• Archives of Plastic Surgery
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• v.38 no.2
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• pp.194-198
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• 2011

Purpose: Heterotopic calcification is the abnormal deposition of calcium salts in tissues other than bone and enamel, and it occurs in the form of dystrophic calcification or metastatic calcification. This deposition can occur under many conditions, but in some rare cases, it may develop in burns and nonhealed scars. It is difficult to treat the combination of heterotopic calcification and ulceration in scar tissues by using conservative therapy and to determine the margin of excision in such cases. Our study proposes the use of intraoperative C-arm-guided mapping of lesions with heterotopic calcification, and adequate excision of ulcers in chronic scars where heterotopic calcification is also observed. Methods: This study included 2 patients and was conducted from January 2010 to July 2010. The first patient was a 63-year-old woman who presented with atypical calcium deposits and chronic ulceration in the lower one-third region of the right leg. The second patient was a 38-year-old man who presented with a nonhealing ulcer that had developed on the right leg 3 months earlier he had a history of 40% scalding burns on the entire body. Surgery is the most reliable method for treating heterotopic calcification therefore, both patients were treated using intraoperative C-arm-guided marginal mapping of heterotopic calcification, followed by release of contracture, and eventually split-thickness skin grafting. Results: Plain radiographs of the leg showed spotty radiopaque areas in the hard part of the scar well superficial to the underlying bones. Histopathological analysis revealed multiple foci of calcified deposits, increased fibrosis, and inflammation in the scar tissue. Surgery-related complications were not observed. Conclusion: C-arm guided excision of calcified scars and the release of contracture can cure nonhealing ulcers and may therefore prevent recalcification.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.414-418
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• 2009

Pemphigus vulgaris is a chronic autoimmune intraepithelial blistering disease with oral mucosal manifestations that very often precede the skin lesions. The vesicles or bullae are produced by an acantholytic process, detachment of differentiating keratinocytes from one another in the epithelial stratum spino sum or spinous cell layer. The pathogenesis of this disease is initially manifested by IgG(mainly) binding to desmosome(desmoglein 3 or 1) in the intercellular spaces of epithelium. This autoantibody binding caused the release of a plasminogen activator(a proteolytic enzyme) from keratinocytes. This ultimately results in cell to cell separation. The mainstay therapy of pemphigus vulgaris is systemic corticosteroids and immunosuppressive agents to eliminate the pathogenic autoantibodies from circulation. A 41-year old woman presented with a 1.5 year history of oral ulceration. There were no lesions on the skin or other mucosal sites. Histology and immunostaining were consistent with pemphigus vulgaris. Control of oral ulceration and normal oral function were achieved after systemic corticosteroids and immunosuppressive agents were instituted.

• Journal of Microbiology and Biotechnology
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• v.26 no.8
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• pp.1392-1397
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• 2016

Curcumin is a polyphenol derived from the plant Curcuma longa, which is used for the treatment of diseases associated with oxidative stress and inflammation. The present study was undertaken to determine the protective effect of curcumin against naproxen-induced gastric antral ulcerations in rats. Different doses (10, 50, and 100 mg/kg) of curcumin or vehicle (curcumin, 0 mg/kg) were pretreated for 3 days by oral gavage, and then gastric mucosal lesions were caused by 80 mg/kg naproxen applied for 3 days. Curcumin significantly inhibited the naproxen-induced gastric antral ulcer area and lipid peroxidation in a dose-dependent manner. In addition, curcumin markedly increased activities of radical scavenging enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase in a dose-dependent manner. Specifically, 100 mg/kg curcumin completely protected the gastric mucosa against the loss in the enzyme, resulting in a drastic increase of activities of radical scavenging enzymes up to more than the level of untreated normal rats. Histological examination obviously showed that curcumin prevents naproxen-induced gastric antral ulceration as a result of direct protection of the gastric mucosa. These results suggest that curcumin blocks naproxen-induced gastric antral ulcerations through prevention of lipid peroxidation and activation of radical scavenging enzymes, and it may offer a potential remedy of gastric antral ulcerations.

• Korean Journal of Veterinary Research
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• v.44 no.4
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• pp.607-613
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• 2004

Helicobacter pylori (H. pylori)-infection is an important pathogen of stomach cancer after chronic gastritis and ulceration in the stomach and duodenum. However, the virulences of H. pylori strains have not been well-defined between clinical isolates. This study was designed to establish water-immersion-restraint stress (WIRS) model in mongolian gerbil for comparison of pathogenicity of H. pylori strains. To determine an optimal duration time for WIRS model in gerbil, 5-week-old Mongolian gerbils were divided into different groups by WIRS duration time. After graded duration of WIRS, the macroscopic ulcer index (UI) was measured with the stomach and duodenum of sacrificed animal. There were no significant differences between male and female in same duration group. However, the UI increased significantly in a time-dependent fashion. The group of 6 hours-WIRS animals showed severe hemorrhage and ulceration in their stomach and duodenum. On the other hand, the very mild lesions induced in 2 hours-treated animals. Therefore, we determined an optimal duration time for WIRS model in gerbil as 4 hours. Thereafter, we evaluated whether this WIRS model in gerbil could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains by enhancement of pathological severity in H. pylori-infected gerbils. Mongolian gerbils were divided into H. pyloriinfected and PBS-inoculated groups. Thereafter, they were divided again into 4 hours-WIRS and no WIRS subgroups. After treatment, the severity of pathological changes was evaluated in a same manner with previous duration-determining experiment. When the animals were exposed to WIRS, the UI was significantly higher in the infected group than in the uninfected group. These results suggested that the established gerbil-WIRS model in this study enhanced effectively the severity of pathogenic changes in the H. pylori-infected Mongolian gerbils and could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains.

• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.280-293
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• 2021

Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ² = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

• Journal of Gastric Cancer
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• v.23 no.1
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• pp.146-158
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• 2023

Endoscopic resection (ER) is widely performed for early gastric cancer (EGC) with a negligible risk of lymph node metastasis (LNM) in Eastern Asian countries. In particular, endoscopic submucosal dissection (ESD) leads to a high en bloc resection rate, enabling accurate pathological evaluation. As undifferentiated EGC (UD-EGC) is known to result in a higher incidence of LNM and infiltrative growth than differentiated EGC (D-EGC), the indications for ER are limited compared with those for D-EGC. Previously, clinical staging as intramucosal UD-EGC ≤2 cm, without ulceration, was presented as 'weakly recommended' or 'expanded indications' for ER in the guidelines of the United States, Europe, Korea, and Japan. Based on promising long-term outcomes from a prospective multicenter study by the Japan Clinical Oncology Group (JCOG) 1009/1010, the status of this indication has expanded and is now considered 'absolute indications' in the latest Japanese guidelines published in 2021. In this study, which comprised 275 patients with UD-EGC (cT1a, ≤2 cm, without ulceration) treated with ESD, the 5-year overall survival (OS) was 99.3% (95% confidence interval, 97.1%-99.8%), which was higher than the threshold 5-year OS (89.9%). Currently, the levels of evidence grades and recommendations for ER of UD-EGC differ among Japan, Korea, and Western countries. Therefore, a further discussion is warranted to generalize the indications for ER of UD-EGC in countries besides Japan.

• Food Science of Animal Resources
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• v.42 no.2
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• pp.313-320
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• 2022

Brazil is considered as a great broiler feet exporter, especially for the Chinese trade. Contact lesions at the tibiotarsal region are responsible for economic losses and there is no model for its classification, thereby this study presents a fast and practical grade system to be used in the poultry industry and proposes these lesion characterizations into three different grades. For this, correlation was made between macroscopic, histological findings and microbiological quantification (Escherichia coli, Staphylococcus spp., Streptococcus spp. and sulphite-reducing clostridia) from contact lesions in the tibiotarsal region of 112 broiler carcasses, divided in four groups (n=28), accordingly to the lesion's intensity. There were no significant differences in microbiological quantification among the groups (p>0.05) except for the grade 3 group, as grade 1 and 2 lesions were in the early stages and histopathological changes such as ulceration were not observed. In grade 3 lesion group, it was observed bacterial cocci grume and ulceration at the articular region and significantly higher microbiological count (p<0.05) for E. coli and Staphylococcus spp. In conclusion, the visual standard proposed in this work, correlated and confirmed by the histopathologic, and microbiologic characterization, allows to precise and fast ascertainment of the contact lesion grade in the tibiotarsal regions of broiler carcasses. Moreover, it should be highlighted that grades 1 and 2 alterations are not caused by an inflammatory process caused by pathogenic agents and should not be considered a public health risk.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.62-70
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• 2024

Purpose: Choledochal cysts are congenital anomalies that occur as localized cystic or fusiform dilatations of the biliary tree. Reflux and stasis of pancreatic enzymes in the biliary duct may relate to the development of intestinal metaplasia which might be an important factor related to the carcinogenesis of choledochal cyst, thus the expression of beta-catenin in the metaplastic epithelium might be associated with malignant transformation of choledochal cyst epithelium. Methods: This study was conducted at a tertiary care pediatric center between October 2014 and March 2017. Forty patients were evaluated for epithelial lining, mural ulceration, fibrosis, inflammation, and metaplasia. Results: Out of 40, 12 cases (30.0%) were the infantile age group and 28 cases (70.0%) were in the classic pediatric group. Ulceration was classified as grade 0 (14 cases, 35.0%), grade 1 (17 cases, 42.5%), or grade 2 (nine cases, 22.5%). Inflammation was classified as grade 0 (2 cases, 5.0%), grade 1 (26 cases, 65.0%), or grade 2 (12 cases, 30.0%). Fibrosis was classified as grade 0 (five cases, 12.5%), grade 1 (11 cases, 27.5%), grade 2 (17 cases, 42.5%), or grade 3 (seven cases, 17.5%). Metaplasia was noted in five (12.5%) out of 40 cases. All choledochal cysts with metaplasia showed beta-catenin nuclear positivity on immunohistochemistry and were followed up. Conclusion: This study emphasizes the importance of detailed histopathological examination and documentation of metaplastic changes. Metaplasia was associated with beta-catenin nuclear positivity. These findings suggest a potential role for beta-catenin as a marker of metaplastic changes in choledochal cysts.

• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.49-53
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• 2024

Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma, with an incidence of about 0.8% to 5% per million people per year, accounting for 1% of soft tissue sarcomas. In its early stage, DFSP is typically found as a violet or pinkish macule or patch, and it can develop into a palpable mass with ulceration or bleeding. The standard treatment for DFSP is wide local excision of the tumor with a 2- to 3-cm negative margin, and radiation therapy or chemotherapy can be conducted with surgical treatment. A 35-year-old man had a palpable mass on the left side of his occipital scalp without color change, ulceration, or bleeding, which typically are present in malignancy. A magnetic resonance imaging (MRI) scan showed a 3-cm homogenous enhanced mass without adhesion between the scalp and the mass. Unexpectedly, a biopsy revealed the round mass to be DFSP. A wide excision and rotation of the scalp flap were performed. The patient recovered without any complications and received adjuvant radiotherapy at a dose of 60 Gray (Gy) for six weeks. There was no recurrence through six months of follow-up. Here we report this unique case of DFSP with atypical presentation.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.1-8
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• 2007

The purpose of this study was to investigate whether there were any changes in taste sensitivity with recurrent aphthous ulceration. Nintyseven subjects(25 males and 72 females) were included for the study and they were categorized into 2 groups(recurrent aphthous ulceration 27 persons, control 70 persons), recurrent aphthous ulceration group was investigated in the department of Oral Medicine, College of Dentistry, Pusan National University from April, 2005 to August, 2006 and control group was investigated in the clinic at Incheon city from June, 2006 to August, 2006. The electrical taste thresholds were measured using an electrogustometer of the 4 different sites(tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows ; 1. The electrical taste threshold showed significant lower in the RAU group. 2. The electrical taste threshold showed significant lower in female group, and showed significant lower except soft palate in male group of the RAU group. 3. The electrical taste threshold showed a tendency to increase in all site of the multiple RAU group, but there were no significant differences. 4. The electrical taste threshold showed a tendency to increase in tongue lateral of the acute RAU group, and showed a tendency to increase in tongue tip, circumvallate papilla, soft palate of the chronic RAU group. 5. After treatment, electrical taste threshold was significant increase than initial visit in the RAU group. 6. After treatment, NAS showed a tendency to decrease in the RAU group.