The present study was performed to examine whether acupuncture can regulate the expression of cytokines that play important roles in wound healing and morphological changes in the burn wound healing of rats, such as transforming growth factor (TGF)-beta1, TGF-beta3, epidermal growth factor (EGF), and interleukin-6 (IL-6). Sprague-Dawley rats weighing 250~300 g were divided into two control groups and two experimental groups. Among the control groups, no-treatment group was classified as C and acupuntured group as Ca. Among the experimental groups, burned group (n = 6) was classified as B and acupunctured group after burn (n = 6) as Ba. The lumbar area of rats was burned 15 x 25 mm in size for 15~18 seconds with special small iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once. Rats in group Ba were acupunctured every 12 hours 3 times. Rats were sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Morphological changes were examined by hematoxylin-eosin staining methods. The expression profiles of TGF-beta1, TGF-beta3, EGF and IL-6 were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. In gross observation, the burn wounds were less odorous and cleaner in the acupunctured group (Ba) compared with those of no-acupuncture group (B). 2. Reepithelialization and formation of panniculus carnosus and granulation tissue were more prominent at days 3 and 7 in the acupunctured group Ba than group B. However, this difference was disappear at day 15. 3. In the muscle of group B, TGF-beta1 was observed after day7. However, in group Ba, TGF-beta1 was observed as early as days 1 and 3 and rapidly turnovered at day 7. 4. For TGF-beta3, both B and Ba groups showed similar results. 5. At day 3, EGF was observed in the subcutaneous tissue in both B and Ba groups. However, in day 7, EGF was rapidly decreased in Ba group compared with that of B. 6. For IL-6, both B and Ba groups showed similar results in epidermis, dermis, subcutaneous tissue and muscle. But, at day 3, IL-6 was rapidly decreased in theconnective tissue under the muscle in Ba group compared with that of B. These results suggest that acupuncture may improve the wound healing in the early stage by increasing the TGF-beta1 that is essential for the formation of extracellular matix and by decreasing EGF.
Acupuncture* ; Animals ; Burns* ; Cytokines ; Dermis ; Epidermal Growth Factor* ; Epidermis ; Granulation Tissue ; Interleukin-6* ; Iron ; Needles ; Odors ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta3* ; Transforming Growth Factors ; Wound Healing* ; Wounds and Injuries*

The present study was performed to examine whether acupuncture can regulate the expression of extracellular matrix proteins that play important roles in burn wound healing of rat, such as fibronectin, type I and IV collagens, and laminin. Sprague-Dawley rats weighing 250~300 g were divided into 4 groups such as normal control group (C), only acupuncture treatment group (Ca), burn treatment group (B), and a group for acupuncture treatment after burn (Ba). We burned 15x25 mm in size for 15~18 seconds at lumbar area of rats with special iron adapter and acupunctured at 5~7 mm in diameter and 1 cm in depth using 0.25 mm x 50 mm acupuncture needle for 20 minutes in wound area. Rats in group Ca were acupunctured once, and rats in group Ba were acupunctured every 12 hours 3 times. Rats sacrificed at days 1, 3, 7, 15 and 20 after burn treatment. Histological changes were examined by azan staining methods and expression profiles of fibronectin, type I and IV collagens, and laminin were detected by immunohistochemical staining methods. The results we obtained were as follows: 1. At day 1, fibers in epidermis, dermis and subcutaneous tissue in both groups B and Ba were not observed. However groups B and Ba exhibited fibers stained mildly and moderately, respectively, in muscle and connective tissues. At day 20 , the level of fiber in group B which was comparable to group C was less than that of in B group. 2. At day 3, fibronectin in group Ba was observed in the muscle. At days 15 and 20, fibronectin was increased in epidermis and dermis of group Ba compared with those of group B. 3. Type I collagen in subcutaneous tissue was observed at days 1, 3 and 7 in both groups B and Ba. However type I collagen was observed only in group Ba at day 15. In the epidermis of group Ba, type I collagen was observed at day 3 and maintained until day 20, while observing only at day 20 in group B. 4. For type IV collagen, both groups B and Ba showed similar results. 5. For laminin, both groups B and Ba showed similar results except the 7th day results. However after day 15, laminin was stained moderately and mildly in groups Ba and B, respectively. These results suggest that acupuncture may improve the burn wound healing by increasing fibronectin and type I collagen.
Acupuncture* ; Animals ; Burns* ; Collagen Type I ; Collagen Type IV ; Collagen* ; Connective Tissue ; Dermis ; Epidermis ; Extracellular Matrix Proteins ; Fibronectins* ; Iron ; Laminin* ; Needles ; Rats* ; Rats, Sprague-Dawley ; Skin ; Subcutaneous Tissue ; Wound Healing* ; Wounds and Injuries*

We reviewed 13 patients with testicular embryonal carcinoma from July 1982 to May 1994. Embryonal carcinoma accounted for about 25% of total testicular tumors(13/56) and about 34% of nonseminomatous germ cell tumors(13/38). Among the patients with embryonal carcinoma, about 85% were diagnosed in the 15-to-34 year age group. About seventy percent of the patients had metastatic disease at the time of diagnosis and 66.7% of these had distant metastasis including by lung, bone, retroperitoneal lymph node and cervical lymph node, attesting to the aggressiveness of embryonal carcinoma and its tendency to early hematogenous spread. Serum AFP was elevated in 10 patients(76.9%) and hCG in 6 patients(46.2%). All patients with stage I (4/13) were treated with radical orchiectomy only, and all patients with stage II(3/13) were treated with radical orchiectomy and retroperitoneal lymph node dissection(RPLND) followed by chemotherapy. Of the patients with stage III(6/13), 4 patients were treated with radical orchiectomy and chemotherapy, and 2 patients with radical orchiectomy and early chemotherapy, followed by RPLND. The pathologic findings of lymph node at the time of RPLND in stage III were 1 residual embryonal carcinoma and 1 fibrosis. In stage I and II, all patients were still alive. In stage III, 2 patients were still alive for 22 and 48 months. Among the 4 expired patients, 2 were from lung metastasis and the others from sepsis might caused by chemotherapy. These results suggest that the radical orchiectomy only with close clinical observation for stage l had a good survival, and long term survival in stage II patients treated with radical orchiectomy and RPLND followed by chemotherapy will be expected. And in stage III, if the side effects of the chemotherapy is reduced, the better survival may be obtained.
Carcinoma, Embryonal* ; Diagnosis ; Drug Therapy ; Fibrosis ; Germ Cells ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Sepsis ; Testis

We purified phytoestrogens from Pueraria root (Pueraria mirifica from Thailand and Pueraria lobata from Korea), which is used as a rejuvenating folk medicine in Thailand and China. Dried, powdered plant material was extracted with 100% ethanol and further separated by concentration, filtration, and thin layer silica gel chromatography. Using the fractions obtained during separation, we first investigated their cytotoxicity in several cancer cell lines from various tissues. The ethanol-extracted components (PE1, PE4) had significant antiproliferative effects on breast cancer cell lines, including MCF-7, ZR-75-1, MDA-MB-231, SK-BR-3, and Hs578T. Second, we compared these results with the cytotoxic effects of known flavonoids, sterols, and coumarins from Pueraria root. The known compounds were not as effective, and occurred in a different polarity region on HPLC. Third, further separation resulted in the isolation of eight different components (Sub PE-A to -H). One of these, PE-D, affected the growth of some breast cancer cell lines (MCF-7, MDA-MB-231) in a dose- and time-dependent manner, as well as the growth of ovarian (2774) and cervical cancer cells (HeLa). Finally, a transfection assay showed that this component had an estrogenic effect similar to 17beta-estradiol, which activates both estrogen receptor a (ER alpha) and ER beta. The NMR analysis determined that spinasterol (stigmasta-7, 22-dien-3beta-ol) is an active cytotoxic component of Pueraria root.
Antineoplastic Agents/isolation & purification/*pharmacology ; Chromatography, High Pressure Liquid ; Estrogen Receptor alpha/agonists ; Estrogen Receptor beta/agonists ; Female ; Humans ; Plant Preparations/therapeutic use ; Plant Roots/*chemistry ; Pueraria/*chemistry ; Research Support, Non-U.S. Gov't ; Stigmasterol/*analogs & derivatives/isolation & purification/pharmacology ; Transfection ; Tumor Cells, Cultured

Objective: Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals. Methods: Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution. Results: TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001). Conclusion Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

Objective: Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals. Methods: Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution. Results: TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001). Conclusion Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

BACKGROUND: Soft tissue clear cell sarcoma is a rare tumor which originates from neural crest cells. Due to its rarity and lack of established treatment, the prognosis of clear cell sarcoma is poor. Here, we reviewed the clinical data and outcome of patients diagnosed with soft tissue clear cell sarcoma in our institution.METHODS: A retrospective study was conducted on pediatric patients who were treated for pathologically confirmed soft tissue clear cell sarcoma at the Seoul National University Hospital, between January 2000 and July 2017.RESULTS: Six patients (3 boys and 3 girls) were diagnosed with soft tissue clear cell sarcoma at a median age of 14 years 4 months (range 11 years 7 months - 19 years 3 months). The median size of the tumor was 5.6 cm (range, 0.6 cm to 7.9 cm). The most frequent symptom was pain (67%), and the most common primary site was the lower limb (67%). Three patients (50%) presented with metastases at diagnosis. Four patients underwent chemotherapy with various therapeutic combinations. Four patients received surgical resection. Only one patient received local radiotherapy. One patient died of primary refractory disease, three patients relapsed, while the remaining two survive event-free.CONCLUSION: Soft tissue clear cell sarcoma is a rare and highly aggressive tumor, for which there is no established treatment. All surviving patients received surgery, indicating that surgery is a key treatment modality. Further genetic studies of soft tissue clear cell sarcoma are needed to find a better treatment strategy.
Diagnosis ; Drug Therapy ; Humans ; Korea ; Lower Extremity ; Neoplasm Metastasis ; Neural Crest ; Pediatrics ; Prognosis ; Radiotherapy ; Retrospective Studies ; Sarcoma, Clear Cell ; Seoul ; Treatment Outcome

Objective: To evaluate the effect of different extracts of Diospyros lotus leaves in atopic dermatitis Methods: Diospyros lotus leaves were extracted in ethanol and treated with or without hydrochloric acid or α-rhamnosidase to obtain three different extracts-ethanol, acid-hydrolyzed, and enzyme-hydrolyzed leaf extracts of date plum. The myricitrin content in all samples was measured using HPLC analysis. In vitro antioxidant and anti-inflammatory activities of the extracts were determined by measuring DPPH radical scavenging activities and nitric oxide production in RAW264.7 cells, respectively. Seven-week-old male hairless mice were used to evaluate the anti-atopic dermatitis effects of three extracts in vivo. Splenocytes and mast cells were used to further determine the anti-atopic dermatitis effects of the major compound in the ethanol leaf extract. Results: Enzyme-hydrolyzed leaf extract showed significant in vitro antioxidant and anti-inflammatory activities, and attenuated atopic dermatitis-like skin symptoms and clinical signs more significantly than ethanol and acid-hydrolyzed leaf extracts in 1-fluoro-2,4-dinitrobenzene and house dust mite antigen-treated hairless mice. Enzyme-hydrolyzed leaf extract also suppressed the serum level of immunoglobulin E, interleukin (IL)-4, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, thymic stromal lymphopoietin, and thymus and activation-regulated chemokine in mice with atopic dermatitis. Furthermore, histological analysis revealed that enzyme-hydrolyzed leaf extract suppressed the increased epidermal thickness, dermal infiltration of inflammatory cells, and infiltration and degranulation of mast cells more markedly than the other two extracts in atopic dermatitis-like skin lesions. In addition, this extract effectively inhibited the production of IFN-γ, IL-4,and thymus and activation-regulated chemokine compared with the other two extracts in concanavalin A-stimulated splenocytes. Myricitrin, a major compound of enzyme-hydrolyzed leaf extract, suppressed atopic dermatitis biomarkers in stimulated mouse splenocytes and HMC-1 human mast cells. Conclusions: These results suggest that enzyme-hydrolyzed leaf extract might be a potential candidate to treat atopic dermatitis.