Over the past two decades, experimental and clinical evidence has established the interleukin-23 (IL-23)/interleukin-17 (IL-17) axis as a key mediator of psoriatic inflammation. IL-23, primarily derived from activated dendritic cells, supports the survival and pathogenic function of type 17 immune cells, which subsequently release IL-17A, IL-17F, and IL-22 to promote keratinocyte activation and recruit inflammatory leukocytes. These mechanistic insights have directly translated into the development of highly effective biologic therapies targeting IL-17 or IL-23, substantially improving the management of psoriasis. Beyond injectable biologics, growing efforts to overcome limitations related to long-term adherence, cost, and accessibility have accelerated the development of non-injectable therapeutic approaches. Oral and topical small-molecule agents, including selective tyrosine kinase 2 (TYK2) inhibitors and IL-23 receptor antagonists, are now broadening the therapeutic options. At the same time, progress in molecular engineering, artificial intelligence–guided protein design, and spatial multi-omic technologies are refining therapeutic discovery and enabling more precise targeting of pathogenic immune circuits. In this review, we outline the current understanding of the IL-23/IL-17 pathway in psoriasis pathogenesis and provide a critical overview of approved and emerging therapies directed at this pathway. We also address key biological and translational challenges, including tissue-specific cytokine functions, interspecies differences, and long-term safety considerations, and discuss how these factors may inform future strategies for precision immunotherapy in psoriasis.

Background: Neonatal porcine pancreatic cell clusters (NPCCs) have been proposed as an alternative source of β cells for islet transplantation because of their low cost and growth potential after transplantation. However, the delayed glucose lowering effect due to the immaturity of NPCCs and immunologic rejection remain as a barrier to NPCC’s clinical application. Here, we demonstrate accelerated differentiation and immune-tolerant NPCCs by in vitro chemical treatment and microencapsulation. Methods: NPCCs isolated from 3-day-old piglets were cultured in F-10 media and then microencapsulated with alginate on day 5. Differentiation of NPCCs is facilitated by media supplemented with activin receptor-like kinase 5 inhibitor II, triiodothyronine and exendin-4 for 2 weeks. Marginal number of microencapsulated NPCCs to cure diabetes with and without differentiation were transplanted into diabetic mice and observed for 8 weeks. Results: The proportion of insulin-positive cells and insulin mRNA levels of NPCCs were significantly increased in vitro in the differentiated group compared with the undifferentiated group. Blood glucose levels decreased eventually after transplantation of microencapsulated NPCCs in diabetic mice and normalized after 7 weeks in the differentiated group. In addition, the differentiated group showed nearly normal glucose tolerance at 8 weeks after transplantation. In contrast, neither blood glucose levels nor glucose tolerance were improved in the undifferentiated group. Retrieved graft in the differentiated group showed greater insulin response to high glucose compared with the undifferentiated group. Conclusion in vitro differentiation of microencapsulated immature NPCCs increased the proportion of insulin-positive cells and improved transplant efficacy in diabetic mice without immune rejection.

Novel H5N6 highly pathogenic avian influenza viruses (HPAIVs) were isolated from duck farms and migratory bird habitats in South Korea in November to December 2017. Genetic analysis demonstrated that at least two genotypes of H5N6 were generated through reassortment between clade 2.3.4.4 H5N8 HPAIVs and Eurasian low pathogenic avian influenza virus in migratory birds in late 2017, suggesting frequent reassortment of clade 2.3.4.4 H5 HPAIVs and highlighting the need for systematic surveillance in Eurasian breeding grounds.
Agriculture ; Animals ; Birds ; Breeding ; Ducks ; Ecosystem ; Genetic Heterogeneity ; Genotype ; Influenza in Birds ; Korea

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/complications/*drug therapy ; Female ; Humans ; Intestinal Fistula/*chemically induced/complications/radiography/surgery ; Intestinal Perforation/*chemically induced/complications/radiography/surgery ; Protein Kinase Inhibitors/*adverse effects/therapeutic use ; Quinazolines/*adverse effects/therapeutic use ; Sigmoid Diseases/*chemically induced/complications/radiography/surgery

Cleft lip and palate are common defects in congenital deformity. Nose deformity is most common among various facial deformities at the center of face. So we must operate to correct the deformity at the earliest stage to give the patients and parents mental relief from anxiety. It is also necessary to establish the facial anthropometry in newborns, because of the current trend of early intervention, such as fetal surgery, lip adhesion, and use of nasoalveolar molding devices. But there is a lack of literature and research on newborns. So we carried out this research to form base data for operations. The nose of 90 newborns in Gwangju-Jeonnam area were analyzed quantitatively, based on 13 facial measuring points and 18 anthropometric values taken directly from the face of newborns. The relationship between the nasal measurements were studied in 11 proportion indices. Followings are our results for newborns. Width of the nasal root was 13.9mm. Width of the nose was 22.1mm. Width of the columella was 4.5mm. Height of the nose was 22.6 mm. Length of the nasal bridge was 20.1mm. Nasal tip protrusion was 8.9 mm. Width of the nostril floor was 6.4mm. Thickness of the nasal ala and length of the nasal ala were 4.0mm, 15.4mm. Length of the columella was 3.9mm. The most common nostril shape was Type II(0-45 degrees in inclination of the nostril axis from the horizontal). Nasal index was 97.8. Columella-nasal tip protrusion length index was 43.9. The development of the columella was relatively incomplete in the case of newborns. The normal indices could be used clinically in identifying it's normality as well as morphologic characteristics of the craniofacial structures. They also could be used in different diagnosis between the morphologically similar congenital craniofacial anomalies, in preoperative design, and assessing the effect of the operation.
Anthropometry* ; Anxiety ; Axis, Cervical Vertebra ; Cleft Lip ; Congenital Abnormalities ; Diagnosis ; Early Intervention (Education) ; Fungi ; Humans ; Infant, Newborn* ; Lip* ; Nose* ; Palate ; Parents

Cryptotia is a relatively common congenital anomaly in orientals. It is charaterized by obliteration of auriculocephalic sulcus and buried ear cartilage of upper pole beneath the scalp skin. In addition, there is often a posterior displacement of the superior crus of antihelix. The goals of surgical correction are the coverage of skin deficit, deepening of the auriculocephalic sulcus and the correction of deformed cartilage. Some authors stressed a tendency for the superior portion of the auricle to spring back to the original portion after surgery. We have devised a surgical method to prevent recurrence of the cartilagenous deformity using combined method of Fukuda and Onizuka. From March in 2001 to Jan, 2004, We have repaired 6 cryptotic deformities in 5 patients including one bilateral cryptotia. Between them We used combined method of Fukuda and Onizuka in 4 severely deformed cryptotic superior ear cartilage correction with satisfactory results. Single Fukuda's method was used in 2 mildly deformed cryptotias. The combined method composed of Z-plasty incision for skin releasing, and incision along the crus and then flattened the crus by mattress suture, multiple incisions in the back of the superior crus and then grafting the piece of conchal cartilage producing a splinting to hold the crus out in a smooth, curved configuration for the correction of the superior portion of the deformed ear. The results were remarkable improvement of profile in severely deformed cryptotia. And so this combined method is useful method for the correction of severely deformed cartilage in cryptotia.
Cartilage ; Congenital Abnormalities ; Ear ; Ear Cartilage ; Humans ; Nose ; Recurrence ; Scalp ; Skin ; Splints ; Sutures ; Transplants

Food allergy is a state of immunologic reaction resulting from the exposure to food or food additive. The clinical symptoms and signs varied from localized symptoms at the site of direct contact such as contact urticaria, localized gastrointestinal symptoms with nausea, pain, vomiting and diarrhea to systemic symptoms occurring in remote organs, such as skin, respiratory system, cardiovascular system. We reported a case of 8 month-old girl with milk allergy who presented skin symptoms after cutaneous contact with milk protein. Developed after 15 minutes of milk contact challenge on forearm and followed by erythematous papules and wheals distributed throughout the face and neck area accompanied by edema and itching. The symptoms were continued for 2 hours and disappeared after an injection of pheniramine maleate.
Cardiovascular System ; Diarrhea ; Edema ; Female ; Food Additives ; Food Hypersensitivity ; Forearm ; Humans ; Infant ; Milk Hypersensitivity* ; Milk Proteins ; Milk* ; Nausea ; Neck ; Pheniramine ; Pruritus ; Respiratory System ; Skin ; Urticaria ; Vomiting

BACKGROUND: This research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future. METHODS: This research conducted a se7-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients Per Practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel ; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations. RESULTS: The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a yea. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel and only 56.2% of the patients insisted the same. There was also a significant difference between two values. (P<0.05) CONCLUSION: The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients had high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.
Commerce ; Compensation and Redress ; Hand ; Hand Strength ; Humans ; Primary Health Care* ; Surveys and Questionnaires

Intussusception can develop at any age but about 95% of patients are children under 2 years-old. Adult intussusception is a rare condition. Unlike children, nearly all adults with intussusception have a lead point such as benign or malignant small bowel tumors, intestinal tuberculosis, or Meckel's diverticulum. First case is a 48-year-old male who was admitted with 2 days of diffuse abdominal cramping pain and no other associated gastrointestinal symptoms. Barium enema revealed ileocolic intussusception with a round cecal mass after barium reduction. An ileocecectomy was performed electively. The pathologic report was cecal cyst, which was an intraluminal structure with an epithelial lining of colonic mucosa. The second case, a 53-year-old male, was admitted with 1 week of diffuse abdominal cramping pain and watery diarrhea. Barium enema revealed ileocecal intussusception. Emergency surgery (ileocecectomy), revealed a polypoid small bowel mass. The pathologic report was lipoma. Recently, we experienced two cases of adult intussusception and report these cases with a brief review of the literature.
Adult* ; Barium ; Child ; Child, Preschool ; Colic ; Colon ; Diarrhea ; Emergencies ; Enema ; Humans ; Intussusception* ; Lipoma ; Male ; Meckel Diverticulum ; Middle Aged ; Mucous Membrane ; Tuberculosis

Sarcoidosis, in general, has a low mortality rate. But cardiac sarcoidosis (CS) is a serious condition which may lead to death. Here, we report a rare case of CS that was treated by heart transplantation. A 47-year-old male had occasional syncopes and atypical chest pain. Ventricular tachycardia with right bundle branch block was noted by electrocardiogram. Multiple fixed myocardial perfusion defects in the interventricular septum and both the inferior-posterior ventricular walls were observed by thallium scan. Coronary angiography was unremarkable. Neither perihilar nor mediastinal lymphadenopathy was noted. The patient also suffered three times from tonic-clonic generalized seizures in 3 years, but no neurologic abnormalities were detected. The explanted heart displayed multiple white patches on the endomyocardial surface, measuring up to 8x7 cm. On microscopic examination, the lesion consisted of multiple well-formed and confluent granulomas with numerous scattered multinucleated giant cells, CD68-positive epithelioid histiocytes, and T-lymphocytes. Neither microorganisms nor foreign material was identified on special stain and culture study. It has been six months since the heart transplant, and the patient has been doing well.
Bundle-Branch Block ; Chest Pain ; Coronary Angiography ; Electrocardiography ; Giant Cells ; Granuloma ; Heart ; Heart Transplantation* ; Histiocytes ; Humans ; Lymphatic Diseases ; Male ; Middle Aged ; Mortality ; Perfusion ; Sarcoidosis* ; Seizures ; Syncope ; T-Lymphocytes ; Tachycardia, Ventricular ; Thallium