The purpose of this study was to evaluate the histologic difference that occured after trichloroacetic acid(TCA) chemical peel in an animal model that was pretreated with Tretinoin alone or Tretinoin-based combined pretreatment kit. Eight Hartley white guinea pigs were used in our study. The dorsal skin of the guinea pigs was divided into six equal squares(2x2 cm). Upper two areas of these six were not pretreated, middle two areas were pretreated for 4 weeks with Tretinoin alone and lower two areas were pretreated for 4 weeks with Tretinoin-based combined kit. Each guinea pig underwent chemical peel with 50% TCA. The wounded areas were biopsied at post-peeling 3 weeks and 6 weeks. The histology revealed that those animals pretreated with combined kit healed quicker than the animals pretreated with Tretinoin alone. This study implies that if patients are treated with Tretinoin-based-combined pretreatment kit before undergoing chemical peel, the pretreatment time will be shortened.
Animals ; Guinea Pigs* ; Guinea* ; Humans ; Models, Animal ; Skin ; Tretinoin* ; Wounds and Injuries

No abstract available.
Actins* ; Humans ; Keratosis, Actinic* ; Phototherapy*

BACKGROUND: Interleukin-4(IL-4) is a 20 kDa glycoprotein and is now known to possess fibrogenic activities. OBJECTIVE: The purpose of this study is to evaluate the effect of IL4 on the extracellular matrix gene expression. METHODS: Quantitation of collagenous protein synthesis, Northern and dot-blot hybridization, transfection experiments and CAT assay in normal human skin fibroblasts were done. RESULTS: Maximal elevation of collagen synthesis was presented at the concentration of IL-4 being S.Ong/ml. In Northern and dot-blot analysis, each level of type I collagens and fibronectin mRNA increased 3.0, and 2.8-fold, respectively in IL4 treated fibroblasts. In CAT to c assay, the percentage of acetylation was 8.3% in the untreated control group and 23.1% in 5.Ong/ml of the IL-4 treated group in normal fibroblasts. The promoter activity was in creased 2.8-fold in II.4(5.Ong/ml) treated fibroblasts compared to the control groups. CONCLUSION: IL4 might be a fibrogenic cytokine that could be important in promoting the biogenesis of collagen proteins. This could be due to increased transcription.
Acetylation ; Animals ; Cats ; Collagen ; Collagen Type I ; Extracellular Matrix* ; Fibroblasts* ; Fibronectins ; Gene Expression* ; Glycoproteins ; Humans ; Interleukin-4* ; RNA, Messenger ; Skin* ; Transfection

PURPOSE: The purpose of this study was to evaluate the mid-term results after anterior cruciate ligament (ACL) reconstruction using a single four-strand semitendinosus tendon. MATERIALS AND METHODS: We evaluated 81 patients (84 cases) who had undergone ACL reconstruction using an autologous single four-strand semitendinosus tendon. The patients consisted of 77 men and 4 women with a mean age of 28.8 years (15-59 years) years. Most injuries were sports related, and the largest number of cases occurred during a soccer game (38 cases). Combined injuries were meniscus injuries in 43 cases, cartilage injuries in 6 cases and medial collateral ligament injuries in 8 cases. Femoral fixation device was PINN-ACL CrossPin in 44 cases and extracortical suspension device in 40 cases. Suture tie around a screw post and an additional bioabsorbable screw were used for tibial fixation. The mean time from injury to surgery was 9+/-16 months (7 days-10 years) and the mean follow-up period was 72.0+/-8.3 months (53-95 months). Clinical evaluation was performed using Lachman test, pivot-shift test, KT-2000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and return to pre-injury sports activity. Radiologic evaluation was performed using plain radiographs to evaluate joint space narrowing. RESULTS: All patients showed normal range of motion at the final follow-up. The Lachman test was positive in 4 cases, and pivot-shift test was positive in 3 cases. Lysholm score improved from 76.7 to 92.2, Tegner activity score improved from 5.1 to 6, IKDC score improved from 72.0 to 86.5, and mean anterior translation by KT-2000 improved from 7.4 mm to 2.3 mm, and 80.2micro of patients returned to pre-injury sports activity. No significant differences in joint space narrowing were observed in plain radiographs. CONCLUSION: In this study, good results were obtained after ACL reconstructions using the autologous four-strand single semitendinosus tendon with maintaining the joint stability at mid-term follow-up.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Cartilage ; Collateral Ligaments ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Reference Values ; Soccer ; Sports ; Sutures ; Tendons*

The symptoms of hypertrophic cardiomyopaty frequently result from impaired left ventricular relaxation, abnormal left ventricular filling, and decreased compliance of left ventricle in spite of normal systolic function. Several studies have suggested that the assessment of transmitral flow velocity waveform with pulsed Doppler echocardiography in patients with hypertrophic cardiomyopathy provide a noninvasive and clinically useful expression of left ventricular diastolic performance. In this study, pulsed Doppler echocardiography was used to measure diastolic indices from transmitral flow velocity waveform and thereby to assess left ventricular diastolic function in 20 patients with hypertrophic cardiomyopathy (14 septal hypertrophy, 3 apical hypertrophy, and 3 concentric hypertrophy). The diastolic indices to measure are isovolumic relaxation time(IVRT), deceleration time(DT), pressure half time(PHT), deceleration of early diastolic flow(DEF), EF slope, peak flow velocity in early diastole(PFVE), peak flow velocity during atrial systole(PFVA), and PFVE/PFVA ratio. The diastolic indices obtained from patients were compared with those in 20 age-matched control subjects without heart disease. The relationship between left ventricular wall thickness index(Th Index) and diastolic indices were evaluated. In addition, the effect of calcium channel-blocking agent on left ventricular diastolic function were evaluated. The results were as follows ; 1) There were no significant differences in RR interval, BP, end-systolic left ventricular dimension, and end-diastolic left ventricular dimension, but significant differences in interventricular septal thickness, posterior wall thickness, and left atrial dimension between hypertrophic group and control group. 2) The systolic index(ejection fraction) showed no significant difference between hypertrophic group and control group. 3) All diastolic indices except PFVA showed significant differences between hypertrophic group and control group. 4) Th Index did not showed a significant correlation with the diastolic indices except PFVE/PFVA. 5) There were no significant changes in RR interval, BP end-systolic left ventricular dimension, end-diastolic left ventricular dimension, left atrial dimension, and ejection fraction between medication and drug withdrawal. IVRT significantly increased after drug withdrawal. But other diastolic indices showed no significant changes after drug withdrawal. According to above results the assessment of left ventricular diastolic function by pulsed Doppler echocardiography was a clinically useful method in detecting diastolic dysfunction in patients with hypertrophic cardiomyopathy. Calcium channel-blocking agent may have beneficial effect in improving left ventricular diastolic function in patients with hypertrophic cardiomyopathy.
Calcium* ; Cardiomyopathy, Hypertrophic* ; Compliance ; Deceleration ; Echocardiography, Doppler, Pulsed* ; Heart Diseases ; Heart Ventricles ; Humans ; Hypertrophy ; Relaxation

PURPOSE: We investigated the factors that predicted later transitional cell carcinoma (TCC) in a subgroup of patients with abnormal cytology and negative initial evaluations. MATERIALS AND METHODS: From January 2002 to June 2007, we retrospectively identified 58 patients. Cases were considered discordant if a work-up of urine cytology was abnormal although initial cystoscopy, upper tract evaluation, and biopsies resulted in a negative or benign diagnosis. Patients who could complete a urine cytology test after 6 to 8 weeks and who were followed up for at least 1 year were included in this study. According to later TCC demonstration, we compared risk factors for TCC between the later TCC group and the benign group and evaluated the independent factors that predicted later TCC by use of a Cox proportional hazards regression model. RESULTS: Of the 58 patients, the mean follow-up was 12.7+/-17.3 months (range: 2-83 months), and 14 patients (23.7%) had a prior history of TCC. During follow-up, 9 patients (15.3%) had TCC and 1 patient had prostate cancer. In the later TCC group, the incidence of a prior history of TCC (p=0.03) and persistent abnormal cytology (p<0.001) were higher than in the benign group in univariate analysis. In the Cox proportional hazards regression model, persistent abnormal cytology (p=0.033, relative risk (RR): 17.380 [95% CI: 1.265-238.783]) was the only independent factor to predict later TCC. The mean follow-up duration of later TCC demonstration was 8.55 months (range: 2-32 months). CONCLUSIONS: Our results suggest that in the setting of persistent abnormal urine cytology with a negative initial evaluation, 53.3% of patients will later develop TCC. Patients with persistent abnormal cytology need intensive follow-up within 1 year.
Biopsy ; Carcinoma, Transitional Cell ; Cystoscopy ; Follow-Up Studies ; Humans ; Incidence ; Prostatic Neoplasms ; Retrospective Studies ; Risk Factors ; Urinary Bladder

A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Case Report ; Diverticulum/*complications/diagnosis ; Human ; Male ; Rectal Fistula/*complications/diagnosis ; Urethral Diseases/*complications/diagnosis

Curschmann's spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June, 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann's spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly coiled mature ones, admixed with thick mucinous back- ground, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.
Cervix Uteri ; Diabetes Insipidus* ; Electrocoagulation ; Female ; Humans ; Infertility ; Leiomyoma ; Mucins ; Mucus ; Parturition ; Pedigree* ; Pilomatrixoma ; Prevalence ; Receptors, Vasopressin* ; Sputum ; Vasopressins*

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. MATERIALS AND METHODS: The study population was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. RESULTS: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. CONCLUSION: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis.
Biopsy ; Diagnosis ; Follow-Up Studies ; Humans ; Male ; Orthopedics ; Osteomyelitis ; Sensitivity and Specificity

BACKGROUNDS: Assessment of the presence and degree of reversibility of airflow obstruction is clinically important in patients with asthma or chronic obstructive pulmonary disease. The measurement of peak expiratory flow(PEF) is a simple, fast, and cheap method to assess the severity of obstruction and its degree of reversibility. Assessing the reversibility of airflow obstruction by peak expiratory flow(PEF) measurements would be is practicable in general practice, but its usefulness has not been well investigated. We compared PEF and FEV1 in assessing reversibility of airflow obstruction in patients with chronic obstructive pulmonary disease or asthma and developed a practical criterion for assessing the presence of reversibility in general practice. METHODS: PEF measurements were performed (Spirometry) in 80 patients(aged 24-78) with a history of asthma or chronic obstructive lung disease before and after the inhalation of 200 mg salbutamol. The change in PEF was compared with the change in forced expiratory volume in one second(FEV1). Reversible airflow obstruction was analysed analyzed according to American Thoracic Society(ATS) criteria. RESULTS: When defined as a 12% A 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 reversibility was were observed in 45%(36) of the patients. Relative operating characteristic(ROC) analysis showed that an absolute improvement in PEF of 30l/min gave optimal discrimination between patients with reversible and irreversible airflow obstruction(the sensitivity and specificity of an increase of 30l/min in detecting a 12% increase above the prebronchodilator value and a 200ml increase in either FVC or FEV1 were 72.2% and 72.7% respectively, with a positive predictive value of 68.4%) CONCLUSIONS: Absolute changes in PEF can be used to diagnose reversible airflow obstruction.
Albuterol ; Asthma ; Discrimination (Psychology) ; Forced Expiratory Volume ; General Practice ; Humans ; Inhalation ; Pulmonary Disease, Chronic Obstructive