Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Syringocystadenocarcinoma papilliferum in situ is extremely rare. A 51-year-old female presented with a solitary yellowish patch on the scalp, accompanied by hair loss and a protruding mass. Histopathological evaluation revealed a large number of sebaceous glands and mild papillomatosis without hair follicles. The tumor contained many cystic spaces filled with amorphous material and a connection to the epidermis. The tumor cells showed papillomatous projections and were multilayered with nuclear atypia but no dermal involvement or lymphovascular invasion. On immunohistochemical analysis, the tumor cells showed immunopositivity for carcinoembryonic antigen, Ki-67, epithelial membrane antigen, and gross cystic disease fluid protein-15. Therefore, the patient was diagnosed with syringocystadenocarcinoma papilliferum in situ originating from a nevus sebaceus. The tumor was removed by wide excision, and no recurrence was observed. Our case report supports the multistep pathogenesis of syringocystadenocarcinoma papilliferum originating from a nevus sebaceus.

Syringocystadenocarcinoma papilliferum in situ is extremely rare. A 51-year-old female presented with a solitary yellowish patch on the scalp, accompanied by hair loss and a protruding mass. Histopathological evaluation revealed a large number of sebaceous glands and mild papillomatosis without hair follicles. The tumor contained many cystic spaces filled with amorphous material and a connection to the epidermis. The tumor cells showed papillomatous projections and were multilayered with nuclear atypia but no dermal involvement or lymphovascular invasion. On immunohistochemical analysis, the tumor cells showed immunopositivity for carcinoembryonic antigen, Ki-67, epithelial membrane antigen, and gross cystic disease fluid protein-15. Therefore, the patient was diagnosed with syringocystadenocarcinoma papilliferum in situ originating from a nevus sebaceus. The tumor was removed by wide excision, and no recurrence was observed. Our case report supports the multistep pathogenesis of syringocystadenocarcinoma papilliferum originating from a nevus sebaceus.

Femoral head fractures combined with hip dislocation are very rare injuries. In most cases, they result from high-energy trauma to the hip or lower extremity during traffic accidents. Various therapy options have been suggested to treat these injuries. Especially, different joint-preserving surgical options have been described for the treatment of traumatic osteochondral injury of the femoral head in young, active patients. In this report, we present a case that a traumatic osteochondral lesion to the femoral head after hip dislocation was treated with osteochondral autografts (OATS) from the non-weight-bearing area of the ipsilateral inferior femoral head through a surgical hip dislocation. After 1 year, the clinical and radiological outcome was satisfactory with no evidence of posttraumatic osteoarthritis and no pain of patients.

No abstract available.
Agaricales ; Dermatitis

Although hair loss in Cronkhite-Canada syndrome (CCS) developed frequently, its exact mechanism has not been elucidated. Thus, we attempted to investigate the histopathologic features of hair loss with scalp biopsy in one case of CSS. The patient complained of persistent diarrhea and diffuse hair loss of the scalp 1 month prior to the hospital visit. CCS has been already diagnosed through colonoscopy and medical examination. Scalp biopsy was performed to evaluate hair loss of the patient, and pathologic examination showed increased telogen hairs (anagen to telogen is 7:8) without specific dermal inflammation and miniaturization of hair follicles. The patient was treated with topical and systemic steroids, and hair loss has almost completely recovered in 5 months. In this case, we investigated the clinical and pathological features of hair loss through scalp biopsy in one case of CCS and reported them with a review of the literature.
Alopecia ; Biopsy ; Colonoscopy ; Diarrhea ; Hair ; Hair Follicle ; Humans ; Inflammation ; Intestinal Polyposis ; Miniaturization ; Scalp ; Steroids

A Spitz nevus is an uncommon benign tumor that often occurs in children. Angiomatoid Spitz nevus is a rare and distinct variant of the Spitz nevus that exhibits a spindle and/or epithelioid nevus between angioma-like, densely arranged small blood vessels. We present a case of angiomatoid Spitz nevus with high cellularity and lymphovascular tumor emboli-like features. In our case, tumor cells with high cellularity were observed throughout the lesion, and lymphovascular tumor emboli-like nests were present.