BACKGROUND: Non-ablative dermal remodeling and ablative skin resurfacing are currently well-established skin treatment modalities. Fractional laser was recently introduced as a new concept for laser skin rejuvenation, and is characterized by creation of a dense pattern of epidermal and dermal microthermal treatment zones (MTZs). However, the precise mechanisms of dermal remodeling by Er:glass fractional laser treatment are largely unknown. OBJECTIVE: The purpose of this study was to investigate the effect of 1,550 nm Er:glass fractional laser treatment on dermal collagen synthesis and expression of TGF-beta1, a potent cytokine involved in collagen synthesis. METHODS: We treated hairless mice with several power densities (5 W 5 mJ~20 W 20 mJ), and examined the tissue samples on days 1, 30, and 90 after treatment. We analyzed the penetrating depth of laser treatment by determining dermal response through assessment of type I collagen synthesis and TGF-beta1 expression by H&E, Masson-trichrome staining, western blot analysis and immunohistochemistry staining. RESULTS: We observed, through H&E staining, that increasing the pulse energy of fractional laser treatment correlated with increasing depth of MTZ. Also, fractional laser treatment increased type 1 collagen synthesis on days 30 and 90, energy dependently. Immunohistochemical study showed that fractional laser treatment increased expression of type I collagen and TGF-beta1, energy dependently, with TGF-beta1 expression peaking on day 1. In addition, according to western blot analysis, expressions of TGF-beta1 and type I collagen were up-regulated in an energy- dependent manner. CONCLUSION: Er:glass fractional laser induced dermal remodeling by up-regulation of TGF-beta1 and type I collagen synthesis, and may be a promising modality for skin rejuvenation.
Animals ; Blotting, Western ; Collagen ; Collagen Type I ; Immunohistochemistry ; Mice ; Mice, Hairless ; Rejuvenation ; Skin ; Transforming Growth Factor beta1 ; Up-Regulation

BACKGROUND AND OBJECTIVES: Globus pharyngeus is the feeling of a lump or foreign body in the throat. Otolaryngologists are often confronted with this condition, and some authors report that it represents 3 percent of all new clinic referrals. Unfortunately, we still do not completely understand the etiologies of globus pharyngeus, but there are recently increasing evidences to link the globus symptoms with various diseases. MATERIAL AND METHODS: We selected 32 globus patients, who exhibited no pathologic condition in physical examinations, and were analysed by general work up, barium esophagogram, 24 hour-ambulatory double-probe pH monitoring, esophageal manometry test, Fuchs' series, and MMPI. RESULTS: The results were as follows, gastroesophago-laryngopharyngeal reflux disease (n=15: 46.9%), various psychotic problems (n=11: 34.4%), esophageal motility disorders (n=7: 21.9%), duodenal ulcer (n=2: 6.3%), Eagle's syndrome (n=2: 6.3%), and hiatal hernia (n=1: 3.1%). In 5 cases, we couldn't find the etiology of globus pharyngeus. CONCLUSION: Globus pharyngeus patients, who had no pathologic findings in layrnx and pharynx, might have laryngopharyngeal-gastroesophageal reflux diseases and psychologic problems.
Barium ; Duodenal Ulcer ; Esophageal Motility Disorders ; Esophageal pH Monitoring ; Foreign Bodies ; Hernia, Hiatal ; Humans ; Hypopharynx* ; Manometry ; MMPI ; Pharynx ; Physical Examination ; Referral and Consultation

A case of gastric anisakiasis due to the larva of Pseudoterranova decipiences was con- firmed by a gastroendoscopic examination. A long whitish nematode larva invading the stomach wall (fundus) was discovered and was extracted using biopsy forceps after 3 days to the onset of symptoms. The worm was 42.6 X 1.1 mm size, and was identified as being a the 4th stage larva of P. decipiens, based upon its morphological characteristics, The patient, residing in Seoul, was a 51-year-old housewife, who complained of severe epi- gastric pain and recalled that she had previously eaten the raw flesh of an Astroconger myriaster in a Japanese restaurant (sushi Bar). This study probably emerges as the 7th human case of gastric anisakiasis of pseudoterranoviasis in Korea.
Anisakiasis ; Asian Continental Ancestry Group ; Biopsy ; Humans* ; Korea ; Larva* ; Middle Aged ; Restaurants ; Seoul ; Stomach ; Surgical Instruments

OBJECTIVE: Microscopic indocyanine green (ICG) angiography is useful for identifying the completeness of aneurysm clipping and the preservation of parent arteries and small perforators. Neuroendoscopy is helpful for visualizing structures beyond the straight line of the microscopic view. We evaluated our prototype of endoscopic ICG fluorescence angiography in swine, which we developed in order to combine the merits of microscopic ICG angiography and endoscopy. METHODS: Our endoscopic ICG system consists of a camera, a light source, a display and software. This system can simultaneously display real-time visible and near infrared fluorescence imaging on the same monitor. A commercially available endoscope was used, which was 4 mm in diameter and had an angle of 30degrees. A male crossbred swine was used. RESULTS: Under general anesthesia, a small craniotomy was performed and the brain surface of the swine was exposed. ICG was injected via the ear vein with a bolus dose of 0.3 mg/kg. Visible and ICG fluorescence images of cortical vessels were simultaneously observed on the display monitor at high resolution. The real-time merging of the visible and fluorescent images corresponded well. CONCLUSION: Simultaneous visible color and ICG fluorescent imaging of the cortical vessels in the swine brain was satisfactory. Technical improvement and clinical implication are expected.
Anesthesia, General ; Aneurysm ; Angiography ; Arteries ; Brain ; Craniotomy ; Ear ; Endoscopes ; Endoscopy ; Fluorescein Angiography* ; Fluorescence* ; Humans ; Indocyanine Green* ; Male ; Neuroendoscopy ; Optical Imaging ; Parents ; Swine* ; Veins

OBJECTIVE: To describe the angiographic embolization as a safe and an effective alternative treatment in the management of obstetrical hemorrhage and in preserving fertility. METHODS: Between March 1999 and May 2003, 43 patients at Asan Medical Center underwent angiographic embolization for the management of obstetrical hemorrhage. All cases received arterial embolization because of obstetrical hemorrhage unresponsive to conservative management or prophylaxis for massive obstetrical hemorrhage. Medical records were reviewed and detailed to collect adequate clinical data such as clinical status, underlying conditions, amount of transfusion, embolization sites, materials of embolization, duration of the procedure, complications associated with embolization, hospital stay, and the success rate. Patients were contacted by telephone to obtain long-term outcome for menstruation, desire for conception, and subsequent pregnancies. RESULTS: We have experienced the clinical successful embolization in 37 (86.0%) of 43 patients of obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was atony of uterus (n=17), followed by abnormal placentation (n=6), genital tract laceration (n=5). The average amount of blood transfusion was 7.0 units (range; 0-36 units). The average length of the time for the procedure was 68.2 minutes (range; 30-150 minutes). The average duration of hospitalization was 6.4 days (range; 3-20 days). The main complication after embolization was numbness and pain on right lower extremities in 5 cases and vessel dissection occurred in 1 case. But there was no major complication related to the procedure. We were able to follow up 28 patients. In all cases menses resumed spontaneously soon after the procedure. Seven cases of long-term follow-up became pregnant, and 3 cases of them completed gestations giving birth to healthy babies. CONCLUSION: The results suggest that angiographic embolization is a relatively noninvasive and highly effective method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.
Blood Transfusion ; Chungcheongnam-do ; Female ; Fertility ; Fertilization ; Follow-Up Studies ; Hemorrhage* ; Hospitalization ; Humans ; Hypesthesia ; Lacerations ; Length of Stay ; Lower Extremity ; Medical Records ; Menstruation ; Parturition ; Placentation ; Pregnancy ; Telephone ; Uterus