OBJECTIVETo study the effect of the technique of synchronously perforating and transplanting hair follicular-units in the treatment of cicatricial alopecia after burn.

METHODSOne hundred and sixty-six patients with 217 bald scar areas after burn were treated with above-mentioned technique from January 2002 to April 2008. Scalp strips, with conforming the necessity for grafting, were harvested from the occipital or temporal region. A series of follicular-units, each composing 1 - 3 hairs, were dissected from the strips under microscope or magnifying glass. Size-matching micro-slots were made in the scarred recipient area with 16 - 20 G needles to accept the grafts. The prepared follicular-unit was synchronously implanted into the bottom of the micro-slot as the needle being withdrawn. Patients who were not satisfactory with the density of hairs after I stage surgery underwent II stage surgery a half year later. Ten recipient areas with clear boundary in 10 patients were optionally chosen to observe the density of follicular-units and hair amount with naked eyes after I stage surgery. Survived transplanted hairs in above-mentioned 10 areas were counted to calculate hair survival rate at follow-up. Patients' postoperative satisfaction ratings were surveyed with questionnaire.

RESULTSIn one half of the patients, treatment was finished after I stage surgery, the other one half received 2 stages of surgery. The follicular-unit density reached 15 - 25 grafts/cm(2) with 40 - 70 hairs/cm(2) after I stage surgery. All patients were followed up for over 8 months. Grafted hairs grew well in a natural way. 96.5% mean hair survival rate was observed in the 10 recipient areas. From patients who received only I stage surgery, 61 patients (73.5%) were very satisfactory and 22 patients (26.5%) satisfactory with the results. From the other half of patients, 76 patients (91.6%) were very satisfactory and 7 patients (8.4%) satisfactory with the results.

CONCLUSIONSThe technique of perforating and transplanting follicular-unit hair synchronously is safe and effective with less surgery-induced injury and less bleeding. Hairs transplanted on cicatricial alopecia area with this technique grow well with high survival rate.

Adolescent ; Adult ; Aged ; Alopecia ; etiology ; surgery ; Burns ; complications ; Child ; Cicatrix ; complications ; Female ; Hair Follicle ; transplantation ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Young Adult

AIMThe clinical manifestation of chronic mountain sickness (CMS) is polycythemia, pulmonary hypertension and mionectic blood. However, the pathogenesis of it is not identified now. So it is necessary to investigate the effects of the angiogenic growth factors on the pathophysiologic development of CMS.

METHODSThe serum levels of basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) in 13 healthy Tibetan natives (Native), 17 healthy people in Xining (control group) and 35 CMS patients were determined by quantitative sandwich enzyme immunoassay. Meanwhile, the levels of Hb, Hct and SaO2 were determined.

RESULTSThe serum levels of bFGF (107.26 +/- 7.86) ng/L, PDGF (630.18 +/- 9.89) ng/L and VEGF (543.74 +/- 6.76) ng/L in CMS were significantly higher than those in Natives (37.01 +/- 9.16; 292.16 +/- 6.88; 125.51 +/- 7.26) ng/L, and in control group (40.58 +/- 5.34; 287.68 +/- 8.33; 76.26 +/- 4.60) ng/L, respectively (P < 0.01). There was no difference between the natives and the control group in bFGF and PDGF (P > 0.05), while there was predominant difference between the Natives and the control group in VEGF (P < 0.01). There was a predominant positive correlation between the serum levels of bFGF, PDGF or VEGF and hemoglobin concentrations in CMS respectively (P < 0.01). And there were positive relations between angiogenic growth factors each other.

CONCLUSIONThe serum levels of bFGF, PDGF and VEGF in patients with CMS significantly increase, these angiogenic growth factors may play important role on the pathophysiologic development of CMS; the VEGF level likely contributes to the adaptation to plateau hypoxia in healthy Tibetan natives; the elevated bFGF, PDGF and VEGF levels are likely associated with excessive erythropoiesis in CMS.

Adult ; Altitude Sickness ; blood ; Case-Control Studies ; Chronic Disease ; Fibroblast Growth Factor 2 ; blood ; Humans ; Male ; Middle Aged ; Platelet-Derived Growth Factor ; metabolism ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo observe the expressions of caspase-8 and caspase-9 mRNA, and explore the changes of apoptosis of bone marrow hematopoietic cells in patients with chronic mountain sickness (CMS).

METHODSOf 18 CMS patients and 16 controls were enrolled in this study. The apoptotic index (AI) of bone marrow mononuclear cells (BMMNC) was measured by TUNEL technique, the levels of caspase-8 and caspase-9 mRNA in BMMNC of CMS patients and controls were determined by RT-PCR. Results (1)The AI of BMMNC in patients with CMS (8.51 ± 3.35)% was lower than that in controls (16.00 ± 4.28)% (P < 0.01); (2) The values of caspase-8 and caspase-9 mRNA were (0.28 ± 0.07) and (0.23 ± 0.08) respectively, in CMS patients, which were significantly lower than those of (0.45 ± 0.09) and (0.41 ± 0.09) respectively, in the controls (both P < 0.01); (3) Hemoglobin (Hb) value was negatively correlated with levels of caspase-8 and caspase-9 mRNA (r values were -0.52 and -0.61 respectively, both P < 0.05) in CMS patients. There was a negative correlation between AI and Hb (r value was -0.89, P < 0.01) in CMS patients. However, the significant relationship was not found between AI and level of caspase-8 or caspase-9 mRNA (P > 0.05).

CONCLUSIONSThe results showed a decrease apoptosis of BMMNCs and reduced levels of caspase-8 and caspase-9 mRNA in CMS patients, the latter might be involved in the change of BMMNCs apoptosis.

Adult ; Altitude Sickness ; metabolism ; pathology ; Apoptosis ; Bone Marrow Cells ; metabolism ; Case-Control Studies ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Humans ; Male ; Middle Aged

OBJECTIVE: To evaluate the efficacy of autogenous bone marrow injection and elastic intramedullary injection in the treatment of bone cyst in children. METHODS: From January 2012 to December 2016, 56 children with simple bone cyst were divided into two groups: autogenous bone marrow blood injection group and elastic intramedullary needle group. There were 28 cases in the autogenous bone marrow blood injection group, 16 boys and 12 girls, aged (7.7±1.9) years old, 10 cases of proximal humerus, 8 cases of proximal femur, 6 cases of proximal tibia and 4 cases of femoral shaft. In the elastic intramedullary needle group, there were 28 cases, 18 boys and 10 girls, aged(7.5±2.2) years old, 11 cases of proximal humerus, 7 cases of proximal femur, 5 cases of proximal tibia, 4 cases of femoral shaft and 1 case of distal femur. The treatment effect was evaluated by Capanna standard. RESULTS: All the patients were followed up, including 17 to 35(25.6±4.2) months in the elastic intramedullary needle group and 19 to 35(27.4±4.8) months in the autogenous marrow blood injection group. According to Capanna's evaluation standard of bone cyst, 27 patients in the elastic intramedullary needle group were treated effectively(25 patients cured, 2 patients healed but some remained lesions), 1 patients recurred, 0 patient had no response to treatment; 18 patients in the autogenous bone marrow blood injection group were treated effectively(13 patients cured, 5 patients healed but some remained lesions), 8 patients of cyst recurred, 2 patients had no response to treatment; the difference between the two groups was statistically significant(<0.01). The overall cure time was calculated by the follow-up of 25 cases in the elastic intramedullary injection group and 13 cases in the autogenous marrow blood injection group. The cure time was(20.2±3.5) months in the elastic intramedullary injection group and(27.7±4.9) months in the autogenous marrow blood injection group. The difference was statistically significant(<0.05). CONCLUSIONS For the treatment of bone cyst in children, the therapeutic effect of elastic intramedullary needle is better than that of autogenous bone marrow blood injection, and the cure time is shorter.
Bone Cysts ; Bone Marrow ; Child ; Child, Preschool ; Female ; Fracture Fixation, Intramedullary ; Humans ; Male ; Neoplasm Recurrence, Local ; Treatment Outcome

Rectal prolapse is a protrusion of the rectum beyond the anal canal. Since rectal prolapse is a surgical disease, it is mostly diagnosed and treated at the surgical department. However, when surgical complications occur or they are suspected after an operation for colorectal disease, colonoscopy may now have a role in diagnosing the actual status of the problem. We present here the case of penetration of mesh at the distal rectum that was incidentally diagnosed by colonoscopy and the patient had previously undergone presacral rectopexy for rectal prolapse. Only one such case has been reported abroad and there has been no such case report in Korea. We report here on a case for which colonoscopy had a crucial role in diagnosing an occult complication after a colorectal operation that used a prosthesis.
Anal Canal ; Colonoscopy ; Humans ; Korea ; Prostheses and Implants ; Rectal Prolapse ; Rectum

OBJECTIVETo prepare a porcine acellular dermal matrix (PADM), and to optimize the interpore distance between PADM and co-grafted split-thickness autologous skin.

METHODSPorcine skin was treated with trypsin/Triton X-100 to prepare an acellular dermal matrix. Micropores were produced on the PADM with a laser punch. The distance between micropores varied as 0.8 mm, 1.0 mm, 1.2 mm and 1.5 mm. Full-thickness defect wounds were created on the back of 144 SD rats. The rats were randomly divided into 6 groups as follows, with 24 rats in each group. Micropore groups I -IV: the wounds were grafted with PADM with micropores in four different intervals respectively, and covered with split-thickness autologous skin graft. Mesh group: the wounds were grafted with meshed PADM and split-thickness autograft.

CONTROL GROUPwith simple split-thickness autografting. The gross observation of wound healing and histological observation were performed at 2, 4, 6 weeks after surgery. The wound healing rate and contraction rate were calculated.

RESULTSTwo and four weeks after surgery, the wound healing rate in micropore groups I and II was lower than that in control group (P < 0.05), but no obvious difference was between micropore groups I , II and mesh group (P > 0.05) until 6 weeks after grafting( P <0.05). The wound contraction rate in micropore groups I and II ([(16.0 +/- 2.6)%, (15.1 +/- 2.4)%] was remarkably lower than that in control group 4 and 6 weeks after grafting (P < 0.05), and it was significantly lower than that in mesh group [(19.3 +/- 2.4)%] 6 weeks after surgery (P <0.05). Histological examination showed good epithelization, regularly arranged collagenous fibers, and integral structure of basement membrane.

CONCLUSIONLaser micropore PADM (0.8 mm or 1.0 mm in distance) grafting in combination with split-thickness autografting can improve the quality of wound healing. PADM with laser micropores in 1.0 mm distance is the best choice among them.

Animals ; Dermis ; transplantation ; Lasers ; Rats ; Rats, Sprague-Dawley ; Skin Transplantation ; methods ; Skin, Artificial ; Swine ; Transplantation, Heterologous