BACKGROUND: bFGF, a member of the fibroblast growth factor family, potently induces vascular smooth muscle cell proliferation and decreased synthesis of the collagens. OBJECTIVE: For further investigation of the effect of bFGF on extracellular matrix homeostasis in the skin, we evaluated the expression of type I and type VII collagen gene at the transcriptional levels. METHOD: We examined that recombinant human bFGF affects the expression of genes involved in ECM synthesis and remodeling in human dermal fibroblasts cultures as judged by Northern blot analysis. RESULTS: The steady state levels of type I and VII collagen gene mRNA were decreased with age dependent pattern up to 0.13 and 0.44 folds respectively. The transcriptional levels of type I collagen mRNA were increased by TGF-B, treatment but markedly decreased by bFGF as well as TNF-a. But there were no synergistic effects bFGF and TNF-a on type I collagen gene expression. The levels of type VII collagen gene expression were increased by both bFGF and TGF-B,. The TNF-a showed slightly antagnostic effects on type VII collagen gene expression. CONCLUSION: The type I and VII collagen gene expression in dermal fibroblasts is clearly subjected to modulation by the cytokines including bFGF with uncoordinate regulatory pathway. In addition to its function of vascular proliferation, bFGF also may play a major role in physiologic skin condition and in repair process such as formation of a stable dermoepidermal junction during skin wound healing.
Blotting, Northern ; Cell Proliferation ; Collagen Type I ; Collagen Type VII ; Collagen* ; Cytokines ; Extracellular Matrix ; Fibroblast Growth Factors ; Fibroblasts* ; Gene Expression* ; Homeostasis ; Humans ; Methods ; Muscle, Smooth, Vascular ; RNA, Messenger ; Skin ; Wound Healing

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin

No abstract available.
Child* ; Humans

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

No abstract available.
Child ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis, Continuous Ambulatory*

Heat stroke is defined as a core body temperature that rises above 40 degrees C accompanied by central nervous system abnormalities such delirium, convulsions or coma. Despite treatment with optimal cooling, heat stroke causes deaths by complications including rhabdomyolysis, renal failure, hepatic dysfunction, disseminated intravascular coagulation syndrome, acute respiratory distress syndrome, bowel ischemia, myocardial injury, and multiple organ failure. In some cases of survival, heat stroke it can cause irreversible CNS damage. Therefore, if exertional heat stroke is properly diagnosed in the emergency room, we must initiate early and aggressive treatment in order to prevent the multiorgan failure and high mortality associated with this condition. To our knowledge, case reports in the literature are rare describing that patients with multiple organ dysfunction and fulminant pneumonia following exertional heat stroke. This study reports on a relevant case, as well as findingsfrom the literature. The case history is presented of a 20- year-old man who presented with exertional heat stroke with sustained hyperpyrexia ongoing after the first day of admission despite optimal treatment including intensive fluid resuscitation. On the 3rd day of admission, chest infiltrated lesions were discovered. From the high-resolution computed tomography results, multifocal consolidations were discovered in both lungs. Blood cultures revealed Staphylococcus hominis. Treatment with proper antibiotics was begun after identifying the blood culture. The patient fully recovered and was discharged on the 10th day after admission.
Anti-Bacterial Agents ; Body Temperature ; Central Nervous System ; Coma ; Delirium ; Disseminated Intravascular Coagulation ; Emergencies ; Heat Stress Disorders ; Heat Stroke ; Hot Temperature ; Humans ; Lung ; Multiple Organ Failure ; Myocardial Ischemia ; Pneumonia ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Resuscitation ; Rhabdomyolysis ; Seizures ; Staphylococcus hominis ; Thorax

BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

No abstract available.
Blood Coagulation*

A 55-year-old Korean female patient who presented with longitudinal black pigmentation affecting the right thumbnail is described. Direct microscopic examination of nail tissue in 15% potassium hydroxide and cultures on Sabourauds glucose agar revealed Candida species. Cardida species as a cause of longitudinal melanonychia has, to our knowledge, been described only once in the literature. Our case may be the second one.
Agar ; Candida* ; Female ; Glucose ; Humans ; Middle Aged ; Pigmentation ; Potassium

BACKGROUND: The real incidence of atherosclerotic lesions in carotid and peripheral arteries in coronary artery disease patients is not well known in Korea. The aim of this study was to prospectively evaluate the prevalence of atherosclerotic involvement of the coronary, carotid, and peripheral arteries in each arterial disease patients. This study was also designed to evaluate the risk factors, the clinical characteristics of associated carotid artery stenosis in patients with coronary artery disease, and associated peripheral vascular disease in patients with coronary artery disease. METHODS: Between June 1996 and March 1998, 475 patients (369 males, 106 females, mean age 60+/-10 years) were studied. Three hundred and seventy-three patients who presented with ischemic symptoms were enrolled in the coronary artery disease group, 81 patients were enrolled in the peripheral vascular disease group due to presenting claudications, and 21 patients were enrolled in the carotid stenosis group due to presenting cerebrovascular symptoms. Coronary angiography was done by the routine method. Carotid angiography was performed at the aortic arch by the digital subtraction angiography method. Peripheral vascular angiography was taken from the suprarenal abdominal aorta to both femoral arteries. RESULTS: 1) Risk factors for coronary stenosis, peripheral vascular disease, and carotid stenosis: The risk factors were not different between coronary stenosis, peripheral vascular disease, and carotid stenosis groups, but smoking was more frequent among patients with peripheral vascular disease than in patients with coronary stenosis (p-value=0.001). 2) Coronary artery stenosis and carotid artery stenosis: The mean age of coronary artery patients with carotid stenosis was significantly older (p-value=0.006) than for patients without carotid stenosis. The prevalence of peripheral vascular disease was more common in patients with carotid stenosis than in patients without carotid stenosis. 3) Coronary artery stenosis and peripheral vascular disease: Carotid stenosis was more common inpatients with peripheral vascular disease than in patients without peripheral vascular disease in the coronary stenosis group. 4) Prevalence of coronary, carotid, and peripheral artery disease: In patients with coronary stenosis, the prevalence of carotid stenosis was 13.9% and that of peripheral vascular disease was 29.2%. In patients with peripheral artery stenosis, the prevalence of coronary stenosis was 45.7% and that of carotid artery disease was 33.3%. In patients with carotid stenosis, the prevalence of coronary stenosis was 81.0% and that of peripheral vascular disease was 52.4%. CONCLUSION: Carotid artery disease and peripheral vascular disease developed concurrently with coronary artery disease in a significant proportion of patients. Therefore, routine angiography of peripheral and carotid arteries in patients with coronary artery disease is considered, especially in old age.
Angiography* ; Angiography, Digital Subtraction ; Aorta, Abdominal ; Aorta, Thoracic ; Arteries ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Incidence ; Inpatients ; Korea ; Male ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking