Adenosquamous cell carcinoma (Ad-SCC) of the colon is rare. The pathogenesis of Ad-SCC is unclear, however, several hypotheses have been suggested. The clinical presentation and gross findings of Ad-SCC of the colon are similar to those of adenocarcinoma of the colon, but Ad-SCC has a more aggressive clinical course and a poorer prognosis. We report on two cases of Ad-SCC of the colon with obstruction; a collision-type Ad-SCC that has not only obstruction but also numerous hepatic metastases, and a composite-type Ad-SCC treated with left hemicolectomy followed by an adjuvant chemotherapy.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Chemotherapy, Adjuvant ; Colon ; Colonic Neoplasms ; Neoplasm Metastasis ; Prognosis

BACKGROUND: Cyclosporine is an immunosuppressant that acts on T-cells and cytokines. Although the efficacy of systemic cyclosporine in the treatment of psoriasis has been established, the relationship between response to cyclosporine and systemic inflammation using the high sensitivity C-reactive protein (hs-CRP) immunoassay is still unclear. OBJECTIVE: The aim of this study is to investigate whether systemic inflammation with clinical and laboratory findings indicate a response after 8 weeks of oral 3 mg/kg cyclosporine therapy in patients with psoriasis. METHODS: Thirty-five patients with psoriasis were treated with oral cyclosporine for 8 weeks. The clinical response to oral cyclosporine was determined using the PASI score. The correlation between hs-CRP and the treatment response to cyclosporine was analyzed. Also, descriptive characteristics of psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI (BMI> or =25) were investigated. RESULTS: Hs-CRP levels and PASI scores were significantly reduced after 8 weeks of oral cyclosporine treatment. Eight patients showed excellent response, fifteen a good response, and twelve a moderate response. The baseline hs-CRP levels in excellent and good response groups (1.35+/-0.59 mg/L and 1.32+/-0.86 mg/L, respectively) to oral cyclosporine were significantly higher than the moderate response group (0.51+/-0.20 mg/L, p=0.004). Psoriatic patients with psoriatic arthritis, metabolic syndrome, and high BMI demonstrated higher levels of baseline hs-CRP. Patients with psoriatic arthritis and metabolic syndrome showed greater response to cyclosporine treatment. CONCLUSION: Patients with greater inflammatory burden, as demonstrated by elevated baseline hs-CRP, have better treatment responses to cyclosporine compared to patients with lesser inflammation.
Arthritis, Psoriatic ; C-Reactive Protein ; Cyclosporine ; Cytokines ; Humans ; Immunoassay ; Inflammation ; Psoriasis ; T-Lymphocytes

Atrophic dermatofibrosarcoma protuberans (DFSP) is an uncommon clinical variant, which clinically mimics other atrophic dermatological conditions. Given the typical 'protuberant' morphology of DFSP, such atrophic lesions may be difficult to diagnose clinically. We report a 44-year-old man who presented with an 8-month history of an asymptomatic, depressed, anetoderma-like plaque on the right subclavicular area. He also presented with a 1-year history of a 1.5x1.5 cm, asymptomatic, firm, erythematous nodule above an atrophic lesion. Biopsy specimens were taken from each lesion. These specimens, along with histochemical staining for CD34, established the diagnosis of dermatofibrosarcoma protuberans.
Adult ; Anetoderma ; Biopsy ; Dermatofibrosarcoma ; Humans

Scleredema and acanthosis nigricans are two distinct dermatological disorders that have been reported in association with insulin resistance. Few reported cases have shown an association between scleredema and acanthosis nigricans. A 53-year-old obese woman with diabetes mellitus presented with a 4-year history of an indurated plaque on the nape and upper mid-back. She also presented with a 20-year history of hyperpigmented, velvety plaques on the neck and both axillae. We report a diabetic patient who developed scleredema and acanthosis nigricans.
Acanthosis Nigricans ; Axilla ; Diabetes Mellitus ; Female ; Humans ; Insulin Resistance ; Middle Aged ; Neck ; Scleredema Adultorum

Phase-partitioning with Triton X-114 (TX114) was applied to the TSP antigen, which may be preferentially associated with the cell wall of M. tuberculosis. The hydrophilic protein components of the TSP antigen were successfully separated from integral hydrophobic macromolecules. To further characterize and examine the cellular immune response of the aqueous fraction of the TSP antigen (TSPa), the in vitro properties of the antigen were measured by lymphoproliferation; surface expression of IL-2 Ra on T lymphocytes was analyzed by flow cytometry; and the cytokine mRNA expression pattern was determined by RT-PCR. Significant lymphoproliferative responses to the TSPa antigen were observed in healthy tuberculin reactive donors after a 5 day in vitro stimulation. TSPa treatment of PBMCs from healthy tuberculin positive subjects for 5 days resulted in progressive augmentation of IFN-r, II 2, and IL-2Ra mRNA expression, as measured by RT-PCR, but considerably reduced IL-4 mRNA expression. In addition, the TSPa antigen stimulated more IL-12 p40 mRNA production than did the PPD antigen, and graduaBy suppressed IL- 10 mRNA expression. Moreover, the CD3' T cells of tuberculin positive subjects displayed a profound increase in their expression of the II 2Ru protein (39.0%) in response to the TSPa antigen. Proliferation was correlated with IL-2 and IL-2Ra mRNAs, but not correlated with distinct IFN-r or IL-12 p40 mRNA production. These findings strongly suggest that the TSPa antigen preferentially evokes the generation of a Thl-like immune response in healthy tuberculin reactors.
Cell Wall ; Flow Cytometry ; Humans* ; Immunity, Cellular* ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune ; RNA, Messenger ; T-Lymphocytes ; Tissue Donors ; Tuberculin ; Tuberculosis

Sunitinib is multitargeted tyrosine kinase inhibitor, and this drug was approved for use to treat gastrointestinal stromal tumor and advanced renal cell carcinoma. It has also been shown to be efficacious in treating neuroendocrine, colon and breast cancer. Sunitinib therapy is often complicated by cutaneous adverse effects such as hand-foot syndrome, hair depigmentation, subungal splinter hemorrhage, xerosis, alopecia and seborrheic dermatitis- like reactions. But there have been no reports on patients presenting with a bullous fixed drug eruption associated with sunitinib administration. We report here on a case of a bullous fixed drug eruption and hand-foot syndrome, and these maladies were caused by this agent.
Alopecia ; Breast Neoplasms ; Carcinoma, Renal Cell ; Colon ; Drug Eruptions ; Gastrointestinal Stromal Tumors ; Hair ; Hand-Foot Syndrome ; Hemorrhage ; Humans ; Indoles ; Protein-Tyrosine Kinases ; Pyrroles

Kikuchi disease, also called histiocytic necrotizing lymphadenitis, is an uncommon, idiopathic and generally self-limited disease, characterized by cervical lymphadenopathy. It can present systemic symptoms and signs, but ocular involvement is unusual. We report a 35-year-old woman who presented sudden decreased visual acuity and a swollen lymph node on the left side of her neck. On laboratory findings, there were no evidences of infection, autoimmune disease and systemic vasculitis. She was diagnosed with Kikuchi disease and bilateral retinal vasculitis by histologic analysis of lymph node, fundoscopy and fluorescein angiography.
Adult ; Autoimmune Diseases ; Female ; Fluorescein Angiography ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Retinal Vasculitis ; Retinaldehyde ; Systemic Vasculitis ; Visual Acuity

Mucoepidermoid carcinoma of the thymus is an extremely rare malignant mediastinal neoplasm, and to our knowledge, only 13 cases have been reported. We report a case of mucoepidermoid carcinoma of the thymus that was seen in a 53-yr-old man with right chest pain. Chest CT scan showed a huge, cystic mass having a focal solid portion with direct invasion of the adjacent anterior chest wall and pericardium in the anterior mediastinum. Mucoepidermoid carcinoma of the thymus should be included in the differential diagnosis for masses of the anterior mediastinum associated with extensive cystic changes, although the carcinoma is exceedingly rare.
Carcinoma, Mucoepidermoid/*diagnosis/pathology ; Fatal Outcome ; Humans ; Male ; Mediastinal Neoplasms/*diagnosis/pathology ; Middle Aged ; Thymus Neoplasms/*diagnosis/pathology

Atopic dermatitis (AD) is characterized by disturbances in epidermal barrier functions and the hyperactive immune response. Staphylococcus aureus (S. aureus) can be cultured from 90% of AD skin lesions and can exacerbate or contribute to the persistent skin inflammation in AD by secreting toxins with superantigenic properties. Superantigens can induce mast cell (MC) degranulation after penetrating the epidermal barrier. The role of MCs in AD is suggested by the increase in the MC number and MC activation. MCs are activated for degranulation and mediator release by allergens that cross-link IgE molecules or by microbial products. Therefore, MCs may be critically involved in the pathogenesis of AD. However, the understanding mechanisms of MC degranulation by S. aureus in relation to AD have still not been fully elucidated. In this study, we found that live S. aureus or methicillin-resistant S. aureus (MRSA) but not heat-killed bacteria induced MC degranulation. The heat-treatment partially inhibited MC degranulation by conditioned media (CM) of S. aureus or MRSA. The calcium chelator ethylene glycol tetraacetic acid (EGTA) did not block MC degranulation induced by live S. aureus or MRSA, but EGTA-treatment partially inhibited MC degranulation by CM from S. aureus or MRSA. These results suggest that live S. aureus and MRSA can degranulate MCs via direct interaction which may be important role in AD.
Allergens ; Bacteria ; Calcium ; Culture Media, Conditioned ; Dermatitis, Atopic ; Egtazic Acid ; Humans* ; Immunoglobulin E ; Inflammation ; Mast Cells ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Skin ; Staphylococcus aureus ; Superantigens

Atopic dermatitis (AD) is characterized by disturbances in epidermal barrier functions and the hyperactive immune response. Staphylococcus aureus (S. aureus) can be cultured from 90% of AD skin lesions and can exacerbate or contribute to the persistent skin inflammation in AD by secreting toxins with superantigenic properties. Superantigens can induce mast cell (MC) degranulation after penetrating the epidermal barrier. The role of MCs in AD is suggested by the increase in the MC number and MC activation. MCs are activated for degranulation and mediator release by allergens that cross-link IgE molecules or by microbial products. Therefore, MCs may be critically involved in the pathogenesis of AD. However, the understanding mechanisms of MC degranulation by S. aureus in relation to AD have still not been fully elucidated. In this study, we found that live S. aureus or methicillin-resistant S. aureus (MRSA) but not heat-killed bacteria induced MC degranulation. The heat-treatment partially inhibited MC degranulation by conditioned media (CM) of S. aureus or MRSA. The calcium chelator ethylene glycol tetraacetic acid (EGTA) did not block MC degranulation induced by live S. aureus or MRSA, but EGTA-treatment partially inhibited MC degranulation by CM from S. aureus or MRSA. These results suggest that live S. aureus and MRSA can degranulate MCs via direct interaction which may be important role in AD.
Allergens ; Bacteria ; Calcium ; Culture Media, Conditioned ; Dermatitis, Atopic ; Egtazic Acid ; Humans* ; Immunoglobulin E ; Inflammation ; Mast Cells ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Skin ; Staphylococcus aureus ; Superantigens