Immune Parameters of Korean Patients with Psoriasis Treated with Low-Dose Cyclosporine

No abstract available.

Immune Parameters of Korean Patients with Psoriasis Treated with Low-Dose Cyclosporine

No abstract available.

Serum Leptin and Adiponectin Levels in Korean Patients with Psoriasis

Psoriasis is a disorder caused by genetic and immunological factors. Leptin, a peptide hormone secreted predominantly from adipose tissue, regulates energy intake and expenditure, as well as the T-helper response. There have been conflicting reports regarding serum levels of leptin and adiponectin in patients with psoriasis. In the present study, we measured serum levels of leptin and adiponectin in Korean patients with psoriasis. Twenty-four patients with psoriasis and fifteen control subjects were included in the study. Serum leptin and adiponectin levels were determined by an immunometric sandwich enzyme-linked immunosorbent assay (ELISA). The mean serum leptin concentration in patients with psoriasis was higher than in controls, and the difference was statistically significant. In contrast, serum adiponectin levels in patients with psoriasis were significantly decreased compared with healthy controls. Leptin levels in vitamin D-deficient patients were statistically significantly higher than in vitamin D-sufficient patients. Serum adiponectin concentrations showed a negative correlation with body mass index (BMI) and psoriasis area and severity index (PASI) in patients with psoriasis. In conclusion, the present study demonstrated that leptin and adiponectin may play a role in the immunopathogenesis of psoriasis and may be useful biomarkers indicating severity of psoriasis in Korean patients.

Dermoscopic Aid in the Diagnosis of Cutaneous Sarcoidosis Resembling Dermatofibroma / 대한피부과학회지

Sarcoidosis is a multisystem granulomatous disease of unknown cause. The lung is the most commonly affected organ, but the skin is frequently involved. Specific sardoidal lesions are most often found on the head and neck area. The most common specific presentation is multiple papular lesions. The present case shows solitary cutaneous sarcoidosis resembling dermatofibroma, located on the thigh. Dermoscopy can help in the differential diagnosis of cutaneous sarcoidosis. Dermoscopic findings are orange globular-like structures and linear vessels, and areas of scar-like depigmentation. Histopathologic findings show non-caseating granulomas with sparse inflammatory cells. We report a case of cutaneous sarcoidosis resembling dermatofibroma, which was diagnosed using dermoscopy.

Dispersion of QT Interval and Other Repolarization Indexes in Acute Myocardial Infarction

BACKGROUND: It is known that QT dispersion represents asynchronous repolarization of ventricle which is related to ventricular fibrillation. The incidence of ventricular arrhythmia is increased after acute myocardial infarction. So this study compared QT dispersion and other repolarization indexes for detection of asynchronous repolarization in acute myocardial infarction. We also investigated which portion of repolarization is the key portion of the asynchrony. METHODS: In 37 acute myocardial infarction patients and 38 angina patients dispersion of QT, JT, JTpeak and QTpeak were measured. We also measured maximum adjacent dispersion of same parameters in precordial leads. In 20 survived patients and 17 dead patients after acute myocardial infarction were also compared. We also investigated correlation of PVC's on Holter monitoring with these repolarization parameters. RESULTS: 1) All ventricular repolarization indexes(QT, QTc, JT, JTpeak, QT peak and TpeakTend dispersion) were significantly increased in acute myocardial infarction group than compared with those of angina group(p<0.05). 2) Maximal precordial dispersion(QT, QTc, JT, JTpeak and QTpeak) were also significantly increased in acute myocardial infarction group than angina group(p<0.05). 3) Dead patient group after myocardial infarction showed significantly increased QTc and TpeskTend dispersion compared with those of survived patient group(p<0.05). 4) Multivariate linear correlation showed that TpeakTend dispersion and JT dispersion was correlated with QT dispersion. CONCLUSIONS: There were asynchronous myocardial repolarization changes in acute myocardial infarction. Our study demonstrated that T wave change was major determinant of dispersion of myocardial repolarization.

Assessment of Left Atrial Appendage Flow Pattern Using Multiplane Transesophageal Echocardiography in Patients with Nonrheumatic Atrial Fibrillation and Ischemic Stroke

BACKGROUND: The efficacy of oral anticoagulant therapy in reducing the risk of stroke and systemic embolism has been demonstrated in patients with nonrheumatic atrial fibrillation, but anticoagulation may introduce the risk for serious complications or adversely affect the patient's usual activities. Because the left atrial appendage(LAA) is the most likely site of thrombus formation in patients with nonrheumatic atrial fibrillation, evaluation of the LAA function with transesophageal echocardiography(TEE) may be helpful to deterrnine the high risk group for ischemic stroke. METHODS: Twenty patients with nonrheumatic atrial fibrillation(group I ), eighteen patients with rheumatic atrial fibillation(group II ) and twenty subjects in normal sinus rhythm without valvular heart disease(group III ) were underwent multiplane TEE examination. We measured maximal and minimal areas, ejection-fraction, and peak contraction and relaxation velocities of LAA. We also observed the presence or absence of thrombus and spontaneous echo contrast (SEC) in the left atrium or LAA. RESULTS: Maximal area of LAA was larger in group I and II compared with group III but there was no difference between group I and group II. Ejection fraction of LAA was much decreased in group I and II compared with group III. Peak contraction and relaxation velocities of LAA were over 45cm/sec in all cases from group Ill, but there was nearly negligible flow measurable in cases from group II. Patients from group I showed two distinct LAA flow patterns, either well defined saw tooth flow pattem(9 cases) or very low flow pattern like that of group II (11 cases). Therefore, patients from group I could be divided into two subgroups according to LAA flow profile. High flow profile subgroup had clear saw tooth flow pattern and revealed over 20cm/sec of peak contraction and relaxation velocities. The other low flow profile subgroup showed under 20cm/sec of both velocities. LAA ejection fraction was more increased in high flow profile subgroup but not significantly. Ischemic stroke occurred in six patients from group I, and all were in the low flow profile subgroup(p<0.05). SEC was observed in eight cases(73%) of the low flow profile subgroup but in only one case(11%) of the high profile sbugroup(p<0.05). All three cases with LAA thrombus belonged to the low flow profile subgroup. CONCLUSIONS: The assessrnent of LAA function by TEE may be helpful to discriminate the high risk group for the potential ischemic stroke in patients with nonrheumatic atrial firillation.

Insulin Resistance and Coronary Artery Disease

BACKGROUND: Insulin resistance has been identified as one of the risk factor of atherosclerosis. Hypertension, obesity, glucose intolerance and dyslipidemia could induce atherosclerosis through mechanism of insulin resistance. And there are some reports that hyperinsulinemia itself could induce coronary artery disease(CAD). Then we planed to investigate relationship between CAD and insulin resistance. And smoking is also known as one major risk factor of CAD. So we also investigated the relationship between smoking and insulin resistance in the CAD patients. METHODS: Among 36 subjects in whom coronary angiography was done, we grouped 25 subjects who had stenotic coronary artery as a CAD group and 11 subjects without stenosis as control group. We compared insulin and glucose response to oral glucose load(75g), serum lipid concentrations, blood pressure, and degree of obesity between two groups. We also divided CAD group into smoking and nonsmoking subgroups, compared the above parameters. RESULTS: 1) There were no significant difference in body mass index, blood pressure, creatinine, cholesterol, HDL-cholesterol, between the CAD group and the control group. There were significantly higher incidence of smokers in CAD group. 2) Insulin concentration at 120 minutes after glucose load were significantly higher in the CAD group than the control group. 3) In the CAD group, fasting plasma insulin concentration insulin area, peak plasma insulin concentration and insulin concentration at 60,90,120 minutes after glucose load were significantly higher in non-smoking group. CONCLUSION: Enhanced insulin reponse such as higher insulin concentration 60 minutes after glucose load in the CAD group suggests that insulin resistance is a risk factor of CAD. And insulin response was more pronounced in the non-smoker subgroup than smoker subgroup in the CAD patients. Thus role of insulin resistance in provoking coronary artery disease is more important in the non-smoker.