Objective: To validate the performance of 3T spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) for staging hepatic fibrosis in a large population, using surgical specimens as the reference standard. Materials and Methods: This retrospective study initially included 310 adults (155 undergoing hepatic resection and 155 undergoing donor hepatectomy) with histopathologic results from surgical liver specimens. They underwent 3T SE-EPI MRE ≤ 3 months prior to surgery. Demographic findings, underlying liver disease, and hepatic fibrosis pathologic stage according to METAVIR were recorded. Liver stiffness (LS) was measured by two radiologists, and inter-reader reproducibility was evaluated using the intraclass correlation coefficient (ICC). The mean LS of each fibrosis stage (F0–F4) was calculated in total and for each etiologic subgroup. Comparisons among subgroups were performed using the Kruskal–Wallis test and Conover post-hoc test. The cutoff values for fibrosis staging were estimated using receiver operating characteristic (ROC) curve analysis. Results: Inter-reader reproducibility was excellent (ICC, 0.98; 95% confidence interval, 0.97–0.99). The mean LS values were 1.91, 2.41, 3.24, and 5.41 kPa in F0–F1 (n = 171), F2 (n = 26), F3 (n = 38), and F4 (n = 72), respectively. The discriminating cutoff values for diagnosing ≥ F2, ≥ F3, and F4 were 2.18, 2.71, and 3.15 kPa, respectively, with the ROC curve areas of 0.97–0.98 (sensitivity 91.2%–95.9%, specificity 90.7%–99.0%). The mean LS was significantly higher in patients with cirrhosis (F4) of nonviral causes, such as primary biliary cirrhosis (9.56 kPa) and alcoholic liver disease (7.17 kPa) than in those with hepatitis B or C cirrhosis (4.28 and 4.92 kPa, respectively). There were no statistically significant differences in LS among the different etiologic subgroups in the F0–F3 stages. Conclusion The 3T SE-EPI MRE demonstrated high interobserver reproducibility, and our criteria for staging hepatic fibrosis showed high diagnostic performance. LS was significantly higher in patients with non-viral cirrhosis than in those with viral cirrhosis.

PURPOSE: We report a case of asymptomatic unexplained visual field loss diagnosed as early retinitis pigmentosa (RP) without pigmentation. CASE SUMMARY: A 33-year-old woman was referred to us with a constricted visual field (C24-2) before laser-assisted in-situ keratomileusis surgery. The visual field test (C30-2) revealed significantly decreased sensitivity between 15 to 25 degrees in both eyes. Close fundus examination revealed a subtle greyish retinal atrophic lesion along the vascular arcade and fluorescein angiography revealed a window defect in accordance with a retinal atrophic lesion in both eyes. Optical coherence tomography showed decreased retinal thickness around the macula. Electroretinogram revealed decreased b waves in rod response. Based on these findings, we diagnosed the patient with early RP without pigmentation. CONCLUSIONS: The possibility of early RP without pigmentation presenting as slight atrophy around the macula without significant pigmental degeneration should also be considered if a patient presents with peripheral visual field constriction without other symptoms. The ophthalmologist should ensure that the location of the visual field defect matches the location of the lesion. In addition, a detailed fundus examination with macular optical coherence tomography can be helpful to diagnose such a lesion.
Adult ; Atrophy ; Constriction ; Female ; Fluorescein Angiography ; Humans ; Pigmentation* ; Retinaldehyde ; Retinitis Pigmentosa* ; Retinitis* ; Tomography, Optical Coherence ; Visual Field Tests ; Visual Fields*

Imatinib mesylate (Gleevec(R)) is a small-molecule inhibitor that selectively inhibits the tyrosine kinase family, including mutated KIT oncoproteins in gastrointestinal stromal tumors (GIST). However, cutaneous reactions to imatinib are common and occur in 7.0% to 88.9% of patients. Nonspecific skin rashes, facial edema, and pruritus are the most common adverse reactions. However, development of psoriasiform drug eruption owing to the drug has rarely been reported. Herein we report on a 66-year-old male patient with GIST who had taken imatinib (400 mg/day) for 2 months. He developed erythematous scaly macules and papules on the trunk and extremities. Histopathological findings were compatible with a psoriasiform drug eruption.
Aged ; Drug Eruptions* ; Edema ; Exanthema ; Extremities ; Gastrointestinal Stromal Tumors* ; Humans ; Male ; Mesylates ; Oncogene Proteins ; Protein-Tyrosine Kinases ; Pruritus ; Psoriasis ; Imatinib Mesylate

PURPOSE: To investigate the effects of the intake of xylooligosaccharide-sugar mixture (XOS) on defecation frequency and symptoms in 56 young women (mean age of 22.1 years old) with constipation. METHODS: Two experiments were conducted. In experiment 1, a randomized double-blind study was performed to evaluate the effect of 6 weeks' intake of 10 g sucrose containing 7% xylooligosaccharide or 10 g sucrose on constipation. In experiment 2, 24 g coffee mixture containing 12.8 g plant cream and 11.2 g xylooligosaccharide-sugar mixture was consumed by the subjects. During the study, the clinical efficacy was assessed by using a daily diary. The subjects indicated the number of frequencies they defecated in a day and the clinical symptom scores. RESULTS: In experiment 1, the mean frequency of defecations was 2.07 in the pretreatment week and increased significantly to 4.05, 4.42, 4.84, 4.84, and 4.05 in weeks 2 to 6 of XOS intake, in comparison with the 3-3.67 with sucrose intake (sucrose, SUC). In experiment 2, the mean frequency of defecations significantly increased from 2.47 in the pretreatment week to 4.11-5.67 in weeks 1-6 of XOS intake. The occurrence of very loose or loose stools in the XOS group was significantly increased in weeks 5 and 6, compared with the pretreatment week and SUC group. XOS intake significantly alleviated the abdominal displeasure and feeling of residual stool leftness in weeks 2, 3, 5, and 6, while SUC did so in weeks 4 and 6 (p < 0.05). The coffee mixture containing xylooligosaccharide-sugar mixture reduced the abdominal displeasure and feeling of residual stool leftness from week 3 until the end of the experiment (p < 0.05). CONCLUSION: Our results suggest that xylooligosaccharide-sugar mixture intake was effective, without adverse effects, for the alleviation of constipation in the young women in this study.
Coffee ; Constipation* ; Defecation* ; Double-Blind Method ; Female ; Humans ; Plants ; Sucrose

PURPOSE: The objective of this study was to investigate the effects of xyloologosaccharide (XOS)-sugar mixture on glycemic index (GI) and blood glucose in human subjects. METHODS: Randomized double-blind cross-over studies were conducted to examine the effect of sucrose with 14% xyloologosaccharide powder (Xylo 14) and sucrose with 20% xylooligosaccharide powder (Xylo 20) on GI and postprandial glucose response at 15, 30, 45, 60, 90, and 120 min. RESULTS: GIs of Xylo 14 and Xylo 20 were 60.0 +/- 23.5 classified within medium GI range, and 54.3 +/- 17.7 within low GI range, respectively. Xylo 14 and Xylo 20 showed significantly lower area under the glucose curve (AUC) for 0-15 min (p = 0.0113), 0-30 min (p = 0.0004), 0-45 min (p < 0.0001), 0-60 min (p < 0.0001), 0-90 min (p < 0.0001), and 0-120 min (p = 0.0001). In particular, compared with glucose, the blood glucose levels of Xylo 14 and Xylo 20 were significantly lower at every time point between 15 and 120 min. CONCLUSION: The results of this study suggested that Xylo 14 and Xylo 20 had an acute suppressive effect on GI and the postprandial glucose surge.
Adult* ; Blood Glucose* ; Cross-Over Studies ; Glucose ; Glycemic Index* ; Humans ; Sucrose

Fixed drug eruption is a pattern of a drug-induced cutaneous reaction. It is characterized by skin erythematous plaques that recur at the same site each time the drug is administered. Now, we report the case of a 26-year-old woman who presented with 2 ill-defined erythematous patches on her back with itching sensation. The patient had a history of ciprofloxacin medication. The patch test with suspected drugs showed negative reactions, but intradermal tests were positive reactions. The patient was diagnosed with fixed-drug eruption due to ciprofloxacin.
Ciprofloxacin ; Drug Eruptions ; Female ; Humans ; Intradermal Tests ; Patch Tests ; Pruritus ; Sensation ; Skin

Panniculitis is a rare cutaneous finding in dermatomyositis (DM), presenting as tender subcutaneous nodules. Because panniculitis may precede other symptoms of DM, and its complications, including pain, lipoatrophy and carcinosis, might be severe and irreversible, early diagnosis and treatment of panniculitis is important. We herein describe a case of dermatomyositis first presenting as panniculitis in a 45-year old man.
Dermatomyositis ; Early Diagnosis ; Panniculitis

Granular parakeratosis is a recently recognized disorder of keratinization that is usually confined to intertriginous areas. The histopathologic features are distinctive and diagnostic. Rarely, histopathologic variants such as follicular granular parakeratosis and granular parakeratosis of eccrine ostia have been described. In this report, we describe a rare case of granular parakeratosis mostly confined to eccrine ostia.
Eccrine Glands ; Keratins ; Neck ; Parakeratosis

BACKGROUND: Dermatofibroma (DF) is one of the most common benign soft tissue tumors, and its diagnosis is not difficult if clinicopathologic features are typical. However, DF occurring on the face is very rare; therefore, it is usually missed clinically. OBJECTIVE: This study was conducted to obtain better understanding of the clinicopathologic features of dermatofibroma of the face. METHODS: This is a retrospective study of fibrous histiocytoma of the face at our center over a 23-year period (1989~2011). Clinicopathologic features of 13 patients were evaluated. RESULTS: Of the 13 patients, ten were female and three were male. The neoplasms presented with various and atypical features, such as nodule, ulceration and papules. Low-power examination revealed that most of the cases were extended beyond the subcutaneous fat layer, showing ill-defined diffuse infiltrative pattern. The most common histologic type was typical fibrocollagenous type, but some cases presented features of cellular or angiomatous type. Mitotic activity was not definite in majority of cases, and usually ranged 0~1 mitoses per 10 HPF and a few atypical cells were shown in 2 cases, but not accompanied by recurrence. Tumor cells in all cases tested were negative for desmin and CD34, but positive for Factor XIIIa and CD68 in majority of the cases. CONCLUSION: Because of its rare development on face and diverse clinical presentation, correct diagnosis with differential diagnosis is thought to be important. DF of the face usually presents with infiltration of deeper structures and still shows a benign behavior.
Desmin ; Diagnosis, Differential ; Factor XIIIa ; Female ; Histiocytoma, Benign Fibrous ; Humans ; Male ; Mitosis ; Recurrence ; Retrospective Studies ; Subcutaneous Fat ; Ulcer