Successful treatment of Kimura’s disease with cyclosporine

( Seol Hwa Seong ),( Ji Yun Jang ),( Myeong Hyeon Yang ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Kimura’s disease (KD) is a rare chronic inflammatory disease of unknown etiology. Clinically, painless subcutaneous swellings and lymphadenopathy mainly involving the head and neck region can be seen. The histopathologic findings of KD show lymphoid follicular hyperplasia with germinal centers, massive eosinophilic infiltration often with the formation of abscess, varying degree of fibrosis, and vascular proliferation. Surgical excision, regional or systemic steroid therapy have formed the mainstay of the treatment, but the consensus on the optimal treatment is not well established. Cyclosporine also can be used and its therapeutic effects are related to the decrease in production of cytokines including IL-2, IL-4, IL-5, which inhibits T-cell proliferation. A 34-year-old female patient presented with localized pruritic solitary erythematous swollen patches on the right cheek. The lesions gradually grew up during last 18 months. Histopathologic findings showed dense lymphocytic follicular hyperplasia, stromal fibrosis, marked eosinophilic infiltration with flat epithelial cells of venules. On the basis of these clinical and histopathologic findings, the diagnosis of KD was made. The patient was treated with oral cyclosporine (200mg/day). A significant improvement in skin lesions was achieved after 20 weeks of treatment and maintained during follow-up period. Herein, we report a case of KD successfully treated with oral cyclosporine.

Metastatic pancreatic cancer mimicking keratoacanthoma: Dermoscopic features

( Seol Hwa Seong ),( Ji Yun Jang ),( Jong Bin Park ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Cutaneous metastasis of internal malignancy is a rare phenomenon that accounts for less than 5% of the patients with cancer and can be confused with benign skin disorders. A 47-year-old male suffering from the pancreatic cancer presented with a well-defined, erythematous coin sized solitary tumor with central ulceration on the face, clinically similar to a keratoacanthoma (KA). On dermoscopy, the ulcerated central amorphous area surrounded by white structureless area and white circles on the erythematous to orange colored background were seen. Polymorphous vascular patterns were asymmetrically distributed with densely aligned, linear serpentine vessels, dotted vessels, and arborizing vessels. The hairpin vessel, a well-known dermoscopic feature of KA, was not seen. Histologic findings showed atypical hyperchromatic cells densely involving the dermis and subcutaneous tissue, transepidermal elimination, and uninvolved epidermis separated from underlying tumor cell infiltration by Grenz zone. Moderately differentiated neoplastic glands and tumor cells showing the ‘Indian file’ arrangment were seen. In the immunohistochemical staining, CA19-9, CK19, and CK7 were positive, whereas, CK20 were negative. On the basis of dermoscopic and histologic findings, the diagnosis of metastatic pancreatic cancer was made. Herein, we report a case of metastatic pancreatic cancer mimicking KA for which the dermoscopy was used as a helpful diagnostic tool.

Localized mycosis fungoides that predominantly affects knuckles of hands

( Seol Hwa Seong ),( Jang Hwan Jung ),( Do Ik Kwon ),( Kang Hoon Lee ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Mycosis fungoides palmaris et plantaris (MFPP) is a variant of mycosis fungoides (MF) that localized on the palms and soles, which often spreads to the dorsal aspect of hands, fingers, and feet. However, it is argumentative to classify localized MF that mainly affects knuckles of hands, with or without involvement of palms, as MFFP. Further, it can be overlooked as chronic hand eczema unless a biopsy is performed. Objectives: To investigate the clinicopathologic features of localized MF that mainly affects the dorsal aspect of hands. Methods: This study was conducted on nine patients diagnosed clinicopathologically MF, and who presented discrete eczematous lesions predominantly on the dorsal aspect of hands. Results: The mean age at the diagnosis was 47.6 years (range, 38-59). The mean duration of the disease was 46.7 months (range, 12-120). Knuckles were the most common site of involvement shown in all nine patients, followed by the volar side of fingers shown in six patients. Five patients reported an occupational history with frequent minor injuries on the hands. During 78.5 months of the mean follow-up, none of the patients had progressive disease. While most histopathologic findings were similar to that of classic MF, spongiosis was more pronounced in our patients. Conclusion: We suppose that trauma may play a role in the development of localized MF, and a high index of suspicion is needed for this diagnostic challenge.

Distinction of bowenoid papulosis, seborrheic keratosis and condyloma acuminatum in genital area with dermoscopic features and human papilloma virus related entities

( Seol Hwa Seong ),( Do Ik Kwon ),( Ji Yun Jang ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Making a clear diagnosis of bowenoid papulosis (BP), seborrheic keratosis (SK) and condyloma acuminatum (CA) in genital area can be difficult. Skin biopsy can be helpful but its invasiveness and low cost-effectiveness provoke to seek other diagnostic methods. Objectives: To investigate distinctive dermoscopic features and human papillomavirus (HPV) related entities that can differentiate BP, SK, and CA. Methods: Dermoscopic patterns and real-time polymerase chain reaction (PCR) to detect HPV were evaluated in 44 biopsy specimens. 10, 13, and 21 specimens of them were histologically confirmed as BP, SK, and CA. Results: The most common site of occurrence was penile shaft in BP, inguinal area in SK and equally penile shaft or inguinal area in CA. Dermoscopic features tend to be different showing structureless pattern (80%) with glomerular vessels (70%) in BP, cobblestone pattern (46%) without specific visible vessels (69%) in SK, and exophytic papillary structures (86%) with high vascularity including hairpin, glomerular, and comma-like vessels (71%, 57%, and 52%, respectively) in CA. Detection rate of HPV in PCR was 90% in BP, 61.5% in SK, and 100% in CA. Commonly found subtype was HPV 16 in BP (46.2%), SK (60.0%), and HPV 6 in CA (42.9%). Conclusion: Dermoscopy can be useful for differential diagnosis of BP, SK, and CA. High-risk HPV was predominant in BP, SK and low-risk HPV in CA implying distinctive HPV related entities.

Unusual clinicohistopathologic features of cutaneous nontuberculous mycobacterial infection caused by Mycobacterium marinum

( Seol Hwa Seong ),( Ji Yun Jang ),( Jong Bin Park ),( Min Soo Jang ),( Kee Suck Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Nontuberculous mycobacteria (NTM), which rarely cause cutaneous lesions, are a heterogeneous group of acid-fast bacilli other than Mycobacterium tuberculosis and Mycobacterium leprae. Among the cutaneous NTM infections, Mycobacterium marinum is the most common pathogen and its clinical manifestation can be variable. A 74-year-old woman presented with diffuse tender erythematous to yellow cellulitis-like patches on the left arm along the discrete papules on the left flank. Histopathologic findings showed caseating granuloma that distinctly had central necrosis with a palisaded lymphohistiocytic infiltration and multinucleated giant cells in the upper dermis. Non-caseating granulomas, nonspecific mixed cell infiltration in the deep dermis, and abscesses in the subcutaneous tissue were seen. Cultures for the NTM and sequencing of the polymerase chain reaction confirmed M. marinum infection. Retrospectively, acid-fast bacilli were found in the Ziehl-Neelsen stain. On the basis of histopathologic, microbiologic, and molecular findings, the diagnosis of cutaneous NTM infection caused by M. marinum was made. Among the variable clinicohistopathologic features of cutaneous NTM infection, cellulitis-like appearance is rarely observed and caseating granuloma surrounded by palisading lymphohistiocytic infiltration is not common. Herein, we report a case of unusual clinicohistopathologic features of cutaneous NTM infection caused by M. marinum.

Epidemiology and clinical outcomes of 151 patients with mycosis fungoides at the Kosin University Gospel Hospital: retrospective 27-year review

( Seol Hwa Seong ),( Do Ik Kwon ),( Ji Yun Jang ),( Jong Bin Park ),( Kee Suck Suh ),( Min Soo Jang ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma with a variety of clinicopathological features. A single center-based large scale study with long-term follow up in Korea has not been reported. Objectives: To investigate epidemiologic features and clinical outcomes of MF patients at the authors’ hospital over a 27-year period. Methods: This is a pilot study conducted on 151 patients diagnosed as MF, from 1991 to 2018, with the retrospective review. Results: Of 151 patients, 62.9% were male and 37.1% female. The mean age at the diagnosis was 44.2 years (range, 5-82). The mean duration of symptoms was 50.4 months (range, 0.25-360). The mean follow-up duration was 57.6 months (range, 2-251). Common subtypes were classic MF (45.0%), mycosis fungoides palmaris et plantaris (MFPP) (23.8%), and folliculotropic MF (7.9%). In early-stage MF (IA-IIA) of 143 patients (94.7%), the 10-year overall survival (OS) was 93.6%. In advancedstage MF (IIB-IVB) of eight patients (5.3%), the 10-year OS was 23.4%. Complete remission (CR) and disease progression were found in 63.6% and 4.6% of the patients. The recurrence after CR was observed in 33 patients (21.9%) and the mean recurrence free-duration was 24.1 months (range, 1-118). Conclusion: Clinical outcomes generally paralleled the previous reports with favorable prognosis in the earlystage MF. Recurrence was not uncommon, largely due to greater prevalence of MFPP.

The Effect of the Water Extracts of Digestive Medicinal Plants on the Shelf-life of Pork Patties

Seol, Kuk-Hwan,Seol, Hyun-Chul,Prayad, Thirawong,Kim, Hyoun-Wook,Jang, Ae-Ra,Ham, Jun-Sang,Oh, Mi-Hwa,Kim, Dong-Hun,Lee, Moo-Ha Korean Society for Food Science of Animal Resource 2011 한국축산식품학회지 Vol.31 No.1

This study was performed to examine the possibility of water extracts of several digestive medicinal plants (DMPEs), such as Amomum tasoko, Alpinia oxyphylla, Citrus unshiu, and Myristica fragrans, as a natural antioxidant. Total phenol contents of each extract were expressed as gallic acid equibalents (GAE) and those were significantly different among A. tasoko ($39.87{\pm}5.77$ mg GAE/g), A. oxyphylla ($30.28{\pm}3.36$ mg GAE/g), C. unshiu ($28.13{\pm}5.01$ mg GAE/g) and M. fragrans ($6.36{\pm}0.30$ mg GAE/g) (p<0.05), and extract of A. tasoko showed significantly higher antioxidative effect than butylated hydroxyanisole (BHA) on linoleic acid peroxidation at 72 h after incubation (p<0.05). Addition of extracts in pork patties did not affect the pH value and total microbes during cold storage. However, thiobarbituric acid reative substances (TBARS) of treated patties were lower in dose dependant manner than that of control as storage period increased (except patties treated with C. unshiu extract), and patties treated with 0.5% A. tasoko extract showed no significant difference with patties treated with 0.5% BHA at day 7.

Assessment of the Inhibitory Activity of Peptide Extracts from Hanwoo Musculus Longissimus on Angiotensin I-Converting Enzyme

Seol, Kuk-Hwan,Song, Ji-Hye,Prayad, Thirawong,Kim, Hyoun-Wook,Jang, Ae-Ra,Ham, Jun-Sang,Oh, Mi-Hwa,Kim, Dong-Hun,Lee, Moo-Ha Korean Society for Food Science of Animal Resource 2011 한국축산식품학회지 Vol.31 No.5

This study was performed to measure the angiotensin I-converting enzyme (ACE) inhibitory activity of peptide extracts derived from the enzymatic proteolysis of Hanwoo Musculus longissimus (M. longissimus) during cold storage. Thermolysin (80 ppm, w/w) and protease type XIII (100 ppm, w/w) were injected separately or in combination for the enzymatic proteolysis of sarcoplasmic and myofibrillar proteins prior to storage at $5^{\circ}C$ (T1) or at $-1^{\circ}C$ (T2) in a chilling room for 9 days. Beef injected with thermolysin (E2) and thermolysin+protease type XIII (E3) showed a significantly higher degree of hydrolysis at both storage temperatures (p<0.05). During the storage period, T1E2 at day 6 and T1E3 at day 9 showed the strongest ACE inhibitory activity with sarcoplasmic and myofibrillar protein proteolysates. Macromolecules greater than 10,000 Da were removed by ultra filtration, and the filtrates were separated into fractions using gel filtration. Five and three major fractions were collected from S-T1E2-6 and M-T1E3-9 extracts, respectively, and the $4^{th}$ fraction of the S-T1E2-6 extracts showed the highest ACE inhibitory rate of $61.96{\pm}7.41%$.

Growth Profile and Toxigenicity of Bacillus cereus in Ready-to-eat Food Products of Animal Origin

Mi Hwa Oh,Jun Sang Ham,Kuk Hwan Seol,Aera Jang,Seung Gyu Lee,Jong Moon Lee,Beom Young Park,Eun Sil Kang,Ki Sung Kwon,In Gyun Hwang 한국축산식품학회 2011 한국축산식품학회지 Vol.31 No.1

The growth profile of Bacillus cereus in ready-to-eat (RTE) food products of animal origin was examined under different temperature and incubation conditions. In sandwiches and Kimbab, B. cereus did not grow or exhibited only minimal growth at 4 and 10℃, but it grew rapidly at ambient temperature. In sandwiches, B. cereus did not grow efficiently at 25℃, however, in ham, the main ingredient of sandwiches, B. cereus growth was observed at the same temperature, with bacterial levels reaching 7.94 Log CFU/g after incubation for 24 h at 25℃. Toxigenicity of B. cereus was observed only at temperatures above 25℃. In Kimbab, B. cereus produced toxin after 9 h at 30℃ and after 12 h at 25℃. Ingredients of sandwiches and Kimbab were collected from 3 different Korean food-processing companies to investigate the source of contamination by B. cereus. Among the 13 tested food items, 6 items including ham were found to be contaminated with B. cereus. Of these ingredients, B. cereus isolates from 3 items produced enterotoxins. None of these isolates harbored the emetic toxin-producing gene. The findings of the present study can be used for risk assessments of food products, including ham and cheese, contaminated with B. cereus.

Simultaneous Detection of 10 Foodborne Pathogens using Capillary Electrophoresis-Based Single Strand Conformation Polymorphism

Mi Hwa Oh,Hee Sung Hwang,Boram Chung,Hyun Dong Paik,Sangha Han,Sun Moon Kang,Jun Sang Ham,Hyoun Wook Kim,Kuk Hwan Seol,Aera Jang,Gyoo Yeol Jung 한국축산식품학회 2012 한국축산식품학회지 Vol.32 No.2

This report outlines the development of a rapid, simple, and sensitive detection system for pathogenic bacteria using a capillary electrophoresis-based, single strand conformation polymorphism (CE-SSCP) combined with PCR. We demonstrate that this method, used with primers targeting the V4 region of the16S rRNA gene, is capable of the simultaneous detection of 10 microbes that could be associated with foodborne illness, caused by animal-derived foods: Salmonella enter-ica, Listeria monocytogenes, Escherichia coli O157:H7, Campylobacter jejuni, Staphylococcus aureus, Bacillus cereus, Clostridium perfringens, Yersinia enterocolitica, Vibrio parahaemolyticus, and Enterobacter sakazakii. The traditional detection techniques are time-consuming and labor-intensive, due to the necessary task of separate cultivation of each target species. As such, the CE-SSCP-PCR method, that we have developed, has the potential to diagnose pathogens rapidly, unlike the traditional technique, in order to prevent foodborne illness in a much more efficient manner.