Eosinophilic cellulitis is a rare, recurrent dermatosis which was first described by Wells in 1971. The etiology and pathogenesis of eosinophilic cellulitis are currently unknown, but a type IV hypersensitivity to various antigens followed by vascular damage seems to play a role in the pathogenesis of eosinophilic cellulitis. Most cases of eosinophilic cellulitis occur in adults. Only 29 cases have been reported in children. Generally, pediatric cases are recurrent but show good response to systemic steroids. We present a case of eosinophilic cellulitis in an 8-year-old boy. Who presented with acute onset of erythematous plaques on both thighs. These lesions were pruritic but not painful. A skin biopsy specimen showed dense mixed inflammatory infiltrations that consisted mostly of eosinophils, lymphocytes and histiocytes. Flame figures surrounded by eosinophils and histocytes and foci of degenerated collagen bundles were observed in the dermis. The lesions resolved rapidly after the initiation of oral steroid therapy. After 6 months, the patient has not experienced recurrence of the disease.
Adult ; Biopsy ; Cellulitis* ; Child* ; Collagen ; Dermis ; Eosinophils* ; Histiocytes ; Humans ; Hypersensitivity, Delayed ; Lymphocytes ; Male ; Recurrence ; Skin ; Skin Diseases ; Steroids ; Thigh

Sclerotic fibroma is often regarded as a unique proliferating lesion, but some authors regard it as an end stage of other neoplasms, especially dermatofibroma. We report two cases of dermatofibroma with sclerotic fibroma-like change. The skin biopsy specimens from different patients showed a common finding of dermatofibroma, while some portions of the tumor were replaced by thick, hyalinized, eosinophilic collagen bundles and empty clefts with low cellularity, which was histologically similar to sclerotic fibroma. According to these findings, dermatofibroma with sclerotic fibroma-like change can be evidence of the possible pathogenesis of sclerotic fibroma.
Biopsy ; Collagen ; Eosinophils ; Fibroma ; Histiocytoma, Benign Fibrous* ; Humans ; Hyalin ; Skin

Radiation recall dermatitis is the development of an inflammatory reaction in the previously irradiated area, precipitated by the administration of certain drugs. A 54-year-old man was diagnosed with follicular lymphoma, grade 3 and stage 3. Cancer recurred two years after complete remission obtained by chemotherapy and radiotherapy. Therefore, he was again treated with fludarabine and mitoxantrone for five cycles, then underwent an allogeneic peripheral blood stem cell transplantation (PBSCT). The patient started to receive methotrexate the day after PBSCT. On the day of the first methotrexate administration, the patient developed erythematous erosions with pruritus and severe pain in the previously irradiated area. The skin lesion resolved almost completely after dressing with topical antibiotics and wet dressing with 0.3% aluminium solution for 2 weeks. We report a case of radiation recall dermatitis in a patient with follicular lymphoma that occurred after receiving methotrexate.
Anti-Bacterial Agents ; Bandages ; Drug Therapy ; Humans ; Lymphoma, Follicular ; Methotrexate* ; Middle Aged ; Mitoxantrone ; Peripheral Blood Stem Cell Transplantation ; Pruritus ; Radiodermatitis* ; Radiotherapy ; Skin

Very rare and unique tumors of infants, fibrous hamartomas were first described by Reye in 1956 as a subdermal fibromatous tumor of infancy. The tumors can occur at birth and are usually diagnosed within the first 2 years of life. The oldest patient reported in the literature was an 11-year-old child. The common sites of involvement are the axillae, upper arms, and upper trunk. Although the lesion is not distinctive clinically, it has a characteristic microscopic appearance of fibrous tissue forming trabeculae, small, round cells that represent primitive mesenchyme, and mature adipose tissue. Herein, we report a case of fibrous hamartoma of infancy in a 26-year-old man, on the uncommon site of a lower extremity.
Adipose Tissue ; Adult ; Arm ; Axilla ; Child ; Hamartoma ; Humans ; Infant ; Mesoderm ; Parturition

PURPOSE: This study aimed to investigate the current status of food service management in elementary care classes. METHODS: A focus group interview with seven care class managers and a survey with 101 care class managers using a self-administered questionnaire in Gyeonggi province were conducted. RESULTS: In the focus group interview, purchased meals and snacks were evaluated as low quality by the care class managers. Frequent use of frozen or processed food and products with low prices were also reported as problems. Care class managers were in charge of meal and snack planning without any guidelines or expert advices. The results of the survey show that most schools serve purchased snacks and meals. The average unit costs of one meal and snack were 4,062 and 1,463 Won, respectively. The average unit costs of snacks during semester (p = 0.015) and vacation (p = 0.039) were significantly lower in rural than urban areas. The percentages of schools that prepared nutrition standards for meal and snack planning in elementary care classes were only 7.4% and 10.9%, respectively. The meal menus were mostly provided by catering service companies, and the snack menus were planned mostly by the care class managers. Menu planning by the care class managers was more usual in rural than urban areas (p = 0.054 for meal planning and p = 0.008 for snack planning). Just 33.7% of schools introduced safety standards for food service in elementary care classes, and more than half of the respondents (56.4%) did not do a regular medical check-up. Only 33.7% of the respondents received education for food safety. CONCLUSION: These results show the necessity for establishment of detailed guidelines for food service in elementary care classes and for the introduction of a food safety and nutrition education program customized for care class managers.
Education ; Focus Groups ; Food Safety ; Food Services ; Gyeonggi-do* ; Humans ; Meals* ; Menu Planning ; Snacks* ; Surveys and Questionnaires

Eupatilin is known to possess anti-apoptotic, anti-oxidative, and antiinflammatoryproperties. We report here that eupatilin has a protective effect onthe ethanol-induced injury in rats. Sprague–Dawley rats were divided into 6 groups:control, vehicle, silymarin, eupatilin 10 mg/kg, eupatilin 30 mg/kg, and eupatilin 100mg/kg. Plasma levels of aspartate aminotransferase (AST) and alanine aminotransferase(ALT) were analyzed to determine the extent of liver damage. Total cholesterol(TC) and triglycerides (TG) were analyzed to determine the level of liver steatosis.Malondialdehyde level, superoxide dismutase (SOD) activity, and glutathione (GSH)level were analyzed to determine the extent of oxidative stress. Tumor necrosis factor(TNF)- and interleukin (IL)-1 were quantified to verify the degree of inflammation.Based on our findings, chronic alcohol treatment significantly changed the serumindexes and liver indicators of the model rats, which were significantly improved byeupatilin treatment. Rats in the eupatilin-treatment group showed reduced levelsof AST, ALT, TG, TC, TNF-, and IL-1, increased SOD activity and GSH levels, and improvedoverall physiology compared to the alcoholic liver disease model rats. H&Estaining also verified the eupatilin-mediated improvement in liver injury. In conclusion,eupatilin inhibits alcohol-induced liver injury via its antioxidant and anti-inflammatoryeffects.

Eupatilin is known to possess anti-apoptotic, anti-oxidative, and antiinflammatoryproperties. We report here that eupatilin has a protective effect onthe ethanol-induced injury in rats. Sprague–Dawley rats were divided into 6 groups:control, vehicle, silymarin, eupatilin 10 mg/kg, eupatilin 30 mg/kg, and eupatilin 100mg/kg. Plasma levels of aspartate aminotransferase (AST) and alanine aminotransferase(ALT) were analyzed to determine the extent of liver damage. Total cholesterol(TC) and triglycerides (TG) were analyzed to determine the level of liver steatosis.Malondialdehyde level, superoxide dismutase (SOD) activity, and glutathione (GSH)level were analyzed to determine the extent of oxidative stress. Tumor necrosis factor(TNF)- and interleukin (IL)-1 were quantified to verify the degree of inflammation.Based on our findings, chronic alcohol treatment significantly changed the serumindexes and liver indicators of the model rats, which were significantly improved byeupatilin treatment. Rats in the eupatilin-treatment group showed reduced levelsof AST, ALT, TG, TC, TNF-, and IL-1, increased SOD activity and GSH levels, and improvedoverall physiology compared to the alcoholic liver disease model rats. H&Estaining also verified the eupatilin-mediated improvement in liver injury. In conclusion,eupatilin inhibits alcohol-induced liver injury via its antioxidant and anti-inflammatoryeffects.

Hydrogen sulfide is well-known to exhibit anti-inflammatory and cytoprotective activities, and also has protective effects in the liver. This study aimed to examine the protective effect of hydrogen sulfide in rats with hepatic encephalopathy, which was induced by mild bile duct ligation. In this rat model, bile ducts were mildly ligated for 26 days. Rats were treated for the final 5 days with sodium hydrosulfide (NaHS). NaHS (25 µmol/kg), 0.5% sodium carboxymethyl cellulose, or silymarin (100 mg/kg) was administered intraperitoneally once per day for 5 consecutive days. Mild bile duct ligation caused hepatotoxicity and inflammation in rats. Intraperitoneal NaHS administration reduced levels of aspartate aminotransferase and alanine aminotransferase, which are indicators of liver disease, compared to levels in the control mild bile duct ligation group. Levels of ammonia, a major causative factor of hepatic encephalopathy, were also significantly decreased. Malondialdehyde, myeloperoxidase, catalase, and tumor necrosis factor-α levels were measured to confirm antioxidative and anti-inflammatory effects. N-Methyl-D-aspartic acid (NMDA) receptors with neurotoxic activity were assessed for subunit NMDA receptor subtype 2B. Based on these data, NaHS is suggested to exhibit hepatoprotective effects and guard against neurotoxicity through antioxidant and anti-inflammatory actions.
Alanine Transaminase ; Ammonia ; Animals ; Aspartate Aminotransferases ; Bile Ducts ; Carboxymethylcellulose Sodium ; Catalase ; Hepatic Encephalopathy ; Hydrogen Sulfide ; Inflammation ; Ligation ; Liver ; Liver Diseases ; Malondialdehyde ; Models, Animal ; N-Methylaspartate ; Necrosis ; Peroxidase ; Rats ; Silymarin ; Sodium

Background: Point-of-care testing (POCT) coagulometers are increasingly used for monitoring warfarin therapy. However, in high international normalized ratio (INR) ranges, significant discrepancy in the INR between POCT and conventional laboratory tests occurs. We compared the INR of POCT (CoaguChek XS Plus; Roche Diagnostics, Mannheim, Germany) with that of a conventional laboratory test (ACL TOP 750; Instrumentation Laboratory SpA, Milan, Italy) and explored possible reasons for discrepancy. Methods: Paired POCT and conventional laboratory test INRs were analyzed in 400 samples from 126 patients undergoing warfarin therapy after cardiac surgery. Coagulation factor and thrombin generation tests were compared using the Mann–Whitney U test. Correlations between coagulation factors and INRs were determined using Pearson correlation coefficients. Results: The mean difference in the INR between the tests increased at high INR ranges. Endogenous thrombin potential levels were decreased at INR <2.0 for CoaguChek XS Plus and 2.0< INR <3.0 for ACL TOP 750 compared with those at INR <2.0 for both tests, indicating a better performance of ACL TOP 750 in assessing thrombin changes. The correlation coefficients of coagulation factors were stronger for ACL TOP 750 INR than for CoaguChek XS Plus INR. Vitamin K-dependent coagulation factors were found to contribute to the INR discrepancy. Conclusions Decreases in vitamin K-dependent coagulation and anticoagulation factors can explain the significant discrepancy between the two tests in high INR ranges. Since conventional laboratory test INR values are more reliable than POCT INR values, a confirmatory conventional laboratory test is required for high INR ranges.

With recent advances in molecular diagnostic methods and targeted cancer therapies, several molecular tests have been recommended for gastric cancer (GC) and colorectal cancer (CRC). Microsatellite instability analysis of gastrointestinal cancers is performed to screen for Lynch syndrome, predict favorable prognosis, and screen patients for immunotherapy. The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor has been approved in metastatic CRCs with wildtype RAS (KRAS and NRAS exon 2–4). A BRAF mutation is required for predicting poor prognosis. Additionally, amplification of human epidermal growth factor receptor 2 (HER2) and MET is also associated with resistance to EGFR inhibitor in metastatic CRC patients. The BRAF V600E mutation is found in sporadic microsatellite unstable CRCs, and thus is helpful for ruling out Lynch syndrome. In addition, the KRAS mutation is a prognostic biomarker and the PIK3CA mutation is a molecular biomarker predicting response to phosphoinositide 3-kinase/AKT/mammalian target of rapamycin inhibitors and response to aspirin therapy in CRC patients. Additionally, HER2 testing should be performed in all recurrent or metastatic GCs. If the results of HER2 immunohistochemistry are equivocal, HER2 silver or fluorescence in situ hybridization testing are essential for confirmative determination of HER2 status. Epstein-Barr virus–positive GCs have distinct characteristics, including heavy lymphoid stroma, hypermethylation phenotype, and high expression of immune modulators. Recent advances in next-generation sequencing technologies enable us to examine various genetic alterations using a single test. Pathologists play a crucial role in ensuring reliable molecular testing and they should also take an integral role between molecular laboratories and clinicians.