We report a case of Becker's nevus associated with smooth muscle hamartoma, in a 21-year-old male patient, which shows clinically match-head sized, flat topped, round to oval, grouped papules with hairs on the outer surface of the right arm, and microscopically reveals numerous bundles of smooth muscle fiber in the dermis.
Arm ; Dermis ; Hair ; Hamartoma* ; Humans ; Male ; Muscle, Smooth* ; Nevus* ; Young Adult

Smell used to be a common diagnostic tool in medicine, and physicians were trained to use their sense of smell during their medical training. Latterly, odor disgnostics have been relegated to secondary status as a diagnostic method. Array-based gas sensors ("Electronic Nose") now offer the potential of a robust analytical approach to exhaled breath analysis for medical use. Many diseases are accompanied by characteristic odor, and their recognition can provide diagonostic clues, guide the laboratory evaluation, and affect the choice of immediate therapy. We are developing an intelligent sensor system for non-invasive health care monitoring combined laboratory based sensor module, pattern recognition subsystem and non-invasive sampling of volatile emitted from a patient into a highly intelligent sensor system that allows the rapid processing of these samples. It is capable to assist early and rapid disgnosis of changes in state of patient, and aid decision making by medical personnel in the treatment of such patients. In this paper, we introduce exhaled breath analysis for potential primary lung disease screening using electronic nose system incorporating an automated solid-phase microextraction (SPME) desorption to enable the system to be used. Aiming to increase the sensitivity, SPME preconcentration is used for sampling of headspace air and the response of sensor module to variable concentration of volatile emitted from SPME fiber is evaluated. The initial result shows the distinguished difference between the lung cancer patients and healthy normal individuals according to the analysis of the respective expiratory gases.
Decision Making ; Delivery of Health Care ; Electronic Nose* ; Exhalation ; Gases ; Humans ; Lung Diseases* ; Lung Neoplasms ; Mass Screening ; Odors ; Smell

Recent studies of molecular biology have suggested that infection with human papillomavirus(HPV) is implicated in the pathogenesis of cervical carinoma. HPV infection alone, however, does not appear to be sufficient for the process of maliganant transformation, suggesting the requirement of additional cellular events. The mutation of p53, which is involved in negative control of cell proliferation, may play a role in the carcinogenesis of cervical carcinoma. The present study was designed to clarify the association between infection with HPV and p53 alteration in primary carcinoma of human uterine cervix. We investigated 46 prim-ary cervical carcinomas for the presence of HPV DNA by in situ hybridization(ISH) with probe specific for HPV 16/18, and examined the accumulation of p53 protein by immunohis-tochemistry(IHC) and the p53 alteration by polymerase chain reaction-single strand confor-mation polymorphism(PCR-SSCP) using formalin fixed, paraffin -embedded tissue. HPV DNA 16/18 was detected in 18 cases(39.1%) of 46 cervical carcinomas. The accumulation of p53 was identified in tumor cells: low level 43.5%(20/46) and high level 32.6% difference of positive reaction by IHC method. But there was no statistical significant between the infection of HPV and the accumulation of p53(p=0.847). Mutations in exons 4 through 9, where the vast majority of point mutations were reported in human neoplasms, were screened by PCR-SSCP analysis. Altered mobilities of the PCR product of p53 were also found in 9 cases(26.5%) of 34 cervical carcinoma: one in exon 4, four in exon 5/6, two in exon 7, and two in exon 8/9. The mutation of p53 was observed in 41.1%(19/46) respective of the result of IHC and PCR-SSCP, and there was slightly higher p53 alteration in HPV negative cases(23.8%, 11/46) than in HPV positive cases(17.4%, 8/46) without statistical significance(p=0.729). The conclusion of these observations suggests that HPV infection and alteration of p53 may play a critical role in tumorigenesis of carcinoma of the human uterine cervix independently, ant there is important difference in the tumorigenic pathway between two factors.
Ants ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; DNA ; Exons ; Female ; Formaldehyde ; Genes, p53* ; Humans ; Molecular Biology ; Paraffin ; Point Mutation ; Polymerase Chain Reaction

Neurocysticercosis (NCC) by Taenia solium is the most common parasitic infection of the central nervous system involving the cerebrum. However, spinal involvement of NCC is rare. Spinal NCC can cause radiculopathy, myelopathy, cauda equina syndrome, and even paraparesis, depending on its location and size. Spinal NCC may require surgical treatment as a first-line treatment because medical therapy can further aggravate the inflammation due to dead cysts, resulting in clinical deterioration. The current standard therapy for spinal NCC is surgical decompression followed by medical therapy. We experienced a case of widespread thoracolumbar intradural extramedullary cysticercosis involving the spinal canal with cerebral cysticercosis. We report this rare case with literature review.
Central Nervous System ; Cerebrum ; Cysticercosis* ; Decompression, Surgical ; Humans ; Inflammation ; Neurocysticercosis ; Paraparesis ; Polyradiculopathy ; Radiculopathy ; Spinal Canal* ; Spinal Cord Diseases ; Spine ; Taenia solium

Objective: Arterial blood gas analysis (ABGA) is routinely performed in hyperventilation syndrome (HVS) patients in the emergency department (ED). We tried to substitute end-tidal carbon dioxide (ETCO2) for arterial partial pressure of carbon dioxide (PaCO2) in HVS patients in ED. Methods: It was a prospective observational cohort study of HVS patients from May 2019 to March 2020. Data of age, sex, vital sign, ETCO2 and ABGA were collected. We compared the Pearson correlation between ETCO2 and PaCO2. Results: A total of 135 HVS patients were included in the study. The average value for ETCO2 was 24.9±7.2. It showed a significant linear between ETCO2 and PaCO2. The Pearson correlation coefficient was 0.893 (P<0.001). The linear correlation coefficients of ETCO2 <20 mmHg and ETCO2 20-35 mmHg groups were 0.513 and 0.827, respectively (P<0.001). Conclusion We suggest that ABGA can be replaced by ETCO2 in HVS patients in ED.

Neutrophil extracellular traps (NETs) exert a novel function of trapping pathogens. Released NETs can accumulate in inflamed tissues, be recognized by other immune cells for clearance, and lead to tissue toxicity. Therefore, the deleterious effect of NET is an etiological factor, causing several diseases directly or indirectly. NLR family pyrin domain containing 3 (NLRP3) in neutrophils is pivotal in signaling the innate immune response and is associated with several NET-related diseases. Despite these observations, the role of NLRP3 in NET formation in neuroinflammation remains elusive. Therefore, we aimed to explore NET formation promoted by NLRP3 in an LPS-induced inflamed brain. Wild-type and NLRP3 knockout mice were used to investigate the role of NLRP3 in NET formation. Brain inflammation was systemically induced by administering LPS. In such an environment, the NET formation was evaluated based on the expression of its characteristic indicators. DNA leakage and NET formation were analyzed in both mice through Western blot, flow cytometry, and in vitro live cell imaging as well as two-photon imaging. Our data revealed that NLRP3 promotes DNA leakage and facilitates NET formation accompanied by neutrophil death. Moreover, NLRP3 is not involved in neutrophil infiltration but is predisposed to boost NET formation, which is accompanied by neutrophil death in the LPS-induced inflamed brain. Furthermore, either NLRP3 deficiency or neutrophil depletion diminished pro-inflammatory cytokine, IL-1β, and alleviated blood-brain barrier damage. Overall, the results suggest that NLRP3 exacerbates NETosis in vitro and in the inflamed brain, aggravating neuroinflammation.These findings provide a clue that NLRP3 would be a potential therapeutic target to alleviate neuroinflammation.

PURPOSE: we often find variable degrees of FDG uptake and patterns in stomach, which can make difficult to distinguish physiologic uptake from pathologic uptake on FDG PET. The purpose of this study was to find out the significant findings of stomach on FDG PET. MATERIALS AND METHODS: Thirty-eight patients who underwent both FDG PET and endoscopy within one week from Jun. 2003, to Aug. 2004 were included in this study. We reviewed 38 patients (18 for medical check up, 15 for work up of other malignancies, and 5 for the evaluation of stomach lesion). Their mean age was 56 years old (range: 32~79), men and women were 28 and 10, respectively. Two nuclear physicians evaluated five parameters on FDG PET findings of stomach with a consensus: 1) visual grades 2) maximum SUV (max.SUV) 3) focal 4) diffuse and 5) asymmetric patterns. We correlated the lesions of FDG PET findings of stomach with those of endoscopy. We considered more than equivocal findings on FDG PET as positive. RESULTS: The six of 38 patients were proven as malignant lesions by endoscopic biopsy and others were inflammatory lesions (ulcer in 3, chronic atrophic gastritis in 12, uncommon forms of gastritis in 5), non-inflammatory lesions (n=3), and normal stomach (n=9). By the visual analysis, malignant lesions had higher FDG uptake than the others. The max.SUV of malignant lesions was 7.95 4.83 which was significantly higher than the other benign lesions (2.9 0.69 in ulcer, 3.08 1.2 in chronic atrophic gastritis, 3.2 1.49 in uncommon forms of gastritis (p=0.044) ). In the appearance of stomach on FDG PET, malignant lesions were shown focal (5 of 6) and benign inflammatory lesions were shown diffuse (9 of 20) and asymmetric (14 of 20). Benign lesions and normal stomach were shown variable degrees of uptake and patterns. Some cases of benign inflammatory lesions such as ulcer and gastritis were shown focal and mimicked cancerous lesion (4 of 15). CONCLUSION: Gastric malignant lesions had higher FDG uptake and focal pattern. However, benign inflammatory lesions had moderate degrees of uptake and diffuse and asymmetric patterns rather than focal. It is difficult to differentiate between benign lesions including normal.
Biopsy ; Consensus ; Electrons* ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Humans ; Male ; Middle Aged ; Positron-Emission Tomography* ; Stomach* ; Ulcer

Superior mesenteric artery (SMA) syndrome is an uncommon cause of a proximal intestinal obstruction. The most characteristic symptoms are postprandial fullness, nausea, and vomiting. The diagnosis is established by ultrasonography and contrast-enhanced computed tomography. Almost all patients respond well to conservative management. However, if conservative management fails, surgical options should be applied. In this article, we report a case of SMA syndrome with Nutcracker syndrome in a patient with diabetes mellitus. Establishing the diagnosis of Nutcracker syndrome is usually based on clinical suspicion and radiological findings. Several complications that have been reported to result from SMA syndrome include peptic ulcer disease, pancreatitis, metabolic alkalosis, and uremic syndrome. However, Nutcracker syndrome accompanied by SMA syndrome is extremely uncommon, as described in this case. To our knowledge, this association has not been reported previously.
Alkalosis ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Humans ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Nausea ; Pancreatitis ; Peptic Ulcer ; Superior Mesenteric Artery Syndrome ; Vomiting

PURPOSE: A prostate cancer prevention trial has demonstrated a higher incidence of high-grade prostate cancers(HGPC, Gleason pattern 4 or greater) among men randomized to receive treatment with finasteride. One of the hypotheses was finasteride causes a detection bias with regards to HGPC by reducing the prostate volume. We investigated the relationship between prostate volume and HGPC in prostate biopsy specimens and prostatectomy specimens(RP) from the same patients. MATERIALS AND METHODS: We retrospectively reviewed a cohort of 173 consecutive patients that underwent a radical prostatectomy. We identified risk factors for HGPC on 12 core needle biopsies and then on RP specimens using univariate and multivariate logistic regression analysis. In transrectal ultrasound(TRUS) volume quartiles, the relationship of HGPC and prostate volume was analyzed between the lowest and the highest quartile. RESULTS: By multivariate analysis, risk factors of HGPC were age and prostate-specific antigen(PSA), but TRUS volume was not associated with HGPC in both biopsy and RP specimens. In TRUS volume quartiles, the relationship of HGPC and prostate volume was not significant. In addition, in a comparison of the lowest and the highest quartile, the relationship of HGPC and prostate volume was not significant. CONCLUSIONS: Prostate volume may not be significantly associated with the grade of prostate cancers diagnosed at 12 core(or more) needle biopsies and at a radical prostatectomy.
Bias (Epidemiology) ; Biopsy ; Biopsy, Large-Core Needle ; Biopsy, Needle ; Cohort Studies ; Finasteride ; Humans ; Incidence ; Logistic Models ; Male ; Multivariate Analysis ; Needles ; Prostate* ; Prostatectomy ; Prostatic Neoplasms* ; Retrospective Studies ; Risk Factors

Golgi SNAP receptor complex 1 (GS28) has been implicated in vesicular transport between intra-Golgi networks and between endoplasmic reticulum (ER) and Golgi. Additional role(s) of GS28 within cells have not been well characterized. We observed decreased expression of GS28 in rat ischemic hippocampus. In this study, we examined the role of GS28 and its molecular mechanisms in neuronal (SK-N-SH) cell death induced by hydrogen peroxide (H2O2). GS28 siRNA-transfected cells treated with H2O2 showed a significant increase in cytotoxicity under glutathione (GSH)-depleted conditions after pretreatment with buthionine sulfoximine, which corresponded to an increase of intracellular reactive oxygen species (ROS) in the cells. Pretreatment of GS28 siRNA-transfected cells with p38 chemical inhibitor significantly inhibited cytotoxicity; we also observed that p38 was activated in the cells by immunoblot analysis. We confirmed the role of p38 MAPK in cotransfected cells with GS28 siRNA and p38 siRNA in the cell viability assay, flow cytometry, and immunoblot. Involvement of apoptotic or autophagic processes in the cells was not shown in the cell viability, flow cytometry, and immunoblot analyses. However, pretreatment of the cells with necrostatin-1 completely inhibited H2O2-induced cytotoxicity, ROS generation, and p38 activation, indicating that the cell death is necroptotic. Collectively these data imply that H2O2 induces necroptotic cell death in the GS28 siRNA-transfected cells and that the necroptotic signals are mediated by sequential activations in RIP1/p38/ROS. Taken together, these results indicate that GS28 has a protective role in H2O2-induced necroptosis via inhibition of p38 MAPK in GSH-depleted neuronal cells.
Animals ; Buthionine Sulfoximine ; Cell Death ; Cell Survival ; Endoplasmic Reticulum ; Flow Cytometry ; Glutathione ; Hippocampus ; Hydrogen ; Hydrogen Peroxide ; Imidazoles ; Indoles ; Methionine ; Neurons ; p38 Mitogen-Activated Protein Kinases ; Rats ; Reactive Oxygen Species ; RNA, Small Interfering ; SNARE Proteins