Although it has been suggested that the calcium antagonist verapamil has beneficial effects on ischemic myocardium, its effect during coronary reperfusion has not been studied in detail. The purpose of this study was to investigate the inhibitory effect of verapamil on myocardial damage quantitatively using 111 In-anticardiac myosin antibody (ACM Ab) and qualitatively using electronmicroscopic method. Anesthetized open-chest dogs were subjected to 1 hour of occlusion of the left anterior descending coronary artery (LAD) followed by 90 minutes of reperfusion. Regional myocardial blood flow was determined by injecting 85Sr-microsphere prior to LAD reperfusion, and regional myocardial damage was measured by injecting 111In-ACm Ab at 30 minutes after LAD reperfusion. Six dogs were randomly selected as saline control and verapamil-treated (0.6 mg/kg. hr) groups each. Saline or verapamil was infused at 40 minutes after LAD occlusion and continued through the experiment. 1) Verapamil produced significant (P<0.05 by Wilcoxon rank sum test) decrease in heart rate, mean arterial blood pressure and double product. There was no significant change in pulmonary hemodynamics or cardiac output. 2) Stroke volume was reduced significantly (P<0.05 by Wilcoxon rank sum test) after 30 minutes of LAD reperfusion in the control group, but it was preserved in the verapamil-treated group. 3) There was an inverse exponential relationship between 111In-ACm Ab localization and regional blood flow in both control (r=-0.86) and verapamil treated (r=-0.71) groups. Significant difference between the two groups was found in exponential curve (p[t]<0.05). 4) A lesser uptake of 111in-ACM Ab was observed in the verapamil treated group compared with that in the control group in the region where the regional blood flow was lower than 30+/- of normal. 5) In the control group, the myocardium showed swelling, contraction bands, and electron dense granules in the mitochondria which were proven to be calcium aggregates. In the verapamiltreated grooup, the myocardium showed fewer electro dense granules and mild degree of contraction bands. This study supports the concept that verapamil reduces the myocardial damage following coronary reperfusion in myocardial infarction and may reduce contraction band necrosis.
Animals ; Arterial Pressure ; Calcium* ; Cardiac Output ; Coronary Vessels ; Dogs ; Heart Rate ; Hemodynamics ; Mitochondria ; Myocardial Infarction* ; Myocardial Reperfusion* ; Myocardium* ; Myosins ; Necrosis ; Regional Blood Flow ; Reperfusion ; Stroke Volume ; Verapamil

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Perfusion*

The combined array comparative genomic hybridization plus single-nucleotide polymorphism microarray (CGH+SNP microarray) platform can simultaneously detect copy number alterations (CNA) and copy-neutral loss of heterozygosity (LOH). Eighteen children with acute myeloid leukemia (AML) (n=15) or myelodysplastic syndrome (MDS) (n=3) were studied using CGH+SNP microarray to evaluate the clinical significance of submicroscopic chromosomal aberrations. CGH+SNP microarray revealed CNAs at 14 regions in 9 patients, while metaphase cytogenetic (MC) analysis detected CNAs in 11 regions in 8 patients. Using CGH+SNP microarray, LOHs>10 Mb involving terminal regions or the whole chromosome were detected in 3 of 18 patients (17%). CGH+SNP microarray revealed cryptic LOHs with or without CNAs in 3 of 5 patients with normal karyotypes. CGH+SNP microarray detected additional cryptic CNAs (n=2) and LOHs (n=5) in 6 of 13 patients with abnormal MC. In total, 9 patients demonstrated additional aberrations, including CNAs (n=3) and/or LOHs (n=8). Three of 15 patients with AML and terminal LOH>10 Mb demonstrated a significantly inferior relapse-free survival rate (P=0.041). This study demonstrates that CGH+SNP microarray can simultaneously detect previously cryptic CNAs and LOH, which may demonstrate prognostic implications.
Adolescent ; Child ; Child, Preschool ; Chromosome Aberrations ; *Comparative Genomic Hybridization ; DNA/*analysis/metabolism ; DNA Copy Number Variations ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Infant ; Kaplan-Meier Estimate ; Leukemia, Myeloid, Acute/*diagnosis/*genetics/therapy ; Loss of Heterozygosity ; Male ; Myelodysplastic Syndromes/*diagnosis/*genetics/therapy ; *Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Real-Time Polymerase Chain Reaction ; Transplantation, Homologous

BACKGROUND: Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. METHODS: From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. RESULTS: The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. CONCLUSIONS: In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.
Burns ; Child, Preschool ; Congenital Abnormalities ; Demography ; Female ; Fingers ; Hand ; Hand Deformities ; Humans ; Incidence ; Male ; Medical Records ; Retrospective Studies ; Skin ; Skin Transplantation ; Tissue Donors ; Transplants

PURPOSE: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. METHODS: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations-the split thickness skin graft-at different clinics, the wound did not heal. The size of the wound was 12 by 8 cm2 and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC(r) for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. RESULTS: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. CONCLUSION: Subfascial endoscopic perforator ligation is a relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be a valuable method for treating severe venous stasis ulcers.
Burns ; Debridement ; Edema ; Fibrosis ; Follow-Up Studies ; Humans ; Leg ; Ligation ; Male ; Porphyrins ; Postoperative Complications ; Recurrence ; Skin ; Transplants ; Varicose Ulcer ; Veins ; Venous Insufficiency

PURPOSE: Patients with serious burns are prone to chondritis due to lack of soft tissue in the auricle, which can cause severe defects in the auricular morphology. In addition, skin damage occurs frequently in the vicinity of post-burn wounds, presenting difficulties in reconstruction surgery. An auricular reconstruction has functional and cosmetic significance. The aim of this study is to develop appropriate reconstruction methods for auricular defects. METHODS: Thirty seven patients, who were treated for auricular defects from 2005 to 2009, were enrolled in this study. A local flap, multiple regional flaps and cartilage framework with or without a temporal fascial flap were applied in reconstruction surgery according to the location of the auricular defect. RESULTS: The age of the subjects ranged from 11 to 56. Some subjects had defects that cover more than half of the helical rim with most exhibiting post-burn scars in the vicinity, for whom a multiple regional flap was used. A single use of a tubed flap was sufficient for subjects with defects that covered less than half of the helical rim. A regional flap was also used for reconstruction in subjects with defects covering both the helical rim and antehelix. CONCLUSION: Achieving satisfactory results from the skin flaps and skin grafts for post-burn auricular defects in both functional and cosmetic aspects is a difficult task. Therefore, selecting an appropriate surgical method through proper diagnosis of the auricular defect and the state of the available skin in the vicinity is essential.
Burns ; Cartilage ; Cicatrix ; Cosmetics ; Humans ; Skin ; Transplants

BACKGROUND: The patients with atopic dermatitis (AD) show a defective barrier function of the skin and symptoms such as xerosis, pruritus and erythematous lesions with increased transepidermal water loss (TEWL). The choice of topical moisturizer is very significant for AD patients because these symptoms could be relieved by a local moisturizing agent that strengthens the epidermal barrier function. OBJECTIVE: This study was performed to evaluate the effects of the moisturizer APDDR-0801, which contains physiologic lipid granules (DermaON(R)), for relieving the symptoms associated with AD. METHODS: 128 patients (17.8+/-12.1 years) who were suffering from mild to moderate AD topically applied the test moisturizer twice daily for up to 4 weeks. The treatment efficacy was evaluated by the investigator global assessment (IGA) score, the eczema area and severity index (EASI) score, the transepidermal water loss (TEWL), the visual analogue scale (VAS) for pruritus and sleep disturbance, and the level of inflammatory cytokines in the horny layer of the flexural areas. RESULTS: The test moisturizer was well-tolerated and 58.6% of the patients achieved clinical improvements (over moderate) after the application of the test moisturizer for 4 weeks. The significant relief of AD symptoms was observed from 2 week to 4 week in a time-dependent manner. Significant improvements in the signs and symptoms of AD were observed at 4 week, such as the EASI score (37.8% improvement), the TEWL (20.3% improvement in the antecubital fossa lesion), the VAS score for pruritus (26.2% improvement), and VAS score for insomnia (39.7% improvement). CONCLUSION: The moisturizer APDDR-0801 (Atobarrier Cream(R), which contains physiologic lipid granules, effectively relieved the symptoms associated with AD.
Cytokines ; Dermatitis, Atopic ; Eczema ; Humans ; Pruritus ; Research Personnel ; Skin ; Sleep Initiation and Maintenance Disorders ; Stress, Psychological ; Treatment Outcome

BACKGROUND: Anaplastic large cell lymphoma (ALCL) is uncommon in children, accounting for approximately 15% of all cases of childhood non-Hodgkin lymphoma. Despite many studies attempting new treatment strategies, treatment outcomes have not significantly improved, and the optimal treatment for pediatric ALCL has not been established. METHODS: The records of newly diagnosed ALCL patients at our institute between July 1998 and April 2013 were reviewed. We evaluated the general characteristics of the patients, chemotherapy regimens, overall survival (OS) rates, and event-free survival (EFS) rates. RESULTS: Twenty-eight ALCL patients were eligible. The median age at diagnosis was 10.8 years. Lymph node involvement was the most common presentation (79%). CCG-5941, a multi-agent T-cell lineage chemotherapy, was the predominant treatment regimen (57%). The five-year OS and EFS rates were 88% and 69%, respectively. Stage, the presence of B symptoms, lung involvement, and bone marrow involvement were significant prognostic factors for EFS (P=0.02, 0.01, 0.01, and 0.02, respectively). Eight patients relapsed, and three died during the study period. Four of the eight patients who relapsed were treated with high-dose chemotherapy and autologous stem cell transplantation (HDCT-ASCT). Two of the four who had undergone HDCT-ASCT developed secondary relapses and were subsequently treated with allogeneic SCT or brentuximab. CONCLUSION: We found that treatment outcomes with multi-agent chemotherapy in children with ALCL were similar to those of previous reports, and that relapsed patients could be salvaged with HDCT-ASCT or allogeneic SCT. A prospective, larger cohort study is warranted to define the optimal treatment for pediatric ALCL.
Bone Marrow ; Child* ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Lung ; Lymph Nodes ; Lymphoma, Large-Cell, Anaplastic* ; Lymphoma, Non-Hodgkin ; Prognosis ; Recurrence ; Stem Cell Transplantation ; T-Lymphocytes

PURPOSE: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. METHODS: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. RESULTS: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap(18), medial plantar island flap(6), rotation flap(5), sural island flap(3), anterolateral thigh free flap(2), lattisimus dorsi muscular flap(2), and contra lateral medial plantar free flap(1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. CONCLUSION: Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor/recipient site(scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.
Accounting ; Burns ; Cosmetics ; Foot ; Forearm ; Free Tissue Flaps ; Heel ; Hyperemia ; Necrosis ; Organic Chemicals ; Palliative Care ; Skin ; Thigh ; Transplants ; Ulcer ; Weight-Bearing

BACKGROUND: An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. METHODS: From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. RESULTS: The mean age of patients was 49.9+/-12.2 years, with 8 male and 2 female. The size of the burn wound was an average of 119.6+/-36.7 cm2. The mean expansion duration was 65.5+/-5.6 days, and the inflation volume was an average of 615+/-197.6 mL. Mean defect size was 122.2+/-34.9 cm2. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. CONCLUSIONS: Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.
Alopecia ; Burns ; Female ; Free Tissue Flaps ; Hematoma ; Humans ; Inflation, Economic ; Male ; Osteomyelitis ; Scalp ; Skin ; Skull ; Tissue Donors ; Tissue Expansion ; Transplants