Signal transducer and activator of transcription 3 (STAT3) has a crucial role in various autoimmune disorders including, inflammatory bowel disease (IBD). Our previous study demonstrated that STAT3 activation by IL-6 in colonic epithelial cells exacerbates experimental ulcerative colitis. Activated T lymphocytes are also found in ulcerative colitis patients with intestinal inflammation, but the role of STAT3 in T cells remains elusive. To determine the STAT3 function of T cells in intestinal inflammation, we generated T cell-specific STAT3 knockout (KO) mice and used dextran sulfate sodium (DSS) to induce colitis. In this study, we demonstrated that T cell-specific STAT3 deletion alleviated DSS-induced colitis in mice, resulting in reduced histological scores and myeloperoxidase (MPO) activity. Importantly, the population of T cells in the spleen and lymph nodes was significantly decreased in the control and DSS-induced groups of STAT3 KO mice. In addition, STAT3 deficiency in T cells markedly reduced the production of interferon (IFN)-γ, IL-6, and IL-17A, whereas IL-10 secretion was increased. Collectively, the results suggest that STAT3 in T cells may be a therapeutic target in ulcerative colitis by balancing the immune response through T cell homeostasis.
Animals ; Colitis* ; Colitis, Ulcerative ; Colon ; Cytokines ; Dextran Sulfate* ; Dextrans* ; Epithelial Cells ; Homeostasis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Interferons ; Interleukin-10 ; Interleukin-17 ; Interleukin-6 ; Lymph Nodes ; Mice ; Peroxidase ; Spleen ; STAT3 Transcription Factor ; T-Lymphocytes

BACKGROUND: The utilization of botulinum toxin has rapidly expanded into various aesthetic applications. Achieving success with the aesthetic use of neurotoxins depends on several factors, including an understanding of the anatomy, the methods of dilution and the injection technique. Any guidelines representing a consensus for aesthetic treatments using botulinum toxin type A (BTA) have not been published in Korea. OBJECTIVE: We wanted to provide consensus recommendations on the treatment of facial wrinkles and benign masseter hypertrophy using BTA in Korean patients. METHODS: A panel of experienced Korean dermatologists was convened to develop a clinical consensus. The clinical consensus was comprised of the recommendations of the panel and the guidelines on general issues, such as the reconstitution and handling of the BTA, the procedural considerations, the dosing and injection-site standardizations, and the prevention and treatment of unwanted effects. Specific recommendations were provided according to the area of treatment, including glabellar lines, horizontal forehead lines, lateral periorbital wrinkles and benign masseter hypertrophy. RESULTS: The recommended final concentration of BTA was 50 units/ml (5 units/0.1 ml) after reconstitution with physiologic saline. For glabellar lines, the members recommend three injection points (a total of 8 units). For forehead wrinkles, the members recommend nine injections in two rows into the frontalis with 1 unit/point. For crow's feet, the members recommend three injections per side (7 units/side) at the lateral part of the orbicularis oculi. For benign masseter hypertrophy, three injections per side (24~30 units/side) were recommended. CONCLUSION: These consensus recommendations will provide a framework for Korean dermatologists who wish to perform safe and efficacious injection of BTA for facial rejuvenation.
Botulinum Toxins ; Botulinum Toxins, Type A ; Consensus ; Foot ; Forehead ; Handling (Psychology) ; Humans ; Hypertrophy ; Korea ; Neurotoxins ; Rejuvenation

BACKGROUND/AIMS: Although a few recent studies have reported the effectiveness of endoscopic pancreatic sphincterotomy (EPST), none has compared physicians' skills and complications resulting from the procedure. Thus, we examined the indications, complications, and safety of EPST performed by a single physician at a single center. METHODS: Among 2,313 patients who underwent endoscopic retrograde cholangiopancreatography between January 1996 and March 2008, 46 patients who underwent EPST were included in this retrospective study. We examined the indications, complications, safety, and effectiveness of EPST, as well as the need for a pancreatic drainage procedure and the concomitant application of EPST and endoscopic sphincterotomy (EST). RESULTS: Diagnostic indications for EPST were chronic pancreatitis (26 cases), pancreatic divisum (4 cases), and pancreatic cancer (8 cases). Therapeutic indications for EPST were removal of a pancreaticolith (10 cases), stent insertion for pancreatic duct stenosis (9 cases), nasopancreatic drainage (7 cases), and treatment of sphincter of Oddi dysfunction (1 case). The success rate of EPST was 95.7% (44/46). Acute complications of EPST included five cases (10.9%) of pancreatitis and one of cholangitis (2.2%). EPST with EST did not reduce biliary complications. Endoscopic pancreatic drainage procedures following EPST did not reduce pancreatic complications. CONCLUSIONS: EPST showed a low incidence of complications and a high rate of treatment success; thus, EPST is a relatively safe procedure that can be used to treat pancreatic diseases. Pancreatic drainage procedures and additional EST following EPST did not reduce the incidence of procedure-related complications.
Adult ; Aged ; Bile Ducts/surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases/*surgery ; Pancreatic Ducts/surgery ; Sphincterotomy, Endoscopic/adverse effects/*methods

The three mammalian isoforms of transforming growth factor-beta (TGF-beta1, beta2, beta3) are potent regulators of cell growth, differentiation, and extracellular matrix deposition. To study their role in skin differentiation, we investigated the expression of TGF-beta isoforms on cell growth and differentiation induction of the human keratinocyte cell line, HaCaT by elevating the Ca2+ concentration. An ELISA and RT-PCR assay revealed secreted TGF-beta 1 protein and TGF-beta1 mRNA were increased during calci-um-induced differentiation. In contrast, major differences were seen for TGF-beta 2 and TGF-beta 3 mRNA which were decreased during differentiation, but TGF-beta 2 and TGF-3beta protein were not evident on an ELISA. These results suggest different functions for each TGF-beta isoforms in epidermal differentiation, such that TGF-beta 1 is associ-ated with the more differentiated state, and TGF-beta 2 and TGF-beta 3 may be associ-ated the more proliferated state.
Cell Differentiation/physiology ; Cell Line ; Gene Expression Regulation, Developmental/*physiology ; Humans ; Keratinocytes/*cytology/*physiology ; Protein Isoforms/metabolism ; Transforming Growth Factor beta/*metabolism

Bleomycin is an antitumoral antibiotic derived from Streptomyces verticillus in 1965. The drug has been used with a varying success in the treatment of squamous cell carcinomas and malignant lymphomas. The cutaneous toxicities of bleomycin include hyperpigmentation, sclerosis, gangrene, nail changes and erythema. Linear streaks appear to be a characteristic eruption induced by bleomycin. We report three cases of flagellate pigmentation from intravenous bleomycin. Three patients were suffering from uterine cervical carcinomas and were treated with chemotherapy with a VBP (vincristine, bleomycin, cisplatire) regimen. During or after their courses of chemotherapy, dark brownish skin lesions developed on the body surface of these patients. A Light microscopic study of each specimen showed increased pigmentation of the basal layer and an electron microscopic study showed a slightly increased number of melanosomes in keratinocytes.
Bleomycin* ; Carcinoma, Squamous Cell ; Drug Therapy ; Erythema ; Gangrene ; Humans ; Hyperpigmentation ; Keratinocytes ; Lymphoma ; Melanosomes ; Pigmentation* ; Sclerosis ; Skin ; Streptomyces

We report five cases of solitary mastocytoma. All patients were under one year of age and diagnosed as solitary mastocytoma based on clinicopathologic findings. Skin lesions were found on the right forearm, left hand, left leg, left elbow and left shoulder. They resolved themselves spontaneously resolution within 2 or 3 years.
Elbow ; Forearm ; Hand ; Humans ; Leg ; Mastocytoma* ; Shoulder ; Skin

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes

BACKGROUND: Psoriasis is a chronic relapsing disease characterized by epidermal hyperproliferation and epiderrnal and dermal inflammatory cell infiltration. The etiology of this disease is still unclear. Recently, there has been growing interest in the probable role of a T cell mediated immune response in the pathogetiesis of psoriasis. The infiltrating cells in psoriatic lesions have been iden- tified by monoclonal ant~ibodies and T cells were found to be the major infiltrating type. OBJECTIVE: This stud was done to investigate the difference of cellular infiltration and adhesion molecule exg!ressions between early and late skin lesions of psoriasis using immunohistochernical studies. Methpds : Patients with psoriatic lesions were divided into two groups. The early gr oup were defined as having skin lisions that had lasted for about 4 weeks, and late group were defined as having skin lesions that had lasted for more than 8 weeks. Then biopsy specirnens were stained using monoclonal antibidies for CD4, CD8, CD1, LFA-1, and ICAM l. RESULTS: 1. CD4 positive cells,vere tly increased in both the early and late groups compared with CD8 positive cells. Z. CD8 positive cells were significantly increased in the late g~roup compared with the early group. 3. CDl-posit,ive dendri!ic cells were more nurnerous in the late group than the early group. 4. There were no significant differences between the early and late group with regard to numbers of LFA-1 positive (ells. 5. ICAM-1 were more strongly expressed on epidermal keratinocytes in the late than the early group. CONCLUSION: CD4-positive cells are important in early and late psoriatic lesions and CD8 positive cells playi more important role in late than early lesions. ICAM-1 and LI'A-1 play a role in cell adhesion of infiltrating cells and lymphocytic rnigration to the epidermis.
Biopsy ; Cell Adhesion ; Epidermis ; Humans ; Intercellular Adhesion Molecule-1 ; Keratinocytes ; Lymphocyte Function-Associated Antigen-1 ; Psoriasis ; Skin ; T-Lymphocytes

Cutaneous ulcers due to candida infection are very rare condition, occurring almost in immunocompromised host or occurring as cutaneous manifestation of systemic candidal infection. A 52-year-old woman presented with cutaneous ulcer on dorsum of left hand which had lasted for about 15 days. Bacterial culture showed nonpathogenic organism, Enterobacter cloacae. Mycologic studies including KOH mount and fungus culture were positive for pseudohyphae and colonies of Candida species. A biopsy specimen from the center of ulcer revealed numerous spores and fungal hyphae in the upper dermis and necrotic epidermis. Bacterial culture and fungus culture of patient's serum and urine were negative. Initial treatment with antibiotics had no effectiveness for 2 weeks. After then we treated with antifungal drug, itraconazole 100mg/day. After 6 weeks of antifungal therapy, the skin lesion was much improved. We report this case, because it showed cutaneous ulcer due to candida infection but had neither systemic candidal infection nor clinical sign of immunosuppression.
Anti-Bacterial Agents ; Biopsy ; Candida* ; Dermis ; Enterobacter cloacae ; Epidermis ; Female ; Fungi ; Hand ; Humans ; Hyphae ; Immunocompromised Host ; Immunosuppression ; Itraconazole ; Middle Aged ; Skin ; Spores ; Ulcer*

We report a case of squamous cell carcinoma arising in giant porokeratosis in an 88-year-old woman. She had a 20 × 12 cm sized erythematous scaly patch with central ulceration on the right parietal area. On histopathologic examination, a skin biopsy specimen from the peripheral ridge of erythematous lesion revealed porokeratosis, and a specimen from the central ulceration showed well differentiated squamous cell carcinoma.
Aged, 80 and over ; Biopsy ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Female ; Humans ; Porokeratosis* ; Rabeprazole ; Skin ; Ulcer