Diabetes is accompanied by delayed wound healing and insufficient granulation tissue formation, possibly because of a defect in fibroblast function. Maintaining glucose level at acceptable low level is considered to be an important part of the clinical treatment of diabetes, but the exact mechanism by which diabetes delays wound repair is not yet known. This study was designed to evaluate the effects of glucose on proliferation([3H]-thymidine uptake) and collagen synthesis([3H]-proline uptake) in dermal fibroblasts from non-lesional skins and chronic wounds. The subjects were divided into 3 groups: non-diabetic control(n = 5), glucose controlled(glycated Hb < 7%) diabetics(n = 5), and glucose uncontrolled(glycosylated Hb > 8%) diabetics(n = 5). The fibroblasts were cultured in two conditions, low glucose(5 mM) and high glucose(20 mM) medium. The data were compared using Mann-Whitney test. The results are as follows: 1. There were no significant differences in the proliferation and collagen synthesis of non-lesional skin fibroblasts in all groups. 2. In high glucose medium culture, the proliferation of the fibroblasts from the wound of the glucose uncontrolled diabetic group was significantly lower than those of the other 2 groups(p< 0.05), and the collagen synthesis of the wound fibroblasts of the control group was significantly higher than those of 2 diabetic groups(p< 0.05). 3. The proliferation and collagen synthesis of the wound fibroblasts in all groups were significantly lower than those of the non-lesional skin fibroblasts(p< 0.05). 4. In the control group and the glucose controlled diabetic group, the proliferation of the wound fibroblasts in the high glucose culture media were lower than those in the low glucose culture media(p< 0.05). Also, in the glucose controlled diabetic group, the collagen synthesis of the wound fibroblasts in the high glucose culture medium was lower than that in the low glucose culture medium(p< 0.05). These results demonstrate that the glucose level may affect the proliferation and collagen synthesis of fibroblasts, and the strict blood glucose control is beneficial to the prevention and treatment of diabetic chronic wounds.
Blood Glucose ; Collagen* ; Culture Media ; DNA* ; Fibroblasts* ; Glucose* ; Granulation Tissue ; Skin ; Wound Healing ; Wounds and Injuries*

Interventional procedures around the cervical spine have been classically performed under the guidance of fluoroscopy with radiation hazards to patients and doctors. Even though under fluoroscopic guidance, vascular and nerve structures cannot be shown and there are actual risks for the patient. Nowadays, we can use high resolution image ultrasound around cervical spine procedures. Real time imaging is possible. Cervical root block, medial branch block and many other interventions can be performed under ultrasound guidance. In out-patient clinics, ultrasound is very helpful in management of cervical problems in differentiating the origin of pain and treatment for the pain. Ultrasound is radiation free, easy to use and the imaging can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound enables visualization of major nerves and vessels and thus leads to improved safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore performed a review to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.
Fluoroscopy ; Humans ; Incidence ; Outpatients ; Spine* ; Ultrasonography

Changes of body temperature were observed in the esophagus and rectum by telethermometer during extracorporeal circulation in 40 cases of open heart for detection of significant differences in survivals and non-survivals. The following results were obtained; 1) Esophageal and rectal temperature(just prior to extracorporeal circulation) were 36.4+/-0.69 degrees C, 36.8+/-0.8 degrees C respectively in non-survivals and 36.0+/-0.73 degrees C, 36.4+/-0.8 degrees C in survivals after open heart surgery 2) Normal differences between rectal and esophageal temperature came to disappear after 30 minutes of extracorporeal circulation in two groups. 3) Esophageal temperatures were higher than rectal temperatures after extracorporeal circulation for open heart surgery in both groups. 4) Changes of temperature differences between rectum and esophagus have no correlation with mortality because of the variation in two areas in both groups.
Body Temperature* ; Clinical Study* ; Esophagus ; Extracorporeal Circulation* ; Heart* ; Mortality ; Rectum ; Thoracic Surgery*

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive lymphoma with an overall incidence of 0.04 cases per 100,000 people. BPDCN is a hematopoietic clonal neoplasm that originates from plasmacytoid dendritic cell precursors. A 63-year-old man presented with multiple erythematous nodules over his whole body, including his face, trunk, and both upper and lower extremities that appeared 1 month ago. Skin biopsy showed diffuse dermal infiltration by monomorphic atypical lymphocytes with large, irregular nuclei and scant cytoplasms. Immunohistochemical staining was positive for CD4, CD56, and CD123. The karyotype test showed abnormalities in male chromosomes 47, XY, ＋8 [2]/46, and XY [25], and mutations in DNMT3A, TET2, SRSF2, and ATRX genes were identified in a next-generation sequencing (NGS)-based acute myeloid leukemia gene panel test. The patient was diagnosed with BPDCN and treated with a KALLA 1406 regimen; however, he died on the 17th day of treatment.

Background: Direct immunofluorescence (DIF) is a histochemical technique used to detect tissue-bound autoantibodies and diagnose various immune-mediated skin diseases. Objective: This study aimed to evaluate the sensitivity of DIF for each disorder, and the consistency between clinical, histopathological, and DIF results. Methods: A retrospective study was conducted in 194 patients who underwent skin biopsy and DIF testing at our hospital between January 2011 and December 2021. An antibody panel against immunoglobulin G (IgG), IgA, IgM, C3, C1q, and fibrinogen was used. The concordance rate and κ-coefficient between the clinical, histopathological, and DIF results were evaluated. Results: DIF was observed to be positive in 87 cases; 51 cases of immune-mediated bullous diseases, seven cases of connective tissue diseases (CTDs), 25 cases of vasculitis, and four cases of other diseases. The overall sensitivity of DIF for immune-mediated bullous diseases was 71.8%, which was higher than that of histopathology (64.8%). In CTDs and vasculitis, the overall sensitivities of DIF were 30.4% and 65.8%, respectively, which were lower than those of histopathology (73.9% and 84.2%, respectively). In addition, good concordance among the clinical, histological, and DIF results was observed. Conclusion DIF is a useful diagnostic method, especially for immune-mediated bullous diseases, lupus erythematosus, and Henoch-Schonlein purpura. However, in other CTDs and vasculitis cases, the sensitivity of DIF is relatively low. Therefore, the diagnostic value of DIF along with clinical and histopathological findings will be maximized only when the DIF test is performed for appropriate diseases.

Odontogenic keratocysts are developmental odontogenic cysts which derived from rests of dental laminas and often found in posterior area of mandible. Because this lesion has tendency of frequent recurrence, treatment of choice is often radical removal of the lesion. Sometimes in case of large cysts, however, conservative therapy like marsupialization is often selected in treatment plan. A 39-years old woman referred to our department for evaluation of large radiolucent lesion that occupies the areas from mandible angle to upper part of ramus and condyle. In cytology, the lesion was identified as odontogenic keratocyst. Marsupialization was our treatment of choice, and the result was so favorable. 2 years later, there was small radiolucent lesion on upper part of mandibular ramus on panoramic view. It was suspected as recurred lesion, and excisional biopsy was done. On biopsy result, it was not a cystic lesion but fibrosis.
Adult ; Biopsy ; Female ; Fibrosis* ; Humans ; Mandible ; Odontogenic Cysts* ; Recurrence

BACKGROUND: Accurate detection of organisms producing extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase is very important for treatment of patients. However, unlike the ESBL confirmatory test, there are no guidelines for detection of organisms producing AmpC beta-lactamase. We evaluated a detection method using boronic acid (BA) for ESBL and AmpC beta-lactamase. METHODS: Clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis showing intermediate resistance or resistance to cefoxitin (FOX) or positive for ESBL were tested. A > or =5 mm increase in zone diameter of ceftazidime/clavulanic acid/BA (CAZ/CA/BA) and/or cefotaxime/clavulanic acid/BA (CTX/CA/BA) versus CAZ/BA and/or CTX /BA was considered positive for ESBL. Likewise, a > or =5 mm increase in zone diameter of FOX/BA and/or cefotetan/BA (CTT/BA) versus FOX and/or CTT alone was considered positive for AmpC beta-lactamase. RESULTS: Among 622 clinical isolates, ESBL positive rates by the CLSI ESBL confirmatory test or by the BA method were 18.1% or 18.4% for E. coli, 38.3% or 40.4% for K. pneumoniae, 8.7% or 8.7% for K. oxytoca, and 14.8% or 14.8% for P. mirabilis, respectively. AmpC beta-lactamase positive rates using the BA method were 3.7% for E. coli, 33.3% for K. pneumoniae, 0% for K. oxytoca, and 7.4% for P. mirabilis. The detection rates of coproducing ESBL and AmpC beta-lactamase were 2.4% in E. coli 27.1% in K. pneumoniae, and 3.7% in P. mirabilis. CONCLUSION: The ESBL confirmatory method using BA was found to enhance the detection of ESBLs, even when potentially masked by AmpC beta-lactamase.
Bacterial Proteins ; beta-Lactamases ; Boron ; Cefoxitin ; Escherichia ; Escherichia coli ; Humans ; Klebsiella ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Masks ; Mirabilis ; Penicillinase ; Pneumonia ; Proteus ; Proteus mirabilis

Individual identification procedure is one of the most improtant part in medicolegal fields. Recently, radiolegal investigation methods have been widely applicated to the medicolegal field for the purpose of individual identification. So authors attempted to determine sex and calculate stature by using roentgenographic findings of long bones of 248 subjects the living materials. In orthoscanographic study for long bones, we measured total length, midshaft width, epiphyseal width, cortical width, head diameter of each bones The total length, midshaft width, cortical width, condylar breath, horizontal & vertical head diameter of femur show statistically significant differentiation between two sexes, in tibia, total length, midshaft, cortical width, proximal and distal epiphyseal width show statistically significant. In fibula, Humerus, radius and ulna, total length is only statistically significant. And other wresults are statistically insignificant. Using femoral and fibial lengths (mm) with "Regression Analysis method" in SAS program, we derived the following fomulae. Height (cm)=95.62±0.148×Total length of Femur. (mm) Height(cm)=82.07±0.22×Total length of Tibia. (mm). In conclusion, radiologic measurement of long bone might be one of the useful methods in individual identification of unknown subject in Korea.
Femur ; Fibula ; Head ; Humerus ; Korea ; Radius ; Tibia ; Ulna

PURPOSE: There is no data about the effect of anti-embolism stockings on intrasession hemodynamics in end stage renal disease patients on hemodialysis (HD). We investigated whether it affects the hemodynamic changes during HD or not. METHODS: We performed 2 HD sessions, before (stocking negative, SN) and after (stocking positive, SP) putting on thigh-high anti-embolism stockings in 11 ESRD patients on HD. In each session, cardiac output (CO), stroke volume (SV), central blood volume (CBV), and peripheral resistance (PR) were measured by ultrasound velocity dilution method at 1 and 3 hours of HD. Ultrafiltration (UF) amount was matched during study. Hemodynamic variables were compared between SN and SP. RESULTS: Mean ages were 51+/-14 years, female was 8, diabetes mellitus was 4, and duration of HD was 56.9+/-28.9 months. There were no differences in pre- and post-HD SBP and DBP, UF amount at 1 hr and 3 hr of HD, and total UF amount between SN and SP. At 1 hr of HD, CBV was greater in SP than in SN (0.85+/-0.32 L vs. 0.93+/-0.32 L, p=0.003). CO (5.56+/-1.22 L/min vs. 5.14+/-1.35 L/min, p=0.075) and SV (73.77+/-19.11 mL vs. 68.95+/-22.21 mL, p=0.05) tended to be increased in SP than in SN. However, there were no differences in TPR between 2 groups. At 3 hr of HD, there were no differences in all hemodynamic variables bewteen SP and SN. CONCLUSION: At early phase of HD, anti-embolism stockings seem to increase CBV, but this effect seems to be attenuated at later phase.
Blood Volume ; Cardiac Output ; Cardiovascular Physiological Phenomena ; Diabetes Mellitus ; Female ; Hemodynamics ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Stockings, Compression ; Stroke Volume ; Ultrafiltration ; Vascular Resistance