To investigate the effects of prostaglandin E1(PGX1) in prevention of proliferative scar formation, we cultured fibroblasts of normal skin (NS), hypertrophic scar (HS) and keloid (KL) tissues obtained from patients. We have compared type I collagenase production of cultured fibroblasts from normal skin, hypertrophic scar, and keloid tissues under various concentrations of PGE1. Our results demonstrate that type I collagenase production was significantly increased after addition of PGE1 in HS and KL, but not NS. Type I collagenase production of HS and KL fibroblasts were increased similarly in 10M and 10M of PGE1 and maximally increased in the concentration of 10M. This promotive effects of PGE1 on the production of type I collagenase was larger in KL than in HS. These results also suggest that PGE1 may play the promotive effects on type I collagenase production in dose-dependent manner. PGE1 may have a role in the prevention of hypertrophic scar and keloid by enhancing the production of type I collagenase of HS and KL fibroblasts. The promotive effects of PGE1 on type I collagenase production was variable depending on its concentration, and its effects was maximum in certain optimal condition. The maximally effective concentration of PGE1 in the prevention of proliferative scar formation should be searched in further investigations for clinical use.
Alprostadil ; Cicatrix ; Cicatrix, Hypertrophic* ; Collagenases* ; Fibroblasts* ; Humans ; Keloid* ; RNA, Messenger* ; Skin

Although sacrococcygeal mass is rare and usually found in infants or children, adolescent or adult patients with protruding mass in sacrococcygeal region occasionally come to us simply for a cosmetic problem. In this situation, even though there is no definite neurological deficit, it should be evaluated whether or not the underlying bony pathology or dural defect exists. Few cases about the sacrococcygeal mass have been reported in adults. We reviewed our cases including preoperative evaluation methods and postoperative diagnosis. From March, 1993 to February, 1997, we experienced 6 adult patients with sacrococcygeal mass and no neurological abnormality. Preoperative evaluation were made by plain X-ray, myelogram, computed tomography(CT), and magnetic resonance imaging (MRI), as needed. Postoperative diagnoses were 2 meningoceles, 2 lipomyelomeningoceles, 1 desmoid tumor, and 1 teratoma. From our experiences, CT or MRI is essential to evaluate the sacrococcygeal mass preoperatively. These methods can visualize the precise anatomic location and extent of the mass, its relation to the spinal cord, and associated bony abnormalities. MRI is superior to CT, especially in defining the nature of the mass and involvement of the spinal cord. Conclusively, even a simple mass in the sacrococcygeal region in adults needs MRI or CT evaluation, and MRI is the most valuable method of evaluating the mass preoperatively and provides important information to establish a treatment plan.
Adolescent ; Adult* ; Child ; Diagnosis ; Fibromatosis, Aggressive ; Humans ; Infant ; Magnetic Resonance Imaging ; Meningocele ; Pathology ; Sacrococcygeal Region* ; Spinal Cord ; Teratoma

Proliferative scarring in the form of keloids and hypertrophic scars continues to be a clinical problem for some patients. The lack of an animal model for such scarring has been an obstacle to studying the biology and effective therapy of these entities. Consequently we created an accurate reproductive animal model to systematically study them. Human proliferative scars were explanted into flaps based on isolated vascular pedicles in congenitally rats. We compared the procollagen type III peptide levels of proliferative scar tissue before and after explanting. The procollagen type III peptide levels of explanted proliferative scar tissue remained increased as before explanting. Histological analysis of the explanted proliferative scar tissue revealed that all explants retained their original histotypic character even after 1 year. We could also retain the volume of implanted proliferative scar for 1 year and studied in vitro cellular proliferation. Fibroblast cultures from explanted scars demonstrated less aggressive growth characteristic than those from original surgical specimens. The advantages of this animal model are as follows: 1. The explants retain their histotypical character for a long period. 2. Placement of the explants outside the dorsum of a nude rat makes serial observation and measurement easier. 3. Agents under test can be injected into the explants through a catheter inserted into a single pedicle of island flap without the possibility of spreading systematically.
Animals* ; Biology ; Catheters ; Cell Proliferation ; Cicatrix* ; Cicatrix, Hypertrophic ; Collagen Type III ; Fibroblasts ; Humans ; Keloid ; Models, Animal* ; Rats ; Rats, Nude

No abstract available.

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

PURPOSE: N-acetylcysteine (NAC) has been known to have protective effects on the prevention of radiocontrast induced nephropathy (RCIN) in chronic renal failure (CRF). We investigated the effects of NAC in acute renal failure (ARF). METHODS: From January to June 2006, we retrospectively enrolled patients with ARF who were checked with contrast computed tomography (CT) at an emergency department. We divided patients into the NAC group and the control group. We compared baseline demographic characteristics, underlying diseases, infused fluid volume, blood urea nitrogen (BUN), and serum creatinine (Cr) level before and after CT scan. ARF was defined as serum Cr>1.5. mg/dL. RCIN was defined as an increase in serum Cr level of at least 0.5 mg/dL or 25% 48 hours after CT. RESULTS: Of a total 106 cases, 23 patients were the NAC group and 83 were the control group. There were no significant differences in baseline findings including underlying disease, cause of ARF and serum Cr level. The volume of infused fluid before and after CT were not different between the two groups (before; p=0.183 after; p=0.149). After CT scan, BUN and serum Cr level were decreased without statistical significance in both groups (NAC vs control group: BUN; 21.0+/-12.9 vs 20.5+/-14.2 p=0.863 Cr; 1.3+/-0.5 vs 1.4+/-0.5 p=0.451). RCIN developed in total 3 cases, 2 cases in the NAC group and 1 in the control group (p=0.524) and one of the NAC group performed hemodialysis. CONCLUSION: In case of patients with ARF, there was no protective effect of NAC on RCIN.
Acetylcysteine* ; Acute Kidney Injury* ; Blood Volume ; Creatinine ; Emergency Service, Hospital ; Humans ; Kidney Failure, Chronic ; Nitrogen ; Renal Dialysis ; Retrospective Studies ; Tomography, X-Ray Computed ; Urea

PURPOSE: Proteomics is a peptide screening approach to identify proteins related to physiological and pathological changes. Our objective was to analyze changes in serum proteome profiles in patients suffering from septic shock, during the first 24-h period of therapy and to determine whether these changes were associated with prognosis. METHODS: This was a retrospective observational study based on prospectively collected data that was conducted in an emergency intensive care unit (ICU) of a tertiary referral hospital. Consecutive patients admitted to the ICU with septic shock were enrolled. We obtained serum samples from the patients at admission (0 h) and 24 h after admission (24 h). Then, we analyzed the serum proteome profiles, performed Western blots, and measured serum lipid profiles. RESULTS: Twenty-seven patients were enrolled. Thirteen patients were grouped into the survivors (SURV) group and fourteen into the non-survivors group on day 30 (NON-SURV). Proteomic analyses and Western blot showed that the expression intensities of proapolipoprotein AI remained unchanged in SURV but decreased in NON-SURV during the first 24-h period of septic shock (p=0.015). Serum high density lipoprotein (HDL) cholesterol level also remained unchanged in SURV but decreased in NON-SURV (p=0.036). CONCLUSION: The decrease in serum proapolipoprotein AI expression during the first 24-h period of therapy was associated with a consistently low serum HDL cholesterol level and a poor prognosis in patients with septic shock.
Apolipoprotein A-I ; Blotting, Western ; Cholesterol ; Cholesterol, HDL ; Emergencies ; Humans ; Intensive Care Units ; Lipoproteins ; Lipoproteins, HDL ; Mass Screening ; Prognosis ; Prospective Studies ; Proteins ; Proteome ; Proteomics ; Retrospective Studies ; Shock ; Shock, Septic ; Stress, Psychological ; Survivors ; Tertiary Care Centers

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

PURPOSE: This study was designed to evaluate the characteristics of exertional heat stroke between the non-survival and the survival groups. METHODS: From January 1996 to December 2002, patients with exertional heat stroke who came to the emergency department of a military hospital were enrolled. Data on individual factors, atmospheric conditions, pre-hospital management, initial vital signs, laboratory findings, presence of seizure attack, and performance of intubation were reviewed retrospectively and compared between the nonsurvival and the survival groups. RESULTS: During the study period, 22 patients were diagnosed as suffering from exertional heat stroke and 5 patients died. Most of the episodes occurred during the summer days with high ambient temperature (mean 30.6+/-3.0 degrees C) and humidity (mean 75.6+/-7.7%), and 13 patients were unacclimatized recruits. The non-survival group showed a lower initial systolic blood pressure, platelet count, arterial pH, and HCO3 - level, and a higher serum creatinine, ALT, and amylase level than did the survival group (p<0.05). However there were no significant differences in individual factors, atmospheric conditions, pre-hospital management, initial pulse rate, temperature, white blood cell count, hemoglobin count, and the sodium, potassium, BUN and AST levels between the two groups. CONCLUSION: Initial systolic blood pressure, platelet count, and arterial pH, as well as HCO3 -, serum creatinine, ALT, and amylase levels seem to be important factors for the prognosis of exertional heat stroke.
Amylases ; Blood Pressure ; Creatinine ; Emergency Service, Hospital ; Heart Rate ; Heat Stroke* ; Hospitals, Military ; Hot Temperature* ; Humans ; Humidity ; Hydrogen-Ion Concentration ; Intubation ; Leukocyte Count ; Military Personnel* ; Platelet Count ; Potassium ; Prognosis ; Retrospective Studies ; Seizures ; Sodium ; Vital Signs