A Case of Linear Hypertrophic Lichen Planus in a Pediatric Patient.

Lichen planus (LP) is a chronic inflammatory disease of the skin and mucosa. Of the various types, the hypertrophic type is characterized by thickened, purplish hyperkeratotic plaques and nodules. The course of hypertrophic LP tends to be more chronic than those of other types. A 12-year-old girl presented with a 2-year history of warty papules and plaques in a zosteriform configuration along one flank. Histopathology revealed hyperkeratosis and papillomatosis with wedge-shaped hypergranulosis. A lichenoid lymphocytic infiltrate with vacuolar change in the basal layer was evident. She was prescribed oral doxycycline, a topical corticosteroid, and tacrolimus. After 7 weeks, the skin lesions became significantly flattened and faded. LP is less common but more severe in children than in adults. The unilateral, linear hypertrophic type of LP is uncommon. Herein, we report a rare case of linear hypertrophic LP in a child.

Analysis of Positive Patch Test Allergens in Allergic Contact Dermatitis Patients with Atopic Dermatitis.

BACKGROUND: There has been debate regarding whether patients with atopic dermatitis (AD) have an altered frequency of contact allergen sensitization. Increased exposure to topical medications and moisturizers as well as impaired skin barrier function increase the risk of contact sensitization, whereas the Th2-skewed inflammatory pathway of AD is associated with a reduced risk. OBJECTIVE: This retrospective study was performed to determine the characteristics of contact sensitization in allergic contact dermatitis (ACD) patients with a current or past history of AD. METHODS: A clinical record review was conducted for patients referred to Ewha Womans University Medical Center, for patch tests between March 2017 and March 2021. We compared the rates of contact sensitization between ACD patients with and without AD. RESULTS: In total, 515 patch test results were reviewed and divided into the AD group (n=53) and non-AD group (n=462). The AD group showed decreased any-allergen positivity (1+, 2+, or 3+) (56.6%) compared to the non-AD group (72.9%) (p=0.013). The positivity rate for budesonide was significantly higher in the AD group (p=0.011), while the prevalence of a positive result for balsam of Peru was higher in the non-AD group (p=0.036). Nickel sulfate, cobalt chloride, and potassium dichromate were the most common sensitized allergens in both groups. CONCLUSION: Our study shows a decreased prevalence of contact sensitization in AD patients compared to non-AD patients. Clinicians should be aware of the risk of corticosteroid allergies in ACD patients with history of AD.

Free-standing TiO2 nanograssy tubular hybrid membrane for polysulfide trapping in Li-S battery.

During the growth of anodic TiO2 nanotubes with a high layer thickness of greater than 20 µm, "nanograss" structures are typically formed on the outermost surface. This happens due to the fact that the engraving of the oxide tubes arises during prolonged exposure to an F- ion containing electrolyte. These TiO2 nanotubular layers have a high aspect ratio with astonishing bundles of nanograss structures on the tube top and especially a high surface area with anatase crystallites in the tubes. By two-step anodization in synergy with the hybridization of a rubber polymer binder, freestanding nanotubular layers consisting of nanograssy surfaces with nano-crystalline particles in the tubes were successfully obtained. Under the highly efficient polysulfide trapping and electrolyte perturbation, this nanotubular hybrid membrane could deliver an enriched performance with a capacity of 618 mA h g-1 after 100 cycles at 0.1C in Li-S batteries.

The complete mitochondrial genome of sleek unicornfish, Naso hexacanthus (Acanthuridae, Perciformes).

The complete mitochondrial DNA sequence of sleek unicornfish, Naso hexacanthus was first determined in this study. The complete mitogenome is 16,611 bp in length composed of 13 protein-coding genes, 2 ribosomal RNAs, 22 transfer RNAs, and a control region. The nucleotides consist of 33.8% A, 20.6% C, 25.0% G, 20.6% T. The gene order and direction are identical to those of N. lopezi and the species of Acanthuridae. The result would be useful to investigate genetic relationships among the species of Naso.

A Case of Vesicular Mycosis Fungoides.

A 44-year-old male presented with 7 months history of nonpruritic round oozing plaques on the extremities and red papules on the trunk. The lesions were resistant to topical and oral steroid prescribed at the other local clinics. Histopathological examination showed parakeratosis with acanthosis and rete ridge elongation as well as spongiotic intraepidermal blisters and dense dermal infiltration of small to medium sized atypical lymphoid cells. Immunohistochemical analysis revealed the lymphocyte infiltrate to be predominantly CD4+ T cells, with CD4/CD8 ratio to be greater than 10:1. Infiltration of large cells that were CD30+ were also noted. This histopathologic findings are consistent with vesicular mycosis fungoides (MF). He was prescribed with narrow-band ultraviolet B twice per week and topical steroid, combined with interferon-α injection for 5 weeks, and his skin lesions significantly faded and were flattened. Vesicular MF is associated with poor prognosis, but our patient was able to show benign course of disease thanks to timely diagnosis. One must consider vesicular MF as a differential for recalcitrant eczematous lesions.

Prognostic factors in diabetes: Comparison of Chi-square automatic interaction detector (CHAID) decision tree technology and logistic regression.

This study aimed to develop a diabetes prediction model. The model performance was compared with logistic regression, and the decision tree Chi-square automatic interaction detection (CHAID) was used to predict diabetes. In total, 3233 patients were included in the analysis. Of these, 589 patients with diabetes and 2644 patients without diabetes were included after analyzing the study sample from the Korean Genome and Epidemiology Study (KoGES)-8 data. In this study, Diabetes Mellitus (DM) diagnosis prediction was compared with logistic regression and prediction through machine learning (ML) using the CHAID decision classification tree. We performed statistical analysis using the CHAID method with International Business Machine (IBM) statistical program SPSS®. We performed logistic regression analysis to predict the classification of diabetes accurately, and the total classification accuracy of the analysis was 81.7%, and the CHAID decision tree classification accuracy was 81.8%. A diabetes diagnosis decision tree was created, which included seven terminal nodes and three depth levels. This analysis showed that a blood pressure problem and hospital visits were the most decisive variables at the time of classification, and two risk levels were created for diabetes diagnosis. The suggested method is a valuable tool for predicting diabetes. Patients who visit the hospital because of blood pressure problems are more likely to develop diabetes than under-treating hyperlipidemia. The diabetes prediction model can help doctors make decisions by detecting the possibility of diabetes early; however, it is impossible to diagnose diabetes using only the model without the doctor's opinion.

Suppression of Transient Receptor Potential Melastatin 7 by Carvacrol Protects against Injured Spinal Cord by Inhibiting Blood-Spinal Cord Barrier Disruption.

When the blood-spinal cord barrier (BSCB) is disrupted after a spinal cord injury (SCI), several pathophysiological cascades occur, including inflammation and apoptotic cell death of neurons and oligodendrocytes, resulting in permanent neurological deficits. Transient receptor potential melastatin 7 (TRPM7) is involved in the pathological processes in many neuronal diseases, including traumatic brain injury, amyotrophic lateral sclerosis, parkinsonism dementia, and Alzheimer's disease. Further, carvacrol (CAR), a TRPM7 inhibitor, is known to protect against SCI by reducing oxidative stress and inhibiting the endothelial nitric oxide synthase pathway. However, the functions of TRPM7 in the regulation of BSCB homeostasis after SCI have not been examined. Here, we demonstrated that TRPM7, a calcium-mediated non-selective divalent cation channel, plays a critical role after SCI in rats. Rats were contused at T9 and given CAR (50 mg/kg) intraperitoneally immediately and 12 h after SCI, and then given the same dose once a day for 7 days. TRPM7 was found to be up-regulated after SCI in both in vitro and in vivo studies, and it was expressed in blood vessels alongside neurons and oligodendrocytes. Additionally, CAR treatment suppressed BSCB disruption by inhibiting the loss of tight junction (TJ) proteins and preserved TJ integrity. CAR also reduced apoptotic cell death and improved functional recovery after SCI by preventing BSCB disruption caused by blood infiltration and inflammatory responses. Based on these findings, we propose that blocking the TRPM7 channel can inhibit the destruction of the BSCB and it is a potential target in therapeutic drug development for use in SCI.

Erratum: Lee et al. Ginseng Extracts, GS-KG9 and GS-E3D, Prevent Blood-Brain Barrier Disruption and Thereby Inhibit Apoptotic Cell Death of Hippocampal Neurons in Streptozotocin-Induced Diabetic Rats. Nutrients 2020, 12, 2383.

The authors have requested that the following changes be made to their paper [...].

A case of porokeratotic adnexal ostial nevus misdiagnosed as wart.

Porokeratotic adnexal ostial nevus may be misdiagnosed as wart based on clinical appearance and morphology. An accurate diagnosis through skin biopsy is crucial, as is the inclusion of rare disorders such as porokeratotic adnexal ostial nevus in the differential diagnosis.

Total saponin extract, ginsenoside Rb1, and compound K alleviate peripheral and central neuropathic pain through estrogen receptors on rats.

In this study, we investigated whether total saponin extract (TSE), ginsenoside Rb1, and Rb1 metabolite compound K, which are isolated from red ginseng, have antinociceptive effects on peripheral and central neuropathic pain (PNP and CNP, respectively). PNP and CNP were induced by tail nerve injury (TNI) at S1 and by contusive spinal cord injury (SCI) at T9 in male Sprague-Dawley rats, respectively. Two weeks after TNI or 4 weeks after SCI, pain-induced rats were orally administered vehicle, TSE (50 mg/kg), Rb1 (12.5 mg/kg), compound K (7 mg/kg), or gabapentin (GBP, 60 mg/kg), and the antinociceptive effects were examined by von Frey filament, cold/warm water, and hot plate analyses. Allodynia and hyperalgesia were significantly alleviated by TSE, Rb1, and GBP 1 hr after drug administration. The immunohistochemistry and real-time RT-PCR results showed that the activation of microglia/astrocytes and the expression of inflammatory mediators such as Il-1ß, Il-6, iNOS, and Cox-2 were also significantly inhibited in L4-L5 spinal cord of CNP-induced rats 1 hr after drug administration. Furthermore, the antinociceptive effects of TSE and Rb1 were reversed by treatment with the estrogen receptor (ER) antagonist ICI182780. In particular, compound K also significantly alleviated both PNP and CNP. Therefore, our results indicate that TSE, Rb1, and compound K have potential antinociceptive effects against neuropathic pain that might be mediated through the ER.

Gallic acid attenuates blood-spinal cord barrier disruption by inhibiting Jmjd3 expression and activation after spinal cord injury.

After spinal cord injury (SCI), blood-spinal cord barrier (BSCB) disruption results in secondary injury including apoptotic cell death of neurons and oligodendrocytes, thereby leads to permanent neurological deficits. Recently, we reported that the histone H3K27me3 demethylase Jmjd3 plays a role in regulating BSCB integrity after SCI. Here, we investigated whether gallic acid (GA), a natural phenolic compound that is known to be anti-inflammatory, regulates Jmjd3 expression and activation, thereby attenuates BSCB disruption following the inflammatory response and improves functional recovery after SCI. Rats were contused at T9 and treated with GA (50 mg/kg) via intraperitoneal injection immediately, 6 h and 12 h after SCI, and further treated for 7 d with the same dose once a day. To elucidate the underlying mechanism, we evaluated Jmjd3 activity and expression, and assessed BSCB permeability by Evans blue assay after SCI. GA significantly inhibited Jmjd3 expression and activation after injury both in vitro and in vivo. GA also attenuated the expression and activation of matrix metalloprotease-9, which is well known to disrupt the BSCB after SCI. Consistent with these findings, GA attenuated BSCB disruption and reduced the infiltration of neutrophils and macrophages compared with the vehicle control. Finally, GA significantly alleviated apoptotic cell death of neurons and oligodendrocytes and improved behavior functions. Based on these data, we propose that GA can exert a neuroprotective effect by inhibiting Jmjd3 activity and expression followed the downregulation of matrix metalloprotease-9, eventually attenuating BSCB disruption after SCI.

Ginseng Extracts, GS-KG9 and GS-E3D, Prevent Blood-Brain Barrier Disruption and Thereby Inhibit Apoptotic Cell Death of Hippocampal Neurons in Streptozotocin-Induced Diabetic Rats.

Type 1 diabetes mellitus is known to be linked to the impairment of blood-brain barrier (BBB) integrity following neuronal cell death. Here, we investigated whether GS-KG9 and GS-E3D, bioactive ginseng extracts from Korean ginseng (Panax ginseng Meyer), inhibit BBB disruption following neuronal death in the hippocampus in streptozotocin-induced diabetic rats showing type 1-like diabetes mellitus. GS-KG9 and GS-E3D (50, 150, or 300 mg/kg, twice a day for 4 weeks) administered orally showed antihyperglycemic activity in a dose-dependent manner and significantly attenuated the increase in BBB permeability and loss of tight junction proteins. GS-KG9 and GS-E3D also inhibited the expression and activation of matrix metalloproteinase-9 and the infiltration of macrophages into the brain parenchyma, especially into the hippocampal region. In addition, microglia and astrocyte activation in the hippocampus and the expression of proinflammatory mediators such as tnf-α, Il-1ß, IL-6, cox-2, and inos were markedly alleviated in GS-KG9 and GS-E3D-treated group. Furthermore, apoptotic cell death of hippocampal neurons, especially in CA1 region, was significantly reduced in GS-KG9 and GS-E3D-treated groups as compared to vehicle control. These results suggest that GS-KG9 and GS-E3D effectively prevent apoptotic cell death of hippocampal neurons by inhibiting BBB disruption and may be a potential therapy for the treatment of diabetic patients.

Inhibition of COX-2 alleviates lumbar spinal stenosis-induced chronic mechanical allodynia in rats.

Chronic low back pain due to lumbar spinal stenosis (LSS) is common, costly, mechanistically complex, and clinically challenging. However, the factors and mechanisms causing and mediating chronic pain induced by cauda equina compression remain unclear. Here, we examined the role of cyclooxygenase (COX)-2 in infiltrated macrophages, a key mediator of inflammation, in chronic neuropathic pain by LSS using an animal model. LSS was induced in adult male rats by cauda equina compression procedure using a silicone block within the epidural spaces of L5-L6 vertebrae. Locomotor deficit was observed after compression and mechanical allodynia was developed progressively for 4 weeks after injury. A number of macrophage were also infiltrated into the spinal parenchyma and cauda equina and COX-2 was expressed in infiltrated macrophages at 28 days after cauda equina compression. The administration of COX-2 inhibitors, celecoxib and MPO-0029, significantly alleviated LSS-induced chronic mechanical allodynia and inhibited the mRNA expression of inflammatory mediators such as tnf-α, Il-1ß, il-6, and inos. Furthermore, COX-2 inhibitors significantly reduced prostaglandin E2 production. These results demonstrated the role of COX-2 in LSS-induced chronic neuropathic pain and suggest that the regulation of COX-2 can be considered as a therapeutic target to relive neuropathic pain.

See-Through Type 3D Head-Mounted Display-Based Surgical Microscope System for Microsurgery: A Feasibility Study.

BACKGROUND: The surgical microscope is used primarily for microsurgeries, which are more complicated than other surgical procedures and require delicate tasks for a long time. Therefore, during these surgical procedures, surgeons experience back and neck pain. To solve this problem, new technology, such as wearable displays, is required to help surgeons maintain comfortable postures and enjoy advanced functionality during microsurgery. OBJECTIVE: The objective of this study was to develop a surgical microscope system that would work with wearable devices. It would include a head-mounted display (HMD) that can offer 3D surgical images and allow a flexible and comfortable posture instead of fixed eyepieces of surgical microscope and can also provide peripheral visual field with its optical see-through function. METHODS: We designed and fabricated a surgical microscope system that incorporates a see-through type 3D HMD, and we developed an image processing software to provide better image quality. The usability of the proposed system was confirmed with preclinical examination. Seven ENT (ear, nose, and throat) surgical specialists and 8 residents performed a mock surgery-axillary lymph node dissection on a rat. They alternated between looking through the eyepieces of the surgical microscope and viewing a 3D HMD screen connected to the surgical microscope. We examined the success of the surgery and asked the specialists and residents to grade eye fatigue on a scale of 0 (none) to 6 (severe) and posture discomfort on a scale of 1 (none) to 5 (severe). Furthermore, a statistical comparison was performed using 2-tailed paired t test, and P=.00083 was considered significant. RESULTS: Although 3D HMD case showed a slightly better result regarding visual discomfort (P=.097), the average eye fatigue was not significantly different between eyepiece and 3D HMD cases (P=.79). However, the average posture discomfort, especially in neck and shoulder, was lower with 3D HMD display use than with eyepiece use (P=.00083). CONCLUSIONS: We developed a see-through type 3D HMD-based surgical microscope system and showed through preclinical testing that the system could help reduce posture discomfort. The proposed system, with its advanced functions, could be a promising new technique for microsurgery.

GS-KG9 ameliorates diabetic neuropathic pain induced by streptozotocin in rats.

BACKGROUND: Diabetic neuropathy is one of the most devastating ailments of the peripheral nervous system. Neuropathic pain develops in ∼30% of diabetics. Here, we examined the suppressive effect of GS-KG9 on neuropathic pain induced by streptozotocin (STZ). METHODS: Hyperglycemia was induced by intraperitoneal injection of STZ. Rats showing blood glucose level > 250 mg/dL were divided into five groups, and treatment groups received oral saline containing GS-KG9 (50 mg/kg, 150 mg/kg, or 300 mg/kg) twice daily for 4 wk. The effects of GS-KG9 on pain behavior, microglia activation in the lumbar spinal cord and ventral posterolateral (VPL) nucleus of the thalamus, and c-Fos expression in the dorsal horn of the lumbar spinal cord were examined. RESULTS: The development of neuropathic pain began at Day 5 and peaked at Week 4 after STZ injection. Mechanical and thermal pains were both significantly attenuated in GS-KG9-treated groups from 10 d after STZ injection as compared to those in the STZ control. GS-KG9 also repressed microglia activation in L4 dorsal horn and VPL region of the thalamus. In addition, increase in c-Fos-positive cells within L4 dorsal horn lamina I and II of the STZ control group was markedly alleviated by GS-KG9. CONCLUSION: These results suggest that GS-KG9 effectively relieves STZ-induced neuropathic pain by inhibiting microglial activation in the spinal cord dorsal horn and VPL region of the thalamus.

Protocatechuic acid improves functional recovery after spinal cord injury by attenuating blood-spinal cord barrier disruption and hemorrhage in rats.

After spinal cord injury (SCI), blood-spinal cord barrier (BSCB) disruption and hemorrhage lead to blood cell infiltration and progressive secondary injuries including inflammation. Inflammatory response is one of the major events resulting in apoptosis, scar formation and neuronal dysfunction after SCI. Here, we investigated whether protocatechuic acid (PCA), a natural phenolic compound, would attenuate BSCB disruption and hemorrhage, leading to functional improvement after SCI. After a moderate contusion injury at T9, PCA (50 mg/kg) was administrated via intraperitoneal injection immediately, 6 h, and 12 h after SCI, and the same dose of PCA once a day until 7 d after injury. Our data show that PCA inhibited apoptotic cell death of neurons and oligodendrocytes and improved functional recovery after injury. PCA also attenuated BSCB disruption and hemorrhage and reduced the infiltration of neutrophils and macrophages compared to vehicle control. Moreover, PCA inhibited the expression and activation of matrix metalloprotease-9, which is well known to disrupt BSCB after SCI. Furthermore, PCA treatment significantly inhibited the expression of sulfonylurea receptor 1 and transient receptor potential melastatin 4, which are known to mediate hemorrhage at an early stage after SCI. Consistent with these findings, the mRNA and protein expression of inflammatory mediators such as tumor necrosis factor alpha, interleukin 1 beta, cyclooxygenase-2, inducible nitric oxide synthase, and chemokines was significantly alleviated by PCA treatment. Thus, our results suggest that PCA improved functional recovery after SCI in part by inhibiting BSCB disruption and hemorrhage through the down-regulation of sulfonylurea receptor 1/transient receptor potential melastatin 4 and matrix metalloprotease-9.

Quantitative Analysis of Metal Contents in Korean Herbs and Herbal Products to Give Advice for Metal Allergic Patient.

BACKGROUND: Herbs have been used worldwide as complementary and alternative medicines. In Korea, herbs for medical purpose are strictly controlled by the Korea Food and Drug Administration (KFDA). But it does not provide standards for metal antigens. OBJECTIVE: This study conducted to identify the metal contents of Korean herbs and herbal products and to give information on counselling metal allergic patient. METHODS: The concentration of three metal allergens with high antigenicity, cobalt (Co), chromium (Cr), nickel (Ni) was quantitatively determined using inductively coupled plasma with a mass spectrometer after nitric acid (HNO3) digestion. The herbal objects are as follows: 1) ten kinds of herb plants, 2) ten herbal products sold in Korean drugstores, and 3) ten herbal extracts prescribed by Korean herbal doctors. RESULTS: In 30 samples, Ni and Cr were detected in all items. Co was not detected in two drugstore products. CONCLUSION: Although the levels of metal detected in this study were very low relative to international guidelines and KFDA regulations, the herbal preparations contained similar or higher metal levels than known metal-rich foods. It can cause problems when it added to the daily diet and cause deterioration of skin lesions of metal sensitized person.

Mucinous Nevus.

Mucinous nevus is an uncommon entity classified as either a cutaneous mucinosis or a connective tissue nevus. The condition presents as grouped papules and coalescent plaques growing in a unilateral or zosteriform manner. The key histopathological feature is a band-like deposition of mucin in the superficial dermis. A 34-year-old male presented with grouped gray-brown papules and confluent plaques exhibiting a zosteriform distribution on the right side of the lower back. The lesions had commenced in childhood. Histological examination revealed mucin deposition in the papillary dermis. Thus, we diagnosed a mucinous nevus. To date, only a few reports of such nevi have been reported in the literature. Therefore we report a rare case of mucinous nevus.

Increased expression of IL-33 in rosacea skin and UVB-irradiated and LL-37-treated HaCaT cells.

Rosacea is one of the most common dermatoses of adults. Although the detailed pathophysiology remains unknown, it is thought that rosacea is caused by a consistently aberrant, innate immune response, and that LL-37 plays an important role. However, involvement of the inflammatory cytokine IL-33 has not yet been studied. We explored the role played by IL-33 in the pathophysiology of rosacea. First, we immunohistochemically evaluated the expression of IL-33 and its receptor (ST2) in rosacea skin. Second, we exposed HaCaT cells to ultraviolet B (UVB) irradiation in the presence or absence of LL-37 and measured the expression of proinflammatory cytokines including IL-33. We also analysed VEGF (vascular endothelial growth factor) mRNA expression and protein release after costimulation of HaCaT cells by LL-37 and IL-33. Immunohistochemically, IL-33 expression was enhanced in the skin of rosacea patients, especially with erythematotelangiectatic subtype. In vitro, UVB and LL-37 synergistically increased mRNAs expression of proinflammatory cytokines, especially IL-33 and IL-1ß. IL-33 protein release was also synergistically increased by LL-37 and UVB treatment. LL-37 and IL-33 stimulated VEGF mRNA expression and VEGF release from HaCaT cells. Our findings suggest that rosacea skin with abundant LL-37 may robustly produce and release IL-33 when exposed to UV radiation. IL-33 may participate in the angiogenesis and vasodilation of rosacea skin by enhancing VEGF release.