PURPOSE: Solar ultraviolet (UV) radiation causes inflammation and matrix metalloproteinase (MMP) overexpression and extracellular matrix depletion, leading to skin photoaging such as wrinkle formation, dryness, and sagging. Activation of MMP is influenced by various molecules such as reactive oxygen species (ROS), proinflammatory cytokines, and transient receptor potential vanilloid type (TRPV)-1, which are increased in UV-irradiated skin cells. Aralia elata (AE) ethanolic extract was reported to inhibit ROS generation caused by UVB-irradiation in keratinocytes. In this study, we investigated the photoprotective effect of AE ethanolic extract on UVB-irradiated human keratinocytes (HaCaT) and human dermal fibroblasts (HDF). METHODS: AE was freeze-dried, extracted in 70% ethanol, and concentrated. Skin cells were treated with AE extract for 24 h and then exposed to UVB (55 mJ/cm2). After 48 h of incubation, proinflammatory cytokines, MMP-1, type-1 procollagen, and TRPV-1 levels were measured by ELISA or Western blotting. RESULTS: Treatment with AE extract (100 µg/mL) significantly inhibited UVB-induced IL-6, IL-8, and PGE2 production in HaCaT by 25.6%, 5.3%, and 70.2%, respectively, and also inhibited elevation of MMP-1 and TRPV-1 caused by UVB irradiation by 20.0% and 41.9%, respectively (p < 0.05). In HDF, AE extract treatment significantly inhibited both elevation of MMP-1 and reduction of type-1 procollagen caused by UVB irradiation (p < 0.05). In addition, type-1 procollagen was elevated by AE extract treatment in normal HDFs (p < 0.05). CONCLUSION: AE 70% ethanol extract has photoprotective ability via reduction of proinflammatory mediators, TRPV-1 and MMP-1 production, and elevation of collagen synthesis. Our findings suggest that AE extract might be a good natural material to protect against UVB-induced premature skin aging.
Aralia* ; Blotting, Western ; Collagen ; Cytokines ; Dinoprostone ; Enzyme-Linked Immunosorbent Assay ; Ethanol* ; Extracellular Matrix ; Fibroblasts* ; Humans* ; Inflammation ; Interleukin-6 ; Interleukin-8 ; Keratinocytes* ; Procollagen ; Reactive Oxygen Species ; Skin Aging ; Skin*

PURPOSE: Ultraviolet (UV)-induced oxidative stress contributes to several adverse biological effects on skin. Many phenolic phytochemicals have been shown to have antioxidant properties and protect skin cells from UV-induced oxidative damage. In this study, we investigated whether or not Aralia elata (AE) has a protective effect against UVB-induced reactive oxygen species (ROS), ultimately leading to photoaging. METHODS: Phenolic content of dried AE and antioxidant properties of AE extract in 70% ethanol weredetermined by measuring DPPH and ABTS radical scavenging activities and ferric reducing antioxidant power (FRAP). The effect of AE extract on cellular ROS generation and expression levels of oxidative stress-response proteins such as superoxide dismutase (SOD)-1, catalase, nuclear factor-erythroid 2-related factor (Nrf)-2,and heme oxygenase (HO)-1 in UVB-irradiated (75 mJ/cm²) human keratinocytes (HaCaT) were further determined by 2'-7'-dichlorofluoresceine diacetate assay and Western blotting, respectively. RESULTS: The total phenolic and flavonoid contents of dried AE were 20.15 mg tannic acid/g and 18.75 mg rutin/g, respectively. The IC₅₀ of AE extract against DPPH radical was 98.5 µg/mL, and ABTS radical scavenging activity and FRAP upon treatment with 1,000 µg/mL of AE extract were 41.8 µg ascorbic acid (AA) eq./mL and 29.7 µg AA eq./mL,m respectively. Pretreatment with AE extract significantly reduced (p < 0.05) ROS generation compared to that in UVB-irradiated control HaCaT cells. Pretreatment with AE extract reversed reduction of Nrf-2 and SOD-1 protein expression and induction of HO-1 protein expression caused by UVB exposure in HaCaT cells, whereas it did not affect catalase expression. CONCLUSION: AE extract in 70% ethanol demonstrated a protective effect against UVB-induced oxidative stress and decreased expression of Nrf-2 and SOD-1 in human keratinocytes. These findings suggest that AE ethanol extract might have potential as a natural resource for a skin antiphotoaging product in the food and cosmetic industry.
Aralia* ; Ascorbic Acid ; Blotting, Western ; Catalase ; Ethanol* ; Heme Oxygenase (Decyclizing) ; Humans* ; Keratinocytes* ; Natural Resources ; Oxidative Stress* ; Phenol ; Phytochemicals ; Reactive Oxygen Species ; Skin ; Superoxide Dismutase

Purpose: The aim of this study was to develop a formalin-fixed paraffin-embedded (FFPE) tissue based multiplex immunochemistry (mIHC) method for high-throughput comprehensive tissue imaging and demonstrate its feasibility, validity, and usefulness. Materials and Methods: The mIHC protocol was developed and tested on tissue microarray slides made from archived gastric cancer (GC) tissue samples. On a single FFPE slide, cyclic immunochemistry for multiple markers of immune cells and cytokeratin for tumor cells was performed; hematoxylin staining was used for demarcation of nuclei. Whole slides were digitally scanned after each cycle. For interpretation of mIHC results, we performed computer-assisted image analysis using publicly available software. Results: Using mIHC, we were able to characterize the tumor microenvironment (TME) of GCs with accurate visualization of various immune cells harboring complex immunophenotypes. Spatial information regarding intratumoral and peritumoral TME could be demonstrated by digital segmentation of image guided by cytokeratin staining results. We further extended the application of mIHC by showing that subcellular localization of molecules can be achieved by image analysis of mIHC results. Conclusion We developed a robust method for high-throughput multiplex imaging of FFPE tissue slides. The feasibility and adaptability of mIHC suggest that it is an efficient method for in situ single-cell characterization and analysis.

Percutaneous cardiopulmonary support (PCPS) provides hemodynamic and pulmonary support simultaneously and is increasingly used in medical practice. However, the presence of extracorporeal circulation and the use of heparin means it is not free of side effects, and use of PCPS for longer than 96 h is associated with poor prognosis. Therefore, along with the decision of when to apply or discontinue PCPS, an integrated team approach between the surgeon and the anesthesiologist to prevent and/ or manage PCPS-related complications is of paramount importance when the patient's physical status mandates prolonged use of PCPS. We hereby report 2 cases addressing successful management of postoperative cardiogenic shock, refractory to pharmacologic support, with early and prolonged application of PCPS in patients who underwent surgical anterior ventricular endocardial restoration and coronary artery bypass surgery.
Coronary Artery Bypass ; Extracorporeal Circulation ; Hemodynamics ; Heparin ; Humans ; Prognosis ; Shock, Cardiogenic ; Thoracic Surgery

Percutaneous cardiopulmonary support (PCPS) provides hemodynamic and pulmonary support simultaneously and is increasingly used in medical practice. However, the presence of extracorporeal circulation and the use of heparin means it is not free of side effects, and use of PCPS for longer than 96 h is associated with poor prognosis. Therefore, along with the decision of when to apply or discontinue PCPS, an integrated team approach between the surgeon and the anesthesiologist to prevent and/ or manage PCPS-related complications is of paramount importance when the patient's physical status mandates prolonged use of PCPS. We hereby report 2 cases addressing successful management of postoperative cardiogenic shock, refractory to pharmacologic support, with early and prolonged application of PCPS in patients who underwent surgical anterior ventricular endocardial restoration and coronary artery bypass surgery.
Coronary Artery Bypass ; Extracorporeal Circulation ; Hemodynamics ; Heparin ; Humans ; Prognosis ; Shock, Cardiogenic ; Thoracic Surgery

BACKGROUND: This study was done to evaluate the sole effect of norepinephrine on the regional myocardial perfusion during displacement of the porcine beating heart using thermal diffusion method. METHODS: Thermal diffusion probe was inserted into the anterior myocardial wall during 20 procedures in 10 male pigs (30-35 kg). The measurements of regional myocardial perfusion and hemodynamic parameters were performed after complete instrumentation (baseline), after displacement of the beating heart anteriorly, and 5 and 15 minutes after norepinephrine infusion, titrated to restore baseline mean arterial pressure (MAP). RESULTS: Norepinephrine infusion reversed the decrease in MAP and myocardial perfusion, caused by displacement of the beating heart (62 +/- 3% to 115 +/- 4% of baseline, P < 0.01; 41 +/- 5% to 125 +/- 4% of baseline, P < 0.05, respectively). CONCLUSIONS: Restoration of MAP with norepinephrine infusion without any preload augmentation reversed deterioration in regional myocardial perfusion during displacement of the porcine beating heart.
Arterial Pressure ; Displacement (Psychology) ; Heart ; Hemodynamics ; Humans ; Male ; Norepinephrine ; ortho-Aminobenzoates ; Perfusion ; Swine ; Thermal Diffusion

Delivery of Health Care ; Health Personnel ; Humans ; Korea ; Measles-Mumps-Rubella Vaccine ; Mumps ; Republic of Korea ; Seroepidemiologic Studies ; Tertiary Healthcare ; Vaccination

Background and Objectives: Oropharyngeal cancers (OPCs) can be staged down to a lower stage with p16 positivity and de-escalated therapy has been the common practice. The aim of this study is to evaluate the survival outcomes based on various clinical factors in advanced OPC patients. Subjects and Method A total of 58 OPC patients in the stage IVA based on the American Joint Committee on Cancer 7th edition were treated with primary surgery or primary chemoradiation therapy from 2010 to 2016. A survival analysis was carried out using the Kaplan- Meier method, log-rank test, and Cox proportional hazards model. Results: The median follow-up was 39.5 months. Thirty-eight and 20 patients received surgery- based and radiation therapy (RT)-based treatments, respectively. Clinical T-stage and treatment method were significant risk factors for 5-year disease-free survival (DFS) rate, and the treatment method was the only significant risk factor for overall-survival (OS) rate. 5-year DFS rate in the surgery-based treatment and RT-based treatment was 76.1% and 36.0% (p=0.001). On multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death [the hazard ratio (HR) for the radiation-based treatment was 6.565 compared to the surgery-based treatment, p=0.002]. 5-year OS rate in the surgery-based treatment and RT-based treatment was 91.1% and 53.4% (p=0.003), respectively. On the multivariate analysis, the surgery-based treatment group was associated with a significantly reduced hazard of death (the HR for the radiation-based treatment was 7.544 compared to the surgerybased treatment, p=0.012). Conclusion The primary surgery-based treatment for advanced OPC showed a better survival outcome than the primary radiation-based treatment, irrespective of p16 positivity.

Isolated sphenoid sinus disease is often misdiagnosed because of its rarity and varing clinical presentation. A 51-year-old male visited the hospital with abnormal brain CT findings which showed homogenous opacification associated with sinus wall expansion on the right sphenoid sinus. Under the impression of isolated sphenoid mucocele, the fenestration of sphenoid sinus was conducted without surgical complication. But, cerebrospinal fluid rhinorrhea spontaneously developed 3 days after fenestration operation and then stopped by sealing the suspicious leakage site with free graft of inferior turbinate mucosa. Based on the pathological findings, paranasal sinus CT and MRI findings, this case is reported to be meningoencephalocele developed in sphenoid sinus.

There are only limited data regarding the seroprevalence of measles of healthcare workers (HCWs) in Korea. We evaluated the seroprevalence of measles in HCWs in a tertiary care hospital in Korea. A total of 7,411 HCWs born from 1952 to 1995 underwent antibody test. The overall seropositivity of measles was 73% (95% confidence interval, 72 – 74). The seropositivity of measles sharply declined from 85% in the 1986 birth cohort to 42% in the 1995 birth cohort, thus signifying pockets of under-immunity. Our data warrant the need for routine antibody tests, followed by measles vaccination or routine measles vaccination in young Korean HCWs.