BACKGROUND: The wound healing process is impaired or delayed in aged patients. The development of a new wound healing model is needed. Nerve growth factor (NGF) plays a special role in wound healing because NGF is expressed only in proliferating tissues such as wounds. OBJECTIVE: The aim of our study was to develop a wound healing model using a 3-dimensional culture system, raft culture, by comparing the level of NGF expression according to the wound stage after an artificial wound was made to the raft samples. We tried to specifically localize the site of NGF expression both in mRNA and protein level. METHODS: Raft culture using normal human keratinocytes was done and a 2 mm slit wound was made in the center of the raft samples. Raft samples of no wound, 4 d, 7 d, and 9 d after wounding were prepared. In situ RT-PCR and immunohistochemistry were performed to detect and localize NGF expression after making wounds and the addition of substance P (SP). RESULTS: We failed to localize NGF mRNA expression in raft samples by in situ RT-PCR. Immunohistochemistry showed NGF staining throughout the epidermis although a little more dense staining was found in the basal layer. NGF(+) cells tended to increase until 7 d after wounding, but there were no significant differences according to the wounding days. There was `a tendency that the SP(+) group showed more NGF(+) cells than the SP(-) group, but there were no statistical differences. CONCLUSION: We think that our in vitro raft wound model using NGF expression could be used, at least in part, as an objective indicator for wound healing. In our raft model lacking nerve, NGF may not be suitable for representing wound healing process because this model can not reflect the interaction between the skin and the nervous system. Expression of growth factors or cytokines other than NGF need to be applied to our raft culture system.
Cytokines ; Epidermis ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Keratinocytes ; Nerve Growth Factor ; Nervous System ; RNA, Messenger ; Skin ; Substance P ; Wound Healing* ; Wounds and Injuries*

PURPOSE: We investigated the anti-inflammatory and anti-fibrotic effects of amniotic membrane(AM) ointment in filtering surgery of rabbits. METHODS: After filtering surgery was performed on both eyes of 10 rabbits, the AM ointment was applied over and under the scleral flap on one eye whereas base ointment excluding AM element was applied to the other as a control. The shapes of blebs were observed under slit-lamp biomicroscopy at postoperative 3 days, 1 week, 2 weeks and 4 weeks, and the tissues were excised for histologic studies. RESULTS: Serial changes of intraocular pressures had no significant difference. Slit-lamp biomicroscopy demonstrated that conjunctival blebs of AM ointment group were more elevated and cystic at 1 and 2 weeks. The heights of conjunctival blebs were significantly higher at 1, 2 and 4 weeks, and the width of scleral tracks was significantly wider at 1 and 2 weeks in AM ointment group. The number of inflammatory cells in the scleral track was significantly less at 3 days and 1 week, the number of fibroblasts in scleral track was significantly less at 2 and 3 weeks in AM ointment group. Masson s trichrome stain was less positive in AM ointment and the stain area of alpha-smooth muscle actin-positive fibroblasts was insignificant with image analysis system. Collagen type 3 appeared in scleral track from postoperative 1 week in control group, however, in AM ointment group, from 4 weeks. CONCLUSIONS: AM ointment is beneficial to suppress fibroblast differentiation, proliferation and inflam-matory reaction in filtering surgery and might be safe and effective adjunctive for enhancement of success in filtering surgery.
Amnion* ; Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Humans* ; Intraocular Pressure ; Rabbits*

Dystrophic epidermolysis bullosa is a rare, chronic non-inflammatory bullous disease, which easily forms bullae by minor mechanical trauma or spontaneously, is inherited either in an autosomal dominant or autosomal recessive fashion. We report herein two cases which presented with bullae, erosions and ulcers on extremities, buttock, chest, abdomen and face and loss of all nail since birth in two sisters. Bulla occured bencath the basal lamina histopathologically, anchoring fibrils were almost absent on electron miaoscopy in both cases. The two sisters represented dystrophic epidermolysis bullosa considering the absence of family history inheritcd in an autosomal dominant fashion and the clinical, histological and electronmicroscopic findings.
Abdomen ; Basement Membrane ; Buttocks ; Epidermolysis Bullosa Dystrophica* ; Extremities ; Humans ; Parturition ; Siblings* ; Thorax ; Ulcer

Chronic mucocutaneous randidiasis is a clinical syndrome characte ized by chronic and reccurent superficial candidal infection of the skin, mucous membranes, and nails. This syndrome is frequently associated with immune deficiency or endocrinopathy, especially hypopar; thyroidism. We report a case of chrcinic mucocutaneous candidiasis associated with hypoparathyroidism in a 8- year-old girl.
Candidiasis ; Candidiasis, Chronic Mucocutaneous* ; Female ; Humans ; Hypoparathyroidism* ; Mucous Membrane ; Skin ; Thyroid Gland

Hemangioma of the testis is an extremely rare lesion, more or less than 10 cases having been reported in infancy or early childhood in the world. We have experienced one case of capillary hemangioma of the left testis in 6 year old Korean male, which was suspicious to be a malignant tumor.
Capillaries* ; Child ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Male ; Testis*

BACKGROUND: During craniotomy operations, the PaCO2 has therapeutic implications because hyperventilation is often used to lower intracranial pressure. PETCO2 is often used as an estimate of PaCO2, with the assumption that P(a-ET)CO2 is relatively constant. To clarify the relationship between PaCO2 and PETCO2, sixty patients undergoing elective craniotomies were studied. METHODS: Arterial blood gases were measured from 30 minutes after endotracheal intubation to skin closure at an interval of 30 minutes in thirty patients, and at random interval in another thirty patients. PETCO2 was simultaneously determined with infrared capnography(Datex AS/3TM, Filand). RESULTS: The PaCO2 was 31.7+/-3.0 mmHg and PETCO2, 26.3+/-2.5 mmHg, with a P(a-ET)CO2 of 5.5+/-2.7 mmHg(n = 431, range between 0-13.5). There was a significant positive correlation between PaCO2 and PETCO2(r = 0.537, slope = 0.440, P<0.001) and between P(a-ET)CO2 and PaCO2(r = 0.625, slope = 0.555, P<0.001). Although changes in the pooled data of PaCO2 and PETCO2 correlated statistically, comparisons in 43 of 60(71.6%) individuals were not correlated. On comparisons of subsequent measurements, 17.0% of changes in PaCO2 and PETCO2 were in opposite directions. P(a-ET)CO2 had a tendency to increase with time during surgery(slope = 0.0082), but there was no statistically significant difference between the measurements. CONCLUSION: The PETCO2 measured with infrared capnography does not provide a stable reflection of PaCO2 in many patients undergoing craniotomy. Therefore, we concluded that capnography must be used in conjuction with arterial blood gas measurements for monitoring the respiratory acid-base status of mechanically ventilated neurosurgical patients undergoing craniotomy.
Capnography ; Carbon Dioxide* ; Carbon* ; Craniotomy* ; Gases ; Humans ; Hyperventilation ; Intracranial Pressure ; Intubation, Intratracheal ; Skin

No abstract available.
Lung*

Twenty-seven consecutive patients who had post-traumatic stiffness of the elbow were treated by operative soft tissue release or by soft tissue release and distraction arthroplasty. The purpose of this study was to describe the method of operation and postoperative management and to evaluate the results in the patients who had operative treatment for the post-traumatic stiffness of the elbow. The type of operative procedure was determined by whether the factors limiting motion were extra-articular (extrinsic) or intra-articular (intrinsic) and by pre-operative radiographic evaluation. The soft tissue release was performed by staged adhesiolysis through lateral or combined lateral and medial approaches. And if the factors limiting motion included a severe intraarticular lesions, distraction arthroplasty using the Judet or Oganesian apparatus was added to soft tissue release. The mean pre-operative arc of active motion was 42 degrees. At follow-up examination, nineteen to sixty-six months postoperatively, the mean post-operative arc of active motion was 103 degrees. There were nine complications (33 percent) in twenty-seven patients. All of them was transient ulnar nerve paresthesia. And we analysed the final results with Mayo elbow performance index for the evaluation of clinical outcome. Twenty-five (93%) of twenty-seven patients had satisfactory result according to Mayo elbow performance index. We conclude arthrolysis with or without distraction arthroplasty is useful for the treatment of posttraumatic elbow stiffness. However, the accurate anatomical knowledge, operative skill, and careful postoperative rehabilitation program were needed in the operative treatment of post-traumatic elbow stiffness.
Arthroplasty ; Elbow* ; Follow-Up Studies ; Humans ; Paresthesia ; Rehabilitation ; Surgical Procedures, Operative ; Ulnar Nerve

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with proper technique. Local anesthetic technique is often preferable to general anesthesia for bronchoscopies since these examinations are mostly undertaken as outpatient procedures. Inhaled topical lidocaine, used to produce anesthesia of the repiratory tract prior to bronchoscopy, may cause anaphylactoid reaction in patients. However lidocaine hypersensitivity reaction is uncommon. We report the case of death due to hypersensitivity to topical lidocaine spray given during routine premedication for this procedure. The possibility of bronchospasm secondary to an adverse reaction to premedication or anesthesia must also be considered.
Anaphylaxis* ; Anesthesia* ; Anesthesia, General ; Bronchial Spasm ; Bronchoscopy* ; Humans ; Hypersensitivity ; Lidocaine* ; Outpatients ; Premedication