Systemic sclerosis is an autoimmune disease characterized by inflammatory reactions and fibrosis. Myofibroblasts are considered therapeutic targets for preventing and reversing the pathogenesis of fibrosis in systemic sclerosis. Although the mechanisms that differentiate into myofibroblasts are diverse, transforming growth factor β (TGF-β) is known to be a key mediator of fibrosis in systemic sclerosis. This study investigated the effects of extracellular vesicles derived from human adipose stem cells (ASC-EVs) in an in vivo systemic sclerosis model and in vitro TGF-β1-induced dermal fibroblasts. The therapeutic effects of ASC-EVs on the in vivo systemic sclerosis model were evaluated based on dermal thickness and the number of α-smooth muscle actin (α-SMA)-expressing cells using hematoxylin and eosin staining and immunohistochemistry. Administration of ASC-EVs decreased both the dermal thickness and α-SMA expressing cell number as well as the mRNA levels of fibrotic genes, such as Acta2, Ccn2, Col1a1 and Comp. Additionally, we discovered that ASC-EVs can decrease the expression of α-SMA and CTGF and suppress the TGF-β pathway by inhibiting the activation of SMAD2 in dermal fibroblasts induced by TGF-β1. Finally, TGF-β1-induced dermal fibroblasts underwent selective death through ASC-EVs treatment. These results indicate that ASC-EVs could provide a therapeutic approach for preventing and reversing systemic sclerosis.

We investigated the combined moisturizing effect of liposomal serine and a cosmeceutical base selected in this study. Serine is a major amino acid consisting of natural moisturizing factors and keratin, and the hydroxyl group of serine can actively interact with water molecules. Therefore, we hypothesized that serine efficiently delivered to the stratum corneum (SC) of the skin would enhance the moisturizing capability of the skin. We prepared four different cosmeceutical bases (hydrogel, oil-in-water (O/W) essence, O/W cream, and water-in-oil (W/O) cream); their moisturizing abilities were then assessed using a Corneometer(R). The hydrogel was selected as the optimum base for skin moisturization based on the area under the moisture content change-time curves (AUMCC) values used as a parameter for the water hold capacity of the skin. Liposomal serine prepared by a reverse-phase evaporation method was then incorporated in the hydrogel. The liposomal serine-incorporated hydrogel (serine level=1%) showed an approximately 1.62~1.77 times greater moisturizing effect on the skin than those of hydrogel, hydrogel with serine (1%), and hydrogel with blank liposome. However, the AUMCC values were not dependent on the level of serine in liposomal serine-loaded hydrogels. Together, the delivery of serine to the SC of the skin is a promising strategy for moisturizing the skin. This study is expected to be an important step in developing highly effective moisturizing cosmeceutical products.
Hyaluronic Acid* ; Hydrogel* ; Hydrogels* ; Liposomes ; Serine* ; Skin* ; Water

PURPOSE: We aimed to investigate the cardiopulmonary effects of pressurized cement insertion in elderly patients undergoing cemented hip hemiarthroplasty. MATERIALS AND METHODS: We conducted a randomized prospective study on elderly patients undergoing cemented hip hemiarthroplasty. Patients were divided into pressurized and non-pressurized groups based on the pressure application during cement insertion. We measured mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), arterial blood gases and serotonin concentration in blood. These variables were measured before bone cement insertion, and 3 and 5 minute after insertion. They were also measured immediately and 15 minutes after reduction. RESULTS: In cemented hip hemiarthroplasty, there were no significant change in MAP (P=0.92), SBP (P=0.85), DBP (P=0.98), HR (P=0.97) and serotonin concentration over time. There were no statistically significant difference between the two groups in MAP, SBP, DBP, HR, PO2, PaCO2, SaO2 and serotonin concentration, though three minutes after cement insertion, both groups showed decreases in SBP, DBP and MBP. CONCLUSION: The pressurization method in cemented hip hemiarthroplasty was not found to be related with development of bone cement syndromes in elderly patients.
Aged ; Arterial Pressure ; Blood Pressure ; Gases ; Heart Rate ; Hemiarthroplasty* ; Hip* ; Humans ; Prospective Studies* ; Serotonin

PURPOSE: Hollow fiber assays offer an early in vivo method of anticancer drug screening. The assays have been optimized for human cancers originating from the lung, breast, colon, ovary, and brain, but not from the stomach and liver. The current study focused on optimization of hollow fiber assays for gastric and hepatocellular carcinoma cell lines. MATERIALS AND METHODS: Gastric (SNU-16, SNU-484, SNU-668) and hepatocellular (HepG2, SK-Hep-1, Hep3B) carcinoma cell lines in hollow fibers were transplanted subcutaneously and intraperitoneally into mice, which were subsequently treated with a standard anticancer agent, paclitaxel. The hollow fiber activity of paclitaxel in each cell line was compared with the xenograft activity. RESULTS: Using optimized inoculation densities and schedules, treatment with paclitaxel was effective in gastric carcinoma cell lines, SNU-16 and SNU-484, but not in SNU-668. In the hollow fiber assays, paclitaxel was effective in hepatocellular carcinoma cell lines, HepG2 and SK-Hep-1, but not in Hep3B. Consistent with the results of the hollow fiber assay, SNU-16 and SNU-484, but not SNU-668, showed tumor regression, and HepG2 and SK-Hep-1, but not Hep3B, showed effective tumor responses following treatment with paclitaxel in xenograft models. When EW7197, a novel compound, and flavopiridol were tested in SNU-16 cells under optimized conditions, the hollow fiber activity showed good correlation with the xenograft activity of each compound. CONCLUSION: Our protocols may be useful for screening candidate small molecules that may exhibit activity against stomach and liver cancers, both of which are common in Korea.
Animals ; Appointments and Schedules ; Brain ; Breast ; Carcinoma, Hepatocellular ; Cell Line ; Colon ; Drug Evaluation, Preclinical ; Female ; Heterografts ; Humans ; Korea ; Liver ; Liver Neoplasms* ; Lung ; Mass Screening ; Mice ; Ovary ; Paclitaxel ; Stomach Neoplasms ; Stomach*

Stress-induced cardiomyopathy, which is also known as takotsubo cardiomyopathy, is a cardiac syndrome of a transient, reversible left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to those of myocardial ischemia without a coronary artery lesion. Stress-induced cardiomyopathy is more common in middle-aged women, and the prognosis is favorable. We report the case of a 50-year-old female patient who underwent a total gastrectomy and developed stress-induced cardiomyopathy after surgery.
Anesthesia ; Anesthesia, General ; Cardiomyopathies ; Coronary Vessels ; Female ; Gastrectomy ; Humans ; Middle Aged ; Myocardial Ischemia ; Prognosis ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

Mixed connective tissue disease (MCTD) has the clinical feature of other collagen vascular diseases. According to several reports recently published, MCTD sometimes involved kidney as benign course. ANCA associated glomerulonephritis occurred in systemic autoimmune disease such as systemic sclerosis or rheumatoid arthritis, not in MCTD. In this case, as we experienced that MPO-ANCA associated glomerulonephritis arose and proceeded to rapid progressive glomerulonephritis (RPGN) in women with MCTD, we report it with review of reference. A 60-year-old woman was admitted with uremia and joint pain. In physical finding and serum test, she was diagnosed with MCTD according to Khan`s criteria. Also MPO antibody and ANCA were noted in specific immunological test and the histologic findings showed crescentic glomerulonephritis. So we diagnosed RPGN induced by MPO-ANCA associated glomerulonephritis. She was treated with immunosuppressive treatment and uremia was improved. RPGN induced by MPO-ANCA associated glomerulonephritis should be ruled out by prompt renal biopsy and require proper treatment.
Antibodies, Antineutrophil Cytoplasmic ; Arthralgia ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Collagen ; Female ; Glomerulonephritis ; Humans ; Immunologic Tests ; Kidney ; Middle Aged ; Mixed Connective Tissue Disease ; Scleroderma, Systemic ; Uremia ; Vascular Diseases

The impact of glucose-free icodextrin (ID) for overnight dwell as compared to conventional glucose-containing dialysate (GD) on potassium (K+) metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients has not yet been investigated. Serum K+ in a total of 255 stable patients (116 on GD and 139 on ID) on CAPD for more than 6 months and in 139 patients on ID before and after ID use (Pre-ID and Post-ID) were observed along with nutritional markers in a 2-year study period (Jan. 2006 to Dec. 2007). The prevalence of hypokalemia was similar between patients on GD and ID (16.7% vs 17.3%), but was lower on Post-ID than Pre-ID (17.3% vs 20.5%) without statistic significance. The mean serum K+ level was higher on ID than on GD (P<0.05) as well as Post-ID than Pre-ID (P<0.001). In the multivariate analysis, serum K+ levels were positively correlated with serum albumin, and creatinine in all patients (P<0.05), and ID-use in younger patients (age< or =56, P<0.001). Serum albumin, creatinine, total CO2, and body mass index were significantly higher on Post-ID than Pre-ID. Icodextrin dialysate for chronic overnight dwell could increase serum K+ levels and lower the prevalence of hypokalemia compared to conventional glucose-containing dialysate. The improved chronic K+ balance in CAPD patients on icodextrin could be related to enhanced nutritional status rather than its impact on acute intracellular K+ redistribution.
Body Mass Index ; Creatinine ; Glucans ; Glucose ; Humans ; Hypokalemia ; Multivariate Analysis ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Potassium ; Prevalence ; Serum Albumin

The cause of IgA nephropathy is unknown, but a mesangial deposition of IgA immune complexes containing antigens from a putative pathogen might be involved in its pathogenesis. We report a case of IgA nephropathy associated with disseminated tuberculosis. A 32-year-old man was presented with sudden onset of edema of both lower legs. The chest X-ray revealed extensive active pulmonary tuberculosis in both lung fields. The abdominal CT, cystoscopy and IVP were compatible with renal tuberculosis and tuberculous cystitis. Besides, the colonoscopic findings with biopsy showed tuberculous colitis. The laboratory data revealed a positive culture for tuberculous bacilli from sputum, 2.7 g of 24-hour urinary protein, and microscopic hematuria. A renal biopsy showed mesangial and segmental endocapillary proliferative glomerulonephritis, consistent with IgA nephropathy. Intense positive stainings for IgA and C3 in the mesangium by Immunofluorescence microscopy. Electron microscopic examination demonstrates segmental endocapillary proliferation, necrosis and mesangiolysis with mild mesangial electron-dense deposits. Treatment with anti-tuberculous medications resulted in gradual disappearance of proteinuria and other various manifestations of the disseminated tuberculosis. Therefore we suggest that IgA nephropathy may be associated with active disseminated tuberculosis.
Adult ; Antigen-Antibody Complex ; Biopsy ; Colitis ; Cystitis ; Cystoscopy ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Leg ; Lung ; Microscopy, Fluorescence ; Necrosis ; Proteinuria ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary ; Tuberculosis, Renal

Goodpasture's syndrome is a disease that is characterized by hemoptysis, anemia, and glomerulonephritis with renal failure. Goodpasture reported a case of a young man who expired as a result of a pulmonary hemorrhage and glomerulonephritis at the recovery phase after an influenza infection in 1919. In 1958, Stanton et al. described a combined case of these two diseases as Goodpasture's syndrome. Since then, antiglomerular basement membrane antibody(anti-GBM Ab) has been confirmed to play an important role in the mechanism of this syndrome, and it was reported that this syndrome was an autoimmune disease. The triad of alveolar hemorrhage, glomerulonephritis and circulating anti-GBM Ab forms the basis of a diagnosis of Goodpasture's syndrome. When patients are affected by disease, the relief of symptoms can be accomplished by eliminating the anti-GBM Ab from the circulatory system through hemodialysis, plasmapheresis and immunoabsorption. However, the patients usually die from a massive pulmonary hemorrhage when the diagnosis or treatment is delayed. The incidence of Goodpasture's syndrome is common in the western world, but it is extremely rare in Korea with only five cases being reported. In three of these cases, pulmonary hemorrhage and renal failure was the initial manifestation. Therefore, hemodialysis or plasmapheresis were absolutely essential treatments. We report a case of Goodpasture's syndrome in Korea with a normal renal function.
Anemia ; Anti-Glomerular Basement Membrane Disease* ; Autoimmune Diseases ; Basement Membrane ; Diagnosis ; Glomerulonephritis ; Hemoptysis ; Hemorrhage ; Humans ; Incidence ; Influenza, Human ; Korea ; Plasmapheresis ; Renal Dialysis ; Renal Insufficiency ; Western World

Primary pulmonary neoplasms are uncommon in children. One such tumor, pleuropulmonary blastoma (PPB), is very rare, highly aggressive and malignant, and originates from either the lungs or pleura. It contains both mesenchymal and benign epithelial elements that resemble fetal lung, and occurs mainly in children aged less than five. The clinal symptoms often suggest upper respiratory tract infection or pneumothorax, but ultrasonography and chest CT scans depict both a large mass occupying an almost entire hemithorax, and a simple lung cyst. Contrast-enhanced CT demonstrates hetergeneous attenuation and a whorled appearance.
Child ; Humans ; Lung ; Lung Neoplasms ; Pleura ; Pneumothorax ; Respiratory Tract Infections ; Tomography, X-Ray Computed ; Ultrasonography