the primary plus scatter radiation images with and without AMS to evaluate the effectiveness of scatter reduction. To obtain the full 2 dimensional (2D) projection image, the whole AMS system was moved to obtain closed septa of the AMS after the first image acquisition. RESULTS: The primary radiation with and without AMS is identical to all the slit widths, but the profiles of the primary plus scattered radiation varied according to the slit widths in the 2D projection image. The average scatter reduction factors were 29%, 15%, 9%, and 8% when the slit widths were 5 mm, 10 mm, 15 mm, and 20 mm, respectively. CONCLUSION: We have evaluated the scatter reduction effect of the AMS in CBCT imaging using the Monte Carlo (MC) simulations. A preliminary study based on the MCNP simulations showed a mount of scatter reduction with the proposed system.
Cone-Beam Computed Tomography

Carbon monoxide (CO) is well-known as toxic gas and intrinsic signaling molecule such as neurotransmitter and blood vessel relaxant. Recently, it has been reported that low concentration of CO exerts therapeutic actions under various pathological conditions including liver failure, heart failure, gastric cancer, and cardiac arrest. However, little has been known about the effect of CO in neurodegenerative diseases like Parkinson’s disease (PD). To test whether CO could exert a beneficial action during oxidative cell death in PD, we examined the effects of CO on 6-hydroxydopamine (6-OHDA)-induced cell death in C6 glioma cells. Treatment of CO-releasing molecule-2 (CORM-2) significantly attenuated 6-OHDA-induced apoptotic cell death in a dose-dependent manner. CORM-2 treatment decreased Bax/Bcl2 ratio and caspase-3 activity, which had been increased by 6-OHDA. CORM-2 increased phosphorylation of NF-E2-related factor 2 (Nrf2) which is a transcription factor regulating antioxidant proteins. Subsequently, CORM-2 also increased the expression of heme oxygenase-1 and superoxide dismutases (CuZnSOD and MnSOD), which were antioxidant enzymes regulated by Nrf2. These results suggest that CO released by CORM-2 treatment may have protective effects against oxidative cell death in PD through the potentiation of cellular adaptive survival responses via activation of Nrf2 and upregulation of heme oxygenase-1, leading to increasing antioxidant defense capacity.
Blood Vessels ; Carbon Monoxide* ; Carbon* ; Caspase 3 ; Cell Death* ; Glioma* ; Heart Arrest ; Heart Failure ; Heme Oxygenase-1 ; Liver Failure ; Neurodegenerative Diseases ; Neuroprotection ; Neurotransmitter Agents ; NF-E2-Related Factor 2 ; Oxidopamine ; Phosphorylation ; Stomach Neoplasms ; Superoxides ; Transcription Factors ; Up-Regulation

PURPOSE: Sudden cardiac death is still a major cause of death and a burden to national public health. Out-of-hospital cardiac arrest (OHCA) patients achieving field Return of spontaneous circulation (ROSC) have better survival rates and good neurological outcomes. The study was designed for analysis of prehospital and hospital clinical characteristics of Heartsaver patients surviving OHCA of cardiac origin. METHODS: A retrospective study was conducted on 31 Heartsaver patients surviving OHCA by Emergency Medical Service (EMS) from March, 2011 to May, 2014; 24 cardiogenic-Heartsaver patients were enrolled in this study. They were divided into the myocardial infarction group (MI group) and the non-myocardial infarction group (Non-MI group) by final diagnosis for comparison of prehospital and in-hospital characteristics. RESULTS: The etiology of cardiac arrest cause of cardiogenic-Heartsaver was categorized according to five groups, including myocardial infarction (29.2%), Brugada syndrome (25.0%), idiopathic ventricular fibrillation (25.0%), idiopathic ventricular tachycardia (8.3%), and coronary spasm (12.5%). Most patients had good neurological outcomes, Cerebral Performance Categories scale (CPC) median was 1.0(1.0-1.0). The MI group showed higher average age (57.1+/-6.49 vs 52.3+/-13.0, p=0.036), high incidence of ST-segment elevation (42.9%), and nonspecific-ST or T-wave change (24.9%) in electrocardiogram (ECG) after ROSC, higher incidence of regional wall motion abnormality in Echocardiography (85.7% vs 23.5%, p=0.009), and higher peak level of CK-MB, troponin I within 12 hours (p=0.005, p=0.014). Some Non-MI patients had undergone an electrophysiologic study and received an implantable cardioverter defibrillator. CONCLUSION: Cardiogenic OHCA patients should be examined by cardiac enzyme, ECG, echocardiography, and coronary angiography in order to differentiate etiology. Besides, to prevent sudden cardiac death from fatal arrhythmia, electrophysiologic study and implantable cardioverter defibrillator insertion therapy must be considered.
Arrhythmias, Cardiac ; Brugada Syndrome ; Cause of Death ; Coronary Angiography ; Death, Sudden, Cardiac ; Defibrillators ; Diagnosis ; Echocardiography ; Electrocardiography ; Emergency Medical Services ; Heart Arrest ; Humans ; Incidence ; Infarction ; Myocardial Infarction ; Out-of-Hospital Cardiac Arrest* ; Public Health ; Retrospective Studies ; Spasm ; Survival Rate ; Tachycardia, Ventricular ; Troponin I ; Ventricular Fibrillation

Colonoscopy is a routinely performed diagnostic and therapeutic procedure for colorectal diseases. Abdominal pain after colonoscopy is a relatively common complication; however, hemoperitoneum is a very rare complication. We report a case of a 51-year-old male patient who suffered from a left upper quadrant pain after diagnostic colonoscopy at a healthcare promotion center. He had a routine screening test, including computed tomography (CT), and the follow-up CT showed an iatrogenic hemoperitoneum without a definite spleen injury. That is complication is rare, but potentially life-threatening. We recommend a high suspicion for this complication for its early diagnosis and proper treatment.
Abdominal Pain ; Colonoscopy* ; Delivery of Health Care ; Early Diagnosis ; Follow-Up Studies ; Hemoperitoneum* ; Humans ; Male ; Mass Screening ; Middle Aged ; Spleen