Basal cell epithelioma arising from epidermis and its appendages is a common skin tumor. But multiple occurence of basal cell epitheliomas and that of arising in an epidermal nevi are extremely rsre. Since the first report by Toyama and Kojima in 1937, only few cases were reported in the world literatures. We observed a case of multiple basal cell epitheliomas arising in an epidermal nevi in a 54-year-old female patient who had rhomboidal verrucous patch on the right side of the cheek and arciform erythematous verrucous eruption from the right side of the eyebrow to the lower eyelid. Clinical features were not compatible with any type of basal cell epithelioma. But histological finding revealed basal cell epithelioma with epidermal nevi. Literatures were briefly reviewed.
Carcinoma, Basal Cell* ; Cheek ; Epidermis ; Eyebrows ; Eyelids ; Female ; Humans ; Middle Aged ; Nevus* ; Skin

One of the most important prognostic factors in LCP disease is the extent of epiphyseal involvement. Magnetic resonance imaging is considered to be the technique of choice for early diagnosis of Legg-Calve-Perthes disease. Gadolinium-enhanced spin-echo MR images were obtained after nonenhanced Tl-weighted(spin-echo) and T2-weighted(gradient-echo) images. Four different areas were identified in the femoral epiphysis(necrosis, regenerative, cartilaginous and normal fatty bone tissue). The histological evolution of LCP is well described by Catterall and others. Comparing their description with our MRI finding, we suggest classification of LCP into three phases: (I) necrosis, (II) regeneration(IIa-early and IIb-late) and (III) reossification and sequale. T2 weighted image was useful in the early stage and Tl weighted image was useful in the later stage for evaluation of involved extent of the disease. With MRI, we think that we can find out the stage of LCP more early and rationally, pathological factors more easily and appropriate time for operation exactly. we believe that MRI is more adequate method to decide the stage of LCP disease.
Classification ; Early Diagnosis ; Legg-Calve-Perthes Disease ; Magnetic Resonance Imaging* ; Necrosis

Actinobacillus actinomycetemcomitans, a rare human pathogen, was repeatedly isolated from the blood of a 20-year-old male patient with patent ductus arteriosus who developed subacute bacterial endocarditis. Difficulties in isolating and identifying the organism are discussed. The bacterial isolate was found to be susceptible to various antimicrobial agents.
Actinobacillus/isolation & purification* ; Adult ; Blood/microbiology* ; Case Report ; Endocarditis, Subacute Bacterial/microbiology* ; Human ; Male ; Septicemia/microbiology

Adipose tissue is a central metabolic organ that controls energy homeostasis of the whole body. White adipose tissue (WAT) stores excess energy in the form of triglycerides, whereas brown adipose tissue (BAT) dissipates energy in the form of heat through mitochondrial uncoupling protein 1 (Ucp1). A newly identified adipose tissue called ‘beige fat’ (BAT-like) is produced through a process called WAT browning. This tissue mainly resides in WAT depots and displays intermediate characteristics of both WAT and BAT. Since the recent discovery of BAT in the human body, along with the identification of molecular targets for BAT activation, stimulating energy expenditure has been considered as a great strategy to treat human obesity and metabolic diseases. Here we summarize recent findings regarding molecular targets and thermogenic small molecules that can stimulate BAT and increase energy expenditure, with an emphasis on possible therapeutic applications in humans.
Adipocytes* ; Adipose Tissue ; Adipose Tissue, Brown ; Adipose Tissue, White ; Energy Metabolism ; Homeostasis ; Hot Temperature ; Human Body ; Humans ; Metabolic Diseases ; Obesity ; Triglycerides

It is known that penicillinase-producing Neisseria gonorrhoeae (PPNG) are frequently found in South-East Asia and the infection does not respond to the recommended does of penicillin. N. gonorrhoeae cultures isolated during June 1977 to June 1979, from Yonsei Medical Center patients were tested for beta-lactamase production. Among the 127 isolates tested one was positive by the rapid iodometric method. The culture also gave a positive result by the method of Hodge et al. No zone of inhibition was observed when its susceptility was tested with a 10 unit penicillin disk. The patient who yielded the organism was a 51-year-old housewife living in Seoul. Neither she nor her husband had ever traveled abroad. This result documented the presence of PPNG in this community. In the future laboratories may require careful watch to detect further spreading of PPNG.
Female ; Gonorrhea/drug therapy ; Human ; Korea ; Neisseria gonorrhoeae/enzymology* ; Neisseria gonorrhoeae/isolation & purification ; Penicillins/therapeutic use ; beta-Lactamases/isolation & purification*

Cardiobacterium hominis, a fastidious gram-negative bacillus rarely causing endocarditis, was isolated from blood culture of a 41-year-old man with subacute bacterial endocarditis. The patient had undergone an operation of valve replacement 4 years before. Growth of the organism was only detected in 1 of 6 blood cultures after 7 days incubation. The isolate showed typical characteristics of C. hominis, i.e., tear-drop like cells and a weak positive indole reaction. The isolate was susceptible to many antimicrobial agents, but penicillin G and streptomycin therapy failed to cure the disease.
Adult ; Bacterial Infections/complications* ; Case Report ; Endocarditis, Subacute Bacterial/etiology* ; Gram-Negative Bacteria ; Human ; Male

PURPOSE: In patients with independent mobility, full hip range of motion and sufficient muscle strength for daily life without cognitive impairment, treatment of a femoral neck fracture with total hip arthroplasty (THA) may be a better option compared to bipolar hip hemiarthroplasty. Here, functional outcomes and complications in patients who underwent THA for femoral neck fracture based on their comorbidity status were analyzed. MATERIALS AND METHODS: Between January 2013 and December 2018, 110 patients were treated with THA for femoral neck fractures at our institution. These patients were retrospectively analyzed for clinical outcomes at final follow-up (mean=24.4 months, range: 6–81 months) using the Harris hip score (HHS) and the presence or absence of two potential comorbidities: i) diabetes mellitus (DM; 35 with and 75 without) and ii) hypertension (HTN; 50 with and 60 without). RESULTS: The incidence of superficial infections at the surgical site in patients with DM was significantly higher compared with patients without DM (P=0.024). There were no significant differences in other potential complications based on DM status. HHS at final follow-up between patients with and without DM and with and without HTN were not significantly different (83.3 vs. 81.0, P=0.39 and 81.6 vs. 82.4, P=0.75, respectively). CONCLUSION: Superficial infections occurred more frequently in patients with DM compared with patients without DM. DM and HTN status are not correlated with HHS.
Arthroplasty, Replacement, Hip ; Cognition Disorders ; Comorbidity ; Diabetes Mellitus ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Humans ; Hypertension ; Incidence ; Muscle Strength ; Range of Motion, Articular ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Macitentan (MAC) reduces morbidity and mortality among advanced-stage pulmonary arterial hypertension (PAH) patients. However, data regarding the histopathologic and hemodynamic benefits of MAC treatment at an early stage of PAH is lacking. METHODS: One week after monocrotaline (MCT) injection, rats were randomly assigned to MAC (n=16), MAC combined with sildenafil (SIL) (MAC+SIL, n=16), or normal saline (MCT, n=16). Twelve sham rats (Sham) were included for comparison. Right ventricular (RV) systolic function was assessed via echocardiography as the RV fractional area change (RV-FAC). An invasive pressure-volume analysis using a Millar conductance catheter was performed 7 weeks after MCT injection. Rats were subsequently euthanized for histopathologic analysis. RESULTS: RV-right atrial pressure gradient on echocardiography was significantly increased 3 weeks after MCT injection, but was maintained in the Sham. RV-FAC was less deteriorated in the MAC, compared to that in the MCT (44±3% vs. 25±7%, p < 0.05), and the co-administration of SIL showed no additional benefit (45±8%, p > 0.05 vs. the MAC). On invasive hemodynamic analyses, RV end-systolic (196±78 µL) and end-diastolic volumes (310±86 µL), pulmonary artery systolic pressure (89±7.2 mmHg), and end-systolic pressure-volume relationship (−254±25.1) were significantly worse in the MCT vs. in the MAC (101±45 µL, 235±55 µL, 40±10.5 mmHg, and −145±42.1, respectively) and MAC+SIL (109±47 µL, 242±46 µL, 38±9.2 mmHg, and −151±39.2, respectively) (all p < 0.05). However, the MAC and MAC+SIL did not differ (all p > 0.05). On histopathology, both RV and lung fibrosis were significantly reduced in the MAC and MAC+SIL vs. in the MCT (all p < 0.05); the 2 treatment groups did not differ. CONCLUSIONS: MAC treatment at an earlier stage significantly attenuated experimental PAH progression hemodynamically and histopathologically.
Animals ; Atrial Pressure ; Blood Pressure ; Catheters ; Echocardiography ; Fibrosis ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Pulmonary ; Lung ; Models, Animal ; Monocrotaline ; Mortality ; Pathology ; Pulmonary Artery ; Rats ; Sildenafil Citrate

BACKGROUND AND OBJECTIVES: Macitentan (MAC) reduces morbidity and mortality among advanced-stage pulmonary arterial hypertension (PAH) patients. However, data regarding the histopathologic and hemodynamic benefits of MAC treatment at an early stage of PAH is lacking. METHODS: One week after monocrotaline (MCT) injection, rats were randomly assigned to MAC (n=16), MAC combined with sildenafil (SIL) (MAC+SIL, n=16), or normal saline (MCT, n=16). Twelve sham rats (Sham) were included for comparison. Right ventricular (RV) systolic function was assessed via echocardiography as the RV fractional area change (RV-FAC). An invasive pressure-volume analysis using a Millar conductance catheter was performed 7 weeks after MCT injection. Rats were subsequently euthanized for histopathologic analysis. RESULTS: RV-right atrial pressure gradient on echocardiography was significantly increased 3 weeks after MCT injection, but was maintained in the Sham. RV-FAC was less deteriorated in the MAC, compared to that in the MCT (44±3% vs. 25±7%, p < 0.05), and the co-administration of SIL showed no additional benefit (45±8%, p > 0.05 vs. the MAC). On invasive hemodynamic analyses, RV end-systolic (196±78 µL) and end-diastolic volumes (310±86 µL), pulmonary artery systolic pressure (89±7.2 mmHg), and end-systolic pressure-volume relationship (−254±25.1) were significantly worse in the MCT vs. in the MAC (101±45 µL, 235±55 µL, 40±10.5 mmHg, and −145±42.1, respectively) and MAC+SIL (109±47 µL, 242±46 µL, 38±9.2 mmHg, and −151±39.2, respectively) (all p < 0.05). However, the MAC and MAC+SIL did not differ (all p > 0.05). On histopathology, both RV and lung fibrosis were significantly reduced in the MAC and MAC+SIL vs. in the MCT (all p < 0.05); the 2 treatment groups did not differ. CONCLUSIONS MAC treatment at an earlier stage significantly attenuated experimental PAH progression hemodynamically and histopathologically.

The cannabinoid (CB2) receptor type 2 has been proposed to prevent the degeneration of dopamine neurons in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice. However, the mechanisms underlying CB2 receptor-mediated neuroprotection in MPTP mice have not been elucidated. The mechanisms underlying CB2 receptor-mediated neuroprotection of dopamine neurons in the substantia nigra (SN) were evaluated in the MPTP mouse model of Parkinson's disease (PD) by immunohistochemical staining (tyrosine hydroxylase, macrophage Ag complex-1, glial fibrillary acidic protein, myeloperoxidase (MPO), and CD3 and CD68), real-time PCR and a fluorescein isothiocyanate-labeled albumin assay. Treatment with the selective CB2 receptor agonist JWH-133 (10 μg kg⁻¹, intraperitoneal (i.p.)) prevented MPTP-induced degeneration of dopamine neurons in the SN and of their fibers in the striatum. This JWH-133-mediated neuroprotection was associated with the suppression of blood-brain barrier (BBB) damage, astroglial MPO expression, infiltration of peripheral immune cells and production of inducible nitric oxide synthase, proinflammatory cytokines and chemokines by activated microglia. The effects of JWH-133 were mimicked by the non-selective cannabinoid receptor WIN55,212 (10 μg kg⁻¹, i.p.). The observed neuroprotection and inhibition of glial-mediated neurotoxic events were reversed upon treatment with the selective CB2 receptor antagonist AM630, confirming the involvement of the CB2 receptor. Our results suggest that targeting the cannabinoid system may be beneficial for the treatment of neurodegenerative diseases, such as PD, that are associated with glial activation, BBB disruption and peripheral immune cell infiltration.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine* ; Animals ; Blood-Brain Barrier ; Chemokines ; Cytokines ; Dopamine* ; Dopaminergic Neurons* ; Fluorescein ; Glial Fibrillary Acidic Protein ; Macrophages ; Mice ; Microglia ; Neurodegenerative Diseases ; Neuroprotection ; Nitric Oxide Synthase Type II ; Parkinson Disease* ; Peroxidase ; Real-Time Polymerase Chain Reaction ; Receptor, Cannabinoid, CB2* ; Receptors, Cannabinoid ; Substantia Nigra