ABSTRACT
After anaplastic large-cell lymphoma (ALCL) was first described by Stain in 1985, there have been several histological variants of ALCL reported. There are classified histological subtypes of ALCL, such as lymphohistiocytic, small cell, Hodgkin-like, composite pattern, and other less common variants including neutrophil-rich ALCL. A 63-year-old male patient presented with erythematous exophytic mass on the left lower leg. In the past, his condition had been diagnosed as abdominal primary cutaneous ALCL (pcALCL), which recurred as systemic ALCL (sALCL) in the left bronchus. After treatment, he achieved complete remission. Histopathologic examination showed large-sized pleomorphic, anaplastic mitotic tumor cells, several neutrophils, and a few lymphocytes. Neutrophil-rich ALCL is a rare histological variant of ALCL. It is characterized by the presence of CD30-positive anaplastic tumor cells with numerous neutrophil infiltrations. Neutrophil-rich ALCL responds well to treatment but tends to recur. There were four cases reported to have recurrent neutrophil-rich ALCL. All cases were diagnosed with neutrophil-rich pcALCL prior to recurrence. Three cases had local recurrence, and only one case relapsed as sALCL. Herein, we present the first case of neutrophil-rich ALCL recurring as sALCL twice.
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BACKGROUND: Alopecia areata (AA) is common non-scarring hair loss disease. Sleep distrubance has been regarded as a triggering or aggravating factor for AA. However, objective evaluation of sleep disturbance and its clinical effect on AA has not been clearly demonstrated. OBJECTIVE: This study investigated objective sleep evaluation tool for AA patients and their clinical correlation. METHODS: Patients presenting with new-onset AA or recurrences of pre-existing AA were included, and those who reported sleep disturbance in the preliminary survey were designated as the sleep disturbance group (SD group). Sleep quality was investigated for them using three self-administered questionnaires: Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleep Scale (ESS). Demographic information and clinical features of AA were analyzed according to sleep quality. RESULTS: A total of 400 participants were enrolled, and 53 were categorized into the SD group. The incidence of stressful events was significantly higher in the SD group (54.7%) than in the non-SD group (25.1%) (p<0.001). Based on the PSQI, 77.3% of participants were objective poor sleepers (score of 5 or more), and they showed a significantly higher incidence of stressful events compared to good sleepers (p=0.019). The proportion of poor sleepers was significantly lower in patients with mild AA (S1) than in those with moderate to severe AA (S2~S5) (p=0.045). CONCLUSION: This study demonstrated a positive correlation among stress, SD, and AA. The degree of SD was objectively represented by the PSQI score, showing different scores according to AA severity.
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An eight-year-old Maltese dog presented with diarrhea and anorexia. Ultrasonography revealed marked focal wall thickening with loss of layering in the distal ileum. Contrast-enhanced computed tomography (CT) revealed a preserved wall layer with hypoattenuating middle wall thickening. In some segments of the lesion, small nodules protruding toward the mesentery from the outer layer were observed. Histopathology revealed focal lipogranulomatous lymphangitis (FLL) with lymphangiectasia. This is the first report to describe the CT features of FLL in a dog. CT features of preserved wall layers with hypoattenuating middle wall thickening and small nodules can assist in diagnosing FLL in dogs.
ABSTRACT
Palisading encapsulated neuroma is a rare, benign, cutaneous nerve sheath tumor. It usually occurs as an asymptomatic solitary skin-colored papule and commonly affects the nose and cheeks. Sometimes, it involves other sites, including the shoulder, upper arm, and trunk, but rarely involves the oral mucosa, including that of the lip. In our case, a 63-year-old female patient complained of a pinkish rubbery nodule on her lower lip. Histopathologic examination demonstrated a well-circumscribed nodule encapsulated by connective tissue stroma in the dermis. The nodule consisted of palisading spindle-shaped tumor cells with wavy and basophilic nuclei. The cells were arranged in streaming fascicles with multiple clefts and were strongly positive for S-100 proteins. To our knowledge, only three cases of palisading encapsulated neuroma on the lower lip have been reported in the Korean literature. Herein, we report a rare case of an oral palisaded encapsulated neuroma.
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BACKGROUND: Oral alitretinoin is effective in the treatment of chronic hand eczema (CHE), and ≥12 weeks of alitretinoin treatment has been shown to be effective in Korean patients. However, in the real world, a considerable number of patients discontinue alitretinoin, which leads to treatment failure. OBJECTIVE: To evaluate the compliance rate of alitretinoin treatment and explore common reasons for poor compliance in patients with CHE in the real world. METHODS: We retrospectively reviewed the electronic medical records of CHE patients treated with alitretinoin. We defined 'poor-compliance' as subjects who were treated with alitretinoin for <12 weeks and 'good-compliance' as subjects who were treated with alitretinoin for ≥12 weeks. We reviewed the demographics, dose, and duration of alitretinoin usage, efficacy, and reasons for poor compliance. RESULTS: A total of 137 subjects were enrolled, and 77 (56.2%) did not complete the 12-week treatment with alitretinoin. Among them, the non-improvement rate was significantly higher in the poor-compliance group than in the good-compliance group (p<0.01). The main reasons for the alitretinoin cessation in the poor-compliance group were insufficient response (40.8%), followed by high cost (34.7%), and adverse events (24.5%). CONCLUSION: Alitretinoin appears the preferred long-term treatment option for CHE. Although there are complaints about late efficacy, cost, and side effects, following proper explanation, these should not justify discontinuation. Physicians need to recognize the reasons for poor compliance with alitretinoin for each patient and suggest continuing alitretinoin for the successful treatment of CHE.
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Congenital triangular alopecia (CTA) is a form of circumscribed, noncicatricial, and noninflammatory hair loss. It manifests as a triangular or oval-shaped alopecic patch on the frontotemporal region of the scalp and rarely involves the temporoparietal or occipital area. That is why it is also called temporal triangular alopecia. However, there has been just one case reported in the middle frontal area. Here, we report a successfully treated case of CTA in a 17-year-old boy who was born with a 2.5 cm × 3.5 cm alopecic patch in the middle frontal area.
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Background@#Computed tomography urography (CTU), based on the excretion of contrast medium after its injection, allows visualization of the renal parenchyma and the renal collecting system. @*Objectives@#To determine the optimal contrast medium dose allocation ratio to apply in split-bolus CTU in dogs. @*Methods@#This prospective, experimental, exploratory study used 8 beagles. In 3-phase CTU, unenhanced-, nephrographic-, and excretory-phase images were obtained with a single injection of 600 mg iodine/kg iohexol. In split-bolus CTU, two different contrast medium allocation ratios (30% and 70% for split CTU 1; 50% and 50% for split CTU 2) were used. Unenhanced phase image and a synchronous nephrographic-excretory phase image were acquired. @*Results@#Although the attenuation of the renal parenchyma was significantly lower when using both split CTUs than the 3-phase CTU, based on qualitative evaluation, the visualization score of the renal parenchyma of split CTU 1 was as high as that of the 3-phase CTU, whereas the split CTU 2 score was significantly lower than those of the two others. Artifacts were not apparent, regardless of CTU protocol. The diameter and opacification of the ureter in both split CTUs were not significantly different from those using 3-phase CTU. @*Conclusions@#Split-bolus CTU with a contrast medium allocation ratio of 30% and 70% is feasible for evaluating the urinary system and allows sufficient enhancement of the renal parenchyma and appropriate distention and opacification of the ureter, with similar image quality to 3-phase CTU in healthy dogs. Split-bolus CTU has the advantages of reducing radiation exposure and the number of CT images needed for interpretation.
ABSTRACT
We evaluated whether the prostate-specific antigen (PSA) mass or free PSA (fPSA) mass (i.e., absolute amount of total circulating PSA or fPSA protein, respectively), versus serum PSA or fPSA concentration, improves the accuracy of predicting the total prostate volume (TPV) in relation to obesity. Among men whose multicore (≥12) transrectal prostate biopsy was negative, 586 who had a PSA of ≤10 ng ml-1 and underwent the fPSA test prior to biopsy were enrolled. The PSA mass or fPSA mass (μ g) was calculated by multiplying the serum level by plasma volume. At each TPV cut-off point (30 ml, 40 ml, and 50 ml), the areas under the receiver operating characteristics curve (AUCs) of each variable were compared in obesity-based subgroups. AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1% at all cut-off points. Subgroup analyses based on obesity showed that, although PSA mass and fPSA mass enhanced accuracy by 4% (P = 0.031) and 1.8% (P = 0.003), respectively, for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men, they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points. Thus, compared with serum PSA or fPSA, the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points. Hence, these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.
ABSTRACT
The treatment of advanced prostate cancer has rapidly evolved. Androgen deprivation therapy is recognized as the first-line therapy for metastatic disease; however, a substantial proportion of patients will eventually progress to develop castration-resistance. For the past several years, docetaxel-based chemotherapy has shown significant therapeutic benefit in castration-resistant prostate cancer. Over the last 5 years, several new agents such as the enzalutamide, abiraterone, cabazitaxel, and 223radium have been developed which have all been associated with improved quality of life, pain palliation, and an increase in survival. Unfortunately, there are no Korean treatment guideline for metastatic prostate cancer and/or castration-resistant prostate cancer which has been developed based on adequate review and assessment of evidences. Thus, a guideline adequate for domestic circumstances is eagerly needed. The Korean Association for Clinical Oncology, the Korean Prostate Society, the Korean Urological Oncology Society, and the Korean Society of Pathologists reviewed and endorsed the guidelines.
Subject(s)
Humans , Drug Therapy , Korea , Medical Oncology , Prostate , Prostatic Neoplasms , Quality of LifeABSTRACT
<p><b>OBJECTIVE</b>To investigate the anti-oxidative stress and preventive effect of modified Gongjin-dan (WSY-1075) in a detrusor underactivity rat model.</p><p><b>METHODS</b>Rats were randomly allocated to three groups: shamoperated (control), bladder outlet obstruction-induced detrusor underactivity (BOO-DU), and BOO-DU with WSY-1075 (WSY) groups. WSY-1075 was orally administrated to rats 200 mg daily for 2 weeks prior to the operation and 4 weeks after the operation. Bladder outlet obstruction was surgically induced in rats by ligation around the urethra avoiding total obstruction. Cystometrography was conducted on rats in each group for examination of bladders.</p><p><b>RESULTS</b>Compared with the control group, bladder outlet obstruction led to a significant increase in oxidative stress with consequent changes to molecular composition, and decrease in maximal detrusor pressure (P<0.05). WSY-1075 treatment significantly suppressed oxidative stress and prevented degenerative and dysfunctional changes in bladder, as compared with BOO-DU group (P<0.05).</p><p><b>CONCLUSION</b>WSY-1075 had beneficial effect on prevention of BOO-DU.</p>
ABSTRACT
We evaluated whether the prostate-specific antigen (PSA) mass or free PSA (fPSA) mass (i.e., absolute amount of total circulating PSA or fPSA protein, respectively), versus serum PSA or fPSA concentration, improves the accuracy of predicting the total prostate volume (TPV) in relation to obesity. Among men whose multicore (≥12) transrectal prostate biopsy was negative, 586 who had a PSA of ≤10 ng ml-1 and underwent the fPSA test prior to biopsy were enrolled. The PSA mass or fPSA mass (μ g) was calculated by multiplying the serum level by plasma volume. At each TPV cut-off point (30 ml, 40 ml, and 50 ml), the areas under the receiver operating characteristics curve (AUCs) of each variable were compared in obesity-based subgroups. AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1% at all cut-off points. Subgroup analyses based on obesity showed that, although PSA mass and fPSA mass enhanced accuracy by 4% (P = 0.031) and 1.8% (P = 0.003), respectively, for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men, they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points. Thus, compared with serum PSA or fPSA, the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points. Hence, these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.
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Nocardia species are aerobic, gram-positive, filamentous, partially acid-fast actinomycetes which are found worldwide in soil and decaying organic plant matter. When they infect human beings, they generally enter through the respiratory tract and then disseminate systemically. Rarely has a primary infection occurred as the result of direct inoculation. Isolation of Nocardia from clinical specimens and identification of species are difficult. But, with the introduction of new genetic technologies, reports of novel species of Nocardia have increased. We describe a case of cutaneous nocardiosis caused by Nocardia takedensis in an 87-year-old woman who was diagnosed by bacterial culture and 16S ribosomal RNA sequencing. N. takedensis has been described as a new species. This report describes the first clinical isolate of N. takedensis from a skin specimen in Korea.
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BACKGROUND: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. METHODS: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. RESULTS: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. CONCLUSION: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.
Subject(s)
Humans , Cicatrix , Diagnosis , Diagnosis, Differential , Forehead , Hypesthesia , Magnetic Resonance Imaging , Medical Records , Neurilemmoma , Orbit , Orbital Neoplasms , Peripheral Nerves , Physical Examination , Postoperative Complications , Recurrence , Retrospective Studies , Schwann Cells , SensationABSTRACT
BACKGROUND: A number of conditions can alter a person's fingernail configuration. The ratio between fingernail width and length (W/L) is an important aesthetic criterion, and some underlying diseases can alter the size of the fingernail. Fingernail curvature can be altered by systemic disorders or disorders of the fingernail itself. Although the shape and curvature of the fingernail can provide diagnostic clues for various diseases, few studies have precisely characterized normal fingernail configuration. METHODS: We measured the W/L ratio of the fingernail, transverse fingernail curvature, hand length, hand breadth, and distal interphalangeal joint width in 300 volunteers with healthy fingernails. We also investigated whether age, sex, height, and handedness influenced the fingernail W/L ratio and transverse fingernail curvature. RESULTS: In women, fingernail W/L ratios were similar across all five fingers, and were lower than those in men. The highest value of transverse fingernail curvature was found in the thumb, followed by the index, middle, ring, and little fingers. Handedness and aging influenced transverse fingernail curvature, but not the fingernail W/L ratio. Fingernails were flatter on the dominant hand than on the non-dominant hand. The radius of transverse fingernail curvature increased with age, indicating that fingernails tended to flatten with age. CONCLUSIONS: Our quantitative data on fingernail configuration can be used as a reference range for diagnosing various diseases and deformities of the fingernail, and for performing reconstructive or aesthetic fingernail surgery.
Subject(s)
Female , Humans , Male , Aging , Anthropometry , Congenital Abnormalities , Fingers , Functional Laterality , Hand , Joints , Nail Diseases , Nails , Radius , Reference Values , Thumb , VolunteersABSTRACT
No abstract available.
Subject(s)
Aged, 80 and over , Humans , Male , DNA, Ribosomal/chemistry , Diabetes Mellitus, Type 2/complications , Fatal Outcome , Mucormycosis/complications , Rhizopus/isolation & purification , Sequence Analysis, DNA , Sequence Homology , Tomography, X-Ray ComputedABSTRACT
No abstract available.
