No abstract available.
Breast* ; Female* ; Fibroadenoma* ; Humans

The use of a cultured autologous keratinocyte sheet has become a recognized method for the coverage of extensive bums during recent years. The disadvantages of these sheet grafts are a long time-lag until keratinocyte sheets are available, the fragility and difficulty in handling of grafts, an unpredictable take rate and extremely high costs. In this study we investigated the transplantation of cultured keratinocytes as single cells suspended in autologous fibrin glue. In a rat model with standardized full thickness wounds, this new transplantation technique was evaluated and compared directly to the conventional keratinocyte sheet grafting technique. After transplantation, wounds were evaluated for the degree of epithelial coverage, and then microscopic structures were evaluated under light and electron microscopy. The results were as follows: 1) The fibrinogen solution prepared from autologous blood had 12 times more fibrinogen compared to the original blood. 2) After transplantation of cultured keratinocyt-es in fibrin glue, the degree of epithelial coverage was 79% at 2 weeks, which was comparable to 17% for cultured keratinocyte sheet graft 3) Typical basement membrane structures were consistently found at 2 weeks after transplantation of keratinocytes in fibrin glue. 4) Rete ridges were found at 4 weeks after transplantation of keratinocytes in fibrin glue. In conclusion, the transplantation technique of keratinocytes in fibrin glue is available earlier than sheet grafts, it transfers actively proliferating cells and it simplifies the grafting procedure. As well, this technique leads to an earlier epithelial covering and an earlier restoration of the dermo-epidermal junction than sheet grafting.
Basement Membrane ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Keratinocytes* ; Microscopy, Electron ; Models, Animal ; Transplants ; Wounds and Injuries

No abstract available.
Nortriptyline* ; Plasma*

In orper to measure the levels of high density lipoprotein cholesterol in psoriasis, 60 psoriatic patients and 30 healthy subjects were included in this study. Lopez-Virells methos was applied for measuring the serum level of high density lipoprotein cholesterol. The results were obtained as follows. The level of serurn HDL cholesterol was 58. 39+17. 40 mg/dl in psoratcs and 50.3+0.31 mg/dl in healthy subjects and 50. 43+ 10. 31 mg/dl in healthy subjects. No significant differences were noted between psoriatics & healthy subjects. 2. The level of serum HDL cholesterol was 56. 40+19. 10 mg/dl in male group of psoriatics and 60. 00+15.47 mg/dl in female group of psoriatics and 48.3+9. 50 mg/dl in healthy male group and 52.60 -10.59 mg/dl in healthy female group. No significant differences of serum HDL cholesteol levels were noted in both sexes.3. The mean value of serum HDL cholesterol by age groups of 10, 20, 30, 40, and 50 years old with psoriasis were 50. 70 mg/dl, 61. 97 mg/dl, 57. 44 mg/dl, 49. 11 mg/dl and 70. 36 mg/dl, respectively and those of healthy groups were 57. 25 mg/ dl, 45. 17 rng/dl, 50. 97 rng/dl, 48. 07 mg/dl and 46. 98 mg/dl, respectively.
Cholesterol, HDL* ; Female ; Humans ; Male ; Middle Aged ; Psoriasis*

BACKGROUND AND OBJECTIVES: Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical septal myotomy-myectomy are two treatment options for patients with drug-resistant hypertrophic cardiomyopathy & a left ventricular outflow tract (LVOT) obstruction. The clinical courses, after nonsurgical and surgical septal myotomy-myectomy, are described in 3 patients with hypertrophic cardiomyopathy that continued to be symptomatic following medical management. SUBJECTS AND MEHTODS: 3 patients (2 women, 1 man), with symptomatic drug-refractory obstructive hypertrophic cardiomyopathy, were the subjects of this study. One patient underwent a PTSMA by injection of ethanol into the septal perforator branches of the left anterior descending coronary artery, and 2 a surgical myotomy-myectomy. Examinations of the early and late follow-up echocardiographic results were performed. RESULTS: Both treatment modalities significantly reduced the peak gradient across the LVOT (ablation : 85 to 7.7 mmHg, myectomy : 104 to 10 mmHg), and led to similar improvements in the New York Heart Association class (ablation : NYHA IV to II, myectomy : NYHA III or IV to NYHA I or II). One patient, who underwent a successful PTSMA, showed a temporary right bundle branch block on the ECG for several days following the PTSMA. At the 1-year follow-up, 2 patients were observed to have persistent symptomatic improvements, with no cardiac complications. CONCLUSION: Both a percutaneous septal myocardial ablation and a surgical myotomy-myectomy resulted in similar degrees of significant improvements of the left ventricular outflow tract obstructions, with improvements of the symptoms. Prospective studies are necessary to compare the long-term efficacy of these two treatment modalities.
Bundle-Branch Block ; Cardiac Surgical Procedures ; Cardiomyopathy, Hypertrophic* ; Catheter Ablation ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Ethanol ; Female ; Follow-Up Studies ; Heart ; Humans ; Ventricular Outflow Obstruction*

Breast reconstruction following mastectomy has, become increasingly popular in recent years. Reconstruction surgeons have responded to patients' needs for effective and versatile procedures that will restore the normal shape and symmetry of breasts. Among the various techniques for these purpose, transverse rectus abdominis myocutaneous(TRAM) flap is now cosidered as the most acceptable technique. However, there are some limitations to use the TRAM flap, such as heavy smoker, obesity, and previous abdominal surgery. Also TRAM flaps are not good candidates for the patients with absent anterior axillary fold. In these respects, latissimus dorsi flap can be used as an alternative method for successful breast reconstuction. Latissiomus dorsi flaps have several advantages as compared to TRAM flaps, such as reliable blood supply, versatility of skin paddle orientation, and low donor site morbidity. It is also available for patients without anterior axillary fold, such as radical mastectomy defect or Poland syndrome. Latissimus dorsi flaps, however, and implants to obtain projection and symmetry of the reconstructed breast. Main disadvantages of latissimus dorsi flap method are difference in color and texture between skins of flap and chest, and capsular contracture resulted in high riding implant or distortion of breast contour. In this study, we performed latissimus dorsi flap for reconstruction fo breast and anterior axillary fold in 10 cases. To minimize the above problems more fullness and natural shape, implants were completely covered with muscle and overexpanded for more than 3-months and then deflated to the desired volume. These maneuvers produced aesthetically acceptable results during the latissimus dorsi breast reconstruction.
Breast* ; Contracture ; Female ; Humans ; Mammaplasty* ; Mastectomy ; Mastectomy, Radical ; Obesity ; Poland Syndrome ; Rectus Abdominis ; Skin ; Superficial Back Muscles* ; Thorax ; Tissue Donors

Neomorphogenesis of cartilage using chondrocyte-polymer constructs is a potential source for development of cartilage reconstruction. Current tissue engineering techniques of neocartilage rely on in vivo implantation of polymer-chondrocyte constructs. The purpose of this study was to find a way to bioengineer cartilage in vitro by entrapping chondrocytes in a molded autologous fibrin glue. Chondrocytes isolated from the cartilage of rabbit joints were combined with fibrinogen extracted by a single cryoprecipitation of autologous plasma, and they were then polymerized with thrombin to create a fibrin glue with a final cell density of 2.5x10(6) cells/ml. The collagen for a control study was used as a polymer. The polymer-chondrocyte constructs were cultured for 4 weeks and the fibrin-chondrocyte constructs molded in the shape of a human ear were cultured for 6 weeks in vitro. Morphometric, histochemical, and histomorphometric analysis including glycosaminoglycan quantitation confirmed the following results: 1) Highly-concentrated autologous fibrinogen was easily extracted by a single cryoprecipition of autologous olasma. 2) The fibrin-chondrocyte constructs demonstrated the presence of actively proliferating chondrocytes with the production of cartilaginous matrix(collagen and glycosaminoglycan) at 1 week after culture, as well as gross and histologic evidence similar to those of normal cartilage at 3-4 weeks after culture. 3) The collagen-chondrocyte constructs demonstrated lower degrees of hardness and transparency, as well as a lower density of cells and glycosaminoglycan during the culture period. 4) Neocartilage generated from fibrin-chondrocyte constructs in the shape of a human ear nearly retained their original configuration and size without degeneration for 6 weeks of culture in vitro. This study demonstrated a novel method for bioengineering the molded cartilage in vitro using autologous fibrin glue as a matrix scaffold. The generated cartilage showed gross and histologic evidence similar to those of normal cartilage, retaining the original gross dimension. With further refinement, this may be a new application of tissue engineering for the reconstruction of cartilage.
Bioengineering ; Cartilage* ; Cell Count ; Chondrocytes* ; Collagen ; Ear ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Fungi ; Hardness ; Humans ; Joints ; Plasma ; Polymers ; Thrombin ; Tissue Engineering*

We report a case of giant cell tumor of the tendon sheath involving the foot, in a 21-year-old female patient, who presented with an asymptomatic tumor on the dorsum of her right foot. Histopathologically the tumor is surrounded by thin fibrous connective tissue. The characteristic findings of the excised specimen revealed a typical mixture of abundunt round or polygonal histocyte-like cells with varying portions of spindle-shaped fibroblast-like cells and multinucleated giant cells. Variable amounts of hyalinized fibrous stromal tissue were also present. After excision, local recurrence has not been observed for 3 months.
Connective Tissue ; Female ; Foot* ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Hyalin ; Recurrence ; Tendons* ; Young Adult

No abstract available.
Nortriptyline* ; Pharmacokinetics*

Comorbidity is a well-established phenomenon in psychiatric illness. And especially most of the depressive disorders examined in both general and clinical population are not pure form. This article reviews findings of comorbidity pattern of depressive disorder from general population and primary care survey. Five interpretations of the concept of comorbidity are discussed in conjunction with the detrimental effects of comorbidity on the treatment efficacy, course and outcome, and social costs. The term of comorbidity needs more qualification to enhance the progress of conceptualization of novel research strategy in experimental psychiatry. It is important for physician to be aware of the possibility of comorbidity in treating patients. Two future directions for research on comorbidity are introduced with methodological problems.
Comorbidity* ; Depressive Disorder* ; Humans ; Primary Health Care ; Treatment Outcome