Objective: We aimed to develop and test a deep learning algorithm (DLA) for fully automated measurement of the volume and signal intensity (SI) of the liver and spleen using gadoxetic acid-enhanced hepatobiliary phase (HBP)-magnetic resonance imaging (MRI) and to evaluate the clinical utility of DLA-assisted assessment of functional liver capacity. Materials and Methods: The DLA was developed using HBP-MRI data from 1014 patients. Using an independent test dataset (110 internal and 90 external MRI data), the segmentation performance of the DLA was measured using the Dice similarity score (DSS), and the agreement between the DLA and the ground truth for the volume and SI measurements was assessed with a Bland-Altman 95% limit of agreement (LOA). In 276 separate patients (male:female, 191:85; mean age ± standard deviation, 40 ± 15 years) who underwent hepatic resection, we evaluated the correlations between various DLA-based MRI indices, including liver volume normalized by body surface area (LV BSA), liver-to-spleen SI ratio (LSSR), MRI parameter-adjusted LSSR (aLSSR), LSSR x LV BSA, and aLSSR x LV BSA, and the indocyanine green retention rate at 15 minutes (ICG-R15), and determined the diagnostic performance of the DLA-based MRI indices to detect ICG-R15 ≥ 20%. Results: In the test dataset, the mean DSS was 0.977 for liver segmentation and 0.946 for spleen segmentation. The BlandAltman 95% LOAs were 0.08% ± 3.70% for the liver volume, 0.20% ± 7.89% for the spleen volume, -0.02% ± 1.28% for the liver SI, and -0.01% ± 1.70% for the spleen SI. Among DLA-based MRI indices, aLSSR x LV BSA showed the strongest correlation with ICG-R15 (r = -0.54, p < 0.001), with area under receiver operating characteristic curve of 0.932 (95% confidence interval, 0.895–0.959) to diagnose ICG-R15 ≥ 20%. Conclusion Our DLA can accurately measure the volume and SI of the liver and spleen and may be useful for assessing functional liver capacity using gadoxetic acid-enhanced HBP-MRI.

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

No abstract available.
Biomarkers* ; Propionibacterium acnes* ; Propionibacterium* ; Vitamin D* ; Vitamins*

BACKGROUND: The effectiveness of ultraviolet (UV) radiation, visible light, or infrared light therapy for the treatment of acne is the subject of ongoing scientific debate. OBJECTIVE: This study was conducted to investigate changes in sebum production and the expression of inflammatory cytokines, matrix metalloproteinases (MMPs), and antimicrobial peptides (AMPs), following exposure of cultured human sebocytes to UVA radiation and light at wavelengths of 650 nm and 830 nm. METHODS: Reverse transcription polymerase chain reaction assays were performed to measure the gene expression levels of inflammatory cytokines (interleukin [IL]-1beta, IL-6, IL-8, and tumor necrosis factor-alpha), MMPs (MMP-1, MMP-3, and MMP-9), and AMPs (psoriasin, hBD-2, hBD-3, and LL-37) in cultured sebocytes after exposure to UVA radiation (2 J/cm2, 3 J/cm2, and 5 J/cm2) and light at wavelengths of 650 nm (14 J/cm2, 29 J/cm2, and 87 J/cm2) and 830 nm (5 J/cm2, 10 J/cm2, and 30 J/cm2). Expression of inflammatory cytokine proteins and sebum production were measured using enzyme-linked immunoassays and a lipid analysis kit, respectively. RESULTS: Exposure of cultured sebocytes to UVA radiation and light at wavelengths of 650 nm and 830 nm did not show a significant increase in the expression of inflammatory cytokines, MMPs, or AMPs. Sebum production was not significantly decreased after exposure to UVA radiation and light at both wavelengths. CONCLUSION: We propose that UVA radiation, visible light, and infrared light can be used to target Propionibacterium acnes for the treatment of acne, without an increase in the expression of inflammatory biomarkers and sebum production.
Acne Vulgaris ; Biomarkers ; Cytokines ; Gene Expression ; Humans ; Immunoassay ; Interleukin-6 ; Interleukin-8 ; Light ; Matrix Metalloproteinases ; Necrosis ; Peptides ; Phototherapy ; Polymerase Chain Reaction ; Propionibacterium acnes ; Reverse Transcription ; Sebum*

Colonic lipomas represent mesenchymal origin tumors that are second most common benign colonic tumor after hyperplastic polyps and adenomatous polyps. The patho-genesis of them is not clear. Most patients are asymptomatic and the lesion is often detected incidentally at colonoscopy, operation, and autopsy. According to the size and the location of lipoma, it may cause intestinal obstruction, perforation, intussusception, and life-threatening bleeding. There have been many reports of small colonic lipomas removed by endoscopic resection. Giant lipoma which is greater than 2 cm in size has been associated with higher risk of perforation, thus it has been removed by surgery until now. We report a case of colonic giant lipoma inducing intussusception which could be removed by endoscopic resection.
Adenomatous Polyps ; Autopsy ; Colon* ; Colonoscopy ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Lipoma* ; Polyps

Kaposi's varricelliform eruption is a characteristic syndrome of disseminated vesiculopustules superimposed on variable pre-existing dermatoses. Among these, atopic dermatitis is most common disease. We report two cases of Kaposi's varicelliform eruption associated with atopic dermatitis in a pair of identical twins. Diagnosis was made by the history, clinical feature, histologic examination and serologic test. These patients' condition was much improved by the treatment with antiviral agent and antibiotics.
Anti-Bacterial Agents ; Dermatitis, Atopic ; Diagnosis ; Humans ; Kaposi Varicelliform Eruption* ; Serologic Tests ; Skin Diseases ; Twins, Monozygotic*

Febrile ulceronecrotic pityriasis lichenoides et varioliformis acuta (PLEVA) is a very rare cutaneous disorder clinically characterized by the acute onset of erythematous papules, vesicles and large coalescent ulceronecrotic lesions on the whole body accompanied by high fever and severe constitutional symptoms. In general, ulceronecrotic lesion is preceded by a typical rash of PLEVA. Histopathologically, it shows widespread epidermal necrosis and fibrinoid necrosis of blood vessel walls in addition to the superficial and deep perivascular lymphocytic infiltrations. Several regimens including systemic corticosteroid, antibiotics, methotrexate or ultraviolet therapy have been challenged in this disorder . We report a typical case of febrile ulceronecrotic PLEVA in a 10-year-old child who showed a dramatic response to methotrexate.
Anti-Bacterial Agents ; Blood Vessels ; Child* ; Exanthema ; Fever ; Humans ; Methotrexate ; Necrosis ; Pityriasis Lichenoides* ; Pityriasis* ; Ultraviolet Therapy

BACKGROUND: Sensitive skin has been described as a skin type showing higher reactivity than normal skin and developing exaggerated reactions when exposed to internal stimulants and external irritants. The lactic acid sting test is widely accepted as a marker of skin sensitivity and employed for the selection of subjects experiencing invisible sensory irritation. OBJECTIVE: To carry out an epidemiological study to assess the prevalence and possible related factors of sensitive skin in a regional population, and to examine the relationship between sensitive skin and subjective irritation using the lactic acid sting test. METHODS: A total of 514 people responded to self-assessment questionnaires composed of questions about the self-perception, related factors, symptoms and signs of sensitive skin. We assessed subjective irritation using the lactic acid sting test in 54 volunteers. RESULTS: The results are summarized as follows: 1. The incidences of self-reported sensitive skin were 55.7% for women, 38.9% for men and 51.0% for all responders. 2. The family history and seasonal variation of sensitive skin were significantly more common in sensitive skin group. 3. The face especially the cheek area was the most sensitive portion of body, cosmetics were common irritants. 4. The lactic acid stinging scores were significantly higher in the sensitive skin group. CONCLUSION: Our survey indicated that sensitive skin is a common problem for people and a complex problem with genetic, individual, environmental implications and the lactic acid sting test is a valuable method to define skin sensitivity.
Bites and Stings* ; Cheek ; Epidemiologic Studies ; Female ; Humans ; Incidence ; Irritants ; Lactic Acid* ; Male ; Patient Selection ; Prevalence ; Seasons ; Self Concept ; Self-Assessment ; Skin* ; Volunteers ; Surveys and Questionnaires

BACKGROUND: It is generally accepted that the most spontaneously-arising epidermal cysts might be related to follicular infundibulum and palmoplantar epidermal cyst (PPEC) has been suggested to be caused from traumatic implantation of epidermal fragments. In addition there were several recent reports of human papillomavirus (HPV) implicating in formation of PPEC and also similar reports in Korean dermatologic literature. But the latter failed to reveal the presence of HPV in PPEC or a specific type of HPV by molecular biologic methods. OBJECTIVE: We tried to identify the presence of HPV and its subtype in PPEC. METHODS: After reviewing routine histopathologic findings recalling HPV infection in 8 PPECS, we undertook immunohistochemistry using polyclonal HPV antibody and polymerase chain reactions with 3 sets of HPV primers. To confirm the actual location of HPV in cyst in situ hybridization with HPV 60 probe was also done. RESULTS: All cases showed more than one feature of HPV infection. The positive reactions were 3 out of 8 on immunohistochemistry and 5 out of 8 on polymerase chain reaction. All cases (4 of 4) were positive on in situ hybridization and they were found in the horny layer and/or wall of cysts. CONCLUSION: PPEC in Korea may show similar typical histopathologic features with those reported in Japan. The HPV were detected in almost PPEC by molecular methods and their subtype was all HPV 60.
Epidermal Cyst* ; Gammapapillomavirus* ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Japan ; Korea ; Polymerase Chain Reaction

PURPOSE: Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of all cases of childhood leukemia. We investigated epidemiology, clinical and laboratory features and treatment outcome of the children with ALL in Korea during recent 5 years. METHODS: One thousand forty nine patients were enrolled between January 1994 and December 1998 from 37 major hospitals in Korea. The data regarding the clinical and laboratory features including age, WBC counts at diagnosis, immunophenotype, morphology, cytogenetics and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed. The differences between groups analyzed by log-rank test. RESULTS: There were 597 males and 452 females. The distribution between the age 2 and 5 years is most common in 46.1%. The annual incidence rate per 100,000 population varied from 1.6 to 2.2. The 5 year event free survival (EFS) rates according to good prognostic factors were as follows: 67% bet ween 1-9 year of age at diagnosis, 69% in under 10,000/mm3of initial WBC count, 74% in early pre-B cell CALLA ( ) immunophenotype, 65% in L3 morphology, 68% in no CNS invasion. Most of patients were treated by CCG treatment protocol. The 5 year EFS was 63%. Main complications were sepsis (21.8%) and hemorrhage (12.5%). The relapse rate was 15.6%. The common causes of death were sepsis, DIC, pneumonia, relapse. CONCLUSION: Our results could provide the most recent and important information about acute lymphoblastic leukemia of children in Korea.
Cause of Death ; Child ; Clinical Protocols ; Cytogenetics ; Dacarbazine ; Diagnosis ; Disease-Free Survival ; Epidemiology* ; Female ; Hemorrhage ; Humans ; Incidence ; Kaplan-Meier Estimate ; Korea* ; Leukemia ; Male ; Medical Records ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Precursor Cells, B-Lymphoid ; Recurrence ; Retrospective Studies ; Sepsis ; Treatment Outcome