Generalized granuloma annulare in infancy following bacillus calmette-guerin vaccination

Generalized granuloma annulare (GGA) is a rare benign granulomatous dermatosis characterized by disseminated necrobiotic dermal papules. Histologically, it presents as a lymphohistiocytic granuloma associated with varying degrees of connective tissue degeneration. It usually occurs in adults and rarely affects infants. Herein, we report an interesting case of GGA which occurred in a 3 month-old girl in association with Bacillus Calmette-Guerin vaccination.

A Case of Allergic Contact Dermatitis Due to DuoDERM Extrathin®

Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin®. Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin® contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin®. We report another case of allergic contact dermatitis due to Duoderm extrathin® in a 32 year-old woman.

Fexofenadine-induced urticaria

Fexofenadine (Allegra® 180) is a second-generation antihistamine. It is widely used as anti-allergic drug, which suppresses various allergic reactions mediated by histamines. A few cases of H1-antihistamine-induced urticaria have been reported. Herein, we report a rare case of fexofenadine-induced urticaria which was confirmed by a prick test, oral provocation test, and flow cytometry assisted-basophil activation test.

Sibutramine (reductil®)-induced cutaneous leukocytoclastic vasculitis: a case report

A 24-year old woman presented with hemorrhagic vesicles on her legs. She had taken sibutramine (Reductil®, Abbott Labs., Seoul, South Korea) for 3 months and developed skin lesions the week before. A skin biopsy showed leukocytoclastic vasculitis with conspicuous eosinophilic infiltration of the tissue. These lesions showed improvement after discontinuation of sibutramine. However, 3 months later the skin lesions recurred on other sites on the lower extremities when the patient was rechallenged with the same drug for 2 weeks. Herein, we report the first case of necrotizing vasculitis induced by sibutramine.

A case of myxoid dermatofibrosarcoma protuberans

Dermatofibrosarcoma protuberans (DFSP) is a slowly growing dermal spindle cell tumor and its myxoid variant, a rare type of DFSP, is characterized by extensive myxoid degeneration. We present the case of a 69-year-old woman with a multinodular reddish plaque on her trunk. Histopathologically, the tumor was located in the dermis and consisted of uniform spindle-shaped cells, showing strongly positive reaction for CD34, and negative for both S-100 and desmin. In addition to the typical storiform pattern, prominent myxoid stromal changes were demonstrated. Herein, we report an interesting case of myxoid DFSP, rarely reported in the dermatology literature.

The Immunohistochemical Patterns of Calcification-related Molecules in the Epidermis and Dermis of the Zebrafish (Danio rerio)

BACKGROUND

The scales of bony fish represent a significant reservoir of calcium and calcification of the elasmoid scale is known to be associated with deposition of mineral crystals from the epidermis to dermis. However, little is known about the exact mechanisms of calcium deposition, mobilization and regeneration occurring in the zebrafish skin.

OBJECTIVE

The purpose of this study was to investigate the expression of calcification-related molecular mediators in both the epidermis and dermis of the zebrafish (Danio rerio), using immunohistochemical study.

METHODS

We examined the skin of zebrafish in four populations of different ages (i.e. 20 days post-fertilization (dpf), 35 dpf, 50 dpf, and the adult zebrafish), using several immunohistochemical markers, including bone morphogenetic protein 4 (BMP-4), β-catenin, osteocalcin, osteopontin and osteonectin.

RESULTS

BMP-4, osteopontin and osteonectin were moderately expressed in the epidermis of zebrafish after 35 dpf. Also, some of the cells in the upper dermis showed strong positivity for BMP-4, osteocalcin, osteopontin and osteonetin.

CONCLUSION

Our results suggest that BMP-4, osteocalcin, osteopontin and osteonectin may play a role in the process of calcification of the elasmoid scale.

Serum selenoprotein P levels in patients with type 2 diabetes and prediabetes: implications for insulin resistance, inflammation, and atherosclerosis

CONTEXT AND OBJECTIVE

The dysregulation of hepatokines may be associated with the pathogenesis of insulin resistance and type 2 diabetes. A recent study has suggested that selenoprotein P (SeP), a novel hepatokine, may play a role in the regulation of glucose metabolism and insulin sensitivity. We examined the relationship between circulating SeP levels and clinical parameters associated with insulin resistance in humans.

PARTICIPANTS AND METHODS

We compared serum SeP concentrations in 100 subjects with diverse glucose tolerance statuses. Furthermore, we evaluated the relationship between SeP and cardiometabolic risk factors including insulin resistance, high-sensitivity C-reactive protein, and carotid intima-media thickness.

RESULTS

Serum SeP concentrations were significantly higher in patients with type 2 diabetes or prediabetes than those with normal glucose tolerance (all P < 0.01) and decreased in a stepwise manner [1032.4 (495.9-2149.4) vs. 867.3 (516.3-1582.7) vs. 362.0 (252.5-694.5), P = 0.004]. In addition, overweight and obese subjects had significantly increased SeP levels compared with lean subjects (P = 0.002). Spearman's partial correlation analysis adjusted for age and gender showed a significant relationship between SeP and cardiometabolic factors including body mass index, waist circumference, systolic blood pressure, triglycerides, glucose, hemoglobin A1c, aspartate aminotransferase, and insulin resistance. Furthermore, in multiple regression analyses, SeP showed an independent association with carotid intima-media thickness as well as high-sensitivity C-reactive protein, even after adjustment for other confounding factors.

CONCLUSIONS

Circulating SeP concentrations were elevated in patients with glucose metabolism dysregulation and were related to various cardiometabolic parameters including insulin resistance, inflammation, and atherosclerosis.

Microlensed dual-fiber probe for depth-resolved fluorescence measurements

We propose and demonstrate a compact microlensed dual-fiber probe that has a good collection efficiency and a high depth-resolution ability for fluorescence measurements. The probe is formed with a conventional fusion splicer creating a common focusing lens on two fibers placed side by side. The collection efficiency of the fabricated probe was evaluated by measuring the fluorescence signal of a fresh ginkgo leaf. It was shown experimentally that the proposed probe could effectively collect the fluorescence signal with a six-fold increase compared to that of a general flat-tipped probe. The beam propagation method was used to design a probe with an optimized working distance and an improved resolving depth. It was found that the working distance depends mainly on the radius of curvature of the lens, whereas the resolving depth is determined by the core diameters of the illumination and collection fibers. The depth-resolved ability of probes with working distances of ~100 μm and 300 μm was validated by using a two-layer tissue phantom. The experimental results demonstrate that the microlensed dual-fiber probe has the potential to facilitate depth-resolved fluorescence detection of epithelial tissue.

The Expressions of TGF-β(1) and IL-10 in Cultured Fibroblasts after ALA-IPL Photodynamic Treatment

BACKGROUND

Topical photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) was originally used for treating superficial skin tumors. The application of PDT to other inflammatory dermatoses like acne vulgaris, psoriasis, granuloma annulare, localized scleroderma and lichen sclerosus has recently been introduced. However, the underlying mechanisms are not well understood. We've previously reported the induction of tumor growth factor (TGF)-β(1) and interleukin (IL)-10 after PDT with ALA and intense pulsed light (IPL) in cultured HaCaT cells.

OBJECTIVE

The purpose of this study was to investigate the expressions of TGF-β(1) and IL-10 in cultured fibroblasts after PDT with using ALA and IPL.

METHODS

Cultured fibroblasts were treated with ALA-IPL PDT (1µmol/L of ALA; 0, 4, 8 and 12 J/cm(2) of IPL). The expressions of TGF-β(1) and IL-10 were investigated by reverse transcription-polymerase chain reaction and enzyme linked immunosorbent assay.

RESULTS

TGF-β(1) mRNA and protein were reduced down to 0.52- and 0.63-fold, respectively, after PDT and the IL-10 protein was increased up to 2.74-fold after PDT.

CONCLUSION

The reduction of TGF-β(1) was prominent after PDT and so an antisclerotic effect can be expected after PDT. The induction of IL-10 may contribute to the anti-inflammatory effect, which explains the therapeutic benefit of PDT for inflammatory dermatoses.

Effect of warfarin withdrawal on thrombolytic treatment in patients with ischaemic stroke

BACKGROUND AND PURPOSE

  Abruptly discontinuing warfarin may induce a rebound prothrombotic state. Thrombolytic agents may also paradoxically induce prothrombotic conditions, which include platelet activation and thrombin generation. Therefore, prothrombotic states may be enhanced by withdrawing warfarin in patients under thrombolytic treatment. This study was aimed to determine whether patients with warfarin withdrawal have different clinical outcomes from those without warfarin use after thrombolytic treatment.

METHODS

  A total of 148 consecutive patients with atrial fibrillation who were not on anticoagulants at admission and who received thrombolysis were included in this study. We compared the outcomes between a warfarin withdrawal group and a no-warfarin group.

RESULTS

  Fourteen patients (9.5%) were included in the warfarin withdrawal group. Although baseline National Institute of Health Stroke Scale (NIHSS) scores, recanalization rates, and hemorrhage frequencies did not differ between the groups, the warfarin withdrawal group showed poorer outcomes. Increased NIHSS scores during the first 7days were more frequent in the warfarin withdrawal group (57.1% vs. 26.9%, P=0.029). The median percent improvement in NIHSS scores at 24h after thrombolysis was also lower in the warfarin withdrawal group. After adjusting for covariates, warfarin withdrawal was a strong predictor of poor functional outcome at 3months (modified Rankin score≥3) (odds ratio, 17.067, 95% CI 2.703-107.748).

CONCLUSIONS

  Discontinuing warfarin was associated with early neurologic deterioration and poor long-term outcomes after thrombolytic treatment.

Zebrafish type XVII collagen: gene structures, expression profiles, and morpholino "knock-down" phenotypes

The human COL17A1 gene encodes type XVII collagen (also known as the 180-kDa bullous pemphigoid antigen), an integral component of hemidesmosomes, attachment complexes providing integrity to the dermal-epidermal junction. Zebrafish, a useful model system to study skin development, displays fully developed hemidesmosomes at approximately 5 days post-fertilization (dpf). We have identified two COL17A1 orthologues in the zebrafish genome, col17a1a and col17a1b, which are expressed in the skin and the neural system, respectively. The proteins coded by these genes have structural module organizations homologous to the human type XVII collagen. "Knock-down" of the expression of col17a1a with a specific morpholino targeting the 5' UTR of the gene resulted in a blistering phenotype and in perturbations in the basement membrane zone. "Knock-down" of col17a1b expression resulted in ablation or in marked reduction of neuromasts in the lateral line. Thus, zebrafish has two COL17A1 orthologues which may have evolved tissue-specific functions during vertebrate development. Collectively, zebrafish provides a model system to study the molecular aspects of skin development and offers insights into the corresponding human diseases.

Comparison of Marketed Cosmetic Products Constituents with the Antigens Included in Cosmetic-related Patch Test

BACKGROUND

Currently, cosmetic series (Chemotechnique Diagnostics, Sweden) is the most widely used cosmetic-related patch test in Korea. However, no studies have been conducted on how accurately it reflects the constituents of the cosmetics in Korea.

OBJECTIVE

We surveyed the constituents of various cosmetics and compare with the cosmetic series, to investigate whether it is accurate in determining allergic contact dermatitis caused by cosmetics sold in Korea.

METHODS

Cosmetics were classified into 11 categories and the survey was conducted on the constituents of 55 cosmetics, with 5 cosmetics in each category. The surveyed constituents were classified by chemical function and compared with the antigens of cosmetic series.

RESULTS

155 constituents were found in 55 cosmetics, and 74 (47.7%) of constituents were included as antigen. Among them, only 20 constituents (27.0%) were included in cosmetic series. A significant number of constituents, such as fragrance, vehicle and surfactant were not included. Only 41.7% of antigens in cosmetic series were found to be in the cosmetics sampled.

CONCLUSION

The constituents not included in the patch test but possess antigenicity are widely used in cosmetics. Therefore, the patch test should be modified to reflect ingredients in the marketed products that may stimulate allergies.

A case of clear cell eccrine porocarcinoma

Eccrine porocarcinoma (EP) is a rare malignant tumor arising from the intraepidermal eccrine duct. The tumor cells frequently contain glycogen, but prominent clear cell changes in EP are rarely reported. A 78-year-old woman presented with a slightly pruritic, erythematous, verrucous plaque on her left thigh. Histopathological examination revealed intraepidermal tumor cell nests composed of small basaloid cells and duct-like structures lined by periodic acid-Schiff (PAS)-positive cuticles. Besides the typical findings of EP, clear cell changes were predominantly observed in the tumor cell aggregations. Herein we report a case of the clear cell variant of EP rarely reported in previous literature.

Curcumin interrupts the interaction between the androgen receptor and Wnt/β-catenin signaling pathway in LNCaP prostate cancer cells

Recently, studies have investigated the significance of the Wnt/β-catenin pathway in prostate cancer. The transcriptional activity of the androgen receptor (AR) is modulated by interaction with coregulators, one of which is β-catenin. Curcumin, a dietary yellow pigment of Curcuma longa, has emerged as having a chemopreventive role. Although curcumin has been shown to inhibit AR expression, its molecular mechanism has not been fully elucidated. In this study, whether curcumin mediates the Wnt/β-catenin signaling pathway with regard to AR/β-catenin interactions was studied. Curcumin was shown to induce significant inhibition of AR expression in a dose-dependent manner. Marked curcumin-induced suppression of β-catenin was shown in the nuclear and cytoplasmic extracts as well as whole cell lysates. Further analysis revealed that phosphorylation of Akt and glycogen synthase kinase-3β were attenuated, but phosphorylated β-catenin was increased after curcumin treatment. Finally, cyclin D1 and c-myc, the target gene of the β-catenin/T-cell factor transcriptional complex, were also decreased. These findings suggest that curcumin modulates the Wnt/β-catenin signaling pathway and might have a significant role in mediating inhibitory effects on LNCaP prostate cancer cells.

Ultrawideband photonic crystal fiber coupler for multiband optical imaging system

We report a photonic crystal fiber (PCF) coupler having an ultrawide spectral bandwidth keeping single mode operation. The use of the PCF coupler in a fiber-based optical coherence tomography (OCT) system enables us to handle the wide spectral bands of various light sources, including superluminescent diodes (SLDs) at 1300 nm and 820 nm, Ti:sapphire lasers, and white-light sources. The multiband imaging performances of the PCF-based OCT system are demonstrated by obtaining dental images at 1300 nm and 820 nm with the same setup. In addition, we show that the PCF coupler could cover the spectrum over a one octave span and guide both the fundamental wave (1030 nm) and the second harmonic wave (515 nm) simultaneously.

A case of congenital dacryocystocele

A 6-day-old infant presented with a deeply bluish cystic mass below the right medial canthus. She had been born healthy. Under the impression of a hemangioma brain computed tomography was conducted. As a result, a diagnosis of congenital dacryocystocele was made. We present this case to show that it is important for a dermatologist to correctly identify congenital dacryocystoceles and appropriately refer the infant to a pediatric ophthalmologist prior to performing invasive measures.

Polymerized urushiol of the commercially available rhus product in Korea

BACKGROUND

Systemic contact dermatitis commonly occurs with the intake of rhus (boiled chicken with rhus) as a health food and a folk medicine to cure gastrointestinal diseases in Korea. Rhus companies insist they have the technology for rhus detoxification. However, the numbers of systemic allergic contact dermatitis patients, caused by rhus, have not decreased. The principle of present techniques for rhus detoxification is the induction of the polymerization of urushiol, but polymerized urushiol may still have antigenicity, although to a diminished degree. The Korean Food and Drug Administration (KFDA) has a regulation to control urushiol use as a food. However, the laboratory method that KFDA uses for detection of rhus can only detect the urushiol monomer.

OBJECTIVE

We conducted experiments to detect polymerized urushiol in rhus products, which were considered not to include urushiol by the KFDA.

METHODS

Rhus product approved by the KFDA was separated with chloroform. The chloroform fractionation was accomplished on a recycle HPLC system. Four peaks were achieved and evaporated to give an amorphous powder. Each powder was analyzed on a NMR system and mass spectrometer.

RESULTS

The material considered to be urushiol dimer, with a 638 molecular weight (MW), was detected in one of the four powders as per the HPLC peaks.

CONCLUSION

We concluded that commercially available rhus product is comprised of material considered to be urushiol dimer. Therefore, even if the antigenicity of the rhus products is low, this product may cause adverse effects and is not completely detoxified.

Cross-talk free and ultra-compact fiber optic sensor for simultaneous measurement of temperature and refractive index

We propose and demonstrate a cross-talk free simultaneous measurement system for temperature and external refractive index (ERI) implemented by dual-cavity Fabry-Perot (FP) fiber interferometer. The sensing probe consists of two cascaded FP cavities formed with a short piece of multimode fiber (MMF) and a micro-air-gap made of hollow core fiber (HOF). The fabricated sensor head was ultra-compact; the total length of the sensing part was less than 600 mum. Since the reflection spectrum of the composite FP structures is given by the superposition of each cavity spectrum, the spectrum measured in the wavelength domain was analyzed in the Fourier or spatial frequency domain. The experimental results showed that temperature could be determined independently from the spatial frequency shift without being affected by the ERI, while the ERI could be also measured solely by monitoring the intensity variation in the spatial frequency spectrum. The ERI and the temperature sensitivities were approximately 16 dB/RIU for the 1.33-1.45 index range, and 8.9 nm/ degrees C at low temperature and 14.6 nm/ degrees C at high temperature, respectively. In addition, it is also demonstrated that the proposed dual-cavity FP sensor has potential for compensating any power fluctuation that might happen in the input light source.

Optical performance monitoring technique using asynchronous amplitude and phase histograms

We report a new optical performance monitoring technique based on the amplitude and phase histograms of the optical signal. The amplitude and phase histograms are obtained by using an intradyne receiver and the asynchronous delay-tap sampling method. From these histograms, we can evaluate the amplitude and phase Q-factors of the optical signal regardless of its modulation format. In addition, by using these Q-factors, we can estimate the bit-error rate (BER) of the monitoring signal.

Electronic Raman scattering of two-band superconductors: a time-dependent Landau-Ginzburg theory approach

Electronic Raman scattering of two-band superconductors is studied based on the time-dependent Landau-Ginzburg theory. The focus is on the possible features of the π phase shift between the two superconducting order parameters which may be realized in the Fe-pnictides. The Raman response was computed up to the Gaussian fluctuations in the functional integral formalism including the long range Coulomb interaction with the four channels of symmetric and antisymmetric combinations of the phases and amplitudes of the two order parameters. The Raman spectra is found to be composed of the quasiparticle and the phase collective mode contributions without mixing between them. The contributions from the quasiparticle and the symmetric phase collective mode (the Anderson-Bogolyubov mode) are similar to the two-band superconductors without the π phase shift. The antisymmetric phase mode (the Leggett mode) originates from the fluctuations of the relative phase of the two order parameters. It lies between twice the smaller gap and twice the larger gap and is damped by the quasiparticles. However, this mode is eliminated by the long range Coulomb interaction in the zero-wavenumber limit.

Localized Sweet's Syndrome in an Irradiated Field

Sweet's syndrome is a reactive dermatosis characterized clinically by fever, leukocytosis, and multiple, erythematous, painful plaques. Histopathologic examination reveals a band-like dense dermal inflammatory infiltrate composed mainly of neutrophils with papillary dermal edema, and no features of vasculitis. We report a case of a 56-year-old female diagnosed with cervical cancer, who underwent surgery and concurrent chemoradiation therapy. Approximately 3 years after completing treatment, she presented with erythematous plaques, principally within the radiation field; the skin biopsy showed features consistent with Sweet's syndrome.

A case of eccrine angiomatous hamartoma associated with verrucous hemangioma

Eccrine angiomatous hamartomas are benign vascular and eccrine malformations often accompanied by hyperhidrosis or pain, increased eccrine glands, and aggregates of vessels. Verrucous hemangiomas are congenital vascular malformations presenting as unilateral grouped papules. Histologically, they show verrucous epidermal change and proliferation of capillaries in the dermis. We report a case of a 47-year-old woman with a red keratotic patch overlying a bluish plaque on the right sole, which had been present since birth. It was accompanied by pain and hyperhidrosis. Histologically, there were verrucous changes in the epidermis, numerous dilated capillaries in the papillary dermis, and increased eccrine glands with angiomatous foci in the deep dermis. The epithelial cells of the eccrine glands were positive for CEA, and the endothelial cells were positive for CD31 and GLUT-1. Eccrine angiomatous hamartomas have been reported in conjunction with other vascular tumors in only a few instances. We report an interesting case of an eccrine angiomatous hamartoma associated with a verrucous hemangioma.

Transmission of 108-Gb/s PDM 16ADPSK signal on 25-GHz grid using non-coherent receivers

We demonstrate the transmission of 108-Gb/s polarization-division-multiplexed (PDM) 16-ary amplitude- and differential phase-shift-keying (16ADPSK) signal by using a non-coherent receiver. We generate the 16ADPSK signal by using a differential 8-ary phase-shift-keying (D8PSK) modulator and a phase-distortion-free amplitude-shift-keying (ASK) modulator. On the other hand, the receiver is implemented by using a delay interferometer based on a 3x3 fiber coupler and the data-aided phase-noise estimation (DAPNE) algorithm. By using these transmitter and receiver, we achieve a nearly quantum-limited receiver sensitivity in the back-to-back condition. In addition, we examine the possibility of transmitting 108-Gb/s signals on a 25-GHz grid without using the coherent detection technology. The results show that we can secure a sufficient optical-signal-to-noise (OSNR) margin after the transmission of 80-km long dispersion managed link. The achieved spectral efficiency is 4.0 bit/s/Hz.