• Title/Summary/Keyword: Cutaneous

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A clinical analysis of juvenile dermatomyositis; focus on clinical manifestations at diagnosis (소아기 피부근염의 임상적 고찰; 진단시 임상증상을 중심으로 한 고찰)

  • Lee, So Young;Bang, Ji Seok;Kim, Hee Seok;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1116-1124
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    • 2007
  • Purpose : Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. Methods : Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. Results : Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. Conclusion : This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.

Forsythiae Fructus Induces VEGF Production via p38 MAPK Activation in Human Keratinocytes (각질형성세포에서 p38 MAPK 활성을 통한 연교의 VEGF 생성 효과)

  • Kim, Mi-Sun;Choi, Yun Ho;Park, Sun Gyoo;Lee, Cheon Koo;Lee, Sang Hwa
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.4
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    • pp.329-336
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    • 2016
  • Cutaneous microvasculature plays a critical role in age-associated skin changes. A considerable reduction of number and size of vessels has been observed in the upper dermis of elderly skin. Forsythiae fructus (FF), the dried fruit of plant Forsythia suspensa (F. suspensa), has been traditionally used as an herbal medicine to treat inflammatory diseases and bacterial diseases. However, its regulatory effect on angiogenic responses has not been elucidated in skin. Therefore, we analyzed secretory profiles upon treatment of FF extract using array designed to detect angiogenesis-associated mediators in human keratinocytes. Because keratinocyte-derived VEGF (vascular endothelial growth factor) has been regarded as a potent factor for new microvasculature under the epidermis, we further investigated the effect of FF extract on VEGF production. We observed that the VEGF expression of mRNA and protein level was increased by about 2 folds in a dose-dependent manner after FF extract treatment. In signaling experiments, FF extract induced rapid p38 MAPK activation within 5 min, and the activation was totally abrogated by pretreatment with a p38 MAPK specific inhibitor. The FF-induced VEGF upregulation was also significantly attenuated by a p38 MAPK inhibition. Taken together, FF extract induces VEGF production via p38 MAPK activation in human epidermal keratinocytes. These novel findings suggest that FF is useful as a potential agent with pro-angiogenic activity and may help to improve age-dependent reduction of the microvasculature in aged skin or to heal skin wound.

Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

Effects of Low-power Laser and TDP on the Cutaneous Wound Healing (피부상처 치유에 대한 저에너지레이저와 특정전자파의 효과)

  • Ahn So-Youn;Park Sang-Ock
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.1-18
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    • 1997
  • The purpose of this study is to investigate the effects of the low power Helium Neon-Infra Red(HeNe-IR) laser and the special electromagnetic therapeutic apparatus stimulation, which is usually designated as TDP by using the initial of Tending Diancibo Pu which is the Chinese inscribed with English, on wound healing in rat. The seventy-five Sprague-Dawley adult female and male rats were assigned to the experimental and control groups. Each rat was anesthetized with pentobarbital sodium, and three full-thickness incisions with 12mm length wert made on the back of the half cf the rats and three deep second degree burns were made on the back of the remainder of the rats. From 34 hours after being injured, the rats of the experimental laser group were irradiated with the 157mW electric power HeNe-IR laser for 2 minutes every day and the rats of the experimental TDP group were stimulated with TDP irradiation with the 4km spot distance for 20 minutes every day during the 17 days. The rats were sacrificed and the wound parts of its were incised on the first day, 4th day, 7th day, 10th day and 17th day respectively after the beginning of wound treatment with laser and TDP irradiation. The incised wound parts were processed appropriately for the light microscopic and electron microscopic examination. The length of incised wound was measured with microcaliper before the wound part was incised. There was a significant decrease in the length of the incised wound of the experimental laser and TDP group, compared with that of control group at 4th day, 7th day and 10th day(p<0.01) after surgery. Through the histological examination of the wound site, the more rapid epithelialization and collagen formation in experimental groups were showed, compared with control group. The histological results were analyzed and summarized as the follows; The epidermis begins to be regenerated and the granulation tissue begins to be changed to the mature pattern in the H-E stained incised skin of the laser and TDP treatment group on the 4th day. The epidermis shows the complete regeneration and the granulation tissue in the dermis in mostly to be matured in the laser and TDP treatment group on the 7th day, compared with control group. The chronic inflammatory cells are oberved and the necrosis of the collagen fibers are partially observed in control group on the 10th day. The dermis of the laser and TOP treatment group reveals relatively compactly arranged collgen bundles with the mature collagen fibers on the 10th day. The epidermis and dennis of the laser and TDP group are repaired normally and the hair follicles are well regenerated on the 17th day. The mild edema and the granulation tissue is observed in the dermis of the control groups and the delayed treatment process is observed on the 17th day. The Most of proliferated collagen fibrils are found to be compact and regular in electron micrograph of burn skin of the laser treatment group on the 10th day hut the interstitial eadema and some inflammatory cells are found in the control group. The above results suggest that through the visual and histological examination the epithelized epithelium and the proliferation of the collagen liters in the dermis occur very effectively with the low power laser treatment and the TDP treatment in the incised wound healing and the burn wound healing.

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Outcome of pregnant mothers with systemic lupus erythematosus (focusing on congenital heart block) (전신성 홍반성 루푸스 산모의 출산아의 임상적 고찰 (완전 방실 블록을 중심으로))

  • Baek, Hey Sung;Choi, Jae Hyung;Kim, Nam Su;Kim, Chang Ryul;Moon, Su Ji
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.381-387
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    • 2006
  • Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Prognostic Significance of Angiogenesis in Non-Small Cell Lung Cancer (원발성 비소세포 폐암에 있어서 미세혈판 신생의 임상적 예후인자로서의 의의)

  • Ko, Hyeck-Jae;Park, Jeong-Hyun;Kuk, Hiang;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.757-765
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    • 2000
  • Background : Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count as a measure of tumor angiogenesis, has been significantly correlated with invasive and metastatic patterns in breast. prostate and cutaneous carcinomas. Materials and Methods : Fifty patients with curatively resected non-small cell lung cancer were evaluated. Tumor tissues embedded in paraffin block were stained by anti CD 31 (PECAM, platelet endothelial cellular adhesion molecule) using immunohistochemical method to assess microvessel count. Microvessels were counted in the most active areas of neovascularization(microscopy, 200$\times$). Results: 1) Mean microvessel count was 47.1$\pm$17.7(per 200$\times$field) in total 50 cases. 2) Mean microvessel count of adenocarcinoma (54.4$\pm$19.9) was significantly higher than that of squamous cancer (43.9$\pm$16.2) (p<0.05), but there were no relationship between microvessel count and TNM stages. 3) Median survival time, 2-year and 5-year survival rates of the low microvascular group (microvessel count<45, 22 cases) were 61 months, 80% and 40%, respectively, and those of the high microvascular group(microvessel count$\geq$45, 28 cases) were 46 months, 75% and 12%, respectively. As results, prognosis of low microvascular group is statistically significantly superior to that of the high microvascular group (p=0.0162, Kaplan-Meier, log-rank). Conclusion : Angiogenesis assessed by microvessel count can be used as one of the significant prognostic factors in non-small cell lung cancer.

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A Clinical Study of Childhood Henoch-Schönlein Purpura (Henoch-Schönlein 자반증 환아의 임상적 고찰)

  • Ha, Tae-Sun;Koo, Hyun-Hoe
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1118-1123
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    • 2003
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous purpura, abdominal pain, arthralgia and renal involvement. The clinical features of HSP have been reasonably well documented but there are still many gaps in our understanding of HSP. The aim of this study was to present the clinical features of 125 children with HSP and compare them with previous reports, placing particular emphasis on clinical information. Methods : We collected the clinical data of 125 patients with acute HSP who visited Chungbuk National University Hospital from March 1992 to April 2002. Data were expressed as the mean or $mean{\pm}SD$ and statistical analysis was performed using Chi-square approximation. P<0.05 was considered as significant. Results : The patient population consisted of 87 boys and 38 girls ranging in age from one to 14 years. HSP occurs throughout the year, but this study shows seasonal skewing, with most patients presenting from fall through spring and a paucity of cases in summer. All patients had non-thrombocytopenic purpura concentrated on the buttocks and lower extremities. Purpuric lesions were also scattered on the arms and occaisionally on the face and ears, but the trunk was largely spared. A recurrence of purpura was defined as the reappearance of a rash or other symptoms following resolution of disease for at least two weeks. The mean number of recurrences was 0.51. Eighty eight patients(70.4%), 18 patients(14.4%) and 67 patients(53.6%) complained of abdomianl pain, gastrointestinal bleeding and arthralgia, respectively. Nephritis occurred in 48(38.4%) patients. Fifteen boys (17.2%) developed epididymitis. Neurologic features occurred in 13(10.4%) and two(15%) of these were seizures. Conclusion : HSP all showing purpura as defined is characterized by various clinical features, including abdominal pain, arthralgia, epididymitis and nephritis which could occur before the appearance of purpura. Therefore, we suggest that the possibility of HSP should be considered in children before invasive procedures, even if the above symptoms and signs present without purpura.

Endoscopic Radial Artery Harvest: Techniques & Results (내시경을 이용한 요골동맥 수확법의 수술 방법과 결과)

  • Jeong, Young-Kyun;Lee, Jong-Tae;Cho, Jun-Yong;Kim, Kyu-Tae;Chang, Bong-Hyun
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.35-41
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    • 2006
  • Background: The radial arteries are being used more often for coronary artery bypass grafting, We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. Material and Method: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. Result: The 23 patients complained of neuralgias on territory of superficial raidal none but no one complained of neuralgias on territory of lateral antebrachial cutaneous none. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9$\pm$3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. Conclusion: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

Retrospective Investigation of Canine Skin and Mammary Tumors in Korea (한국에서 개 유선종양과 피부종양의 발생현황)

  • Kim, Yeong-Hun;Ahn, Na-Kyoung;Roh, In-Soon;Yoon, Byung-Il;Han, Jeong-Hee
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.556-562
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    • 2009
  • Skin tumors and mammary gland tumors have been shown to be the most common neoplasia in most of the strains of dogs. The risk for tumor development increases significantly with age and the prevalence and distribution are various according to individual tumors. The aim of this study is to classify histopathologically the skin and mammary gland tumors for recent two years, 2005 and 2006. A total of 128 skin and 240 mammary gland samples of dogs were selected that were submitted to National Veterinary Research and Quarantine Service and Kangwon National University from January 1, 2005 to December 31, 2006. The excised tissue were fixed in 10 percent neutral buffered formalin and processed routinely to paraffin wax. Sections were cut at $3{\mu}m$, stained with haematoxylin and eosin. The slides were examined based on the morphological criteria of M. H. Goldschmidt and W. Misdorp under a light microscope. The age of the dogs ranged from 1 to 19 years with a median of 8.7 years. The mean age of the skin and mammary gland tumors was 7.4 and 9.3 years. 47 (12.8%) were males and 259 (70.4%) were female with a male to female ratio of 0.18. Yorkshire terrier and maltese were more susceptible breeds, accounting for 44.3% of skin and mammary gland tumors. In skin tumors, epithelial, adnexal, and mesenchymal origin tumors were 18 (14.1%), 53 (41.4%), and 57 cases (44.5%), repectively. Among the epithelial, adenexal, and mesenchymal origin tumors, basal cell tumor (8.6%), sebaceous adenoma (15.6%), and histiocytoma (25.0%) were predominant in the incidence rate, respectively. In case of mammary gland tumors, 201 (83.8%) were benign and 39 (16.3%) were malignant with a benign to malignant ratio of 5.15. The most frequent mammary gland tumor was benign mixed tumor (35.0%) followed by mammary adenoma-complex type (31.7%).

The Review of Environment, Food and Exercise on Allergy Anaphylaxis (환경, 음식 및 운동 알레르기 반응에 대한 고찰)

  • Kwak, Yi-Sub;Baek, Young-Ho;Kim, Seung-Hyun;Kim, Young-Il;Yoo, Byung-In
    • Journal of Life Science
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    • v.20 no.1
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    • pp.147-152
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    • 2010
  • Exercise-induced anaphylaxis (EIA) is a physical allergy, sometimes severe, triggered by exertion following specific food intake. It was defined for the first time in 1980. EIA is associated with different kinds of exercise. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the findings of an elevated serum histamine level during exhaustive exercise. As predisposing factors of EIA, a specific or even nonspecific sensitivity to food has been reported. Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise which was preceded by the ingestion of the causal food allergens. The diagnosis of FDEIA is heavily dependent on clinical history. Allergy tests may need to be performed using a broad panel of food and food additives. As with food allergies, FDEIA diagnosis is based on interview, biological test and skin test. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episodes. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise. Two cases of EIA are presented (EIA to circumstances; FDEIA) in this paper, The diagnosis, pathophysiology and therapy of FDEIA are also reviewed.