Psoriasis concurrent with inflammatory bowel disease.

BACKGROUND: Previous studies have indicated an association between psoriasis and inflammatory bowel disease (IBD), and the concurrence of the two diseases reportedly has higher morbidities in Caucasian populations. However, reports on the concurrence of psoriasis with IBD in the Asian population in the literature are scarce. Objective To analyse the characteristics of psoriasis concurrent with IBD and investigate the associated morbidity in the Asian population. METHODS: We retrospectively examined the medical records of 15 patients with a confirmed diagnosis of both psoriasis and IBD. Sixty age-, gender-, and ethnicity-matched patients with a confirmed diagnosis of only psoriasis were included as controls. Both cases and controls had visited the Seoul National University Hospital or Seoul National University Boramae Hospital between 1990 and 2012. The characteristics of psoriasis, presence of comorbidity and laboratory parameters were compared between the two groups. RESULTS: Compared to controls with psoriasis only, cases of psoriasis concurrent with IBD had a younger age of onset, longer duration of psoriasis and a higher Psoriasis Area Severity Index (PASI) score. A larger proportion of cases was treated with phototherapy, systemic therapy and biologics. However, all these differences above were not statistically significant. Cases of psoriasis with concurrent IBD showed higher erythrocyte sedimentation rate and C-reactive protein levels compared with the controls (both P = 0.000). Furthermore, this case group had a higher proportion of patients with psoriatic arthritis and with more than one autoimmune disease as compared with the control group (P = 0.007 and 0.005 respectively). CONCLUSION: Asian patients having psoriasis concurrent with IBD exhibited different characteristics as compared with those having psoriasis only, particularly in terms of psoriasis severity, risk of psoriatic arthritis, systemic inflammatory parameters and presence of autoimmune comorbidity. However, further studies elucidating the exact pathogenesis and including a larger number of patients are required.

An outbreak of skin and soft tissue infection caused by Mycobacterium abscessus following acupuncture.

Although outbreaks of Mycobacterium abscessus infection have been reported, none of these reports has identified the potential sources of infection and modes of transmission. In April 2008, we identified and investigated an outbreak of M. abscessus skin and soft tissue infections following acupuncture among the patients who visited an oriental medical clinic. Active surveillance of patients who had visited the clinic was conducted to define the extent of the outbreak. Environmental cultures and a case-control study were performed to elucidate the source of infection and mode of transmission. From 1002 patients interviewed, 109 patients were identified as having suffered M. abscessus skin and soft tissue infections at acupuncture sites. A single strain of M. abscessus was isolated from the wounds of 31 patients and nine environmental samples, including a diluted glutaraldehyde solution. The case-control study revealed that a higher numbers of visits to the clinic for acupuncture (adjusted OR (aOR) 20.12; 95% CI 4.34-93.35) and the use of interferential current therapy or low-frequency therapy (aOR 36.12; 95% CI 5.54-235.44) were associated with the development of M. abscessus infection. The contaminated diluted glutaraldehyde solution that was used to disinfect the physical therapy devices may have been the source of the outbreak of M. abscessus infection in the 109 patients who underwent acupuncture.

Atherogenecity of LDL and unfavorable adipokine profile in metabolically obese, normal-weight woman.

OBJECTIVE: The relationship of visceral adiposity with adipocytokines and low-density lipoprotein (LDL) particle distribution and oxidation in Asian metabolically obese, normal-weight (MONW) individuals has not been evaluated. We aimed to investigate the association between visceral adiposity and adipocytokines and cardiovascular disease (CVD) risk factors in MONW Korean women with normal glucose tolerance. METHODS AND PROCEDURES: We examined the metabolic characteristics of 135 non-obese (BMI <25 kg/m(2)) women aged 25-64 years. Twenty-five women (BMI <25 kg/m(2) and visceral fat adiposity (VFA) > or =100 cm(2)) were classified as MONW and 25 women (BMI <25 kg/m(2) and VFA <100 cm(2)), pair-matched for age, weight, height, and menopausal status, as control group. Plasma lipid profiles and adipocytokines were evaluated in these two groups. RESULTS: MONW subjects had higher systolic (P < 0.05) and diastolic blood pressure (P < 0.005) and higher concentrations of triacylglycerol (TG) (P < 0.005), insulin (P < 0.01), and free fatty acid (FFA) (P < 0.05) than control subjects. There was no significant difference between two groups in LDL-cholesterol (LDL-C) concentrations; however, MONW subjects had smaller LDL particles (P < 0.01) and higher concentrations of oxidized LDL (ox-LDL) (P < 0.05) compared with controls. Moreover, MONW subjects had higher concentrations of tumor necrosis factor-alpha (TNF-alpha) (P < 0.05), interleukin-6 (IL-6) (P < 0.05) and leptin (P < 0.05), and lower plasma adiponectin concentrations (P < 0.05). Higher intake of saturated fat with lower ratio of polyunsaturated fatty acids (PUFAs) to saturated fatty acids (SFA) and lower fiber intake than normal subjects were found in MONW women. DISCUSSION: We found an unfavorable inflammatory profile and a more atherogenic LDL profile in MONW female subjects even in the absence of a known CVD risk factors. Moreover, MONW consumed more saturated fat and less fiber than the control group.

Genetic variation at the perilipin locus is associated with changes in serum free fatty acids and abdominal fat following mild weight loss.

OBJECTIVE: Perilipin (PLIN) is a class of protein-coating lipid droplets in adipocytes. We aimed to examine the association between common single-nucleotide polymorphisms (SNPs) at PLIN locus with circulating free fatty acid (FFA) and abdominal fat distribution in response to weight loss. METHODS: Non-diabetic/overweight-obese Koreans (n=177) participated in a 12-week calorie restriction (-300kcal/day) program. Seven SNPs (6209T>C, 10076C>G, 10171A>T, 11482G>A, 13042A>G, 13048C>T and 14995A>T), abdominal fat areas (visceral/subcutaneous fat areas at 1st lumbar and 4th lumbar levels), serum lipids, glucose, insulin, FFA, oxidized low-density lipoprotein (LDL) and urinary 8-epi-prostaglandin F(2alpha) (PGF(2alpha)) were examined. RESULTS: Single-nucleotide polymorphisms 10076C>G/10171A>T showed the strongest positive linkage disequilibrium (LD) (D'=0.923, R (2)=0.839, P<0.001) and SNPs11482G>A/14995A>T showed moderate positive LD (D'=0.824, R (2)=0.578, P<0.001). Calorie restriction induced 4.6% weight loss with significant abdominal fat reduction. In response to weight loss, subjects with nCA/nCA haplotypes at SNPs 10076C>G/10171A>T showed greater reduction in FFA levels than those with CA/CA haplotype (CA/CA: C/C at SNP 10076 and A/A at SNP 10171, nCA: non-CA haplotype carrier). On the other hand, subjects with nGA/nGA haplotype at SNPs 11482G>A/14995A>T had increased FFA levels with a rapid loss in abdominal fat, whereas GA/GA haplotype carriers had reduction in FFA levels. These results still remained significant after adjusting for age, gender and BMI. Prostaglandin F(2alpha) and oxidized LDL were also more reduced in GA/GA haplotype carriers than in nGA haplotype carriers. This effect remained significant after adjusting for baseline level, age, gender and BMI. Paradoxically, nGA haplotype carriers had increased levels of urinary PGF(2alpha) after weight reduction. CONCLUSION: Fasting plasma FFA changes following a modest weight loss in overweight-obese subjects are influenced by the genetic variability at the PLIN locus. Furthermore, circulating FFA changes rather than body fat itself may determine changes in lipid peroxides such as urinary PGF(2alpha) and oxidized LDL.

The association of SNP276G>T at adiponectin gene with circulating adiponectin and insulin resistance in response to mild weight loss.

OBJECTIVE: The purpose of this study was to determine whether common single nucleotide polymorphisms (SNPs) at the adiponectin (ADIPOQ) locus influence changes in circulating adiponectin and the features of insulin resistance in response to a weight loss intervention. SUBJECTS: In total, 294 nondiabetic/overweight-obese Koreans participated in a clinical intervention study lasting 12 weeks involving a caloric reduction of -300kcal/day. METHODS: Plasma adiponectin, blood lipids, glucose and insulin concentrations were measured at baseline and after weight loss. Insulin resistance was estimated by homeostasis model assessment insulin resistance (HOMA-IR) derived from fasting glucose and insulin concentrations. We genotyped for three SNPs, 45T>G, 276G>T and -11377C>G. RESULTS: At baseline, HOMA-IR was significantly higher in GG homozygotes than in carriers of the T allele at SNP276G>T of the adiponectin gene (P<0.05). With regard to SNP45T>G and SNP -11377C>G, we did not find any genotype related differences in baseline levels of HOMA-IR and adiponectin. In the 45/276 haplotype test, homozygous for the TG haplotype had significantly lower concentrations of plasma adiponectin (P<0.05). After the 12-week weight loss intervention, the significant decreases in HOMA-IR (P<0.001) and increases in adiponectin (P<0.01) were observed in GG homozygotes at SNP276, which were not shown in carriers of the T allele. Furthermore, there was a significant difference in the decreases in HOMA-IR between the GG homozygotes and carriers of the T allele at SNP276 (P<0.05). Regarding SNP45T>G and SNP -11377C>G, there was no association between SNP45T>G and SNP -11377C>G and decreases in HOMA-IR. In the 45/276 haplotype test, there was a significant difference in changes of adiponectin levels among those with different haplotype combinations (P<0.05). CONCLUSION: The SNP276G>T of the ADIPOQ gene is associated with different responses of circulating adiponectin and insulin resistance to mild weight loss in overweight-obese subjects.

Molecular dynamics simulation of size and strain rate dependent mechanical response of FCC metallic nanowires.

Current computational simulations on metallic nanowires are largely focused on ultrathin wires with characteristic sizes smaller than 2 nm. The electronic, thermal and optical properties form the bulk of these studies, with investigations of the mechanical properties centred on the breaking force of monatomic chains, and the structural evolution of small nanowires subjected to axial, shear, bending and torsional forces. This study seeks to build on the wealth of current knowledge for computational simulation on the mechanical properties of metallic nanowires. The simulation scale will be upped to 24 000 atoms to study a larger metallic nanowire with a 6 nm characteristic size scale. The commonly studied Au nanowire is studied in conjunction with the rarely examined Pt nanowire. The effects that size and strain rate have on the stretching behaviour of these nanowires are investigated through the simulation of nanowires with three characteristic sizes of 2, 4 and 6 nm, subjected to three distinct strain rates of 4.0 x 10(8), 4.0 x 10(9) and 4.0 x 10(10) s(-1). The selected strain rates produce three distinct modes of deformation, namely crystalline-ordered deformation, mixed-mode deformation and amorphous-disordered deformation, respectively. The mechanisms behind the observations of these distinct deformation modes are analysed and explained. A Doppler 'red-shift' effect is observed when the nanowires are strained at the highest strain rate of 4.0 x 10(10) s(-1). This effect is most pronounced for the nanowire subjected to the largest stretch velocity. As a result, a constrained dynamic free-vibration phenomenon is observed during stretching, which eventually leads to delocalized multiple necking, instead of a single localized neck when it is strained at a lower rate. This unique phenomenon is discussed and future research effort is in the pipeline for a more detailed investigation into metallic nanowires strained at a supersonic velocity.

Self-assembly of one-dimensional surface structures: long-range interactions in the growth of Ir and Pd on W(110).

Self-assembly of one-dimensional surface structures is examined by tracking single Ir and Pd atoms on W(110) as they incorporate into chains of Ir and Pd, respectively. Ir adatoms move parallel to the chains, but do not come close to the chain sides; incorporation occurs only at the ends. Pd adatoms also migrate parallel to Pd chains, and incorporate at the ends. Occasionally, in the end region, they do jump to the side of a chain, and migrate there until they find an end site. Incorporation behavior for both Ir and Pd is driven by highly anisotropic, long-ranged interactions between atoms on the surface.

Changes in external ear resonance after ventilation tube (Grommet) insertion in children with otitis media with effusion.

OBJECTIVE: As otitis media with effusion is common in children, the effects of a ventilation tube should be taken into account in the prescription of hearing aids for children. In ears with a ventilation tube, the external auditory canal communicates directly with the middle ear space, and so the impedance of the middle ear may change. Consequently, this will affect external-ear resonance. The aim of this study is to observe the effects of the tympanic membrane perforations caused by the ventilation tube on external-ear resonance. We selected 30 ears with otitis media with effusion to measure external-ear resonance before and after ventilation tube insertion. We compared the external-ear resonance of a control group with that of the otitis media with the effusion group and two types of ventilation-tube groups, respectively. In the subjects who have otitis media with effusion, the average gain of the peak resonance was larger than that in the control group. After ventilation-tube insertion, the amplitude of the gain decreased to the same level as the control group, but a characteristic negative gain appeared around 1000 Hz in about half of all cases. This negative gain was observed more frequently in the ventilation tube with a larger diameter. The raised peak resonance gain in the otitis media with effusion group decreased to a level roughly the same as that of the control group after ventilation-tube insertion. Provision of an additional gain in the low frequencies around 1000 Hz should be considered for patients with a ventilation tube when prescribing hearing aids.

Ornithine decarboxylase and tyrosine kinase activity in juvenile polyps of childhood.

Juvenile polyps (JP) are the most common colonic tumor in children. Although considered benign, malignant transformation has been reported in JP. Ornithine decarboxylase (ODC) and tyrosine kinase (TyK) enzymes are markers for a rapid cell proliferation index. DNA aneuploidy score and p53 gene expression are late malignant changes seen in patients with colon cancer. In this study, we investigated ODC and TyK activities as well as DNA aneuploidy score and p53 expression in juvenile polyps compared with the adjacent normal colonic mucosa. Results showed that ODC was significantly increased in JP compared with the adjacent normal colonic mucosa. TyK activity was increased in 3/5 polyps and decreased in 2/5 polyps compared with the mucosa. Mean TyK activity was higher in JP compared with normal mucosa but did not reach significance (707 and 632 pmol/mg pmol, respectively). Moreover, changes in phosphorylization of TyK proteins was also observed in JP but not in normal mucosa. JP had a normal DNA aneuploidy score and showed no expression of p53 gene. We conclude that JP do not express p53 gene and aneuploidy but had higher activity of ODC and TyK enzymes, suggesting a higher stage of cell proliferation.

Does endothelin play a role in the pathogenesis of early diabetic nephropathy?

Endothelin-1 (ET-1) causes dramatic vasoconstriction and reduction of renal blood flow, with a decreased glomerular filtration rate (GFR). Early diabetic nephropathy is characterized by elevation of GFR and the formation of intrarenal microaneurysms. However, the mechanisms are unclear. To elucidate the pathophysiologic significance of urinary ET-1 in early diabetic nephropathy, the 24-h urinary excretion of ET-1 in 12 normal subjects and 20 patients with newly diagnosed type 2 diabetes mellitus were determined by a highly sensitive radioimmunoassay. The 24-h urinary ET-1 excretion in patients with diabetes mellitus (14.2 +/- 3.1 pmol, mean +/- SEM) was significantly lower (p < 0.05) than that of normal subjects (25.0 +/- 3.7 pmol). This decrease in urinary excretion of ET-1 in patients with recent-onset diabetes mellitus suggests a possible role of ET-1 in the pathogenesis of early diabetic nephropathy.

Cancer of the large bowel in children.

We present the morphologic and clinical features of large bowel carcinoma in 22 patients seen over 18 years at St. Jude Children's Research Hospital. We saw 18 cases of mucinous adenocarcinoma, three of well differentiated adenocarcinoma, and one case of poorly differentiated adenocarcinoma. The patients ranged in age from 9 to 19 years with a median age of 15. There were 12 female and ten male patients; 12 were black and ten were white. Eighteen patients had Dukes' stage C disease, with median survival of seven months and one patient alive 12 months after diagnosis. Three patients had Dukes's stage B disease, with two patients surviving 16 months each and one presently alive seven months after diagnosis. Only one patient had Dukes' stage A disease and is alive 121 months after diagnosis. Large bowel carcinoma in children is predominantly mucinous adenocarcinoma and occurs in the adolescent age group. Tumor distribution is fairly even throughout the large bowel, and all subtypes of the tumor are positive for carcinoembryonic antigen (CEA) on immunohistologic study. Active tumor and tumor regrowth are always accompanied by high serum levels of CEA. The tumor has no predilection for sex, but is significantly more frequent in blacks (P less than .05). Discovery of the tumor in an early stage improves the prognosis.

Glioblastoma in children.

Both morphologic and clinical features of 72 consecutive cases of brain tumors, collected over 9 years at Le Bonheur Children's Medical Center, were reviewed. We identified 11 cases as glioblastoma, representing 16% of all intracranial neoplasm and 26% of glial tumors. The patients ranged in age from 1 to 15 years with the median age of 10 years. There were 4 females and 7 males; 2 blacks and 9 whites. The median survival was 9 months. The tumor was observed in both cerebrum and cerebellum. Sexual predominance was not appreciable, although there was male excess. The tumor was significantly more frequent in whites than blacks (p less than 0.05). Similar racial predominance was noted in the other, more common brain tumors in children such as astrocytoma and medulloblastoma.

Venous aneurysm.

A 19-month-old girl had a congenital aneurysm of the neck vein. We attribute the pathogenesis of venous aneurysm to a defective vascular wall. The treatment of choice is simple surgical excision.

Malignant "histiocytic" lymphoma in childhood.

Forty-one cases of childhood "histiocytic" lymphoma were studied morphologically and immunologically to determine whether this tumor type is composed of true histiocytic cells. Lysozyme and alpha-1-antichymotrypsin were used as markers for histiocytes, and cytoplasmic immunoglobulins were used as markers for B cells. Both indirect immunofluorescence and immunoperoxidase methods were used for functional characterization of tumor cells. Eight different subgroups were identified in the series, and only one case was proved to be true histiocytic lymphoma. When survival was evaluated for different subgroups, excluding convoluted lymphocytic, unclassified, and true histiocytic lymphomas, mixed follicular cell lymphoma had the most favorable prognosis; six of seven patients survived for at least one year. Immunoblastic lymphoma, by contrast, had an unfavorable prognosis; none of four patients were alive one year after diagnosis. The difference is statistically significant (P < 0.05) by chi-square analysis. Other groups of lymphoma (large cleaved, large noncleaved, and small noncleaved) had an intermediae prognosis (three of five, six of nine, and five of nine patients surviving at one year). Our results indicate that "histiocytic" lymphoma is a morphologically heterogeneous group of neoplasms, mostly not related to true histiocytes, and that morphologic subclassification may be useful in predicting prognosis.

Antimyosin and antirhabdomyoblast sera: their use for the diagnosis of childhood rhabdomyosarcoma.

Antisera against myosin of human normal skeletal muscle and against rhabdomyoblasts of autopsy-proved rhabdomyosarcoma were raised in white rabbits, purified, and assessed for their usefulness in the diagnosis of childhood rhabdomyosarcoma. The specificity of the antisera was tested by both immunofluorescence and immunoperoxidase methods in seven cases of autopsy-proved rhabdomyosarcoma, five of malignant lymphoma, three of neuroblastoma, and two of Ewing's sarcoma. Antimyosin serum tested positive for all cases of rhabdomyosarcoma and negative for other types of tumor. Antirhabdomyoblast serum was positive in all cases of rhabdomyosarcoma and cross-reacted with cases of neuroblastoma and Ewing's tumor, although the intensity of staining was much decreased. Our results indicate that antimyosin serum is specific for childhood rhabdomyosarcoma and can be used to differentiate this from other childhood "round cell" tumors.